Ua manaʻo paha ʻoe he mau ʻenemi paha i ʻike ʻole ʻia e ko kākou mau maka? Aia kekahi mau maʻi e hele pinepine mai ana a hōʻino i ko kākou ʻike. I kēia lā, e kamaʻilio kākou e pili ana i kahi maʻi maka i koʻikoʻi iki, akā inā ʻike mua kākou iā ia, hiki iā ia ke kōkua iā kākou e kāohi iā ia. Ua kapa ʻia kēia ʻo Cytomegalovirus Retinitis, a i ʻole `(Cytomegalovirus Retinitis)`, a i ʻole `(CMV) Retinitis` no ka pōkole.
He aha ka cytomegalovirus (CMV) retinitis?
I ka ʻōlelo maʻalahi, ʻo ka `(CMV) Retinitis` he maʻi maka koʻikoʻi. Loaʻa pinepine ia i nā poʻe me nā ʻōnaehana pale nāwaliwali. Ua lohe paha ʻoe i ka ``Retinitis``. He mumū ia o ka ``Retina`` i loko o ka maka. ʻO kēia ``Retina`` ka ʻāpana koʻikoʻi loa o ka maka e kōkua iā mākou e ʻike a ʻike i ka mālamalama.
I kēia manawa, e haʻi iki aku wau iā ʻoe e pili ana i kēia maʻi i kapa ʻia ʻo `(CMV)`. No ke ʻano `(Necrotizing virus)` kēia. ʻO ia hoʻi, hoʻopau kēia maʻi i nā ʻiʻo o ko mākou kino. I ka pololei, he maʻi kēia no ka ʻohana maʻi `(Herpes)`. ʻO ka mea kupaianaha, ua loaʻa paha i ka hapa nui o mākou kēia maʻi `(CMV)` i loko o ko mākou kino i kekahi manawa o ko mākou ola, akā ʻaʻole mākou e ʻike. Ke moe nei ia i loko o ke kino. Eia naʻe, i ka wā e nāwaliwali ai ka ʻōnaehana pale o kekahi, hiki i kēlā maʻi moe ke hana hou a hoʻoulu i nā maʻi e like me `(CMV) Retinitis`.
ʻO wai ka mea i ʻoi aku ka paʻakikī ke hoʻomohala i kēia?
E like me kaʻu i ʻōlelo ai ma mua, ʻoi aku ka nui o ka pilikia o ka poʻe me nā ʻōnaehana pale nāwaliwali o ka hoʻomohala ʻana i kēia `(CMV) Retinitis`. ʻO ia hoʻi:
- No ka poʻe me ka `(HIV/AIDS)`: ʻO ka ʻoiaʻiʻo, ʻo ka `(CMV) Retinitis` ke kumu nui o ka makapō i waena o ka poʻe me ka `(HIV/AIDS).
- No ka poʻe e hana ʻia ana i ka chemotherapy no ka maʻi ʻaʻai: Hoʻemi kēia lāʻau i ka pale ʻana o ke kino.
- ʻO ka poʻe i loaʻa i nā hoʻoili kino, nā hoʻoili iwi iwi, a i ʻole e lawe ana i nā lāʻau immunosuppressant ma muli o nā kūlana autoimmune (nā maʻi e hoʻouka ai ka ʻōnaehana pale o ke kino i kāna mau cell ponoʻī). Hoʻonāwaliwali kēia mau lāʻau i ka ʻōnaehana pale kūlohelohe o ke kino.
E noʻonoʻo wale, i ka wā e nāwaliwali ai nā kiaʻi i loko o ko kākou kino, he mea maʻalahi no ka ʻaihue ke komo i loko. Ke nāwaliwali ka ʻōnaehana pale, he mea maʻalahi no ka maʻi "(CMV)" ke komo i loko o ka maka a hana i ka pōʻino.
He aha nā hōʻailona o kēia maʻi?
ʻO kahi pilikia me kēia, ʻaʻohe paha he mau hōʻailona i nā pae mua o ka CMV Retinitis. Eia naʻe, i ka wā e ʻike ʻia ai nā hōʻailona, hiki iā lākou ke komo pū me:
- Nā mea lana: Manaʻo e like me nā mea ʻeleʻele liʻiliʻi, e like me nā ʻupena nananana, e lana ana i mua o nā maka: He mea maʻamau kēia no ka hapa nui o nā kānaka, akā pono ʻoe e hopohopo inā piʻi koke ia.
- ʻO ka scotoma scintillating: He ʻano kēia e like me nā kukui liʻiliʻi o ke kukui a i ʻole nā kiko ʻeleʻele e neʻe ana i mua o nā maka.
- ʻIke maka peripheral: ʻO ke ʻano kēia ua hoʻemi ʻia ka nui o nā mea a puni ʻoe e hiki ai iā ʻoe ke ʻike me ka nānā pololei ʻana i mua.
- Metamorphopsia: Hiki ke loli ke ʻano o nā mea, me he mea lā e nānā ana i loko o ke aniani wai.
- ʻIke pōwehiwehi.
- ʻAʻole hiki ke kau pono i nā maka ma ka mālamalama ʻālohilohi, nā maka polū (Photophobia).
- Nā maka ʻulaʻula.
- ʻEha maka.
I kekahi manawa hoʻomaka kēia mau hōʻailona ma kekahi maka a laila laha i kekahi. No laila, inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ʻoiai inā he nāwaliwali kou ʻōnaehana pale maʻi, he mea nui e ʻike koke i ke kauka.
No ke aha e kū mai ai ka CMV retinitis?
I ka ʻōlelo maʻalahi, loaʻa ka CMV Retinitis ke loaʻa iā ʻoe ka maʻi CMV a hoʻopilikia ka maʻi i kou retina. ʻAʻole kēia i hana ʻia e kahi maʻi hou e komo ana i ke kino, akā, ma muli o ka hoʻoulu hou ʻana o kahi maʻi i moe mua ʻia, ʻoiai e nāwaliwali ana ka ʻōnaehana pale o nā pākeke.
Pehea ʻoe e ʻike ai i kēia? (Diagnosis)
Inā loaʻa iā ʻoe kēia mau hōʻailona, pono ʻoe e ʻike i kahi loea maka (Ophthalmologist). E nīnau ʻo ia iā ʻoe e pili ana i kou mōʻaukala olakino a me nā hōʻailona o kēia manawa. A laila, e hāʻawi lākou i nā kulu maka a hana i kahi hoʻāʻo dilation.
No ke aha i hoʻonui ʻia ai kēia mau maka? ʻAe kēia i ke kauka e ʻike maikaʻi i loko o ka maka. Hiki iā ia ke nānā i nā hōʻailona o ka maʻi ma ka retina a me nā ʻāpana ʻē aʻe o ka maka. Inā ua ʻike ʻia ʻoe me ka retinitis, hiki iā ia ke hana i nā hana lab, e like me nā hoʻāʻo koko, e ʻike i ke kumu pololei.
He aha nā lāʻau lapaʻau?
Aia nā lāʻau antiviral e hiki ke mālama i ka CMV retinitis. Eia nō naʻe, e hoʻomanaʻo ʻoiai hiki i kēia mau lāʻau ke kāohi i ka maʻi, ʻaʻole hiki iā lākou ke ho'ōla loa.
Hiki i kāu kauka ke hoʻoholo e hāʻawi iā ʻoe i hoʻokahi a ʻoi aku paha o kēia mau lāʻau antiviral:
- `(Valganciclovir)`: Hāʻawi ʻia kēia ma ke ʻano he pila i lawe ʻia ma ka waha.
- `(Ganciclovir)`: Hiki ke hāʻawi ʻia kēia ma ke ʻano he wai i hāʻawi ʻia i loko o kahi aʻa `(Intravenously - IV)` a i ʻole ma ke ʻano he inikini i loko o ka maka `(Intravitreal injection - IVI)`.
- `(Foscarnet)`: Hāʻawi ʻia kēia ma ke ʻano he `(IV)` a i ʻole `(IVI)`.
- `(Cidofovir)`: Hāʻawi ʻia kēia ma ke ʻano he `(IV)` a i ʻole `(IVI)`.
- `(Letermovir)`: He lāʻau lapaʻau waha nō hoʻi kēia.
- `(Fomiversen)`
Hiki i ka manawa lapaʻau ke hala i kekahi mau pule. No ka mea, aia ma mua kahi manawa o ka lapaʻau koʻikoʻi (ʻInitial period of therapy`), a laila pono ʻoe e lawe i ka lāʻau lapaʻau e kāohi i ka maʻi (`Maintenance therapy`). No laila, pono ʻoe e hoʻomanawanui me kēia lāʻau lapaʻau.
Aia kekahi mau pilikia i ka mālama ʻana?
I kekahi manawa, hiki i nā lāʻau antiviral no ka CMV retinitis ke hoʻoulu i kāu ʻōnaehana pale e pane nui. Hiki i kēia ke alakaʻi i kahi maʻi i kapa ʻia ʻo uveitis. ʻO ka Uveitis kahi mumū o kekahi ʻāpana o ka maka. Hiki i kēia ke hoʻolilo i ka maka i ʻulaʻula, pehu, a ʻeha.
ʻO kekahi mea ʻē aʻe, i kekahi manawa hiki i ka lāʻau lapaʻau i hāʻawi ʻia no ka `(CMV) Retinitis` ke lilo i mea ʻole (`Drug resistance`). Inā hana ʻia kēlā, aia kekahi mau lāʻau lapaʻau ʻē aʻe no ka `(CMV)` i kūʻē i ka `(Ganciclovir)`, no ka laʻana. ʻO kekahi o lākou ʻo `(Leflunomide)` a me `(T-lymphocyte infusion)`.
He aha ka mea e hana ai inā loaʻa iā ʻoe ka CMV retinitis? (Nā hopena)
Loaʻa nā hopena maikaʻi loa ke ʻike mua ʻia ka maʻi a hoʻomaka koke ʻia ka lāʻau. Inā ʻaʻole mālama ʻia, hiki i ka CMV Retinitis ke alakaʻi i ka ʻike haʻahaʻa a me ka makapō piha.
ʻO kekahi maʻi koʻikoʻi e hiki ke hana me ka CMV retinitis ʻo ia ka retinal detachment. ʻO kēia ka manawa e kaʻawale ai kou retina mai ka ʻiʻo e paʻa ana iā ia. He maʻi koʻikoʻi loa kēia, akā hiki ke hoʻoponopono ʻia me ke ʻoki ʻana.
Āhea wau e ʻike ai i ke kauka?
Inā ʻike ʻoe i nā loli koke i kou ʻike - no ka laʻana, ʻike ʻana i nā kiko ʻeleʻele i mua o kou mau maka a i ʻole ka ʻeha o ka maka - e ʻimi koke i ke kōkua lapaʻau. He pilikia olakino ka retinal detachment.
Inā nāwaliwali kou ʻōnaehana pale maka, he mea nui e hana i nā hoʻokolohua maka maʻamau i hiki iā ʻoe ke loaʻa i kekahi pilikia ma mua o ko lākou lilo ʻana i mau hōʻailona.
He aha nā nīnau āu e nīnau ai i ke kauka?
Hiki iā ʻoe ke nīnau i kāu kauka i nā nīnau e like me kēia e pili ana i ka `(CMV) Retinitis`:
- ʻEhia ka lōʻihi e pono ai iaʻu e hoʻi mai a hōʻike (`Nā Hālāwai`)?
- Pono anei iaʻu e hōʻalo i nā meaʻai, nā mea inu, a i ʻole nā hana?
- ʻEhia ka lōʻihi o ka mālama ʻana?
- I ke kūlana hea e pono ai iaʻu e ʻike koke iā ʻoe, a i ʻole e hele i kahi lumi pilikia?
- He aha nā kumuwaiwai i loaʻa e kōkua iaʻu e ola maʻamau me koʻu nalowale ʻana o ka ʻike?
- Hiki iaʻu ke komo i nā hoʻokolohua lapaʻau no kēia maʻi?
He aha ka ʻokoʻa ma waena o ka CMV retinitis a me ka HIV retinopathy?
ʻO "Retinopathy" kahi maʻi o ka retina. Hiki i nā "(CMV) Retinitis" a me "(HIV) Retinopathy" ke hōʻino i kou retina a lilo ka ʻike. Eia nō naʻe,Hoʻokumu ʻia kēia mau kūlana ʻelua e nā ʻano virus ʻelua. Hiki i ka virus HIV ke hana i ka HIV retinopathy (i kapa ʻia hoʻi ʻo HIV microvasculopathy). ʻO ka virus CMV ke kumu o ka CMV retinitis.
I ke ʻano o ka mālama ʻana, hāʻawi ʻia nā lāʻau antiviral no ka `(CMV) Retinitis.` Eia naʻe, ʻaʻole pono ka `(HIV Retinopathy)` i kekahi lāʻau kūikawā.
ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai
Inā nāwaliwali kou ʻōnaehana pale maʻi, e noʻonoʻo mau ana paha ʻoe i kāu mau hōʻailona a ke ʻike nei i nā kauka. Me kēia mau mea a pau, ʻo ka hele pinepine ʻana i ke kauka maka e like me ka pilikia.
Akā e hoʻomanaʻo, inā loaʻa iā ʻoe ka `(CMV) Retinitis`, ʻo ka wikiwiki o kou ʻike ʻia ʻana a me ka mālama ʻia ʻana, ʻoi aku ka maikaʻi o kou kūleʻa. ʻOiai ʻaʻole paha e ʻike ʻia nā hōʻailona o `(CMV) Retinitis` a hiki i kou nalowale ʻana o kou ʻike, he mea nui loa ia e hana i nā hoʻokolohua maka maʻamau.
No laila, e mālama pono i kou mau maka, no ka mea, ʻo ia ko kākou waiwai nui no ka ʻike ʻana i ke ao nei.
👩🏽⚕️ Nā nīnau hou aku (FAQs)
💬 He ʻano makapō anei ka Cytomegalovirus Retinitis (CMV Retinitis) i hoʻokumu ʻia e kahi maʻi i loko o ka maka?
ʻAe! He maʻi ʻo CMV e moe ana i loko o ke kino o nā kānaka he nui a puni ka honua. Inā ikaika ko kākou palekana, ʻaʻole ia e hoʻopilikia. Akā, i ka wā e hāʻule ai ka 'palekana o kekahi i ka ʻole' (ʻoi aku hoʻi i nā poʻe me ka maʻi HIV/AIDS koʻikoʻi a me nā maʻi kanesa), hoʻouka pololei kēia maʻi i ka retina o ka maka a hoʻomakapō loa i ka maka.
💬 He aha nā hōʻailona o kēia maʻi ke pā i nā maka?
ʻO ka pōʻino o kēia, ʻo ia ka wā e hana ʻia ai, ʻaʻole e ʻeha iki ka maka, ʻaʻole hoʻi e lilo i ʻulaʻula! Manaʻo ka mea maʻi e lilo ana ko lākou ʻike i mea pōhihihi, ʻike lākou i nā kiko ʻeleʻele he nui e lana ana i loko o ka maka, a nalowale mālie ko lākou ʻike peripheral.
💬 Pehea ʻoe e hāʻawi ai i ka lāʻau lapaʻau e pale aku iā ʻoe iho mai kēia maʻi ke pā i kou mau maka?
Pono kēia i ke kūkākūkā koke ʻana me ke kauka maka! ʻO ka mea mua, e hāʻawi ka haukapila i kahi inikini 'antiviral' (Intravitreal Ganciclovir/Foscarnet) i loko o ka maka. Eia kekahi, no ka hoʻihoʻi ʻana i ke ʻano maʻamau o ka mea maʻi, he mea nui e hoʻoikaika i kāna ʻōnaehana pale (ma ka hāʻawi ʻana iā ia i ka lāʻau HIV).
ʻO Cytomegalovirus, CMV, retinitis, maʻi maka, palekana, hemahema o ka ʻike, HIV, AIDS, nā maʻi maka
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