Ke ʻeha nei hoʻi kou mau maka i ka maʻi diabetes? Ua lohe anei ʻoe i kēia maʻi i kapa ʻia ʻo Diabetes-Related Macular Edema?

Inā loaʻa iā ʻoe ka maʻi diabetes, pono ʻoe e mālama pono i kou mau maka, ʻeā? No ka mea, e like me kou ʻike, ʻo ka maʻi diabetes kahi maʻi e hiki ke hoʻopilikia i ko mākou mau maka ma nā ʻano i manaʻo ʻole ʻia. I kēia lā, e kamaʻilio mākou e pili ana i ia mea, kahi pehu e kū mai ana i loko o ko mākou mau maka, ʻoiai ma kahi ʻāpana koʻikoʻi o ko mākou ʻike, ma muli o ka maʻi diabetes. ʻO kēia ka mea a nā kauka e kapa nei he `(Diabetes-Related Macular Edema)` a i ʻole `DME`.

He aha ka Diabetes-Related Macular Edema (DME)?

I ka ʻōlelo maʻalahi, ʻo ka DME kahi pehu e kū mai ana ma waenakonu o ka retina, kahi i loko o kou maka i kapa ʻia ʻo macula, ʻo ia ka ʻāpana o ka maka a mākou e hoʻohana ai e ʻike maopopo i nā mea. E noʻonoʻo iā ia e like me kou maka me ke kāmela, a ʻo ka retina e like me ke kiʻiʻoniʻoni i loko o kēlā kāmela. ʻO kēia kahi i loaʻa ai nā cell photosensitive. No laila, ʻo kēia ʻāpana o ka retina, i kapa ʻia ʻo macula, ʻo ia ka mea e kōkua iā mākou e heluhelu i nā paʻi liʻiliʻi a ʻike maopopo i nā mea mamao.

ʻOi aku ka nui o kou loaʻa ʻana i ka DME inā loaʻa iā ʻoe ka retinopathy e pili ana i ka maʻi diabetes. Hoʻonāwaliwali ka maʻi diabetes i nā kīʻaha koko liʻiliʻi i loko o kou maka. A laila hiki iā lākou ke hoʻokahe i ke koko a me ka wai. I kekahi manawa, hiki ke hana ʻia nā kīʻaha koko hou a nāwaliwali loa ʻaʻole pono ma laila. Hiki i kēia mau mea ke hoʻokahe maʻalahi. Ke hōʻiliʻili kēia wai e kahe ana i loko o ka macula, pehu ia.

Pehea ka maʻamau o kēia ʻano?

ʻAʻole nā ​​kānaka a pau me ka maʻi diabetes e loaʻa i kēia maʻi. Eia nō naʻe, ua ʻōlelo ʻia ma kahi o hoʻokahi o ka ʻumikumamāhā o ka poʻe me ka maʻi diabetes e loaʻa paha i kēia maʻi `DME`. ʻOiai ke piʻi nei ka nui o ka poʻe me ka maʻi diabetes ma Sri Lanka, he mea nui loa ia e makaʻala i kēia.

He aha nā hōʻailona o kēia? E nānā inā loaʻa iā ʻoe kēia mau mea pū kekahi...

ʻAʻole paha e hiki koke mai nā hōʻailona o ka DME, a i kekahi manawa e ulu mālie ana lākou. Akā e makaʻala i kēia mau mea:

• ʻIke pōwehiwehi a ʻike pālua paha: He hōʻailona maʻamau kēia. E ʻike paha ʻoe ua pōwehiwehi a pōwehiwehi paha kou ʻike ke heluhelu ʻoe, nānā i ke TV, a nānā paha i kahi mea mamao.
• Nā mea lana: ʻO ke ʻano o nā kiko ʻeleʻele liʻiliʻi a i ʻole nā ​​​​pūnawelewele e neʻe ana i mua a i mua i mua o nā maka.
• Paʻakikī ke hoʻokaʻawale i nā kala: ʻOi aku ka ʻeleʻele o kekahi mau kala ma mua o ka maʻamau a paʻakikī paha ke hoʻokaʻawale kekahi mai kekahi.
• Scotomas: E ʻike paha ʻoe i kahi wahi ʻeleʻele ma waenakonu a ma ka ʻaoʻao paha o ka mea āu e nānā nei.
• Nā laina pololei a me ke ʻano kekee: Inā ʻoe e nānā i kahi mea e like me ka lihi pololei o ka puka a i ʻole ka puka makani a nānā aku ia he kekee, kīkoʻo, a ʻāwili paha, he hōʻailona nō hoʻi kēlā.
• ʻIke i ke kukui ʻālohilohi: Hiki ke paʻakikī ke ʻike i ka lā a i ʻole nā ​​​​kukui ʻālohilohi, a he uliuli paha nā maka.
• ʻO ka mea āu e ʻike ai me kekahi maka, ʻokoʻa ka ʻike ʻia ʻana me kekahi maka: ʻOiai he hōʻailona ʻē kēia, hiki ke hiki i kekahi poʻe.

Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​​​ʻoi aku ka maikaʻi o ka ʻike ʻana i kahi ophthalmologist me ka hoʻokaʻulua ʻole.

No ke aha lā kēia e hana nei? He aha ke kumu o kēia?

E like me kaʻu i ʻōlelo ai ma mua, ʻo ke kumu nui o kēia, ʻo ia ka nui o ke kō koko kiʻekiʻe i kāohi ʻole ʻia no ka manawa lōʻihi. Hoʻopōʻino kēia i nā kīʻaha koko palupalu i loko o ka maka.

Ua kapa mākou i ka pōʻino o nā kīʻaha koko i loko o ka maka i hana ʻia e ka maʻi diabetes he "Diabetes-Related Retinopathy (DRR)". ʻElua mau hihia nui o kēia:

1. `Non-proliferative DRR`: Ma kēia, nāwaliwali nā kīʻaha koko a hoʻokumu ʻia nā puʻupuʻu liʻiliʻi e like me ka pōpō (microaneurysms) ma waho o nā paia. ʻAe kēia i ke koko a me ka wai e kahe i loko o ka macula.

2. `Proliferative DRR`: He hihia koʻikoʻi iki kēia. Maanei, ma kahi o nā kīʻaha koko i hōʻino ʻia, hoʻomaka nā kīʻaha koko hou a nāwaliwali loa e hana i loko o ka maka ʻaʻole pono ma laila. He palupalu loa kēia mau kīʻaha koko hou, no laila e hoʻokahe maʻalahi lākou i ke koko a me ka wai, e hoʻoulu ai i ka macula e pehu.

ʻO ka mea nui loa, inā ʻaʻole mālama pono ʻia kēia maʻi `DME` a i ka manawa kūpono, hiki iā ia ke alakaʻi mālie i ka nalowale loa o kou ʻike. No laila, ʻaʻole kēia he mea e lawe māmā ʻia.

Pehea e ʻike ai nā kauka i kēia maʻi?

ʻAʻole paha ʻoe e ʻike i kēia pehu mai ka home mai. Eia nō naʻe, hiki i ke kauka maka ke ʻike iā ia ke nānā lākou i kou mau maka. ʻO ia ke kumu e pono ai i ka poʻe me ka maʻi diabetes ke nānā pinepine ʻia ko lākou mau maka. Inā ʻike mua ʻia, ʻoi aku ka maʻalahi o ka mālama ʻana.

Ma waho aʻe o ka nānā ʻana i kou mau maka, hiki i ke kauka ke hana i nā hoʻokolohua kūikawā e like me:

• ʻO ka Optical Coherence Tomography (OCT): Ua like kēia me ke scan o loko o kou maka. Hiki iā ia ke ana pololei i ka mānoanoa o kou retina a me ka macula. Hiki iā ia ke ʻike maopopo inā he pehu a me ka nui.
• ʻO ka Fluorescein Angiography: Ma kēia hoʻokolohua, ua hoʻokomo ʻia kahi kala kūikawā i loko o kahi aa koko i kou lima. A laila, lawe kahi kāmela kūikawā i nā kiʻi o ka kala i kona hele ʻana ma o nā kīʻaha koko i loko o kou maka. E ʻike maopopo ʻia nā kahe ʻana o nā kīʻaha koko i nā kiʻi.
• Hoʻāʻo ʻo 'Amsler Grid': He hoʻāʻo maʻalahi loa kēia. Ke noi ʻia nei ʻoe e nānā i kahi grid o nā huinahā a ʻike inā ua kīkoʻo ʻia, kūlou ʻia, a nalowale paha nā laina. Inā he pilikia me ka macula, e ʻike paha ʻoe i kahi loli i kēia mau laina.

He aha nā lāʻau lapaʻau no kēia? Hiki ke ho'ōla ʻia?

ʻO ka nūhou maikaʻi, aia nā lāʻau lapaʻau kūpono loa no DME. Me kekahi mau lāʻau lapaʻau hou, inā ʻike mua ʻia ka maʻi, hiki ke hoʻohuli i kekahi o nā pōʻino i hana ʻia.

Aia kekahi mau ʻano lapaʻau nui:

1. Ka lāʻau lapaʻau Anti-VEGF:Aia kekahi protein i kapa ʻia ʻo Vascular Endothelial Growth Factor (VEGF) e kōkua ana i nā kīʻaha koko hou e ulu i loko o ko kākou mau maka. ʻO kēia lāʻau lapaʻau e pili ana i ka hāʻawi ʻana i kahi lāʻau lapaʻau e ālai ana i ka hana o ka protein VEGF ma ke ʻano he inikini i loko o ka maka. Hāʻawi ʻia kēia inikini i hoʻokahi manawa i ka mahina, a i ʻole e like me ka mea e pono ai. ʻO kēia mau lāʻau lapaʻau ka mea maʻamau e hoʻohana ʻia:

• ʻAflibercept (Eylea®)
• ʻO Bevacizumab (Avastin®)
• ʻO ka lāʻau lapaʻau Faricimab (VABYSMO®)
• ʻO Ranibizumab (Lucentis®)

2. Lapaʻau steroid: Hoʻohana ʻia nā steroid e hōʻemi i ka pehu. Hiki ke hāʻawi ʻia kēia mau mea ma ke ʻano he inikini i loko o ka maka a i ʻole he mau implants liʻiliʻi (kahi ʻāpana lāʻau lapaʻau lōʻihi) hiki ke waiho ʻia i loko o ka maka. Nā Laʻana:

• ʻO Dexamethasone (Ozurdex®) (he implant kēia)
• ʻO ka `Fluocinolone acetonide (Iluvien®)` (he `implant` nō hoʻi kēia)

3. Lapaʻau Laser (Laser Photocoagulation): I kekahi mau hihia, hiki ke hoʻohana ʻia ke kukui laser e "sila" i nā kīʻaha koko e liki ana a hoʻōki i ka liki ʻana.

4. Vitrectomy: He ʻoki kino kēia. Hana ʻia kēia ʻoki kino e wehe i ke koko, ka wai, a i ʻole ka ʻiʻo ʻeha i loko o ka maka e huki ana i ka macula. ʻAʻole pono nā kānaka a pau i kēia.

Me kekahi o kēia mau lāʻau lapaʻau, he mea nui e mālama pono i ke kō koko a me ke kahe koko, inā ʻaʻole e hōʻemi ʻia nā hopena o ka lāʻau lapaʻau.

Aia kekahi mau hopena ʻaoʻao a i ʻole nā ​​pilikia o ka lāʻau lapaʻau?

E like me nā kaʻina hana lapaʻau āpau, aia kekahi mau pilikia liʻiliʻi e pili ana, akā haʻahaʻa ka likelika o nā pilikia.

• Ma muli o ke ʻano o ka hoʻokomo ʻana, he wahi liʻiliʻi paha ka hiki ʻana mai o kahi huakini i loko o ka maka. I mea e pale aku ai i kēia, ua hoʻomaʻemaʻe pono ʻia ka maka ma mua o ke ʻano o ka hoʻokomo ʻana.
• Ma hope o ke komo ʻana, hiki ke hana ʻia nā pehu ea liʻiliʻi i loko o ka maka. E nalo wale aku kēia mau mea i loko o kekahi mau lā.
• Hiki ke ʻulaʻula a me ka maneʻo iki. Hiki paha kēia ma muli o ka wai i hoʻohana ʻia e hoʻomaʻemaʻe i ka maka ma mua o ka inikini. ʻO ka hoʻohana ʻana i nā waimaka hana hiki ke kōkua i ka hōʻemi ʻana i kēia mau ʻeha.
• Hiki i nā lāʻau lapaʻau steroid ke hoʻoulu i nā cataracts a i ʻole ke piʻi ʻana o ke kaomi intraocular. No laila, e nānā mau ke kauka i kēia.

ʻEhia ka manawa e ʻoi aku ai koʻu maikaʻi ma hope o ka lāʻau lapaʻau?

ʻAʻole ʻeha ka maka i ka DME. No laila, ma kahi o ka manaʻo "maikaʻi" ma hope o ka inikini, ua hoʻōki ʻia ka hōʻino ʻana i ka macula a me ka retina a i ʻole ua hoʻohuli hapa ʻia. E hoʻomaka mālie paha kou ʻike e maopopo.

Ma hope o ka lāʻau lapaʻau `Injection`, ʻaʻole hiki iā ʻoe ke hele i ka hana a i ke kula paha. Eia nō naʻe, inā loaʻa iā ʻoe kahi ʻoki `Vitrectomy`, hiki ke hala ma kahi o ʻelua a ʻehā pule e hoʻōla ai.

He aha ka mea e hiki ke hana ʻia e hōʻemi ai a pale aku paha i kēia mai ka hana ʻana?

Inā loaʻa iā ʻoe ka maʻi diabetes, ʻaʻole paha e hiki iā ʻoe ke hoʻopau loa i kou pilikia o ka loaʻa ʻana o DME. Eia nō naʻe, nui nā mea hiki iā ʻoe ke hana e hōʻemi i kou pilikia:

• E kāohi pono i kāu maʻi diabetes: E mālama i kou pae kō koko e like me ka ʻōlelo a kāu kauka. E lawe pono i kāu lāʻau lapaʻau a kāohi i kāu ʻai.
• Inā loaʻa iā ʻoe nā maʻi mau ʻē aʻe e like me ke koko kiʻekiʻe, e kaohi pono iā lākou.
• E hōʻoia e nānā ʻia kou mau maka e ke kauka maka i nā manawa maʻamau. Paipai ʻia ka poʻe me ka maʻi diabetes e nānā ʻia ko lākou mau maka ma ka liʻiliʻi hoʻokahi i ka makahiki.
• Inā ʻoe e puhipaka, e hoʻōki i kēia lā. He mea ʻino loa hoʻi ka puhipaka i nā kīʻaha koko ma nā maka.
• E ʻai i ka meaʻai olakino. E ʻai i nā huaʻai a me nā mea kanu hou aʻe.
• E hoʻoikaika kino i nā manawa a pau.

Inā loaʻa iaʻu kēia maʻi, pehea lā ka wā e hiki mai ana?

Inā ua ʻike ʻia ʻoe me DME a mālama pono ʻia, maikaʻi ka nānā ʻana. ʻOiai inā ʻike ʻia a mālama ʻia i ka wā mua, hiki i kekahi mau lāʻau lapaʻau hou ke hoʻihoʻi i kekahi o ka ʻike i nalowale.

Eia nō naʻe, inā ʻaʻole mālama ʻia, hiki i ka ʻike ke lilo i mea hōʻino nui, e paʻakikī ai ka hana ʻana i ke ola o kēlā me kēia lā. ʻO ia ke kumu he mea nui ka ʻike mua ʻana a me ka mālama ʻana.

Pehea lā wau e mālama ai iaʻu iho?

ʻOiai ʻo ka DME kahi maʻi e hoʻopilikia ai i nā maka, ʻo ka mālama pono ʻana i kou kino holoʻokoʻa hiki ke kōkua i ka kaohi ʻana i ke ʻano.

• Inā loaʻa iā ʻoe nā maʻi mau e like me ka maʻi diabetes, ke koko kiʻekiʻe, ka cholesterol kiʻekiʻe, a i ʻole ka momona, e hoʻāʻo i kāu mea maikaʻi loa e kaohi pono iā lākou.
• E ʻai i ka meaʻai olakino a e hoʻoikaika kino i ka nui.
• E pale i ka puhipaka.
• E nānā i kou mau maka i nā manawa maʻamau, e like me ka ʻōlelo a kāu kauka maka.
• Inā nalowale koke kou ʻike, ʻeha nui kou maka, a ʻike koke paha i kahi pale ʻeleʻele i mua o kou mau maka, e ʻike koke i ke kauka a i ʻole e hele i ka haukapila.

He aha nā nīnau āu e nīnau ai i ke kauka?

Ke hele ʻoe e ʻike i ke kauka, mai poina e nīnau i kēia mau nīnau:

• "He aha hou aʻe kaʻu e ʻike ai e pili ana i kēia maʻi `(Diabetes-Related Macular Edema)`?"
• "He aha ke ʻano lapaʻau āu e ʻōlelo nei he mea kūpono loa iaʻu?"
• "He aha nā hopena ʻaoʻao a i ʻole nā ​​pilikia o kēia lāʻau lapaʻau?"
• "ʻEhia pinepine e pono ai iaʻu e nānā i koʻu mau maka?"
• "He aha ke ʻano o nā hōʻailona i manaʻo ʻia he pilikia ma kēia kūlana 'DME'?"

ʻO ka mea hope loa aʻu e ʻōlelo ai, ʻo kēia...

He maʻi ka maʻi diabetes e hiki ke hoʻopilikia i nā ʻāpana he nui o ko kākou kino. I waena o lākou, he kuleana nui nā maka. Inā loaʻa iā ʻoe ka maʻi diabetes, ʻoiai inā loaʻa iā ʻoe kahi maʻi i kapa ʻia ʻo 'diabetes-related retinopathy', ua piʻi aʻe kou pilikia o ka loaʻa ʻana o 'DME'. Hoʻonui kēia pilikia i ka lōʻihi o kou loaʻa ʻana i ka maʻi diabetes.

No laila, he mea nui loa ka hoʻokolokolo maka maʻamau a ʻike i kekahi pehu a i ʻole nā ​​​​kīʻaha koko hou i loko o ka maka i ka wā mua. No ka mea, inā ʻike mua ʻia ka maʻi a hoʻomaka ʻia ka lāʻau lapaʻau, aia kahi manawa kūpono e hoʻopakele i kou ʻike maka makamae. I kekahi manawa, inā hoʻomaka mua ʻia ka lāʻau lapaʻau, hiki ke hoʻohuli ʻia ka pōʻino i hana ʻia e ka `DME`.

No laila, e mālama pono i kou mau maka. I ka wā e noho ana me ka maʻi diabetes, e hoʻolilo i ka mālama maka i hoʻokahi o kāu mau kuleana nui.

` maʻi kō, edema macular, retinopathy, olakino maka, nalowale o ka ʻike, mālama maka, maʻi kō, maʻi maka, retina