Inā loaʻa iā ʻoe ka maʻi diabetes, ʻike ʻoe i ka nui o kāu e hoʻokele ai. Nui nā mea e hana ai, e like me ke kāohi ʻana i kou pae kō koko, ka mālama ʻana i kāu ʻai, a me ka hoʻoikaika kino. I waenakonu o kēia mau mea a pau, hiki iā mākou ke poina i kekahi manawa i ko mākou mau maka. Akā ʻo kekahi o nā pilikia koʻikoʻi loa e hiki ke hana ma muli o ka maʻi diabetes, ʻo ia ka nalowale o ka ʻike. I waena o lākou, ʻo ke ʻano maʻamau a me ka hoʻoweliweli paha i ka ʻike, ʻo ia ka Diabetic Macular Edema, a i ʻole DME no ka pōkole. Hiki ke hopohopo iki ka lohe ʻana i kēia inoa. Akā, mai hopohopo. Inā ʻike pono ʻia ʻoe e pili ana i kēia a loaʻa ka lāʻau lapaʻau i ka manawa kūpono, hiki iā ʻoe ke pale i kou mau maka makamae.
I ka ʻōlelo maʻalahi, he aha ka Diabetic Macular Edema (DME)?
ʻAe, e ʻōlelo kākou penei. Ma ke kua o kou maka, aia kahi ʻāpana koʻikoʻi loa e hana ana e like me ke kiʻiʻoniʻoni i loko o kahi kāmela. Kapa mākou ia he retina . Hoʻopaʻa ʻia nā kiʻi a mākou e ʻike ai ma kēia retina. Ke loaʻa iā ʻoe ka maʻi diabetes, ʻoiai inā ʻaʻole i kāohi ʻia kou pae kō koko no ka manawa lōʻihi, hoʻomaka nā kīʻaha koko liʻiliʻi i loko o kou maka e hōʻino ʻia. E like me ka paipu wai kahiko, nāwaliwali kēia mau kīʻaha koko a hoʻomaka e hoʻokahe i ke koko a me ka wai. Kapa mākou i kēia ʻano he Diabetic Retinopathy .
I kēia manawa, ke hōʻiliʻili kēia wai e kahe ana i loko o ka retina, hoʻomaka ia e pehu. Aia kahi ʻāpana koʻikoʻi loa o ka retina e kōkua iā mākou e ʻike maopopo, ma waenakonu, i kapa ʻia ʻo ka macula . Ke hōʻiliʻili kēlā wai e kahe ana i loko o ka macula a pehu ia, ʻo ia ka mea a mākou e kapa nei he Diabetic Macular Edema (DME) . Ke pehu ka macula, hoʻopilikia pololei ia i kā mākou ʻike ʻoi a maopopo.
Loaʻa iā ʻoe nā hōʻailona e like me kēia?
ʻO kahi pilikia me DME, ʻaʻole ia e hōʻike i kekahi mau hōʻailona i nā pae mua. Akā i ka holomua ʻana o ke kūlana, e ʻike paha ʻoe i nā mea e like me:
- ʻIke pōwehiwehi: Ke heluhelu nei i kahi puke, ke nānā nei i ke TV, a i ʻole ke nānā ʻana i ka maka o kekahi, lilo ke kikowaena o ke kiʻi i mea pōwehiwehi a maopopo ʻole.
- ʻIke ʻia nā kiʻi me he nalu lā a ʻaleʻale paha: ʻOiai kahi laina pololei e hiki ke ʻike ʻia me he nalu lā.
- Nā waihoʻoluʻu mae: Me he mea lā ua nalowale ka ʻōlinolino a me ka moakāka o nā waihoʻoluʻu, me he mea lā ua "holoi ʻia."
Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, mai hoʻokaʻulua . E ʻike koke i kāu kauka. Inā loaʻa iā ʻoe ka maʻi diabetes, he mea nui e hoʻokolokolo i ka maka ma ka liʻiliʻi i hoʻokahi manawa i ka makahiki , ʻoiai inā ʻaʻohe ou hōʻailona.
Pehea e ʻike ai ke kauka i ka DME?
Ke hele ʻoe i ke kauka, e nīnau mua ʻo ia iā ʻoe i kekahi mau nīnau a laila e hana i kahi hoʻokolokolo maka.
Nā nīnau e nīnau aku ai i ke kauka
- Ua ʻike anei ʻoe i kekahi mau loli i kou ʻike i kēia mau lā iho nei?
- ʻEhia ka lōʻihi o kou ʻike ʻia ʻana he maʻi diabetes ʻoe? Aia kekahi o kou ʻohana i loaʻa iā ia?
- Pehea kou kō koko a me kou pae A1c?
- He koko kiʻekiʻe kou a i ʻole he cholesterol kiʻekiʻe?
- Aia kekahi mau maʻi ʻē aʻe?
Ma hope o kēlā, hana nui ʻia kēia mau hoʻokolohua i ka wā o nā hoʻokolokolo maka.
| Inoa o ka hoʻāʻo | I ka ʻōlelo maʻalahi, he aha kāu e hana ai me kēia? |
|---|---|
| Hoʻāʻo ʻIke Maka | ʻO kēia ka hoʻāʻo ʻike heluhelu a kākou a pau i ʻike ai. Ana ia i ka maopopo o kou ʻike ʻana ma nā mamao like ʻole. |
| Hoʻokolohua Maka Dilated | E kau ke kauka i nā kulu i loko o kou maka e hoʻonui i ka lua ʻeleʻele i loko o kou maka. A laila, me ka hoʻohana ʻana i kahi mea hana kūikawā, e nānā lākou i loko o kou maka e nānā i ke kūlana o kou retina, inā he wai e kahe ana mai nā kīʻaha koko, a inā he pehu. |
| ʻO ka Fluorescein Angiogram (FA) | He hoʻāʻo kūikawā kēia. Hoʻokomo ʻia kahi waihoʻoluʻu kūikawā i loko o kahi aa koko i loko o kou lima. I ka hele ʻana o ka waihoʻoluʻu ma o nā kīʻaha koko i loko o kou maka, lawe ke kāmela kūikawā i nā kiʻi. Hiki i kēia ke kōkua i ke kuhikuhi ʻana i kahi e kahe ana nā kīʻaha koko. |
| ʻO ka Tomography Hoʻohui Optical (OCT) | Ua like kēia me ke kiʻi ʻana o loko o ka maka. Lawe kahi kāmela kūikawā i ke kiʻi o kahi ʻāpana kea o ka retina. Hiki i kēia ke ana pololei i ka nui o ka pehu ʻana i loko o ka macula a me ka nui o ka wai i hōʻiliʻili ʻia. |
Ma hope o kēia mau hoʻokolohua, e hoʻoholo ke kauka inā he DME kou a pehea ke koʻikoʻi.
He aha nā lāʻau lapaʻau no DME?
ʻO ka mea pōmaikaʻi, aia i kēia manawa nā lāʻau lapaʻau kūpono loa no DME. E paipai kāu kauka i ka lāʻau lapaʻau kūpono loa e pili ana i kou kūlana.1. Nā inikini Anti-VEGF
ʻO kēia ka lāʻau lapaʻau nui a maikaʻi loa i loaʻa i kēia manawa. He protein ʻo VEGF e kōkua ana i nā kīʻaha koko hou a nāwaliwali e hana i loko o ko kākou mau maka. Ke ālai nei kēia mau inikini i kēlā protein VEGF. Ke pale nei kēia i nā kīʻaha koko hou mai ka hana ʻana a me ke kahe ʻana o ke wai mai nā kīʻaha koko e kū nei. Hoʻokomo pololei ʻia kēia mau inikini i loko o ka maka. ʻOiai paha he mea weliweli iki ke kani ʻana, hoʻomāʻū ia i ka maka no laila ʻaʻole ia e ʻeha nui. ʻO nā lāʻau lapaʻau i hoʻohana pinepine ʻia:
- ʻAflibercept (Eylea)
- ʻO Bevacizumab (Avastin)
- ʻO Ranibizumab (Lucentis)
- Faricimab-svoa (Vabysmo) - He lāʻau lapaʻau hou kēia e ālai ana i nā protein VEGF a me Ang-2.
2. Ka mālama ʻana i ka laser (Laser Photocoagulation)
Inā ʻoi aku ka koʻikoʻi o ke kūlana, hoʻohana ʻia nā lasers e "sila" a puhi paha i nā kīʻaha koko e liki ana. Hiki i kēia ke kōkua i ka kaohi ʻana i ka pehu. Pono paha ʻoe e loaʻa i kekahi mau lāʻau lapaʻau.
3. Nā lāʻau lapaʻau ʻē aʻe
I kekahi mau hihia, hoʻohana ʻia nā inikini steroid. Eia kekahi, inā e kahe ana ke koko o ka wai i loko o ka maka (vitreous humor) a ke kumu o ka ʻike pōwehiwehi, hana ʻia kahi hana ʻoki kino i kapa ʻia ʻo vitrectomy e wehe i ka wai a hoʻololi iā ia me kahi wai maopopo.
Nā mea hiki iā ʻoe ke hana e mālama iā ʻoe iho
Ma waho aʻe o nā lāʻau lapaʻau a kāu kauka e hāʻawi ai iā ʻoe, nui nā mea hiki iā ʻoe ke hana iā ʻoe iho. ʻO ka hana pololei ʻana i kēia mau mea hiki ke kōkua i ka pale ʻana i ka maʻi mai ka ʻino ʻana.
- E kāohi i kāu maʻi diabetes: ʻO kēia ka mea nui loa. E mālama i kou kō koko, ke koko, a me nā pae cholesterol ma nā pae kūpono i kuhikuhi ʻia e kāu kauka. E lawe i ka lāʻau lapaʻau i kuhikuhi ʻia e like me ke kauoha.
- He nohona olakino: E ʻai i ka meaʻai kaulike, e kāohi i kou kaumaha, a e hoʻoikaika kino i kēlā me kēia lā. E kamaʻilio me kāu kauka e pili ana i kēia a e hana i kahi hoʻolālā kūpono iā ʻoe.
- Mai hōʻalo i nā hoʻokolohua maka: Mai hoʻopaneʻe i ka nānā ʻana i kou mau maka no ka mea manaʻo ʻoe ʻaʻohe hewa. Makemake kāu kauka e ʻike pinepine iā ʻoe e ʻike i ka maikaʻi o kāu lāʻau lapaʻau a e nānā i nā pilikia ʻē aʻe.
- E noʻonoʻo i kou olakino noʻonoʻo: He mea maʻamau ke kaumaha a me ka hopohopo ke loaʻa iā ʻoe nā pilikia ʻike. E kamaʻilio e pili ana i kou mau manaʻo me kou ʻohana, kahi hoaaloha hilinaʻi, a i ʻole kāu kauka. E ʻimi i ke kōkua mai kahi kākāʻōlelo olakino noʻonoʻo inā pono.
E hoʻomanaʻo, he maʻi mālama maka ka DME inā ʻike mua ʻia a mālama pono ʻia. No laila, mai makaʻu, e kū i mua me ka wiwo ʻole.
Leka Lawe-Home
- Inā loaʻa iā ʻoe ka maʻi diabetes, ʻo ka mālama ʻana i kou kō koko, ke koko, a me ka cholesterol ma lalo o ka kaohi ke ala maikaʻi loa e pale ai i kou mau maka.
- ʻOiai inā ʻaʻohe ou hōʻailona, e hōʻoia e hana i kahi hoʻokolokolo maka piha piha ma ka liʻiliʻi i hoʻokahi manawa i ka makahiki.
- Inā ʻike ʻoe i nā hōʻailona e like me ka ʻike maka pōwehiwehi, nā kiʻi i hoʻopāpā ʻia, a i ʻole nā kala mae, e ʻike koke i ke kauka.
- I kēia manawa, aia nā lāʻau lapaʻau kūpono loa no DME (nā inikini Anti-VEGF, nā lasers). ʻO ka hoʻomaka mua ʻana o ka lāʻau lapaʻau, ʻo ka nui o ka manawa kūpono e mālama ai i ka ʻike.
- ʻAʻole ʻoe hoʻokahi ma kēia huakaʻi. E kiʻi i ke kākoʻo mai kāu kauka, ʻohana, a me nā hoaaloha.
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