Me he mea lā e hana ʻia ana nā kīʻaha koko hou i loko o kou maka? E kamaʻilio kākou e pili ana i kēia neovascularization o ka maka?

I kekahi manawa, loaʻa i ko kākou mau maka nā pilikia i manaʻo ʻole ʻia, ʻeā? I ka manawa koke, lilo ko kākou ʻike i mea pōwehiwehi, a i ʻulaʻula a ʻeha ko kākou mau maka. Aia paha kekahi ʻano ma hope o kēia mau mea a kākou i lohe ʻole ai. ʻO kekahi o ia ʻano ʻo ia ka ocular neovascularization, a i ʻole ke kūkulu ʻia ʻana o nā kīʻaha koko hou i loko o ka maka.

He aha ke ʻano o ka hoʻokumu ʻia ʻana o nā kīʻaha koko hou i loko o ka maka? (Neovascularization of the Eye)

I ka ʻōlelo maʻalahi, ʻo ia ka manawa e hoʻokumu ʻia ai nā kīʻaha koko hou i loko o ka maka. Eia nō naʻe, ulu kēia mau kīʻaha koko ma nā wahi i pono ʻole ai lākou, ma nā ʻano i pono ʻole ai lākou, a i kekahi manawa keu aku . Ulu lākou e like me nā nāhelehele. Hiki ke hana ʻia nā ʻiʻo fibrous hou ma waena o kēia mau kīʻaha koko hou. ʻO ia ka manawa e hoʻomaka ai ka ʻike e hoʻopilikia ʻia.

ʻO kēia ka mea a mākou e kapa nei i ka lāʻau lapaʻau he "Neovascularization", ʻo ia hoʻi ke kūkulu ʻia ʻana o nā kīʻaha koko hou i makemake ʻole ʻia i loko o ka maka. Hiki i kēia ke alakaʻi i ka mumū a me ka ʻōpala i loko o ka maka, kahi e hiki ai ke alakaʻi i ka emi ʻana a i ʻole ka nalowale loa o ka ʻike . ʻO ka hapa pinepine, ua hana ʻia kēia ʻano e kahi ʻeha a i ʻole ka maʻi e hoʻomau nei.

Ma hea i loko o ka maka e hiki ai i kēia mau kīʻaha koko hou ke hana ʻia?

I kēia manawa, e nānā kākou i nā ʻāpana o ka maka e hiki ai i kēia mau kīʻaha koko hou ke hoʻopilikia. He ʻōkana paʻakikī a palupalu hoʻi ka maka.

• Choroid: Aia kēia ma waena o ka retina a me ka sclera, ka ʻāpana keʻokeʻo o ka maka. Maanei kahi e loaʻa ai ka hapa nui o nā kīʻaha koko e hoʻolako ana i ke koko i ka maka.
• Retina: ʻO kēia kahi e hoʻololi ʻia ai ke kukui e komo ana i ka maka i mau hōʻailona uila a hoʻouna ʻia i ka lolo. ʻO kēia ka mea e hiki ai iā mākou ke ʻike i nā mea.
• Macula: Aia kēia ma waenakonu o ka retina. Kōkua ia iā mākou e ʻike maopopo i nā mea e kū pono ana i mua o mākou.
• ʻIris: ʻO kēia ka ʻāpana o ka maka e hāʻawi iā ia i kona kala. ʻO ka pōʻai ʻeleʻele liʻiliʻi ma waenakonu, ʻo ia ka haumāna , aia nō hoʻi ma ʻaneʻi.
• Cornea: ʻO kēia ka ʻāpana mālamalama, e like me ke aniani o ka maka ma ke alo, e like me ka puka makani.
• Conjunctiva: He membrane lahilahi kēia e pale ana i ka maka.

Hoʻokumu ʻia ʻana o nā kīʻaha koko hou i loko o ka papa vascular `(Choroidal Neovascularization - CNV)`

I kēia manawa, e nānā kākou i kēia `(Choroid)`, ʻo ia hoʻi, ke kūkulu ʻia ʻana o nā kīʻaha koko hou i loko o ka papa vascular. Ua kapa ʻia kēia ʻo `(Choroidal Neovascularization - CNV)`.

ʻIke pinepine ʻia kēia i nā poʻe me ka macular degeneration pili i ka makahiki (AMD). Manaʻo nā kauka ʻo ke kumu ka piʻi ʻana o nā pae o kahi kemika i kapa ʻia ʻo Vascular Endothelial Growth Factor (VEGF), ka mea i hana ʻia e ka retina o ke kanaka me AMD.

ʻAʻole maʻamau kēia mau kīʻaha koko hou. Ua nāwaliwali loa lākou, e like me ka paipu haki.Hiki i kēia ke hoʻoheheʻe i nā wai, a i kekahi manawa ke koko, i loko o ka retina. E noʻonoʻo iā ia e like me kahi pōpō liʻiliʻi i piha i ka wai, a hiki ke hana ʻia kahi pehu ma ka retina.

Hiki i kēia mau kumu o `(CNV)` ke hoʻoulu i nā kīʻaha koko hou e hana ʻia ma ka retina waena (Macular Neovascularization - MNV). Eia nō naʻe, i kekahi manawa hiki ke hana ʻia `(MNV)` me ke kumu ʻole. I ia mau hihia, ua kapa ʻia hoʻi ʻo `(Idiopathic)`, ʻo ia hoʻi "no ke kumu i ʻike ʻole ʻia".

Ka Neovascularization Corneal

ʻO ka mea aʻe, e kamaʻilio kākou e pili ana i ke kūkulu ʻia ʻana o nā kīʻaha koko hou i loko o ka cornea. E hoʻomanaʻo, ʻo ka cornea ka ʻāpana maopopo o ka maka. ʻO ka maʻamau, ʻaʻohe ona kīʻaha koko. ʻO ia ke kumu he maopopo loa ia. No laila, inā e hana ʻia nā kīʻaha koko hou i loko, hiki ke hoʻopilikia ʻia kēlā maopopo, a hiki ke like me ka noe. Hiki i kēia ke hoʻolilo i ka ʻike i mea pōuliuli.

Pili kēia "Corneal Neovascularization" me nā ʻano maʻi maka like ʻole.

Ka Neovascularization Retinal

ʻO ka neovascularization retinal ka hoʻokumu ʻia ʻana o nā kīʻaha koko hou a ʻano ʻē i loko o ka retina. E hoʻomanaʻo, ʻo ka retina kahi e loaʻa ai nā hunaola ʻike mālamalama. Hiki ke hana ʻia kēia kūlana e nā maʻi like ʻole a me nā ʻeha. He nāwaliwali kēia mau kīʻaha koko hou a hiki ke kahe ke koko a hoʻokahe i ka wai.

ʻO ka neovascularization o ka Iris

ʻO ka Neovascularization o ka Iris ka ulu ʻana o nā kīʻaha koko hou a ʻano ʻē i loko o ka iris - ka ʻāpana o ka maka e hāʻawi i ke kala i ka maka. Ua kapa ʻia hoʻi ʻo Rubeosis Iridis. Pili ia me kahi ʻano glaucoma koʻikoʻi i kapa ʻia ʻo Neovascular Glaucoma. ʻO ka Glaucoma kahi maʻi e hōʻino ana i ke aʻalolo optic a he hoʻoweliweli nui ia i ka ʻike.

He aha nā hōʻailona o kēia maʻi?

I kēia manawa, e nānā kākou i nā hōʻailona a kākou e ʻike ai a ʻike i ka wā e hoʻokumu ʻia ai nā kīʻaha koko hou i loko o ka maka. Hiki ke ʻokoʻa kēia mau hōʻailona ma muli o kahi i hoʻokumu ʻia ai nā kīʻaha koko hou.

Inā hoʻokumu ʻia nā kīʻaha koko hou i loko o ka choroid a me ka macula:

• Hiki i nā mea āu e ʻike ai ke ʻano kekee a kekee paha , e like me ke nānā ʻana ma o ka wai a i ʻole ma o ke aniani kekee.
• Ke nānā pololei ʻoe i mua, e ʻike paha ʻoe i kahi hakahaka a i ʻole kahi kiko ʻeleʻele i waenakonu o kāu ʻike.

Inā hoʻokumu ʻia nā kīʻaha koko hou i loko o ka cornea (Corneal Vascularization):

ʻAʻole paha ʻoe e loaʻa i kekahi mau hōʻailona. Eia naʻe, inā loaʻa iā ʻoe, hiki iā ʻoe ke ʻike i kēia mau mea:

• ʻEha maka.
• ʻUlaʻula o nā maka.
• Nā maka waimaka.
• ʻIke i ka mālamalama (Photophobia) - ʻO ke ʻano kēia o ka paʻakikī i ka nānā ʻana i nā mea e like me ka lā a me nā kukui ʻālohilohi.
• Inā ʻoe e hoʻokomo i nā aniani hoʻopili, ʻaʻole paha ʻoe e hiki ke hoʻokomo iā lākou no nā hola he nui.

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

ʻAe, e nānā kākou i ke kumu e hana ʻia ai nā kīʻaha koko hou i loko o ka maka ma kēia ʻano, a he aha nā kumu. He ʻokoʻa iki nā kumu o kēia mau hoʻokumu ʻana ma kēlā me kēia wahi.

ʻO nā kumu o ke kūkulu ʻia ʻana o nā kīʻaha koko hou i loko o ka choroid a me ka macula:

• ʻO ka macular degeneration: ʻO kēia ke kumu nui.
• ʻIke kokoke loa.
• ʻO ka histoplasmosis ocular kahi maʻi fungal o ka maka.
• ʻEha maka.
• Nā kaha angioid: Ua like kēia me nā māwae i hana ʻia ma kekahi o nā papa o ka retina.
• Uveitis: He hui kēia o nā maʻi maka e hiki ai ke hoʻoulu i ka mumū i loko o ka maka, ka ʻulaʻula, a me ka ʻeha maka.

ʻO nā kumu o ke kūkulu ʻia ʻana o nā kīʻaha koko hou i loko o ka cornea:

• Nā maʻi hānau ʻia: ʻO kēia nā maʻi i loaʻa i ka wā hānau.
• ʻEha maka: Eia kekahi laʻana, nā kuni kemika.
• ʻO keratitis maʻi.
• Nā maʻi ʻaleʻale.
• ʻŌnaehana palekana a me nā maʻi mumū.
• ʻO ka hoʻohana lōʻihi ʻana i nā aniani hoʻopili hiki ke hoʻoneʻe i ka oxygen i nā ʻiʻo (Hypoxia).
• Ke hōʻole ʻia ʻana o kahi kāpili corneal e ke kino.

ʻO nā kumu o ke kūkulu ʻia ʻana o nā kīʻaha koko hou i loko o ka retina:

• ʻO ka maʻi retina.
• Retinopathy: Hoʻokomo pū kēia me nā kūlana e like me ka retinopathy pili i ka maʻi diabetes, ka retinopathy cell sickle, a me ka retinopathy o ka hānau mua ʻana.
• Hoʻemi ʻia ke kahe koko i loko o nā kīʻaha koko nui i kou ʻāʻī (nā ʻaʻa carotid).
• Ka paʻa ʻana o nā aʻa koko retinal: ʻO kēia ke ālai ʻana o kahi kīʻaha koko i loko o ka retina.

ʻO nā kumu o ke kūkulu ʻia ʻana o nā kīʻaha koko hou i loko o ka iris:

• ʻO ka retinopathy e pili ana i ka maʻi diabetes.
• Ka paʻa ʻana o nā aʻa retinal waena.
• ʻO ka maʻi ischemic ocular: He kūlana i hoʻokumu ʻia e ka emi ʻana o ke kahe koko i ka maka.
• Ka wehe ʻana o ka retina: ʻO kēia ka wā e kaʻawale ai ka retina mai kona mau ʻiʻo kākoʻo.
• ʻUveitis.

Pehea ʻoe e ʻike ai i kēia? He aha nā hoʻāʻo?

ʻĀ, inā loaʻa iā ʻoe nā hōʻailona e like me kēia, pehea e ʻike pololei ai ke kauka iā ia? Aia kekahi mau hoʻokolohua no kēlā.

• Hoʻokolokolo maka o ke kukui ʻoki i hoʻonui ʻia:I kēia, hoʻopili ʻia nā kulu maka i ka maka, hoʻonui ʻia ka haumāna , a nānā pono ʻia ka ʻaoʻao o loko o ka maka me kahi mea hana kūikawā, e like me ka microscope.
• ʻO ka Optical Coherence Tomography (OCT): Ua like kēia me ke scan o loko o ka maka. Hiki iā ia ke lawe i nā kiʻi ʻokiʻoki maopopo o nā papa i loko o ka maka. Hiki iā ia ke nānā i nā mea e like me nā kīʻaha koko hou a me nā kahe wai.
• ʻO ka angiography Fluorescein a i ʻole ka angiography ʻōmaʻomaʻo Indocyanine: ʻO kēia ke komo ʻana i kahi waihoʻoluʻu kūikawā i loko o kahi aa koko i kou lima a me ke kiʻi ʻana i nā kiʻi o nā kīʻaha koko i loko o kou maka. Hiki i kēia ke hōʻike maopopo i nā mea e like me nā ālai ʻana a me nā leaka i loko o nā kīʻaha koko.

He aha nā lāʻau lapaʻau?

ʻOkoʻa ka mālama ʻana no kēia ʻano ma muli o ke kumu a me ka ʻāpana o ka maka i hoʻopilikia ʻia. ʻO ka maʻamau, hoʻokomo kēia mau lāʻau lapaʻau i nā lāʻau lapaʻau a me/a i ʻole ka ablation, ka mea e luku ai i nā kīʻaha koko hou a ʻano ʻē.

Nā ʻano lāʻau lapaʻau:

ʻO kekahi o kēia mau mea he mau inikini intravitreal i hāʻawi pololei ʻia i loko o ka maka. Hana nui kēia mau mea ma ka kaohi ʻana i kahi kemika i kapa ʻia ʻo VEGF a me ka hōʻemi ʻana i ke kūkulu ʻia ʻana o nā kīʻaha koko hou.

• ʻO `Bevacizumab (Avastin®)` (Hoʻohana ʻia kēia `(off-label)`, ʻo ia hoʻi, ʻaʻole ia no ka maʻi i ʻae ʻia ai, akā no ka mea ua ʻike ʻia he pono)
• ʻO Brolucizumab (Beovu®)
• ʻAflibercept (Eylea®)
• ʻO Ranibizumab (Lucentis®)
• Lapaʻau Gene: He ʻano lapaʻau hou kēia e kū nei i ke kahua noiʻi.
• Nā mea hoʻopaʻa MMP: No ka laʻana, he pila i kapa ʻia ʻo Doxycycline , i hāʻawi ʻia e hoʻoulu i ka ulu ʻana o nā kīʻaha koko hou i loko o ka cornea.

Nā ʻano e luku ai i nā ʻiʻo ʻē:

• ʻO ka lāʻau lapaʻau ablation Laser: Hoʻohana kēia i nā kukuna laser e "puhi" a luku i nā kīʻaha koko hou.
• ʻO ka lāʻau lapaʻau Photodynamic (PDT): Pili kēia i ka hoʻokomo ʻana i kahi lāʻau lapaʻau mālamalama i loko o ka maka, a laila e hoʻomālamalama ana i kahi kukui kūikawā i loko o ka maka e luku koho i nā kīʻaha koko kūpono ʻole.
• Cauterization: Hoʻohana kēia ʻano hana i ka wela e mālama ai i nā kīʻaha koko kūpono ʻole.

E hoʻomanaʻo hoʻi: Hiki i kēia mau lāʻau lapaʻau ke loaʻa nā hopena ʻaoʻao. No ka laʻana, hiki i nā steroids a me nā lāʻau anti-VEGF ke loaʻa nā hopena ʻaoʻao e hoʻopilikia i ke kino holoʻokoʻa. Eia kekahi, ke luku lākou i nā kīʻaha koko, hiki ke hōʻino ʻia nā ʻiʻo olakino i kekahi manawa. No laila, he mea nui e kūkākūkā i nā pono a me nā pōʻino o kēlā me kēia lāʻau lapaʻau me kāu kauka a koho i ka mea kūpono loa iā ʻoe.

He aha kā mākou e hana ai e pale aku iā mākou iho mai kēia kūlana?

ʻOiai ʻaʻole hiki ke pale loa ʻia kēia maʻi, aia kekahi mau mea hiki iā mākou ke hana e mālama i ko mākou mau maka a hōʻemi i ka pilikia:

• Ma mua o ka launa maka ʻanaE holoi pono i kou mau lima me ke kopa.
• Inā ʻoe e ʻaʻahu ana i nā aniani hoʻopili, e hahai i nā kuhikuhi pololei no ka hoʻohana ʻana a me ka hoʻomaʻemaʻe ʻana iā lākou. Mai ʻaʻahu iā lākou no ka lōʻihi ma mua o ka manawa i kuhikuhi ʻia. E wehe iā lākou i ka wā e hiamoe ana.
• E nīnau i kāu kauka e pili ana i nā meaʻai a me nā mea hoʻohui e hiki ke kōkua i ka mālama ʻana i kou mau maka i ke olakino. No ka poʻe me AMD, aia kekahi ʻano mea hoʻohui i kapa ʻia ʻo AREDS 2 hiki ke kōkua i ka hoʻōki a i ʻole kaohi ʻana i ka holomua o ka maʻi i kona mau wā mua.
• E hahai i nā ʻano nohona olakino. ʻO ia hoʻi ka ʻai ʻana i ka meaʻai kaulike, ka hoʻoikaika kino mau , a me ka pale ʻana i ka puhipaka. Inā loaʻa iā ʻoe kekahi mau maʻi olakino, e like me ka maʻi diabetes a i ʻole ke koko kiʻekiʻe, e kāohi pono iā lākou.

He aha ka mea e hiki ke manaʻo ʻia me kēia kūlana?

Inā ʻaʻole mālama ʻia kēia hoʻokumu ʻana o nā kīʻaha koko hou, e emi mālie ana kou ʻike a nalowale loa. He hopena nui kēlā i kou ola, ʻeā?

Aia kekahi mau mea e pili ana i ka holomua o ka lāʻau lapaʻau. ʻO kēia mau mea kahi o ke koko i hoʻopaʻa ʻia, pehea kona koʻikoʻi, kou mau makahiki, a inā he mau pilikia olakino ʻē aʻe kāu. ʻO ka wikiwiki o ka ʻike ʻia a me ka mālama ʻia ʻana, ʻoi aku ka maikaʻi o ka hopena.

Āhea wau e ʻike ai i ke kauka?

Inā nalowale koke kou ʻike maka, ʻeha nui kou maka, a i ʻole he ʻeha wela kou mau maka e paʻakikī ai ka ʻike ʻana i ka mālamalama, e ʻike koke i ke kauka. Eia kekahi, inā ʻike ʻoe i kekahi mau loli i kou ʻike maka (e laʻa me ka ʻike maka pōwehiwehi, nā kiko ʻeleʻele), a i ʻole kekahi mau hōʻailona ʻē aʻe āu e manaʻo ai he pilikia paha, e ʻike koke i ke kauka maka.

He mea nui hoʻi e hana i nā hoʻokolohua maka maʻamau e like me ka ʻōlelo a kāu kauka maka. Inā pilikia ʻoe no kekahi mau maʻi maka (e laʻa me ka maʻi diabetes, ka mōʻaukala ʻohana o AMD), pono paha ʻoe e hele pinepine.

He ʻelua mau mea ʻokoʻa anei ka "Neovascularization" a me ka "Angiogenesis"?

He kumuhana hohonu iki kēia, akā i ka ʻōlelo maʻalahi, ʻo `(Angiogenesis)` ke kaʻina hana o nā kīʻaha koko hou e lālā ana mai nā kīʻaha koko e kū nei. ʻO `(Vasculogenesis)` ke kaʻina hana o nā kīʻaha koko hou e hoʻomaka ana mai nā pūnaewele (me he mea lā e hoʻomaka ana mai ka wā ʻole). Hiki ke hoʻohana ʻia `(Neovascularization)` e hana i nā kīʻaha koko hou ma nā ʻano ʻelua. No laila, he huaʻōlelo ākea iki ʻo `(Neovascularization)`, a hiki ke hoʻokomo i kēia mau ʻano hana kīʻaha koko hou.

ʻO nā mea nui a mākou e hoʻomanaʻo ai mai kēia moʻolelo, ʻo ia

No laila, ua kamaʻilio nui mākou e pili ana i kēia kūlana i kapa ʻia ʻo "Neovascularization of the Eye", kahi e hoʻokumu ʻia ai nā kīʻaha koko hou i loko o ka maka. ʻOiai he mea weliweli iki kēia, inā ʻike ʻia a mālama ʻia i ka manawa kūpono, aia kahi manawa kūpono e hiki ke mālama ʻia ke kūlana a hiki ke mālama ʻia ka ʻike.

• Inā ʻike ʻoe i kahi loli koke o ka ʻike, ka ʻulaʻula, ka ʻeha, a i ʻole ka paʻakikī o ka ʻike ʻana i ka mālamalama ʻālohilohi, mai hoʻokaʻulua. E ʻike koke i kahi kauka maka.
• Inā loaʻa iā ʻoe nā maʻi e like me ka maʻi diabetes, hyperopia, a i ʻole ka mōʻaukala ʻohana o AMD, e nānā mau i kou mau maka e like me ke kauoha a kāu kauka.
• E hoʻohana pono i ka lāʻau lapaʻau a kāu kauka i kuhikuhi ai, e hahai i kāna mau kuhikuhi, a mai hoʻōki i ka lāʻau lapaʻau ma waena o ka manawa.
• E pale loa i ka puhipaka. He mea ʻino loa ka puhipaka i ke olakino o nā maka, ʻoiai no nā maʻi e like me ka AMD a me ka maʻi maka maʻi diabetes.
• ʻAʻole wale ka ʻai olakino a me ka hoʻoikaika kino mau he mea maikaʻi no kou mau maka, akā no kou kino holoʻokoʻa. E hoʻokomo i nā mea kanu ʻōmaʻomaʻo, nā huaʻai, a me nā iʻa i waiwai i ka omega-3 i kāu papaʻai.

E hoʻomanaʻo, he mea waiwai nui kou mau maka. ʻO lākou ke kumuwaiwai waiwai nui loa a kākou e ʻike ai i ke ao nei. No laila, ʻo kou kuleana ke mālama pono iā lākou. Inā ʻoe e makaʻala ma mua a hana i nā hana e pono ai, hiki iā ʻoe ke pale aku i nā pilikia he nui.

ʻO ka Neovascularization o ka Maka, Nā Maʻi Maka, ʻIke, Retina, Ophthalmology, Lapaʻau Maka