Ke emi nei ke kahe koko o kou maka? E aʻo kākou e pili ana i kēia (Ocular Ischemic Syndrome)!

Ua nalowale koke anei kou ʻike maka, a i ʻole ke ʻike nei ʻoe i kahi ʻeha ʻē a hiki ʻole ke wehewehe ʻia a i ʻole ke kaumaha ma kekahi a i ʻole nā ​​maka ʻelua? A i ʻole e uliuli kou mau maka ke hele ʻoe i waho? I kekahi manawa manaʻo mākou he ʻeha maka wale nō kēia, akā aia paha kekahi mea ʻoi aku ka koʻikoʻi ma hope. ʻO ia ke ʻano o ka Ocular Ischemic Syndrome. ʻOiai paha he mea weliweli iki ka inoa, e kamaʻilio maʻalahi kākou e pili ana.

He aha kēia `(Ocular Ischemic Syndrome)`?

I ka ʻōlelo maʻalahi, ʻo ka Ocular Ischemic Syndrome kahi maʻi maka kakaikahi e kū mai ana i ka wā ʻaʻole lawa ke koko i ko mākou mau maka. ʻO ke kumu nui o kēia o nā waihona momona (i kapa ʻia hoʻi he plaques) i loko o nā kīʻaha koko nui ma ko mākou ʻāʻī i kapa ʻia ʻo Carotid Artery. Hoʻolako pū kēia mau kīʻaha koko i ke koko i ko mākou mau maka. No laila, i ka wā e ālai ʻia ai kēia mau kīʻaha koko, emi ka nui o ke koko e hele ana i nā maka. Hiki i kēia ke hana i nā pilikia ʻike a me ka ʻeha o ka maka.

ʻO ia hoʻi, ʻo ke ʻano o kēia inoa, huaʻōlelo no huaʻōlelo, penei:

• ʻO ke ʻano lapaʻau o "Ocular" ʻo ia hoʻi "e pili ana i nā maka."
• ʻO "Ischemic" a i ʻole "Ischemia" kahi kūlana kahi e emi ai ke kahe o ke koko ma muli o ka "atherosclerosis" (ka lahilahi a paʻakikī paha o nā aʻa). ʻO kēia kūlana ke kumu o ka "Carotid Artery Disease" (Carotid Artery Disease).
• ʻO ka "Syndrome" e pili ana i kahi kūlana kahi e kū pū ai kekahi mau hōʻailona.

No laila, i hui pū ʻia kēia mau mea a pau, he hōʻiliʻili kēia o nā hōʻailona i hoʻokumu ʻia e ka emi ʻana o ke kahe koko i nā maka. ʻO kēia kūlana, ma ke ʻano kūikawā, hiki ke lilo i hōʻailona mua o ka `(Carotid Artery Disease)`. ʻO kēia kūlana i kapa ʻia ʻo `(Carotid Artery Disease)` e hoʻonui i ka pilikia o ka hahau ʻana a me ka hōʻeha puʻuwai . No laila, he mea nui loa ka makaʻala i kēia.

No ke aha e hana ʻia ai kēia? He aha nā kumu o ka `(Ocular Ischemic Syndrome)`?

E like me kaʻu i ʻōlelo ai ma mua, ʻo ke kumu nui o kēia ʻo ia ka `(Carotid Artery Disease)` (Carotid Artery Disease) . Ua kapa ʻia hoʻi kēia ʻo `(Carotid Artery Stenosis)`. ʻO `(Stenosis)` ke ʻano o ka haiki ʻana a i ʻole ka paʻa ʻana o kahi aʻa. ʻO kēia mau kīʻaha koko ʻelua i kapa ʻia ʻo `(Carotid Arteries)` ma nā ʻaoʻao ʻelua o kou ʻāʻī e lawe ana i ke koko momona oxygen i kou poʻo, ʻāʻī, lolo, a me nā maka. No laila, i ka wā e hoʻomaka ai ka `(Plaque)`, kahi mea ʻaila, e hōʻiliʻili i loko o kēia mau kīʻaha koko (ua kapa ʻia hoʻi kēia ʻo `(Atheroma)`), ua paʻa ke kahe o ke koko.

Hoʻomaka nā kīʻaha koko i kapa ʻia ʻo `(Ophthalmic Arteries)` e hoʻolako ana i ke koko i ko kākou mau maka mai kēia mau `(Carotid Arteries)`. No laila, ʻaʻole lawa ke koko o ke kanaka me `(Carotid Artery Disease)` i ko lākou mau maka. ʻO kēlā nele o ke koko ke kumu o `(Ocular Ischemic Syndrome)`.

Ma waho aʻe o kēia kumu nui, aia kekahi mau kumu ʻē aʻe i ʻike pinepine ʻole ʻia:

• `(Carotid Artery Dissection)` (kahi ʻano like me ka carotid artery dissection)
• ʻO ka Vasculitis (ka mumū ʻana o nā kīʻaha koko). ʻO nā laʻana e komo pū me Takayasu's Arteritis, Giant Cell Arteritis (GCA), a me Behcet's Disease.
• `(Fibrovascular Dysplasia)`
• ʻO ka ʻeha koko
• `(Maʻi Moyamoya)`

ʻO wai ka mea i pilikia nui?

He maʻi laha ʻole ka Ocular Ischemic Syndrome, e hoʻopilikia ana ma kahi o 8 mau kānaka no ka miliona.

Hoʻopilikia pinepine kēia maʻi i nā kānaka ma waena o 50 a me 80 mau makahiki. ʻOi aku ka pālua o ka loaʻa ʻana o ia ma mua o nā wāhine i nā kāne .

Aia kekahi mau kumu pilikia e hoʻopilikia i kēia:

• `(Maʻi Pūnaʻau)` (Nā maʻi o ka ʻōnaehana cardiovascular, ʻo ia hoʻi, nā maʻi e pili ana i ka puʻuwai a me nā kīʻaha koko)
• Ka Maʻi ʻAʻa Coronary (CAD)
• Maʻi diabetes
• Ke koko kiʻekiʻe (Hypertension)
• ʻO ka momona, ka puhipaka, a i ʻole nā ​​mea ʻelua.
• `(Maʻi Moyamoya)` (He maʻi nō hoʻi kēia e pili ana i nā kīʻaha koko e hoʻolako ana i ke koko i ka lolo)
• Inā ua loaʻa iā ʻoe kahi hahau ma mua a i ʻole kahi hoʻouka ischemic transient (TIA) (e like me ka mini-stroke).

He aha nā hōʻailona o ka Ocular Ischemic Syndrome?

ʻAʻole ʻike mau ʻia nā hōʻailona o kēia maʻi. Akā i ka wā e ʻike ʻia ai nā hōʻailona, ​​hoʻokahi wale nō maka e pili pinepine ai . Hoʻopilikia nui kēia maʻi i kou ʻike. E nānā i kēia mau hōʻailona inā loaʻa iā ʻoe kekahi:

• He ʻeha ʻeha a palupalu hoʻi e puka mai ana mai loko mai o ka maka a hele mai a hele aku i kēlā me kēia manawa.
• Loaʻa ka ʻeha o ka maka ke piʻi aʻe ke kaomi o ka maka.
• Nā haumāna i hoʻonui ʻia (pōʻai ʻeleʻele ma waenakonu o ka maka).
• Manaʻo e like me nā kiko ʻeleʻele a i ʻole nā ​​​​lālā e lana ana i mua o nā maka (Eye Floaters).
• Ka nalowale mālie a koke paha o ka ʻike (Low Vision) a i ʻole ka nalowale ʻana o ka ʻike no ka manawa pōkole a laila loaʻa hou iā ia (Transient Vision Loss).
• Ka paʻakikī i ka nānā ʻana i ka mālamalama, ka ʻike maka pōwehiwehi (Photophobia).
• Manaʻo e like me ʻoe e ʻike nei i ʻelua mau mea (Diplopia).

Pehea e hoʻomaopopo pono ai nā kauka i kēia?

Hiki ke like nā hōʻailona o ka Ocular Ischemic Syndrome me nā kūlana ʻē aʻe e like me ka diabetic retinopathy a me ka Central Retinal Vein Occlusion (CRVO). No laila, he mea nui e loaʻa kahi hōʻailona pololei .

Hana nā Ophthalmologists i nā hoʻokolohua aʻe e hōʻoia i kēia maʻi:

• Hoʻokolokolo makaHana ʻia nā hoʻokolohua maka like ʻole e ʻike ai i ke kumu o nā pilikia ʻike. No ka laʻana, kahi hoʻokolohua maka dilated, kahi optical coherence tomography (OCT) scan, kahi electroretinography (kahi hoʻokolohua e ana i ka hana o ka retina), a me nā visual-evoked potentials (kahi hoʻokolohua e ana i ka hana o ka ʻōnaehana nerve e pili ana i ka ʻike).
• ʻO Fluorescein Angiogram : He hoʻāʻo kēia kahi e hoʻokomo ʻia ai kahi waihoʻoluʻu kūikawā i loko o kahi aa koko ma ka lima e nānā i ka lōʻihi o ke kahe ʻana o ke koko i loko o nā kīʻaha koko i loko o ka maka a inā paha e kahe ana ke koko mai nā kīʻaha koko.

Eia kekahi, hiki i kahi cardiologist (he kauka loea i nā maʻi puʻuwai a me nā kīʻaha koko) ke kauoha i nā hoʻokolohua e like me kēia e nānā ai i ka maʻi carotid artery:

• `(Carotid Artery Duplex Vascular Ultrasound)` (He scan o nā kīʻaha koko ma ka ʻāʻī)
• ʻO `(CT Angiogram - CTA)`, `(Carotid Angiogram)` a i ʻole `(Magnetic Resonance Angiogram - MRA)` (he mau ʻano scan kūikawā kēia e nānā ana i ke kūlana o nā kīʻaha koko ma ka ʻāʻī).

He aha nā lāʻau lapaʻau no kēia?

Aia kekahi mau ʻanuʻu pili like i ka mālama ʻana i ka Ocular Ischemic Syndrome. Pono kēia i ke alu like ʻana o nā loea like ʻole.

Ka lāʻau lapaʻau no nā pilikia maka:

• Nā ʻano inikini maka: Nā lāʻau anti-VEGF a i ʻole nā ​​steroid. Kōkua kēia i ka hōʻemi ʻana i ka pehu ʻana ma ka retina.
• Nā kulu maka lāʻau lapaʻau: E hōʻemi i ke kaomi intraocular a me ka mumū.
• He mea pono paha ke hana i ka mālama maka laser e pale ai i ke kaomi maka kiʻekiʻe.

Lapaʻau no ka `(Carotid Artery Disease)`:

• Nā lāʻau hoʻokahe koko, a me nā lāʻau lapaʻau e kāohi i nā kūlana e like me ka maʻi diabetes a me ke koko kiʻekiʻe.
• ʻO Carotid Angioplasty a me Stenting: He kaʻina hana e hoʻopiha ʻia ai kahi kīʻaha koko i paʻa me kahi mea like me ka balloon a hoʻokomo ʻia kahi stent (kahi ʻōmole liʻiliʻi e like me ka mesh) e pale aku ai i ka paʻa hou ʻana.
• Carotid Endarterectomy: He hana ʻoki e wehe i ka palaki i kūkulu ʻia i loko o kahi kīʻaha koko.

He aha nā pilikia e hiki ai i kēia ke hana?

ʻAʻole nā ​​kānaka a pau me ka Ocular Ischemic Syndrome e loaʻa koke nā pilikia ʻike koʻikoʻi. Eia nō naʻe, ma kahi o ka hapalua o ka poʻe me ke ʻano e ʻike i kekahi kekelē o ka nalowale ʻana o ka ʻike i loko o hoʻokahi makahiki . Eia kekahi, ma kahi o ʻehiku o ka ʻumi o ka poʻe e loaʻa i kahi maʻi i kapa ʻia ʻo Neovascular Glaucoma. I ka Neovascular Glaucoma, hana ʻia nā kīʻaha koko hou a ʻano ʻē i loko o ka maka, e ālai ana i ke kahe ʻana o ka wai i loko o ka maka. Hiki i kēia ke hana i ke kaomi maka kiʻekiʻe loa.

He aha ke kūlana olakino o kekahi me ka Ocular Ischemic Syndrome?

ʻO ka ʻoiaʻiʻo, ʻo ke kūlana i kapa ʻia ʻo `(Carotid Artery Disease)` e hoʻoulu ai i ka `(Ocular Ischemic Syndrome)` hiki ke hoʻoweliweli i ke ola . Ma hope o ka ʻike ʻia ʻana me `(Ocular Ischemic Syndrome)`, i loko o ʻelima mau makahikiKokoke i ʻehā o ka ʻumi kānaka e make ana i ka hōʻeha puʻuwai a i ʻole ka hahau. No laila, ʻo ka ʻimi mua ʻana i ke kōkua lapaʻau a me ka hoʻololi ʻana i ke ʻano o ka nohona hiki ke kōkua nui i ka pale ʻana i kou olakino.

Mea nui: ʻAʻole wau e hoʻāʻo nei e hoʻoweliweli iā ʻoe me kēia. Akā, he mea nui loa ia e hoʻomaopopo i ke koʻikoʻi o kēia kūlana a hana i nā hana e pono ai.

Hiki ke pale ʻia ka Ocular Ischemic Syndrome?

ʻAe, aia nā mea hiki iā ʻoe ke hana e hōʻemi i kou pilikia o ka loaʻa ʻana o ka `(Carotid Artery Disease)` a ma o ia mea, `(Ocular Ischemic Syndrome).` Eia kēia mau mea:

• E ʻai i ka meaʻai olakino no ka puʻuwai, e like me ka Mediterranean Diet.
• E ʻimi i nā ala olakino e hoʻokele ai i ke kaumaha.
• E kāohi maikaʻi i ka maʻi diabetes a me ke koko kiʻekiʻe.
• E mālama i kahi kaumaha olakino e kūpono iā ʻoe.
• Inā ʻoe e puhipaka ana, e noi i ke kōkua e haʻalele.
• E noho hana ikaika e like me ka hiki a hoʻoikaika kino.

Āhea wau e ʻike ai i ke kauka?

Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, ​​e ʻike pono i ke kauka:

• ʻEha i nā maka.
• He pilikia kekahi loli o ka ʻike.

Eia kekahi, inā ʻike ʻoe i nā hōʻailona o ka maʻi lolo (e like me ka paʻakikī i ka ʻōlelo ʻana, ka mae ʻana o kekahi ʻaoʻao o ke kino, ke kūlou ʻana o kekahi ʻaoʻao o ka maka), e hele koke i ka haukapila a kāhea aku paha i ka 1990.

He aha kaʻu e nīnau aku ai i kaʻu kauka?

Ke hele ʻoe e ʻike i ke kauka, hiki iā ʻoe ke nīnau i nā nīnau e like me:

• No ke aha lā wau e loaʻa nei i kēia mau hōʻailona?
• He aha nā hoʻokolohua e pono ai iaʻu e hana?
• He aha ka lāʻau lapaʻau maikaʻi loa noʻu?
• He aha kaʻu e hana ai e hoʻomaikaʻi ai i ke olakino o koʻu puʻuwai?
• He aha kaʻu e hana ai e mālama i koʻu ʻike?
• Pono anei au e hopohopo e pili ana i nā pilikia?

He mea hopohopo maoli kekahi ʻano e hoʻopilikia ai i nā maka. Inā loaʻa iā ʻoe ka Ocular Ischemic Syndrome, ʻo nā loli o ka ʻike maka paha ka hōʻailona mua e ālai ʻia ana kou mau kīʻaha koko a ua emi ke kahe ʻana o ke koko i kou poʻo. Hiki i kēia ke hōʻailona o nā ʻano ʻē aʻe, e like me ka Carotid Artery Disease. Hiki i nā ʻano maka ʻē aʻe ke hana i kēia mau hōʻailona.

No laila, he mea nui loa ke ʻike ʻana i kahi kauka maka i loaʻa ka ʻike i ka nānā ʻana a me ka mālama ʻana i kēlā mau maʻi maka kakaikahi . Pono paha ʻoe e ʻike i kahi kauka puʻuwai e mālama i ka "Maʻi Carotid Artery". Hana kēia lāʻau lapaʻau ma ka wehe ʻana i kahi kīʻaha koko i paʻa a hoʻomaikaʻi i ke kahe koko i nā maka. Hiki iā ʻoe ke hana i nā hoʻololi nohona e pale ai i kou puʻuwai a me kou ʻike maka.

ʻO ka mea nui e hoʻomanaʻo (Leka Lawe-Home)

• ʻO ka Ocular Ischemic Syndrome kahi maʻi i hoʻokumu ʻia e ka emi ʻana o ke kahe koko i nā maka, ʻo ke kumu nui ʻo ia ka paʻa ʻana o nā kīʻaha koko ma ka ʻāʻī (Carotid Arteries).
• Inā loaʻa iā ʻoe nā hōʻailona e like me ka emi ʻana o ka ʻike a i ʻole ka ʻeha o ka maka, e ʻimi pono i ke kōkua lapaʻau.
• He hōʻailona paha kēia o ka "Carotid Artery Disease", kahi e hoʻonui ai i ka pilikia o ka hōʻeha puʻuwai a me ka hahau .
• Me ka ʻike mua ʻana, ka mālama kūpono, a me nā hoʻololi ʻana i ke ʻano o ka nohona, hiki ke mālama ʻia ke olakino.
• He mea nui loa ka pale ʻana i ka puhipaka, ʻai i ka meaʻai olakino, hoʻoikaika kino, a kaohi i ka maʻi diabetes a me ke koko kiʻekiʻe.

Inā he mau nīnau hou aku kāu e pili ana i kēia, mai kānalua e kamaʻilio me kāu kauka. Ke makemake nei iā ʻoe e ho'ōla koke!

ʻO ka maʻi Ischemic Ocular, ka emi ʻana o ke kahe koko i nā maka, ka maʻi Carotid Artery, ka emi ʻana o ka ʻike, ka ʻeha o ka maka, ka maʻi Carotid Artery, Atherosclerosis