E noʻonoʻo ʻoe ua nalowale koke ʻoe i kahi ʻike iki ma kekahi maka, a ke manaʻo nei hoʻi ʻoe i ka ʻeha ke neʻe ʻoe i kou maka. Malia paha ʻaʻole ʻoe e ʻike i nā kala e like me ma mua, me he mea lā ua mae iki lākou. He mea maʻamau ke manaʻo iki i ka makaʻu ke hana ʻia kekahi mea e like me kēia. ʻO kēia nā hōʻailona nui o kahi maʻi i kapa ʻia ʻo Optic Neuritis a mākou e kamaʻilio nei i kēia lā. ʻOiai ʻaʻole kēia i kūkākūkā pinepine ʻia, he mea nui loa ia iā kākou āpau e makaʻala iā ia no ka mea e hoʻopilikia ia i ko kākou ʻike maka.
I ka ʻōlelo maʻalahi, he aha ka Optic Neuritis?
ʻO ka Optic Neuritis (ON) kahi maʻi neurological . Hoʻokumu ʻia ia e ka mumū o ke aʻalolo optic , ke aʻalolo e hoʻopili ai i ko mākou mau maka i ko mākou lolo. E noʻonoʻo i ke aʻalolo optic e like me kahi 'uea' e lawe ana i nā leka mai ko mākou mau maka i ko mākou lolo. ʻO kēia 'uea' ka mea e hoʻouna i ka ʻike a mākou e ʻike ai i ko mākou lolo, e haʻi ana iā mākou, "Auē, he mea kupaianaha kēia."
He uhi momona ko kēia mau ʻaʻalolo a puni lākou. Ua like ia me ka uea me ka insulation a puni. Kāhea mākou i kēia ʻo ka myelin sheath. Ke loaʻa ka Optic Neuritis, ua hōʻino ʻia kēia myelin sheath pale. A laila ʻaʻole hele pono nā leka e hele ana ma o kēlā uea. Huikau nā leka. ʻO ia ke kumu e hoʻoulu ai kēia maʻi i ka nalowale o ka ʻike , ka ʻeha, a me nā pilikia ʻike ʻē aʻe.
He aha nā ʻano nui o ka optic neuritis?
Hiki ke hoʻokaʻawale ʻia kēia kūlana i ʻekolu ʻano nui. He ʻokoʻa iki kēlā me kēia ʻano. E nānā kākou i ke ʻano o lākou.
| ʻAno | Wehewehena |
|---|---|
| Maʻamau | ʻO kēia ke ʻano maʻamau. Hoʻopilikia pinepine ia i hoʻokahi maka wale nō. ʻOiai me ka ʻole o ka lāʻau lapaʻau, hoʻōla ka hapa nui o ka poʻe i loko o kekahi mau lā. Eia nō naʻe, paipai maoli nā kauka i ka lāʻau lapaʻau no kēia no nā kumu ʻē aʻe. |
| ʻAʻole maʻamau | Hoʻopilikia pinepine kēia ʻano i nā maka ʻelua. ʻAʻole hoʻi e ho'ōla koke. Ua ʻike ʻia e ka noiʻi e pili ana paha kēia ʻano me nā maʻi neurological paʻakikī ʻē aʻe. |
| Pediatric (ʻano i loaʻa i nā keiki liʻiliʻi) | ʻO kēia ke ʻano o ka Optic Neuritis e loaʻa ana i nā keiki ʻōpio. ʻOiai he like kona me nā ʻano ʻelua ʻē aʻe, aia kekahi mau ʻokoʻa koʻikoʻi. Akā ʻo ka nūhou maikaʻi, ʻoi aku ka nui o ka hiki ke ho'ōla piha ʻia kēia ʻano. |
He aha nā hōʻailona o kēia maʻi?
ʻO nā hōʻailona o ka Optic Neuritis e pili kokoke ana i ko mākou mau maka a me ka ʻike. ʻO ka hapa nui o ka manawa, ua hana ʻia kēia mau hōʻailona e ka hōʻino ʻia ʻana o ke aʻalolo ma hope o ka maka (`retrobulbar`). E nānā kākou i nā hōʻailona nui.
| Hōʻailona | He Wehewehe Maʻalahi |
|---|---|
| ʻEha maka | ʻO kēia ka hōʻailona nui. ʻOi aku ma mua o 90% o ka poʻe e ʻike i kēia ʻeha. Hoʻonui ka ʻeha ke neʻe nei i nā maka . Eia nō naʻe, i kekahi mau ʻano atypical, hiki ke nalo loa ka ʻeha. |
| Ua emi ka ʻike maka | ʻO ke ʻano kēia, ʻike ʻoe i nā mea he pōwehiwehi a maopopo ʻole. I ka pololei, ua emi kou ʻike maka. Hiki ke koʻikoʻi loa kēia i nā keiki ʻōpio. |
| Ka nalowale ʻana o kahi ʻāpana o ka laulā ʻike maka | ʻO kēia ka manawa e nalowale ai kahi hakahaka a i ʻole kekahi ʻāpana o kāu kahua ʻike. I ka Optic Neuritis, ʻike pinepine ʻia kēia hakahaka ma ke kikowaena o kāu ʻike. |
| Makapō kala (Dyschromatopsia) | He mea kēia e hana ʻia ana i nā poʻe he nui. ʻAʻole ʻike ʻia nā kala e like me ka mea e pono ai. Me he mea lā ua mae a palalulu lākou. Hiki ke paʻakikī loa ka hoʻokaʻawale ʻana i ke kala ʻulaʻula . |
He aha ke kumu o ka optic neuritis?
Ua ʻike mākou i kēia manawa ua hoʻokumu ʻia ka Optic Neuritis e ka mumū o ke aʻalolo optic. No laila aia kekahi mau kumu hiki ke kumu o kēia mumū .
Nā kūlana Autoimmune a me ka mumū
ʻO kēia ka mea a nā kānaka noiʻi e manaʻo nei ke kumu nui. ʻO kahi maʻi autoimmune ke hoʻouka hewa ka ʻōnaehana pale o ko mākou kino, ʻo ia hoʻi ka ʻōnaehana pale , i kā mākou mau hunaola maikaʻi ponoʻī.
- ʻO ka Neuritis Optic Maʻamau: Hoʻopili pinepine ʻia kēia ʻano me kahi maʻi i kapa ʻia ʻo Multiple Sclerosis (MS) . ʻO ka ʻoiaʻiʻo, ua ʻike mua ʻia ka nui o ka poʻe me MS ke loaʻa iā lākou ka Optic Neuritis. Ua ʻike ʻia ma kahi o 50% o ka poʻe e loaʻa ana ka Optic Neuritis e loaʻa iā MS i loko o 15 mau makahiki.
- ʻO ka Neuritis Optic Atypical: Pili kēia ʻano me nā maʻi autoimmune ʻē aʻe e like me Neuromyelitis Optica (NMO) a me ka maʻi pili i ka MOG-antibody (MOGAD) .
Nā maʻi
Hiki i nā maʻi like ʻole ke hōʻino i nā aʻalolo. Pēlā nō hoʻi no ke aʻalolo optic. ʻOi aku ka nui o nā maʻi e hoʻoulu ai i ka Optic Neuritis i nā keiki ʻōpio.
- Nā maʻi viral: Nā maʻi e like me ka chickenpox, herpes, cytomegalovirus, HIV, nā maʻi i lawe ʻia e ka namu, a me ka measles.
- Nā maʻi bacteria: Ka maʻi ʻōniʻoniʻo pōpoki, ka maʻi Lyme, ka maʻi puʻupuʻu, a me ka syphilis.
- Nā maʻi fungal: Nā maʻi fungal e like me Cryptococcosis a me Candidiasis.
- Nā maʻi Parasitic: ʻO Toxoplasmosis, i hoʻouna ʻia mai nā pōpoki, a me Toxocariasis, i hoʻouna ʻia mai nā ʻīlio.
ʻO kekahi mau lāʻau lapaʻau a me nā mea ʻawahia
Hiki i kekahi mau lāʻau lapaʻau a me nā mea ʻawahia ʻē aʻe a mākou e lawe ai ke hana i kēia.
- Nā lāʻau lapaʻau i hāʻawi ʻia no kekahi mau maʻi (e like me ka ethambutol).
- Nā lāʻau lapaʻau no ka puʻuwai (e.g. amiodarone).
- Nā lāʻau lapaʻau no ka malaria (e like me chloroquine, hydroxychloroquine).
- Nā lāʻau lapaʻau anticancer.
- Nā huahana paka a me ka nikotine.
- ʻAila a me ka methanol.
Nā kumu ʻē aʻe
- Hoʻemi ʻia ke koko (ischemia):Inā ʻaʻole loaʻa i ke aʻalolo optic ka nui o ke koko e pono ai, hiki ke hōʻino ʻia nā hunaola aʻalolo.
- Nā hemahema o ka wikamina: ʻO ka hemahema o ka wikamina B12 ma ke ʻano kūikawā hiki ke hōʻeha nui a mau loa i nā aʻalolo.
- ʻO ke kaomi ʻana o ke aʻalolo: ʻO ke kaomi ʻana o ke aʻalolo optic ma muli o kahi puʻupuʻu lolo a i ʻole kekahi kumu ʻē aʻe.
- Maʻi diabetes (maʻi diabetes ʻano 2): Inā ʻaʻole i kaohi ʻia ka maʻi diabetes, kiʻekiʻe ka pilikia o ka hōʻino ʻia ʻana o nā aʻalolo ma muli o ke kiʻekiʻe o ke kō koko.
ʻO wai ka mea i ʻoi aku ka pilikia o ka loaʻa ʻana o kēia maʻi?
Hiki i kekahi mau kumu ke hoʻonui i ka pilikia o ka hoʻomohala ʻana i ka Optic Neuritis.
- Kāne: ʻOi aku ka nui o ke ʻano maʻamau e ulu i nā wahine ma mua o nā kāne, ʻoiai ʻoi aku ka nui o ke ʻano atypical i nā kāne.
- Makahiki: ʻO ke ʻano maʻamau ka mea maʻamau i nā poʻe ma waena o 20 a me 40 mau makahiki. ʻO ke ʻano atypical ka mea maʻamau i nā poʻe ma lalo o 18 mau makahiki a ʻoi aku paha ma mua o 50 mau makahiki.
- Lāhui: ʻOi aku ka nui o ka pilikia o ka poʻe keʻokeʻo i ka loaʻa ʻana o kēia maʻi.
- Kahi: ʻO ka poʻe e noho ana ma nā ʻāina anuanu, mamao loa mai ka equator, he kiʻekiʻe iki ka pilikia o ka loaʻa ʻana o ka optic neuritis e pili ana i ka MS. Ua manaʻo ʻia ua hoʻopili ʻia kēia e ka lā a me nā pae wikamina D.
- Loaʻa nā maʻi autoimmune ʻē aʻe: ʻOi aku ka nui o ka pilikia o ka poʻe me nā maʻi e like me lupus a me sarcoidosis.
Pehea e ʻike pono ai ke kauka i kēia maʻi?
Inā loaʻa iā ʻoe kēia mau hōʻailona, pono ʻoe e ʻike mua i kahi loea mālama maka. E nīnau ʻo ia iā ʻoe e pili ana i kāu mau hōʻailona a me kou mōʻaukala olakino. A laila, e hana lākou i kahi hoʻokolokolo maka piha.
E hoʻomanaʻo, mai hoʻowahāwahā i kahi loli i kou ʻike, ʻoiai inā hele pū me ka ʻeha. E ʻike i ke kauka i ka hikiwawe loa.
Hiki i ke kaʻina hana hoʻāʻo ke komo pū me:
- Ke nānā ʻana i ka ʻike maka.
- Ka hoʻāʻo ʻana i ke kahua ʻike.
- Ke hoʻāʻo nei pehea e ʻike ʻia ai nā kala.
- Ke nānā nei i nā reflexes haumāna.
Ma hope o kēia mau hoʻokolohua, inā manaʻo ke kauka he Optic Neuritis kēia, e kuhikuhi ʻo ia iā ʻoe no nā hoʻokolohua hou aku. I waena o lākou, he mea nui loa ka MRI scan .
Hiki i kahi scan MRI ke hōʻike maopopo inā he mumū o ke aʻalolo optic. Hiki iā ia ke nānā i nā loli i loko o ka lolo ('nā lesions o ka lolo') inā he kānalua ua hana ʻia kēia e MS.
Eia kekahi, hiki ke hana ʻia nā hoʻāʻo koko a me nā hoʻāʻo mimi e nānā i ka maʻi a i ʻole nā antibodies i nā maʻi e like me NMO a i ʻole MOGAD. I kekahi manawa hiki ke hana ʻia kahi lumbar puncture.
He aha nā lāʻau lapaʻau no kēia?
ʻElua mau ala nui e mālama ai i ka optic neuritis.
1. Nā Steroid e hōʻemi i ka mumū: Hāʻawi pinepine ʻia nā Steroid ma ke ʻano intravenous (IV) no 3-5 mau lā ma nā nui kiʻekiʻe. Hiki i kēia ke hōʻemi koke i ka pehu a me ka mumū i loko o ke aʻalolo, hōʻemi i ka ʻeha, a kōkua i ka hoʻihoʻi ʻana i ka ʻike. A laila, hāʻawi paha kāu kauka iā ʻoe i nā steroid ma ke ʻano o nā pila e lawe ai no kahi manawa pōkole. He mea nui e lawe i kēia mau lāʻau lapaʻau e like me ka mea a kāu kauka e ʻōlelo ai iā ʻoe.
2. Ke mālama ʻana i ke kumu kumu: Inā he maʻi ia, e hāʻawi ʻia nā antibiotics. Inā he maʻi autoimmune ia e like me NMO a i ʻole MOGAD, pono paha ʻoe e hana i nā lāʻau lapaʻau kikoʻī e like me ka plasma exchange (PLEX).
Na kāu kauka e hoʻoholo i ka lāʻau lapaʻau maikaʻi loa no kou kūlana.
Pehea ka lōʻihi o kēia kūlana? E hoʻi hou mai anei koʻu ʻike?
Hoʻololi kēia ma muli o ke ʻano o ka maʻi, ke ʻano o ka lāʻau āu e loaʻa ai, a pehea e pane ai kou kino iā ia.
- ʻO ka Neuritis Optic Maʻamau: He pilikia pōkole kēia. Nalo ka ʻeha i loko o kekahi mau lā. Hiki ke hala i ʻelua pule a ʻekolu mahina no ka hoʻi hou ʻana o ka ʻike i ka maʻamau. Ma kahi o 90% o nā hihia, hoʻi ka ʻike i ka maʻamau a kokoke paha i ka maʻamau i loko o hoʻokahi makahiki.
- ʻO ka Neuritis Optic Atypical: He ʻoi aku ka koʻikoʻi o kēia. Hiki ke lōʻihi nā hōʻailona. ʻAʻole paha e hoʻōla piha ka ʻike. No laila, he mea nui loa ka ʻike ʻana i kēia ʻano i ka wā mua a hoʻomaka i ka lāʻau lapaʻau.
- Pediatric: ʻOi aku ka maikaʻi o ka manawa e ho'ōla ai nā keiki ma mua o nā pākeke. He kākaʻikahi nā hopena lōʻihi. Eia nō naʻe, inā loaʻa i kahi keiki kēia, hiki ke lilo i hōʻailona mua o MS, no laila makaʻala nā kauka iā ia.
He aha ka mea e hana ai i ka wā pilikia?
Inā nalowale koke kou ʻike maka , he pilikia olakino ia. Pono ʻoe e hele koke i ka haukapila kokoke loa i ka Emergency Department (ETU) . Eia kekahi, inā he mau loli i kou ʻike maka, ʻeha, a i ʻole ka pohihihi ʻana, mai hoʻowahāwahā iā ia a e ʻike koke i ke kauka. ʻO ka wikiwiki o kou hoʻomaka ʻana i ka lāʻau lapaʻau, ʻoi aku ka maikaʻi o kou manawa e hoʻopakele ai i kou mau maka.
Leka Lawe-Home
- ʻO ka ʻeha i ka neʻe ʻana o nā maka a me ka ʻike pohihihi a emi paha ka ʻike ʻana nā hōʻailona nui o ka Optic Neuritis.
- Mai hoʻowahāwahā i kēia mau hōʻailona. E ʻike koke i kahi kauka maka. Inā nalowale koke kou ʻike, e hele koke i ka ETU o ka haukapila.
- ʻO ka optic neuritis paha ka hōʻailona mua o nā maʻi koʻikoʻi ʻē aʻe, e like me ka multiple sclerosis (MS), no laila he mea nui loa ka loaʻa ʻana o kahi maʻi pololei.
- Aia nā lāʻau lapaʻau kūpono no kēia. ʻO ka wikiwiki o ka hoʻomaka ʻana o ka lāʻau lapaʻau, ʻoi aku ka maikaʻi o ka manawa e hoʻōla ai ka maka.
- E hahai pono i nā ʻōlelo a kāu kauka. E lawe i ka lāʻau lapaʻau ma ka nui i kuhikuhi ʻia a me ka manawa i kuhikuhi ʻia.
ʻO ka neuritis optic, ʻeha maka, nalowale o ka ʻike, MS, sclerosis maha, maʻi neurological
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