Neuritis Optic

Ko te neuritis optic te mate e puta mai ana i te pupuhi (te mumura) e whakaraha ana i te tūtae kanohi—he kohinga muka tūtae e kawe ana i ngā korero tirohanga mai i tō kanohi ki tō roro. Ko ngā tohu noa o te neuritis optic ko te mamae i te nekehanga o te kanohi, me te ngaro o te tirohanga mo te wā poto i tetahi kanohi.

Ko te neuritis optic te nuinga o te wā ka pā ki tetahi kanohi. Āe pea ngā tohu:

• Te mamae. Ko te nuinga o te hunga e whānau mai ana te neuritis optic he mamae kanohi kei te kino ake te nekehanga o te kanohi. I etahi wā, ka rite te mamae ki te mamae ngawari i muri i te kanohi.
• Te ngaro o te tirohanga i tetahi kanohi. Ko te nuinga o te hunga he iti rawa te hekenga o te tirohanga, engari he rerekē te nui o te ngaro. Ko te ngaro o te tirohanga e kitea ana te nuinga o te wā ka whānau mai i roto i ngā haora, i ngā rā rānei, ā, ka pai ake i roto i ngā wiki, i ngā marama rānei. Ko te ngaro o te tirohanga he mau tonu ki ētahi tangata.
• Te ngaro o te mara tirohanga. Ka taea te ngaro o te tirohanga taha i roto i tetahi tauira, pēnei i te ngaro o te tirohanga pokapū, te ngaro rānei o te tirohanga taha.
• Te ngaro o te tae o te tirohanga. Ko te neuritis optic te nuinga o te wā ka pā ki te kite tae. Āe pea ka kite koe kua iti ake te mārama o ngā tae i te mea noa.
• Ngā rama e whiti ana. Ko ētahi o te hunga he neuritis optic te pūrongo e kite ana i ngā rama e whiti ana, e wiri ana rānei me ngā nekehanga o te kanohi.

Ko ngā āhuatanga o te kanohi ka tino kino. Ka taea e ētahi te arahi ki te ngaro o te tirohanga mō ake tonu atu, ā, ka hono atu ētahi ki ētahi atu raruraru hauora kino. Whakapa atu ki tō tākuta mēnā:

• Ka puta mai ngā tohu hou ki a koe, pēnei i te mamae o te kanohi, i te rerekētanga rānei o tō tirohanga.
• Ka kaha ake ngā tohu kāore rānei e pai ake te rongoā.
• Kei a koe ngā tohu tino pēnei, tae atu ki te ngaro o te tirohanga i ngā kanohi e rua, te tirohanga takirua, me te kore o te pūngāwerewere, te ngoikore rānei o tetahi wahi, tetahi atu wahi rānei o ngā waewae, e taea ai te tohu i te mate o te pūnaha io.

Kaore i te mohiotia te take tino o te neuritis optic. E whakaponohia ana ka whanake mena ka whai whakaaro he te pūnaha ārai mate ki te mea e hipoki ana i tōu tūpuna tirohanga, ka puta ai te mumura me te pakaru o te myelin.

I te nuinga, ka āwhina te myelin i ngā whakaohooho hiko kia tere te haere mai i te kanohi ki te roro, kei reira ka hurihia hei korero tirohanga. Ka whakaroa te neuritis optic i tenei tukanga, ka pā ki te tirohanga.

Ko ēnei āhuatanga autoimmune e whai hononga pinepine ana ki te neuritis optic:

• Te mate maha sclerosis. He mate te mate maha sclerosis i te wa e whakaeke ana tō pūnaha ārai mate i te kakahu myelin e hipoki ana i ngā muka io i roto i tō roro. I roto i te hunga e whai neuritis optic ana, ko te tūponotanga o te whanaketanga o te mate maha sclerosis i muri i tetahi wāhanga o te neuritis optic ko te 50% pea i roto i te oranga.

  Ka nui ake tō tūponotanga ki te whanake i te mate maha sclerosis i muri i te neuritis optic ki te whakaatu mai he whara i runga i tō roro te whakaahua whakaata pūmanawa (MRI).

• Neuromyelitis optica. I roto i tēnei āhuatanga, ka pā te mumura ki te tūpuna tirohanga me te taura tuaiwi. He rite te neuromyelitis optica ki te mate maha sclerosis, engari kaore te neuromyelitis optica e pā te kino ki ngā io i roto i te roro i te maha o te mate maha sclerosis. Engari, he nui ake te kino o te neuromyelitis optica i te MS, ka puta pinepine he iti ake te ora i muri i te whakaeke i te whakataurite ki te MS.

• Te mate antibodi glycoprotein oligodendrocyte myelin (MOG). Ka taea e tēnei āhuatanga te whakaeke i te mumura ki te tūpuna tirohanga, te taura tuaiwi, te roro rānei. He rite ki te MS me te neuromyelitis optica, ka taea te puta mai ngā whakaeke mumura. Ko te ora mai i ngā whakaeke glycoprotein oligodendrocyte myelin (MOG) he pai ake i te ora mai i te neuromyelitis optica.

Ina uaua ake ngā tohu o te neuritis optic, me whakaaro ki ētahi atu take e hono ana, tae atu ki:

• Ngā mate huaketo. Ka taea e ngā mate huaketo pēpeha, tae atu ki te mate Lyme, te kirika ngeru, me te syphilis, te huaketo rānei, pēnei i te measles, te mumps me te herpes, te whakaeke i te neuritis optic.
• Ētahi atu mate. Ka taea e ngā mate pēnei i te sarcoidosis, te mate Behcet me te lupus te whakaeke i te neuritis optic.
• Ngā rongoā me ngā poizon. Kua honoa etahi rongoā me ngā poizon ki te whanaketanga o te neuritis optic. Ko te ethambutol, e whakamahia ana hei whakaora i te mate pukupuku, me te methanol, he kai nui i roto i te antifreeze, ngā peita me ngā kaiwhakawehe, e hono ana ki te neuritis optic.

Ngā take morearea mō te whanaketanga o te neuritis optic:

• Tau. Ko te nuinga o te wā ka pā te neuritis optic ki ngā tāngata pakeke i waenganui i te 20 me te 40 tau.
• Ira tangata. He nui atu te tūponotanga o ngā wāhine ki te whanake i te neuritis optic i te hunga tāne.
• Iwi. Ka puta ake te neuritis optic i ngā Pākehā.
• Ngā rerekētanga irahiko. Pea ka piki ake te tūponotanga o te whanaketanga o te neuritis optic, te mate moutere rānei, nā ētahi rerekētanga irahiko.

Ko ngā raruraru e puta mai ana i te neuritis optic pea ka uru ki:

• Te whara o te tūtae kanohi. Ko te nuinga o te iwi he whara tūturu o te tūtae kanohi i muri i tetahi wāhanga o te neuritis optic, engari pea kore e puta he tohu tūturu.
• Te heke o te mārama o te tirohanga. Ko te nuinga o te iwi ka ora anō te tirohanga noa, te tata noa rānei i roto i ngā marama tokomaha, engari pea ka mau tonu te ngaro wāhanga o te whakamārama tae. Ki ētahi, ka mau tonu te ngaro o te tirohanga.
• Ngā pānga o te maimoatanga. Ko ngā rongoā steroid e whakamahia ana hei whakaora i te neuritis optic ka whakaiti i tō pūnaha mate pukupuku, ā, ka nui ake te mate o tō tinana ki ngā mate. Ko ētahi atu pānga ko ngā huringa ngākau me te piki o te taumaha.

Kaore he uauatanga

He pūmau koe ki te kite i tetahi tohunga kanohi mō te whakatau, ā, ko te nuinga o te wā ka whakawhirinaki ki tō hītori hauora me te whakamātautau. He pūmau te tohunga kanohi ki te mahi i ngā whakamātautau kanohi e whai ake nei:

Ngā whakamātautau anō hei whakatau i te neuritis optic pea:

Whakaahua ā-mahi (MRI). Ka whakamahi te tātaritanga whakaahua ā-mahi (MRI) i tētahi mara mahi me ngā pūkaha o te kaha ngaru reo hei hanga i ngā whakaahua o tō tinana. I te wā o te MRI hei tirotiro i te neuritis optic, pea ka whiwhi koe i te whakakī atu o te otinga whakakāhua hei whakaputa i te uaua optic me ētahi atu wāhanga o tō roro kia kitea ake i runga i ngā whakaahua.

He mea nui te MRI hei whakatau mena kei reira ngā wāhi pakaru (lesions) i roto i tō roro. Ka tohu ēnei lesions i te tūponotanga nui o te whanake i te multiple sclerosis. Ka taea hoki e te MRI te whakakore i ētahi atu take o te ngaro o te tirohanga, pēnei i te mate pukupuku.

He pūmau tō tākuta ki te tono kia hoki mai koe mō ngā whakamātautau whai muri i te rua ki te whā wiki i muri i te tīmatanga o ō tohu hei whakau i te whakatau o te neuritis optic.

• Te whakamātautau kanohi noa. Ka tirotirohia e tō tākuta kanohi tō tirohanga me tō kaha ki te kite i ngā tae me te ine i tō tirohanga taha (peripheral).

• Ophthalmoscopy. I tēnei whakamātautau, ka whakamahia e tō tākuta tētahi rama mārama ki roto ki tō kanohi ka tirotiro i ngā hanganga kei muri o tō kanohi. Ka aromatawaihia e tēnei whakamātautau kanohi te kōpae optic, te wāhi e tomo atu ai te uaua optic ki te retina i roto i tō kanohi. Ka pupū te kōpae optic i te tata ki te toru o ngā tāngata e pangia ana e te neuritis optic.

• Te whakamātautau whakautu mārama pupillary. Pea ka nekehia e tō tākuta tētahi rama rama ki mua i ō kanohi hei kite i te āhua o te whakautu a ō ngākau ina whakaaturia ki te mārama. Mēnā kei a koe te neuritis optic, kāore ō ngākau e pēhi pēnei i ngā ngākau i roto i ngā kanohi hauora ina whakaaturia ki te mārama.

• Whakaahua ā-mahi (MRI). Ka whakamahi te tātaritanga whakaahua ā-mahi (MRI) i tētahi mara mahi me ngā pūkaha o te kaha ngaru reo hei hanga i ngā whakaahua o tō tinana. I te wā o te MRI hei tirotiro i te neuritis optic, pea ka whiwhi koe i te whakakī atu o te otinga whakakāhua hei whakaputa i te uaua optic me ētahi atu wāhanga o tō roro kia kitea ake i runga i ngā whakaahua.

  He mea nui te MRI hei whakatau mena kei reira ngā wāhi pakaru (lesions) i roto i tō roro. Ka tohu ēnei lesions i te tūponotanga nui o te whanake i te multiple sclerosis. Ka taea hoki e te MRI te whakakore i ētahi atu take o te ngaro o te tirohanga, pēnei i te mate pukupuku.

• Ngā whakamātautau toto. Kei te wātea tētahi whakamātautau toto hei tirotiro i ngā mate huaketo, i ngā antibodies motuhake rānei. Ka hono te neuromyelitis optica ki tētahi antibody e pā ana ki te neuritis optic kino. Pea ka tukuna ngā tāngata e pangia ana e te neuritis optic kino ki tēnei whakamātautau hei whakatau mena he pūmau te whanake i te neuromyelitis optica. Mō ngā take koretake o te neuritis optic, pea ka whakamātautauhia hoki te toto mō ngā antibodies MOG.

• Optical coherence tomography (OCT). Ka ine tenei whakamātautau i te mātotoru o te paparanga uaua nerve retina o te kanohi, e iti ake te mātotoru i te neuritis optic.

• Te whakamātautau mara tirohanga. Ka ine tenei whakamātautau i te tirohanga taha o ia kanohi hei whakatau mena kei reira tetahi ngaro o te tirohanga. Ka taea e te neuritis optic te whakaputa i tetahi tauira o te ngaro o te mara tirohanga.

• Te whakautu whakaohooho tirohanga. I tēnei whakamātautau, ka noho koe ki mua i tētahi mata e whakaaturia ana tētahi tauira checkerboard whakawhitiwhiti. Ka honoa ki tō ulu ngā wāea me ngā papatahi iti hei tuhi i ngā whakautu a tō roro ki te mea e kite ana koe i runga i te mata. Ka korerohia e tēnei momo whakamātautau ki tō tākuta mena he iti ake te tere o ngā tohu hiko ki tō roro i te noa hei hua o te pakaru o te uaua optic.

Ko te nuinga o te wa ka pai ake te neuritis optic i a ia ano. I etahi wa, ka whakamahia nga rongoa steroid hei whakaiti i te mumura i te ngongo optic. Ko nga paanga kino pea mai i te maimoatanga steroid ko te piki o te taumaha, te huringa o te ngakau, te whero o te mata, te raru o te kopu me te moe kore.

Ka tukuna te maimoatanga steroid ma te uaua (intravenously). Ka tere ake te ora o te tirohanga ma te rongoa steroid intravenous, engari kaore e kitea he awe ki te nui o te tirohanga ka ora koe mo te neuritis optic noa.

Ina kore e angitu te rongoa steroid, a kei te mau tonu te ngaro o te tirohanga nui, tera pea ka awhina te maimoatanga e kiia nei ko te maimoatanga whakawhiti plasma i etahi tangata ki te ora o ratou tirohanga. Kaore ano kia whakaukia e nga rangahau he pai te maimoatanga whakawhiti plasma mo te neuritis optic.

Ki te mate koe i te neuritis optic, a he rua neke atu ranei nga lesions o te roro e kitea ana i runga i nga whakaahua MRI, tera pea ka pai koe ki nga rongoa multiple sclerosis, penei i te interferon beta-1a, te interferon beta-1b ranei, ka taea te whakaroa, te awhina ranei i te aukati i te multiple sclerosis (MS). Ka whakamahia enei rongoa whakauru mo nga tangata kei te nui te morearea o te whanake MS. Ko nga paanga kino pea ko te pouri, te mamae i te waahi whakauru me nga tohu rite ki te mate huaketo.

Ko te nuinga o te iwi ka ora tata ki te tirohanga noa i roto i nga marama ono i muri i tetahi wa o te neuritis optic.

Ko te hunga e hoki mai ana to ratou neuritis optic he nui ake te morearea o te whanake MS, neuromyelitis optica, te mate ranei e hono ana ki te antibody myelin oligodendrocyte glycoprotein (MOG). Ka taea te hoki mai te neuritis optic ki nga tangata kaore he mate o raro, a ko aua tangata te nuinga he pai ake te poroporoaki mo te wa roa mo to ratou tirohanga i era tangata e mate ana i te MS, neuromyelitis optica ranei.

Kaore he uauatanga