Whakaheke Macular Makariri

Ka puta te whatū o te rōrehu macular, ka ngaro te tirohanga mā, noa (maui) ka pupū. Ki te whanake o te rōrehu macular, ka puta he waahi matapo i waenganui o te mara tirohanga (matau).

Ko te rōrehu macular makuku he āhuatanga o te kanohi e pā ana ki te tirohanga mōrearea, kua iti rānei te tirohanga waenganui. Ko tētahi momo rōrehu macular e pā ana ki te pakeke, kei hea ngā oko toto e tukutaku ana i te wai, i te toto rānei ki tētahi wāhanga o te retina e kiia nei ko te macula (MAK-u-luh). Ko te macula te kawenga mō te tirohanga waenganui.

Ko te rōrehu macular makuku tētahi o ngā momo rōrehu macular e rua e pā ana ki te pakeke. Ko tetahi atu momo, ko te rōrehu macular maroke, he maha ake, he iti ake te kino. Ka tīmata tonu te momo makuku hei momo maroke.

Ka āwhina pea te kite wawe me te whakaora i te rōrehu macular makuku ki te whakaiti i te ngaro o te tirohanga. I ētahi wā, ka taea e te whakaora wawe te whakaora i te tirohanga.

Ko ngā tohu o te whakaheke macular makuku e puta pūmau ana, ā, ka kino haere hāere. Ā, e āhei ana te whai: Te whakapōrehuretanga o te tirohanga, pēnei i ngā raina tika e āta kīhai i te tika. Te whakaiti i te tirohanga pokapū i tetahi kanohi, i ngā kanohi rānei e rua. Te hiahia kia mārama ake te rāpoi ina pānui ana, i te mahi tata rānei. Te raruraru ki te whakarite ki ngā taumata mārama iti, pēnei i te tomo atu ki tētahi wharekai, i tētahi whare tapere rānei e pouri ana. Te piki o te mōrehuretanga o ngā kupu tā. Te raruraru ki te whakakite i ngā mata. Tetahi waahi mōrehu, tetahi waahi matapo rānei i roto i te mara tirohanga. Kāo reira te whakaheke macular e pā ana ki te tirohanga taha, no reira kāo reira e āhei ai te matapo katoa. Tirohia tō kaimahi tiaki kanohi mēnā: Ka kite koe i ngā huringa i roto i tō tirohanga pokapū. Ka ngaro i a koe te kaha ki te kite i ngā kōrero ataahua. E āhei ana ēnei huringa hei tohu tuatahi o te whakaheke macular, inā koa kei runga ake i te 60 ō tau.

Tirohia tō kaimahi tiaki kanohi mena:

• Ka kite koe i ngā huringa i tō tirohanga pūtake.
• Ka ngaro tou kaha ki te kite i ngā kōrero ataahua.

Ko ēnei huringa pea te tohu tuatahi o te whakaheke o te macular, ina koa ki te pakeke ake koe i te 60 tau.

Ko te mākula kei muri o te kanohi, kei waenganui o te retina. Ka taea e te mākula hauora te kite mārama o waenganui. He nui te maha o ngā pūtau whakaiti marama e kiia nei ko ngā kōnū me ngā rakau kei roto i te mākula. Ka hoatu e ngā kōnū te tae o te kanohi, ā, ka taea e ngā rakau te kite i ngā atarangi o te hina.

Kāhore tetahi e mōhio ki te take pono o te whakaheke macular makuku, engari ka whanake i roto i te hunga he whakaheke macular maroke. I roto i te katoa o te hunga he whakaheke macular e pā ana ki te pakeke, tata ki te 20% o rātou kei a rātou te ahua makuku.

Ka taea te whanake o te whakaheke macular makuku i roto i ngā huarahi rerekē:

• Te ngaro o te tirohanga i puta mai i te tipu o ngā oko toto koretake. I etahi wā, ka tipu mai ngā oko toto hou i te choroid i raro, ā, ki roto i te mākula. Kāhore tēnei tipu e noa, ā, ki te pēnei, ka kiia ko te choroidal neovascularization. Ko te choroid te paparanga o ngā oko toto kei waenganui i te retina me te kakahu o waho, o te kanohi, e kiia nei ko te sclera. Ka taea e ēnei oko toto te rere wai, te toto rānei, ka pā ki te mahi o te retina, ka arahi ki te ngaro o te tirohanga.
• Te ngaro o te tirohanga i puta mai i te kohinga o te wai kei muri o te kanohi. Ki te rere te wai i te choroid, ka taea te kohikohi i waenganui i te paparanga pūtau angiangi e kiia nei ko te retinal pigment epithelium me te retina, i roto rānei i ngā paparanga o te retina. Ka taea e tēnei te whakaputa i ngā koretake i ngā paparanga mākula, ka hua ki te ngaro o te tirohanga, te whakapōrōrangi rānei.

Ngā take ka piki ake pea te tūponotanga o te whakaheke o te macular e whai ake nei:

• Tau. Ko te mate nei te nuinga o te hunga 50 tau neke atu.
• Hītori whānau me ngā irahiko. He āhuatanga tuku iho tēnei mate, arā, ka taea te rere i roto i ngā whānau. Kua kitea e ngā kairangahau etahi irahiko e hono ana ki te āhuatanga.
• Iwi. Ko te whakaheke o te macular he mea noa ake i ngā Pākehā.
• Te whakakī. Ko te whakakī i ngā hikareti, te whakamahinga ranei i te paowa tapeka i ia rā, ka piki ake te tūponotanga o te whakaheke o te macular.
• Te momona. E kī ana te rangahau ka piki pea te tūponotanga o te whakaheke o te macular i te tīmatanga, te wā waenga rānei, kia puta ki tetahi āhua kino ake o te mate.
• Te mate ngākau whatumanawa. Ki te pēhea te mate o tō ngākau me ō oko toto, ka piki pea te tūponotanga o te whakaheke o te macular.

Ko te hunga kua tupu to ratou mate macular maroke ki te ngaro o te tirohanga waenganui he nui ake te tūponotanga o te pouri me te motu hapori. Ki te ngaro rawa o te tirohanga, ka taea e te tangata te kite i ngā whakairoiro e kore e tū. E mohiotia ana tenei āhuatanga ko te mate Charles Bonnet.

He mea nui te whakamātautau kanohi ā-rōpū hei kimi i ngā tohu o te whakaheke o te macular i te wā tīmata. Ka āhei pea enei tikanga e whai ake nei ki te whakaiti i te tūponotanga o te whanake i te whakaheke macular makuku:

• Kaua e kai hikareti. He nui ake te tūponotanga o te hunga kai hikareti ki te whanake i te whakaheke o te macular i te hunga kāore e kai hikareti. Tono atu ki tetahi kaimahi hauora mō te āwhina ki te mutu i te kai hikareti.
• Whakaritehia te taumaha hauora me te whakakori tinana ā-rōpū. Ki te hiahia koe ki te ngaro taumaha, whakaitihia te maha o ngā kaora e kai ana koe, me te whakapiki i te nui o te whakakori tinana e whiwhi ana koe i ia rā.
• Kōwhiria he kai e whai hua ana i ngā hua me ngā huawhenua. Kei roto i ēnei kai ngā huaora antioxidant e whakaiti ana i tō tūponotanga ki te whanake i te whakaheke o te macular.
• Whakauruhia te ika ki tō kai. Ka āhei pea ngā ngako momona Omega-3, kei roto i te ika, ki te whakaiti i te tūponotanga o te whakaheke o te macular. Kei roto hoki i ngā nati pērā i ngā nati walnut ngā ngako momona Omega-3.

Ngaro Whakawhānuihia te Whakaahua Kati Ngaro Ngaro Ko te ahua o ngā tāpiringa kōwhai, e kiia nei ko ngā drusen, i runga i ngā whakaahua tae o te retina e tohu ana i te whanaketanga o te mate macular maroke o te tīmatanga (maui). I te whakawhānui haere o te āhuatanga ki te wāhanga matatau (matau), ka ngaro pea te kanohi i ngā pūtau tātari mārama e hanga ana i te macula. E mohiotia ana tenei ko te atrophy. Kupenga Amsler Whakawhānuihia te Whakaahua Kati Kupenga Amsler Kupenga Amsler I te tiro i te kupenga Amsler i te wāhanga matatau o te mate macular, ka kite pea koe i ngā raina kupenga kua whakapōrearea, i tetahi waahi kau i te taha o waenganui o te kupenga (matau). Hei whakatau i te mate macular makuku, ka tirotirohia e te taote kanohi te hītori hauora me te whānau, ka mahi i tetahi whakamātautau kanohi katoa. Hei whakau i te whakatau o te mate macular, ka taea e te taote kanohi te whakaaro ki ētahi atu whakamātautau, tae atu ki: Te tirotiro i te pū o muri o te kanohi. Ka maka e te taote kanohi ngā matū ki roto i ngā kanohi hei whakawhānui i a rātou, ka whakamahi i te taputapu motuhake hei tirotiro i te pū o muri o te kanohi. Ka titiro te taote kanohi ki te ahua kua whakapohehehia e te tāpiringa kōwhai e hangaia ana i raro i te retina, e kiia nei ko te drusen. He maha ngā drusen kei ngā tāngata e pangia ana e te mate macular. He whakamātautau mō ngā huringa i waenganui o te mara tirohanga. Ka taea te whakamahi i te kupenga Amsler hei whakamātautau i ngā huringa i waenganui o te mara tirohanga. I te mate macular, ko ētahi o ngā raina tika i roto i te kupenga ka ngaro pea, ka whati, ka whakapōrearea. Angiography fluorescein. I te wā o tēnei whakamātautau, ka whakauruhia e te taote kanohi te tae ki roto i te uaua i te ringa. Ka haere te tae ki te whakamārama i ngā uaua toto i roto i te kanohi. Ka tangohia e te kamera motuhake ngā whakaahua i te haere o te tae i roto i ngā uaua toto. Ka whakaatu pea ngā whakaahua i ngā uaua toto e rere ana, i ngā huringa retinal. Angiography indocyanine green. Pēnei i te angiography fluorescein, ka whakamahi tēnei whakamātautau i te tae kua whakauruhia. Ka taea te whakamahi hei whakau i ngā kitenga o te angiography fluorescein, i te tautuhi i ngā uaua toto raruraru i roto i te retina. Tomography whakapiri whakaata. Ka whakaatu tēnei whakamātautau whakaahua kore-whakauru i ngā waahanga tapawha o te retina. Ka tautuhi i ngā wāhi o te ngāwari, te mātotoru, te pupuhi. Ka whakamahia hoki tēnei whakamātautau hei awhina i te tirotiro i te āhua o te whakautu o te retina ki ngā maimoatanga mate macular. Angiography tomography whakapiri whakaata (OCT). Ka whakaatu tēnei whakamātautau whakaahua kore-whakauru i ngā waahanga tapawha o te retina. Ka tautuhi i ngā wāhi o te ngāwari, te mātotoru, te pupuhi. Ka taea te whakaeke i ēnei e te kohinga wai mai i ngā uaua toto e rere ana ki roto, ki raro i te retina. Te tiaki i te Kaupapa Hauora Mayo Ka taea e ta mātou rōpū manaaki o ngā tohunga Kaupapa Hauora Mayo te āwhina i a koe ki ō mate macular, ki ngā take hauora e pā ana ki te makuku Tīmata Mai I konei

E wātea ana ngā rongoā ka āhei pea te āwhina i te whakaheke i te tere o te whākētanga o te mate, ā, kia tiakina ai te tirohanga kei reira. Ki te tīmata wawe, ka ora pea te tirohanga kua ngaro.

Ko ētahi rongoā, e kiia ana ko ngā rongoā anti-VEGF, ka āhei pea te āwhina i te mutu i te tipu o ngā uaua toto hou. Ka aukati ēnei rongoā i ngā pānga o ngā tohu tipu e tuku ana te tinana hei whakaputa i ngā uaua toto hou. Koinei te raina tuatahi o te rongoā mō ngā wāhanga katoa o te macular degeneration makuku.

Ngā rongoā e whakamahia ana hei whakaora i te macular degeneration makuku:

• Bevacizumab (Avastin).
• Ranibizumab (Lucentis).
• Aflibercept (Eylea).
• Brolucizumab (Beovu).
• Faricimab-svoa (Vabysmo).

Ka whakauruhia ēnei rongoā e te taote kanohi ki te kanohi e pā ana. Ka hiahiatia pea ngā tāpui i ia 4 ki te 6 wiki hei pupuri i te pānga pai o te rongoā. I ētahi wā, ka ora pea te tirohanga i te wā e whakaitihia ana ngā uaua toto, ā, ka ngākau te tinana i te wai kei raro i te retina.

Ngā tūponotanga pea o ēnei tāpui:

• Hemorrhage conjunctival.

• Mate.

• Te wehewehe o te retina.

• Te mumura o te kanohi.

• Whakaora photodynamic. Ko tēnei tukanga he rongoā pea mō te tipu uaua toto koretake i te macular degeneration makuku. Heoi, he iti rawa te noho noa atu i te rongoā me ngā tāpui anti-VEGF.

  I te wā o te whakaora photodynamic, ka whakauru te taote kanohi i te rongoā e kiia nei ko te verteporfin (Visudyne) ki roto i te uaua i te ringa. Ka haere atu te rongoā ki ngā uaua toto i te kanohi. Ka whakamahi te taote kanohi i te mārama arotahi mai i te laser motuhake ki ngā uaua toto e pā ana i te kanohi. Ka whakahohetia tēnei i te verteporfin, ka meinga ai te kati o ngā uaua toto. Ka mutu tēnei i te rerenga.

  Ka pai ake pea te tirohanga me te whakaiti i te tere o te ngaro o te tirohanga. Ka hiahiatia pea ngā whakaora anō i te wā, i te mea ka tuwhera anō pea ngā uaua toto i whakaorahia.

  I muri i te whakaora photodynamic, ka hiahiatia pea te karo i te rā tika me ngā mārama mārama kia tae ra ano te rongoā ki te tinana. Ka roa pea tēnei kia torutoru ngā rā.

• Photocoagulation. I te wā o te whakaora photocoagulation, ka whakamahi te taote kanohi i te raina laser kaha te kaha hei hiri i ngā uaua toto raruraru kei raro i te macula. Ka āwhina tēnei tukanga i te mutu o te toto mai i ngā uaua, me te whāinga ki te whakaiti i te pakaru atu ki te macula. Ahakoa tenei rongoā, ka tipu anō pea ngā uaua toto, ka hiahiatia ai te whakaora atu. Ka taea hoki e te laser te whakaputa i te toka e hanga ana i te waahi matapo.

He torutoru ngā tāngata he macular degeneration makuku kei a rātou e whiwhi ana i tēnei rongoā. Kāore i te noho noa tēnei i te nuinga o te wā ki te mea he uaua toto raruraru kei a koe kei raro tonu i te pokapū o te macula. I tua atu, ko te nui o te pakaru o te macula, ko te iti o te tūponotanga o te angitu.

• Te whakaora tirohanga iti. Kāore te macular degeneration e pā ana ki te pakeke e pā ana ki te tirohanga taha, ā, kāore i te tikanga ka puta he matapo katoa. Engari ka taea te whakaiti, te whakakore rānei i te tirohanga pokapū. Me whai tirohanga pokapū koe hei pānui, hei taraiwa, hei whakakite i ngā kanohi o te tangata. Ka āhei pea te whiwhi i te tiaki mai i te tohunga whakaora tirohanga iti, he kaiwhakaora mahi, he taote kanohi me ētahi atu kua whakangungua ki te whakaora tirohanga iti. Ka taea e rātou te āwhina i te kimi i ngā huarahi hei whakarite ki te tirohanga e huri haere ana.

Whakaora photodynamic. Ko tēnei tukanga he rongoā pea mō te tipu uaua toto koretake i te macular degeneration makuku. Heoi, he iti rawa te noho noa atu i te rongoā me ngā tāpui anti-VEGF.

I te wā o te whakaora photodynamic, ka whakauru te taote kanohi i te rongoā e kiia nei ko te verteporfin (Visudyne) ki roto i te uaua i te ringa. Ka haere atu te rongoā ki ngā uaua toto i te kanohi. Ka whakamahi te taote kanohi i te mārama arotahi mai i te laser motuhake ki ngā uaua toto e pā ana i te kanohi. Ka whakahohetia tēnei i te verteporfin, ka meinga ai te kati o ngā uaua toto. Ka mutu tēnei i te rerenga.

Ka pai ake pea te tirohanga me te whakaiti i te tere o te ngaro o te tirohanga. Ka hiahiatia pea ngā whakaora anō i te wā, i te mea ka tuwhera anō pea ngā uaua toto i whakaorahia.

I muri i te whakaora photodynamic, ka hiahiatia pea te karo i te rā tika me ngā mārama mārama kia tae ra ano te rongoā ki te tinana. Ka roa pea tēnei kia torutoru ngā rā.

Photocoagulation. I te wā o te whakaora photocoagulation, ka whakamahi te taote kanohi i te raina laser kaha te kaha hei hiri i ngā uaua toto raruraru kei raro i te macula. Ka āwhina tēnei tukanga i te mutu o te toto mai i ngā uaua, me te whāinga ki te whakaiti i te pakaru atu ki te macula. Ahakoa tenei rongoā, ka tipu anō pea ngā uaua toto, ka hiahiatia ai te whakaora atu. Ka taea hoki e te laser te whakaputa i te toka e hanga ana i te waahi matapo.

He torutoru ngā tāngata he macular degeneration makuku kei a rātou e whiwhi ana i tēnei rongoā. Kāore i te noho noa tēnei i te nuinga o te wā ki te mea he uaua toto raruraru kei a koe kei raro tonu i te pokapū o te macula. I tua atu, ko te nui o te pakaru o te macula, ko te iti o te tūponotanga o te angitu.

Ka pā te ngaro o te tirohanga mai i te whakaheke macular ki te kaha ki te mahi i ngā mea pēnei i te pānui, te mohio ki ngā kanohi me te taraiwa. Ka āwhina pea ēnei tohutohu ki te whakahaere i te huringa o te tirohanga: Tirohia te rongoā o ō anō. Ki te whakamahi koe i ngā hononga karāhe rānei, kia tino hou te rongoā. Ki te kore ngā anō hou e āwhina, tonoa he tohutoro ki te tohunga tirohanga iti. Whakamahia ngā kaitirotiro. Ka taea e te maha o ngā taputapu whakamārama te āwhina i a koe ki te pānui me ētahi atu mahi tata, pēnei i te tuitui. Kei roto i ēnei taputapu ngā karāhe whakamārama ringa rānei ngā karāhe whakamārama e mau ana koe pēnei i ngā anō. Ka taea hoki e koe te whakamahi i te pūnaha pouaka whakaata kōwhiri kua kati e whakamahi ana i te kāmera ataata hei whakamārama i ngā rauemi pānui me te whakaatu i runga i te mata ataata. Hurihia tō whakaatu rorohiko me te tāpiri i ngā pūnaha oro. Whakaritea te rāhi tuhi i roto i ngā tautuhinga o tō rorohiko. Ā, whakaritea tō mata kia whakaatu i te nui atu o te rerekētanga. Ka taea hoki e koe te tāpiri i ngā pūnaha putanga kōrero, ngā hangarau rānei ki tō rorohiko. Whakamahia ngā āwhina pānui hiko me ngā atanga reo. Tamatahia ngā pukapuka tuhi nui, ngā rorohiko papa me ngā pukapuka oro. Kei te hoahoa etahi taupānga papa me ngā waea atamai hei āwhina i ngā tāngata he iti te tirohanga. Ā, he maha o ēnei taputapu inaianei kei te haere mai me ngā āhuatanga mohio reo. Kōwhiria ngā taputapu motuhake i hangaia mō te iti o te tirohanga. He maha ngā karaka, te reo irirangi, ngā waea me ētahi atu taputapu he maha rawa ngā nama. Ka kite pea koe he ngāwari ake te matakitaki i te pouaka whakaata me te mata nui o te taumata teitei, ka hiahia pea koe ki te noho tata atu ki te mata. Whakamahia ngā mārama mārama ake i tō kāinga. Ka āwhina te mārama pai ake ki te pānui me ētahi atu mahi o ia rā, ā, ka whakaiti pea i te tūpono o te hinga. Whakaarohia ō kōwhiringa kawe. Ki te taraiwa koe, tirohia tō tākuta ki te kite mena he haumaru te haere tonu. Kia tino tupato i ētahi wā, pēnei i te taraiwa i te pō, i te nui o te waka rānei i te kino o te rangi. Whakamahia te kawe tūmatanui, tonoa rānei tētahi hoa, whānau rānei hei āwhina, ina koa ki te taraiwa i te pō. Rānei whakamahia ngā ratonga waka iti, ngā whatunga taraiwa tūāpapa, ngā ratonga kawe rānei. Whiwhi tautoko. Ka uaua pea te whakaheke macular, ā, ka hiahia pea koe ki te huri i tō oranga. Ka haere pea koe i ngā kare-a-roto maha i a koe e whakarite ana. Whakaarohia te kōrero ki tētahi kaiāwhina, uru rānei ki tētahi rōpū tautoko. Whakapau i te wā ki ngā mema whānau me ngā hoa tautoko.