Kev ua kom pom kev zoo rau thaum laus yog qhov nyuaj heev. Feem ntau thaum muaj hnub nyoog laus lub peev xwm pom tau maj mam ploj. Qhov no yog vim lub fact tias tag nrho cov tib neeg lub cev nqaij daim tawv pib "hnav" dhau sij hawm. Ib qho ntawm thawj qhov kev txom nyem yog cov ntaub so ntswg ntawm qhov muag. Nws ntseeg tias qhov muag tsis pom kev los ntawm hnub nyoog 40-45 xyoos. Qhov no tshwm sim txawm tias ib tus neeg tsis tau muaj teeb meem pom kev hauv nws lub neej yav dhau los. Qhov muag tsis pom kev tshwm sim maj mam. Cov neeg feem coob txhawj xeeb txog "farsightedness", uas yog, tsis muaj peev xwm pom cov khoom nyob ze. Qee zaum, teeb meem loj dua tuaj. Cov no muaj xws li pathologies xws li cataracts, glaucoma, thiab lwm yam. Lwm yam kab mob uas muaj feem xyuam rau lub hnub nyoog macular degeneration. Cov kab mob zoo li no txaus ntshai vim nws tuaj yeem ua rau tsis pom kev.
Lub tswvyim ntawm lub hnub nyoog ntsig txog retinal degeneration
Age-related macular degeneration (AMD) yog ib yam kab mob uas tsim los ntawm cov txheej txheem dystrophic hauv retina ntawm lub qhov muag. Cov cheeb tsam no ncaj qha ntsig txog lub taub hauhlwb (yog ib tug peripheral analyzer). Nrog kev pab los ntawm retina, kev xaav ntawm cov ntaub ntawv yog tsim thiab nws hloov mus rau hauv cov duab pom. Nyob rau saum npoo ntawm lub peripheral analyzer muaj ib cheeb tsam uas muaj ntau receptors - rods thiab cones. Nws yog hu ua macula (daj chaw). Cov receptors uas ua rau qhov chaw nruab nrab ntawm retina muab xim pom kev rau tib neeg. Tsis tas li ntawd, nws yog nyob rau hauv macula uas lub teeb tsom. Ua tsaug rau txoj haujlwm no, tib neeg lub zeem muag yog qhov ntse thiab meej. Lub hnub nyoog ntsig txog macular degeneration ntawm retina ua rau macular degeneration. Tsis tsuas yog cov xim txheej hloov pauv, tab sis kuj yog cov hlab ntsha uas pub rau thaj chaw no. Txawm tias muaj tseeb hais tias tus kab mob no hu ua "muaj hnub nyoog-txog macular degeneration", nws muaj peev xwm tsim tsis tau tsuas yog nyob rau hauv cov neeg laus. Feem ntau, thawj cov tsos mob ntawm kev hloov pauv hauv lub qhov muag pib hnov los ntawm hnub nyoog 55 xyoos. Los ntawm lub hnub nyoog laus thiab laus laus, tus kab mob no nce mus txog qhov uas ib tug neeg tuaj yeem tsis muaj peev xwm pom kiag li.
Hnub nyoog ntsig txog macular degeneration ntawm retina yog ib yam kab mob. Feem ntau qhov no pathology ua rau muaj kev tsis taus thiab kev tsis taus. Nws yog dav faib nyob rau hauv America, Asia thiab Europe. Hmoov tsis zoo, tus kab mob no feem ntau kuaj tau nyob rau theem lig. Hauv cov xwm txheej no, nws yog ib qho tsim nyog yuav tsum tau mus rau kev kho mob phais. Txawm li cas los xij, nrog rau kev kho mob raws sij hawm, nrog rau kev siv cov kev tiv thaiv kev tiv thaiv, nws muaj peev xwm zam kom tsis txhob muaj kev phais mob thiab cov teeb meem ntawm pathology (dig muag).
Ua rau muaj hnub nyoog ntsig txog macular degeneration
Zoo li tag nrho cov txheej txheem degenerative, tus kab mob no zoo li qeeb thiab nce zuj zus. Cov ua rau dystrophic hloov nyob rau hauv lub macula ntawm lub retina tej zaum yuav txawv. Qhov tseem ceeb yog qhov kev cuam tshuam ntawm cov ntaub so ntswg ntawm qhov muag. Txawm li cas los xij, hauv qee tus neeg, kev hloov dystrophic tshwm sim sai dua, thaum lwm tus nws qeeb dua. Yog li ntawd, muaj kev xav tias muaj hnub nyoog ntsig txog macular degeneration yog los ntawm noob caj noob ces, thiab tseem muaj nyob rau hauv cov neeg ntawm European haiv neeg. Lwm yam kev pheej hmoo muaj xws li: haus luam yeeb, arterial hypertension, nquag raug lub hnub. Raws li qhov no, nws tuaj yeem txheeb xyuas qhov ua rau macular degeneration. Cov no suav nrog:
- kab mob vascular. Ib qho ntawm cov kev pheej hmoo yog atherosclerosis ntawm cov hlab ntsha me. Kev ua txhaum ntawm oxygen xa mus rau cov ntaub so ntswg ntawm lub qhov muag yog ib qho ntawm cov txheej txheem tseem ceeb rau kev txhim kho degeneration.
- Ntau tshaj.
- Tsis muaj cov vitamins thiab qee cov kab mob. Ntawm cov khoom tsim nyog rau kev saib xyuas cov ntaub so ntswg retinal, ib qho tuaj yeem tawm: lutein thiab zeaxanthin.
- Qhov muaj ntau ntawm "dawb radicals". Lawv ua rau muaj kev pheej hmoo ntawm kev tsim lub cev degeneration ob peb zaug.
- haiv neeg nta. Tus kab mob no tshwm sim nyob rau hauv cov neeg uas muaj lub teeb qhov muag xim. Qhov tseeb yog tias nyob rau hauv cov neeg sawv cev ntawm haiv neeg Caucasian, qhov ntom ntawm cov xim muaj nyob rau hauv lub retina yog tsawg. Vim li no, cov txheej txheem dystrophic tsim sai dua, zoo li cov tsos mob.kab mob.
- Kev noj haus tsis zoo.
- Nyob hauv tshav ntuj ncaj qha yam tsis muaj tsom iav kev nyab xeeb.
Pathology feem ntau tshwm sim hauv cov neeg uas muaj lub nra hnyav hauv keeb kwm yav dhau los (muaj tus kab mob hauv niam txiv, pog). Feem ntau, tus kab mob no tau kuaj pom hauv cov poj niam.
Hnub nyoog ntsig txog macular degeneration: pathophysiology ntawm cov txheej txheem
Zoo li txhua qhov kev hloov pauv degenerative, tus kab mob no muaj cov txheej txheem ntawm kev loj hlob. Tsis tas li ntawd, lub pathogenesis ntawm cov txheej txheem dystrophic tseem tsis tau kawm tag nrho. Nws paub tias nyob rau hauv kev cuam tshuam ntawm cov yam tsis zoo, cov ntaub so ntswg macula undergoes irreversible kev puas tsuaj. Feem ntau, pathology pib tsim nyob rau hauv cov neeg uas muaj kab mob vascular (atherosclerosis, ntshav qab zib mellitus), rog rog. Tsis tas li ntawd, tus kab mob no yuav luag ib txwm pom ntawm cov neeg haus luam yeeb. Vim qhov thaiv ntawm lub txaj vascular thiab khoom noj khoom haus tsis txaus ntawm cov ntaub so ntswg qhov muag, muaj hnub nyoog ntsig txog macular degeneration. Lub pathogenesis ntawm tus kab mob yog raws li kev ua txhaum ntawm redox tshuav nyiaj li cas. Dawb radicals ua lub luag haujlwm tseem ceeb hauv cov txheej txheem no. Cov tshuaj no yog tsim nyob rau hauv macula rau ntau yam. Ua ntej, macula ntawm retina yog tas li raug rau oxygen thiab lub teeb. Tsis tas li ntawd, muaj ntau cov fatty acids nyob rau hauv cheeb tsam no, uas zoo li oxidize. Lwm qhov tseem ceeb hauv kev tsim cov kab mob pathology yog keeb kwm ntawm retina. Tom qab tag nrho, lub plhaub ntawm lub qhov muag yog suav tias yog ib qho peripheral analyzer thiab yog ncaj qha ntsig txoghlwb. Yog li ntawd, nws yog qhov tshwj xeeb tshaj yog rau "kev tshaib plab oxygen."
Txhua yam ntawm cov xwm txheej no ua rau muaj qhov tseeb tias cov ntaub so ntswg ntawm macula maj mam ua thinner. Raws li qhov tshwm sim ntawm raug rau radicals, cell membranes raug rhuav tshem. Lub retina ua ntau dua rau lub teeb. Raws li kev cuam tshuam ntawm ultraviolet thiab infrared hluav taws xob, AMD txhim kho sai dua. Tag nrho cov txheej txheem no ua rau lub fact tias lub epithelium ntawm macula pib "poob" pigment receptors, undergoes atrophy. Yog hais tias qhov kev puas tsuaj ntawm macula tsis nres nyob rau hauv lub sij hawm, cov ntaub so ntswg detachment tshwm sim. Cov theem kawg yog qhov pom ntawm qhov caws pliav thiab kev txhim kho ntawm qhov muag tsis pom.
Cov ntaub ntawv muaj hnub nyoog ntsig txog cov retinal degeneration
Muaj 3 hom ntawm macular degeneration. Qhov kev faib tawm no yog nyob ntawm kev hloov morphological tshwm sim hauv cov ntaub so ntswg retinal. Kev faib tawm yog tsim nyog los txiav txim siab txog kev kho tus kab mob.
Morphological hom kab mob:
- Hnub nyoog ntsig txog macular degeneration - daim ntawv ntub dej: tus cwj pwm los ntawm kev muaj exudate. Qhov kev xaiv no tsis tshua muaj, hauv 20% ntawm cov neeg mob. Nws muaj kev kawm tau sai heev. Yog hais tias ib tug neeg lub zeem muag yog sai heev deterioration (nyob rau hauv ob peb hnub), nws yog tsim nyog xav tias ib tug kab mob xws li hnub nyoog-txog macular degeneration. Daim ntawv ntub dej tsim tawm vim neovascularization, uas yog, cov tsos ntawm ntau cov hlab ntsha tshiab ntawm lub retina. Muab qhov kev puas tsuaj hauv cell membranes, lawv permeability nce. Yog li ntawd, edema tsim thiabhemorrhages.
- Hnub nyoog ntsig txog macular degeneration - daim ntawv qhuav: tus yam ntxwv los ntawm chav kawm qeeb. Hauv lwm txoj kev, hom kab mob no hu ua atrophy. Qhuav lub hnub nyoog ntsig txog macular degeneration tshwm sim hauv 90% ntawm cov neeg mob. Ntawm kev kuaj xyuas, drusen tau sau tseg - lub teeb foci ntawm atrophy, tsis txaus ntawm cov xim txheej, qhov tsis xws luag hauv epithelium.
- Cicatricial daim ntawv ntawm macular degeneration. Nws suav hais tias yog theem kawg ntawm AMD. Nws yog characterized los ntawm detachment ntawm lub epithelium thiab tsim ntawm connective cov ntaub so ntswg (scar). Hauv qhov no, muaj qhov tsis pom kev ua tiav.
Nyob rau qee kis, daim ntawv qhuav ntawm AMD hloov mus ua qhov sib txawv ntawm tus kab mob. Feem ntau qhov no tshwm sim nrog cov kab mob vascular, thiab tshwj xeeb - ntshav qab zib retinopathy. Cov kev hloov pauv no qhia txog qhov tsis zoo ntawm kev kwv yees thiab yog lub teeb liab rau kev ua haujlwm ceev.
Cov tsos mob ntawm lub hnub nyoog ntsig txog macular degeneration
Nyob ntawm daim ntawv ntawm AMD, cov tsos mob ntawm tus kab mob tuaj yeem txhim kho tau qeeb thiab sai. Feem ntau, rau lub sijhawm ntev, macular degeneration tsis ua rau nws tus kheej xav tau ntau xyoo. Nyob rau hauv daim ntawv qhuav ntawm AMD, drusen tshwm nyob rau saum npoo ntawm retina - thaj chaw ntawm atrophy. Yog li ntawd, qhov pom kev maj mam deteriorates. Cov pigment txheej raug kev txom nyem ntau dua, vim qhov ci ntawm cov xim yog me ntsis ploj. Visual acuity yuav hloov, tab sis tsuas yog me ntsis. Daim ntawv ntub dej ntawm macular degeneration tsim sai heev. Hauv ob peb hnub, qhov pom kev tuaj yeem cuam tshuam loj heev, mus txog qhov muag tsis pom. Vim yogo thiab nce daim nyias nyias permeability, hemorrhages tuaj yeem tshwm sim uas pom ntawm qhov muag liab qab. Cov tsos mob pom nrog AMD:
- Hloov qhov sib piv thiab qhov ci ntawm daim duab.
- Txuag qhov pom kev pom.
- Curvature, distortion of objects.
- fuzzy image.
- Zoo pom qhov pom kev poob.
- nyeem tsis tau txawm hnav tsom iav.
Nrog rau kev txhim kho ntawm pathology maj mam, cov cim qhia ntawm tus kab mob yuav tsis tuaj yeem mus ntev. Tom qab ntawd maj mam deterioration ntawm lub hauv paus tsis pom kev. Thaum saib tom ntej, feem ntau ntawm cov duab yuav plooj. Txawm li cas los xij, peripheral (lateral) tsis pom kev yog khaws cia. Maj mam, thaj chaw cuam tshuam nce.
Nrog rau daim ntawv ntub dej thiab cicatricial ntawm AMD, qhov muag tsis pom tshwm sim sai. Tsis zoo li hom qhuav degeneration, peripheral tsis pom kev yog tsis tshua muaj khaws cia. Nrog rau kev kho raws sijhawm ntawm AMD, kev txhim kho ntawm qhov muag tsis pom kev tuaj yeem nres.
Kev kuaj mob ntawm lub hnub nyoog ntsig txog retinal degeneration
Hnub nyoog ntsig txog macular degeneration tuaj yeem kuaj pom ntxov. Yog li ntawd, cov neeg uas raug kev txom nyem los ntawm vascular txhab yuav tsum tau mus xyuas los ntawm ib tug ophthalmologist 1-2 zaug ib xyoos. Kev kuaj mob ntawm AMD yog nyob ntawm cov ntaub ntawv anamnesis thiab kev kuaj tshwj xeeb. Cov neeg laus feem ntau yws yws ntawm qhov pom ntawm "qhov chaw" ua ntej lawv ob lub qhov muag, zoo li huab cua. Kev kuaj mob ntawm "macular degeneration" feem ntau yog ua thaum pom kev tsis zoo rau cov poj niam, tshwj xeeb tshaj yog tias muaj keeb kwm ntawmmuaj hom 2 mob ntshav qab zib mellitus, atherosclerosis ntawm cov hlab ntsha. Ntxiv nrog rau qhov kev ntsuam xyuas, ntau qhov kev kuaj mob ophthalmological tau ua. Ntawm lawv yog kev ntsuas qhov pom kev pom, perimetry, stereoscopic biomicroscopy.
Txhawm rau ntsuas qhov xwm txheej ntawm cov hlab ntsha, ua fluorescein angiography ntawm fundus. Ua tsaug rau txoj kev tshawb no, nws muaj peev xwm txheeb xyuas cov cheeb tsam ntawm detachment ntawm epithelium, atrophic drusen, neovascularization. Txawm li cas los xij, hom kev ntsuas ntsuas no muaj contraindications thiab txaus ntshai. Yog li ntawd, ua ntej txiav txim siab mus kuaj mob, nws tsim nyog mus ntsib kws kho mob thiab tau txais nws cov lus qhia.
Yuav ua li cas kho mob macular degeneration?
Thaum kuaj pom tseeb, kev kho mob rau hnub nyoog ntsig txog macular degeneration yuav tsum pib tam sim ntawd. Daim ntawv qhuav ntawm tus kab mob tsis tshua muaj kev txhoj puab heev, yog li nws yog amenable rau kev kho tshuaj. Qhov no yuav tsis pab tshem tawm cov kab mob pathology tag nrho, txawm li cas los xij, nws yuav ncua (slow down) txheej txheem rau ob peb lub hlis lossis xyoo. Ua ntej tshaj plaws, nrog AMD, koj yuav tsum ua raws li kev noj haus. Xav tias cov txheej txheem atrophic txhim kho vim tsis muaj carotenoids thiab thaiv cov hlab ntsha, tus neeg mob yuav tsum tsis suav nrog cov tsiaj rog. Txhawm rau tiv thaiv atherosclerotic hloov pauv hauv cov hlab ntsha me ntawm retina, koj yuav tsum noj ntau cov txiv hmab txiv ntoo, tshuaj ntsuab, thiab zaub. Tsis tas li ntawd, kev noj zaub mov zoo li no yuav pab daws qhov tsis muaj cov vitamins thiab minerals.
Txhawm rau tiv thaiv cov dawb radicals, nws raug nquahu kom siv sijhawm tsawg dua hauv tshav ntuj. Tsis tas li ntawd, cov neeg mob yuav tsumnoj cov tshuaj antioxidants. Cov no suav nrog cov vitamin E thiab C. Txhawm rau txhim kho cov ntshav mus rau fundus, nws raug nquahu kom siv cov tshuaj antiplatelet, vasodilators.
Hnub nyoog ntsig txog macular degeneration - daim ntawv ntub dej: kho kab mob
Nrog rau daim ntawv ntub dej ntawm macular degeneration, tsis yog tsuas yog siv tshuaj kho mob xwb, tab sis kuj kho phais. Cov tshuaj uas kho cov xim txheej ntawm retina muaj xws li tshuaj "Lutein" thiab "Zeaxanthin". Cov tshuaj no yog cov pab pawg ntawm cov tshuaj antioxidants. Tsis tas li ntawd, nws raug nquahu kom noj cov zaub mov uas muaj zinc. Yog tias tus kab mob tau tsim los ntawm kev mob ntshav qab zib retinopathy, nws yuav tsum tau ua raws li kev kho mob hypoglycemic raws li kev tswj hwm ntawm glycemic profile.
Kev kho mob ntawm retinal degeneration
Kev kho mob ib leeg tsis txaus yog tias tus neeg mob tau kuaj pom muaj hnub nyoog ntsig txog macular degeneration. Kev kho mob ntawm pathology yuav tsum tau ua ke nrog kev kho phais. Qhov no yog qhov tseeb tshwj xeeb rau daim ntawv ntub dej ntawm AMD. Tam sim no, yuav luag txhua lub tsev kho mob ophthalmological ua laser kho ntawm macular degeneration. Tej zaum nws yuav txawv. Kev xaiv ntawm txoj kev yog nyob ntawm theem ntawm AMD thiab tshwm sim ntawm pathology. Muaj cov hauv qab no ntawm kev kho phais:
- Laser coagulation ntawm neovascular membrane.
- Photodynamic kho nrog Vizudin.
- Transpupillary laser thermocorrection.
Yog tias ua tau thiab tsis muaj contraindications, pigment epithelium transplantation, vitrectomy (nrog rauhemorrhage nyob rau hauv lub cev vitreous ntawm lub qhov muag).
Tiv thaiv lub hnub nyoog ntsig txog retinal degeneration
ntsuas kev tiv thaiv muaj xws li: noj zaub mov, poob phaus. Nrog rau cov kab mob vascular, kev haus luam yeeb yog pom zoo. Tsis tas li ntawd tsis txhob raug tshav ntuj ncaj qha rau cov neeg uas muaj lub teeb qhov muag xim. Tsis tas li ntawd, kev tiv thaiv suav nrog kev siv cov vitamins los ntxiv dag zog rau lub zeem muag thiab kab mob.
