Lub cev vitreous yog cov pob tshab uas ua rau cov kab noj hniav ntawm lub qhov muag thiab muab tso rau hauv qab lub lens. Sab nraud, nws yog ib puag ncig los ntawm ib daim nyias nyias, hauv nws tau muab faib ua cov channel (tracts). Yog tias liquefaction, wrinkling lossis detachment ntawm no gel yog pom, ces lawv hais txog DST ntawm lub qhov muag.
Qhov no yog dab tsi?
Cov tsos ntawm qhov sib txawv ntawm cov duab, qhov loj me lossis qib ntawm opacities hauv vitreous qhia txog cov txheej txheem degenerative. Feem ntau, pathologies raug kuaj pom nyob rau hauv uas cov khoom ntawm qhov chaw hloov pauv.
Feem ntau nws yog pob tshab, tab sis muaj cov xov tshwj xeeb - fibrils. Nrog rau cov hnub nyoog hloov pauv lossis vim qee yam kab mob, lawv ua kom tsis muaj zog thiab tuaj yeem tawg, uas ua rau pom kev tsis pom kev. Hauv qhov no, kev puas tsuaj ntawm lub cev vitreous ntawm lub qhov muag tsim. Nws yuav tsum raug sau tseg tias cov kev mob no nyuaj rau kev kho, thiab kev hloov pauv hauv lub hnub nyoog laus tsis tau kho (nrog kev kho kom tsim nyog, lawv tsuas tuaj yeem txo qis).
Etiology
Raws li txoj cai, kev puas tsuaj ntawm lub cev vitreous ntawm lub qhov muag, qhov ua rau muaj ntau haiv neeg, yog qhov tshwm sim ntawm kev puas tsuaj rau lub qhov muag,haus luam yeeb, siv tshuaj los yog tej yam tshuaj. Kuj tseem muaj cov kev hloov pauv pathological cuam tshuam nrog cov txheej txheem kev laus ntawm lub cev. Tsis tas li ntawd, nyob rau hauv lub xub ntiag ntawm myopia, thaum raug lub sij hawm ntev thiab nquag kev ntxhov siab nyob rau hauv lub cev ntawm lub zeem muag, poob siab, kev puas tsuaj ntawm lub cev vitreous ntawm lub qhov muag kuj tuaj yeem tsim.
Yog hais tias etiological yam tshwm sim, ces dystrophy los yog o nyob rau hauv lub retina, lub cev qaug zog, retinopathy, choroid lesions, metabolic kev hloov nyob rau hauv lub qhov muag yuav tsum tau hais.
Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias kev hloov pauv sai sai tuaj yeem ua rau muaj qhov tshwm sim ntawm retinal detachment, uas muaj qhov ua tiav thiab tsis pom kev tsis pom kev, yog li kev sab laj nrog tus kws kho qhov muag yog qhov yuav tsum tau ua.
yam ntxwv ntawm kev hloov pauv hauv lub cev vitreous
Thaum nws cov liquefaction tsim, tom qab ntawd, raws li txoj cai, kev hloov pauv pathological tau pom nyob hauv thaj chaw nruab nrab. Lub periphery ntawm lub cev vitreous tsis hloov. Feem ntau, cov voids yog tsim, uas muaj cov khoom fiber ntau thiab coagulation khoom. Tej zaum kuj yuav muaj cov hlua los yog cov yeeb yaj kiab uas ntab dawb hauv qhov nruab nrab liquefied los yog txuas mus rau lub pob zeb ntawm lub qhov muag, ua rau muaj kev hloov pauv hauv qhov muag pom.
Kev puas tsuaj ntawm lub cev vitreous ntawm lub qhov muag hauv qhov tshwm sim hnyav tshaj plaws yog nws qhov wrinkling. Nws yog nrog los ntawm kev nro ntawm cov pob qij txha vitreoretinal, uas nyob rau hauv mob hnyav ua rau photopsy, retinal rupture,cov tsos mob ntawm hemorrhages nyob rau hauv lub vitreous lub cev.
Nws yuav tsum tau muab sau tseg tias cov kev hloov pauv puas yooj yim dua los kuaj pom ntawm kev npaj cov tshuaj microscopic. Kev tshuaj xyuas qhov teeb meem uas siv cov kev tshawb fawb soj ntsuam yog qhov nyuaj heev thiab yuav tsum muaj kev kho mob ntau.
Kev kho mob tshwm sim
Thaum kev puas tsuaj ntawm lub cev vitreous tsim, cov tsos mob ntawm qhov kev ua txhaum cai no yuav suav nrog qhov tshwm sim ua ntej lub qhov muag ntawm ntau yam ntawm cov ntsiab lus ntab, uas ua rau pom ntau dua thaum xav txog qhov chaw monochrome - phab ntsa dawb, daus lossis ntuj.. Cov neeg mob kuj yuav pom muaj huab cua. Nws tshwm sim vim muaj kev hloov pauv ntawm lub teeb pom kev dhau los ntawm lub qhov muag qhov muag thiab cuam tshuam nrog cov duab ntxoov ntxoo ntawm lub retina, uas txo qhov pom kev zoo thiab yuav qhia tau tias qhov muag puas loj dua. Kev mus ntsib kws kho mob tsis tu ncua tuaj yeem ua rau tsis pom kev ua tiav.
Kev rhuav tshem cov fibrils ntawm lub cev vitreous tshwm sim rau tus neeg mob xws li nplej, pob, xov lossis zaj duab xis uas ua rau tsis pom kev thiab txav mus tom qab qhov muag.
Nws yuav tsum tau muab sau tseg tias ib qho ntawm cov laj thawj feem ntau ntawm kev mus ntsib kws kho qhov muag yog qhov tsis txaus siab txog qhov tshwm sim ntawm "flying fly" ua ntej lub qhov muag, uas tsis tuaj yeem tshem tawm. Tom qab kev ntsuam xyuas tsim nyog, nws yog kev puas tsuaj ntawm cov vitreous uas tau kuaj pom.
Golden rain symptom
Qee lub sij hawm cov neeg mob uas mus ntsib kws kho qhov muag yws txog qhov pom ntawm qhov muag daj thaum txav lawv lub qhov muag. Lawv tuaj qhov twg?
Kev ua haujlwm ntawm cov kab mob ntawm ntau yam kabmob (piv txwv li, ob lub raum, daim siab lossis cov qog endocrine) ua rau muaj kev cuam tshuam ntawm cov txheej txheem metabolic thiab ua rau muaj kev hloov pauv hauv lub cev colloidal media thiab lawv cov ntxhia. Qhov no kuj tseem siv tau rau lub cev vitreous, nyob rau hauv qhov kev hloov pauv hauv zos pathological tsim thiab cov txheej txheem ntawm nag lossis daus thiab coagulation tshwm sim, nrog rau kev tso tawm ntawm cov muaju, qhov ntev ntawm qhov tsis tseem ceeb - tsis ntau tshaj 0.05 hli.
Cov nyiaj no hu ua synchisis scinllillas. Lawv feem ntau muaj cov roj cholesterol lossis tyrosine, khaws cia hauv lub cev liquefied vitreous nyob rau hauv ib qho tseem ceeb, thiab thaum lub qhov muag txav mus, lawv viav vias zoo li lub pendulum, pib shimmer thiab ci, uas predetermines cov tsos mob ntawm "golden rain", uas yog ib tug pendulum. tsis tshua muaj kev puas tsuaj thiab ua rau tus neeg mob nrhiav kev kho mob.
Diagnosis
Kev puas tsuaj ntawm lub cev vitreous ntawm lub qhov muag tau kuaj pom siv cov txheej txheem yooj yim - ophthalmoscopy. Nrog filamentous kev hloov pauv, optically khoob kab noj hniav raug nthuav tawm, uas zoo li ntsug slits lossis ntau yam duab. Lub phaj ciam teb sab hauv ntawm lub cev vitreous yog tsis muaj kev hloov pauv, tab sis grey-dawb fibers tuaj yeem pom tam sim tom qab nws. Lawv tuaj yeem muaj qhov sib txawv thicknesses thiab sag nyob rau hauv daim ntawv ntawm garlands.
Yog tias cov txheej txheem pathological nce mus, ces cov lus hais tsis sib haum, tsim ib kab noj hniav. Qhov no yog nrog los ntawm kev puas tsuaj ntawm cov qauv ntawm lub cev vitreous. Ntawmophthalmoscopy, fragments ntawm fibril threads tuaj yeem pom. Yog hais tias qhov opacity nyob ze ntawm lub retina, ces nws yog ib qho nyuaj rau pom (txawm nyob rau qhov loj me me).
Kuv yuav tsum hais tias qhov kev hloov pauv no feem ntau pom nyob rau hauv cov neeg laus, nrog rau cov neeg mob uas ib txhij kuaj pom tias muaj myopia siab lossis dystrophic lesions ntawm lub qhov muag sab hauv.
tshuaj kho mob
Txawm hais tias cov tshuaj (xws li kho qhov muag) yog nyob rau theem siab, niaj hnub no tsis muaj txiaj ntsig txhais tau tias yuav tiv thaiv kev puas tsuaj ntawm cov vitreous lub cev fibrils lossis pab txhawb kev ploj ntawm cov uas twb raug puas lawm. Feem ntau cov tshuaj pharmacological uas tau sau tseg rau kev puas tsuaj tsuas yog tiv thaiv kev loj hlob ntawm cov kab mob pathological. Tias yog vim li cas koj yuav tsum ceev faj txog cov tshuaj uas cov tuam txhab lag luam hais tias lawv cov khoom tuaj yeem kho CTD.
Raws li txoj cai, instillations ntawm 2% poov tshuaj iodide los yog 3% "Emoxipin", uas yog muab tshuaj parabulbarno, yog siv topically. Rau kev tswj hwm qhov ncauj, cov tshuaj absorbable tau raug sau tseg, piv txwv li, Wobenzym lossis Traumeel S. Tsis tas li ntawd, cov neeg mob tau qhia kom kawm txog kev kho cov tshuaj vitamin. Yog li, kev kho mob ntawm DST ntawm lub qhov muag yuav tsum suav nrog kev noj cov ascorbic acid thiab B vitamins.
Yog tias tsim nyog, cov txheej txheem physiotherapeutic tuaj yeem raug sau - electrophoresis nrog lidase thiab ultrasound therapy.
Laser kho mob
Hnub no txhua yamlaser manipulations tau dhau los ua neeg nyiam heev, uas, nrog DST, yog qhov zoo tshaj plaws rau kev puas tsuaj ntawm ntab opacities. Xws li kev kho mob yog qhov tsawg kawg nkaus, tab sis yuav tsum muaj kev tsim nyog thiab kev tshaj lij ntawm tus kws kho mob. Nws koom nrog laser kev puas tsuaj ntawm opaque fragments nyob rau hauv lub vitreous lub cev, uas tawg mus rau hauv me me hais uas tsis cuam tshuam rau lub zeem muag.
Laser cuam tshuam ntawm lub vitreous hu ua vitreolysis. Nws tuaj yeem suav nrog kev txiav tawm ntawm vitreo-corneal adhesions. Yog hais tias lub zos hernias ntawm lub vitreous lub cev tsim, uas ua rau deformation ntawm cov menyuam kawm ntawv thiab qhov chaw tsis raug ntawm lub lens intraocular, qhov sib thooj ntawm ST yog excised. Hauv qhov no, YAG laser siv. Lub zog mem tes raug xaiv ib tus zuj zus (los ntawm 1.5 txog 8.0 mJ). Kev ua tiav ntawm kev ua haujlwm yog nyob ntawm qhov viscosity thiab pob tshab ntawm lub cev vitreous, nrog rau qhov loj ntawm qhov opacities.
kev kho mob phais
Kev kho kev puas tsuaj ntawm lub cev vitreous ntawm lub qhov muag los ntawm txoj kev phais hu ua vitrectomy. Cov kev kho mob no suav nrog kev tshem tawm ib nrab lossis ua tiav ntawm CT, uas yog ua los ntawm kev siv lub tshuab vitrectomy uas muaj vitreotome (txiav ntsuas) thiab endo-illuminator.
Thaum twg siv tshuaj tua kab mob? Raws li txoj cai, nws tau ua tiav nrog kev puas tsuaj rau lub cev vitreous vim qhib kev raug mob, nrog nws cov huab, nrog rau cov hemorrhages thiab retinopathy.
Lub sijhawm ua haujlwm yog los ntawm 30 mus rau90 feeb. Nws yog ua los ntawm kev siv tshuaj loog hauv zos lossis dav dav, nws tuaj yeem muaj ib lossis ntau theem, nyob ntawm theem thiab hom kab mob.
Hloov cov vitreous, cov khoom siv polymers yog siv, nrog rau cov ntsev ntsev sib npaug. Feem ntau, kua perfluoroorganic tshuaj, gases los yog silicone roj tau noj. Ib qho vitreous hloov pauv yuav tsum yog pob tshab li qhov ua tau, nrog qhov tsim nyog viscosity thiab lub zog refractive. Nws kuj yuav tsum tsis txhob resorbable los yog ua rau muaj tshuaj lom, inflammatory los yog ua xua.
Tom qab ua haujlwm, cov neeg mob raug qhia kom saib xyuas tus kws kho qhov muag, txwv tsis pub lub cev thiab qhov muag pom kev ntxhov siab, thiab qhov kub thiab txias hloov pauv sai. Txwv tsis pub, txoj kev pheej hmoo ntawm cov teeb meem inflammatory, re los ntshav, cataracts, siab intraocular siab los yog retinal vascular occlusion nce.
