Qaybta dambe ee indhaha ayaa u shaqeyneysa iyadoo la ilaalinayo qaabka ileyska, qabashada muraayadda meel ku taal, iyo kicinta dareen-qabadka maskaxda ee maskaxda laga soo galo unugyada fotoreceptor ee ku yaal indhaha indhaha.
Raajada , choroid (lakabka lafaha ee isha), iyo dareemaha indhaha ayaa ka kooban qaybo badan oo ka mid ah qeybta hore, oo leh dhowr cudur oo HIV-la xiriira oo soo bandhiga gudaha buqarrooyinka bukaanka, badanaa marxaladda dambe ee cudurka HIV.
Dhibaatooyinka qaybta dambe ee-horay ugu soo bandhigtay isbeddelada dhiigga ee retina - ayaa lagu arkaa 50% illaa 70% bukaanka qaba HIV , waxaana laga yaabaa inay keenaan dhaawac joogto ah ama dhaawac culus ah oo loo yaqaan retinopathy.
Caabuqyo kale oo la xiriira HIV-ga ee qaybta hore ee ka midka ah:
- Cytomegalovirus (oo loo yaqaan CMV)
- Toxoplasmosis (infekshan caadi ah oo si fudud u faafa)
- Cudurka 'Cryptococcosis' (cudur kale oo fayraska HIV-ga la xiriira)
- Qaaxada (TB)
Cytomegalovirus
Cytomegalovirus (CMV) waa herpesvirus in uu ku dhaco in ka badan kala badh tirada dadka qaangaarka ah, marar dhif ah oo soo bandhigaysa cudur ku dhaca kuwa leh nidaam difaaca oo karti leh (marka laga reebo, marmar, calaamado la mid ah mononucleosis ). Inkastoo inta badan laga bilaabo hooyada ilaa ilmaha, waxaa sidoo kale lagu gudbin karaa qaangaarnimada iyada oo loo marayo xiriir galmo. Sidan oo kale, cudurrada CMV ee ragga galmoodka la leh ragga waa qiyaastii 90%, maadaama ay la socdaan dad qaba HIV.
CMV ayaa indhaha ku dari kara dhowr siyaabood, inkastoo ay badanaa ku dhacdo mararka qaarkood infilmidda xanuunka 'retina', oo loo yaqaan 'retinitis'. Cudurku inta badan wuxuu ku dhacaa bukaanada tiradoodu ay CD4 ka hooseyso 50 unug / mL waxayna muujiyaan calaamadaha inta u dhaxaysa aragtida dabaqyada ilaa luminta aragtida iyo xitaa indha la'aanta.
Marka cudurka CMV-da lagu ogaado baaritaanka xasaasiyadda, waxay si dhaqso ah u horumarin karaan, badanaa toddobaadyo gudahood. Iyadoo aan wax daawo ah la gelin, dhaawacyadu waxay horumarin karaan xarumo dhexe (dib udhaca dibadda xarunta), yareynta muuqaalka muuqaalka iyo mararka qaarkood keena aragti dhamaystiran oo lumis ah. Iyadoo inta badan cillad-celinta CMV ay inta badan bixiso labada dhinac (labadaba indhaheeda), waxay sidoo kale soo bandhigi kartaa hal dhinac (hal il ah).
Valganciclovir waxaa loo tixgeliyaa daroogada xulashada daaweynta CMV retinitis, oo afka laga qaato sida laba goor maalintii qiyaasta muddada induction-ka, oo ay ku xigto qiyaasta hal mar ah xilliga dayactirka. Ganciclovir ayaa sidoo kale laga yaabaa in la qoro laakiin waa la siiyaa xididada, halkii laga hadli lahaa hadal muddo dhan 21 maalmood ah.
Si kale, gogol-galka ganciclovir-gebi ahaan, daqiiqado tallaal ah ayaa si toos ah loogu siiyaa goobta infekshanka-mararka qaarkood lagu galiyo isha. Badanaa waxaa loo isticmaalaa xaalado qoto dheer oo ka mid ah retinitis-ka CMV, waxay u ogolaataa daawooyinka dheeraadka ah ee dheeraadka ah ee daawada qoyan (jilicsanaanta buuxisa ee buuxisa booska u dhexeeya muraayada iyo retina).
Toxoplasma
Toxoplasma waa sababta ugu badan ee loo yaqaan retinochoroiditis (infekshanka retina iyo / ama qolofta) ee dadweynaha, iyo kan labaad ee ugu badan dadka qaba HIV.
Iyadoo ay sababtay bukaanka protozoan, ee Toxoplasma gondii , cudurku wuxuu saameeyaa in ka badan 200,000 oo qof sannad kasta oo Maraykanka ah, waxaana lagu faafiyaa labadaba ama iyadoo la cuno hilib hilib leh. Inta badan waxay la xiriiraan bisadaha (inkastoo ay ku jiraan xayawaan badan oo diiran), taabashada saxarada xayawaanka ayaa sidoo kale loo arkaa in ay tahay sabab weyn oo keena gudbinta T. gondii .
Marka toxoplasmosisku keeno isha, waxay muujinaysaa jaale-caddaan ah laf-dhabarka oo ay weheliso jilicsanaanta jilicsanaanta. Aqoonsiga waxaa badanaa lagu sameyn karaa baaritaanka indhaha, oo leh baaritaano dhiig oo antibody ah oo bixiya xaqiijinta serolojik.
Qalabka steroids ee marmarka qaarkood waxaa loo isticmaalaa in lagu daaweeyo kiisaska fudud ee 'toxoplasma retinochoroiditis', halka kiisaska daran ee badanaa loo qoro isku dhafka pyrimethamine, folinic acid iyo sulfadiazine. Dadka qaba HIV-ga sareeya, daaweyn joogta ah oo joogto ah ayaa laga yaabaa in loo baahdo, marar dhif ah oo la adeegsanayo isticmaalka trimethoprim-sulfamethoxazole, isku dhafka kaas oo guud ahaan si fiican u dulqaatay.
Cryptococcosis
Cryptococcosis waa infekshan ay keento neefsashada hawo-qaadashada, Cryptococcal neoformans-ka , kaas oo badanaa muujin kara meninjaaytis (mararka qaarkood nafta halis galisa ee xuubabka xajinta ee xuubka maskaxda ee ku wareegsan maskaxda iyo xangulada laf-dhabarka). Inta badan dadka lugta ku leh waxay u muuqdaan kuwo soo bandhigaya marxaladda labaad marka ay timaado qulqulatada 'cryptococcal meningitis' , gaar ahaan marka ay weheliso septicaemia.
Infekshanka xuubka waxaa lagu gudbin karaa nidaamka dhexe ee neerfaha (CNS) iyada oo loo marayo dareemaha indhaha ama dhiigga marka uu cudurku ku faafo (sida, ka sii faafitaanka cudurka caabuqa).
Baaritaanka, dhaawacyo badan oo huruud ah ayaa lagu ogaan karaa korriinka iyo / ama retina. Haddii aan la daaweyn, faafitaanka infakshanka ku dhaca unugyada indhaha ee indhaha ayaa mararka qaarkood keeni kara lumis arag.
Daaweynta nidaamsan ee qoorgooyaha 'Cryptococcal meningitis' ayaa guud ahaan lagu bixiyaa iyada oo la adeegsanayo amphotericin B iyo flucyosinos, oo loo arko daaweynta doorashada. Dawooyinka antifungal ayaa inta badan la ogaadaa marka ay ka shakiyaan nacasku.
Qaaxada
Qaaxada (tiibayda) waxay u egtahay in ay ka yar tahay cudurada kale ee la xiriira HIV laakiin waxaa mararka qaarkood lagu arkaa bukaanada qaba HIV oo leh qaaxo sambab ah. Waxay u egtahay in ay soo bandhigto sida granuloma nodule-ga ah ee korriimada waxayna muujin kartaa tirooyinka CD4 (ka badan 150 unug / mL) marka loo eego cudurrada kale ee la xiriira HIV ee qaybta hore. Daaweynta nidaamka leh daawooyinka ka hortagga tiibayda ayaa sida caadiga ah loo qoraa habka lagu taliyey ee ficilka.
Ilaha:
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