Glaukoma-Dr Sita

 

Ilkugahk

`r. Bm. Zctk Vrctkskrc, ZpH (G) @cvcsc Ilkugahk, Gktkrkg `kn Do`kb Toerkgsc Zultkn Kiuni Oyo Jontor TZC Zultkn Kiuni / EG _NCZZ_LK Zohkrkni

 

Buhar kguas  

Buhar Kquas tor`kpkt `c Jkhork Ajulc Kntorcar ( JAK ) 

Vohorcgskkn JAK = Go`klkhknnyk

clluhcnktcan

Gomorncbknnyk  

= eajkl = Pyn`kll

oeeojt  @cdontug `c garpus sclckrcs  Zogrosc

`krc prasosus sclckrcs  @cponikrubc alob togknkn `krkb

 

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@cguhpulgkn `c JAV   jolkb kntkrk lonsk `kn crcs (pupcl)  vonk go JAK  trkdoguluh  gknklcs Zjblohh sclckrcs kntorcar  Aut elaw torikntuni pk`k = ◇

su`utmkrcnikn JAK trkdoguluh ◇ Lodkr Gorkpktkn

 

Vra`ugsc Buhar Kguas @cpra`ugsc holkluc : hogkncsho ecscalaics ykctu  

@ceusc = hogkncsho portugkrkn can ‚ can sojkrk pksce holkluc hohdrkn `onikn gansontrksc ykni dordo`k.

 

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_ltrkecltrksc

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  Vortugkrkn tormk`c holkluc hohdrkn sohc porhokdol.

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  Gotcgk `krkb holowktc gkpclor prasosus sclckrcs

 

plkshk kgkn honiklkhc ponotrksc `klkh `cn`cni gkpclor go rukni cntorstcsckl kntkrk gkpclor `onikn opctol sclckrcs

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  Vrossuro `opon`ont

 

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Prknspart kgtce 

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Horupkgkn poriorkgkn poriorkgkn can ‚ can ( Nk, Jl `kn dcjkrdankt ) ykni hohdutubgk hohdutubgkn n onoric

  Holcdktgkn Nk+ / G+ KPV kso, onzch onzch gkrdankt knbc`rkso



  Onoriy `opon`ont, prossuro cn`opon`ont

 

Voniklcrkn Buhar Kguas  

Autelaw buhar kguas tor`crc `krc `uk mklur, ykctu =  

Prkdojulkr Autelaw / Vrossuro @opon`ont Autelaw / Ganvonscankl Horupkgkn klcrkn utkhk buhar buhar kguas ( 36 % ), JAK   trkdojulkr  trkdojulkr hosbwarg   gknklcs  gknklcs Zjblohh  go vonk opcsglork  opcsglork   scnus  scnus gkvornasus

 

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Nan ganvonscankl / _voasjlorkl autelaw  

Horupkgkn scstoh poniklcrkn utkhk ykni go`uk, sogctkr ?-;6% `krc tatkl. kguas  `krc JAK  husgulus sclckrcs `kn raniik suprkgarac`kl  vonkvonk `c garpus sclckrcs, garac`  dor`ceusc honohdus sglork.

Buhar

Zcstoh

klcrkn cnc rolktce tc`kg dorikntuni

pk`k pordo`kkn togknkn

 

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Eunisc _ntug

◇ ◇ ◇

 

honiktur togknkn dalk hktk Pogknkn narhkl ;6 ‚ 46 hhBi Zodkikc ho`ck roerkgtk Zuhdor nutrcsc lonsk `kn garnok ( ilugask, kskh khcna ) Nutrcsc `onikn jkrk `ceusc `kn ashascs

 

Ilkugahk    

Zcn`rahk `onikn PCA sodkikc ekgtar rcscga utkhk Zcn`rahk  @ctkn`kc `onikn =PCA tcniic  Vonjogunikn  Vonyohpctkn

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pkpcl N CC

lkpkni pkn`knikn ykni sposcecg sposcecg  

@csodkdgkn ikniiukn `cnkhcgk buhar kquas =  Vohdontugkn  Bkhdktkn

buhar kquas dorlodcbkn

poniklcrkn buhar kquas

◇

Dlag pupcl

◇ Zu`ut JAK sohpct  Bkhdktkn

pohduknikn ( aut elaw ) buhar kquas

 

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Vra`ugsc dorlodcbkn  Pormk`c

pk`k crc`ascglctcs, totkpc dcksknyk gonkcgkn tc`kg

nyktk, gkronk `cchdknic `onikn autelaw ykni honcnigkt (solkhk tkg k`k bkhdktkn)  

Bkhdktkn poniklcrkn buhar   Dlag

pupcl

◇ Vro`cspascsc Cntuhosonsc

lonsk

◇ Vroscpctksc 

Zynogbck pastorcar (ajjlutca pupcl / sojlutca pupcl)  Kgaha`ks  Kgaha`kscc

>>

 

Zu`ut

JAK sohpct ◇ Vro`cspascsc Zuhdu hktk pon`og, bcporhotrap ◇ Vroscpctksc @ch lcibt Vupcl hc``clktksc  tanus crcs tcniic, crcs holcpkt honmk`c lodcb todkl  crcs honohpol go garnok porceor  su`ut honmk`c tortutup

 

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Bkhdktkn pk`k pohduknikn jkcrkn buhar  Ikniiukn pk`k trkdojulkr hosbwarg Bkhdktkn pk`k gknklcs Zjblohh 

Don`unikn scstoh vonk

 

Ekgtar rcscga  

Bcportonsc Vktaecscalaic

doluh molks

Zkhk4

tormk`c kgcdkt ekgtar ogstrcnscg kgcdkt `oionorksc ykni dorponikrub pk`k tanus skrke schpktcg

@uikkn

lkcn = P@ honyodkdgkn poncnigktkn roscstonsc pohdulub `krkb `klkh garpus sclcsrcs ↔ pra`ugsc BK honcnigkt

Voncnigktkn

P@ krtorc `klkh wkgtu lkhk muik honyodkdgkn poncnigktkn P@ vonk ↔ roscstonsc klcrkn BK 

 

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@ckdotos Hollctus Bcporilcgohck ↔ honcnigktgkn vcsgasctks `krkb ↔  poncnigktkn roscstonsc klcrkn `krkb `c vonk opcsglork   ↔  bkhdktkn klcrkn golukr buhar kguas↔  poncnigktkn togknkn cntrkagulc Ucsgasctks ykni tcniic ↔ poncnigktkn togknkn `krkb krtorc-krtorc ykni hohpor`krkbc dalk hktk  ↔ poncnigktkn togknkn cntrkagulc Noavksgulkrcsksc

pk`k mkrcnikn uvok

 

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Vohdkickn Ilkugahk  Ilkugahk

prchor 

◇ Zu`ut tortutup ◇ Zu`ut tordugk  Ilkugahk

sogun`or 

◇

 Kgcdkt adkt ‚ adkt tortontu, trkuhk ktku gahplcgksc trkuhk gahplcgksc ponykgct `c dalk hktk / scstohcg  Ilkugahk

ganionctkl

◇ Ilkugahk ykni tchdul somkg lkbcr / knkg-knkg

 

Ilkugahk prchor su`ut tortutup  @csodut muik = •Cnelkhktacr Cnelkhktacr  ilkujahk •Nkrraw knilo ilkujahk •Ilkugahk ganiostce 

  Ztk`cuh

Vra`rahkl  Kgut

( sudkgut )

/ cnelkhksc cnelkhksc

Grancs  Kdsalut @oionorktce  

 

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Ilkugahk prchor su`ut tortutup 

Ztk`cuh Vra`rahkl ◇ Zudmogtce  Zkgct

gopklk sodolkb pk`k hktk ykni skgct (tchdul pk`k wkgtu saro bkrc gkronk pupcl hc``clktksc sobcniik crcs honodkl `kn 

honohpol torbkhdkt) pk`k trkdoguluh  aut elaw Vonilcbktkn so`cgct honurun Holcbkt polknic `c sogctkr lkhpu (bklla) 

Hktk horkb

◇ Admogtce 

Cnmogsc

sclcor rcnikn O`ohk garnok rcnikn PCA

honcnigkt

 

Ilkugahk prchor su`ut tortutup   

Ztk`cuh Kgut / cnelkhksc ◇ Zudmogtce  Zkgct

gopklk bodkt pk`k hktk ykni skgct @csortkc hukl, huntkb ( ! @@ = ponykgct JU / kd`ahcnkl ) Hktk horkb Vonilcbktkn

gkdur  Holcbkt bklla ◇ Admogtce Cnmogsc sclcor  O`ohk garnok JAK

`knigkl, Pyn`kll oeeojt (+) Vupcl holodkr / lanmani, TV (-) Ilkujahk

elojgon PCA sknikt tcniic

 

Ilkugahk prchor su`ut tortutup   

Ztk`cuh Kdsalut ◇ Ucsus 8 6 ◇ Zkgct gopklk ◇ Hktk horkb ◇ PCA sknikt tcniic, `alarask ktku nan `alarask

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Ztk`cuh @oionorktce  ◇ Ucsus 8 6 ◇ @oionorksc garnok ( dullko, voscgol ) ◇ PCA tcniic, rksk skgct tchdul kgcdkt `oionorksc

garnok

 

Ilkugahk prchor su`ut tortutup  Vormklknkn ponykgct ( stk`cuh kgut )  

Horupkgkn goikwkt`krurktkn goikwkt`krurktkn `c  `c dc`kni hktk  sktu sorkdut kgsan hktc `klkh wkgtu 40 mkh ( PCA > :6 hhBi )

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PCA bkrus soiork `cturungkn `onikn adkt ( ! Ansot )

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Vrcnscp torkpc = aporktce  Dclk soiork torktksc, ponurunkn vcsus dorscekt rovorscdol Dclk dorlknmut  oxjkvktca ilkujahktask   ponyohpctkn lkpkni pkn`knikn

 

Porkpc cncsckl  

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Honogkn pra`ugsc BK

   k`ronoricg sologtce / nan sologtce (! Vk`k pon`orctk  mkntuni, VVAG ) tchalal hklokt 6,? % / dotkxalal 6,?%

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JKC ksotkzalkhc` :x4?6 hi Honurungkn valuho vctrous = kiont bcporashatcg

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Ilcsoral ;hL / gi DD

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Hknnctal CU ( ! ponykgct mkntuni )

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 autelaw BK =

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Hcatcguh ( ! Porikntuni pcihon crcs ) pclajkrpcn 4-0 %

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Vrastkilkn`cn

 

Ilkugahk prchor su`ut tordugk  •Vrchkry apon knilo ilkujahk •Jbrancj schplo ilkujahk  

Zudmogtce   Pkg

dknykg golubkn sobcniik sorcni torlkhdkt `ctohugkn



@otogsc `onikn tanahotrc rutcn ( `c ktks 06 tb ) knkhnosk golukrik  boro`ctor 

 Vorlu  

Hogkncsho  @oionorksc

hktrcgs ogstrksol `kn on`atol mkrcnikn trkdoguluh   gohkhpukn ekiasctascs,  autelaw buhar kguas torikniiu



 muhlkb `kn `ckhotor parc on`atol gknklcs Zjblohn,  icknt vkjualos

 Ikniiukn

hogkncsho eoo`dkjg

 

Ilkugahk prchor su`ut tordugk   

Vormklknkn ponykgct Hktk tonkni, tkg k`k tkn`k-tkn`k `krc lukr  Vormklknkn polkn-polkn tkpc prairosce  horuskg N.CC  tormk`c oxjkvktca ilkujahktask / juppcni Pogknkn dalk hktk tc`kg torlklu tcniic (dar`or lcno

40 hhBi)vcsus hkscb dkcg  lknmut lkpkni

Hulk‚hulk

pkn`knikn hkgcn sohpct ( tunnol vcscan ) Golubkn gkdur pk`k saro bkrc, sorcni goskn`uni 

= JAK= Admogtce Vrcnscp torkpc

`klkh. ho`cgkhontask

 

 

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Golkcnkn jarnok  Loujahk

k`boront

 Bypbohk

`kn bypapyan

Golkcnkn `c J.A.K Golkcnkn `c crcs  Tudoascs

crc`cs

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Golkcnkn `c pupcl  Ajlutca `kn sojlutca pupcl Golkcnkn `c lonsk  Jktkrkjt

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chhktur `kn bypor hktur 

Golkcnkn `c jarpus vctrouh  Bkohapbtbklhas

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Golkcnkn `c rotcnk  Pbrahdascs

vonk jontrklcs rotcnk

 

Ilkugahk ganionctkl  

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Pormk`c alob gkronk trkdoguluh tortutup hohdrkn Pkn`k `cnc =  Lkgrchksc  Vbatapbadck  Garnok

surkh  @ckhotor garnok doskr   

Pkn`k lknmut  Dupbtklhas

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Porkpc  Iancatahc

 

 Nourapktc aptcg ilkugahktask  

•

Ekgtar hogkncs = >>  Kgcdkt ponogknkn ponogknkn lknisuni sorkdut sorkdut kgsan `kn mkrcnikn mkrcnikn ponyagani

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Pormk`c juppcni / ogsgkvksca ilkugahktask = ponjogunikn

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lkhcnk grcdrask go pastorcar  Bcstalaic = gobclknikn kgsan, sol ilck `kn vksk

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Ekgtar hotkdalcg

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Pormk`c ikniiukn klcrkn kgsaplkshcg kpaptascs / gohktckn sol iknilcan

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Ekgtar vksgulor

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Ikniiukn poreusc go N CC = bcporvcsgasctks, bcporkiroiksc, bcporkiroiksc, bcporgakiulksc

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Vk`k pon`orctk narhatonscan ilkujahk

 

Kgcdkt ilkugahk  

Goruskgkn pk`k N.CC

 

Vonyohpctkn lkpknikn pkn`kni `in golubkn =  Zorcni

torkntug

 Zorcni

nkdrkg homk/ gursc

 Dutk

sonmk

 Vonilcbktkn

gkdur 

 

Vohorcgskkn untug ilkugahk  

_gur togknkn dalk hktk  Jkrk

`cictkl



@onikn tanahotor Zjbcatz tanahotor kplknksc

 @onikn  @onikn  

tanahotor nan gantkg

Panairkec  _ntug

honiugur muhlkb ponyklurkn jkcrkn buhar (autelaw ekjclcty )

 

Eun`usgapc  Vorbktcgkn

pk`k pkpcl N.CC, k`knyk oxjkvktca

ilkujahktask

 

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Vohorcgskkn lkpknikn pkn`kni  @onikn tost ganerantksc  @onikn porchotor   @onikn tkniont sjroon Iancasgapc  @onikn lonsk iancasgap untug honclkc lodkr su`ut JAK Pos pravagksc  @onikn jkrk hcnuh kcr   @onikn hksug go gkhkr iolkp  @onikn pohdorckn hc`rcktcguh  @onikn jkrk tc`ur tonigurkp  Vordo`kkn togknkn 2 hhBi kntkrk sodoluh tos `kn sosu`kb tos `ckniikp hon`orctk ilkugahk, bkrus hulkc `cdorc torkpc

 

Vohorcgskkn Ilkugahk  

Voniugurkn togknkn dalk hktk  Zojkrk

`cictkl (`onikn pklpksc)  @onikn tanahotor Zjbcatz  @onikn tanahotor kplknkt

 

Vohorcgskkn Ilkugahk  

Voniugurkn togknkn dalk hktk `onikn tanahotor kplknkt

 

Voniugurkn togknkn dalk hktk 

@onikn tanahotor kplknkt

 

Vohorcgskkn Ilkugahk  

Eun`usgapc  _ntug

honclkc pkpcl n.CC  Jkrc k`knyk oxjkvktca ilkujahktask

 

Vohorcgskkn lkpkni pkn`knikn  

Vohorcgskkn lkpknikn pkn`kni  @onikn

tost ganerantksc

 @onikn

porchotor 

 @onikn

tkniont sjroon

 

Porkpc ilkugahk  

Adkt-adktkn  Gkrdancg

knby`rkso cnbcdctar (kzotkzalkhc`o 4?6 hi)  Hcatcguh (pclajkrpcn 4%, osorcn 6,4?%) 

Zchpktahchotcg (opcnopbrcn 6,?%) dlajgor (Pchalal hklokt)

 Dotk  

Aporksc  Crc`atahc 

Ecltrksc = trkdogulogtahc

 

Porchk gkscb…