Yintoni ekufuneka uyazi ngesifo seswekile

Imfundo yezeMpilo

Unjani umbono wakho? Ukuba unesifo seswekile, unokufuna ukuba uqaphele ngakumbi ngempilo yamehlo akho.

Isifo samehlo seswekile sesona sizathu siphambili sobumfama, ngokweZiko leLiso leLizwe (NEI). Phakathi kweentlobo ezahlukeneyo zesifo seswekile, ezibandakanya i-glaucoma, i-cataract, kunye nesifo seswekile i-edema, i-diabetic retinopathy sesona sizathu sokulahleka kombono phakathi kwabantu abanesifo seswekile.

Abantu bacinga ukuba isifo seswekile siyabachaphazela amanqanaba eswekile yegazi , kodwa abasoloko becinga ukuba ichaphazela amehlo abo, utshilo ugqirha wamehlo uRahul Khurana, MD, isithethi seklinikhi yeAmerican Academy of Ophthalmology (AAO). Kodwa kubalulekile ukuba benze njengoko ukufumanisa kwangoko kunye nonyango olufike ngexesha unokuwunciphisa kakhulu umngcipheko wokulahleka kombono.

Ngo-Novemba yiNyanga yeSwekile yeSizwe kunye neNyanga yeSizwe yeSifo seSwekile. Ke, ngeli xesha lonyaka liphawula ithuba elihle lokuba ufunde ngakumbi ngendlela isifo seswekile esinokuyichaphazela ngayo impilo yamehlo akho. Unokufunda ngakumbi malunga neemeko ezinje ngesifo seswekile, kwaye unokukhusela njani iingxaki zombono okanye ilahleko enkulu yombono ekuphuhliseni.

Yintoni i-retinopathy yeswekile?

I-retinopathy yeswekile yimeko ekhula ngenxa yomonakalo kwimithambo yegazi encinci yeretina, elucekeceke lweethishu ngasemva kweliso kufutshane ne-optic nerve.

NgokwamaZiko oLawulo lweNtsholongwane kunye noThintelo (CDC), isifo seswekile sesifo seswekile esona sizathu siphambili sokungaboni kakuhle kunye nokungaboni phakathi kwabantu abadala abakwiminyaka yokusebenza eUnited States . Phantse 8 yezigidi zabantu abadala banesifo seswekile, kwaye elo nani kulindeleke ukuba likhule. Umbutho wezeMpilo weHlabathi ukwabika ukuba isifo seswekile esibangela ukuphantse kubangele phantse I-3% yokulahleka kombono kwihlabathi liphela.

Kwilihlo elisempilweni, iretina ifumana ukukhanya kwelensi yamehlo, ize ikuguqule oko kukhanya ibe yimiqondiso ize ithumele loo miqondiso kwingqondo. Yile ndlela ubona ngayo.

Kodwa ukuba unesifo seswekile kwaye amanqanaba eglucose egazini akho aphezulu kakhulu, amehlo akho anokuhlawula ixabiso. Xa amanqanaba eswekile yegazi ehlala enyukile ngokuhamba kwexesha, anokuyonakalisa imithambo yegazi yakho-leyo ibandakanya imithambo yegazi encinci emehlweni akho. Ngenxa yoko, loo mithambo yegazi inokuqalisa ukudumba okanye ukuqhekeka. Abanye baqala ukuvuza ulwelo kwi-retina yakho. Umzimba wakho unokuphendula ngokuzama ukukhulisa imithambo yegazi emitsha, kodwa oko kunokubangela iingxaki ezintsha. Ekugqibeleni, unokuphulukana namandla okubona.

Zimbini iintlobo eziphambili ze Ukujonga kwakhona isifo seswekile : I-retinopathy (i-NPDR) engenasifo kunye nesifo seswekile esandayo (PDR).

Isifo seswekile esinganyangekiyo

Isifo seswekile esinganyangekiyo kwinqanaba lokuqala kwesi sifo. Usenokungaziqapheli naziphi na iimpawu ngeli nqanaba, nangona abanye abantu bexela uburharha.

Ezinye iingcali zahlulahlulahlulahlula i-retinopathy ezingafakwanga ngokwamabakala zibe ngamanqanaba amathathu. Nantsi into eyenzekayo ngezo zigaba:

• I-retinopathy epholileyo engabonakaliyo Ngeli nqanaba, iindonga ze-capillary ziqala ukuba buthathaka, zibangele ukuba ii-microaneurysms zikhule.
• I-retinopathy e-nonproliferative ephakathi: Ii-microaneurysms ziqala ukugqabhuka, zibangele ukopha okuncinci kwi-retina. Imithambo yegazi ebuthathaka iyavuza okanye ilile ulwelo kwi-retina. Ukuvuza kunokwenza inxenye yokudumba kweretina. Eminye imithambo yegazi iyavalwa, kunciphisa ukuhanjiswa kwegazi kwiretina.
• Ubunzima be-retinopathy engapheliyo Ukuqhekeka okungakumbi kuyenzeka, kwaye imithambo yegazi emininzi iyavalwa, ukusika ngakumbi ukunikezelwa kwegazi kwiretina.

Ukuqhubeka kwesifo seswekile

Isifo seswekile esiqhubekayo sisifo esiphambili sesifo seswekile.

Xa uphuhlisa le fomu, i-retina yakho iqala ukukhula imithambo yegazi emitsha, inkqubo eyaziwa ngokuba yi-neovascularization, ngokwe-AAO. Ezo mithambo mitsha yegazi zihlala zibuthathaka, ngenxa yoko zihlala zivuleka kwaye zophe igazi kwi-vitreous, into efana nejeli embindini wamehlo akho. Xa oku kusenzeka, unokuqaphela ezinye iincinci ezincinci okanye imigca ejikelezayo kwinqanaba lakho lombono. Ezi zidadayo zinokulalisa okanye zivimbele umbono wakho.

Nangona kunjalo, ayisiyiyo yonke into enokwenzeka ukuba une-PDR. Izicubu ezinqabileyo zingenza kule mijelo yegazi mitsha, enokuthi ikhokelele kwi-retina. Iretina ikhutshwa kwindawo yayo yesiqhelo ngasemva kweliso lakho, ukuze iiseli zakho zamehlo zingafumani unikezelo lwesiqhelo lweoksijini kwimithambo yegazi. Okude ukuba ishiywe inganyangwa, kunokwenzeka ukuba eli lungu lokugcina linokukhokelela ekuphulukaneni nombono ngokusisigxina.

Unokwazi njani ukuba isifo seswekile sichaphazela amehlo akho?

Kumanqanaba okuqala esifo seswekile, unokuhlala ungonwabanga ukuba akukho nto iphosakeleyo. Umbono wakho unokubonakala uqhelekile.

Kodwa, unokuba kumanqanaba okuqala wesifo seswekile ngaphandle kokuqonda. Yiyo loo nto iimviwo zamehlo ezibanzi zibaluleke kakhulu: Ekuphela kwendlela onokuyazi ngayo kukuba ugqirha wamehlo wakho abone iimpawu zomonakalo ngexesha lovavanyo lwamehlo olucociweyo.

Ngenxa yokuba ucinga ukuba ulungile, musa ukubeka emngciphekweni wokuphulukana nombono wakho kunye nokuphuhlisa ubumfama, uyalumkisa U-Amir Moarefi, MD, uMMS , ugqirha wamehlo e-Long Beach, California.

Iimpawu zeswekile yesifo seswekile ziqala ngombono omdaka. Ngokwe-AAO, ezinye iimpawu, njengoko isifo siqhubeka, zinokubandakanya:

• Iindawo zokudada okanye amabala kumbono wakho
• Indawo emnyama kumbono wakho ophakathi
• Unengxaki yokubona ebusuku
• Imibala ijongeka ngathi iphelile okanye ihlanjiwe
• Umbono utshintsha ukusuka kokufiphala ukuya kokucacileyo

Ukuba ishiywe inganyangwa, isifo se-diabetic retinopathy sinokukhokelela nakwezinye iimeko zamehlo, ezinje ngohlobo lwe iglaucoma eyaziwa njenge-glaucoma ye-neovascular.

Ngaphezu koko, malunga nesiqingatha sabo bonke abantu abanesifo seswekile esiqhubekayo ekuphuhliseni imeko yeswekile yesifo seswekile (i-DME). Ngale meko, inxenye yeretina yakho ebizwa ngokuba yi-macula iqala ukudumba ngenxa yayo yonke into evuzayo ephuma kwimithambo yegazi. Oku kunokubangela ukungaboni kakuhle.

Ezinxulumene: Iimpawu zokuqala ezili-10 zesifo seswekile kunye nokubonwa nini ngumboneleli wezempilo

Ngubani ophuhlisa i-retinopathy yeswekile?

Nabani na onesifo seswekile angahlakulela ukujonga isifo seswekile. Akunandaba nokuba unayo i-Type 1 diabetes okanye i-Type 2 diabetes. Kodwa kuya kufuneka uthathele ingqalelo ukuba unesifo seswekile kangakanani.

Okukhona unesifo seswekile, umngcipheko ophakamileyo onawo wokuba nesifo seswekile ngokuhamba kwexesha, utshilo uGqirha Khurana.

Kungenxa yokuba ekuhambeni kwexesha, amanqanaba eswekile egazi aphezulu kunokubangela ukonakala kuloo mithambo mincinci yegazi iliso lakho. Umngcipheko mkhulu ukuba unengxaki yokulawula amanqanaba eswekile yegazi kunye nokuwagcina kuluhlu lwakho ekujoliswe kulo.

Kukho nezinye izinto ezinobungozi kwi-retinopathy yesifo sikashukela, kuquka:

• Ugqatso: Abantu base-Afrika baseMelika nabaseSpanishi kubonakala ngathi banomngcipheko ophezulu wokukhula kwesifo seswekile.
• Imbali yosapho: Uphando lubonisa ukuba imbali yosapho yesifo seswekile inokunyusa amathuba okuba uyiphuhlise, nayo.
• Ukukhulelwa: Ukuba uphuhlisa isifo seswekile xa ukhulelwe, amathuba akho okuba nesifo seswekile kamva ebomini ayonyuka- kwaye namathuba akho okuba nesifo seswekile.
• Ezinye iimeko zonyango: Ukuba une-cholesterol ephezulu okanye uxinzelelo lwegazi oluphezulu, usemngciphekweni owandayo wokuphucula ukubonwa kwakhona kwesifo seswekile.

Ngaba umonakalo wamehlo onesifo seswekile unokubuyiselwa umva?

Ngokukodwa kumanqanaba okuqala, isifo se-diabetic retinopathy siyanyangeka.

Nokuba uphulukana nombono kwi-diabetic retinopathy, ngoku sineseti entsha yokukhetha ukuyilawula, ucacisa uGqirha Khurana. Ke, kubaluleke ngakumbi ukubona i-ophthalmologist yakho xa unesifo seswekile.

Unyango lwesifo seswekile lubandakanya:

• Ukulawula iswekile egazini: Thintela umonakalo ukuba ungabikho kwimithambo yegazi elisweni lakho, kwaye akunakufuna unyango olongezelelweyo. Ungathetha ne-endocrinologist yakho ukuba ufuna uncedo ngalo msebenzi.
• Amayeza: Ugqirha wamehlo wakho unokucebisa amayeza ngohlobo lwee-steroids okanye Unyango lwe-anti-VGEF . Unyango oluchasene ne-VGEF ziinaliti zamayeza ayilelwe ukuthintela iprotein eveliswa ziiseli zakho ebizwa ngokuba kukukhula kwe-vascular endothelial factor, ekhuthaza ukukhula kwenqanawa yegazi. Iinaliti zinokucothisa okanye ziyeke ukukhula ngokungaqhelekanga kwenqanawa yegazi enokuthi ichaphazele okanye inciphise umbono wakho. Amayeza amathathu aphambili e-anti-VGEF Avastin , ULucentis , kunye Eylea .
• Utyando lweLaser: Ukuba uqhubele phambili, okanye ukwandiswa kwesifo seswekile, unokuba ngumgqatswa wohlobo lonyango lwelaser olubizwa usasaze utyando lwe-laser , ikwabizwa ngokuba yi-panretinal photocoagulation. Ngokusisiseko, isusa imiphetho yeretina, isuse eminye yemithambo yegazi ebangela ukulahleka kombono.
• IVitomyomy: Ngokutsho kwe-AAO, olu hlobo lotyando lunokulungela umntu onesimo esiphambili sesifo seswekile. Ibandakanya ukususa enye ye-vitreous gel kunye nokuvuza kwemithambo yegazi ngasemva kweliso (kwaye ngamanye amaxesha izicwili ezibomvu). Ukususa ezo zinto kuvumela ukukhanya ukuba kugxile kwakhona kwi-retina ukuze ubone.

Njengalo naluphi na uhlobo lonyango, kukho ukunyuka kunye nokuhla kweendlela zokhetho ezahlukeneyo zesifo seswekile.
Umzekelo, i-panretinal photocoagulation inokusebenza kakhulu, utshilo uGqirha Moarefi, kodwa wena uncama umbono wakho wendlela ukuze ugcine umbono wakho ophakathi. Kwaye oko kunokuchaphazela amandla akho okwenza eminye imisebenzi yakho yokuphila kwemihla ngemihla, kubandakanya ukuhamba nokuqhuba.

Ngexesha elithile, ukuba i-diabetic retinopathy ifikelele kwinqanaba eliphezulu, ngekhe kubekhona ukuguqula umonakalo, utshilo uGqirha Khurana. Ngelo xesha, ugqirha wamehlo wakho uya kugxininisa ekugcineni umbono osenawo-kwaye umise nawuphi na umonakalo ongaphezulu ukuba ungenzeki.

Abantu abanesifo seswekile banokuthintela njani iingxaki zamehlo?

Ekuphela kwendlela yokuthintela umonakalo kukuthatha ngokungathí sina kwaye usebenze ngokujonga kwakho, uGqirha Moarefi ucacisa.

Oko kuthetha ukuba nabani na onesifo seswekile kufuneka acwangcise uvavanyo lwamehlo olubanzi qho ngonyaka , Ugqirha wamehlo wakho unokuvavanya impilo yeretina kwaye ajonge iimpawu zomonakalo ozayo. Ugqirha wakho uya kulawula amathontsi wamehlo enza ukuba abafundi bakho babe banzi, okanye bandise, ukuze babone kakuhle i-retina.

Ukuba ugqirha wamehlo akho ukrokrela ukuba unesifo seswekile, unokuvavanywa kuvavanyo lokuqonda isifo olubizwa ngokuba yi-fluorescein angiogram. I-fluorescein angiography (FA) kubandakanya ukujova idayi enemibala kwimithambo yakho, emva koko usebenzise ikhamera ukuthatha imifanekiso yezo zigazi zegazi zikwi-retina xa idayi idlula kuzo.

Musa ukuvuthela uviwo lwakho lwamehlo, nokuba awuzange uqaphele naziphi na iimpawu.

Nikezela iyure enye yonyaka wakho ekuqaleni ukuze uqiniseke ukuba awusokoli ubomi bonke bokungaboni okanye ukukhubazeka okubonakalayo nokwasemzimbeni, utshilo uGqirha Moarefi.

Unokusebenza ukukhusela i-retinopathy yeswekile ekuphuhliseni ngokugcina iswekile yegazi iphantsi kolawulo olufanelekileyo. Ngokwe-National Institute of Diabetes kunye neDigestive and Kidney Diseases (NIDDK), ukuba ujolise ekulawuleni amanqanaba eswekile yegazi, unokukwazi ukunqanda ukuba namanqanaba aphakamileyo angapheliyo anokonakalisa loo mithambo yegazi emehlweni akho.

Kodwa kukho ezinye iimeko zempilo ekufuneka ujonge kuzo ukulawula: uxinzelelo lwegazi kunye namanqanaba akho e-cholesterol. Ukulawula ezi meko zintathu, ezibizwa ngokuba yi-NIDDK ngokuba nesifo seswekile i-ABCs kunokukunceda uhlale usempilweni kwaye ugcine amehlo akho esempilweni, nawo.

Nokuba ufumana uvavanyo lwamehlo oluhlaziyiweyo ngonyaka kwaye uphaphile malunga nokugcina amanqanaba eswekile yegazi kuluhlu lwakho ekujoliswe kulo, jonga naluphi na utshintsho kumbono wakho. Ukuba uqala ukuqaphela ezinye iimpawu ezingaqhelekanga, ungazihoyi.

Umzekelo, ukuba uqaphela ukugqabhuka kweeflethi ezintsha okanye ukukhanya kokukhanya, oku kunokuba luphawu lokuqina kwethina, olunokwenzeka kwiimeko eziphambili zesifo seswekile. Yimeko enzulu kakhulu enokubangela ukulahleka kombono ngokusisigxina ukuba ayilungiswa ngokukhawuleza.