I-retinopathy yesifo sikashukela iwukulimala kwemithambo ye-retinal esehlwini lamehlo. Isifo esinjalo siyinkinga evamile yesifo sikashukela, ngeshwa engabangela ubumpumputhe.
Ukuhlangana kwamandla kwamakhono okubonakalayo kwenzeka emaphesenti angama-85 abantu abaphethwe yisifo sikashukela sohlobo 1 isikhathi eside lesi sifo (kusuka eminyakeni engama-20). Futhi ezigulini ezinesifo sikashukela sohlobo 2 saphakathi nesikhathi esidala, ukulimala kwemithambo yamehlo kubonakala ngamaphesenti angama-50.
Kuyavela ukuthi enye yezinkinga ezivame kakhulu zesifo sikashukela ukungaboni kubantu abadala, abaneminyaka engama-20 kuye kwengama-74. Kepha uma isiguli sihlolwa ngokuhlinzwa ngudokotela wamehlo futhi sibheka ngokucophelela zonke izincomo zakhe, khona-ke kungenzeka ukuthi umbono oqhubekayo uzoqhubeka.
Ngeshwa, ezigabeni zakamuva, i-retinopathy yesifo sikashukela ingaholela ekulahlekelweni ngokuphelele kombono. Ngalezi zizathu, abantu abaphethwe yi-retinopathy yesifo sikashukela esande kakhulu bavame ukutuswa odokotela ukuthi benze i-laser coagulation.
Ngenxa yale ndlela yokwelashwa, ukuqala kobumpumputhe kungabambezeleka isikhathi eside futhi isifo esifana nesifo sikashukela i-retinopathy singakhishwa. Abaningi besifo sikashukela banezimpawu ze-retinopathy esigabeni sabo sokuqala. Okwamanje, lesi sifo asithuthuki, ngakho-ke, ukuthikameeka okubukwayo akubonwa. Bangatholakala kuphela ngemuva kokuhlolwa ngudokotela wezifo zamehlo.
Namuhla, isikhathi sokuphila kubantu abane-Type 1 no-2 sikashukela siyanda. ubungozi bokushona ngenxa yezifo zenhliziyo kuyancishiswa. Futhi lokhu kusikisela ukuthi i-retinopathy yesifo sikashukela inesikhathi esiningi sokuthuthuka kubantu abaningi. Ngaphezu kwalokho, izifo zamehlo zivame ukuhambisana nezinye izinkinga zesifo sikashukela, njengesifo sezinso kanye nonyawo lwesifo sikashukela.
Izimbangela zesifo wamehlo ezigulini ezinesifo sikashukela
Ngeshwa, izimbangela eziyinhloko zokwakhiwa kwe-retinopathy yesifo sikashukela azikanqunywa okwamanje. Namuhla, ososayensi bacubungula imiqondo eyahlukahlukene. Kodwa-ke, izici sezivele zaziwa, ngakho-ke abantu abanesifo sikashukela kufanele bazi ngabo futhi babanake lapho behlangabezana nokuxilongwa kwesifo sikashukela se-retinopathy.
Amathuba okuba nezifo zamehlo akhuphuke uma:
- ukukhulelwa
- isakhi sofuzo;
- uma izinga likashukela wegazi likhuphuka njalo;
- ukubhema;
- isifo sezinso;
- umfutho wegazi ophakeme (umfutho wegazi ophakeme);
- abantu abadala bathambekele kakhulu kwi-retinopathy yesifo sikashukela.
Kepha izimbangela eziphambili zilele ku-hypertension ye-arterial kanye noshukela omkhulu wegazi, ophakeme kunabo bonke abanye, ngisho nokungalawulwa, izimpawu - isikhathi sesifo sikashukela, ufuzo kanye nezici ezihlobene nobudala.
Kwenzekani ngesikhathi se-retinopathy yesifo sikashukela?
Ngenxa yokubhema, ushukela wegazi kanye nomfutho wegazi ophakeme, imithambo emincane okuthunyelwa ngayo igazi emehlweni, ebanga ukulethwa kwezakhi nomoya-mpilo, futhi yile ndlela izinqubo ezibangela ukubuyiswa kwesifo sikashukela ezingachazwa ngayo. Ngokuvamile, izimpawu zikashukela wegazi eliphakeme kufanele zihlale zikwethusa, ngoba imiphumela yazo ihlala iba yingozi kakhulu.
Futhi uma kuqhathaniswa nezinye izicubu zomzimba, i-retina yeso idla ushukela omningi nomoya-mpilo ngeyunithi ngayinye yesisindo sayo.
I-Retinology. Isigaba esandisayo
Ngenxa yokuhlaselwa yindlala komoya we-tishu, umzimba uqala ukukhulisa ama-capillaries amasha ukubuyisela ukuhamba kwegazi okujwayelekile emehlweni. Le nto ibizwa ngokuthi ukwanda. Kepha isigaba sokuqala esandayo se-retinology sibonisa ukuthi inqubo leyo ibingakaqalwa.
Kuze kube manje, kuphela izindonga zemithambo yegazi eziwohlokayo. Le nto ibizwa ngokuthi yi-miconeurism. Kwezinye izimo, uketshezi negazi ligeleza kusuka kuma-capillaries kuya kwi-retina. Kulokhu, imicu yezinzwa ye-retina iyavuvukala, bese kuthi i-macula (maphakathi ne-retina) inyakaze. Le nto ibizwa ngokuthi i-macular edema.
Proliferation ibizwa ngokuthi ukwanda emehlweni yemithambo yegazi emisha. Zintekenteke impela, ngenxa yalokho zingena ukopha. Futhi isigaba esandayo se-retinopathy yesifo sikashukela sibonisa ukuthi inqubo yokukhula kwemithambo yegazi emisha esikhundleni seyonakalisiwe isivele isiqalile.
Njengomthetho, imikhumbi engajwayelekile ibonakala kwi-retina, kepha ngezikhathi ezithile ikhula ize ibe ngumzimba we-vitreous - into efana nejelly, into esobala egcwalisa ngokuphelele maphakathi neso. Imikhumbi emisha ekhulayo, ngeshwa, ayisebenzi kahle.
Zintekenteke, okunomthelela ekuweni kwegazi okuvame kakhulu. Ukuqhekeka kwegazi kuqongelela, lapho amafomu izicubu zomzimba, ngamanye amazwi, kuvela izibazi endaweni ye-hemorrhage, i-retinopathy yesifo sikashukela ihlala ihlangana nemiphumela.
Kunezikhathi lapho i-retina yelulwa futhi isuka kude nodonga lwangemuva lweso. Le nto ibizwa ngokuthi ukwenqatshwa njenge-retinal. Lapho imikhumbi esanda kusungulwa iphazamisa ukugeleza ngokwemvelo kokugeleza kwamanzi, khona-ke ingcindezi esemeyweni yeso inyuka, okukhinyabeza ukulimala kwe-opic nerve, enomsebenzi obalulekile ezigulini ezitholakala ukuthi zinesifo sikashukela sikashukela.
I-nerve idlulisela isithombe kwingqondo. Kulesi sigaba, isiguli siqala ukubona izithombe ezifiphele, izinto ezihlanekezelwe, umbono ongemuhle ebusuku, nokuningi.
Ungakuvimbela kanjani i-retinopathy?
Qaphela ukuthi okudingeka kuqala yi-glucose yegazi kuyinto ejwayelekile, futhi kuphela lapho lelo zinga liyohlala lisesimweni esifunayo, futhi futhi uma umfutho wegazi ungeqi ku-130/80 mm RT. Ubuciko. Ke ubungozi be-retinopathy nezinye izinkinga zesifo sikashukela kuzoncipha kakhulu.
Kepha kufanele kukhunjulwe ukuthi yisiguli uqobo kuphela esingalawula futhi siqaphe isimo sempilo yaso, ukuze impilo yakhe ibe yinde nempilo yayo ibe mihle kakhulu.
Izigaba ze-retinopathy
Ukuze uqonde ukuthi izigaba zesifo sikashukela zihluka kanjani, nokuthi yini ebangela izimpawu zaso, kubalulekile ukuqonda ukuthi iso lomuntu lisebenza kanjani nokuthi linamalungu amangaki.
Imisebe ekhanyayo ingena iso, lapho-ke iyakhishwa ku-lens futhi igxile ku-retina. I-retina ingaphakathi langaphakathi le-ocular equkethe amaseli we-photoreceptor, enikeza ukuguqulwa kwemisebe yokukhanya ibe yimizwa yezinzwa nokusebenza kwayo kokuqala. Lesi sithombe siqoqwa kwi-retina, ngemuva kwalokho singena kwi-optic nerve bese siyilandela ubuchopho.
I-vitreous iyinto etholakala phakathi kwe-retina nelensi. Imisipha inamathele esitho, ngenxa yokuthi iso lingahamba ngezindlela ezihlukile.
Kunendawo ekhethekile e-eye retina lapho i-lens igxila ukukhanya. Le ndawo ibizwa ngokuthi yi-macula, kuyadingeka ukuxoxa nge-retinopathy.
Ukuhlukaniswa kwe-retinopathy:
- isigaba sokuqala;
- isigaba sokuqala
- isigaba esandayo;
- isigaba esibulalayo (ukuguqulwa kokugcina ku-retina).
Isigaba esingelona ukwanda
Uma kwenzeka isifo sikashukela sefinopathy, imikhumbi edla i-retina iyonakala. Esigabeni sokuqala sesi sifo, imikhumbi emincane kakhulu - ama-capillaries athinteka kuqala.
Ukuvuleka kwezindonga zazo kukhuphuka kakhulu, ngenxa yokuthi kwakheka i-hemorrhage kanye ne-edema ye-retinal.
Isigaba sokugcina
Kulesi sigaba, izinguquko ku-retina ziya ngokwanda. Lapho kutholwa i-ophthalmologist, iminonjana yama-hemorrhages amaningi, izindawo ze-ischemic, ukunqwabelana kwamamanzi kuyabonakala. Ngamanye amagama, udokotela ubona iziphazamiso zokujikeleza kwegazi, ngenxa yalokho izikebhe "zibulawa yindlala." Kulesi sigaba, inqubo ihlanganisa i-macula, futhi isiguli sikhala ngokukhinyabezeka okubukwayo.
Isigaba esandisayo
Kulesi sigaba, kuvela imikhumbi emisha, isusa okuvele konakele. Imithambo yegazi ihluma ngokungena kwi-vitreous. Kepha izikebhe ezisanda kwakhiwa zingcolile, ngalokho-ke ukuphuma kwesibindi ngenxa yazo kwenzeka kaningi.
Isigaba se-terminal
Imvamisa esigabeni sokugcina, umbono uvinjelwa ukuphuma kwe-vitreous hemorrhages. Kulesi simo, kwakheka inani elikhulu lezicucu zegazi, ngenxa yokuthi i-retina yeluliwe futhi ukwenqatshwa kwayo kuqala.
Lapho ilensi iyeka ukubamba imisebe yokukhanya kuma-macula, umuntu abe impumputhe ngokuphelele.
Izimpawu nokuxilongwa kwe-retinopathy yesifo sikashukela
Izimpawu eziphambili zalesi sifo ziyanda kakhulu ukubonwa kwe-acuity noma ukulahleka kwayo ngokuphelele. Kepha izimpawu ezinjalo ezibalulekile zivele lapho inqubo isivele isiqalile kakhulu. Ngakho-ke, ukwelashwa okusheshayo kuqalile, umbono omuhle isikhathi eside uzogcinwa.
Bonke abanesifo sikashukela kudingeka bahlolwe njalo ngudokotela wamehlo kanye njalo ezinyangeni eziyisithupha. Kungcono ukuthi udokotela wamehlo onolwazi olunzulu ekuxilongeni nasekuphatheni i-retinopathy yesifo sikashukela abambe iqhaza ekuhlolweni nasekwelashweni. Ungathola uchwepheshe onjalo esikhungweni sezokwelapha esikhethekile sabanesifo sikashukela.
Umdwebo wokuhlolwa ngudokotela wezamehlo kwabanesifo sikashukela:
- Hlola i-eyeball kanye nezinkophe zakho, kungakhathaleki ukuthi kunezimpawu yini.
- Yenza i-visiometry.
- Hlola izinga lokucindezela kwe-intraocular. Kunqunywa kanye ezinyangeni eziyi-12 kwabanesifo sikashukela abagule iminyaka eyishumi noma ngaphezulu.
- Yenza i-biomicroscopy yeso elingaphandle.
Esimweni lapho izinkomba kanye nenkomba yengcindezi ye-intraocular ivumela khona-ke emva kokunwetshwa komfundi, kutholakala ukuxilongwa okwengeziwe, okubandakanya:
- I-Vitreous ne-crystalline biomicroscopy isebenzisa isibani se-slit.
- Ukuhlolwa kwesifunda se-macular kanye ne-optic disc.
- I-ophthalmoscopy eqondile futhi eguquguqukayo (eyenziwe ngendlela engxenyeni ephakathi nendawo iye emaphethelweni akude, kuwo wonke ama-meridians).
- Ukuthwebula isithombe kwe-Fundus ngekhamera engeyona eyezi-mydriatic noma ikhamera ye-fundus.
- Ukuxilongwa komzimba we-retina kanye ne-vitreous kusibani se-alkali usebenzisa i-lens yeGoldman (isibuko esithathu).
Ngesikhathi sokuxilongwa kwe-retinopathy, izindlela ezibucayi kakhulu i-fluorescein angiography nezithombe ze-fundus, ngemuva kwalokho kunqunywe ukwelashwa.
Ngabe iphathwa kanjani isifo sikashukela i-retinopathy?
Izinkinga zingalashwa ngalezi zindlela ezilandelayo:
- I-retinal cauterization (i-laser coagulation).
- Imijovo yamehlo. Izidakamizwa ze-antiVEGF zifakwa emgodini wamehlo. Umuthi lo ubizwa ngokuthi yi-ranibizumab. Lokhu kwelashwa kusetshenziswe kusukela ngonyaka ka-2012 ngemuva kokuthi izivivinyo zifakazele ukusebenza ngempumelelo komuthi. Imijovo inqunywa ngokwehlukana noma ngokuhlangana ne-laser coagulation.
- I-Vitrectomy ene-endolasercoagulation. Lokhu kwelashwa kusetshenziswa uma izindlela ezimbili zangaphambili bezingasebenzi. Ngendlela, ucwaningo lwanamuhla luveze ukuthi akukho mthelela kwezidakamizwa zemithambo yegazi, kanye namavithamini, ama-antioxidants nama-enzyme. Kusukela manje kuqhubeke, i-dicinone, i-caviton, enkulu - akusanconyelwa ukunquma, ngoba umbono ovela kubo awuthuthuki, futhi nengozi yemiphumela emibi iyanda, ukwelashwa akuthembekile.
I-Vitrectomy ne-laser Photocoagulation
Ukwelashwa kwe-laser Photocoagulation ibizwa ngokuthi i-retinal cauterization (pinpoint) ukuvikela ukukhula kwe-vascular. Le ndlela yokwelapha isifo sikashukela i-retinopathy isebenza kahle. Uma ukubumbana kwenziwe ngendlela efanele nangesikhathi esifanele, inqubo ingalungiswa-ke cishe emaphesenti angama-80 wamacala esigaba sokukhula kanye naku-50% wamacala esigabeni esandayo se-retinopathy.
Ngaphansi kwethonya lokwelashwa kwe-laser, imithambo yegazi "engadingekile" iyafudumala, ngenxa yalokho igazi lihlangana kubo, bese ligcwele izicubu ezinama-fibrous. Ngenxa yale ndlela yokwelashwa, ungagcina umbono ngisho nasezigabeni zakudala ze-retinopathy ezingxenyeni ezingaphezu kwesigamu sabanesifo sikashukela seminyaka eyi-10-12.
Ngemuva kokuhlangana kokuqala kwe-laser, kubaluleke kakhulu ukuthi uhlolwe yilolu luhlolo olulandelayo ngudokotela wezifo zamehlo, futhi, uma kunesidingo, enze ezinye izindlela zokwelapha ze-laser. Njengomthetho, ukuhlolwa kokuqala ngemuva kwe-Photocoagulation kunqunywe ngenyanga, futhi izivivinyo ezilandelayo - isikhathi esingu-1 ezinyangeni ezi-3 noma ngaphezulu kaningi. Konke kuncike izinkomba zomuntu ngamunye zesiguli.
Kwenzeka ukuthi ngemuva kokuba ukwelashwa kwe-laser coagulation kwenziwe, umbono wesiguli uzoncipha kancane, umbono wobusuku uzoncipha, futhi usayizi wensimu yokubuka uzokwehla. Ngokuhamba kwesikhathi, lesi simo sizinza isikhathi eside, kepha izinkinga zingenzeka - ukuvuselelwa kwesibindi emzimbeni we-vitreous.
