Health Library

Retinopathy Yehuka

Pfupiso

Retinopathy yehuka (die-uh-BET-ik ret-ih-NOP-uh-thee) chirwere chinokonzerwa nechirwere cheshuga chinotapura maziso. Chinokonzerwa nekuvadzika kwezvipembenene zveropa zve tishu inonzwa chiedza kumashure kweziso (retina).

Pakutanga, retinopathy yehuka ingasave ne zviratidzo kana kuti ingave nezviratidzo zvishoma zvekuona. Asi inogona kukonzera matambudziko ekuona.

Iyi chirwere chinogona kuitika kune ani naani ane chirwere cheshuga chemarudzi maviri, rudzi rwe 1 kana rudzi rwe 2. Kwenguva yakareba yaunenge uine chirwere cheshuga uye shuga yako isingadzoreki, ndipo paunenge uine mukana mukuru wekuwana chirwere ichi chemaziso.

Zviratidzo

Unogona kusava ne zviratidzo pakutanga kwe diabetic retinopathy. Sezvo mamiriro ezvinhu achiwedzera, unogona kuwana:

Maberere kana tambo dzakapenga dziri kufamba mukuona kwako (floaters)
Kuona kusapfava
Kuona kuchinja-chinja
Nzvimbo dzakapenga kana dzisina chinhu mukuona kwako
Kurasikirwa nekuona

Zvinokonzera

Kufamba kwenguva, shuga yakawanda muropa rako inogona kukonzera kuvhara kwezvipembenene zvidiki zveropa zvinopa retina chikafu, zvichicheka chikafu rayo cheropa. Somugumisiro, ziso rinoedza kukura ropa idzva. Asi izvi ropa idzva harisi kukura zvakanaka uye rinogona kubuda nyore nyore.

Kune marudzi maviri e diabetic retinopathy:

Diabetic retinopathy yekutanga. Muchimiro ichi chinowanzoitika — chinonzi nonproliferative diabetic retinopathy (NPDR) — ropa idzva harisi kukura (proliferating).

Kana uine nonproliferative diabetic retinopathy (NPDR), masvingo eropa mumatunhu eropa ari muchiso chako anowira. Zvipembenene zvidiki zvinobuda kubva kumasvingo ezvipembenene zvidiki, dzimwe nguva zvichibuda mvura neropa muretina. Zvipembenene zvikuru zve retina zvinogona kutanga kuwedzera uye kuva zvisina kujairika muhupamhi. NPDR inogona kufambira mberi kubva kune yakapfava kusvika kune yakakomba sezvo zvipembenene zvakawanda zveropa zvichivharwa.

Dzimwe nguva kukuvara kwezvipembenene zveropa zve retina kunotungamira kune kuunganidzwa kwemvura (edema) muchikamu chepakati (macula) cheretina. Kana macular edema ikadzikisa kuona, kurapwa kunodiwa kudzivirira kurasikirwa kusingaperi kwekuona.
Diabetic retinopathy yakakomba. Diabetic retinopathy inogona kufambira mberi kune rudzi urwu rwakakomba, runonzi proliferative diabetic retinopathy. Murudzi urwu, zvipembenene zveropa zvakakuvara zvinovhara, zvichikonzera kukura kweropa idzva, risina kujairika muretina. Izvi ropa idzva rakapfava uye rinogona kubuda muchinhu chakajeka, chakafanana nejeli chinopfuura pakati peye yako (vitreous).

Pakupedzisira, tishu yekakuvara kubva pakukura kweropa idzva inogona kukonzera retina kubva kumashure kweziso rako. Kana ropa idzva richikanganisa kuyerera kwemvura kunze kweziso, kumanikidzwa kunogona kuunganidzwa mubhora reziso. Kuunganidzwa uku kunogona kukuvadza tsinga inotakura mifananidzo kubva kuziso rako kuenda kuuropi rako (optic nerve), zvichiguma ne glaucoma.

Zvinhu zvinokonzera njodzi

Munhu wese ane chirwere cheshuga anogona kurwara retinopathy yechirwere cheshuga. Njodzi yekurwara kweziso inogona kuwedzera nekuda kwezvinotevera:

Kuva nechirwere cheshuga kwenguva yakareba
Kusadzorwa zvakanaka kwehuwandu hweshuga yeropa rako
Kufembedza kwepamusoro kweropa
Cholesterol yakakwira
Pamuviri
Kushandisa fodya
Kuva mutema, Hispanic kana Native American

Matambudziko

Diabetic retinopathy inosanganisira kukura kwezvipembenene zveropa zvisina kujairika muretina. Zvinetso zvinogona kukonzera matambudziko akakomba ekukuona:

Kuyerera kweropa muVitreous. Zvipembenene zvitsva zveropa zvinogona kubuditsa ropa munhuwi wakajeka, wakaita sejeli unozadza pakati pemaziso ako. Kana huwandu hweropa huri shoma, unogona kuona chete mabhuru machena mashoma (floaters). Muzviitiko zvakakomba, ropa rinogona kuzadza cavity ye vitreous uye kuvhara zvachose kuona kwako.

Kuyerera kweropa muVitreous pachayo kazhinji hakuiti kukuvadzwa kusingaperi kwekuona. Ropa rinowanzo bvisa maziso mukati memavhiki mashoma kana mwedzi. Kunze kwekunge retina yako yakakuvadzwa, kuona kwako kunogona kudzoka pakujekesa kwaro kare.

Kuparadzana kweRetina. Zvipembenene zvisina kujairika zveropa zvinobatanidzwa neDiabetic retinopathy zvinokurudzira kukura kwemavara emakanda, izvo zvinogona kubvisa retina kubva kumashure kweziso. Izvi zvinogona kukonzera mabhuru anofamba mukuona kwako, kupemhemereka kwechiedza kana kurasikirwa kukuru kwekuona.
Glaucoma. Zvipembenene zvitsva zveropa zvinogona kukura muchikamu chemberi cheziso rako (iris) uye kukanganisa kuyerera kwakajairika kwemvura kubva kumaziso, zvichikonzera kuwedzera kumanikidzwa maziso. Iyi pressure inogona kukuvadza tsinga inotakura mifananidzo kubva kumaziso ako kuenda kuuropi rako (optic nerve).
Bofu. Diabetic retinopathy, macular edema, glaucoma kana kusanganiswa kwemamiriro ezvinhu aya kunogona kukonzera kurasikirwa kwakakwana kwekuona, kunyanya kana mamiriro ezvinhu asina kutarisirwa zvakanaka.

Kudzivirira

Hausi kuita kuti retinopathy yehutachiona hwehutachiona irege kuitika nguva dzose. Zvisinei, bvunzo dzemaziso dzenguva dzose, kutonga kwakanaka kweglucose yeropa neBP, uye kuita chimwe chinhu pakutanga kana paine matambudziko ekushaya kuona zvinogona kubatsira kudzivirira kurasikirwa kwakanyanya kwekuona. Kana uine chirwere cheshuga, dzikisa njodzi yekuwana retinopathy yehutachiona hwehutachiona nekutevera zvinotevera:

Tonga chirwere cheshuga chako. Ita kuti kudya kwakanaka nekuita zvemuviri zvive chikamu chezuva nezuva. Edza kuwana ma miniti anenge 150 ekuita zvemuviri zvine simba, senge kufamba, vhiki imwe neimwe. Tora mishonga yemukanwa yeshuga kana insulin sezvakarayirwa.
Tarisa nhanho yeshuga yeropa rako. Ungada kutarisa uye kunyora nhanho yeshuga yeropa rako kanopfuura kamwe pazuva - kana kazhinji kana uri kurwara kana uri pasi pekumanikidzwa. Bvunza chiremba wako kuti ungatarisa sei shuga yeropa rako.
Bvunza chiremba wako nezve bvunzo ye hemoglobin yakasanganiswa. Bvunzo ye hemoglobin yakasanganiswa, kana bvunzo ye hemoglobin A1C, inoratidza avhareji yeshuga yeropa rako kwemavhiki maviri kusvika matatu usati waita bvunzo. Kune vanhu vazhinji vane chirwere cheshuga, chinangwa cheA1C ndechekuva pasi pe7%.
Chengeta BP yako ne cholesterol ichitongwa. Kudya zvokudya zvine utano, kuita zvemuviri nguva dzose uye kurasikirwa nehuremu hwakawandisa zvinogona kubatsira. Dzimwe nguva mishonga inodikanwawo.
Kana uchifuma kana uchishandisa mamwe marudzi etsoko, bvunza chiremba wako kuti akubatsire kukanda. Kusvuta kunowedzera njodzi yematambudziko akasiyana-siyana eshuga, kusanganisira retinopathy yehutachiona hwehutachiona.
Cherechedza kuchinja kwekuona. Taura nachiremba wemaziso ako nekukurumidza kana kuona kwako kuchinja kamwe kamwe kana kuita kusapfava, kuita mavara kana kusapfava. Yeuka, chirwere cheshuga hachitungamiri pakurasikirwa nekuona. Kuita basa rakakosha mukugadzirisa chirwere cheshuga kunogona kuenda kure pakudzivirira matambudziko.

Kuongorora

Retinopathy yehuka huonekwa zvakanaka nekuongororwa kwakazara kweziso rakavhurika. Mukuyongororwa uku, madonhwe anoiswa mumaziso ako anowedzera (kuvhura) vadzidzi vako kuti chiremba wako aone zviri nani mukati memaziso ako. Madonhwe anogona kukonzera kuti kuona kwako kwepedyo kusapfava kusvika apfuura, maawa akawanda gare gare.

Mukuyongororwa, chiremba weziso rako acharamba achitsvaga zvinhu zvisina kujairika mukati nekunze kwemaziso ako.

Mushure mekunge maziso ako avhurwa, ruvara runoiswa mumutsinga uri muruoko rwako. Zvadaro mifananidzo inotorwa sezvo ruvara ruchifamba-famba nemidziyo yeropa yemaziso ako. Mifananidzo inogona kuratidza midziyo yeropa yakavharwa, yakaputsika kana kubuda ropa.

Ne bvunzo iyi, mifananidzo inopa mifananidzo ye-cross-sectional ye retina inoratidza kukora kwe retina. Izvi zvichabatsira kuona kuti mvura yakawanda sei, kana iripo, yakabuda mune tishu ye retina. Gare gare, bvunzo dze optical coherence tomography (OCT) dzinogona kushandiswa kutarisa kuti kurapwa kuri kushanda sei.

Kurapa

Kurapa, kunonyanya kuenderana nerudzi rwema diabetic retinopathy yaunayo uye kuti yakakomba sei, kunangidzirwa pakunonoka kana kumisa kufambira mberi.Kana uine mild kana moderate nonproliferative diabetic retinopathy, ungasafanirwa kurapwa nekukurumidza. Zvisinei, chiremba wemaziso achaongorora maziso ako zvakanyanya kuti aone kana uchida kurapwa.Shanda nechikurapa cheshuga (endocrinologist) kuti uone kana paine nzira dzekuvandudza manejimendi eshuga yako. Kana diabetic retinopathy iri mild kana moderate, kutonga zvakanaka kweropa shuga kazhinji kunogona kunonoka kufambira mberi.Kana uine proliferative diabetic retinopathy kana macular edema, uchada kurapwa nekukurumidza. Zvichienderana nezvinetso zvakakosha zve retina yako, sarudzo dzinogona kusanganisira:

Kuisa mishonga mumaziso. Mishonga iyi, inonzi vascular endothelial growth factor inhibitors, inoiswa muvitreous yeziso. Inobatsira kumisa kukura kwezvipembenene zvitsva zveropa uye kuderedza kuunganidzwa kwemvura.

Mishonga mitatu inobvumirwa neU.S. Food and Drug Administration (FDA) yekurapa diabetic macular edema — faricimab-svoa (Vabysmo), ranibizumab (Lucentis) uye aflibercept (Eylea). Mishonga yechina, bevacizumab (Avastin), inogona kushandiswa off-label yekurapa diabetic macular edema.

Mishonga iyi inoiswa uchishandisa topical anesthesia. Kuisa mishonga kunogona kukonzera kusagadzikana kwakapfava, sekupisa, kuchema kana kurwadziwa, kwemaawa makumi maviri nemana mushure mekuisa mishonga. Zvinogona kuitika zvinokonzerwa nezvinosanganisira kuunganidzwa kwekunetseka mumaziso nehutachiona.

Kuisa mishonga uku kuchafanirwa kudzokororwa. Muzvimwe zviitiko, mushonga unoshandiswa ne photocoagulation.

Photocoagulation. Kurapa uku kwe laser, kunozivwawo se focal laser treatment, kunogona kumisa kana kunonoka kubuda kweropa nemvura mumaziso. Panguva yekurapa, kubuda kweropa kubva kuzvipembenene zvisina kunaka zveropa kunorapwa ne laser burns.

Focal laser treatment kazhinji inoitirwa muhofisi yechiremba kana mu eye clinic mune imwe nguva. Kana iwe waiva neblurred vision kubva kumacular edema usati waopereswa, kurapa kungasadzorera kuona kwako kune zvakajairwa, asi zvinogona kuderedza mukana we macular edema kuipa.

Panretinal photocoagulation. Kurapa uku kwe laser, kunozivwawo se scatter laser treatment, kunogona kudzikisa zvipembenene zvisina kunaka zveropa. Panguva yekurapa, nzvimbo dze retina kure nemacula inorapwa ne scattered laser burns. Kupisa kunokonzera kuti zvipembenene zvitsva zvisina kunaka zveropa zvidzikire uye zviite mavara.

Kazhinji inoitirwa muhofisi yechiremba kana mu eye clinic mune maviri kana kupfuura nguva. Kuona kwako kuchave kusina kunaka kwezuva rimwe mushure mekurapa. Kurasikirwa kwe peripheral vision kana night vision mushure mekurapa kunogoneka.

Nepo kurapa kunogona kunonoka kana kumisa kufambira mberi kwe diabetic retinopathy, hachisi mushonga. Nekuti chirwere cheshuga chinoramba chiripo, kukuvara kwe retina uye kurasikirwa nekuona zvichiri kuitika.

Kunyangwe mushure mekurapwa kwe diabetic retinopathy, uchada kuongororwa kwemaziso nguva dzose. Panguva imwe, ungada kurapwa kuwedzerwa.

Kuisa mishonga mumaziso. Mishonga iyi, inonzi vascular endothelial growth factor inhibitors, inoiswa muvitreous yeziso. Inobatsira kumisa kukura kwezvipembenene zvitsva zveropa uye kuderedza kuunganidzwa kwemvura.

Mishonga mitatu inobvumirwa neU.S. Food and Drug Administration (FDA) yekurapa diabetic macular edema — faricimab-svoa (Vabysmo), ranibizumab (Lucentis) uye aflibercept (Eylea). Mishonga yechina, bevacizumab (Avastin), inogona kushandiswa off-label yekurapa diabetic macular edema.

Mishonga iyi inoiswa uchishandisa topical anesthesia. Kuisa mishonga kunogona kukonzera kusagadzikana kwakapfava, sekupisa, kuchema kana kurwadziwa, kwemaawa makumi maviri nemana mushure mekuisa mishonga. Zvinogona kuitika zvinokonzerwa nezvinosanganisira kuunganidzwa kwekunetseka mumaziso nehutachiona.

Kuisa mishonga uku kuchafanirwa kudzokororwa. Muzvimwe zviitiko, mushonga unoshandiswa ne photocoagulation.
Photocoagulation. Kurapa uku kwe laser, kunozivwawo se focal laser treatment, kunogona kumisa kana kunonoka kubuda kweropa nemvura mumaziso. Panguva yekurapa, kubuda kweropa kubva kuzvipembenene zvisina kunaka zveropa kunorapwa ne laser burns.

Focal laser treatment kazhinji inoitirwa muhofisi yechiremba kana mu eye clinic mune imwe nguva. Kana iwe waiva neblurred vision kubva kumacular edema usati waopereswa, kurapa kungasadzorera kuona kwako kune zvakajairwa, asi zvinogona kuderedza mukana we macular edema kuipa.
Panretinal photocoagulation. Kurapa uku kwe laser, kunozivwawo se scatter laser treatment, kunogona kudzikisa zvipembenene zvisina kunaka zveropa. Panguva yekurapa, nzvimbo dze retina kure nemacula inorapwa ne scattered laser burns. Kupisa kunokonzera kuti zvipembenene zvitsva zvisina kunaka zveropa zvidzikire uye zviite mavara.

Kazhinji inoitirwa muhofisi yechiremba kana mu eye clinic mune maviri kana kupfuura nguva. Kuona kwako kuchave kusina kunaka kwezuva rimwe mushure mekurapa. Kurasikirwa kwe peripheral vision kana night vision mushure mekurapa kunogoneka.
Vitrectomy. Maitiro aya anoshandisa incision diki mumaziso ako kubvisa ropa pakati pemaziso (vitreous) pamwe chete ne tishu yekukuvadzwa inokwevera retina. Inoitirwa mune surgical center kana muchipatara uchishandisa local kana general anesthesia.

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