I mit pawh hian zunthlum a vei em? He natna hi Diabetes-Related Macular Edema tih hi i hre tawh em?

Zunthlum i neih chuan i mit i enkawl belh a ngai a ni lawm ni? A chhan chu, in hriat angin zunthlum hi kan mit beisei loh takin a nghawng thei a ni. Vawiin hian chutiang chiah chu kan sawi dawn a, chu chu kan mit chhungah, a bik takin kan mit hmuhna hmun pawimawh takah, zunthlum avanga lo awm thin a ni. Hei hi Doctor ten (Diabetes-Related Macular Edema) emaw DME emaw an tih chu a ni.

Diabetes-Related Macular Edema (DME) hi eng nge ni?

A awlsam zawngin sawi ila, DME hi mit chhunga thil chi hrang hrang kan hmuh theihna tura kan hman thin, i mit chhunga macula an tih hmun, retina lairil lama lo awm a ni. I mit chu camera ang maiin ngaihtuah la, retina chu chu camera chhunga film ang mai a ni. Hei hi photosensitive cells awmna hmun a ni. Chuvangin he retina peng, macula an tih hi lehkhabu te te chhiar leh hla tak tak thil chiang taka hmuh theihna tura min puitu a ni.

Diabetes-related retinopathy i neih chuan DME i vei theihna a sang zawk. Zunthlum hian i mit chhunga thisen kalna kawng te tak te te chu a tichak lo hle. Chumi hnuah thisen leh tui an leak thei a ni . A châng chuan thisen kalna kawng thar, chak lo tak tak, chuta awm lo, a lo awm thei bawk. Hengte hi awlsam takin a leak thei bawk. He leaking fluid hi macula-ah a lo awm khawm chuan a lo hring chhuak thin.

Hetiang dinhmun hi engtiang chiahin nge a awm?

Zunthlum vei zawng zawng hian he natna hi an nei vek lo. Mahse, zunthlum vei mi sawm leh pali zinga pakhat velin he DME natna hi an nei thei niin an sawi. Sri Lanka ramah hian zunthlum vei an pung chho zel a, hei hi hriat chian a pawimawh hle.

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Hei hi eng symptoms nge ni? Hengte pawh hi i nei em tih en rawh...

DME symptoms hi a lo lang nghal lo mai thei a, a chang chuan zawi zawiin a lo awm thin. Mahse, heng thilte hi hre reng ang che:

• Blurred vision emaw double vision emaw: Hei hi a lan chhuah dan tlangpui a ni. I chhiar emaw, TV i en emaw, hmun hla tak i en emaw hian i mit a fiah lo emaw, a fiah lo emaw tih i hmu mai thei.
• Floaters: Mit hmaa black dot te te emaw, spider web emaw a kal leh haw te hriatna .
• Rangkachak thliar hran harsa: Rangkai thenkhat chu a hma aia dum deuh emaw, thliar hran harsa emaw a ni thei.
• Scotomas: I thil en lai laiah emaw, a sir lamah emaw hmun dum i hmu thei.
• Line dinglam leh hmel hrual: Kawngkhar emaw, tukverh emaw sir dinglam ang chi thil i en a, a hrual, a inzawm, a hrual emaw a lang a nih chuan chu pawh chu a chhinchhiahna a ni.
• Eng êng laka sensitivity: Ni êng emaw, êng êng takah emaw hmuh a harsa thei a, mit chu a sen angin a lang thei bawk.
• Mit pakhata i hmuh chu mit dangin a danglamin a lang: Hei hi chhinchhiahna mak deuh ni mah se, mi thenkhatah chuan a thleng thei a ni.

Heng symptoms pakhat emaw a aia tam emaw i neih chuan mit lam doctor pan hmasak phawt a tha ber.

Engvangin nge hetiang hi a lo awm? Hei hi eng nge a chhan?

Ka sawi tawh ang khan hei hi a chhan ber chu hun rei tak chhunga thisen sugar level sang lutuk hi thunun loh vang a ni. Hei hian mit chhunga thisen kalna kawng nalh tak takte chu a tichhia a ni.

Zunthlum vanga mit chhunga thisen kalna kawng chhiatna hi Diabetes-Related Retinopathy (DRR) kan ti a. Hei hi thil pawimawh tak pahnih a awm a:

1. Non-proliferative DRR: Hemiah hian thisen kalna kawngte chu a chak lo va, bang pawnah balloon ang chi bulge te te (microaneurysms) a lo awm ta a ni. Chungte chuan thisen leh tui chu macula chhungah a luang lut thei a ni.

2. Proliferative DRR: Hei hi a pawi deuh deuh a ni. Hetah hian thisen kalna kawng chhia ai chuan mit chhungah hian thisen kalna kawng thar, chak lo tak tak, chuta tang lo chu a lo piang tan ta a ni. Heng thisen kalna kawng tharte hi a chhe hle a, chuvangin awlsam takin thisen leh tui an leak a, chu chuan macula a ti hring chhuak thin.

A pawimawh ber chu he DME natna hi uluk leh a hun taka enkawl a nih loh chuan zawi zawiin i mit a hloh vek thei a ni. Chuvangin hei hi thil awlsam tak a ni lo.

Engtin nge doctor-te hian he natna hi an hriat theih?

He swelling hi in atang hian i hmu lo mai thei. Mahse, mit doctor-in i mit an enfiah hian a hmuchhuak thei a ni. Chuvang chuan zunthlum vei te chu an mit enfiah fo tur a ni. A hmaa hriat chhuah a nih chuan enkawl a awlsam zawk.

I mit a enfiah bakah hian doctor chuan test bik a ti thei bawk a, chungte chu:

• Optical Coherence Tomography (OCT): Hei hi i mit chhung lam scan ang mai a ni. I retina leh macula thickness dik takin a teh thei a ni. A hring a awm em tih leh engzat nge a awm tih chiang takin a hmu thei.
• Fluorescein Angiography: He test-ah hian i kut chhunga vein pakhatah dye bik inject a ni. Tichuan, special camera chuan i mit chhunga thisen kalna kawng hrang hranga dye a kal lai thlalak a la a. Thisen kalna kawnga leak awm reng reng chu thlalak ah hian chiang takin a lang ang.
• Amsler Grid Test: Hei hi test awlsam tak a ni. Square grid en la, line-te chu a inzawm em, a ben em, a awm lo em tih en turin an ti che a ni. Macula-ah harsatna a awm chuan heng line-ah hian inthlak danglamna i hmu mai thei.

Hei hi eng enkawlna nge ni? Dam theih a ni em?

Thu lawmawm tak chu tunah hian DME enkawlna tha tak tak a awm ta a ni. Damdawi thar thenkhat nen chuan natna hi hriat hmasak a nih chuan chhiatna thleng tawh thenkhat chu tihdanglam theih a ni.

Enkawl dan tlangpui engemaw zat a awm a:

1. Anti-VEGF hmanga enkawlna:Protein pakhat Vascular Endothelial Growth Factor (VEGF) tih a awm a, chu chuan kan mit chhunga thisen kalna kawng thar a lo thang lian thei a ni. He enkawlnaah hian mit chhunga injection anga VEGF protein hnathawh tikhawlo thei damdawi pek a ni. He injection hi thla khatah vawi khat pek thin a ni a, a tul angin pek thin a ni. A hnuaia damdawi te hi hman tlanglawn ber a ni:

• Aflibercept (Eylea®) tih a ni
• Bevacizumab (Avastin®) hmanga damdawi hman tur a ni
• Faricimab-svoa (VABYSMO®) tih a ni
• Ranibizumab (Lucentis®) tih a ni

2. Steroid enkawl dan: Steroid hi a hring tihziaawmna atan pawh hman a ni. Chungte chu mit chhunga injection angin emaw, mit chhunga dah theih implant tenau (damdawi chi khat) angin pek theih a ni. Entirnan:

• Dexamethasone (Ozurdex®) (hei hi implant a ni) .
• Fluocinolone acetonide (Iluvien®) (hei hi implant a ni bawk)

3. Laser hmanga enkawlna (Laser Photocoagulation): A then phei chuan laser light hmangin thisen kalna kawng (leak) te chu "seal" theih a ni a, a leak chu tihtawp theih a ni.

4. Vitrectomy: Hei hi surgery a ni. He surgery hi mit chhunga thisen, tui emaw, macula-a hrualtu scar tissue emaw lakchhuahna atana tih a ni. Hei hi mi zawng zawngin kan mamawh vek lo.

Heng enkawlna eng pawh hmang hian i thisen sugar leh thisen sang hi control tha tak a nih a pawimawh hle a, chuti lo chuan enkawlna result a tlahniam thei a ni.

Enkawlna hian side effect emaw complication emaw a nei em?

Damdawi lam thil dang ang bawkin, hlauhawmna tenau tak tak a awm a, mahse harsatna awm theihna chu a tlangpuiin a tlem hle.

• Injection avang hian mit chhunga natna hrik a luh theihna chance tlemte a awm. Chutiang a nih loh nan injection tih hmain mit chu uluk takin an tifai thin.
• Injection hnu hian mit chhungah boruak bubble te te a lo awm thei a. Chungte chu ni rei lote hnuah anmahni chauhin an bo vek ang.
• Redness leh itching tlem a awm thei. Hei hi injection hmaa mit tihfai nana solution hman vang pawh a ni thei. Mittui siam (artificial tears) hman hian heng harsatna te hi a tihziaawm thei a ni.
• Steroid hmanga enkawlna hian a chang chuan mitdel emaw, mit chhunga pressure tihsan emaw a thlen thei bawk. Chuvangin doctor chuan hei hi a enfiah reng ang.

Engtiang chiahin nge enkawl hnuah ka dam leh ang?

DME hian mit a ti na lo tlangpui. Chuvangin injection hnua "tha zawk" anga inhriat ai chuan macula leh retina chhiatna chu tihtawp emaw, a then emaw tihdanglam a ni. I mit hmuh chu zawi zawiin a chiang tan mai thei.

Injection hmanga enkawl hnuah chuan hnathawhna leh sikul i kal thei tawh dawn lo. Mahse, Vitrectomy surgery i neih chuan a dam leh theih nan kar hnih atanga kar li vel a ngai thei.

Hetiang thil hi tih tlem emaw, a thlen loh nan emaw eng nge tih theih ang?

Zunthlum i vei chuan DME vei theihna chu i ti bo vek thei lo mai thei. Mahse, i risk tihtlem nan thil tam tak i tih theih a awm a:

• I zunthlum hi uluk takin thunun rawh: Doctor-in a tih angin i thisen sugar level kha vawng reng ang che. I damdawi ei tur dik tak ei la, i ei leh in pawh control rawh.
• Natna dang, thisen sang ang chi i neih chuan control tha rawh.
• I mit chu mit lam doctor hnenah a hun takah enfiah tir thin ang che. Zunthlum vei te chu kum khatah vawi khat tal mit endik tir a tha.
• Meizial i zu a nih chuan vawiin hian chawlhsan rawh. Meizial zuk hian mit chhunga thisen kalna kawng a tichhe hle bawk.
• Ei leh in hrisel ei rawh. Thlai leh thlai ei tam zawk rawh.
• Exercise neih fo thin ang che.

Hetiang dinhmun hi ka neih chuan hmalam hun chu eng ang nge ni ang?

DME i vei tih hmuhchhuah a nih a, uluk taka enkawl i nih chuan outlook a tha tlangpui. A bik takin a hmaa hriatchhuah leh enkawl a nih chuan damdawi thar thenkhat hian mit hmuhna hloh tawh thenkhat pawh a siam tha thei a ni.

Mahse, enkawl loh chuan mit hmuhna chu nasa takin a tichhe thei a, nitin nunah hnathawh a harsa thei hle. Chuvang chuan a hmaa hmuhchhuah leh enkawl hi a pawimawh em em a ni.

Engtin nge ka in enkawl ang?

DME hi mit tichhe thei natna ni mah se, i taksa pum enkawl ṭhat chuan i natna chu a thunun thei a ni.

• Natna khirh tak tak, zunthlum, thisen sang, cholesterol sang, thau lutuk i neih chuan theihtawp chhuahin i thunun tha ang.
• Ei leh in hrisel ei la, exercise tam tak nei rawh.
• Meizial zuk loh tur.
• I mit chu a hun takah enfiah tir la, i mit doctor-in a rawt angin.
• I mit a tlakchham thut a, mit na tak i neih emaw, i mit hmaa screen dum i hmuh thut a nih chuan doctor pan nghal emaw, damdawi inah emaw kal nghal rawh.

Doctor hnenah eng zawhna nge i zawh tur?

Doctor hmu tura i kal hunah heng zawhnate hi zawh theihnghilh suh:

• "He natna (Diabetes-Related Macular Edema) chungchangah hian eng nge ka hriat belh tur?"
• "Eng treatment method nge ka tan a tha ber?"
• "He enkawlna hian eng side effect nge a neih emaw, eng complication nge a neih?"
• "Engzat nge ka mit ka check tir ang?"
• "He DME dinhmunah hian eng ang symptom nge emergency anga ngaih?"

Ka sawi tur hnuhnung ber chu hei hi a ni...

Zunthlum hi kan taksa peng tam tak a nghawng thei a ni. Chung zingah chuan mit hian hmun pawimawh tak a chang a ni. Diabetes i vei a nih chuan, a bik takin diabetes-related retinopathy tih natna pawh i neih chuan DME vei theihna a sang hle. He risk hi zunthlum i neih rei poh leh a sang chho zel a ni.

Chuvang chuan mit endik fo a, mit a hring emaw, thisen kalna thar emaw a awm chuan hriat hmasak a pawimawh hle. A chhan chu natna hi a hmaa hriatchhuah a nih a, enkawl tan a nih chuan i mit hmuhna hlu tak chhanchhuah theihna chance a sang hle. A châng chuan enkawl ṭan hma a nih chuan DME-in a tihchhiat chu a let leh thei a ni.

Chuvangin, i mit kha fimkhur rawh. Zunthlum natna nena i nun lai hian mit enkawl hi i mawhphurhna ber pakhatah siam rawh.