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.

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.

` zunthlum, macular edema, retinopathy, mit hriselna, mit hmuh lohna, mit enkawlna, zunthlum, mit natna, mit natna