Ese amaso yawe na yo arwaye diyabete? Ese wigeze wumva iyi ndwara yitwa Diyabete-Related Macular Edema?

Niba urwaye diyabete, ugomba kwita cyane ku maso yawe, sibyo? Kuko, nkuko ubizi, diyabete ni indwara ishobora kugira ingaruka ku maso yacu mu buryo butunguranye. Uyu munsi, tugiye kuvuga ku kintu nk'icyo, kubyimba biba mu maso yacu, cyane cyane mu gice cy'ingenzi cy'amaso yacu, bitewe na diyabete. Ibi ni byo abaganga bita `(Diabete-Related Macular Edema)` cyangwa `DME`.

Kurwara indwara ya diyabete (DME) ni iki?

Mu magambo make, DME ni ukubyimba kugaragara hagati muri retina, agace kari imbere mu jisho ryawe kitwa macula, ari na ko gace k'ijisho dukoresha kugira ngo turebe ibintu neza. Tekereza nk'aho ijisho ryawe rimeze nka kamera, naho retina ikaba nk'agace kari muri iyo kamera. Aha niho uturemangingo tw'ifoto tuba turi. Rero iki gice cya retina, cyitwa macula, ni cyo kidufasha gusoma inyandiko nto no kubona ibintu biri kure neza.

Ufite amahirwe menshi yo kurwara DME iyo ufite diyabete iterwa na retinopathy. Diyabete igabanya imitsi mito y'amaraso mu jisho ryawe. Hanyuma ishobora kuva amaraso n'amazi. Hari igihe imitsi mishya y'amaraso idakomeye ishobora kwirema idakwiye. Iyi mitsi ishobora no kuva amaraso byoroshye. Iyo iyi mitsi iva yibumbiye mu macula, irabyimba.

Iyi ndwara ikunze kugaragara gute?

Si abantu bose barwaye diyabete barwara iyi ndwara. Ariko, bivugwa ko umuntu umwe kuri cumi na bane barwaye diyabete ashobora kurwara iyi ndwara ya 'DME'. Kubera ko umubare w'abarwaye diyabete ukomeje kwiyongera muri Sri Lanka, ni ngombwa cyane kubimenya.

Ni ibihe bimenyetso by'ibi? Reba niba nawe ufite ibi...

Ibimenyetso bya DME bishobora kudahita bigaragara, kandi rimwe na rimwe bigenda bikura buhoro buhoro. Ariko menya ibi bintu:

• Kubona nabi cyangwa kureba kabiri: Iki ni ikimenyetso gisanzwe. Ushobora gusanga amaso yawe adasobanutse cyangwa adasobanutse iyo usoma, ureba televiziyo, cyangwa ureba ikintu kiri kure.
• Ibyuma birebire: Kumva utudomo duto tw'umukara cyangwa udusimba tw'igitagangurirwa tugenda imbere y'amaso .
• Kugorana gutandukanya amabara: Amabara amwe ashobora kwijima kurusha uko bisanzwe cyangwa kugorana kuyatandukanya.
• Scotoma: Ushobora kubona akadomo k'umukara hagati cyangwa ku ruhande rw'icyo ureba.
• Imirongo igororotse n'isura igoramye: Iyo urebye ikintu kimeze nk'inkombe igororotse y'urugi cyangwa idirishya kandi gisa n'ikigoramye, cyararambuye, cyangwa gihinyaguritse, icyo nacyo ni ikimenyetso.
• Kumva urumuri rwinshi: Bishobora kugorana kubibona mu zuba cyangwa mu matara yaka, kandi amaso ashobora kugaragara nk'ubururu.
• Ibyo ubona n'ijisho rimwe bibonwa mu buryo butandukanye n'irindi jisho: Nubwo iki ari ikimenyetso kidasanzwe, gishobora kubaho kuri bamwe.

Niba ufite kimwe cyangwa byinshi muri ibi bimenyetso, ni byiza kujya kwa muganga w’amaso vuba.

Kuki ibi bibaho? Impamvu ni iyihe?

Nkuko nabivuze mbere, impamvu nyamukuru ibitera ni isukari nyinshi mu maraso itagira ingaruka ku rugero rugenwa mu gihe kirekire. Ibi byangiza imiyoboro y'amaraso yoroshye iri mu jisho.

Kwangirika kw'imitsi y'amaraso mu jisho tubyita "Diabete-Related Retinopathy (DRR)``. Hari ibimenyetso bibiri by'ingenzi by'ibi:

1. `DRR idakwirakwira`: Muri ibi, imiyoboro y'amaraso iracika intege kandi uduce duto tumeze nk'udupira (microaneurysms) tugaragara hanze y'inkuta. Ibi bituma amaraso n'amazi bisohoka mu macula.

2. `Proliferative DRR`: Iki ni ikibazo gikomeye kurushaho. Aha, mu mwanya w’imitsi y’amaraso yangiritse, imitsi mishya kandi idakomeye cyane itangira kugaragara mu jisho itari iyo. Iyi mitsi mishya y’amaraso iracika intege cyane, bityo irasohoka byoroshye amaraso n’amazi, bigatuma macula ibyimba.

Igikuru ni uko iyo iyi ndwara ya `DME` idavuwe neza kandi ku gihe, ishobora gutuma utabona neza. Rero iki si ikintu cyo gufata nk'ikintu cyoroshye.

Ni gute abaganga basuzuma iyi ndwara?

Ushobora kutabona iki kibyimba uri mu rugo. Ariko, umuganga w'amaso ashobora kugisuzuma iyo asuzumye amaso yawe. Niyo mpamvu abantu barwaye diyabete bagomba gusuzumwa amaso yabo buri gihe. Iyo kigaragaye hakiri kare, biroroha kuvura.

Uretse gusuzuma amaso yawe, muganga ashobora no gukora ibizamini byihariye nka:

• Isuzuma ry’imiterere y’amaso (OCT): Ibi ni nko gupima imbere mu jisho ryawe. Bishobora gupima neza ubunini bwa retina na macula yawe. Bishobora kureba neza niba hari ikibyimba n’ingano yacyo.
• Isuzuma rya Fluorescein Angiography: Muri iki kizamini, irangi ryihariye rishyirwa mu mutsi uri mu kuboko kwawe. Hanyuma, kamera yihariye ifata amafoto y'irangi mu gihe rinyura mu mitsi y'amaraso iri mu jisho ryawe. Ibintu byose biva mu mitsi y'amaraso bizagaragara neza mu mashusho.
• Ikizamini cya `Amsler Grid`: Iki ni ikizamini cyoroshye cyane. Usabwa kureba uruziga rw'impande z'impande ukareba niba imirongo yararambuye, igoramye, cyangwa ibuze. Niba hari ikibazo kuri macula, ushobora kubona impinduka muri iyi mirongo.

Ni ubuhe buryo bwo kuvura ibi? Ese bishobora kuvurwa?

Inkuru nziza ni uko ubu hari uburyo bwiza bwo kuvura DME. Hamwe n'imiti mishya, iyo indwara igaragaye hakiri kare, birashoboka ko yakwangiza bimwe mu byangiritse byakozwe.

Hari uburyo bwinshi bw'ingenzi bwo kuvura:

1. Ubuvuzi burwanya imisemburo y'ibimera:Hari poroteyine yitwa Vascular Endothelial Growth Factor (VEGF) ifasha imiyoboro mishya y'amaraso gukura mu maso yacu. Ubu buvuzi bukubiyemo gutanga umuti ubuza imikorere ya poroteyine ya VEGF nk'urushinge mu jisho. Uru rushinge rutangwa rimwe mu kwezi, cyangwa kenshi uko bikenewe. Imiti ikurikira ikunze gukoreshwa:

• `Aflibercept (Eylea®)`
• `Bevacizumab (Avastin®)`
• `Faricimab-svoa (VABYSMO®)`
• `Ranibizumab (Lucentis®)`

2. Kuvura indwara ya steroid: Indwara za steroid nazo zikoreshwa mu kugabanya kubyimba. Izi zishobora gutangwa nk'inshinge mu jisho cyangwa nk'udushinge duto (umuti umara igihe kirekire) dushobora gushyirwa mu jisho. Ingero:

• `Dexamethasone (Ozurdex®)` (iyi ni `implant`)
• `Fluocinolone acetonide (Iluvien®)` (iyi nayo ni `implant`)

3. Uburyo bwo kuvura hakoreshejwe laser (Laser Photocoagulation): Hari ubwo urumuri rwa laser rushobora gukoreshwa mu "gufunga" imiyoboro y'amaraso irimo kuva no guhagarika kuva.

4. Guca mu maso: Ubu ni ukubaga. Ubu buryo bwo kubaga bukorerwa kugira ngo haveho amaraso, amazi, cyangwa inkovu mu jisho ririmo gukuramo macula. Si buri wese ubikeneye.

Muri ubwo buryo bwose bwo kuvura, ni ngombwa ko isukari yo mu maraso yawe n'umuvuduko w'amaraso bigenzurwa neza, bitabaye ibyo ibisubizo by'ubuvuzi bishobora kugabanuka.

Ese hari ingaruka mbi cyangwa ingorane zikomoka ku buvuzi?

Nkuko bigenda ku buvuzi ubwo aribwo bwose, hari ingaruka nke zibaho, ariko ibyago byo kurwara muri rusange ni bike.

• Kubera "inshinge" iterwa, hari amahirwe make ko mikorobe ishobora kwinjira mu jisho. Kugira ngo hirindwe ibi, ijisho risukurwa neza mbere yo "guterwa".
• Nyuma yo guterwa urushinge, utubyimba duto tw’umwuka dushobora kwirema imbere mu jisho. Utwo tubyimba tuzashira ubwatwo mu minsi mike.
• Gutukura no gushyuha gato bishobora kubaho. Ibi bishobora no guterwa n'umuti ukoreshwa mu gusukura ijisho mbere yo guterwa inshinge. Gukoresha amarira y'ubukorano bishobora kugabanya ubu burwayi.
• Uburyo bwo kuvura indwara ya steroide rimwe na rimwe bushobora gutera indwara ya katarakte cyangwa kwiyongera k'umuvuduko w'amaso. Kubwibyo, muganga azahora asuzuma ibi.

Nzumva meze neza nyuma y'igihe kingana iki?

Ubusanzwe DME ntabwo itera ububabare mu jisho. Rero aho kumva "umeze neza" nyuma yo guterwa urushinge, kwangirika kwa macula na retina birahagarara cyangwa bigasubira inyuma gato. Ubuhanga bwawe bwo kureba bushobora gutangira kugenda neza buhoro buhoro.

Nyuma yo kuvurwa "Injection", ntuzashobora kujya ku kazi cyangwa ku ishuri. Ariko, niba warakorewe "Vitrectomy", bishobora gufata ibyumweru bibiri kugeza kuri bine kugira ngo ukire.

Ni iki cyakorwa kugira ngo ibi bigabanuke cyangwa bikumirwe?

Niba urwaye diyabete, ushobora kutabasha gukuraho burundu ibyago byo kurwara DME. Ariko hari byinshi wakora kugira ngo ugabanye ibyago byo kurwara:

• Genzura diyabete yawe neza: Komeza urugero rw'isukari mu maraso yawe nk'uko muganga agusaba. Fata imiti yawe neza kandi ugenzure indyo yawe.
• Niba ufite izindi ndwara zidakira nk'umuvuduko ukabije w'amaraso, zigenzure neza.
• Menya neza ko ujya usuzuma amaso yawe na muganga w’amaso buri gihe. Abantu barwaye diyabete barasabwa kujya basuzuma amaso yabo nibura rimwe mu mwaka.
• Niba unywa itabi, rekeraho uyu munsi. Kunywa itabi nabyo byangiza cyane imitsi y'amaraso mu maso.
• Kurya indyo yuzuye. Kurya imbuto n'imboga nyinshi.
• Gukora imyitozo ngororamubiri buri gihe.

Niba mfite iyi ndwara, ejo hazaza hazaba hameze gute?

Iyo usanzwe urwaye DME kandi ukavurwa neza, ubusanzwe icyizere kiba cyiza. Cyane cyane iyo usanzwe urwaye indwara kandi ukavurwa hakiri kare, hari imiti mishya ishobora no kugarura bumwe mu buryo bwo kureba bwari bwaratakaye.

Ariko, iyo itavuwe, ubushobozi bwo kutabona bushobora kwangirika cyane, bigatuma bigorana gukora mu buzima bwa buri munsi. Niyo mpamvu kuyimenya hakiri kare no kuyivura ari ingenzi cyane.

Nkwiye kwiyitaho nte?

Nubwo DME ari indwara igira ingaruka ku maso, kwita ku mubiri wawe wose bishobora gufasha mu kugenzura iyo ndwara.

• Niba ufite indwara zidakira nka diyabete, umuvuduko ukabije w'amaraso, cholesterol nyinshi, cyangwa umubyibuho ukabije, gerageza uko ushoboye kose kuzigenzura neza.
• Kurya indyo yuzuye kandi ugire imyitozo ngororamubiri ihagije.
• Irinde kunywa itabi.
• Jya usuzuma amaso yawe buri gihe, nk'uko muganga wawe w'amaso yabigusabye.
• Niba uhita utakaza amaso, ukagira ububabare bukomeye mu maso, cyangwa ubonye ibara ry'umukara imbere y'amaso yawe, gana muganga cyangwa jya kwa muganga ako kanya.

Ni ibihe bibazo ugomba kubaza muganga?

Iyo ugiye kwa muganga, ntukibagirwe kubaza ibi bibazo:

• "Ni iki kindi nkwiye kumenya kuri iyi ndwara (Diyabete-Related Macular Edema)?"
• "Ni ubuhe buryo bwo kuvura wangiriye inama bwo kumbera bwiza?"
• "Ni izihe ngaruka mbi cyangwa ingorane z'ubu buvuzi?"
• "Ni kangahe nkwiye gusuzumwa amaso?"
• "Ni ibihe bimenyetso bifatwa nk'ibintu byihutirwa muri iki gihe cya 'DME'?"

Ikintu cya nyuma ngomba kuvuga ni iki...

Diyabete ni indwara ishobora gufata ibice byinshi by'umubiri wacu. Muri zo, amaso agira uruhare runini. Niba urwaye diyabete, cyane cyane niba ufite indwara yitwa `diabete-related retinopathy`, uba ufite ibyago byinshi byo kurwara `DME`. Ibi byago biriyongera uko umara igihe kirekire urwaye diyabete.

Kubwibyo, ni ngombwa cyane kwipimisha amaso buri gihe no kumenya kubyimba cyangwa imitsi mishya y'amaraso mu jisho hakiri kare. Kuko iyo indwara igaragaye hakiri kare kandi igatangira kuvurwa, hari amahirwe menshi yo kurokora icyerekezo cyawe cy'agaciro. Hari igihe, iyo ubuvuzi butangiye hakiri kare, ibyangiritse byatewe na 'DME' bishobora gusubizwa inyuma.

Rero, fata neza amaso yawe. Mu gihe urwaye diyabete, shyira ubuvuzi bw'amaso mu nshingano zawe z'ingenzi.

` diyabete, kubyimba kwa macular, retinopathy, ubuzima bw'amaso, kutabona neza, kuvura amaso, diyabete, indwara z'amaso, retina