Ingabe amehlo akho nawo anesifo sikashukela? Uke wezwa ngalesi simo esibizwa ngokuthi i-Diabetes-Related Macular Edema?

Uma unesifo sikashukela, kufanele unakekele amehlo akho kakhulu, akunjalo? Ngoba, njengoba wazi, isifo sikashukela yisimo esingathinta amehlo ethu ngezindlela ezingalindelekile. Namuhla, sizokhuluma ngento enjalo, ukuvuvukala okwenzeka ngaphakathi kwamehlo ethu, ikakhulukazi engxenyeni ebaluleke kakhulu yokubona kwethu, ngenxa yesifo sikashukela. Yilokhu odokotela abakubiza ngokuthi `(I-Diabetes-Related Macular Edema)` noma `I-DME`.

Kuyini i-Diabetes-Related Macular Edema (DME)?

Kalula nje, i-DME ukuvuvukala okwenzeka enkabeni ye-retina, indawo engaphakathi kweso lakho ebizwa ngokuthi i-macula, okuyingxenye yeso esiyisebenzisela ukubona izinto ngokucacile. Cabanga ngakho njengokuthi iso lakho lifana nekhamera, kanti i-retina ifana nefilimu kuleyo khamera. Yilapho amangqamuzana azwela ukukhanya atholakala khona. Ngakho-ke le ngxenye ye-retina, ebizwa ngokuthi i-macula, yiyona esisiza ukufunda umbhalo omncane futhi sibone izinto ezikude ngokucacile.

Kungenzeka kakhulu ukuthi ube ne-DME uma une-retinopathy ehlobene nesifo sikashukela. Isifo sikashukela senza imithambo yegazi emincane esweni lakho ibe buthaka. Bese ivuza igazi noketshezi. Ngezinye izikhathi, imithambo yegazi emisha, ebuthakathaka kakhulu ingakheka engeyona eyalapho. Le mithambo yegazi ingavuza kalula. Uma lolu ketshezi oluvuzayo luqoqana ku-macula, luyavuvukala.

Sivame kangakanani lesi simo?

Akuwona wonke umuntu onesifo sikashukela othola lesi simo. Kodwa-ke, kuthiwa cishe umuntu oyedwa kwabayishumi nane onesifo sikashukela angase abe nalesi simo 'se-DME'. Njengoba inani labantu abanesifo sikashukela landa eSri Lanka, kubaluleke kakhulu ukuqaphela lokhu.

Ziyini izimpawu zalokhu? Bheka ukuthi nawe unazo lezi...

Izimpawu ze-DME zingase zingaveli ngokuzumayo, futhi ngezinye izikhathi zikhula kancane kancane. Kodwa qaphela lezi zinto:

• Ukubona okufiphele noma ukubona okubili: Lokhu kuyimpawu evamile. Ungase uthole ukuthi ukubona kwakho kufiphele noma kufiphele uma ufunda, ubuka i-TV, noma ubheka okuthile okukude.
• Ama-Floaters: Umuzwa wamachashazi amancane amnyama noma ama-spider web ehamba phambili naphambili phambi kwamehlo.
• Ubunzima bokuhlukanisa imibala: Eminye imibala ingaba mnyama kunokujwayelekile noma kube nzima ukuyihlukanisa komunye nomunye.
• Ama-Scotomas: Ungase ubone ibala elimnyama phakathi noma ohlangothini lwalokho okubukayo.
• Imigqa eqondile kanye nokubukeka okugobile: Uma ubheka into efana nohlangothi oluqondile lomnyango noma ifasitela bese ibukeka igobile, inwetshiwe, noma imibimbi, lokho nakho kuyimpawu.
• Ukuzwela ekukhanyeni okukhanyayo: Kungaba nzima ukubona ekukhanyeni kwelanga noma ekukhanyeni okukhanyayo, futhi amehlo angase abonakale eluhlaza okwesibhakabhaka.
• Lokho okubonayo ngeso elilodwa kubonakala ngendlela ehlukile ngeso elinye: Nakuba lokhu kuyimpawu engavamile, kungenzeka kwabanye abantu.

Uma unesinye noma ngaphezulu salezi zimpawu, kungcono ukubona udokotela wamehlo ngokushesha.

Kungani lokhu kwenzeka? Iyini imbangela yalokhu?

Njengoba ngishilo ngaphambili, imbangela enkulu yalokhu amazinga aphezulu kashukela egazini angalawuleki isikhathi eside. Lokhu kulimaza imithambo yegazi ebucayi ngaphakathi kweso.

Sibiza umonakalo emithanjeni yegazi esweni ngokuthi "i-Diabetes-Related Retinopathy (DRR)``. Kunezimo ezimbili eziyinhloko zalokhu:

1. `I-DRR Engasabalali`: Kulokhu, imithambo yegazi iba buthaka bese kwakheka amaqhubu amancane afana namabhaluni (ama-microaneurysms) ngaphandle kwezindonga. Lokhu kuvumela igazi noketshezi ukuthi kuvuze ku-macula.

2. `I-Proliferative DRR`: Lesi yisimo esibucayi kancane. Lapha, esikhundleni semithambo yegazi eyonakele, imithambo yegazi emisha, ebuthakathaka kakhulu iqala ukwakheka ngaphakathi kweso okungeyona eyalapho. Le mithambo yegazi emisha ibuthakathaka kakhulu, ngakho-ke ivuza igazi noketshezi kalula, okwenza i-macula ivuvuke.

Into ebaluleke kakhulu ukuthi uma lesi simo se-'DME' singelashwa kahle futhi ngesikhathi, singaholela kancane kancane ekulahlekelweni umbono wakho ngokuphelele. Ngakho-ke lokhu akuyona into okufanele uyithathe kalula.

Odokotela bakuthola kanjani lokhu?

Ungase ungakuboni lokhu kuvuvukala ekhaya. Kodwa-ke, udokotela wamehlo angakubona uma ehlola amehlo akho. Yingakho abantu abanesifo sikashukela kufanele bahlolwe amehlo abo njalo. Uma kutholakala kusenesikhathi, kulula ukukwelapha.

Ngaphezu kokuhlola amehlo akho, udokotela angenza nokuhlolwa okukhethekile okufana nalokhu:

• I-Optical Coherence Tomography (OCT): Lokhu kufana nokuskena ingaphakathi leso lakho. Kungalinganisa ngokunembile ubukhulu be-retina yakho kanye ne-macula. Kungabona ngokucacile ukuthi kukhona ukuvuvukala nokuthi kungakanani.
• I-Fluorescein Angiography: Kulolu vivinyo, kufakwa idayi ekhethekile emthanjeni ongalweni yakho. Ngemuva kwalokho, ikhamera ekhethekile ithatha izithombe zedayi njengoba ihamba emithanjeni yegazi esesweni lakho. Noma yikuphi ukuvuza emithanjeni yegazi kuzobonakala ngokucacile ezithombeni.
• Ukuhlolwa kwe-`Amsler Grid`: Lokhu ukuhlolwa okulula kakhulu. Ucelwa ukuthi ubheke igridi yezikwele bese ubona ukuthi imigqa iluliwe, igobile, noma ayikho. Uma kunenkinga nge-macula, ungase ubone ushintsho kule migqa.

Yiziphi izindlela zokwelapha lokhu? Ingabe kungelapheka?

Izindaba ezinhle ukuthi manje sekukhona ukwelashwa okusebenzayo kakhulu kwe-DME. Ngeminye imithi emisha, uma lesi sifo sitholakala kusenesikhathi, kungenzeka ukulungisa omunye umonakalo owenzekile.

Kunezindlela eziningana zokwelapha eziyinhloko:

1. Ukwelashwa kwe-Anti-VEGF:Kukhona iphrotheni ebizwa ngokuthi i-Vascular Endothelial Growth Factor (VEGF) esiza imithambo yegazi emisha ukukhula ngaphakathi kwamehlo ethu. Lokhu kwelashwa kuhilela ukunikeza umuthi ovimba ukusebenza kwephrotheni ye-VEGF njengomjovo esweni. Lo mjovo unikezwa kanye ngenyanga, noma kaningi ngangokunokwenzeka. Imithi elandelayo ivame ukusetshenziswa:

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

2. Ukwelashwa ngama-steroid: Ama-steroid asetshenziswa futhi ukunciphisa ukuvuvukala. Lawa angafakwa njengomjovo esweni noma njengezinto ezincane ezifakwayo (umuthi ohlala isikhathi eside) ezingafakwa ngaphakathi kweso. Izibonelo:

• `Dexamethasone (Ozurdex®)` (lokhu `kuyi-implant`)
• `I-Fluocinolone acetonide (Iluvien®)` (lokhu futhi kuyi-`implant`)

3. Ukwelashwa nge-laser (i-Laser Photocoagulation): Kwezinye izimo, ukukhanya nge-laser kungasetshenziswa "ukuvala" imithambo yegazi evuzayo nokuvimba ukuvuza.

4. Ukuhlinzwa kwe-Vitrectomy: Lokhu ukuhlinzwa. Lokhu kuhlinzwa kwenzelwa ukususa igazi, uketshezi, noma izicubu zesilonda ngaphakathi kweso ezidonsa i-macula. Akuwona wonke umuntu okudingayo lokhu.

Nganoma yikuphi kwalokhu kwelashwa, kubalulekile ukugcina ushukela wegazi lakho kanye nomfutho wegazi kulawulwa kahle kakhulu, ngaphandle kwalokho imiphumela yokwelashwa ingase yehle.

Ingabe ikhona imiphumela emibi noma izinkinga zokwelashwa?

Njenganoma iyiphi inqubo yezokwelapha, kunezingozi ezincane ezihilelekile, kodwa amathuba okuba nezinkinga ngokuvamile aphansi.

• Ngenxa 'yomjovo', kunethuba elincane lokuthi igciwane lingangena esweni. Ukuvimbela lokhu, iso lihlanzwa kahle ngaphambi 'komjovo'.
• Ngemva komjovo, amabhamuza amancane omoya angakheka ngaphakathi kweso. Lawa azonyamalala ngokwawo ezinsukwini ezimbalwa.
• Kungase kube nokubomvu nokulunywa okuncane. Lokhu kungase kubangelwe nesisombululo esisetshenziswa ukuhlanza iso ngaphambi komjovo. Ukusebenzisa ukudabuka kokwenziwa kungasiza ekunciphiseni lokhu kungakhululeki.
• Ukwelashwa ngama-steroid ngezinye izikhathi kungabangela i-cataract noma ukwanda kwengcindezi yangaphakathi kweso. Ngakho-ke, udokotela uzohlala ehlola lokhu.

Ngizozizwa ngingcono ngokushesha kangakanani ngemva kokwelashwa?

I-DME ivame ukungabangeli ubuhlungu esweni. Ngakho-ke esikhundleni sokuzizwa "ungcono" ngemva kokujova, umonakalo we-macula kanye ne-retina uyamiswa noma uhlehliswe kancane. Ukubona kwakho kungase kuqale ukucaca kancane kancane.

Ngemva kokwelashwa 'ngomjovo', ngeke ukwazi ukuya emsebenzini noma esikoleni. Kodwa-ke, uma uhlinzwa 'nge-Vitrectomy', kungathatha cishe amasonto amabili kuya kwamane ukululama.

Yini engenziwa ukunciphisa noma ukuvimbela lokhu ukuthi kungenzeki?

Uma unesifo sikashukela, ungase ungakwazi ukuqeda ngokuphelele ingozi yakho yokuba ne-DME. Kodwa-ke, kunezinto eziningi ongazenza ukuze unciphise ingozi yakho:

• Lawula kahle isifo sikashukela sakho: Gcina amazinga kashukela egazini lakho njengoba udokotela wakho ekuncoma. Thatha imithi yakho kahle futhi ulawule ukudla kwakho.
• Uma unezinye izifo ezingamahlalakhona njengomfutho wegazi ophakeme, zilawule kahle.
• Qiniseka ukuthi uhlola amehlo akho ngudokotela wamehlo njalo ngezikhathi ezithile. Abantu abanesifo sikashukela bayanconywa ukuthi bahlole amehlo abo okungenani kanye ngonyaka.
• Uma ubhema, yeka namuhla. Ukubhema nakho kuyingozi kakhulu emithanjeni yegazi emehlweni.
• Yidla ukudla okunempilo. Yidla izithelo nemifino eminingi.
• Vivinya umzimba njalo.

Uma nginalesi simo, ikusasa liyoba njani?

Uma utholakale une-DME futhi welashwa kahle, umbono uvame ukuba muhle. Ikakhulukazi uma utholakale futhi welashwa kusenesikhathi, eminye imithi emisha ingabuyisela ngisho nokubona okulahlekile.

Kodwa-ke, uma kungelashwa, ukubona kungaphazamiseka kakhulu, okwenza kube nzima ukusebenza empilweni yansuku zonke. Yingakho ukutholakala kusenesikhathi kanye nokwelashwa kubaluleke kangaka.

Kufanele ngizinakekele kanjani?

Nakuba i-DME iyisimo esithinta amehlo, ukunakekela umzimba wakho wonke kungasiza ekulawuleni lesi simo.

• Uma unezifo ezingamahlalakhona ezifana nesifo sikashukela, umfutho wegazi ophakeme, i-cholesterol ephezulu, noma ukukhuluphala ngokweqile, zama konke okusemandleni akho ukuzilawula kahle.
• Yidla ukudla okunempilo futhi uvivinye umzimba ngokwanele.
• Gwema ukubhema.
• Hlola amehlo akho njalo ngezikhathi ezithile, njengoba kunconywe udokotela wakho wamehlo.
• Uma ulahlekelwa umbono ngokuzumayo, uzwa ubuhlungu obukhulu emehlweni, noma ubona isikrini esimnyama phambi kwamehlo akho, bona udokotela noma uye esibhedlela ngokushesha.

Yimiphi imibuzo okufanele uyibuze udokotela?

Uma uya kudokotela, ungakhohlwa ukubuza le mibuzo:

• "Yini enye okufanele ngiyazi ngalesi simo (i-Diabetes-Related Macular Edema)?"
• "Iyiphi indlela yokwelapha oyincomayo engcono kakhulu kimi?"
• "Yimiphi imiphumela emibi noma izinkinga zalokhu kwelashwa?"
• "Kufanele ngihlolwe amehlo kangaki?"
• "Yiziphi izimpawu ezibhekwa njengeziphuthumayo kulesi simo se-'DME'?"

Into yokugcina engingayisho yile...

Isifo sikashukela yisifo esingathinta izingxenye eziningi zomzimba wethu. Phakathi kwazo, amehlo adlala indima enkulu. Uma unesifo sikashukela, ikakhulukazi uma unesifo esibizwa ngokuthi 'i-diabetes-related retinopathy', usengozini enkulu yokuthola 'i-DME'. Le ngozi iyanda uma unesifo sikashukela isikhathi eside.

Ngakho-ke, kubaluleke kakhulu ukuhlolwa kwamehlo njalo nokuthola noma yikuphi ukuvuvukala noma imithambo yegazi emisha esweni kusenesikhathi. Ngoba uma lesi sifo sitholakala kusenesikhathi futhi ukwelashwa kuqalwe, kunethuba elikhulu lokusindisa umbono wakho oyigugu. Ngezinye izikhathi, uma ukwelashwa kuqalwe kusenesikhathi, umonakalo obangelwe yi-'DME' ungabuyiselwa emuva.

Ngakho-ke, nakekela amehlo akho. Uma uphila nesifo sikashukela, yenza ukunakekelwa kwamehlo kube ngomunye wemithwalo yakho yemfanelo eyinhloko.

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