Ukwehla kwe-macular, okuvame ukubhekwa ngokuthi i-macular degeneration ehlobene nobudala (i-ARMD noma i-AMD), iyimbangela ehamba phambili yobumpumputhe e-United States. Lesi simo sithinta kakhulu abantu abaneminyaka engama-65 nangaphezulu. Ezinye izinkinga ze-macular ezithinta abantu abasha zingase zibhekwe njenge-macular degeneration, kodwa leli gama ngokuvamile libhekisela ekujuleni kwe-macular okuhlobene neminyaka.
I-AMD ithinta i- macula , ingxenye ebucayi ye-retina enesibopho esibukhali, esivela phakathi. I-AMD ingaphathwa, nakuba ingelashwa.
Kunezinhlobo ezimbili ezinkulu zokuguqulwa kwe-macular okuhlobene nobudala :
- Emile (Okungeyona Eyesifo Neovascular) AMD
I-AMD eyomile, ebizwa nangokuthi i-non-exudative macular degeneration, uhlobo oluvame kakhulu, libala ngamaphesenti angaba ngu-90 azo zonke izimo ze-AMD. E-AMD eyomile, ushintsho olubonakalayo kulawo maseli ahlotshiswe amehlo, lushiya izindawo zokuhlanza, ukuhlunga i-pigment, nokudonswa (idiphozi ephuzi ngaphansi kwe-retina).
I-AMD eyomile ivame ukuqhubeka kancane kancane. Kunezigaba ezintathu: zakuqala, eziphakathi, futhi ezithuthukile. Isigaba sokuqala sibonakala ngombono odlalwayo noma ovamile noma ukulahlekelwa okubukeka kahle. Ukulahlekelwa kombono okuphakathi kubanzi, i-drusen eyengeziwe ingase ibonakale noma ikhulise, futhi izinguquko zemibala zikhula njengoba isimo sithuthuka. Izinga lokulahlekelwa kombono lihluka nge-AMD eyomile kepha ayifinyeleleki ngokungajwayelekile ekumpumputhe ngokomthetho. I-macular tishu ye-atrophy nokukhwabanisa okuncane kungase kuthuthuke.
- Okumanzi (Neovascular) AMD
Ama-akhawunti we-AMD amanzi cishe amaphesenti angu-10 kuwo wonke amacala we-AMD. Abantu abanefomu elomile le-AMD bangase bathuthukele efomini elomile kakhulu. Ukukhula komkhumbi wegazi omusha (neovascularization) kwenzeka ngaphansi kwe-retina. Nakuba lezi zitsha zishaya, zinyama ngokwemvelo. Igazi nomswakama kuvuza emithanjeni entsha yegazi, ngokuvamile kuphakamisa i-macula futhi kubangele ukuphazamiseka okubukwayo, okungaholela ekulimaleni kokugcina komzimba. Ukwehliswa kungase kwenzeke, kubangele ukulahleka okukhulu kombono futhi, izikhathi eziningi, ukuphuphutheka komthetho.
Amanye ama-diagnostic degeneration diagnoses ahlanganisa:
- Ukuguqulwa kwe-Geographic Macular
Ukuguqulwa kwe-geographic macular kuyindlela ephakeme yokwehla kwesimo se-macular. Lapha, kunendawo ejwayelekile yokulahlekelwa kwama-epithelial cells (RPE) we-retinal pigment. I-RPE, ehlinzeka ngemuva kweso umbala obomvu obomvu, isisiza ukondla ama-photoreceptors esweni, izintambo nama-cones. Ngenxa yalokho, noma yini ebangela izifo ku-RPE ekugcineni izothinta izintambo nama-cones ku-retina.
Ibizwa ngokuthi "indawo" ngoba izindawo ezinkulu ze-RPE ezilahlekile zivela njengezizwekazi ezizungezwe ulwandle lwe-retina enempilo. Ngezinye izikhathi kuchazwa ngokuthi i-RPE dropout. Ngokujwayelekile, akukho ukuvuza okuketshezi noma ukuphuma kwegazi, futhi ukulahlekelwa kombono kwenzeka kancane kakhulu. Odokotela bacwaninga ukwelashwa kwegciwane kanye nokwelashwa kwe-RPE ukuguqulwa. - Ukukhishwa kwe-Juvenile Macular
I-Juvenile macular dystrophy noma i-degeneration izuzwe njengefa futhi ithinta abantu abasha nezingane. Ngokuvamile, isimo siyi-autosomal ngokweqile, okusho ukuthi kuvela lapho ingane ithola izakhi zofuzo ezivela emzimbeni ngamunye. I-Juvenile i-macular degeneration ayithinti umbono wombono noma umbono we-peripheral. Abantu abahlakulela ukukhubazeka kwe-juvenile ye-macular balahlekelwa umbono ophakathi futhi bangaboni. Kunezinhlobo ezimbili eziyinhloko zokwehla kwesifo se-juvenile macular: Isifo se-Stargardt kanye ne-Vitelliform macular dystrophy.
Izimpawu
Ukulahleka kombono ku-degular degeneration kuya kancane kangangokuthi ungase ungaboni ekuqaleni. Ngokuvamile akukho buhlungu. Njengoba lesi sifo sithuthuka, umbono wakho ungabonakala futhi izinto zingabonakala zihlanekeziwe. Abanye abantu abane-AMD bangase bakhononde ngezinhlamvu ezingekho ngamagama noma kunzima ukubona ukuphrinta okuncane.
Njengoba isimo sithuthuka, kungase kube khona ukulahleka okujulile noma ukukhonjiswa kombono ophakathi, ngenkathi umbono wesiphambano ungaguquki. Ngezinye izikhathi, umbono wombala ungashintshwa.
Izimpawu ze-AMD zizobe zikhona, nakuba zingcono kakhulu zitholakale ngezokwelapha ze-eye.
Izimbangela
Izinhlobo ezivame kakhulu zokulahlekelwa kwe-macular ezihlobene nokukhula.
Kukhona nezinye izici eziningana ezaziwayo ezibangelwa ukukhula kwesimo se-macular ezihlobene nobudala:
- Ubudala
- Ukubhema
- Umlando womndeni
- Umbala wamehlo okukhanya
- I-hypertension
- Ukuchayeka kwelanga
- Izifo zenhliziyo
- I-cholesterol ephakeme
- Ukukhuluphala
- Ubulili besifazane
- Ukubhekela phambili
Imvelo yakho ingase ibe negalelo ekuthuthukiseni i-AMD, futhi ucwaningo lwamanje lubhekene nezakhi zofuzo ezingase zandise noma zinciphise ingozi yokuthuthukisa i-AMD .
Ukuxilongwa
Ukuxilongwa kwe-AMD kwenziwa emva kokuhlolwa kwelanga okuphelele kwenziwa ngumuntu ochwethempiyutha noma ophthalmologist.
Umbono wezinga elikude neleduze nalo lilinganiselwa. Isivivinyo esibizwa ngokuthi "igridi ye-Amsler" senziwa ukuthola izindawo eziyimpumputhe, ukugoqa imigqa, noma ukuphazamiseka embonweni. Ukuhlolwa okuhlolisisiwe kwe-retinal kuvumela udokotela ukubona umbono ophakanyisiwe we-macula.
Udokotela wakho wezilanga uzobheka izimpawu ezifana nalezi:
- Idla futhi ishintshe kumaseli ahlotshisiwe ku-macula, ngenxa yamademoni ekwakhiweni kwamademoni
- Ukukhula komkhumbi wegazi omusha (neovascularization): Ukuntuleka kwe-oksijeni ekutheni kungabonakala ukuthi kungabonakalisa abaxhumanisi bamakhemikhali abangela lokhu.
- Umfutho wegazi noma igazi oye wangena emathisini e-retinal (ngenxa yemithambo yegazi entsha, ebuthakathaka njengoba edala)
Uma i-AMD icatshangwa, ukuhlolwa kwedayi-injection, i-fluorescein angiography (FA), ingahle ilandelwe. Olunye uvivinyo lokuxilonga, ukuhlangana kwe-optical tomography (OCT), kungenziwa futhi. Uma i-AMD itholakele, ukuhanjiswa kumchwepheshe we-retinal kuza okulandelayo.
Ukwelapha
Ayikho ukwelashwa okwaziwa ukubola kwe-macular. Ukwelashwa kwe-AMD kugxile ekubambezelekeni noma ekunciphiseni ukuqhubeka kwalesi sifo futhi kuyahlukahluka kuye ngesigaba salo.
NgokweSifundo Se-Eye-Related Related Diseases Study (AREDS), izithako zokudla okunomsoco oqukethe amavithamini C no-E, i-beta-carotene, ne-zinc zikhonjiswe ukuphuza noma ukubambezela ukuqhubeka kwe-AMD eyomile kuma-AMD aphezulu ngamaphesenti angu-28 kwabanye abantu abanesimo .
Ukwelashwa kwe-AMD emanzi kugxile ekuvimbeleni ukuvuza okuketshezi kusuka ku-neovascularization. Izinqubo ezifana ne-photocoagulation ne-macloc translocation zenziwe ngemiphumela eguquguqukayo. I-anti-vascular endothelial factor factor (anti-VEGF) imithi isetshenziselwa ukwelashwa kwe-macular degeneration. Le mithi ijojowe ngqo emehlweni bese isabela ukumisa imishaya yegazi emisha.
Uma unemibono ebalulekile yokulahleka ngenxa ye-AMD, izikhungo zombono eziphansi nodokotela bangancoma imikhiqizo noma ukuguqulwa kwekhaya okungabuyisa umbono osebenzayo futhi uthuthukise izinga lakho lokuphila . Amanye alawa madivaysi afaka izibuko zokufunda eziphezulu ezinamandla noma ama-bifocals, amalensi we-telescopic, amadivayisi abanjwe ngesandla, ama-magnifiers, namathelevishini avaliwe. Ezinye izincomo, njengokusebenzisa amawashi amakhulu amanani nama-stove, izincwadi ezinkulu zokuphrinta, izifanekiso zokubhala kanye namadivaysi okukhuluma nge-elekthronikhi, zingathuthukisa ngokuphawulekayo ikhwalithi yakho yokuphila ne-macular degeneration.
Ukubhekana
Ukuphila nokulahlekelwa kombono wokushisa kwe-macular kungadinga ukwenza ukujwayela kokuphila. Izici ezibalulekile zokuphila ezithintekayo kufaka ukushayela, ukufunda, nokuqhuba imisebenzi emihle ehamba phambili efuna uhla olugcwele lwemibono, njengokuthunga nokusebenzisa amathuluzi. Kwezinye izimo, imisebenzi ingadinga ukusola. Kodwa kwabanye, amadivayisi wokusiza (afana nabakhulisa) kanye nokuguqulwa kungasiza futhi kukuvumele ukuthi uqhubeke.
Ukusekelwa kwezenhlalakahle kuyasiza, hhayi ukukusiza nje ukulungisa kepha ukukusiza ngemisebenzi yansuku zonke uma kudingeka. Ungase ucabange nokuhlola ukunikezwa okufana nokuhamba komphakathi.
Izwi elivela
Kubalulekile ukuba uhlole ukuhlolwa kwamehlo njalo njengengxenye yesondlo sakho sempilo yonke impilo yakho yonke, ngisho noma ungenayo umbono wokulahleka. Uma ukuhlolwa kubonisa ukuthi unezibonakaliso zokuqala zokukhubazeka kwe-macular, qiniseka ukuthi ulandele udokotela wakho wezinyo njengoba kunconywa futhi uhambelane nezinyathelo eziphakanyisiwe zokumisa isimo kusukela ekuthuthukisweni, njengoba lokhu kungenza umehluko ekuvimbeleni ukulahleka kombono.
> Imithombo:
> I-Gheorghe A, i-Mahdi L, i-Musat O, i-Mac-L ehlobene nobudala be-Macular. Rom J Ophthalmol. 2015 Apr-Jun; 59 (2): 74-7.
> Narayanan R, Kuppermann BD, Izihloko ezishisayo kwi-Dry AMD, Curr Pharm Des. 2017; 23 (4): 542-546. i-doi: 10.2174 / 1381612822666161221154424.