Ukwehla kwe-macular okuhlobene nobudala

Ukwehla kweMacular kuyinkinga yamehlo ebulala kancane umbono obukhali, ophakathi. Lokhu kwenza kube nzima ukubona imininingwane emihle nokufundwa.

Lesi sifo sivame kakhulu kubantu abangaphezu kweminyaka engama-60, yingakho sivame ukubizwa ngokuthi yi-age-related macular degeneration (ARMD noma i-AMD).

I-retina ingemuva kweso. Ishintsha ukukhanya nezithombe ezingena esweni zibe amasignali ezinzwa athunyelwa ebuchosheni. Ingxenye ye-retina ebizwa ngokuthi i-macula yenza umbono ubukhali futhi ube nemininingwane eminingi. Yindawo ephuzi maphakathi ne-retina. Inenani eliphakeme lemibala emibili yemvelo (imibala) ebizwa nge-lutein ne-zeaxanthin.

I-AMD ibangelwa ukulimala emithanjeni yegazi ehlinzeka nge-macula. Lolu shintsho lulimaza ne-macula.

Kunezinhlobo ezimbili ze-AMD:

• I-AMD eyomile yenzeka lapho imithambo yegazi engaphansi kwe-macula iba mncane futhi iphuke. Imali encane ephuzi, ebizwa nge-drusen, ifomu. Cishe bonke abantu abane-macular degeneration baqala ngefomu elomile.
• I-AMD emanzi yenzeka cishe kubantu abayi-10% abanokuwohloka kwe-macular. Imithambo yegazi emisha engajwayelekile futhi entekenteke kakhulu ikhula ngaphansi kwe-macula. Le mikhumbi ivuza igazi noketshezi. Lolu hlobo lwe-AMD lubangela iningi lokulahleka kombono okuhambisana nesimo.

Odokotela abaqiniseki ukuthi yini ebangela i-AMD. Lesi simo asivamile ngaphambi kweminyaka yobudala engama-55. Sivela kakhulu kubantu abaneminyaka engama-75 noma ngaphezulu.

Izici ezinobungozi ze-AMD yilezi:

• Umlando womndeni we-AMD
• Ukuba Mhlophe
• Ukubhema ugwayi
• Ukudla okunamafutha amaningi
• Ukuba ngowesifazane

Ungahle ungabi nazimpawu ekuqaleni. Njengoba lesi sifo siba sibi kakhulu, ungaba nezinkinga ngombono wakho ophakathi.

IZIMPAWU ZOKOMISA AMD

Uphawu oluvame kakhulu lwe-AMD eyomile umbono ofiphele. Izinto ezisengxenyeni emaphakathi yombono wakho zivame ukubukeka zihlanekezelwe futhi zifiphele, futhi imibala ibukeka ifiphele. Ungaba nenkinga yokufunda ukuphrinta noma ukubona eminye imininingwane. Kepha ungabona kahle ngokwanele ukuhamba nokwenza imisebenzi eminingi yansuku zonke.

Njengoba i-AMD eyomile iba yimbi, ungadinga ukukhanya okwengeziwe ukuze ufunde noma wenze imisebenzi yansuku zonke. Indawo efiphele enkabeni yombono kancane kancane iba nkulu futhi ibe mnyama.

Ezigabeni zakamuva ze-AMD eyomile, ungahle ungakwazi ukubona ubuso baze basondele.

IZIMPAWU ZE-WET AMD

Uphawu lokuqala oluvame kakhulu lwe-AMD emanzi ukuthi imigqa eqondile ibukeka isontekile futhi i-wavy.

Kungahle kube nendawo encane emnyama maphakathi nombono wakho eba nkulu ngokuhamba kwesikhathi.

Ngazo zombili izinhlobo ze-AMD, ukulahleka kombono okumaphakathi kungenzeka ngokushesha. Uma lokhu kwenzeka, kuzodingeka ubonwe ngokushesha ngudokotela wamehlo. Qiniseka ukuthi lo dokotela wamehlo unolwazi lokwelapha izinkinga nge-retina.

Uzohlolwa iso. Amaconsi azobekwa emehlweni akho ukuze unwebise (uvule) abafundi bakho. Udokotela wamehlo uzosebenzisa amalensi akhethekile ukubuka i-retina yakho, imithambo yegazi, kanye ne-optic nerve.

Udokotela wamehlo uzobheka ushintsho oluthile kuma-macula nasemithanjeni yegazi nase-drusen.

Ungacelwa ukuthi umboze iso elilodwa bese ubheka iphethini yemigqa ebizwa ngegridi ye-Amsler. Uma imigqa eqondile ibukeka i-wavy, kungaba uphawu lwe-AMD.

Olunye uvivinyo olungenziwa lubandakanya:

• Kusetshenziswa udayi nekhamera ekhethekile ukubheka ukugeleza kwegazi ku-retina (i-fluorescein angiogram)
• Ukuthatha isithombe sentambo yangaphakathi yeso (fundus photography)
• Usebenzisa amaza okukhanya ukubuka i-retina (i-optical coherence tomography)
• Isivivinyo esikala i-pigment ku-macula

Uma une-AMD ethuthukile noma eyomile eyomile, akukho ukwelashwa okungabuyisa umbono wakho.

Uma une-AMD yokuqala futhi ungabhemi, inhlanganisela yamavithamini athile, ama-antioxidants, ne-zinc kungavimba ukuthi lesi sifo singabi sibi kakhulu. Kepha akukwazi ukukubuyisela emuva umbono osuvele ulahlekile.

Inhlanganisela ivame ukubizwa ngefomula "AREDS". Izithasiselo ziqukethe:

• Ama-milligram angama-500 (mg) kavithamini C
• Amayunithi angama-400 amazwe omhlaba we-beta-carotene
• 80 mg we-zinc
• 2 mg wethusi

Thatha le nhlanganisela yamavithamini kuphela uma udokotela wakho eyincoma. Qiniseka ukuthi udokotela wakho uyazi nganoma yimaphi amanye amavithamini noma izengezo ozithathayo. Ababhemayo akufanele basebenzise lesi sengezo.

I-AREDS ingakusiza futhi uma unomlando womndeni nezici zobungozi ze-AMD.

I-Lutein ne-zeaxanthin, okuyizinto ezitholakala kwimifino eluhlaza, nazo zinganciphisa ubungozi bokuwohloka kwe-macular okuhlobene nobudala.

Uma une-AMD emanzi, udokotela wakho angancoma:

• Ukuhlinzwa nge-Laser (i-laser photocoagulation) - umsebe omncane wokukhanya uqeda imithambo yegazi evuzayo, engajwayelekile.
• Ukwelashwa kwe-Photodynamic - ukukhanya kusebenze umuthi ojojowe emzimbeni wakho ukubhubhisa imithambo yegazi evuzayo.
• Imithi ekhethekile evimbela ukuthi imithambo yegazi emisha yakhiwe esweni ifakwa esweni (lena inqubo engenabuhlungu).

Izinsizakusebenza zokubona okuphansi (njengamalensi akhethekile) nokwelashwa kungakusiza ukuthi usebenzise umbono onawo kahle, futhi uthuthukise ikhwalithi yempilo yakho.

Vala ukulandelela nodokotela wamehlo wakho kubalulekile.

• Nge-AMD eyomile, vakashela udokotela wamehlo wakho kanye ngonyaka ukuze uhlolwe ngokuphelele.
• Nge-AMD emanzi, ungahle udinge ukuvakashelwa okuqhubekayo, mhlawumbe njalo ngenyanga.

Ukuthola ushintsho lombono kusenesikhathi kubalulekile ngoba lapho welashwa ngokushesha, kuba ngcono imiphumela yakho. Ukutholwa kusenesikhathi kuholela ekwelashweni kwangaphambili futhi kaningi, kuba nomphumela ongcono.

Indlela enhle yokuthola izinguquko ukuzihlola ekhaya ngegridi ye-Amsler. Udokotela wamehlo wakho angakunika ikhophi yegridi noma ungaphrinta eyodwa kwi-Intanethi. Hlola iso ngalinye ngazinye ngenkathi ugqoke izibuko zakho zokufunda. Uma imigqa ibukeka i-wavy, shayela udokotela wamehlo wakho ngokushesha ukuze ubonane.

Lezi zinsizakusebenza zingahlinzeka ngeminye imininingwane ngokuwohloka kwe-macular:

• Inhlangano YeMacular Degeneration - macularhope.org
• INational Eye Institute - www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/age-related-macular-degeneration

I-AMD ayithinti umbono ohlangothini (wokuzungeza). Lokhu kusho ukuthi ukulahleka kombono okuphelele akwenzeki. Imiphumela ye-AMD ekulahlekelweni kombono ophakathi kuphela.

I-AMD emnene, eyomile imvamisa ayibangeli ukukhubazeka kokulahleka kombono ophakathi.

I-AMD emanzi ivame ukuholela ekulahlekelweni kombono obalulekile.

Ngokuvamile, nge-AMD ungalahlekelwa amandla okufunda, ukushayela imoto, nokubona ubuso buqamama. Kepha abantu abaningi abane-AMD bangenza imisebenzi yansuku zonke ngaphandle kobunzima obukhulu.

Uma une-AMD, umhlinzeki wakho wokunakekelwa kwezempilo angancoma ukuthi uhlole umbono wakho nsuku zonke ngegridi ye-Amsler. Shayela umhlinzeki wakho ngokushesha uma imigqa ibukeka i-wavy. Shayela futhi uma ubona ezinye izinguquko kumbono wakho.

Yize ingekho indlela eyaziwayo yokuvimbela ukonakala kwe-macular, ukuhola indlela yokuphila enempilo kunganciphisa ubungozi bokuthuthukisa i-AMD:

• Ungabhemi
• Gcina ukudla okunempilo okunezithelo nemifino eningi futhi kunamafutha ezilwane amancane
• Vocavoca umzimba njalo
• Gcina isisindo esinempilo

Bona ochwepheshe bakho bokunakekelwa kwamehlo njalo ukuze uvivinye iso lakho.

Ukwehla kwe-macular okuhlobene nobudala (i-ARMD); I-AMD; Ukulahleka kombono - i-AMD

• Ukwehla kwamakhompiyutha
• URetina

Iwebhusayithi yeAmerican Academy of Ophthalmology. IKomidi leRetina / Vitreous, Isikhungo saseHoskins Sokunakekelwa Kwamehlo Okusezingeni. Umhlahlandlela Wephethini Yokuzikhethela Ekhethwayo. Ukwehla kwe-macular degeneration PPP 2019. www.aao.org/preferred-practice-pattern/age-related-macular-degeneration-ppp. Kubuyekezwe u-Okthoba 2019. Kufinyelelwe ngoJanuwari 24, 2020.

UWenick AS, uBressler NM, uBressler SB. Ukwehla kwe-macular okuhlobene nobudala: i-AMD yokuqala engeyona imithambo yegazi, i-AMD ephakathi, kanye ne-atrophy yendawo. Ku: Schachat AP, Sadda SR, Hinton DR, Wilkinson CP, Wiedemann P, abahleli. URitina kaRyan. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2018: isahluko 68.