Ukuvalelwa komthambo we-retinal

Ukuvaleka komthambo we-retinal ukuvimba komunye wemithambo emincane ethwala igazi liye kwi-retina. I-retina ungqimba lwezicubu ngemuva kweso elikwazi ukuzwa ukukhanya.

Imithambo ye-retinal ingavinjelwa lapho i-clot yegazi noma i-fat deposits ibambeka emithanjeni. Lokhu kuvinjelwa kungenzeka kakhulu uma kukhona ukuqina kwemithambo (i-atherosclerosis) esweni.

Izindwangu zingasuka kwezinye izingxenye zomzimba futhi zivimbe umthambo ku-retina. Imithombo evame kakhulu yamahlule yinhliziyo nomthambo we-carotid entanyeni.

Ukuvinjelwa okuningi kwenzeka kubantu abanezimo ezinjenge:

• Isifo somthambo weCarotid, lapho imithambo yegazi emibili emikhulu entanyeni iyancipha noma ivinjwe
• Isifo sikashukela
• Inkinga yesigqi senhliziyo (i-atrial fibrillation)
• Inkinga ye-valve yenhliziyo
• Amazinga aphezulu amafutha egazini (hyperlipidemia)
• Umfutho wegazi ophezulu
• Ukusebenzisa kabi izidakamizwa
• I-arteritis yesikhashana (ukulimala kwemithambo ngenxa yokuphendula komzimba)

Uma igatsha lomthambo we-retina livinjiwe, ingxenye ye-retina ngeke ithole igazi ne-oxygen eyanele. Uma lokhu kwenzeka, ungalahlekelwa yingxenye yombono wakho.

Ukufiphaza okungazelelwe noma ukulahleka kombono kungenzeka ku:

• Lonke iso elilodwa (central retinal artery occlusion noma i-CRAO)
• Ingxenye yeso elilodwa (ukuvalwa kwegazi lomthambo we-retinal noma i-BRAO)

Ukuvaleka komthambo we-retinal kungahlala imizuzwana embalwa noma imizuzu embalwa, noma kungahlala unomphela.

Ukunqamuka kwegazi esweni kungaba uphawu lokuxwayisa lwamahlule kwenye indawo. Ihlule ebuchosheni lingadala isifo sohlangothi.

Ukuhlolwa kokuhlola i-retina kungafaka:

• Ukuhlolwa kwe-retina ngemuva kokuhlanza umfundi
• I-Fluorescein angiography
• Ingcindezi yangaphakathi
• Impendulo ye-reflex yabafundi
• Ukuhlehlisa
• Ukuthwebula izithombe
• Sika ukuhlolwa kwelambu
• Ukuhlolwa kombono oseceleni (ukuhlolwa kwensimu ebonakalayo)
• Ubukhali obubukwayo

Ukuhlolwa okujwayelekile kufanele kufake phakathi:

• Ukushaya kwegazi
• Ukuhlolwa kwegazi, kufaka phakathi amazinga e-cholesterol ne-triglyceride kanye nesilinganiso se-erythrocyte sedimentation
• Ukuhlolwa komzimba

Ukuhlolwa kokuthola umthombo wehlwili elivela kwenye ingxenye yomzimba:

• I-Echocardiogram
• I-Electrocardiogram
• Ukuqapha kwenhliziyo ngesigqi senhliziyo esingajwayelekile
• I-Duplex Doppler ultrasound yemithambo ye-carotid

Alukho ikhambi elifakazelwe lokulahleka kombono okubandakanya iso lonke, ngaphandle uma kubangelwa esinye isifo esingalashwa.

Izindlela zokwelashwa eziningana zingazama. Ukuze ube wusizo, lezi zindlela zokwelashwa kufanele zinikezwe kungakapheli amahora amabili kuya kwayi-4 ngemuva kokuqala kwezimpawu. Kodwa-ke, inzuzo yalezi zindlela zokwelashwa ayikaze ifakazelwe, futhi ayivamisile ukusetshenziswa.

• Ukuphefumula (ukuhogela) ingxube ye-carbon dioxide-oxygen. Lokhu kwelashwa kubangela ukuthi imithambo ye-retina ivuleke (ivuleke).
• Ukubhucungwa kweso.
• Ukususwa koketshezi ngaphakathi kweso. Udokotela usebenzisa inaliti ukukhipha inani elincane loketshezi ngaphambili kweso. Lokhu kubangela ukwehla okungazelelwe kwengcindezi yamehlo, kwesinye isikhathi okungadala ukuthi ihlwili lingene emthanjeni wegatsha omncane lapho lizodala umonakalo omncane.
• Isidakamizwa sokuqandeka, isicubu seplasminogen activator (tPA).

Umhlinzeki wezokunakekelwa kwempilo kufanele abheke imbangela yokuvaleka. Ukuvinjelwa kungaba yizimpawu zenkinga yezokwelapha esongela impilo.

Abantu abanokuvinjelwa komthambo we-retinal kungenzeka bangabuyeli umbono wabo emuva.

Izinkinga zingafaka:

• I-Glaucoma (i-CRAO kuphela)
• Ukulahleka okuncane noma okuphelele kombono esweni elithintekile
• Unhlangothi (ngenxa yezici ezifanayo ezinomthelela ekuvalekeni komthambo we-retinal, hhayi ngenxa yokuvaleka uqobo)

Shayela umhlinzeki wakho uma ukufiphaza okungazelelwe noma ukulahleka kombono.

Izinyathelo ezisetshenziselwa ukuvimbela ezinye izifo zomthambo wegazi (semithambo yegazi), ezinjenge-coronary artery disease, zinganciphisa ubungozi bokuvaleka komthambo we-retinal. Lokhu kufaka phakathi:

• Ukudla ukudla okunamafutha amancane
• Ukuzivocavoca umzimba
• Ukuyeka ukubhema
• Ukwehlisa isisindo uma ukhuluphele ngokweqile

Kwesinye isikhathi, izinciphisi zegazi zingasetshenziswa ukuvimbela umthambo ukuba uphinde uvinjwe. I-Aspirin noma ezinye izidakamizwa ezilwa nokujiya zisetshenziswa uma inkinga isemithanjeni ye-carotid. I-Warfarin noma amanye ama-thinner wegazi anamandla asetshenzisiwe uma inkinga isenhliziyweni.

Ukuvinjelwa komthambo we-retinal emaphakathi; I-CRAO; Ukuvaleka komthambo we-retinal yegatsha; IBRAO; Ukulahleka kombono - ukuvalwa komthambo we-retinal; Umbono ofiphele - ukuvalwa komthambo we-retinal

• URetina

UCioffi GA, uLiebmann JM. Izifo zohlelo olubonakalayo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 395.

Crouch ER, Crouch ER, Isibonelelo TR.I-Ophthalmology. Ku: Rakel RE, Rakel DP, ama-eds. Incwadi Yezokwelapha Yomndeni. Umhlaka 9. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 17.

UDuker JS, uDuker JS. Ukuvinjelwa kwemithambo yegazi. Ku: Yanoff M, Duker JS, ama-eds. I-Ophthalmology. Umhlaka 5. IPhiladelphia, PA: Elsevier; 2019: isahluko 6.

UPatel PS, uSadda SR. Ukuvalelwa komthambo we-retinal. Ku: Schachat AP, Sadda SR, Hinton DR, Wilkinson CP, Wiedemann P, abahleli. URitina kaRyan. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2018: isahluko 54.

I-Salmon JF. Isifo semithambo yegazi. Ku: Salmon JF, ed. IKanski’s Clinical Ophthalmology. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2020: isahluko 13.