Matenda a shuga a retinopathy

Matenda a shuga a retinopathy ndi matenda omwe mitsempha yam'mimba imadwala matenda ashuga. Chizindikiro chachikulu cha matendawa ndi kuchepa kwamono. 90% ya anthu odwala matenda ashuga ali ndi vuto lalikulu lowona.

Retinopathy imawoneka soymptomatic, kotero anthu ayenera kulumikizana osati ndi endocrinologist, komanso ophthalmologist. Izi ziwathandiza kuti aziona.

Chithandizo cha matendawa m'magawo oyambira chikhoza kukhala chosasangalatsa, pogwiritsa ntchito madontho amaso kapena mankhwala. Woopsa, laser kapena opaleshoni imagwiritsidwa ntchito. Munkhaniyi tikambirana za matenda ashuga retinopathy, zomwe zimayambitsa, etiology komanso njira zabwino zochizira.

Matenda a shuga a retinopathy

Zomwe zimayambitsa chilondacho ndizosintha kwa mtima (kuchuluka kwa kuchuluka ndi kukula kwa ziwiya zatsopano za retina.

Kupewa komanso kuchiza matenda a shuga a retinopathy amachitika, monga lamulo, akatswiri awiri - a ophthalmologist ndi endocrinologist. Zimaphatikizanso kugwiritsa ntchito mankhwala osokoneza bongo (mankhwala a insulin, antioxidants, angioprotectors) ndi chithandizo chakumaloko - madontho amaso ndi kulowererapo kwa laser.

Njira zamatsenga zomwe zimachitika mthupi motsogozedwa ndi matenda ashuga zimawononga kwambiri mtima. Ponena za maso, pafupifupi 90% ya odwala ali ndi vuto lalikulu lakuwona komanso lotchedwa diabetesic retinopathy.

Chochititsa chachikulu cha matendawa ndi kuyambika kwa asymptomatic komanso kuwonongeka kosasintha kwa zida za ocular, zomwe ndi zina mwazomwe zimapangitsa kuti anthu asamachite bwino.

1. Zosakondweretsa.
2. Preproliferative.
3. Kuchulukitsa.

Kuphwanya kosagwirizana kwa retina ndi ziphuphu ndi gawo loyambirira la chitukuko cha matenda. M'magazi a munthu wodwala matenda ashuga, kuchuluka kwa shuga kumawuka, komwe kumapangitsa kuwonongeka kwa ziwiya zam'maso, chifukwa cha izi, kuchuluka kwa zipupa za ziwiya zam'mimba kumawonjezera, ndikuwapangitsa kukhala osatetezeka komanso osalimba.

Kufooka kwa ziphuphu zakumaso ndi ma retina kumakwiyitsa zotupa za m'mitsempha, motsutsana ndi kumbuyo komwe micaneurysms imakulira. Makoma atatu amitsempha yamagazi amapatsira gawo lamwazi m'madzimo, ndipo redness imawoneka pafupi ndi cornea, yomwe imakwiyitsa retema edema.

Pomwe gawo lodontha likalowera pakatikati pa retina, macular edema amawonekera. Kwa tsambali, njira yayitali, yokhala ndi asymptomatic imakhala yodziwika, pakakhala kusintha kwa masomphenya.

Preproliferative diabetesic retinopathy ndi gawo lachiwiri la matenda isanayambike kukula kwa retinopathy. Matendawa amapezeka kawirikawiri, pafupifupi 5-7% ya matenda onse a shuga.

Chiwopsezo chotenga gawo ili la matendawa limawonekera kwambiri kwa odwala omwe ali ndi vuto loyang'ana patali, kuchepa kwa mitsempha ya carotid, atrophy ya mitsempha ya m'mitsempha.

Pakadali pano, wodwalayo amakhala ndi vuto la okosijeni la retina, atakwiya chifukwa cha kuphwanya kwa mapangidwe a arterioles, matenda am'mitsempha ya hemorrhagic a retina angachitike, pali zotupa za mitsempha.

Maselo "okhala ndi njala" amapanga zinthu zapadera za vasoproliferative zomwe zimayambitsa kukula kwa zombo zaposachedwa (neovascularization). Monga lamulo, neovascularization imagwira ntchito zoteteza m'thupi. Mwachitsanzo, ndi kuvulala, izi zimathandizira kuchiritsa kwa bala, pambuyo pakuzandikizidwa - kuzindikirika kwake kwabwino.

Macular edema mu shuga ndikusintha kwa pathological m'chigawo chapakati cha retina. Vutoli silimabweretsa khungu, koma limatha kuyambitsa kuwona (wodwalayo ali ndi zovuta zina powerenga, zinthu zazing'ono zimayamba kuwona).

Macular edema ndi imodzi mwazomwe zikuwonetsa kuchuluka kwa odwala matenda ashuga retinopathy, koma nthawi zina amatha kuonekanso ndi zizindikiro zochepa za osalimbikitsa odwala matenda ashuga retinopathy. Kukhazikika kwa macular edema kumatha kuchitika popanda kuwononga mawonekedwe.

Chifukwa chiyani nthendayi ndiyowopsa kwa maso?

Mulimonsemo, hyperglycemia, ndiko kuti, kuchuluka kwa shuga m'magazi, kumakhudza maselo, kuphatikizapo khoma lamitsempha.

Imakhala yochepa kwambiri - magazi ndi madzi a m'magazi amalowa momasuka m'malo opanga ma cell, magazi amawoneka mosavuta pa endothelium yowonongeka. Poyamba, matenda ashuga amakhudza ziwiya zazing'ono, motero mitsempha ya m'mimba ndi mitsempha ndiyanso iwonso.

Kodi izi zimakhudza bwanji masomphenya?

Mu magawo oyamba, kugwa kwa ntchito zowoneka sikungachitike. Inde, retina - minyewa yocheperako - imakhudzidwa kwambiri ndi kusokonezeka kwa magazi, koma njira zowonjezera, komanso mawonekedwe osakhalitsa apakati, macular dera, amapereka malingaliro ovomerezeka.

Magazi akatuluka m'mitsempha yosinthika, mbali zina za retina zimapumira m'matumbo kapena kutaya chakudya (gawo la thrombosis).

Pomwepo, zizindikiro zoyambirira za matendawo ziziwoneka:

• "Ntchentche" pamaso,
• chithunzi blur
• kupindika kwa mizere.

Zizindikiro zowopsa ndizakuchepa kwamaso, maonekedwe akuwala (mphezi), kusowa kwofananira kwa gawo lina m'munda wamasomphenya (kukhazikitsidwa kwa "shroud"). Nthawi zina zochitika zotere zimasonyeza kukula kwa kufalikira kwa retinal

Zowopsa

Ndi zolakwika zilizonse zomwe zingachitike, ndibwino kusamalira kupewa komanso kuchiza matenda obwera ndi nkhawa. Kuopsa kowonera kumawonjezeka ngati zinthu zowonjezera zilipo.

Zomwe zimawonjezera mwayi wa mawonetseredwe a matendawa:

1. Osasunthika spikes m'magazi a magazi
2. Kuthamanga kwa magazi
3. Kusuta ndi zizolowezi zina zoyipa,
4. Matenda a impso ndi chiwindi
5. Mimba komanso nthawi yodyetsa mwana,
6. Zosintha zokhudzana ndi ukalamba mthupi,
7. Makamaka.

Kutalika kwa shuga kumakhudzanso kuwonekera kwa matendawa. Amakhulupirira kuti mavuto amakono amawoneka pafupifupi zaka 15 mpaka 20 atazindikira, koma pali zomwe zingachitike.

Muubwana, pamene vuto la mahomoni limafotokozanso ndi zomwe zimayambitsa matenda ashuga, kusintha kwa matenda ashuga retinopathy kumatha kupezeka m'miyezi ingapo. Ichi ndi chizindikiro choopsa kwambiri, chifukwa ngati zinthu zitakhala choncho, ngakhale pang'onopang'ono pounikira ndikusamalitsa, chiopsezo chakhungu chakula.

Matenda a shuga

Matendawa matenda a shuga ayambanso matenda ofala kwambiri. Matenda a shuga amakhudza onse akulu ndi ana.

Madokotala amayanjana ndi kuchuluka kwa odwala omwe ali ndi matenda ashuga ndikuti masiku ano, makamaka m'mizinda yayikulu, zomwe zimayambitsa matendawa ndizofala kwambiri:

• malo oyipa
• onenepa kwambiri
• kuperewera kwa zakudya m'thupi
• zolimbitsa thupi zochepa
• "Sedentary" moyo
• kupsinjika
• kutopa kwambiri.

Malinga ndi akatswiri, kuchuluka kwa anthu odwala matenda ashuga kumatha kufika pa 2025 - 300 miliyoni, omwe ndi anthu 5% padziko lonse lapansi.

Matenda a shuga amawoneka ndi shuga wambiri. Nthawi zambiri, maselo a pancreatic (ma cell a beta) amatulutsa insulin - timadzi timene timayendetsa kagayidwe, shuga, shuga m'magazi, komanso mafuta ndi mapuloteni.

Mu matenda a shuga mellitus, chifukwa chosakwanira kupanga insulin, zovuta za metabolic zimachitika, ndipo shuga wamagazi amatuluka. Ndipo, monga mukudziwa, ndi shuga yemwe ndi wofunikira pakugwira bwino ntchito kwa maselo a thupi.

Kuperewera kwa insulin m'matenda a shuga sikuti kumangokhala ndi maselo amthupi, komanso kumabweretsa kuwonjezeka kwa shuga osagwirizana ndi magazi. Nawonso, shuga wambiri amachititsa kuti mafuta asamayende bwino komanso kuti mafuta azikundana m'magazi, mapangidwe a ziwongo.

Izi zimatsogolera kuti lumen ya ziwiya zimacheperachepera, ndipo magazi ake m'misempha amachepa mpaka kuthe. Mu shuga mellitus, omwe ali pachiwopsezo chachikulu ndi mtima, maso, zida zowonera, ziwiya zamiyendo, ndi impso.

Matenda a shuga a retinopathy amakhala ndi zaka 5-10 kuchokera ku matenda a shuga kuchokera mwa anthu. Mtundu wa I wa matenda a shuga a mellitus (wodalira insulini), matenda ashuga a shuga amawonjezereka msanga ndipo proliferative matenda ashuga retinopathy amapezeka msanga.

Zoyambitsa matenda ashuga:

1. Kudziletsa
2. Kunenepa kwambiri.
3. Matenda ena omwe amayambitsa kuwonongeka kwa maselo a beta omwe amapanga insulin. Awa ndi matenda a pancreatic - kapamba, khansa ya kapamba, matenda am'minyewa ya endocrine.
4. Matenda a ma virus (rubella, chikuku, mliri wa hepatitis ndi matenda ena, kuphatikiza chimfine). Matendawa amatengera anthu omwe ali pachiwopsezo.
5. Kupsinjika kwa mantha. Anthu omwe ali pachiwopsezo ayenera kupewa nkhawa komanso nkhawa.
6. M'badwo. Ndi kuchuluka kwa zaka khumi zilizonse, mwayi wokhala ndi matenda osokoneza bongo umawonjezereka.

Kuphatikiza pa kumverera kofooka ndi kufooka, kutopa msanga, chizungulire komanso zizindikiro zina, matenda a shuga amawonjezera mwayi wokhala ndi matenda amtundu wa khungu ndi glaucoma, komanso kuwonongeka kwa retina. Chimodzi mwazomwe zimawonetsa matenda ashuga ndi matenda a shuga.

Zomwe zimayambitsa matenda a shuga a retinopathy

Kufotokozera mwachidule tanthauzo la njira yomwe imatsogolera pakupanga matendawa ndikosavuta kwambiri. Kusintha kwa kagayidwe kachakudya kamene kamayambitsa matenda ashuga kumabweretsa vuto pakagwiritsidwe ka magazi kupita ku zida za ocular. Ma cellvessel amaso ndi otsekeka, zomwe zimabweretsa kuwonjezeka kwa kukakamiza komanso kuwonongeka kwa makoma.

Kuphatikiza apo, zinthu zakunja zochokera m'mitsempha yamagazi zimatha kulowa mu retina, chifukwa zotchingira zachilengedwe zoteteza mu shuga zimayamba kukwaniritsa ntchito yake moyipitsitsa. Makoma amitsempha yamagazi amayamba kuchepa ndipo amatha kutayika, zomwe zimapangitsa kuti magazi azituluka komanso azithanso kuona.

Zowonongeka za matenda ashuga a retina ndi ziphuphu zakumaso zimachitika mwachindunji, zovuta zowoneka mochedwa za matenda a shuga, pafupifupi 90% ya odwala pankhaniyi ali ndi vuto losaona.

Zomwe matendawa amatchulidwa zimasinthidwa nthawi zonse, pomwe kugonja kwa cornea ndi retina m'magawo oyamba kumatha popanda zizindikiro zowoneka. Pang'onopang'ono, wodwalayo amayamba kuwona kuwonekera pang'ono kwa chithunzicho, mawanga ndi chophimba chikuwonekera pamaso pa maso, omwe amayamba chifukwa cha kuphwanya kwamaso kwa diso - ziphuphu.

Popita nthawi, chizindikirocho chimakulirakulira, masomphenya amachepa kwambiri ndipo khungu lonse limayamba kulowa.

Zombo zatsopano za retina ndizosalimba. Amakhala ndimakoma oonda, opangidwa ndi maselo amodzi, amakula mwachangu, amadziwika ndi kusinthasintha kwachangu kwa madzi a m'magazi, kuwonjezeka kwa fragility. Ndi fragility iyi yomwe imatsogolera kuwoneka kwamatumbo osiyanasiyana akhungu mkati mwa diso.

Tsoka ilo, milandu yayikulu ya hemophthalmus sindicho chokhacho chomwe chimapangitsa kuti masomphenyawo asokonezeke. Komanso, kukula kwa khungu kumayambitsidwa ndi zigawo zam'magazi zotuluka m'magazi omwe amapangidwamo kumene, kuphatikiza njira zomwe zimapangitsa kuti khungu lizipindika, komanso kuwonongeka kwa khungu.

Kutalika kosagwirizana kwa mawonekedwe a fibrovascular popangika mu ma optic nerve disk komanso kwakanthawi kwakanthawi kwamitsempha yamagazi kumayambitsa kuyambika kwa kupatutsira kwa retina, komwe kumafalikira kudera lamasentimita ndipo kumakhudza mawonekedwe apakati.

Izi, pamapeto pake, zimatha kukhala chinthu chofunikira kwambiri pakuwonekera kwa regmato native retinal detachment, yomwe imakwiyitsa kukula kwa iris rubeosis. Masewera am'madzi otumphukira kwambiri amasungunuka ndi madzi ochokera kumitsempha, omwe amachititsa kuti khungu lizigwira bwino ntchito.

Chingwe chotere cha pathogenetic chimakhala chokhwima kwambiri ndipo chimangofotokoza mawonekedwe osasangalatsa okha. Zachidziwikire, nthawi yayitali kuchuluka kwa matenda ashuga sikutha nthawi zonse.

Mulimonsemo, kupita patsogolo kwake kungasiye mwadzidzidzi. Ndipo ngakhale pankhani iyi, monga lamulo, kutayika kwa masomphenya kumayamba, njira zowonongeka pazowonera zomwe zatsala zimachepetsedwa kwambiri.

Kodi odwala matenda ashuga atha kupewa khungu?

Kuchuluka kwa odwala omwe ali ndi matenda a shuga kwa nthawi yayitali amakhala ndi zotupa za m'maso ndi retina, yomwe imatha kukhala osiyanasiyana.

Chifukwa chake, akatswiri adazindikira kuti pafupifupi 15% ya odwala omwe amapezeka ndi matenda osokoneza bongo amakhala ndi zizindikiro zochepa za matenda ashuga retinopathy, omwe amakhala ndi matenda opitirira zaka zisanu, pafupifupi 29% ya odwala ali ndi zizindikiro, 50% ya odwala omwe ali ndi zaka 10 mpaka 15.

Ndiye kuti munthu akadwala matenda ashuga kwambiri, ndiye kuti pamakhala chiwopsezo chachikulu chowonongeka.

Zina, monga:

• kuchuluka kulimbikira kwa kuthamanga kwa magazi ndi ndende ya magazi,
• kuwonongeka kwaimpso,
• kuphwanya kuchuluka kwa magazi lipids,
• kuchuluka kwa mafuta ochulukirapo,
• kagayidwe kachakudya,
• kunenepa kwama degree osiyanasiyana,
• chibadwa
• nthawi yapakati
• zizolowezi zoipa
• zotupa za m'maso.

Komabe, kuyang'anira shuga wamagazi pafupipafupi, kutsatira kadyedwe kena ndikukhalanso ndi moyo wathanzi, kutenga mavitamini ndi michere minyewa yamaaso, yopangidwa makamaka kwa odwala omwe ali ndi matenda ashuga (Antotsian Forte ndi ena) kungachepetse chiopsezo chakhungu chifukwa cha zovuta za shuga.

Njira yothandiza kwambiri yopewa kutaya kwamaso ndikuwona momwe pafupipafupi amayendera wodwala yemwe ali ndi matenda a shuga ndi ophthalmologist ndi endocrinologist, kutsatira malingaliro awo.

Choopsa chachikulu chomwe matendawa amatenga ndi nthawi yayitali yopanda zizindikiro. Pa gawo loyamba, kuchepa kwa masomphenya sikumveka konse, chinthu chokhacho chomwe wodwala angayang'anire kwambiri ndi macular retinal edema, yomwe imadziwonetsera yokha mukusowa kwa lakuthwa kwa chithunzi, zomwe zimakonda kuchitika ndi zilonda zam'mimba.

Zimakhala zovuta kwa wodwala kuwerenga ndi kugwira ntchito ndi zazing'ono, zomwe nthawi zambiri amazitcha kuti atopa kapena kukomoka.

Chizindikiro chachikulu cha kuwonongeka kwa retinal chimawonetsedwa pokhapokha kukhathamiritsa kwamphamvu mu thupi la vitreous, lomwe kwa wodwala yemwe ali ndi matenda ashuga amamva mu mawonekedwe a kuchepa kwapang'onopang'ono kapena lakuthwa mu kuwona kwa chidwi.

Mitsempha yama cell imakonda kuphatikizidwa ndi mawonekedwe amdima oyandama komanso chophimba pamaso pa diso, chomwe patapita nthawi chimatha popanda kufufuza. Kutulutsa kwamphamvu kwambiri kumatsogolera pakuwonongeka kwathunthu.

Chizindikiro cha macular edema ndimamvekanso chophimba pamaso pa maso. Kuphatikiza apo, ndizovuta kuwerenga kapena kugwira ntchito pafupi.

Gawo loyambirira la matendawa limadziwika ndi mawonekedwe a asymptomatic, omwe amachititsa kuti azindikire chithandizo chamankhwala komanso chapanthawi yake.Nthawi zambiri madandaulo akuwonongeka kwa ntchito yowonekera amabwera mu gawo lachiwiri kapena lachitatu, chiwonongeko chinafika pamlingo waukulu.

Zizindikiro zazikuluzikulu za retinopathy:

1. Kuwona koperewera, makamaka kudera lakunja,
2. Maonekedwe a "ntchentche" patsogolo pa maso,
3. Kuwona kwamaso am'maso
4. Kuwerenga zovuta
5. Kutopa kwakukulu ndi kuwawa m'maso,
6. Chophimba kapena mthunzi womwe umasokoneza mawonekedwe abwinobwino.
7. Kukhalapo kwa chizindikiro chimodzi kapena zingapo kungawonetse mavuto akulu amawonedwe.

Pankhaniyi, muyenera kukaonana ndi dokotala - a ophthalmologist. Ngati mukukayikira kukhazikitsidwa kwa matenda ashuga retinopathy, ndibwino kuti musankhe katswiri wopanikizika - ophthalmologist - retinologist. Dokotala wotereyu amakhala ndi odwala omwe amapezeka ndi matenda osokoneza bongo ndipo amathandizira kudziwa molondola zomwe zasintha.

Zizindikiro

Nthawi zambiri, matenda a shuga amathandizira kuti minyewa ya m'maso ipangidwe, mtima ndi mtima, impso komanso vuto la magazi. Kuzindikiritsa mavuto munthawi yake kumathandiza kuwunika momwe wodwalayo alili komanso kuteteza motsutsana ndi zovuta zoyipa.

Phunziro lili bwanji:

• Katswiri amapanga kafukufuku wamitundu yozungulira - yowonera. Izi ndizofunikira kudziwa mkhalidwe wa retina m'madera otumphukira.
• Ngati ndi kotheka, yang'anani ndi njira zamagetsi. Ikuwonetsetsa kukula kwa mitsempha yam'mimba ya retina ndi zida zowonekera.
• Tonometry ndi muyeso wa kupanikizika kwa intraocular. Ndi mitengo yowonjezereka, chiwopsezo cha zovuta chimakulirakulira.
• Ophthalmoscopy ndi kuwunika kwa fundus. Amachitidwa pa chipangizo chapadera, chopweteka komanso chofulumira.
• Kufufuza kwa Ultrasound kwamkati mwa diso kumachitika ngati kuli kofunikira kudziwa chitukuko cha matenda a m'maso ndi magazi obisika. Nthawi zambiri zombo zomwe zimadyetsa zida za ocular zimawunikiranso.
• Mgwirizano wogwirizira Tomography ndiyo njira yothandiza kwambiri yodziwira kapangidwe ka zida zowoneka. Mumakulolani kuti muwone macular edema, osawoneka panthawi yoyeserera nokha ndi magalasi.

Pofuna kukhalabe ndi ntchito kwa zaka zambiri, odwala matenda ashuga amayenera kukayezetsa magazi pafupifupi miyezi isanu ndi umodzi. Izi zikuthandizira kudziwa njira yomwe yayamba m'magawo oyambilira komanso kupewa matenda oopsa.

Odwala omwe ali ndi matenda osokoneza bongo omwe ali ndi vuto la matenda am'mimba kwambiri ndi khansa, amafunika kuyang'aniridwa ndi ophthalmologist ndikupita kukapimidwa pafupipafupi.

Amachitanso njira zodziwira matenda:

1. Visometry - kutsimikiza kwamawonedwe malinga ndi tebulo lapadera,
2. zoyipa - zimakupatsani mwayi kuti muwone mawonekedwe amaso aliwonse, kuwonongeka kwa cornea, monga munga, gawo lowonekera lidzakhala ndi gawo laling'ono kuposa lomwe limakhala ndi diso labwino.
3. biomicroscopy ya khoma lakunja kwa eyebine - osadziwika kukhudzana kwa zotupa za retina ndi ziphuphu pogwiritsa ntchito nyali.
4. diaphanoscopy - imakupatsani mwayi wodziwa kukhalapo kwa zotupa pazida zakunja za cornea ndi mkati mwa eyebone,

Zikachitika kuti khungu la maso, ma mandala kapena thupi lamphamvu litapezeka, kafukufukuyu amachitika ndi ma ultrasound.

Kupewa kwa zovuta komanso kupewa khungu kumakhazikitsidwa pakudziwitsa zam'mapapo zam'mimba, retina ndi fundus, zomwe zikuwonetsa kupita patsogolo kwa matenda ashuga retinopathy.

Mankhwala

Kukonzanso odwala omwe ali ndi matenda ashuga retinopathy (DR) amakhalabe amodzi mwa zovuta kwambiri komanso zovuta kuzimitsa maso. DR ndiye amene akutsogolera khungu kwa anthu akuluakulu.

Mayendedwe a Conservative chithandizo cha DR:

• Kulipiritsa kwa matenda ashuga komanso zovuta zokhudzana ndi metabolic:
• chakudya kagayidwe kachakudya
• kuthamanga kwa magazi (BP) (renin - angiotensin - aldosterone system blockers),
• lipid ndi mapuloteni kagayidwe (mavitamini A, B1, B6, B12, B15, fenofibrate, anabolic steroids),
• retinal kagayidwe kachakudya:
• antioxidant mankhwala
• mitsempha ya minyewa yothandizira,
• aldose reductase zoletsa,
• angiogenesis blockers,
• kukonza matenda a mtima dongosolo ndi magazi rheology:
• magazi othandizira magazi
• vasodilators,
• angioprotectors
• othandizira omwe amasintha mkhalidwe wa endothelium ndi chapansi membrane wa mtima khoma.

Mndandandawu umasinthidwa nthawi zonse ndikusinthidwa. Zimaphatikizapo magulu onse odziwika omwe amaimiridwa ndi magulu osiyanasiyana a mankhwala, komanso madera atsopano, olimbikitsa.

Njira zopanda chithandizo chilichonse cha mankhwala a DR (onse osakhazikika ndikuchita opaleshoni) ndikubwezeretsanso kwa matenda ashuga komanso zovuta zokhudzana ndi metabolic - protein and lipid metabolism.

Chomwe chimapangitsa kupewa ndi kuchiza matenda a DR ndiye chindapusa chokwanira cha kagayidwe kazakudya. Mtundu woyamba wa matenda ashuga, kuchuluka kwa glucose mpaka 7.8 mmol / L amadziwika kuti ndizovomerezeka, ndipo zomwe zili glycosylated hemoglobin HbA1 zafika pa 8.5-9,5%. Mtundu wachiwiri wa matenda ashuga, kuchuluka kwa glycemia kumakhala kokwezeka pang'ono, poganizira momwe wodwalayo alili.

Malinga ndi zotsatira za kafukufuku wa EUCLID, kugwiritsa ntchito kwa ACE inhibitor lisinopril kunachepetsa chiopsezo cha kupitanso patsogolo kwa retinopathy nthawi 2 ndikuchepetsa kuchuluka kwa milandu yatsopano ndi 1/3 mkati mwa zaka 2 zowonedwa.

Kuphatikiza pa kugwiritsa ntchito bwino kwa lisinopril, kugwiritsa ntchito kwa mitundu ina ya ACE inhibitors (Captopril, fosinopril, perindopril, ndi zina zambiri).

Komanso, pakuwongolera kagayidwe ka lipid ndi mapuloteni, olemba angapo amalimbikitsa kugwiritsa ntchito mavitamini A, B1, B6, B12, B15, fenofibrate ndi anabolic steroids.

Amadziwika kuti fenofibrate, kuwonjezera pa kukonza kwa hypertriglyceridemia ndi dyslipidemia wosakanikirana, imatha kuletsa mawu a VEGF receptors ndi neovascularization, komanso kukhala ndi antioxidant, anti-kutupa ndi neuroprotective.

M'magawo oyambilira a DR, kutchulidwa kwa lipid peroxidation kunadziwika, chifukwa chomwe wolemba adapeza zabwino kuchokera kugwiritsidwa ntchito kwa tocopherol (1200 mg patsiku).

Zotsatira zabwino zomwe zidawonetsedwa ndikugwiritsa ntchito mitundu yovuta ya antioxidant - systemic (alpha-tocopherol) ndi mafilimu am'deralo (ophthalmic mankhwala omwe ali ndi emoxipin), ndi mankhwala a mexidol.

Zotsatira zamankhwala zamaphunziro angapo owona kawiri, owongoleredwa ndi placebo ku DR adatsimikizira zovuta zamachitidwe a Tanakan mwa mawonekedwe osintha machitidwe a retina ndikuwonjezera kuwonekera kwamphamvu.

• Mitsempha yamitsempha yama minyewa.

Kuyambira 1983, kafukufuku wambiri komanso wazachipatala adachitidwa pakugwiritsa ntchito ma peptide bioregulators ku DR. Peptide bioregulators amawongolera kagayidwe kachakudya mu retina, ali ndi anti-aggregation ndi hypocoagulation zotsatira, ndi antioxidant ntchito.

Aldose reductase zoletsa. Kugwiritsa ntchito aldose reductase inhibitors, ma enzyme omwe amatenga gawo la glucose metabolism kudzera njira ya polyol ndi kudzikundikira kwa sorbitol m'maselo a insulini odziyimira pawokha, akuwoneka kuti akuwonjeza.

M'maphunziro oyesera a nyama, zidawonetsedwa kuti aldose reductase inhibitors imalepheretsa kuchepa kwa pericyte pa retinopathy.

• Direct inhibitors a mtima endothelial kukula factor (VEGF).

Kugwiritsira ntchito ma inhibitors mwachindunji a vascular endothelial grow factor (VEGF) ndi gawo lina lolimbikitsa ku chithandizo cha DR. Monga tikudziwika, chinthu cha VEGF chimayambitsa kukula kwa zombo zapakhomo zopangidwa kumene, kutaya magazi ndi kutulutsa kuchokera mu ziwiya za patina.

Intraocular dongosolo la anti-VEGF factor imatha kukhala yogwira magawo oyambilira a DR ndikuchepetsa macular edema kapena retinal neovascularization. Pakadali pano ma anti 4 a anti-VEGF alipo: pegaptamib sodium, ranibizumab, bevacizumab, aflibercept.

Ma Vasodilator pakali pano amalimbikitsidwa kuti azigwiritsidwa ntchito mosiyanasiyana komanso mosamala. Pali chochitika chabwino chogwiritsa ntchito xanthinol nicotinate pochotsa matenda a hemorheological ku DR komanso mitundu ya hypotonic komanso hypertonic.

Njira zomwe zimalimbitsa khoma lamitsempha, poletsa kuchuluka kwake, ndi gulu lalikulu pakati pa mankhwala omwe amagwiritsidwa ntchito pochiza DR.

Kuchokera pagululi, rutin ndi zotumphukira zake, vitamini E, ascorbic acid, ndi doxium (calcium dobsilate) adagwiritsidwa ntchito. Pogwiritsa ntchito mankhwala a gululi kwa nthawi yayitali (miyezi 4 - 8 kapena kuposerapo), olemba adafufuza kutulutsa kwina kwa retinal.

Kuwongolera mkhalidwe wa endothelium ndi chapansi chotupa cha khoma lamasamba kumawoneka kuti ndi njira imodzi yolimbikitsira pankhani ya chithandizo cha magawo oyambirira a DR komanso kupewa kupewa kwa matendawa.

Zaka zaposachedwa, pakhala pali malipoti ambiri akugwiritsidwa ntchito kwa mankhwalawa Sulodexide (Wessel Duet F, Alfa Wassermann) kuchokera pagulu la glycosaminoglycans (GAG), lomwe lili ndi gawo laling'ono la heparin (80%) ndi dermatin-sulfate (20%) pa chithandizo cha DR.

Sulodexide ndi DR imakhala ndi zovuta:

1. angioprotective - kubwezeretsanso kwa magetsi kwa chipinda chapansi komanso kukhulupirika kwa khoma la mtima.
2. antithrombotic,
3. microsolytic,
4. antihypertensive

Njira zopangira opaleshoni

Kuphatikiza kwa laser sikumakhala koopsa komanso kothandiza kwambiri. Pakadali pano pakupanga mankhwala, iyi ndiye njira yabwino kwambiri yowongolera mashuga matenda ashuga retinopathy.

Ndondomeko ikuchitika pogwiritsa ntchito mankhwala oletsa ululu m'malo momwe madontho, safunikira kukonzekera mosamala komanso nthawi yayitali yokonzanso.

Malangizo apadera amafunikira kuyesedwa koyambirira, ngati kuli kotheka, chithandizo chamankhwala pambuyo potsatira njirayi ndi nthawi yopumula mutatha kulowererapo.

Ndondomeko imatenga pafupifupi theka la ola, wodwalayo samamva kupweteka komanso kusapeza bwino. Pankhaniyi, kugonekedwa kwa chipatala kwa wodwala sikufunikanso, chifukwa njirayi imachitika pang'onopang'ono.

Zovuta zokhazokha za laser coagulation ndizofufuza akatswiri wabwino komanso zida zosakwanira zamagulu azachipatala. Si chipatala chilichonse chomwe chimakhala ndi zida zotere, chifukwa chake okhala kumadera akutali ayenera kulingaliranso mtengo wa ulendowu.

Nthawi zina, mphamvu ya laser coagulation ikhoza kukhala yosakwanira, motero njira ina imagwiritsidwa ntchito - opareshoni. Amatchedwa vit sahihiomy ndipo amachitidwa pansi pa opaleshoni yotupa.

Chofunikira chake ndikuchotsa ma membrane owonongeka a retinal, thupi lamatupi oyeserera komanso kukonza kwa mtima. Malo abwinobwino a retina mkati mwa nsidze ndi mawonekedwe a kulumikizana kwamankhwala amatithandizanso.

Nthawi yokonzanso imatenga masabata angapo ndipo imafuna mankhwala othandizira pambuyo pake. Amathandizira kuthetsa kuthekera kotheka, kuteteza chitukuko cha matenda obwera pambuyo pake ndi zovuta.

Kusankhidwa kwa njira yoyenera yowonetsera mashuga retinopathy kumachitika malinga ndi momwe wodwalayo alili. ziyenera kudziwika kuti ndizosatheka kukwaniritsa machiritso athunthu, chifukwa chake, izi zimachepetsa njira za m'maso.

Mwina m'zaka zochepa wodwalayo adzafunikanso kulowererapo, motero amapita kwa ophthalmologist atachita bwino opaleshoni yake.

Kupewa

Hyperglycemia yomwe yakhalapo kwa nthawi yayitali. Pali malingaliro pa kufunikira kwa chitetezo cha mthupi pazomwe zimapangidwira retinopathy.

Pathogenesis

Pathogenesis ya diabetesic retinopathy ndi yovuta. Chitsogozo chachikulu ndi kusokonezeka kwa ma cellcirculation komwe kumachitika chifukwa cha mapangidwe a ziwiya zam'mimba komanso kusintha kwa kagayidwe kachakudya kosakanikirana ndi matenda a shuga.

Mu shuga mellitus, chotchinga chamagazi, chomwe chimalepheretsa kulowa kwa mamolekyu akuluakulu m'mitsempha yamagazi kulowa m'matumbo am'mimba, chimakhala chovomerezeka, chomwe chimayambitsa zinthu zosafunikira kulowa mu retina.

Pakukula kwa zizindikiridwe, kuphatikizika kwina kumadziwika: kusintha kwa magazi mosiyanasiyana… .kuwonongeka kwa magazi end Kupweteketsa kotsekemera kotsekemera kotsekemera → kuchuluka kolimba kwachulukidwe → mapangidwe a masinthidwe amizere yamagazi ndi kuchepa kwa misempha.

Gulu

Mu 1992, Kohner E. ndi Porta M. adaganiza za gulu la WHO la matenda ashuga a retinopathy, omwe tsopano amavomerezedwa:

• Nonproliferative Retinopathy (diabetesic retinopathy I) - yodziwika ndi kukhalapo kwa maso a masinthidwe am'magazi mwa ma micaneurysms, hemorrhages (mwanjira ya madontho ang'onoang'ono kapena mawanga a mawonekedwe ozungulira (palinso otayika), amtundu wakuda, amtundu wapakatikati mwa fundus kapena m'mitsempha yayikulu yakuya zigawo za retinal), exudative foci (yodziwika pakatikati pa fundus, chikasu kapena choyera ndi malire omveka bwino kapena opanda mawonekedwe) ndi retema edema. Retinal edema yodziwika pakati (macular) dera kapena m'matima akuluakulu ndi chinthu chofunikira kwambiri pakukula kwa matenda osokoneza bongo a retinopathy.
• Preproliferative retinopathy (diabetesic retinopathy II) - yodziwika ndi kupezeka kwa zamkati zamkati (lakuthwa, kuzungulira, kupezeka kwa malupu, kuwirikiza ndi / kapena kutulutsa kusinthasintha kwa mitsempha yamagazi), kuchuluka kwakukulu kwa "thonje" lakumaso, ma intraretinal microvascular anomalies (IRMA), ma hemorrhages ambiri am'mimba.
• Proliferative retinopathy (diabetesic retinopathy III) - yodziwika ndi neovascularization ya optic disc ndi / kapena mbali zina za retina, vitreous hemorrhages, mapangidwe a minyewa ya fibrous m'dera la preretinal hemorrhages. Zombo zatsopano zomwe zimapangidwa ndizowonda kwambiri komanso zosalimba - zotupa zobwereza mobwerezabwereza zimachitika, zomwe zimapangitsa kuti retina isasunthike. Zombo zatsopano zopangidwa ndi Iris of eye (rubeosis) nthawi zambiri zimabweretsa kukula kwa sekondale (rubeous) glaucoma.

Chithunzi cha kuchipatala

Magawo oyamba a chotupa amadziwika ndi kusowa kwa zizindikiro zamaso (kuchepa kwa maonedwe owoneka, kupweteka, ndi ena). Kuwonongeka kapena kuchepa kwa maonedwe acuity ndi chizindikiro chakumapeto chomwe chimayimira njira yofikira patali, yosasinthika (musanyalanyaze kuyesedwa kwamakono kwa ophthalmological).

Choyambitsa chachikulu cha kutayika kwamaso ndi matenda ashuga retinopathy, mawonekedwe osiyanasiyana omwe amapezeka mu 80-90% ya odwala. Malinga ndi Pulofesa A. Efimov, mu kafukufuku wa ophthalmological wa anthu 5,334 omwe ali ndi matenda a shuga, retinopathy yamatenda osiyanasiyananso adapezeka mu 55.2% ya odwala (gawo I - 17.6%, gawo II - 28.1%, gawo lachitatu - mu 9.5%). Kuwonongeka kwathunthu kwa masomphenya pakati pa onse omwe adawayeza kunali pafupifupi 2%.

Retinopathy - kuwonongeka kwa ziwiya za retina. "Zolinga" zazikulu pakusintha kwamachitidwe mu retina:

1. arterioles - lipogaline arteriosulinosis ("plasma vasculosis"), omwe amakhudzidwa kwambiri ndi arterioles osakhazikika komanso capillaries m'dera lotsatira la fundus,
2. mitsempha - kukulira ndi kusinthika,
3. capillaries - kuchepa, kuchuluka kwachulukidwe, kufalikira kwa capillaries, kuchititsa kupweteka kwa mtima, kupindika kwa kwapakati pa khoma ndi mapindikidwe a endothelial, kukula kwa zigawo zam'munsi, mapangidwe a micaneurysms, hemorrhages, arteriovenous shunts, neovascularization,
4. kutupa kwa striatum opticum ulusi, wowoneka bwino ngati malo otuwa ndi mawanga amtambo, wotchulidwa kuti exudates, edema ya optic disc, atrophy ndi gawo la retina.

Zizindikiro

Osachepera 1 pachaka, anthu odwala matenda a shuga amayeza mayeso, kuphatikizapo kufunsa mafunso, kuyeza kupenyerera ndi kupenya (atatha kufinya) kuti apeze zotuluka, zotupa zodontha, ma michereurysms ndi kuchuluka kwa ziwiya zatsopano. Zoyenera, kuyeserera kumachitika ndi ophthalmologist wodziwa bwino chipatala cha matenda ashuga.

Chithandizo

Chithandizo cha matenda ashuga retinopathy ndichovuta, chimachitika ndi endocrinologist ndi ophthalmologist. Zofunikanso monga kupatsidwa zakudya zoyenera ndi insulin. Ndikofunikira kuchepetsa mafuta muzakudya, m'malo mwa mafuta a nyama ndi mafuta am'masamba, osapatula chakudya chambiri (shuga, maswiti, zoteteza), komanso kugwiritsa ntchito zinthu zambiri zomwe zimakhala ndi lipotropic (tchizi tchizi, nsomba, oatmeal), zipatso, masamba (kupatula mbatata). Mankhwala othandizira a Vitamini ndilofunikira kwambiri, makamaka gulu B (B₁, B₂, B₆, B₁₂, B₁₅) mkati ndi makolo. Vitamini C, P, E amakhala ndi zoteteza kukhoma la mtima (3-4 pachaka, maphunziro a mwezi umodzi). Angioprotectors akuphatikizapo anginin (prodectin), dicinone, doxium. Mankhwalawa amatengedwa monga adanenera dokotala.

• Mu gawo ine matenda ashuga retinopathy (sanali proliferative retinopathy), kawirikawiri mobwerezabwereza mayeso ophthalmic. Dokotala amayenera kuwunika momwe wodwalayo amalamulirira kuchuluka kwa shuga m'magazi.
• Mu diabetesic retinopathy ya II kapena III siteji (prroliferative and proliferative retinopathy, motero), laser Photocoagulation ikuwonetsedwa.

Kafukufuku waposachedwa wa DS adayesa kugwiritsa ntchito rendes-angiotensin receptor blocker (PAC) ya candesartan ya mtundu 1 ndi matenda a shuga a 2. Kugwiritsa ntchito kwa candesartan sikunachepetse kupita patsogolo kwa retinopathy. Phunziroli, panali njira yochepetsera kukula kwa retinopathy. Pakufufuza kocheperako kwa RASS, kwawonetsedwa kuti kukulitsa kwa retinopathy mu mtundu 1 wa matenda osokoneza bongo kumachepetsa ndi ASD kutsekeka ndi losartan ndi angiotensin-kutembenuza enzyme enalapril inhibitor. Chifukwa chake, kugwiritsidwa ntchito kwa ASD blockers kungakhale koyenera kwa odwala omwe ali ndi matenda amtundu wa 1 komanso retinopathy, koma osati ndi matenda a shuga 2.

Diabetesic retinopathy imalumikizidwa ndi zovuta zingapo za epigenetic, kuphatikizapo methylation ya Sod2 ndi MMP-9 genes ndikulemba kwambiri mtundu wa LSD1 en gene. Kuthekera kwa kugwiritsa ntchito mankhwala a epigenetic kuwongolera pakali pano kuli kulingaliridwa.

Ziwonetsero

Muzochitika zapamwamba komanso kuphatikiza kwa matenda osokoneza bongo a shuga ndi matenda oopsa, atherosulinosis ndi yoopsa kwambiri.

Kupewa

Mukukula ndi kupitiliza kwa retinopathy yamitundu yonse ya matenda a shuga, ntchito yofunika imaperekedwa pamlingo wolipirira pazomwe zimayambitsa matenda. Kukula kwa ochepa matenda oopsa ndi matenda ashuga nephropathy, omwe amaphatikizidwa ndi retinopathy, kukulitsa njira ya retinopathy mu matenda a shuga. Atherosulinosis imapita patsogolo kwambiri pakati pa anthu omwe ali ndi matenda osokoneza bongo aang'ono ndipo amakhala ovuta kwambiri - chifukwa cha kukhalapo kwa microangiopathy, mwayi wopanga kufalikira koyenda umachepetsedwa. Kuti mupeze vuto la panthawi yake, wodwala aliyense yemwe ali ndi matenda ashuga amayenera kuwunikidwa ndi ophthalmologist osachepera 1 pachaka ndipo ngati kudandaula komwe kumachitika.

Popewa zotupa zam'maso kwambiri, kupezeka kwawo koyambirira ndikofunikira - achinyamata omwe ali ndi matenda ashuga amayenera kuwunikidwa ndi ophthalmologist osachepera nthawi 1 m'miyezi 6. Chidwi chachikulu chiyenera kuperekedwa kwa mawonekedwe a odwala omwe ali ndi matenda osokoneza bongo a nthawi yayitali - ndi kuwonjezereka kwa nthawi ya matenda osokoneza bongo, kuchuluka kwa kudziwika kwa matenda ashuga retinopathy kumawonjezereka.

Njira yokhayo yodalirika yopewera matenda ashuga retinopathy ndiyomwe imapangitsa chithandizo cha magawo ake onse ndi chindapusa chokwanira pa matenda a shuga mellitus (mulingo wa glycated hemoglobin HbA_1C .

Kodi matenda ashuga retinopathy ndi chiyani?

Matenda a shuga amakhala ndi zovuta pa ziwalo zonse za mthupi ndi machitidwe a munthu, koma ma retina amatha kugwa ndimatenda a pathological. Ichi ndichifukwa chachilendo cha kapangidwe kake ndi thupi. Matenda a shuga a maso amayamba kutsika kwa maso onse, koma ndi kuwonongeka kosiyanasiyana ndi kuuma kwa njirayo.

Retina ndiye maziko amaso omwe amatithandiza kuti tizitha kuwona. Njira zonse za metabolic mu retina zimachitika mosadukiza kudzera mu ma cellvascular network amaso. Ndi choroid uyu amene amakhudza matenda ashuga. Ma Microvessels amapezeka pa fundus, momwe amathandizira retina, amapatsa oxygen, ndipo zinthu zowola zimachotsedwa.

Ndi matenda ashuga, zotengera zimakhala zowonda, kuonda, kutaya mphamvu, kutsimikiza kwawo kumaphwanyidwa, kusinthana kudzera makoma kumakulirakulira. Izi zimabweretsa kukoka kwamphamvu kwa retina, komwe kumapangitsa kuti magwiridwe ake akhale othandizira, kutsitsa ntchito zowoneka, kusintha kwa dystrophic mu mitsempha ya optic. Umu ndi momwe matenda ashuga a retinopathy amawonekera.

Zombo zatsopano zimayamba kukula (kulipirira zakale), koma zimakhala zowawa kwambiri komanso zosalimba, zomwe zimatsogolera ku aneurysms, hemorrhages, ndi edema.

Nthawi zambiri, thupi lamphamvu limakutidwa ndi ziwiya zatsopano, zomwe nthawi zambiri zimayenera kukhala zofanana komanso zowonekera. Ndipo ngati chotengera chatsopano chaphulika mkati mwa vitreous, kukha magazi kotchedwa hemophthalmus kumachitika. Pankhaniyi, magazi amatchinga, kulepheretsa kuwala kwa kuwala kwa retina.

Komanso, ziwiya zatsopano, chifukwa cha kupyapyala kwake, makoma osanjikiza amodzi, zimakhala ndi mphamvu zambiri, zomwe zimapangitsa kuti thukuta la madzi a m'magazi lifike kunsi kapena kwapafupi. Mwanjira imeneyi, edema yamatumbo iwo eni komanso zimakhala zomwe zimapereka magazi zimapangidwa.

Matenda opatsirana

Mavuto a retinopathy mu shuga:

1. Kuchulukitsidwa kwazovuta za intraocular, kuukira kwatsoka kwa glaucoma.
2. Retinal edema, macular edema - mawonekedwe a chifi patsogolo pa maso, chithunzi chosazungulira.
3. Edema, cholowa chamafuta.
4. Kutupa kwam'mimba kapena ziwalo zina za khungu.
5. Vitreous hemorrhage - imaphwanya kuwonekera kwake, limodzi ndi chophimba pamaso pa maso.
6. Mphaka
7. Kuchepetsa pang'ono kapena kuwona kwathunthu.
8. Matenda a shuga amakhudza ziwiya zonse za thupi, chifukwa chake, matenda a shuga angioretinopathy amathandizana ndi angiopathy (kuwonongeka kwa mitsempha yonse yamagazi), komanso chiwopsezo cha stroketi, kugunda kwa mtima ndi mtima.

Tikukupemphani kuti muwonere vidiyoyi, yomwe imafotokoza zovuta zomwe zingachitike chifukwa cha matendawa:

Gulu la matenda

Matenda a shuga a retinopathy amasankhidwa ndi gawo lachitukuko. Magawo atatu akuluakulu a matendawa amasiyanitsidwa kutengera kuuma kapena magawo a kuwonongeka kwa mtima mu mtima.

Gawo la retinopathy mu matenda osokoneza bongo:

1. Non-proliferative diabetesic retinopathy ya 1 gawo - yodziwika ndi kuwonongeka kwa ma retine microvessels, aneurysms, hempoint hemorrhages, ang'ono exudative foci. Palibe Symbomatology ya matenda ashuga retinopathy; ndizotheka kudziwa njira pokhapokha pofufuza ndalama.
2. Gawo 2 Prerolopative diabetesic retinopathy - kuchuluka kwa ziwiya zowonongeka kumawonjezereka, komanso kuuma kwa njirayi. Maukonde opanga minyewa amakula kwambiri, ndikamakhala ndi ma blockages, malupu, kuwirikiza kapena kusamvana, kuchuluka kwa zotupa ndi kuchuluka. Chithunzi cha chipatala panthawiyi chimatha kusowa kwathunthu kapena kuwoneka nthawi ndi nthawi, paroxysmally, munthawi imodzimodzi ndi kuphipha kwa shuga m'magazi.
3. Gawo 3 proliferative (chosasinthika) matenda ashuga retinopathy - kuwonongeka kwathunthu kwa ziwiya zam'mimba. Chifukwa cha kuthekera kwawo kuonetsetsa kuti kagayidwe kabwino, kukula kachulukidwe (kapangidwe kake) ka zinthu zatsopano za maso kumachitika ndi zotengera zatsopano za maso pomwe sipamayenera kukhala ziwiya zamtundu uliwonse. Chithunzi chotchedwa chipatala, kutayika kwamphamvu, kopita patsogolo.

Matenda a shuga angioretinopathy pa gawo lachitatu amayamba kuwoneka bwino. Tsoka ilo, palibe chomwe chitha kuchiritsidwa pakadali pano. Njirayi imatha kuyimitsidwa kapena kuchedwetsa, kwinaku ikusintha momwe masomphenyawo adawonekera.

Mutha kuwona bwino za matenda ndi mitundu yake mu kanemayo:

Zolinga zakukula kwa matenda amisala

Chifukwa chachikulu komanso chokhacho cha kukula kwa matenda ashuga retinopathy ndikuwonjezereka kwa shuga m'magazi. Mkhalidwe uwu umawonedwa mu shuga mellitus, pamene thupi silipanga insulin yokwanira.

Mitsempha yonse imakhudzidwa (angiopathy), ndipo motsutsana ndi izi, zovuta za retinopathy (zotupa zam'mimba) zimayamba mu matenda a shuga. Kuphatikiza pa matenda ashuga, palinso zinthu zina zomwe zimayambitsa chitukuko cha matenda ashuga retinopathy.

Zifukwa zoyipa zopangira matenda ashuga:

1. Matenda a metabolism, kunenepa kwambiri.
2. Matenda a impso.
3. Matenda oopsa.
4. Kusokonezeka kwa mahormone, kukonzanso panthawi yomwe muli ndi pakati, kutha kapena matenda a endocrine.
5. Matenda amtundu kapena kupezeka kwa matendawa m'mabanja apafupi.
6. Zizolowezi zoipa.
7. Chiwopsezo cha matenda chikuwonjezereka ndi zaka za wodwalayo.

Kukula kwakukulu kwa matenda ashuga retinopathy kumalumikizidwa ndi kusowa kwa zizindikiro asanasinthe kusintha. Chifukwa chake, onse odwala matenda ashuga ayenera kuyesedwa ndi ophthalmologist osachepera katatu pachaka. Kafukufuku wopindulitsa azithandizira adotolo kuti athe kuwona bwino momwe ziwiya zotsatsira zilili.

Matenda a shuga a retinopathy - Zizindikiro zazikuluzikulu ndi zomwe zimayambitsa matenda ashuga:

1. Ntchentche, nsonga, nyenyezi patsogolo pa maso, kunachepetsa, kutulutsa kowoneka.
2. Masomphenya akuthwa kwakanthawi, kuyandama kukuwoneka. Mtsogolomo, odwala amagwirizanitsa chizindikiro ichi ndi nthawi yakuchulukanso kwa shuga.
3. Malo opanda kanthu, kuphwanya kuwonekera kwa madera ena a malo owonera.
4. Maonekedwe a malo akuda m'munda wowonekera.
5. Hemophthalmus, chotumphukira chotengera chokhala ndi magazi otayika, chikuwoneka ndi kuchepa kowoneka bwino, komanso mtundu wofiyira wa gawo lamaso.

Zakudya zamankhwala

Zakudya ndi zakudya zoyenera ndi theka la kupambana kwa matenda ashuga kapena zovuta zake. Cholinga chachikulu cha zakudya zamankhwala ndikuwonetsetsa kuti pakukhazikika, kukhala ofanana pakudya zamagalimoto komanso kutsatira zochitika zolimbitsa thupi. Pa matenda ashuga retinopathy, zakudya ziyenera kukhala zokwanira.

Sitipangira izi kugwiritsa ntchito zakudya za anthu ena ndikudziyambitsa nokha. Zakudya zoyenera ziyenera kutumizidwa ndi dokotala potengera zaka zanu, jenda, kulemera, mtundu wa zochitika zolimbitsa thupi komanso mtundu wa matenda ashuga.

Zinthu zomwe ndi zotsutsana kwambiri:

• mwachangu, chakudya chamafuta (shuga, confectionery, uchi, zipatso, timadziti),
• mowa
• zakudya zamafuta ambiri (mayonesi, batala, mafuta anyama, zonona),
• kusuta
• yokazinga
• zamchere
• zokometsera.

Mankhwala

Mankhwalawa retinopathy ya matenda ashuga, chifukwa cha kutuluka kwakanthawi kwa malo a retina, madontho m'maso samathandiza. Chomwe chimagwiritsidwa ntchito nthawi zambiri ndi mtundu wa mankhwala apiritsi, jakisoni womwe umabayidwa pafupi ndi diso kapena mu eyebusy yokhayokha, jekeseni wamitsempha, jakisoni wamkamwa kapena ma dontho.

Mankhwala omwe amagwiritsidwa ntchito pochiza matenda a shuga:

1. Angioprotectors - mankhwala omwe amasintha machitidwe am'madzi am'mimba (Pentoxifylline, Doxyum, Anginin, Parmidin).
2. Ma Anticoagulants - amachepetsa mapangidwe wamagazi (Etamzilat, Ditsinon, Fraksiparin, Heparin, Flexal).
3. Mankhwala a nootropic kuti atukule mkhalidwe wama cell a mitsempha (Cerebrolysin, Piracetam, Trental).
4. Mankhwala othandizira kutupa (Ibuprofen, Dexamethasone, Prednisolone).
5. VEGF factor blocker ndi imodzi mwama mankhwala apamwamba a matenda ashuga retinopathy, omwe amapitilira kuchuluka kwa ziwiya zotsika. Mankhwalawa amathandizira kuthetsa mapangidwe amitsempha yatsopano yamagazi ndi kuzimiririka kwa omwe amapangidwa kale. Drawback yokhayo ndi mtengo wake wokwera. Sikuti odwala onse ali ndi mwayi wogula, koma amayenera kuperekedwa nthawi ndi nthawi, koma mosalekeza. Pegaptanib kapena Makugen (mtengo wake ndi ma ruble 50,000), Ranibizumab kapena Lutsentis (mtengo wake ndi ma ruble 47,000).
6. Mavitamini a gulu B, C, E, R.
7. Mankhwala omwe amapanga metabolism mu retina: "Phosphaden", "Emoksipin", "Taufon".
8. Ngati ndi kotheka, mankhwala othandizira.

Onerani kanema wokhudza kuchiza matenda ashuga retinopathy osachitidwa opaleshoni:

Anthu, njira zapanyumba

Tikukuchenjezani kuti chithandizo chamankhwala azikhalidwe za anthu odwala matenda ashuga chikuyenera kuvomerezedwa ndi a ophthalmologist osati kuwononga chithandizo chachikulu cha mankhwala. Kudzichiritsa nokha kumangokulitsa kapena kukulitsa matenda.

Wamba nettle amadziwika mu wowerengeka mankhwala. Imadyedwa yaiwisi, ndi ma saladi, opangidwira msuzi kapena ma decoctions, amaumirira ndi chindapusa. Kachiwiri, tiyi wa linden, bwino amachepetsa shuga la magazi.

Pamankhwala mutha kugula amalonda kapena matenda a shuga, mankhwalawa azitsamba, popanda kuwonjezera pazinthu zopangidwa. Zothandiza tincture wa calendula, blueberries, madzi a lingonberry, masamba a aloe, persimmons, cranberries.

Mankhwala othandizira

Njira zopangira opaleshoni zimaphatikizira kukoka kwa laser kwa retina. Mtundu wa opaleshoni umatengera dera la retina, lomwe limayamwa ndi mtundu wa ntchito yomwe ikuchitika, yomwe imachitika:

• wakhama
• panretinal
• mwa mtundu wake.

Ndi mtundu wanji wa coagulation komanso malo oti achite, amawasankha ndi dokotala wa opaleshoni ya retinal yemwe angachite opareshoni.

Chinsinsi cha opareshoni ndikuwonetsedwa kwa laser kumadera ena a retina kuti apange bala lakusokonezeka ndi kusiya magazi, komanso kuchepetsa edema. Laser coagulation imagwiritsidwanso ntchito popewa kufinya kwa retinal.

Opaleshoni imagwiritsidwa ntchito kumapeto kwa matendawa, nthawi zambiri siamokhayo, chifukwa kuchuluka kwa ziwiya zowonongeka kumakulirakulira nthawi zonse.

Chovuta cha opaleshoni iyi ndi kuyipa kwa kuwonongeka kwa maselo owonekera m'malo omwe ali ndi laser, amangotentha, ndikupanga mawanga akhungu pa retina. Chifukwa chake opaleshoniyo siyopanikizika, ndipo ndi chanzeru kuti sibweretse vutoli.

Onani kanemayo pamankhwala a laser a matendawa:

Kupewa matenda

Kwa anthu athanzi, kupewa kuyenera kuyamba ndi kuyezetsa magazi, mwa apo ndi apo. Ngati mulingo upitilira 3,3,5,5 mmol / l, ndiye kuti zonse zili mu dongosolo. Mulingo wanu wothira shuga ukakhala wabwinobwino, muyenera kufunsira kwa endocrinologist kuti mupeze upangiri, mwina awa ndi chizindikiro choyamba cha matenda ashuga.

Retinopathy koyambirira amapezeka ndi matenda a shuga, ndizosavuta kuthana nawo. Ngati muli ndi matenda ashuga, musanyalanyaze mayeso oletsa kupewa matenda a ophthalmologist. Muyenera kumvetsetsa bwino kuti posachedwa vutoli lidzakupezani, ndipo kudziwona kwakanthawi ndi chithandizo kumatha kukupulumutsani.

Sungani zolemba zanu m'mabuku osungira ndikugawana nawo pama webusayiti. Lembani njira zanu zamankhwala mu ndemanga ndikukhala athanzi.

Pathogenesis ndi zomwe zimayambitsa

Pathogenesis ya matenda ashuga retinopathy ndi ovuta. Zina mwazomwe zimayambitsa ndikuwonongeka kwa mitsempha ya magazi ya retina: kupezeka kwawo mopitirira muyeso, kufalikira kwa ma capillaries, mawonekedwe a minofu yowonjezera (khungu) ndi ziwiya zatsopano. Kusintha koteroko kumachitika chifukwa cha majini a kapangidwe ka retina.

Osati gawo lofunika kwambiri pakukula kwa matendawa limaseweredwa ndi kusintha kwa metabolic komwe kumachitika ndi shuga m'magazi. Pamaso pa matenda a shuga mpaka zaka 2, odwala matenda ashuga retinopathy amapezeka 15% ya odwala, mpaka zaka 5 - mu 28%, mpaka zaka 10-15 - mu 44-50%, kuyambira 20 mpaka 30 - mu 90-100%.

Zowopsa zomwe zimakhudza kuthamanga ndi pafupipafupi kwa kupitirira kwa matenda ndikuphatikizira:

• mulingo wa hyperglycemia,
• kutalika kwa matenda ashuga
• aakulu aimpso kulephera
• ochepa matenda oopsa
• kunenepa kwambiri (kunenepa kwambiri),
• kagayidwe kachakudya matenda
• dyslipidemia.

Komanso kukula ndi kupitilira kwa matenda ashuga retinopathy amathandizira kutenga pakati, kutha msinkhu, zizolowezi zoyipa.

Chithunzi cha kuchipatala

Matenda a shuga a retinopathy amakula ndipo amapita patsogolo popanda kukhala ndi zikhalidwe. Kuchepa kwa masomphenya m'malo osatukuka sikuwonekeratu. Kuphatikizika kwa zinthu zowoneka kumatha kupangitsa kuti macular edema. Mavuto akuwerenga pafupi kwambiri amadziwikanso. Kuphatikiza apo, kukula kwa masomphenya kumadalira kuchuluka kwa shuga m'magazi.

Pakukula kwa matendawa, chophimba ndi chovunda choyandama chikuwonekera pamaso (chifukwa cha kukoka kwamitsempha yamagazi). Pakapita kanthawi, amadzionekera okha. Ndi kuvulala kwakukulu, kuwonongeka kowopsa kapena kuwonongeka kwathunthu kumachitika mu thupi lamphamvu.

Mankhwala othandizira

Mu magawo oyamba a matendawa, njira yayikulu yochizira ndiyothandiza. Wodwalayo akuwonetsedwa kugwiritsa ntchito kwakanthawi mankhwala omwe amachepetsa kuwonongeka kwa capillaries - angioprotectors (Doxyum, Parmidin, Dicinon, Predian). Zimafunikanso kukhala ndi shuga wokwanira m'magazi.

Pochiza komanso kupewa mitsempha yam'mimba, Sulodexide, ascorbic acid, vitamini P ndi E. Amayikidwa Antioxidants (mwachitsanzo, Strix). Kukonzekera uku kumakhala ndi beta-carotene ndi mabulosi abulu. Zinthu zofunikira izi zimathandizira kuwona, kulimbitsa ma network, kuteteza motsutsana ndi zotsatira zoyipa zamagetsi.

A malo apadera pa matenda a shuga a retinopathy ndi matenda a kagayidwe kazinthu. Izi zimachitika pomwa mankhwala ochepetsa shuga. Conservative mankhwala imaphatikizanso matenda a wodwalayo.

Anthu omwe akudwala matendawa amayenera kukayezetsa kuchipatala. Kutengera kuzunzika kwa maphunziro a shuga, nthawi za kulumala zimatsimikizika. Wodwalayo amakhala ataphatikizidwa pantchito yokhudzana ndi katundu wambiri, kugwedezeka, kuwongola mutu ndi thupi, kukweza zolemetsa. Ndikoletsedwa kugwira ntchito zoyendera ndi m'masitolo otentha.

Mavuto omwe angakhalepo

Zotsatira zoyipa za matenda ashuga retinopathy:

• mphira
• sekondale yachiwiri yamkati,
• kuchepa kwakukulu kwa masomphenya
• hemophthalmus,
• retinal traction
• khungu lathunthu.

Izi zimafunikira kuwunikidwa kosalekeza ndi katswiri wa zamankhwala, neuropathologist, ophthalmologist ndi endocrinologist. Mavuto ena amathetsedwa ndikupanga opaleshoni.

Chithandizo chothandiza kwambiri cha matenda ashuga retinopathy ndikuchepetsa kuchuluka kwa shuga wamagazi ndikukhalabe ndi chikhalidwe chawo. Idyani kumanja ndikumapita kwa ophthalmologist wanu pafupipafupi. Kamodzi pa sabata, madzulo, kuyeza kukakamiza kwa intraocular. Ndi kuzindikira kwakanthawi komanso njira zovuta zochizira, pamakhala mwayi uliwonse wokhala ndi mawonekedwe.

Zambiri

Diabetesic retinopathy ndi vuto lakumapeto kwenikweni kwa matenda ashuga, onse omwe amadalira insulin komanso osadalira insulini. Mu ophthalmology, matenda ashuga retinopathy amachititsa kuwonongeka kwa odwala omwe ali ndi matenda ashuga a 80-90% milandu. Mwa anthu omwe ali ndi matenda ashuga, khungu limakula ka 25 kawiri kuposa oyimira ambiri. Pamodzi ndi matenda ashuga a retinopathy, anthu omwe ali ndi matenda ashuga ali ndi chiopsezo chachikulu cha matenda a mtima, matenda ashuga nephropathy ndi polyneuropathy, matenda amtundu wamatumbo, glaucoma, kuchepa kwa matenda a Cac ndi CVC, phazi la matenda ashuga komanso matenda opatsirana. Chifukwa chake, mankhwalawa a shuga amafunika njira zingapo, kuphatikizapo kutenga nawo mbali kuchokera kwa akatswiri kuchokera ku endocrinologists (a diabetes), ophthalmologists, cardiologists, podologists.

Zoyambitsa ndi Zoopsa

Kupanga kwa chitukuko cha matenda ashuga retinopathy kumalumikizidwa ndi kuwonongeka kwa mitsempha yamitsempha yamagazi (ma cell a retina): kuchuluka kwawo kwachulukidwe, kuchuluka kwa capillaries, mawonekedwe a ziwiya zatsopano komanso kukula kwa minofu yowonjezereka.

Odwala ambiri omwe ali ndi nthawi yayitali matenda a shuga amakhala ndi zizindikiro kapena zina zowonongeka ku fundus. Ndi nthawi yayitali ya matenda a shuga mpaka zaka 2, matenda a shuga a retinopathy amapezeka pamlingo wina kapena mu 15% ya odwala, mpaka zaka 5 mu 28% ya odwala, mpaka zaka 10-15 mu 44-50%, pafupifupi zaka 20-30 mu 90-100%.

Zowopsa zomwe zimakhudza pafupipafupi komanso kukula kwa matenda ashuga retinopathy zimaphatikizapo kutalika kwa matenda ashuga, hyperglycemia, matenda oopsa, kulephera kwa impso, dyslipidemia, metabolic syndrome, ndi kunenepa kwambiri. Kukula ndi kupitilira kwa retinopathy kumatha kuthandizira kutha msinkhu, kutenga pakati, chibadwa chamtsogolo, komanso kusuta.

Zizindikiro za matenda a shuga a retinopathy

Matendawa amakula ndipo amapita patsogolo osapweteka komanso asymptomatic - uku ndiko kunyenga kwake kwakukulu. Mchigawo chosakulira, kuchepa kwa masomphenya sikumvedwa kwenikweni. Macular edema imatha kuyambitsa kusakanikirana kwa zinthu zooneka, kuvuta kuwerenga kapena kugwira ntchito pafupi.

Mokulira kwa gawo la matenda ashuga retinopathy, pakachitika zotupa m'mitsempha, malo akuda ndi chophimba zimawonekera patsogolo pa maso, omwe patapita kanthawi amawonekera okha. Ndi zotupa zazikulu mu thupi la vitreous, kuchepa kwambiri kapena kuwonongeka kwathunthu kwa masomphenya kumachitika.

Zotsogola ndi kupewa

Zovuta zingapo za matenda ashuga retinopathy amatha kukhala glaucoma yachiwiri, matenda amkati, kuchepa kwa khungu, hemophthalmus, kuchepa kwakukulu kwa masomphenya, khungu lathunthu. Zonsezi zimafunikira kuyang'anira odwala omwe ali ndi matenda ashuga ndi endocrinologist ndi ophthalmologist.

Ntchito yofunikira kwambiri yoletsa kupitirira kwa matenda ashuga retinopathy imaseweredwa ndikuwongolera moyenera shuga ndi kuthamanga kwa magazi, kudya kwa hypoglycemic komanso mankhwala a antihypertensive. Kuchita kwakanthawi kwa njira zopangira laser zimathandizira kuyimitsidwa ndi kusinthidwa kwa kusintha kwa ndalama.

Kukula ndi magawo a matendawa

Ndi kuwonjezeka kwa shuga wamagazi, pali makulidwe amitseko ya mitsempha yamagazi. Zotsatira zake, kupsinjika mwa iwo kumakwera, zotengera zimawonongeka, kukulitsidwa (ma micaneurysms), ndi mawonekedwe ang'ono a hemorrhages.

Kukula kwa magazi kumachitikanso. Fomu ya Microthrombi, kutsekereza lumen ya ziwiya. Pali mpweya wa m'mimba wa retina (hypoxia).

Popewa hypoxia, zikopa ndi mitsempha yamagazi zimapangidwa, kudutsa malo omwe akhudzidwa. Zomangira zimamanga mitsempha ndi mitsempha, koma kusokoneza kayendedwe ka magazi m'magulu ang'onoang'ono ndipo potero kumawonjezera hypoxia.

Mtsogolo, zombo zatsopano zimamera mu retina, m'malo mwa zowonongeka. Koma ndi owonda kwambiri komanso osalimba, chifukwa chake amawonongeka mwachangu, zotupa zimachitika. Zombo zomwezo zimatha kumera mu kuwala kwa mitsempha yotulutsa maso, thupi lotulutsa thupi, kuyambitsa glaucoma, kusokoneza kutuluka kwamadzi kuchokera kumaso.

Kusintha konseku kumatha kuyambitsa zovuta zobweretsa khungu.

Magawo atatu a matenda a shuga a retinopathy (DR) ali ndi matenda osiyanasiyana:

1. Nonproliferative retinopathy (DR I).
2. Preproliferative retinopathy (DR II).
3. Proliferative retinopathy (DR III).

Gawo la retinopathy limakhazikitsidwa ndi ophthalmologist mukamayang'ana ndalama kudzera mwa wophunzirayo, kapena pogwiritsa ntchito njira zapadera zofufuzira.

Ndi retinopathy wosapindika ma micaneurysms amapangidwa, zotupa zazing'onoting'ono m'mitsempha yam'mimba, zimayang'ana kutuluka (thukuta la gawo lamwazi), zimasiyana pakati pamitsempha ndi mitsempha. Ngakhale edema ndiyotheka.

Mu gawo lachiwonetsero kuchuluka kwa zotupa, ma exudates amawonjezeka, amakula kwambiri. Mitsempha ya retinal ikukula. Optic edema imatha kuchitika.

Pa gawo lochulukirachulukira pali kuchuluka (kuchuluka) kwamitsempha yamagazi mu retina, mitsempha yam'maso, kuchuluka kwa zotupa m'mimba ya retina ndi vitreous. Mitundu yocheperako yamkaka, imakulitsa njala ya okosijeni ndikupangitsa kuti minye izitulutsidwa.

Ndani amakula pafupipafupi?

Pali zinthu zina zomwe zimawonjezera mwayi wokhala ndi matenda ashuga a retinopathy. Izi zikuphatikiza:

• Kutalika kwa matenda ashuga (zaka 15 pambuyo pa kuyambika kwa matenda ashuga theka la odwala omwe salandila insulin, ndipo 80-90% ya omwe adalandira kale ali ndi retinopathy).
• Mitsempha yayikulu yamagazi ndipo pafupipafupi imadumphadumpha kuchokera pamwamba kwambiri mpaka pamiyeso yotsika kwambiri.
• Matenda oopsa.
• Kukweza mafuta m'thupi.
• Mimba
• Matenda ashuga nephropathy (kuwonongeka kwa impso).

Ndi ziti zomwe zikuwonetsa kukula kwa matendawa?

M'magawo oyamba, matenda ashuga retinopathy samadziwonetsa mwanjira iliyonse. Wodwala alibe nkhawa. Ichi ndichifukwa chake ndikofunikira kwambiri kwa odwala omwe ali ndi matenda ashuga, mosasamala madandaulo, kukaonana ndi ophthalmologist nthawi zonse.

Mtsogolomo, kumverera kowoneka bwino, kowoneka bwino, ntchentche zosinthika kapena mphezi patsogolo pa maso, ndi pamaso pa zotupa, kumayang'ana malo amdima. M'magawo apambuyo, kuwona kwakumaso kumachepa, mpaka kutsimikiza kwathunthu.

Zovuta zake ndi ziti?

Pakakhala chithandizo choyenera cha matenda a shuga komanso matenda ashuga retinopathy, zovuta zawo zimayamba, zomwe zimapangitsa khungu.

• Kutengeka kwapang'onopang'ono. Zimachitika chifukwa cha zipsera m'thupi lamatumbo lomwe limamangidwa ndi retina ndikulikoka pamene diso likuyenda. Zotsatira zake, misozi imapangidwa ndikuwonongeka kwamawonedwe kumachitika.
• Rubeosis wa Iris - kumera kwa mitsempha yamagazi mu iris. Nthawi zambiri zoterezi zimapindika, zimayambitsa zotupa m'chipinda cham'maso cha munthu.

Chithandizo cha matenda ashuga retinopathy, komanso zovuta zina za shuga, ziyenera kuyamba ndi matenda a glycemia, kuthamanga kwa magazi ndi mafuta m'thupi. Ndi kuchuluka kwambiri kwa shuga m'magazi, akuyenera kuchepetsedwa pang'onopang'ono kupewa ischemia ya retinal.

Chithandizo chachikulu cha matenda a shuga a retinopathy ndi laser. Izi zimapangitsa kuti retina ikhale ndi mtanda wa laser, chifukwa chomwe chimakhala ngati chogulitsidwa kumaso amaso. Kuphatikiza kwa laser kumakupatsani mwayi kuti "mutatseketsa" zombo zomwe zangopangidwa kumene kuti zizigwira ntchito, kupewa edema ndi kuchotsetsanso kwina, ndikuchepetsa ischemia yake. Imachitidwa ndi proliferative ndipo nthawi zina prrolifative retinopathy.

Ngati sizingatheke kuchita laser coagulation, vitlimomy imagwiritsidwa ntchito - kuchotsa thupi la vitreous limodzi ndi magazi ndi zipsera zamagazi.

Poletsa kupanikizika kwamitsempha, mankhwala omwe amatchinga njirayi, mwachitsanzo, ranibizumab, amagwira ntchito. Amalowetsedwa mu thupi lamphamvu kangapo pachaka pafupifupi zaka ziwiri. Kafukufuku wasayansi awonetsa kuchuluka kwakukulu kwa kusintha kwamawonedwe pakugwiritsa ntchito gulu ili la mankhwalawa.

Komanso, pochiza matenda a shuga a retinopathy, mankhwalawa amagwiritsidwa ntchito omwe amachepetsa hypoxia, magazi ochepa m'magazi (makamaka mafupa), mankhwala a mahomoni otsogolera thupi la vitreous.

Kuzindikira kwa odwala

Kutalika kwa moyo ndi kusungidwa kwa mawonekedwe owonekera kumadalira kuchuluka kwa kuwonongeka kwa maso, zaka komanso nthawi yayitali ya matenda ashuga. Ndikovuta kwambiri kuzindikira kuti palibe, chifukwa Zizindikiro za wodwala ziyenera kukumbukiridwa.

Kuphatikiza apo, ndi diabetesic retinopathy, kuwonongeka kwa ziwalo zina ndi machitidwe kumayesedwa pogwiritsa ntchito njira zosiyanasiyana zapadziko lonse lapansi. Pafupifupi, kukula kwa retinopathy kumachitika zaka 10 mpaka 15 pambuyo pa kutsimikiza kwa matenda a shuga, ndipo zotsatira zosasinthika zimapezekanso panthawiyi.

Nthawi zambiri, zovuta za matendawa zimatchedwa kupezeka kwa matenda ophatikizika ndi matenda. Matenda a shuga amakhudza ziwalo zonse zamkati ndi kachitidwe ka thupi, koma ntchito yowoneka imakhala yoyambirira.

Matenda a shuga a retinopathy ndi omwe amachititsa kuti anthu azikhala ndi matenda ashuga kwambiri. Mothandizidwa ndi kusintha kwa kayendetsedwe ka kagayidwe kazinthu, ntchito ya zotengera zomwe zimagwiritsa ntchito zida za ocular zimalephera, zomwe zimayambitsa zotupa za m'magazi ndi njira ya maso.

Matendawa samadziwonekeranso kumayambiriro, kotero odwala ambiri amapita kwa dokotala kale ndi njira zosasintha. Kuti izi zisachitike, muyenera kupita kukaonana ndi maso kuti mumayang'ane maso anu ndi ma retina.