Epithelial pasi-kati membrane dystrophy (EBMD), inozivikanwawo sechirwere chemukati chemuviri chinyorwa kana mapepa-dot-fingerprint dystrophy, inowanzoitika iyo inobata chikamu chekunze cheziso. Izvi zvinowanzokonzera vanhu vanopfuura makore makumi matatu. EBMD dzimwe nguva inonyarara, ichisiya avo vanobatwa vasingazivi nezvehupenyu hwavo. Vamwe vanhu vane chirwere vane hutsinye hunokanganisa hupenyu huri hupenyu hushoma apo vamwe vanogona kunge vane zvirwere zvisingaperi zvinoratidzika sezvinoita zuva rose.
Kunzwisisa EBMD
EBMD inorwara yeasalal epithelial cells iri muchemberi kwekornea. Aya masero e-basal anonamatira kune wechipiri membrane layer, zvakare anonzi Bowman's layer. Mune EBMD, masero e-basal anoita zviratidzo zvisina kufanana neminwe zvinonamatira kubva pane zvakasvibiswa pasi memakumbo. Izvo zvinoratidzika zvinokonzera kuti epithelial seli dzisunungurwe uye dzisinganamati pamwe nechemberi. Pamwe pamwe nekumwe kuchinja kunowanikwa pakati pemasero epithelial, kuchinja uku kunopa maitiro emarita, mavara, neminwe yeminwe mukati mekonoa. Izvi zvinoshanduka kuchinja zvinogona kuonekwa nekushandiswa kwechigadziko chemwenje .
Zviratidzo zveEBMD
Vanhu vane EBMD vanogona kunyunyuta pamusoro pezviratidzo zvinotevera:
- Kuchengetedza kwemaonero
- Chiratidzo chakasvibiswa
- Kunetseka kwakanyanya
Vanhu vazhinji vanobatwa neEBMD vane kuchinja kwechiono kunze kwekunetseka. Zvisinei, inenge 10 muzana ine zvikamu zvinorwadza zvekudzoka kwekudengenyeka kwenyika.
Kudzokorora kunokonzera kukanganiswa kunokonzera kusakwana kwepamusoro pekonoa inoitika nguva nenguva. Izvi zvinokanganisa nzvimbo dzisina masero epithelial anowira nyore nyore nekuda kwechirwere. Iwa masero anosununguka nekuda kwezviratidzo-zvingaita sezvinoita, zvichiita kuti varasikirwa nekunamatira kune chikamu chemukati.
Zviratidzo zvinowanzova zvakanyanya pakukwira kana panguva yemangwanani nokuti ziso rinochema usiku uye masero asina kunyatsotevedzwa anoita seanova nyore nyore.
Kuongororwa kweEBMD
EBMD inowanzorasikirwa navanachiremba semapopu emakorome, dot, uye kuoneka kweminwedzi kazhinji kunowedzera nemamiriro ezvinhu inogona kunge yakajeka mumatambudziko akawanda. Zvisinei, patinenge tichinyatsoongorora, izvi zvinoshanduka zvinogona kuonekwa. Vanachiremba vemaziso vachanyatsoteerera zviratidzo zvenyu uye zvakazara nezvehutano zvakaitika izvo zvingavapa zvinyorwa. Chinhu chinokosha cheja tsvina chinogona kuiswa muziso rako kuita senyeredzi yakasvibirira inoshanduka kuoneka yakajeka. Vanachiremba vanogonawo kuita keratometry kana kuti corneal topography iyo inoyera chimiro chegornea. Mafirimu ako emabvudzi achaverengerwawo pasi pe microscope kuti atonge zvimwe zvinhu zvakadai se keratoconjunctivitis sicca nemamwe maziso akaoma akaoma.
Kurapa kweEBMD
Kurapa kweEBMD kune vanhu vasina zviratidzo zvinoratidzika kunosanganisira kushandisa misodzi yepamusoro kazhinji pazuva kuti ikurudzire zvakakwana epithelial cell health. Vanhu vane zviratidzo zvinotaridzika vachaudzwa kuti vawedzere kushandiswa kwemisodzi yemafungiro, uyewo mafuta ekuzora maziso anoshandiswa vasati vavata.
Kana pane nhoroondo yemaziso akaoma, chimiro chechirongwa chinokurudzirwa zvakare. Punctal occlusion inosanganisira kuisa kabhonji kadiki kana kuti silicone plug mumvura inosvimha misodzi yeziso kuitira kuchengeta misodzi yemurwere. Blindfolds kana goggles inogonawo kuva chikamu cherongwa hwekurapa kudzivirira kuswa kubva kuitika usiku.
Mumatambudziko akakomba, vanachiremba vanorayira maziso e hypertonic kana mafuta masikati masikati uye usiku iyo inogadziriswa munyu inokonzera maridhi kunze kwekromaa, ichiita kuti ive yakakwana. Izvi zvinobatsira masero epithelial anoramba akawedzerwa zvakasimba kutevedzwa ku cornea. Pane dzimwe nguva, vanachiremba vachashandisa soft contact lens kuti vafambise konea.
Mumamiriro ezvinhu umo murwere anowedzera kuchinja kwechirwere, varapi vachapa madonhiyoti madonhwe. Cyoroplegic madonhwe anogonawo kushandiswa kuderedza marwadzo nekuvandudza nyaradzo. Cyoroplegic madonhwe anonyaradza kubvumira muziso zenguva pfupi kuora mutezo mukati meziso iro rinogona kubvumirana zvakasimba uye rinokonzera kurwadziwa. Dutu rinoputika, misodzi yakanyungudutswa uye misoro yemaziso isingaiti steroidal anti-inflammatory inogonawo kurongerwa.
Shoko Rinobva
Kana iwe usingapinduri zvakanaka nemishonga, nzira inonzi anterior stromal puncture inogona kukurudzirwa. Anterior stromal puncture inosanganisira chiremba achishandisa nhengo isina kubereka kuti aumbe zviduku, zvakadzama zvepctures zvinodarika membrane yakaderera. Izvi zvinokonzera mavanga maduku kuti aumbe nekukurumidza kuporesa, zvichiita kuti masero anopfuura akawanda asungirire pamabhanhire zviri nani. Imwe nzira yekurapa ndeye PTK. PTK, photorefractive therapeutic keratectomy, inoshandisa laser kushandura kunze kwekonoa kuderedza zviratidzo.
Kunobva:
Primary Care of the Anterior Segment, Second Edition. Copyright 1995, Appleton & Lange.