{"id":19261,"date":"2015-01-12T10:46:00","date_gmt":"2015-01-12T09:46:00","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=19261"},"modified":"2015-01-12T10:46:00","modified_gmt":"2015-01-12T09:46:00","slug":"pri-cukrovce-jsou-dulezite-prohlidky-oci-hrozi-slepota","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=19261","title":{"rendered":"P\u0159i cukrovce jsou d\u016fle\u017eit\u00e9 prohl\u00eddky o\u010d\u00ed, hroz\u00ed slepota"},"content":{"rendered":"

Cukrovka se vyskytuje jak v dosp\u011bl\u00e9m tak i v d\u011btsk\u00e9m v\u011bku. To, \u017ee s sebou p\u0159in\u00e1\u0161\u00ed spoustu omezen\u00ed v \u017eivot\u011b pacienta a \u017ee sou\u017eit\u00ed s n\u00ed je velmi slo\u017eit\u00e9, v\u00edme. Toto onemocn\u011bn\u00ed m\u00e1 v\u0161ak i sv\u00e9 dal\u0161\u00ed komplikace, kter\u00e9 dok\u00e1\u017e\u00ed velmi potr\u00e1pit.<\/strong><\/p>\n

Na ot\u00e1zky ohledn\u011b diabetick\u00e9 retinopatie odpov\u00edd\u00e1 MUDr. Ad\u00e9la Vesel\u00e1 z o\u010dn\u00edho odd\u011blen\u00ed Oblastn\u00ed nemocnice P\u0159\u00edbram .<\/p>\n

– Co je to cukrovka (diabetes mellitus) a jak\u00e9 jsou jej\u00ed nej\u010dast\u011bj\u0161\u00ed komplikace?<\/p>\n

Je to civiliza\u010dn\u00ed onemocn\u011bn\u00ed, kter\u00fdm trp\u00ed v sou\u010dasn\u00e9 dob\u011b zhruba 10 procent \u010desk\u00e9 populace. Je to onemocn\u011bn\u00ed, p\u0159i kter\u00e9m na\u0161e t\u011blo neum\u00ed hospoda\u0159it s gluk\u00f3zou (cukrem) v organismu a bez l\u00e9\u010dby doch\u00e1z\u00ed k p\u0159\u00edli\u0161 vysok\u00e9 hladin\u011b cukru v krvi. Tato hyperglykemie organismus d\u00e1le po\u0161kozuje. Hlavn\u00ed p\u0159\u00ed\u010dinou je \u00fapln\u00e9 chyb\u011bn\u00ed hormonu inzulinu nebo jeho defektn\u00ed \u00fa\u010dinek. Nejv\u00edce p\u0159i tomto onemocn\u011bn\u00ed trp\u00ed c\u00e9vy, doch\u00e1z\u00ed k po\u0161kozen\u00ed ledvin, o\u010d\u00ed, perifern\u00edch nerv\u016f, syndromu diabetick\u00e9 nohy, ke zhor\u0161en\u00e9mu hojen\u00ed ran a dal\u0161\u00edm komplikac\u00edm.<\/p>\n

– Budeme\u00acli hovo\u0159it p\u0159\u00edmo o onemocn\u011bn\u00ed zraku, \u010dili diabetick\u00e9 retinopatii, vysv\u011btlete podrobn\u011bji a jakou komplikaci se jedn\u00e1?<\/p>\n

Diabetick\u00e1 retinopatie je po\u0161kozen\u00ed s\u00edtnice cukrovkou. Vedle v\u011bkem podm\u00edn\u011bn\u00e9 makul\u00e1rn\u00ed degenerace p\u0159edstavuje nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinu slepoty ve vysp\u011bl\u00fdch zem\u00edch. V\u00fdskyt diabetick\u00e9 retinopatie p\u0159ich\u00e1z\u00ed v pr\u016fm\u011bru po des\u00edti letech trv\u00e1n\u00ed nemoci, to je ale zna\u010dn\u011b individu\u00e1ln\u00ed, z\u00e1vis\u00ed to p\u0159edev\u0161\u00edm na dlouhodob\u00e9 kompenzaci diabetu. Rozli\u0161ujeme diabetickou retinopatii neproliferativn\u00ed a proliferativn\u00ed. U t\u00e9 proliferativn\u00ed vlivem nedostate\u010dn\u00e9ho prokrven\u00ed s\u00edtnice doch\u00e1z\u00ed k tvorb\u011b novotvo\u0159en\u00fdch c\u00e9v, kter\u00e9 mohou v\u00e9st k dal\u0161\u00edm komplikac\u00edm. D\u00e1le mluv\u00edme o cystoidn\u00edm makul\u00e1rn\u00edm ed\u00e9mu, co\u017e je otok v m\u00edst\u011b \u017elut\u00e9 skvrny (m\u00edsto nejost\u0159ej\u0161\u00edho vid\u011bn\u00ed), kter\u00fd je zp\u016fsoben defektn\u00edmi c\u00e9vami a prokrven\u00edm t\u00e9to oblasti a zp\u016fsobuje zhor\u0161en\u00e9 vid\u011bn\u00ed.<\/p>\n

– Jak\u00e9 jsou p\u0159\u00edznaky a dok\u00e1\u017ee toto onemocn\u011bn\u00ed odhalit s\u00e1m pacient nebo je to v\u00fdhradn\u011b v rukou l\u00e9ka\u0159e?<\/p>\n

M\u016f\u017ee se projevovat zhor\u0161en\u00fdm vid\u011bn\u00edm, \u010dasto ale b\u00fdv\u00e1 diabetick\u00e1 retinopatie bez p\u0159\u00edznak\u016f pro pacienta, a to i velmi dlouhou dobu. Proto jsou nezbytn\u00e9 pravideln\u00e9 kontroly o\u010dn\u00edho pozad\u00ed v \u0161irok\u00fdch zornic\u00edch u o\u010dn\u00edho l\u00e9ka\u0159e. D\u00e1le dle n\u00e1lezu prov\u00e1d\u00edme dal\u0161\u00ed specializovan\u00e1 vy\u0161et\u0159en\u00ed, jako je OCT (optick\u00e1 koheren\u010dn\u00ed tomografie) nebo fluorescen\u010dn\u00ed angiografie.<\/p>\n

– Pokud l\u00e9ka\u0159 zjist\u00ed v\u00fdskyt t\u00e9to nemoci, jak bude prob\u00edhat l\u00e9\u010dba?<\/p>\n

Z\u00e1kladem l\u00e9\u010dby je snaha o co nejlep\u0161\u00ed kompenzaci diabetu p\u0159i \u00fazk\u00e9 spolupr\u00e1ci s diabetologem. Zlat\u00fdm standardem l\u00e9\u010dby je laserov\u00e1 fotokoagulace s\u00edtnice, kter\u00e1 tenk\u00fdm paprskem laseru o\u0161et\u0159\u00ed posti\u017een\u00e1 m\u00edsta. Tento z\u00e1krok se prov\u00e1d\u00ed ambulantn\u011b, n\u011bkdy ve v\u00edce sezen\u00edch. V sou\u010dasn\u00e9 dob\u011b existuje l\u00e9\u010dba protil\u00e1tkou proti r\u016fstov\u00e9mu faktoru, kter\u00e1 zabra\u0148uje vzniku ne\u017e\u00e1douc\u00edch novotvo\u0159en\u00fdch c\u00e9v (u proliferativn\u00ed diabetick\u00e9 retinopatie, neovaskul\u00e1rn\u00edho glaukomu) a zm\u00edr\u0148uje otok s\u00edtnice (u cystoidn\u00edho makul\u00e1rn\u00edho ed\u00e9mu). Ta se pod\u00e1v\u00e1 ve form\u011b injekce do sklivce po m\u00edstn\u00edm znecitliv\u011bn\u00ed. P\u0159i velmi v\u00e1\u017en\u00e9m po\u0161kozen\u00ed se p\u0159istupuje k operaci \u2013 vitrektomii (odstran\u011bn\u00ed sklivce).<\/p>\n

– Lze tomuto onemocn\u011bn\u00ed p\u0159edch\u00e1zet?<\/p>\n

Nezbytn\u00e9 jsou pravideln\u00e9 preventivn\u00ed prohl\u00eddky o\u010dn\u00edho pozad\u00ed oftalmologem, a to alespo\u0148 jedenkr\u00e1t ro\u010dn\u011b. D\u00e1le je velmi d\u016fle\u017eit\u00e1 dobr\u00e1 kompenzace diabetu, celkov\u00e1 \u00faprava \u017eivotospr\u00e1vy, v\u010detn\u011b vhodn\u00e9 pohybov\u00e9 aktivity. Mezi nep\u0159\u00edzniv\u00e9 faktory \u0159ad\u00edme p\u0159edev\u0161\u00edm vysok\u00fd krevn\u00ed tlak, obezitu, poru\u0161enou hladinu tuk\u016f a cholesterolu v krvi a kou\u0159en\u00ed.<\/p>\n

– Jak\u00e1 rizika hroz\u00ed v p\u0159\u00edpad\u011b nel\u00e9\u010den\u00e9 retinopatie?<\/p>\n

Mezi komplikace pat\u0159\u00ed hemoftalmus (krv\u00e1cen\u00ed do vnit\u0159ku oka), trak\u010dn\u00ed odchl\u00edpen\u00ed s\u00edtnice, zvl\u00e1\u0161tn\u00ed forma bolestiv\u00e9ho zelen\u00e9ho z\u00e1kalu a\u017e \u00fapln\u00e1 slepota.<\/p>\n

– D\u00e1 se tedy v\u0161eobecn\u011b \u0159\u00edci, \u017ee pacient \u2013 diabetik by nem\u011bl podce\u0148ovat preventivn\u00ed prohl\u00eddky na o\u010dn\u00edm?<\/p>\n

Jednozna\u010dn\u011b ano.<\/p>\n

P\u0159\u00edbramsk\u00fd den\u00edk<\/p>\n","protected":false},"excerpt":{"rendered":"

Cukrovka se vyskytuje jak v dosp\u011bl\u00e9m tak i v d\u011btsk\u00e9m v\u011bku. To, \u017ee s sebou p\u0159in\u00e1\u0161\u00ed spoustu omezen\u00ed v \u017eivot\u011b pacienta a \u017ee sou\u017eit\u00ed s […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14173,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-19261","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/19261","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=19261"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/19261\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14173"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=19261"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=19261"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=19261"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}