Method for the diagnosis of early diabetic optic neuropathy

 

(57) Abstract:

The invention relates to medicine, in particular to ophthalmology. The method includes determining, in patients with diabetes alkaline phosphatase activity in the tear fluid and if its activity is less than 110 U/l, diagnose diabetic optic neuropathy. The invention provides improved accuracy of diagnosis.

The invention relates to medicine and can be used for the diagnosis of early stages of diabetic optic neuropathy.

Changes in the optic nerve diabetes is not well known scientific works on this issue are divergent. A significant difference in the results of observations are due to different methodological approaches in research. The problem of diagnostics of diabetic optic neuropathy remains an actual problem.

The known method preclinical diagnosis of disorders of the optic nerve in patients with diabetes using visocontrastometry (Clinical and functional features of the changes of the optic nerve in juvenile diabetic retinopathy // Vestnik of ophthalmology, 2001, No. 3, S. 7-11.). However, this way the Gnostics diabetic optic neuropathy.

The technical result is achieved that determine the activity of alkaline phosphatase tear fluid of patients with diabetes and if its activity is less than 110 U/l, diagnose diabetic optic neuropathy.

It is known that high concentrations in the optic nerve phosphorylated glucose may contribute to the development of optic neuropathy in diabetes mellitus. Enzyme dephosphorylation glucose, which catalyzes the removal of phosphate groups, is alkaline phosphatase. In this regard, the alkaline phosphatase activity in the tear fluid may be a diagnostic criterion of the condition of the optic nerve in patients with diabetes mellitus.

The method is performed by a fence of lacrimal fluid microdonation in the volume of 4-5 ml and research in her kinetic method of alkaline phosphatase activity.

The study of the lacrimal fluid of 40 patients (80 eyes) with a diagnosis of diabetic optic neuropathy was established that the local level of alkaline phosphatase activity in the tear fluid is less than 100 IU/L.

Clinical example 1. The Patient Century.

Insulin-dependent diabetes mellitus 3 is the basis of the obtained results suspected diabetic optic neuropathy.

The fundus of the eye: OU - easy masanotti borders of the optic disc, decolorize, veins slightly expanded.

Vis OU=1,0. In the field of view of a single absolute and relative scotomas, the threshold electric sensitivity of 68 and 65 μa, electrical lability reduced - 32 and 34 Hz, colorimetric analysis of the optic nerve is identified criteria diabetic optic neuropathy.

The presumptive diagnosis of early diabetic optic neuropathy in a patient confirmed, completed the treatment with a positive functional outcome.

Clinical example 2. Patient A.

Insulin-dependent diabetes mellitus 5 years.

The level of activity of alkaline fastasy in tear fluid OD - 228,41 U/l, OS - 235,36 U/L. a

Ophthalmoscopically - optic disc pale pink, boundaries clear, veins are enlarged, twisted, arteries narrowed multiple point hemorrhages and limited exudate.

Vis OU=0,8. In view of the defects are not detected, the threshold electric sensitivity and lability in norm, colorimetric analysis of the signs of diabetic optic neuropathy is not found.

Thus, the study of the level of activity in the tear fluid alkaline phosphatase allows early diagnosis of diabetic optic neuropathy.

Method for the diagnosis of early diabetic optic neuropathy, characterized in that the determined activity of alkaline phosphatase in the tear fluid of patients with diabetes and if it is below 110 U/l, diagnose diabetic optic neuropathy.



 

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