Method for predicting primary narrow-angle glaucoma

FIELD: medicine, ophthalmology.

SUBSTANCE: one should detect the following ocular parameters: the depth of anterior chamber of the eye, the thickness of lens and the length of anterior-posterior ocular axis to calculate the ratios of parameters between each other to obtain the value for glaucoma prediction. The value for glaucoma prediction should be calculated as the ratio of lenticular thickness against the depth of anterior chamber and the length of anterior-posterior ocular axis by the following formula: where t - the thickness of lens; h - the depth of anterior chamber; l - the length of anterior-posterior ocular axis; 145 - the constant. At the value being equal or above 10 one should predict primary narrow-angle glaucoma.

EFFECT: higher efficiency of prediction.

2 ex

 

The invention relates to medicine, namely to ophthalmology, and can be used for detection of primary angle-closure glaucoma.

Modern ultrasonic equipment used in ophthalmic practice, allows with sufficient accuracy to measure not only the size of the whole eyeball, but its individual parts, such as the cornea and lens. It is also known that the values of the ratio of these parameters of the eyeball as it anteroposterior size, anterior chamber depth, crystalline lens thickness depends largely on the likelihood of developing diseases such as primary angle-closure glaucoma.

A known method for predicting primary angle-closure glaucoma (see the description of the invention to the patent of Russian Federation №2223729, M CL a 61 F 9/00, 07.08.2002,), which consists in determining the parameters of the eye: measuring the anterior chamber depth, lens thickness and length of the anteroposterior axis of the eye, and calculation of relationship parameters between themselves to obtain predictor of glaucoma, which is compared with a reference value. However, besides the already mentioned parameters, the known method further define the bandwidth of the scleral spur, the bandwidth of the ciliary body and the width of the schlemm's canal. Calculate the relations of the parameters for the four different the formulas and, accordingly, the conclusion about the prognosis of angle-closure glaucoma doing on the basis of the comparison obtained by the calculation of the four results. This can lead to errors in assessing the availability of primary angle-closure glaucoma. In addition, the proposed method of diagnosis according to the authors is only applicable for people of the Mongoloid race.

The present invention solves the problem of reducing the errors during the development of a new method for predicting primary angle-closure glaucoma. The technical result consists in increasing the efficiency of diagnosis of primary angle-closure glaucoma on the basis of obligatory diagnostic survey indicators ultrasound biometry of the eye. The proposed method was tested in the diagnosis 3496 patients Volgograd branch of IRTC "eye microsurgery" named after academician S.N. Fedorov without angle-closure glaucoma and 3320 patients identified with a diagnosis of angle-closure glaucoma.

The value of the predictor of glaucoma, calculated by the mathematical dependence, greater than or equal to the control value, predicts primary angle-closure glaucoma with the sensitivity of the method of 92.5%.

This technical result is achieved in that in the method of prognozi the Finance primary angle-closure glaucoma, which consists in determining the parameters of the eye: anterior chamber depth, lens thickness, length anteroposterior axis of the eye, and calculation of relationship parameters between themselves to obtain predictor of glaucoma, which is compared with a reference value, the predictor of glaucoma calculated as the ratio of the thickness of the lens to the anterior chamber depth and the length of the anteroposterior axis of the eye by the formula:

where t is the thickness of the lens;

h - the depth of the anterior chamber;

l is the length of the anteroposterior axis of the eye;

145 - constant

and when the value of the predictor of glaucoma, equal to or more than 10, predict primary angle-closure glaucoma.

A method for predicting primary angle-closure glaucoma is as follows.

The patient ultrasound biometrics and determine the parameters of the eye: anterior chamber depth, crystalline lens thickness and the length of the anteroposterior axis of the eye. According to the formulathey calculate the relationship of the thickness of the lens to the anterior chamber depth and the length of the anteroposterior axis of the eye and receive a predictor of glaucoma. Index To compare with the control value is 10 and the value of the index equal to or more than 10, predict primary angle-closure glaucoma

Example No. 1.

Patient H., 45 years old.

Diagnosis: moderate hyperopia both eyes. Primary angle-closure 111a operated glaucoma of the right eye, primary angle-closure 1A glaucoma of the left eye.

Visual acuity of the right eye: 0,2+4,0 D=0,5;

visual acuity of the left eye: 0,1+4,5 D=1,0.

On the right eye of the sum of the peripheral degree field of view is 380°in the Central field of view of the absolute and relative pathological scotomas.

On the left eye, the amount of peripheral degrees field of view - 520°in the Central field of view - pathological relative scotomas.

When ophthalmoscopy right eye optic disc pale grey, clear boundaries, Subtotal regional glaucomatous excavation, the ratio of the diameter of the excavation to the diameter of the optic nerve (e/D) is 0.8.

When ophthalmoscopy left eye optic disc pale pink, clear boundaries, the primary surface excavation, the ratio of the diameter of the excavation to the diameter of the optic nerve (e/D) is 0.3.

If gonioscopy right eye - the angle of the anterior chamber of the eye is closed in all departments, on the left eye anterior chamber angle of the eye is closed onits circumference.

The tonometry test with mediation positive on the left eye on the medicated m is triaza intraocular pressure increased by 7 mm Hg from the original value.

The patient held ultrasound biometry in both eyes and defined eyes: the crystalline lens thickness, anterior chamber depth and the length of the anteroposterior axis of the eye. The data of ultrasound biometrics: right eye - the crystalline lens thickness of 4.8 mm, the depth of the anterior chamber of the eye - 2.2 mm, length anteroposterior axis of the eye - 22.2 mm; left eye, the crystalline lens thickness of 4.7 mm, depth of the anterior chamber - 2.3 mm, the length of the anteroposterior axis of the eye - 22,0 mm

Formula calculate the predictor of primary angle-closure glaucoma for the right eye:

for the left eye:

Obtained values of the predictor of primary angle-closure glaucoma compared with the control value of 10. Since the estimated values of more than 10, confirmed by the presence of the patient angle-closure glaucoma in both eyes. Given the survey data, the left eye is made of prophylactic laser iridectomy.

Example No. 2.

Patient K., 58 y.o.

Diagnosis: hypermetropia low degree of both eyes.

Visual acuity in both eyes: 0,1+1,5 D=1,0.

The peripheral field of vision in both eyes in norm - 540°pathological scotomas not found.

When ophthalmoscopy in both eyes drive the viewer is on nerve pale pink, boundaries clear, physiological excavation, the ratio of the diameter of the excavation to the diameter of the optic nerve (e/D) is equal to 0.2.

Tonometry intraocular pressure in both eyes equal to 21 mm Hg

The tonometry test with mediation in both eyes is negative. On the right eye the intraocular pressure remained equal to 21 mm Hg on the left eye - 20 mm Hg

If gonioscopy in both eyes, the angle of the anterior chamber of the eye is of medium width, open in all departments.

Indicators of topography on both eyes were within normal limits.

The data of ultrasound biometrics: right eye - the crystalline lens thickness is 4.2 mm, the depth of the anterior chamber of the eye - 2.9 mm, the length of the anteroposterior axis of the eye and 23.1 mm; left eye, the crystalline lens thickness is 4.2 mm, the depth of the anterior chamber of the eye - 2.9 mm, the length of the anteroposterior axis of the eye - 23,0 mm

Formula calculate the predictor of primary angle-closure glaucoma for the right eye:

for the left eye:

Obtained values of the predictor of primary angle-closure glaucoma compared with the control value of 10. Since the calculated metric values less than 10, confirmed by the absence of the patient's angle-closure glaucoma in both eyes.

A method for predicting primary Zack is Topolino glaucoma, which consists in determining the parameters of the eye: anterior chamber depth, lens thickness and length of the anteroposterior axis of the eye, and calculation of relationship parameters between themselves to obtain predictor of glaucoma, characterized in that the predictor of glaucoma calculated as the ratio of the thickness of the lens to the anterior chamber depth and the length of the anteroposterior axis of the eye by the formula:

where t is the thickness of the lens;

h - the depth of the anterior chamber;

l is the length of the anteroposterior axis of the eye;

145 - constant

and when the value of the predictor of glaucoma is equal to or more than 10, predict primary angle-closure glaucoma.



 

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