METHOD OF PREDICTION OF PROGRESSION OF OPEN-ANGLE GLAUCOMA IN COMBINATION WITH DIABETIC RETINOPATHY IN PATIENTS WITH DIABETES

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, ophthalmology, methods of eye examination using optical coherence tomography (OCT) for prediction of progression of open-angle glaucoma (OAG) combined with diabetic retinopathy (DRP). Macular area of retina (MAR) OCT is made defining volume of retinal edema in 9 sectors: in central fossa, in 3 and 5 mm from it from nose, temporal, top and bottom sides, in each scanning point of these 9 zones and total volume of pathologically changed MAR. At values of these parameters criterion R₁ is calculated, characterizes by intensity of edema in thickness of retina in 9 sectors of MAR by formula: $R_1=\frac{{\displaystyle \sum \left(h_i-h_{\min }\right)}}{\left(h_{\max }-h_{\min }\right)9}\mathop{\mathrm{image}}$, where h_i is thickness of retina in each scanning point; h_min is retinal thickness without taking into account values in extreme and central points; h_max is maximum of measured values of retinal thickness. Further OCT-scanning of optic nerve disc (ON) is made, criterion R_GDR is determined based on measurement results, characterizing by morphological changes in structures of ON in OAG at I, II, III stages in combination with DRP with diabetic macular edema (DME) by formula: $Rgdr=\frac{Sp\sqrt{Se}}{VpR1},\mathop{\mathrm{image}}$ where S_e is area of excavation (mm²); S_u is integrated area of neuro-retinal disc rim (NRR) (mm²); V_u is integral volume JF NRR (mm³). If R_GDR= (3.0-5.5) and S_u/v_u3.5 OAG stage I is diagnosed combined with DRP and DME and low risk of progressing is predicted with favorable prognosis for vision. If R_GDR= (5.5-10.0) and S_u/v_u= (3.5-5.0), OAG stage II is diagnosed combined with DRP and DME and high risk of progression with favorable prognosis are predicted. If R_GDR10.0 and S_u/v_p 5.0 OAG stage III is diagnosed in combination with DRP and DME and high risk of progression with unfavorable prognosis are predicted.;EFFECT: method provides objective diagnostics and quantitative assessment of risk of progression of above combined pathology taking into account most important factors of pathogenesis.;1 cl, 16 dwg, 5 ex, 2 tbl