RU2281696C2 - Method for early preclinical diagnostics of fibrous rupture in zonule of zinn - Google Patents

Abstract

FIELD: medicine, ophthalmology.

SUBSTANCE: it is necessary to detect ocular parameters due to ultrasound biomicroscopy, moreover, one should measure the angle developed between the line that connects ciliary groove with the site of iris's touching a lenticular capsule and the line from the above-mentioned site with the border of visible equatorial picture of lenticular capsule and maximal thickness of ciliary body upon a tested and paired eye, and if simultaneously the above-mentioned angle at pathologically altered eye is increased by 6.0, and thickness of ciliary body is decreased by 0.1 mm against corresponding parameters of paired eye one should diagnose the availability of fibrous ruptures of zonule of Zinn.

EFFECT: higher accuracy of preclinical diagnostics.

2 dwg, 2 ex

Description

The invention relates to the field of ophthalmology. A known method is to determine the parameters of the eye by ultrasound biomicroscopy (see Pavlin CJ. Harasiewicz K. Foster FS. Ultrasound biomicroskopy of anterior segment structures in normal and glaucomatous eyes. AM J Ophthalmol 1992; 113: 381-9).

However, this method has a significant drawback - it does not allow the diagnosis of rupture of fibers of the zinc binder.

The technical problem is solved by the invention - improving the accuracy of early preclinical diagnosis of rupture of fibers of the zinc ligament.

The specified technical problem is solved by the fact that in the method of early preclinical diagnosis of ruptures of the fibers of the zinc ligament, which consists in determining the parameters of the eye using ultrasound biomicroscopy, it additionally measures the angle formed between the line connecting the ciliary groove with the point of contact of the iris with the lens capsule and the line from the point of contact of the iris with the lens capsule with the border of the visible equatorial image of the lens capsule and the maximum thickness of the ciliary body on the examined and paired eyes, and If the above angle simultaneously on pathologically altered eye increases by more than 6,0 °, and ciliary body thickness is reduced by more than 0.1 mm, the gap conclude Zinn ligament fibers.

The set of essential distinguishing features proposed by the authors is necessary and sufficient for an unambiguous positive solution to the claimed technical problem - improving the accuracy of early preclinical diagnosis of rupture of fibers of the zinc binder.

The proposed invention is illustrated in FIG. 1 and 2.

In FIG. 1 shows a diagram of the method (the eye is normal).

FIG. 2 shows a specific example of the method.

Figure 1 indicates: cornea 1, iris 2, ciliary body 3, iridociliary sulcus 4, anterior lens capsule 5, anterior chamber 6, posterior chamber 7, the point of contact of the iris with the lens capsule 8, the visible equatorial image of the lens capsule 9. Angle 12 formed between the line 10 connecting the furrow with the point of contact of the iris with the lens capsule and line 11 from the point of contact of the iris with the lens capsule with the border of the visible equatorial image of the lens capsule, 13 is the thickness of the ciliary body.

In FIG. 2, positions 4, 8, 9, 10, 12, 13 are indicated.

The invention is as follows.

Initially, eye parameters are determined by ultrasonic biomicroscopy. Additionally measure the angle 12 formed between the line 10 connecting the ciliary groove with the point of contact of the iris with the lens capsule and line 11 from the point of contact of the iris with the lens capsule with the boundary of the equatorial image of the lens capsule. Measure the thickness of the ciliary body 13 on the examined eye. Next, the same parameters are measured on the double eye normal.

If, at the same time, the above angle on the pathologically altered eye increases by more than 6.0 °, and the thickness of the ciliary body decreases by more than 0.1 mm, then a conclusion is made about the breakdown of the fibers of the zinc ligaments.

The method is illustrated by the following clinical examples.

Example 1: Patient R. born in 1978 (26 years old), outpatient card number 796152.

Visus OD - 1, O D OS - 1, O D

Intraocular pressure according to Maklakov OD - 15.9 mm Hg

OS - 17.7 mmHg

A - OD method - front camera - 3.30 mm, lens - 3.55, eye length - 24.06

OS - front camera, 3.29 lens - 3.53, eye length - 23.95.

In the study on a slit lamp, it was noted:

OD - front camera uniform, 3.0 mm deep, iris pattern unchanged, pigment border preserved. The pupil is round in shape, in the center, reaction to light of the II-III degree, the crystalline lens.

OS - uniform front camera 3.0 mm deep, iris pattern unchanged, pigment border preserved. The pupil is round in shape, in the center, reaction to light of the II-III degree, the crystalline lens.

In the study on UBM, we measured the angle 12 formed between line 10 connecting the ciliary groove with the point of contact of the iris with the lens capsule and line 11 from the point of contact of the iris with the lens capsule with the boundary of the equatorial image of the lens capsule. The thickness of the ciliary body 13 was measured.

Where were the following data obtained:

On the right eye - the value of the angle 12 - at 6 o'clock the angle is 8.92 °

at 12 o’clock the angle is 8.7 °

the thickness of the ciliary body 13 - at 6 hours - 0.62 mm.

at 12 hours - 0.68 mm.

on the left eye - angle 12 - at 6 o'clock angle - 9.1 °

at 12 o’clock the angle is 8.9 °

the thickness of the ciliary body 13 - at 6 hours - 0.61 mm.

at 12 hours - 0.63 mm.

Conclusion: the data obtained indicate the absence of ruptures of the fibers of the zinc ligament in both eyes.

Example 2. Patient M., born in 1934 (68 years old), outpatient card number 563027.

Was admitted to the hospital with complaints of decreased visual acuity, more on the right eye and increased intraocular pressure.

Visual acuity OD-0.05 sph-2,5D = 0.1 OS- 0.6 sph + 1.OD = 0.8-0.9

Intraocular pressure according to Maklakov: OV-24 mm Hg

OS - 19 mmHg

A - OD method - front camera - 3.13 m, lens - 4.64

eye length - 23.57

OS - front camera - 3.20, lens - 4.74

eye length - 23.51

In the study on a slit lamp, it was noted:

OD - anterior chamber uneven in the center with a depth of 3.0 mm dystrophy of the iris of the II degree. The pupil is round in shape, reaction to light of 0-I degree. PES 2-3 degrees. Clouding of the lens in the cortical layers and under the posterior capsule.

OS - uniform anterior chamber 3.0 mm deep, dystrophy of the iris of the II degree. The pupil is round in shape, in the center, reaction to light of the II degree, slight opacification of the lens in the cortical layers.

OD - Primary open-angle glaucoma IIb, complicated cataract, PES 2-3 degrees.

OS - Initial cataract.

In the study on UBM, we measured the angle 12 formed between line 10 connecting the ciliary groove with the point of contact of the iris with the lens capsule and line 11 from the point of contact of the iris with the lens capsule with the boundary of the equatorial image of the lens capsule. The thickness of the ciliary body 13 was measured.

Where were the following data obtained:

On the right eye - angle 12 - at 6 o'clock angle - 30.86 °

at 12 hours angle - 36.20 °

the thickness of the ciliary body 13 - at 6 hours - 0.648 mm

at 12 hours - 0.610 mm

on the left eye - angle 12 - at 6 o'clock angle - 9.32 °

at 12 o’clock the angle is 8.72 °

the thickness of the ciliary body 13 - at 6 hours - 0.72 mm

at 12 hours - 0.76 mm.

Output:

The above angle on the pathologically changed eye (at 6 hours - 30.86 °, and at 12 hours is 36.20 °) increases by more than 6 ° of the corresponding parameters (at 6 hours - 9.32 °, and at 12 hours 8, 72 °,) on the double eye. At the same time, a decrease in the ciliary body on the pathologically changed eye (at 6 hours - 0.648 mm, and at 12 hours - 0.610 mm) by more than 0.1 mm from the paired eye parameters (at 6 hours - 0.76 mm, and at 12 hours - 0.72 mm). Therefore, this allows us to make a conclusion about the rupture of the fibers of the zinc binder in the studied segments.

The use of the invention improves the accuracy of early preclinical diagnosis of rupture of fibers of the zinc ligament.

Claims (1)

A method for the diagnosis of ruptures of fibers of the zinc bond, including determining the parameters of the eye using ultrasound biomicroscopy, characterized in that the angle formed between the line connecting the ciliary groove with the point of contact of the iris with the lens capsule and the line from the point of contact of the iris with the lens capsule with the boundary of the visible equatorial images of the lens capsule and the maximum thickness of the ciliary body on the examined and paired eyes, and if at the same time the above angle on the pathologically altered gl since it increases by 6.0, and the thickness of the ciliary body decreases by 0.1 mm relative to the corresponding parameters of the paired eye, then the presence of ruptures of the fibers of the zinc ligament is diagnosed.

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