METHOD FOR EARLY DIAGNOSTICS AND PREDICTION OF DIABETIC AND HYPERTENSIVE RETINOPATHY PROGRESSING IN CASE OF COMBINED COURSE OF TYPE 2 DIABETES MELLITUS AND HYPERTENSIVE DISEASE Russian patent published in 2017 - IPC A61B3/10 A61B5/21 A61B10/00 

FIELD: medicine.

SUBSTANCE: invention relates to early diagnostics of retinopathy (DR) in patients with combined course of type 2 diabetes mellitus (Type 2 DM) and hypertensiove disease (HD). Optic coherent tomography (OCT) of macular zone (MZ) of retina is performed, volume of retina thickness in 9 sectors: in fovea centralis, 3 and 5 cm from it from nasal, temporal upper and lower sides is determined. After that, change of sensitivity threshold of MZ is determined by method of fundus-microperimetry MAIA by demonstrating light stimuli into the area of fovea centralis and 3 and 5 cm around it. Level of glycated haemoglobin in patient's blood plasma is determined by standard method, prekallikrein and kallikrein level indices, as well as activity of elastase from neutrophils (NE) in lacrimal fluid (LF) samples are determined by photometric method with application of chromogenic substrates. Patient's systolic and diastolic arterial pressure (SAP and DAP) are measured. The following criteria are calculated on the basis of obtained data by mathematical calculations: R₁, characterising expression of increase in edema volume thickness by thickness of retina in the said 9 MZ sectors; R₂, characterising degree of change of MZ sensitivity threshold taking into account light stimulus intensity; D₃, characterising the level of glycated haemoglobin (HbA1c) in blood plasma; D₄, characterising the level of perkallikrein in LF; D₅, characterising the level of kallikrein in LF; D₆, characterising the level of NE in LF; D₇, characterising the level of SAP; D₈, characterising the level of DAP. After that, value of D_RDH criterion is calculated by formula , where R₁, R₂, D₃, D₄, D₅, D₆, D₇, D₈ are the values mentioned above. Group and risk of disease progressing are determined in accordance with generalised D_RDH criterion in accordance with the following intervals: at 1.75≥D_RDH>1.72 - preclinical stage of DR; at 1.72≥D_RDH>1.67 - non-proliferative stage of DR, low risk of progressing; at 1.67≥D_RDH>1.63 - non-proliferative stage of DR, high risk of progressing with unfavourable clinical prediction for vision.

EFFECT: method provides prediction of possibility of retinopathy progressing taking into account compensatory-adaptive consistency of vascular system in patients of the said group and early diagnostics of preclinical stage of the said pathology.

15 dwg, 2 ex