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OPHTHALMOLOGY
INVENTION
Patent of the Russian Federation RU2241993

METHOD OF DIAGNOSTICS OF SPECIFIC INFLAMMATORY DISEASES OF THE VISION ORGAN

The name of the inventor: Kovalevskaya Maria Alexandrovna (RU)
The name of the patent owner: Kovalevskaya Maria Alexandrovna (RU)
Address for correspondence: 394036, Voronezh, ul. Kutsigina, 6, ap. 145, M.A. Kovalevskaya
Date of commencement of the patent: 2003.07.11

The invention relates to medicine, namely to ophthalmology, and is intended for the diagnosis of specific inflammatory diseases of the organ of vision, such as chlamydia, mycoplasmosis, candidiasis, toxoplasmosis, inflammation caused by golden staphylococcus. Determine the value of acid-base balance (pH) on the most hyperemic surface of the conjunctiva. With its value of 8.0-12.0 diagnosed acute stage of chlamydia, 5.1-6.0 - subacute stage. At a pH value of 7.43 - acute stage of candidiasis, 6.21 - a subacute stage. At a pH value of 8.18 - an acute stage of toxoplasmosis, 5.46 - subacute. At a pH value of 3.45 - an acute stage of mycoplasmosis, 4.52 - a subacute stage. At pH 6.0-6.8 - an acute stage of inflammation caused by golden Staphylococcus, 4.75 - subacute stage. The method increases the accuracy of differential diagnosis and the appointment of adequate treatment for various types of specific inflammatory diseases of the organ of vision.

DESCRIPTION OF THE INVENTION

The invention relates to medicine, namely to ophthalmology, and is intended for the diagnosis of specific inflammatory diseases of the organ of vision, such as chlamydia, mycoplasmosis, candidiasis, toxoplasmosis, inflammation caused by golden staphylococcus.

Since the diagnosis of a particular inflammatory disease of the organ of vision determines the nature of the therapeutic tactics, the task of increasing the accuracy of diagnosis, provided that it is simple and accessible, is very relevant.

There are various ways of indirectly determining the presence of microbial agents in the body, in particular, by means of enzyme immunoassay, direct immunofluorescence reaction, detection of microorganism DNA (RU 2039986, 20.07.95; RU 2009505, 15.03.94; Witkin S et al., Detection of C. Trachomatis by the PCR.Am.J Obstet Gynecol 1993; 5: 1438-1442; Gomberg MA - Medicine for all .- 1997. - No. 1. - P.12-14).

The main drawback of all these methods is the impossibility, based on the results of the study, using expensive equipment, to quickly assign etiotropic therapy for eye diseases and to reveal the stage of the process according to objective criteria. Otherwise, antibiotic therapy with an empirically selected drug can prove to be not only ineffective, but also harmful, as it can strengthen the resistance of pathogenic microorganisms and weaken immune defense.

A cultural method for the diagnosis of chlamydia and mycoplasma diseases is known, based on the cleavage of certain substances necessary for the growth and reproduction of organisms. The indicator of this is the change in the pH value and, as a consequence, the color of the medium where the indicator (N.Soh 1938 - KTRipa et PA) Mardon is added. - 1973. Kozlova VI, Pouchner AF. Viral, chlamydial and mycoplasmal diseases. - M., 1995. - P.194-217).

However, this method was not used in ophthalmology, in particular, for the diagnosis of specific inflammatory diseases of the organ of vision.

The closest analogue of the proposed method is the method for diagnosing chlamydial conjunctivitis, which consists in detecting chlamydia DNA by polymerase chain reaction (PCR) using oligonucleotide primers (RU, 2205876, 10.06.2003). The method makes it possible to carry out a specific determination in the sample of the presence of chlamydia, regardless of the species, the combination of species and the presence of species related to chlamydia. However, the method is complex and expensive.

The object of the present invention is to develop a simple, accessible screening method for diagnosing specific inflammatory diseases of the eye.

The technical result of the proposed method is to obtain reliable results for differential diagnostics and the appointment of adequate treatment for various types of specific inflammatory diseases of the organ of vision.

The technical result is achieved by determining the acid-base balance of the conjunctiva in the zone of maximum hyperemia.

A prerequisite for conducting studies on the pH in the conjunctival cavity for various specific inflammatory diseases of the organ of vision was experimental studies on frogs in order to study the biochemistry of the eye with pH measurement depending on the illumination of the eye and its temperature (A. Piri and R. van Geiningen. With L.Szvereva L.L., TV Shlopak, Biochemistry of the Eye., M., Medicine, 1968, pp.235-237).

We conducted numerous studies on patients with various inflammatory diseases of the anterior segment of the eye and obtained data indicative of changes in pH characteristic for various types of specific inflammatory diseases of the organ of vision. The data were statistically processed, and reliable figures of pH changes were obtained depending on the type of infection, and the course of the disease. The data obtained are verified using specific culture tests for various types of microorganisms. As a result, conclusions are drawn that at an pH value of 8.0-12.0, the acute stage of chlamydia is diagnosed, 5.1-6.0 is a subacute stage; At pH 7.43 - acute stage of candidiasis, 6.21 - subacute stage; At a pH value of 8.18 - acute stage of toxoplasmosis, 5.46 - subacute; At pH 3.45 - acute stage of mycoplasmosis, 4.52 - subacute stage; At a pH of 6.0-6.8 - an acute stage of inflammation caused by golden staphylococcus, 4.75 - a subacute stage.

The method is carried out as follows. The glass electrode of the pH meter with a 3 mm diameter ball end, specially designed for recording the pH of small sample volumes, for example, from Hanna instruments HI-8314, which was calibrated before the beginning of the measurements and calibrated with standard buffer solutions, is injected into the detachable conjunctival cavity, Where it contacts at the points of the greatest hyperemia of the mucosa. After amplification, the electrical signal is fed to the electronic display and the pH value is fixed. Depending on its magnitude, one or another type of infectious pathology is diagnosed. With its value of 8.0-12.0, the acute stage of chlamydia is diagnosed, 5.1-6.0 is a subacute stage; At pH 7.43 - acute stage of candidiasis, 6.21 - subacute stage; At a pH value of 8.18 - acute stage of toxoplasmosis, 5.46 - subacute; At pH 3.45 - acute stage of mycoplasmosis, 4.52 - subacute stage; At a pH of 6.0-6.8 - an acute stage of inflammation caused by golden staphylococcus, 4.75 - a subacute stage.

Example 1
Patient T, 43 years old. 6 months are sick. Complains of itching, separation, redness of both eyes. Objectively: marked sharp edema and redness of the eyelids, in the corner of the eye - a cluster of mucoid-purulent discharge, more to the right. Biomicroscopy: hyperemia and edema of the lower eyelid mucosa, hypertrophy of follicles located in the form of beads. The pH was measured with a pH meter HI-8314, the glass electrode was immersed in a spherical end into the conjunctival cavity so that contact was made with the mucosa separable at the points of greatest hyperemia. After amplification, an electrical signal is sent to the scoreboard. The pH was evaluated in the dynamics of the inflammatory process: in the acute stage, pH 8.04. This indicator characterized a pronounced specific process - ophthalmoccidiosis. The control was carried out by the concentration of inclusions that were more than 30. After 2 weeks, the inflammatory process passed into the subacute stage against a background of specific treatment, the pH values ​​of the detachable corresponded to 5.0-6.0, and the number of inclusions of chlamydia decreased by 48%. In the control for cure, the pH was 3.5, and the concentration of inclusions decreased by 85%.

Example 2
Patient K., 23 years old, is sick for 1 month. Complaints: irritation, purulent discharge from the eyes. During examination, a large amount of the separated and infiltration of the mucous lids and the eyeball was detected. The pH value was measured with a glass electrode of the HI-8314 pH meter immersed in the conjunctival cavity, with contact at the points of the greatest hyperemia of the mucosa. In the acute period, the pH was 6.0, Staphylococcus aureus was found in the bacteriosseous. Analysis of the intensity of infection was accompanied by monitoring the pH value. After a specific treatment, the symptoms of inflammation decreased after three days. The pH value was 4,75 in the subacute stage, and the pH value was 4.35 after recovery.

Example 3
Patient 3. Complaints of irritation, viscous discharge from the eyes. Objectively: biomicroscopy revealed: infiltration and edema of the conjunctiva, viscous white discharge, suspicion of Candida albicans. Using the HI-8314 pH meter, a pH of the conjunctival cavity was measured with the globular end of the conjunctiva in the discharge cavity of the conjunctiva, with contact at the points of the greatest hyperemia of the mucosa, in the acute stage it was 7.43, in the subacute stage - 6.21. After the specific treatment, there was a recovery, the pH was 4.23, there were no complaints of the patient, there were no signs of inflammation of the shells of the eyeball.

Example 4
Patient K. Complaints of irritation, separated. Objectively: a filmy discharge, a mixed infection of the conjunctiva of the ocular block. Suspicion of mycoplasmosis. A pH value of 3.45 in the acute stage was determined by a glass electrode of pH-meter HI-8314 immersed in the conjunctival cavity contacting at the points of the greatest hyperemia of the mucous membrane. Mycoplasmosis is diagnosed and verified. After the specific treatment, the stage of inflammation subsided, in the subacute phase the pH value was 4.52.

Example 5
Patient A. Diagnosis: toxoplasmosis of anterior segment of eye, acute keratoconjunctivitis. Using a HI-8314 pH meter, a glass electrode with a globular end placed in the conjunctival cavity of the eye that contacted the points of greatest hyperemia of the mucosa revealed a pH value that is 8.18 in the acute stage. The diagnosis of toxoplasmosis is confirmed. After a specific treatment, when the inflammatory process subsides, the pH value in the subacute is 5.46. Recovering - the pH value was 4.35.

Thus, the use of the proposed method allows to quickly and accurately diagnose a specific inflammatory disease of the organ of vision, as well as determine the type and stage of inflammation for adequate treatment.

CLAIM

The method of diagnosis of specific inflammatory diseases of the organ of vision, characterized by the fact that the value of acid-base balance (pH) is determined on the most hyperemic surface of the conjunctiva and at its value 8,0-12,0 diagnose the acute stage of chlamydia, 5.1-6.0 - Subacute stage; At a pH value of 7.43 - an acute stage of candidiasis, 6.21 - a subacute stage; At a pH value of 8.18 - acute stage of toxoplasmosis, 5.46 - subacute; At a pH value of 3.45 - an acute stage of mycoplasmosis, 4.52 - a subacute stage; At a pH of 6.0-6.8 - an acute stage of inflammation caused by golden Staphylococcus, 4.75 - a subacute stage.

print version
Date of publication 06.01.2007gg