Background: Diseases of the visual organ negatively affect the quality of life of the elderly. A comprehensive study of the pathology of the visual organ among the elderly population of the Voronezh region has not been conducted. The aim of the study: Analysis of visual deficit and geriatric status of rural patients with various ophthalmic pathologies. Materials and methods: The data were obtained retrospectively from medical records and case histories of 842 elderly patients (≥60 years old) who sought inpatient medical care in the "ophthalmology" profile in the period from 2018 to 2020. The extracted data included: age, gender, marital status, occupation, visual acuity, primary and concomitant ophthalmological diagnoses, medications, surgical interventions on the eyes. Results: The average age of patients was 69.8±7,5 years, 524 (62.2%) women. The most common were cataracts and glaucoma, there were also patients with AMD, DARP, refractive disorders, retinal detachment, senile pathology of the eyelids. Anti-glaucomatous drugs had a predominant share (57.1%) among all drugs used for the treatment of eye diseases. 66.4% were hospitalized for surgery, and 18.1% had previously undergone eye surgery. 61.4% of patients had a decrease in visual acuity of less than 40% in both eyes on admission, while 8.1% had poor vision or blindness in 1 or both eyes. Age and glaucoma were factors largely associated with severe visual deficits and blindness. Certain geriatric syndromes are associated with age in patients with visual deficits, among which the greatest prevalence is characteristic of falls syndrome, anxiety-depressive syndrome and cognitive impairment syndrome. Conclusion: The most common age-related eye diagnoses are glaucoma, cataract, and AMD. It is necessary to popularize the promotion of prevention and timely treatment of preventable causes of low vision and geriatric syndromes in the elderly.
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The number of premature babies, including those with extremely low birth weight (ELBW), is steadily growing every year. In surviving ELBW infants, retinopathy of prematurity (ROP) more often develops, which has a more severe course, depending not only on the degree of immaturity and somatic burden of premature babies but also on the quality of nursing. The aim of this work is to determine the risk factors for ROP progression in profoundly premature ELBW infants to optimize the tactics of their treatment. Materials and methods. We studied the case histories of 155 surviving premature ELBW infants with ROP of various stages treated in perinatal centres of the Belgorod region in 2014-2019. Results. In premature ELBW infants, ROP of varying severity was found to be diagnosed in 90% of cases. The anamnesis of the mothers of the examined patients with moderate and severe ROP was dominated by unfavorable preceding pregnancies (miscarriages, silent miscarriage and ectopic pregnancies, medical abortions).The need for preterm infants in mechanical ventilation was established to depend on the severity of ROP and the duration of mechanical ventilation (p < 0.05). Frequent, not always justified red blood transfusions leading to the replacement of fetal haemoglobin with adult haemoglobin are also essential factors in ROP progression.
Systemic immunological disorders are associated with various geriatric conditions, including cognitive dysfunction. However, in patients with diabetic retinopathy, the changes of blood interleukin profile were studied without considering the severity of cognitive impairment. The aim of this study was to analyze blood plasma levels and intercorrelations of interleukins in the patients with diabetic retinopathy accompanied by mild and moderate cognitive impairment. Fifty-four elderly patients with diabetic retinopathy and mild cognitive impairment, and 62 patients with diabetic retinopathy and moderate cognitive disorders underwent inpatient examination and treatment at the Tambov branch of the S. Fedorov Center of Eye Microsurgery over 2021-2022. The interleukins contents in blood plasma were studied by enzyme immunoassay using the Protein Contour kit, including IL-1α, IL-1β, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-12, IL-17, IL-18. The diagnostics of diabetic retinopathy was based on comprehensive ophthalmological examination, according to the Clinical recommendations of the Society of the Russian Association of Ophthalmologists «Diabetes mellitus: diabetic retinopathy, diabetic macular edema». Cognitive functions were assessed according to a valid Mini- Mental-State-Examination scale. It has been shown that the patients with diabetic retinopathy and moderate cognitive impairment have a significantly increased level of all the studied proinflammatory interleukins, as compared to similar cohort with diabetic retinopathy accompanied by a mild cognitive impairment. In mild cognitive disorders, the content of IL-6 in blood plasma was higher (24.4±2.1 pg/mL versus 5.1±0.8 pg/mL, p < 0.001). Development of moderate cognitive impairment in the patients with diabetic retinopathy was also accompanied by a statistically significant increase of plasma IL-8 to 36.7±3.5 pg/mL versus 10.5±2.3 pg/mL with mild cognitive impairment; IL-17, to 21.9±1.8 pg/mL versus 8.5±1.1 pg/mL, respectively. Concentrations of anti-inflammatory interleukins in blood plasma of the patients with diabetic retinopathy and moderate cognitive dysfunction were significantly decreased, i.e., IL-4 to 2.1±0.3 pg/mL versus 3.4±0.5 pg/mL in cases of mild mental deterioration; IL-10, to 8.7±0.5 pg/mL versus 15.4±1.3 pg/mL, respectively. A sufficient correlation was shown between the levels of systemic interleukins and moderate cognitive disorders in the patients with diabetic retinopathy. For the proinflammatory interleukins in cases of moderate cognitive impairment, an inverse correlations with IL-1β (r = -0.336; p = 0.021), IL-6 (r = -0.584; p = 0.019), IL-8 (r = -0.469; p = 0.006), and with IL-17 (r = -0.348; p = 0.018) were shown. The content of IL-4 and IL-10 in blood plasma of the patients with diabetic retinopathy correlated with moderate cognitive impairment at a significant level of r = +0,407 (p = 0.016) and r = +0.359 (p = 0.008), respectively. In mild cognitive impairment, the correlations with fewer numbers of interleukins were revealed, i.e., IL-1β, IL-6, IL-8 and IL-10, and exhibit weaker connections, except of IL-6 (a moderate connection level). Development of moderate cognitive impairment among the patients with diabetic retinopathy may be caused by increase in IL-1β, IL-6, IL-8, IL-17, and a decrease in IL-10.
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