Cognitive impairment and anxiety-depressive disorders in patients with age-related macular degeneration and cataract of old age are considered. 125 patients 6074 years old suffering from age-related macular degeneration combined with cataract were examined at the Tambov branch of the interdisciplinary scientific and technical complex "Eye Microsurgery named after Academician S.N. Fedorov". 74 patients of similar age without age-related macular degeneration served as controls. Anxiety was assessed by the Spielberger Hanin questionnaire, depressive status by the "Center for Epidemiological Studies Depression scale". The validity of the differences was determined by the Mann Whitney's U-criterion. It was established that among elderly patients suffering from age-related macular degeneration combined with cataract, cognitive deficits, an average level of personal anxiety, a significant specific gravity with an average level and an increased level of personal anxiety, depressive disorders, and in the control group a low level of anxiety and the absence of generally depressive disorders. Therefore, age-related macular degeneration increases the incidence of cognitive and anxiety-depressive impairment, and patients suffering from this ophthalmic pathology need geriatric examination and correction of cognitive and anxiety-depressive impairment. In general, macular degeneration is the leading cause of vision loss in old age and can contribute to the development of cognitive and anxiety-depressive disorders, which are practically unexplored among this contingent.
Currently, there are negative trends in the incidence of cataract, which, along with glaucoma, is the most common cause of visual impairment in various countries. Cataract prevalence continues to be high, necessitating the search for new treatment technologies and criteria for assessing the health and quality of life of this population. The purpose: to study the quality of life of patients with cataract against the background of ultrasonic phacoemulsification with implantation of soft intraocular lenses. Nei-VFQ-25 quality of life was studied in 182 patients with nuclear–cortical form of cataract before and after ultrasonic phacoemulsification. The integral index and components of the quality of life of patients with cataract before treatment are significantly reduced. The quality of life of patients with cataracts significantly increases in 3 months after surgical treatment in all indicators. Especially vision significantly improved in the distance, near vision, General health. Improving the quality of life of patients with cataracts after treatment indicates the effectiveness of the used ultrasonic phacoemulsification. In this case, the cause is a violation in the field of role-playing physical and emotional functioning. In the long-term period (6 months after treatment) there is an improvement in the quality of life of patients with mechanical trauma in many respects, except for the role of physical functioning. This study for the first time revealed the effect of ultrasonic phacoemulsification with implantation of soft intraocular lenses on the quality of life of patients with cataract. For the first time using a specific questionnaire NEI-VFQ-25 revealed the scale on which there is an improvement in the quality of life after surgery. The leading indicators of quality of life of patients with cataracts, characterizing the effectiveness of treatment with high-tech method of ultrasonic phacoemulsification, were established for the first time.
The syndrome of senile asthenia in elderly patients with combined glaucoma and cataracts on the background of interleukin imbalance has not been practically studied. Aim. To study the features of senile asthenia syndrome and systemic interleukin profile in elderly patients with combined glaucoma and cataract. Materials and methods. In clinical conditions, the senile asthenia syndrome was studied in 220 patients aged 60–74 years with primary glaucoma combined with cataract, using the questionnaire "Age is not a hindrance". The content of interleukins was determined in the blood by flow cytometry. Results. Senile asthenia syndrome among elderly patients with combined glaucoma and cataracts was detected in 33.1% of cases, with senile preasthenia syndrome – in 30.9% of cases. The value of the senile asthenia index is 0.53±0.07, which corresponds to severe senile asthenia. The formation of senile asthenia in the examined patients with comorbid ophthalmic diseases is mainly due to the presence of chronic diseases, low self-esteem of their own health and inability to walk fast. Changes in the systemic interleukin profile in elderly patients with glaucoma and cataracts are characterized by hyper-production of anti-inflammatory interleukins and, above all, blood interleukins 17 and 2, as well as a significant decrease in the content of anti-inflammatory interleukins. Conclusion. Therefore, the presence of senile asthenia syndrome in elderly patients with glaucoma and cataracts is associated with an imbalance of interleukin status.
Purpose. To examine macular zone using OCT-angiography followed endovitreal intervention with regard to rhegmatogenous retinal detachment. Material and methods. The study included 26 patients (36 eyes) divided into two groups: main and control. The main group consisted of 16 patients (16 eyes) operated on for rhegmatogenous retinal detachment. All the main group patients underwent endovitreal intervention regarding rhegmatogenous retinal detachment using standard technique 25g. The silicone oil and gas tamponade was performed as the last stage of surgical intervention. The control group included healthy subjects (10 people-20 eyes) of the same age without any ophthalmopathology. Macular zone was examined using spectral domain optical coherence tomography on RTVue XR Avanti (Optovue, Inc., Fremont, CA). Scanning size was 3x3 mm. Scan protocol AngioVue Angio retina 3.0 was used. All measurements were performed in the foveal area (1 mm in circumference) and parafovea-the region between foveal border and a circumference 3 mm in diameter round the center. Macular zone examination by angio-OCT method according to the above-mentioned protocol was performed in a month followed endovitreal intervention. Results. The most significant indices, which distinguish patients after surgery (main group) from healthy subjects (control group) were found to be data of vascular density of macular microcirculatory channel of the retina in all areas and sectors. Conclusion. The investigation performed showed the importance and high informativity of optical coherence tomography-angiography when assessing macular zone after endovitreal intervention as regards rhegmatogenous retinal detachment.
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