Among the causes of visual impairment, cataract occupies a significant proportion, which indicates a need for studying the causes of its development. Over recent years, an important role has been given to impaired immunoregulatory reactions in its genesis. So far, however, participation of systemic cellular immunity in occurence of different clinical types of cataract remains poorly known. The aim of the present study was to assess association between parameters of systemic cellular immunity and development of mature nuclear cataract. On the basis of IRTC “S.N. Fedorov Eye Microsurgery Center” (Tambov Branch), a study of major immune cells subpopulations in peripheral blood was performed over 2019-2020 in 63 patients aged 60-84 years, suffering from mature nuclear cataract (the study group). The control group consisted of 47 patients aged 60 to 84 years without ocular disorders in the history and at the time of examination. The evaluation of differentiated cell clusters was carried out with BD FACS Canto II flow cytometer. As a result, a statistically significant decrease in the absolute number of CD19+ to 0.18±0.003 × 109 /L was revealed in the patients from the main group versus 0.42±0.05 × 109 /L in controls; the relative number of CD19+ was decreased to 8.36±1.1% versus 19.64±1.3%, respectively, along with absolute content of CD3+ cells of 0.92±0.08 × 109 /L versus 1.57±0.06 × 109 /L in controls. On the contrary, the absolute number of CD56+ in the patients with mature nuclear cataract was significantly increased to 0.27±0.02×109 /L compared to 0.15±0.03 × 109 /L in the age control group. The relative risk values are statistically significant, and the highest levels were found for CD19+ and CD3+ cell clusters, which were 3.237 and 2.954 for the absolute number, and 1.952 and 2.748, for the relative number, respectively. These findings suggest that development of a mature nuclear cataract is associated primarily with a decrease in absolute and relative contents of B and T lymphocytes at the systemic level, which may be of practical importance when used as immunological markers of nuclear cataract.

The development of diabetic retinopathy is associated with matrix metalloproteinases, but they are rarely used to predict this pathology. The purpose of the study is to predict the development of nonproliferative diabetic retinopathy in old age based on the level of matrix metalloproteinases in blood plasma. The main group of the study consisted of 63 patients 60–74 years old with nonproliferative diabetic retinopathy, control consisted of 56 patients of the same age without the diabetic retinopathy and other ophthalmopathology at present and in history. Examination of patients in both groups included: tonometry, visiometry, standard fundus photography, optical coherence tomography, optical coherence tomography-A, fluorescence angiography. Determination of matrix metalloproteinases was carried out by the method of enzyme-linked immunosorbent assay. A statistically significant increase in matrix metalloproteinase was found — 9 in the main group of patients to 55,7 ± 2.6 ng / ml versus 40.2 ± 1.9 ng / ml in age control, matrix metalloproteinase — 2 to 269.8 ± 1.2 ng / ml versus 221.9 ± 3.6 ng / ml, respectively. Based on the level of matrix metalloproteinases — 2 (X1) and (X2) of the blood by the regressive method for predicting the development of diabetic retinopathy, which has the form Y = 28.315 + 3.892 × X1 + 2.453 × X2, which will allow detecting the disease at an early stage.

Immune disorders play an important role in development of age-related ophthalmic diseases (e.g., cataracts, age-related macular degeneration), as well as in geriatric conditions and, above all, in senile asthenia syndrome, the leading deficiency syndrome among people at their older age. However, the changes in systemic interleukins in patients with simultaneous presence of two age-associated conditions (cataract and senile asthenia syndrome) were only poorly studied. The aim of the present work was to evaluate the systemic interleukin profile in elderly patients affected by cataracts combined with senile asthenia syndrome of different severity. Patients and methods: The contents of interleukins in blood serum was analyzed in a clinical setting among patients aged 60 to 74 years for all the groups which manifested with isolated cataracts (n = 58), cataracts and senile preasthenia (n = 49), and cataracts and senile asthenia syndrome (n = 56). The diagnosis of senile asthenia syndrome was established in accordance with indexes of the phenotypic model by Fried L. et al., and cataracts, according to results of clinical ophthalmological examination. Determination of IL-1, IL-1β, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-12, IL-13, IL-17 and IL-18 were performed by enzyme immunoassay followed by calculation of relative risk for each of the above interleukin, as generally accepted. Results: A statistically significant increase of IL-1, IL-1β, IL-6, IL-8, IL-13 levels, along with decrease in IL-4, IL-10 were shown in the patients presenting with combination of cataract and senile pre-asthenia, as compared with patients with only cataracts. Among the patients with cataracts and senile asthenia syndrome, the disorders were diagnosed for a large number of interleukins, with increased levels of IL-1, IL-1β, IL-6, IL-8, IL-9, IL-12, IL-13, IL-17, IL-18, and decreased concentrations of IL-4, IL-10, in comparison with cases of isolated cataract, or cataract combined with senile preasthenia. Significant values of relative risk were revealed for cataract and senile preasthenia, i.e., for IL-1 (1.27), IL-1β (1.20), IL-4 (1.21), IL-6 (1.19), IL-8 (1.93), IL-10 (2.15) and IL-13 (1.23), and, in cases of cataracts and senile asthenia syndrome, for IL-1 (1.45), IL-1β (1.31), IL-4 (1.38), IL-6 (1.57), IL-8 (2.86), IL-10 (2.39), IL-13 (1.39), IL-17 ( 1.27). The results obtained point to marked changes in the mentioned systemic interleukins among the patients aged 60 to 74 years, and more pronounced association of these changes with cataract combined with senile asthenia syndrome, than with cataract and senile preasthenia.

Cataract in patients of older age groups is one of the reasons for the deterioration of geriatric status, the manifestations of which are geriatric syndromes, but insufficient attention paid to the study of the latter.Purpose. To study the prevalence of geriatric syndromes among patients with UC, depending on visual acuity without correction.Patients and methods. Geriatric syndromes were studied in 220 elderly patients with UC, in 240 elderly patients with FC and 200 elderly patients without UC based on methods of complex geriatric assessment. The following geriatric syndromes were analyzed: sarcopenia, hypomobility, malnourishment, pain syndrome, and disorders of general motor activity, psychological problems, cognitive disorders, anxiety-depressive status, sleep disorders and urination.Results. It was found that the deterioration of visual acuity without correction of less than 0.3 is accompanied by an increase in the majority of geriatric syndromes in elderly and senile patients with UC and especially in 75–89 years of hypomobility syndrome to 93.2 ± 2.5 cases of cognitive impairment to 89.3 ± 3.0 cases, malnutrition to 88.3 ± 3.2 cases and psychological problems to 79.6 ± 4.0 cases per 100 examined, which is significantly higher by 2.0–2.4 times compared to patients of the same age with UC with visual acuity without correction more than 0.3. A decrease in visual acuity of less than 0.3 in patients with UC contributes to an increase in the prevalence and average number of geriatric syndromes in old age to 8.2 ± 1.0 cases versus 3.9 ± 0.8 cases in old age with UC with visual acuity of more than 0.3 (P < 0.001).Conclusion. The revealed dependence of the prevalence of geriatric syndromes, taking into account visual acuity, indicates the relevance of timely correction.