Diabetic retinopathy occupies a special place among the causes of the progression of decrease and loss of visual acuity, significantly impairing the quality of life and age-related viability, an integral indicator that is considered allostatic load. However, the allostatic load in patients suffering from diabetic retinopathy, as well as in other ophthalmological diseases, has not been practically studied and biomarkers characterizing the allostatic load of patients with diabetic retinopathy remain unknown.Purpose. To study of allostatic load in patients with diabetic retinopathy and the identification of biomarkers that most determine it.Patients and methods. Allostatic load was studied in 78 elderly patients with diabetic retinopathy and in 62 patients with type 2 diabetes mellitus without diabetic retinopathy. Allostatic load was analyzed according to systolic and diastolic blood pressure, body mass index, glycated hemoglobin, total cholesterol, triglycerides, albumins, C-reactive protein, homocysteine in the blood and glomerular filtration rate.Results. The most pronounced and statistically significant excess in patients with diabetic retinopathy compared with patients with diabetes mellitus without diabetic retinopathy was found to be the content of glycated hemoglobin in the blood up to 10.2 % versus 7.4 % and homocysteine up to 15.5 mmol/l versus 7.9 mmol/l, respectively. The value of the allostatic index was significantly higher in patients with diabetic retinopathy, amounting to 4.6 ± 0.4 points, versus 2.9 ± 0.3 points in patients with diabetes mellitus without ophthalmopathology under consideration (p < 0.001). Factor analysis made it possible to identify biomarkers of allostatic load in patients with diabetic retinopathy — glycated hemoglobin, homocysteine, triglycerides and albumins.Conclusion. These biomarkers are proposed to be used in assessing the age-related viability and effectiveness of rehabilitation measures carried out among patients with diabetic retinopathy.

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.

A common complication of diabetes mellitus, mainly type 2, is diabetic retinopathy, among which the most unfavorable form for complete loss of vision is considered to be proliferative diabetic retinopathy. The participation of the complement system in the development of proliferative diabetic retinopathy is mainly devoted to experimental work on a limited number of blood complement components and without assessing their risk in the pathogenesis of the disease. The purpose of the study was to determine the association of components of the blood serum complement system with the development of proliferative diabetic retinopathy in the elderly. In clinical conditions, 115 patients 60–74 years old suffering from proliferative diabetic retinopathy and 48 patients of the same age with the absence of this ophthalmopathology were examined. The components of the blood complement system were studied by enzyme immunoassay and hemolytic method. The relative risk of the influence of the complement components was calculated according to the generally accepted method. There was a statistically significant increase in the blood serum of patients with proliferative diabetic retinopathy of most components of the complement system, with the exception of the C1 ing. and C5 components. The content of the C3a component increased especially to 127.6 ± 4.7 ng / ml versus 30.4 ± 3.5 ng/ml in the control, the C5a component to 5.6 ± 0.5 ng/ml versus 2.4 ± 0.3 ng/ml, and factor H to 228.7 ± 4.9 versus 106.3 ± 3.8 mng / ml, respectively. The highest value of the relative risk among the studied components is inherent in the C3a component of the blood complement with a reliable confidence interval of 4,451–5,103. The development of proliferative diabetic retinopathy in the elderly is associated with an increased content of C3a, C5a components and factor H in the blood serum, which can be used to develop targeted therapy for this disease.

ФГАУ «МНТК «Микрохирургия глаза» им. акад. С. Н. Федорова» Минздрава РоссииПроанализированы результаты 300 операций (150 пациентов). Пациенты были разделены на две группы. В первую группу входили пациенты, прооперированные по технологии фемтоЛАЗИК (150 глаз). Послеоперационное лечение стандартное. Во вторую группу входили пациенты, прооперированные по технологии ReLEx smile (150 глаз): 111 получали послеоперационное лечение без использования стероидов, 39 -с использованием гормональных пре-паратов. Период наблюдения составлял 1-3 года. При стандартном отделении лентикулы послеоперационное лече-ние не требует использования стероидных препаратов. We analyzed our surgical results with 150 patients (300 eyes). The patients were divided into two groups. The first group included patients who underwent femto-LASIK surgery (150 eyes). The patients received conventional postoperative care. The second group included patients who underwent ReLEx smile surgery (150 eyes). In 111 out of 150 eyes the patients did not receive steroids in the immediate postoperative period. In 39 out of 150 eyes the patients received steroids in the postoperative period. The follow-up period was 1-3 years. We conclude that in standard lenticule extraction the postoperative treatment does not require the use of steroids.Key words: femtoLASIK, ReLEx smile, steroids, NSAIDs.На сегодняшний день фемтосекундные лазерные установки в офтальмологии применяются при форми-ровании роговичного клапана, послойной и сквозной кератопластике, создании роговичных туннелей для им-плантации интрастромальных сегментов, интрастро-мальном формировании роговичной лентикулы, интра-стромальной коррекции пресбиопии, а также для выполнения фемтосекундного капсулорексиса и фраг-ментации ядра хрусталика [1][2][3][4].Фемтосекундный лазер с высокой частотой сле-дования импульсов и контролируемой компьютером ска-нирующей оптической системой доставки луча выпол-няет локализованные микрофоторазрушения, которые могут быть размещены рядом друг с другом, формируя разрезы произвольной формы. Учитывая очень малую длительность лазерного импульса, данная процедура по-лучила название фемтосекундного лазерного разреза -фемтодиссекции [4][5][6]. Сложные фигуры могут быть получены пересечением этих плоскостей разреза.При формировании роговичного клапана в зави-симости от глубины среза пересекаются разные по тол-щине коллагеновые волокна, которые затем сокраща-ются к периферии роговицы. Это приводит к эффекту уплощения центра роговицы еще до проведения абля-ции. Кроме того, после проведения абляции, направ-ленная наружу сила натяжения неповрежденных во-локон, расположенных на периферии зоны абляции, при-водит к дополнительному уплощению центра роговицы, утолщению и увеличению кривизны периферии рого-вицы [1]. Это ведет к усилению преломляющей спо-собности периферической части роговицы.ReLEx -это новое поколение методов лазерной коррекции зрения. Данный метод объединяет последние разработки в области фемтосекундных технологий с ме-тодом высокоточного формирования оптической линзы (лентикулы)...

Purpose. To analyze the outcomes of the national polymer microshunt implantation in refractory glaucoma surgery and to show its efficacy and safety. Patients and methods. We analyzed the results of treatment of 90 patients (90 eyes) with refractory glaucoma. All patients were divided into two groups: main group and comparison group. The patients in the main group (44 eyes) were implanted with the national polymer microshunt (Reper-NN). The patients in the comparison group (46 eyes) were implanted with Ex-PRESS. Control criteria in the postoperative period included visometry, tonometry by Maklakov, computed perimetry. The examinations were performed preoperatively, at discharge, in a month, in six months and later postoperatively.Results. When implanting the national polymer microshunt we reached the significant decrease in the intraocular pressure in the postoperative period in comparison with the preoperative level. The implantation outcomes of the national polymer microshunt and Ex-PRESS were comparable in efficacy and safety. The easy implantation and special construction of the national polymer microshunt provided with the sufficient efficacy and safety in refractory glaucoma surgery and allowed recommending its further application in the clinical practice.Conclusion. The use of Reper-NN microshunt is effective and safe method of treating refractory glaucoma. The implantation of this shunt may be the method of choice both in primary and secondary refractory glaucoma surgery. The least price of Reper-NN microshunt in comparison with the foreign analogue allows this surgery to be more available for patients with refractory glaucoma.