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Glaucoma and cataract continue to be the leading causes of visual deficits, especially in older age groups, but the association of visual deficits with cognitive impairments has not been sufficiently studied. The aim of this study is to study visual impairment as a marker of cognitive impairment in patients with cataracts and glaucoma. The study included 326 elderly patients with cataracts and 318 elderly patients with primary open-angle glaucoma. The degree of cognitive impairment was determined using the Mini-Mental State Examination (MMSE) scale. Visual deficit was assessed by visual acuity without correction and maximum corrected visual acuity, and the severity of visual deficit was assessed by the scale we proposed. It was found that with low visual deficit (visual acuity without correction 0,51-0,60 and over 0,61) in the examined patients, the average score on the MMSE scale varied from 28,4±0,6 to 28,7±0,8 points (p>0,05), corresponding to subjective cognitive disorders. However, with a pronounced visual deficit (visual acuity without correction to 0,20 and 0,21-0,30), the average score is 13,9±0,3 and 16,5±0,4 (p<0,001), which indicates moderate dementia. Practically similar patterns about the association of cognitive impairments with the magnitude of visual deficit were also obtained when assessing visual deficit by maximum corrected visual acuity. The associativity of cognitive impairment with visual defect in patients with cataract and glaucoma was confirmed by the correlation method, according to which the correlation coefficient with visual acuity without correction is r=+0,428 (p<0,05), and with maximum corrected visual acuity - r=+0,385 (p<0,05). The results of the study allow us to consider visual deficit as a marker of cognitive impairment.

Along with an increase in the number of elderly and senile populations, there will simultaneously be an increase in the prevalence of age-associated ophthalmopathology and sarcopenic obesity, which can potentially contribute to a decrease in patients' activities in everyday life, but the latter remains practically unexplored, and if analyzed, then without the use of special scales for patients with visual organ pathology or quality of life indicators. The aim of the study was to study the effect of sarcopenic obesity and age-associated ophthalmopathology on the activities of patients in everyday life. 125 mature and elderly patients suffering from sarcopenic obesity combined with cataract and 138 patients of similar age with sarcopenic obesity combined with glaucoma were examined. Sarcopenic obesity was detected by the presence of obesity with a body mass index ≥30 kg/m2 and sarcopenia on the scale of the European Working Group on Sarcopenia in older people, supplemented by carpal dynamometry. It was found that, in comparison sarcopenic obesity with age-related cataracts, it has a more significant effect on changing activities in daily life, contributing to the formation of complete dependence on outside help (12,18 points) compared with sarcopenic obesity and glaucoma (10,18 points), p<0,001, when moderate dependence on others was found. However, regardless of the nosology of the ophthalmic disease, in both clinical groups, the leading limitations of activities in daily life were needle threading (1,84±0,03 vs 1,52±0,02 points), nail clipping - 1,75±0,03 vs 1,43±0,04 points, respectively. The results obtained can be used in gerontology in the implementation of measures to correct and maintain functionality in the daily life of patients with sarcopenic obesity combined with glaucoma and cataracts.

Application of new materials and methods in the diagnosis and treatment of eye diseases is one of the promising research areas in modern ophthalmology. Significant progress has been made in understanding the pathogenesis, diagnosis and treatment of eye diseases using nanotechnologies and nanomaterials. This paper presents the main achievements and results of original research on this issue. It has been shown that nanoparticles are able to overcome biological barriers, deliver drugs to the target site, and provide the required drug release rate. Modern nanotechnological approaches in tissue engineering are also being actively introduced into ophthalmology, making it possible to create nanoframeworks for growing three-dimensional cellular structures, including arrays of pigment epithelium cells and retinal ganglion cells for the treatment of retinal damage caused by degenerative diseases, injuries and infections.

The development of diabetic retinopathy is associated with matrix metalloproteinases, but they are rarely used to predict this pathology. The aim of the study was to predict the development of non-proliferative diabetic retinopathy in old age by the level of matrix metalloproteinases in blood plasma. The main study group consisted of 63 patients aged 60-74 years with type 2 diabetes mellitus and non-proliferative diabetic retinopathy, the control was 56 patients of the same age with type 2 diabetes mellitus and the absence of diabetic retinopathy and other ophthalmopathology at present and in the anamnesis. Examination of patients of both groups included: tonometry, visiometry, standard fundus photoregistration, optical coherence tomography, optical coherence tomography-A, fluorescent angiography. Determination of matrix metalloproteinases was carried out by the method of solid-phase enzyme immunoassay. There was a statistically significant increase in matrix metalloproteinase-9 in the main group of patients to 55,7±2,6 ng/ml versus 40,2±1,9 ng/ml in the age control, matrix metalloproteinase-2 to 269,8±4,2 ng/ml versus 221,9±3,6 ng/ml, respectively. Based on the level of matrix metalloproteinases-2 (X1) and -9 (X2) in the blood, a regression model was created by the regression method to predict the development of diabetic retinopathy, having the form Y=28,315+3,892·X1+2,453·X2, which will allow detecting the disease at an early stage.

A potential factor that significantly reduces the social activity of older people is visual impairment due to age-associated eye diseases - cataracts and diabetic retinopathy, which dominate in this age cohort. The aim of the study was to study the social activity of elderly patients with diabetic retinopathy and cataracts. According to a special questionnaire, 115 people 60-74 years old with combined cataract and diabetic retinopathy and 102 people 60-74 years old without ophthalmological diseases were questioned based on the Tambov branch of the MNTK «Academician S.N.Fedorov Eye Microsurgery». It was found that the average score of social activity in patients with cataract and diabetic retinopathy is statistically significantly lower, amounting to 3,10±0,08 points, versus 5,38±0,09 points in people without ophthalmopathology. The main reasons that reduce social activity in patients with visual impairment are problems with making various purchases and using public or personal transport. Factor analysis confirmed that the contribution of these reasons to the decrease in social activity is the highest and amounts to 0,876 and 0,708, respectively. Therefore, it is recommended to increase social assistance to patients with cataracts and diabetic retinopathy in solving the problems of using transport and purchasing various goods.