Aim        A comprehensive assessment of retinal microcirculation in patients with stable ischemic heart disease (IHD) exhibiting obstructive and non-obstructive coronary artery (CA) lesions. Materials and methods This observational comparative study included 35 patients with stable IHD, divided into those with CA obstructive lesions (n=25) and those with ischemia with non-obstructive coronary arteries (INOCA) (n=10). A control group consisted of 30 healthy volunteers with no cardiovascular risk factors. The groups were matched for age and body mass index. All participants underwent coronary angiography or CT coronary angiography. Tissue perfusion and the amplitude-frequency spectrum of blood flow fluctuations (endothelial component) were assessed via laser Doppler flowmetry (LDF) of the bulbar conjunctiva, and optical coherence tomography angiography (OCT-A) of the macular region was performed using the SOLIX platform (Optovue, USA). Results Compared to the control group, patients with INOCA exhibited significantly higher vascular resistance (σ) and coefficient of variation (Kv), indicating more pronounced perfusion fluctuations. Both obstructive IHD and INOCA groups showed reduced endothelial flow amplitudes, a marker of endothelial dysfunction. OCT-A revealed that while macular vessel density remained stable, all IHD patients had increased foveal avascular zone (FAZ) area and perimeter. Specifically, the FAZ area was more significantly enlarged in obstructive IHD, whereas the FAZ perimeter was greater in INOCA ( p <0.05). The left eye FAZ perimeter showed moderate diagnostic accuracy in differentiating stable IHD patients from healthy volunteers (AUC=0.632). Conclusion LDF of the bulbar conjunctiva effectively captures systemic vascular alterations in IHD and differentiates between obstructive and non-obstructive IHD. The integration of LDF and OCT-A provides a promising multimodal approach for the early detection of microvascular impairment, including in IHD patients.

Background/Objectives: Corneal confocal microscopy (CCM) quantifies subbasal corneal nerve fibers noninvasively and may inform peripheral neuroaging. PhenoAge is a validated clinical measure of biological aging linked to morbidity and mortality risk and therefore provides a geriatric-relevant index of systemic aging. We aimed to assess corneal nerve morphology in clinically healthy adults and determine whether CCM-derived parameters are associated with biological age (PhenoAge) beyond chronological age. Methods: Eighty-four healthy volunteers (22–89 years) underwent CCM. PhenoAge was calculated using the Levine algorithm. Associations with chronological age and PhenoAge were tested using Spearman correlations (eye-specific and participant-level mean of both eyes). Paired inter-eye differences were assessed, and linear mixed-effects models (random intercept for participant; fixed effects for age/PhenoAge and eye) were fitted. Results: Mean chronological age was 50.8 ± 15.5 years, and mean PhenoAge was 47.1 ± 16.3 years. No systematic inter-eye differences were detected (all p > 0.05). Across analyses, older age and higher PhenoAge were associated with lower main corneal nerve fiber measures, most consistently for main-fiber density. Participant-level sensitivity analysis (mean of both eyes) confirmed inverse associations of both chronological age and PhenoAge with main-fiber length and density (all p ≤ 0.035). In mixed-effects models, main-fiber density was associated with chronological age (β = −0.020/year, p = 0.032) and PhenoAge (β = −0.019/year, p = 0.037). Conclusions: CCM-derived corneal nerve morphology demonstrates aging-related patterns in clinically healthy adults. The association between PhenoAge and main-fiber density may suggest a systemic biological aging component and warrants longitudinal validation.

Alport syndrome (AS) is a genetically determined disease caused by abnormalities in the genes encoding alpha-3/4/5 chains of type IV collagen. Collagen IV is the most important structural component of the glomerular basement membranes, retina and inner ear, therefore, genetic mutations in this disease lead to kidney damage, vision and hearing impairment. Depending on the type of mutation, the clinical features of AS vary from asymptomatic decrease to early development of end-stage renal disease (ESRD), hearing loss and blindness. At the same time, AS is one of the most common causes of familial proteinuria in the population. Historically, this disease was considered a pediatric disease and more common in males, although currently its prevalence among women is high. The female sex is associated with a milder course and late development of complications, including vision and hearing impairment and ESRD. According to J.P. Jais et al., ESRD is observed by the age of 45 in 12 % of patients with the x-linked variant of AS. Early onset of severe manifestations is quite rare, which leads to insufficient diagnosis of genetically determined kidney diseases, late genetic testing and initiation of treatment, including transplantation. Currently, the problem of detection, therapeutic and surgical treatment of AS remains a difficult issue to resolve.This article presents a clinical case of diagnosis and management of a young patient with the x-linked COL4A5 variant of AS, complicated by renal parenchymal hypertension and early progression to ESRD, which required renal replacement therapy (dialysis) and kidney transplantation. The subsequent 2.5-year follow-up showed a significant improvement in the condition of target organs against the background of timely treatment.

Background: This research was conducted to compare the relationship between a comprehensive set of optical coherence tomography (OCT) parameters of the fovea and two measures of age-biological and chronological-in healthy adults. Methods: This cross-sectional study analyzed swept-source optical coherence tomography (OCT) data from 154 healthy adults aged 22–89 years. Parameters assessed: foveal thickness, foveal pit depth and diameter, pit slope steepness, and the presence or absence of the foveal bulge. Biological age was calculated using the PhenoAge algorithm. Results: The core geometry of the foveal pit showed no significant dependence on either type of age (p > 0.1). In contrast, the prevalence of the foveal bulge declined significantly with age: from ~80% in the youngest group (17-44 years) to 0-50% in the oldest group (75-92 years) (p = 0.0014 for PhenoAge, p = 0.0208 for chronological age). The odds ratio (OR) for the loss of the bulge per year of age was 0.96 (95% CI: 0.94–0.98).Conclusion: The foveal architecture remains structurally stable throughout adulthood. The foveal bulge emerges as a sensitive biomarker of age-related changes. Biological age does not provide additional predictive value over chronological age for foveal structural parameters under physiological aging conditions.

BACKGROUND: The search for noninvasive and clinically accessible biomarkers of aging remains a relevant challenge in modern medicine. The crystalline lens, whose morphometric parameters change predictably with age, serves as a convenient model for the quantitative assessment of age-related changes and the potential estimation of biological age. AIM: To perform a correlation analysis of lens morphometric parameters measured with the CASIA2 device and chronological and biological age calculated using the PhenoAge model in healthy individuals across different age groups. METHODS: We conducted a cross-sectional multicenter study. We included ophthalmologically and somatically healthy individuals from various age groups. All participants underwent anterior segment optical coherence tomography with assessment of the radii of curvature of the anterior (Front R, Front Rs, Front Rf) and posterior (Back R, Back Rs, Back Rf) lens surfaces, lens thickness (LT), equatorial diameter (LE-Dia), tilt (Tilt), and decentration (Decent). Biological age was estimated using the PhenoAge model. Statistical analysis included Spearman correlation coefficient (r), generalized estimating equations accounting for inter-eye correlation, and linear regression models with 10-fold cross-validation to assess predictive accuracy. Differences were considered significant at p 0.05. RESULTS: The study included 111 patients (222 eyes) aged 22–89 years. Statistically significant inter-eye asymmetry was found for the following parameters: Back R, Back Rf, LE-Dia, and Tilt (p 0.05 Lens thickness (LT) demonstrated a strong positive correlation (r = 0.747–0.765, p 0.0001), while Front R, Front Rs, and Front Rf showed a moderate negative correlation (r = −0.613 to −0.653, p 0.0001) with both chronological and biological age. Correlations with biological age for some parameters (e.g., LT) were comparable to or slightly stronger than those with chronological age. Predictive analysis revealed moderate accuracy for individual age prediction (minimum mean absolute error 8 years), indicating limited independent prognostic value of individual parameters. CONCLUSION: Lens morphometric parameters, particularly its thickness and anterior surface curvature, are closely associated with the aging process. Comparable, and in some cases stronger, associations with biological age suggest that lens morphology may be sensitive to individual aging rates. These parameters may therefore be of interest as components of noninvasive multiparametric approaches to the assessment of biological aging.

Background: This research compared the relationship between foveal optical coherence tomography (OCT) parameters and two age measures—biological and chronological—in healthy adults. Methods: This cross-sectional study analyzed swept-source optical coherence tomography (OCT) data from 308 eyes of 154 healthy adults aged 22–89 years. Parameters assessed: foveal thickness, foveal pit depth and diameter, pit slope steepness, and the presence or absence of the foveal bulge. Biological age was calculated using the PhenoAge algorithm. Results: The core geometry of the foveal pit showed no significant dependence on either type of age (all p ≥ 0.66). In contrast, the foveal bulge prevalence declined significantly with age (adjusted p = 0.011 for chronological age, p = 0.005 for biological age; OR per year ≈0.95, 95% CI 0.92–0.98 for both age models). Model-predicted prevalence decreased from approximately 93% in younger adults to 60–68% in the 60–74-year-old group. Conclusion: The foveal architecture remains structurally stable throughout adulthood. The foveal bulge emerges as a sensitive qualitative marker of age-related changes. Biological age does not provide additional predictive value over chronological age for foveal structural parameters under physiological aging conditions.