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Uzun F, Aydın E, Akgöz H, Aslan MG. Complete Blood Cell Count-Derived Inflammation Biomarkers and the Need for Laser Capsulotomy Due to Posterior Capsule Opacification Following Cataract Surgery. J Inflamm Res 2024; 17:6075-6082. [PMID: 39253563 PMCID: PMC11382797 DOI: 10.2147/jir.s473655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 08/28/2024] [Indexed: 09/11/2024] Open
Abstract
Background Inflammation plays a significant role in the proliferation, migration, and differentiation of lens epithelial cells after cataract surgery, clinically manifested as posterior capsule opacification (PCO). This condition is typically treated with neodymium: yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy. Our objective is to evaluate the association between blood-derived inflammatory markers and the development of clinically significant PCO necessitating treatment with laser capsulotomy. Materials and Methods We conducted a retrospective review of charts for all patients who underwent Nd:YAG laser capsulotomy in our department between January 2021 and December 2022. The study included 70 patients who diagnosed with clinically significant PCO requiring treatment with Nd:YAG laser capsulotomy following cataract surgery, as well as 70 pseudophakic controls with no signs of PCO. Complete blood cell count parameters were obtained from medical records and the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were calculated. Results The mean age of the Nd:YAG laser capsulotomy and control group was 71.83±8.46 and 72.27±9.98 years, respectively. The preoperative NLR scores for the Nd:YAG laser capsulotomy group (mean rank = 34.43) were statistically significantly higher than those of the control group (mean rank = 25.41) (p = 0.044). However, after adjusting for preoperative measurements, no statistically significant differences were observed between the groups for the other parameters. Conclusion Preoperative NLR scores were higher in patients who developed clinically significant PCO requiring treatment with Nd:YAG laser capsulotomy. This finding suggests that patients with elevated systemic inflammation may be at an increased risk of developing PCO following cataract surgery. Further research is needed to evaluate the role of systemic inflammation in the pathogenesis of PCO.
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Affiliation(s)
- Feyzahan Uzun
- Recep Tayyip Erdogan University, School of Medicine, Department of Ophthalmology, Rize, Turkey
| | - Emre Aydın
- Recep Tayyip Erdogan University, School of Medicine, Department of Ophthalmology, Rize, Turkey
| | - Hasan Akgöz
- Recep Tayyip Erdogan University, School of Medicine, Department of Ophthalmology, Rize, Turkey
| | - Mehmet Gökhan Aslan
- Recep Tayyip Erdogan University, School of Medicine, Department of Ophthalmology, Rize, Turkey
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Alhalwani AY, Baqar R, Algadaani R, Bamallem H, Alamoudi R, Jambi S, Abd El Razek Mady W, Sannan NS, Anwar Khan M. Investigating Neutrophil-to-Lymphocyte and C-Reactive Protein-to-Albumin Ratios in Type 2 Diabetic Patients with Dry Eye Disease. Ocul Immunol Inflamm 2024; 32:925-931. [PMID: 36637884 DOI: 10.1080/09273948.2022.2152698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/09/2022] [Accepted: 11/21/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Patients with Diabetes mellitus (DM) are at risk of developing dry eye disease (DED). We investigated routine laboratory parameters in patients with type 2 DM (T2D) and T2D-DED to identify potential inflammatory markers. METHODS A retrospective study of 241 randomly selected patients (30 DED non-diabetic, 120 T2D, and 91 with T2D-DED). The neutrophil-to-lymphocyte ratios (NLR), CRP-to-albumin ratios (CAR), and the glycosylated haemoglobin A1c (HbA1c) results were correlated between groups. RESULTS The NLR and HbA1c were significantly higher in the T2D-DED group (p≤0.001 and 0.0001, respectively) when compared with T2D and DED non-diabetic groups. CAR was insignificantly high in the three groups (p=0.192). A positive correlation was identified between CAR and NLR in T2D-DED patients (p= 0.008). CONCLUSION In T2D-DED patients, NLR was significantly high and positively correlate with CAR. These results predicate diabetes with dry eye complications, and biomarker-mediated inflammation may have important roles in DED pathogenesis.
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Affiliation(s)
- Amani Y Alhalwani
- College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Department of Biomedical Research, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
| | - Rawan Baqar
- College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Rawan Algadaani
- College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Hala Bamallem
- College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Rwzan Alamoudi
- College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Shatha Jambi
- College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Wessam Abd El Razek Mady
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Naif S Sannan
- College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Department of Biomedical Research, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
| | - Muhammed Anwar Khan
- College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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Özer Ö, Doğan L, Baysal Z, Basir H, Çıftçı AT, Eröz P, Güçlü ES. Evaluation of peripheral blood inflammatory biomarkers in sickle cell disease with and without retinopathy. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06569-9. [PMID: 38976013 DOI: 10.1007/s00417-024-06569-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/18/2024] [Accepted: 06/24/2024] [Indexed: 07/09/2024] Open
Abstract
BACKGROUND The aim of this study was to evaluate the clinical significance of blood-cell associated inflammation markers in patients with sickle cell disease (SCD) and sickle cell retinopathy (SCR). METHODS Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), systemic immune inflammation index (SIII), systemic inflammation response index (SIRI), systemic inflammation modulation index (SIMI) and aggregate systemic inflammation index (AISI) were calculated. This study included 45 healthy controls (Group 1) and 100 SCD (Group 2). Patients in Group 2 were then divided into two groups: without SCR (Group 3) and with SCR (Group 4), and patients with SCR (Group 4) were further divided into two groups: non-proliferative sickle cell retinopathy (NPSCR) (Group 5) and proliferative sickle cell retinopathy (PSCR) (Group 6). RESULTS The mean values for NLR, PLR, SIII, SIRI, AISI, and SIMI were significantly higher in Group 2 compared to Group 1 (p = 0.011 for NLR, p = 0.004 for SIII, and p < 0.001 for others). Furthermore, AISI and SIMI parameters demonstrated statistically significant discriminatory power to distinguish Group 5 from Group 6 (p = 0.0016 and p = 0.0006, respectively). CONCLUSION Given the critical role of inflammatory mechanisms in the pathogenesis of SCD and its related complications, the assessment of blood-cell-associated inflammatory markers may present a pragmatic and advantageous approach to the clinical oversight and therapeutic intervention of SCD.
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Affiliation(s)
- Ömer Özer
- Department of Ophthalmology, Niğde Ömer Halisdemir University, Niğde, 51240, Turkey.
| | - Levent Doğan
- Department of Ophthalmology, Niğde Ömer Halisdemir University, Niğde, 51240, Turkey
| | - Zeki Baysal
- Department of Ophthalmology, Niğde Ömer Halisdemir University, Niğde, 51240, Turkey
| | - Hakan Basir
- Clinic of Internal Medicine, Gülnar State Hospital, Mersin, Turkey
| | - Ali Türker Çıftçı
- Department of Biostatistics and Medical Informatics, Niğde Ömer Halisdemir University, Niğde, Turkey
| | - Pınar Eröz
- Clinic of Ophthalmology, Tarsus State Hospital, Mersin, Turkey
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D'Souza S, Nair AP, Ashok N, Kannan R, Dickman MM, Nuijts RMMA, Shetty R, Sethu S, Ghosh A. Elevated neutrophils and reduced NK cells are associated with altered tear molecular signatures and clinical sequelae of chronic ocular Stevens-Johnson syndrome. Ocul Surf 2024; 34:9-21. [PMID: 38703818 DOI: 10.1016/j.jtos.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 04/14/2024] [Accepted: 04/17/2024] [Indexed: 05/06/2024]
Abstract
PURPOSE Stevens-Johnson syndrome (SJS) is characterised as an immuno-inflammatory condition with potentially blinding ocular sequelae. Therefore, we have investigated the ocular surface immune cell profile and correlated it with secreted tear molecular factors and clinical ocular sequelae in SJS patients. METHODS 21 patients (42 eyes) with chronic ocular SJS and 16 healthy controls (20 eyes) were included in the study. Severity, types of keratopathies and ocular surface (OS) manifestations were determined. OS wash samples from study subjects were used to determine the status of 13 immune cell subsets using flow cytometry. Levels of 42 secreted immuno-inflammatory factors were measured by flow cytometry-based multiplex ELISA in tear samples. RESULTS Neutrophils (Total, activated), neutrophils/NK cells ratio, neutrophils/T cells ratio were significantly (p < 0.05) elevated in SJS, while, proportions of T cells and NKT cells were significantly lower in SJS patients. Positive association between neutrophils and chronic ocular surface complication score (COCS) was observed, whereas, a negative association was noted between NK cells and COCS. Tear fluid levels of IL-6, IL-8, IL-18, IFNα/β/γ, TNFα, LIF, IL-8, HGF, sTNFR-I, NGAL, Granzyme, Perforins, MMP9/TIMP1 ratio were significantly higher in SJS. Loss of Limbal niche correlated significantly with immune profile and clinical sequelae. Increased neutrophils, decreased NK cells and specific set of altered secreted immuno-inflammatory mediators including bFGF, and IL-8 were observed in SJS patients with different types of keratopathies compared to those without keratopathy. CONCLUSION Distinct ocular surface immune profile variations were observed to correlate with clinical stages of chronic ocular SJS. Our findings uncover novel mechanisms and potential for targeted therapy in chronic ocular SJS patients.
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Affiliation(s)
- Sharon D'Souza
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Archana Padmanabhan Nair
- GROW Research Laboratory, Narayana Netralaya Foundation, Bangalore, India; Manipal Academy of Higher Education, Manipal, India
| | - Nikhil Ashok
- GROW Research Laboratory, Narayana Netralaya Foundation, Bangalore, India
| | - Ramaraj Kannan
- GROW Research Laboratory, Narayana Netralaya Foundation, Bangalore, India
| | - Mor M Dickman
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, the Netherlands
| | - Rudy M M A Nuijts
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Rohit Shetty
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Swaminathan Sethu
- GROW Research Laboratory, Narayana Netralaya Foundation, Bangalore, India.
| | - Arkasubhra Ghosh
- GROW Research Laboratory, Narayana Netralaya Foundation, Bangalore, India.
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Alhalwani AY, Jambi S, Borai A, Khan MA, Almarzouki H, Elsayid M, Aseri AF, Taher NO, Alghamdi A, Alshehri A. Assessment of the systemic immune-inflammation index in type 2 diabetic patients with and without dry eye disease: A case-control study. Health Sci Rep 2024; 7:e1954. [PMID: 38698793 PMCID: PMC11063262 DOI: 10.1002/hsr2.1954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 05/05/2024] Open
Abstract
Background The inflammation plays a role in the pathophysiology of type-2 diabetes progression, and the mechanism remains unclear. The systemic immune-inflammation index (SII) is a novel inflammatory marker for type 2 diabetes patients and integrates multiple indicators in complete blood counts and routine blood tests. Aim Since there is no international diagnostic standard for dry eye disease (DED), this study uses low-cost inflammatory blood biomarkers to investigate the correlation between SII and DM2-DED and determine the diagnosis indices of other biomarkers in DM2-DED. Methodology A case-control retrospective analysis of totel patients n = 293 randomly selected and categorized into four groups: DED, DM2, DM2-DED, and healthy subjects. Demographic and blood biomarker variables were classified as categorical and continuous variables. The platelet-to-lymphocyte ratio (PLR), lymphocytes-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio (NLR), and SII were calculated platelet count multiply by NLR and analyzed for their correlation for all groups. Results Focusing on DM2-DED patients was more common in females, 59.6%, than in males, 40.2%. The mean ages were 60.7 ± 11.85 years, a statistically significant difference with all groups. In the study group DM2-DED, there was an increase in all blood markers compared to all remaining groups except PLR. Only neutrophil, hemoglobin A1c (HbA1c), and fasting blood sugar levels were statistically significant differences in DM2-DED patients (p > 0.001, p < 0.001, and p < 0.001, respectively) compared to all groups. There was a positive correlation between HbA1c and PLR, HbA1c and NLR, and HbA1c and SII (r = 0.037, p = 0.705; r = 0.031, p = 0.754; and r = 0.066, p < 0.501, respectively) in the DM2-DED group. Conclusion This study demonstrated that elevated SII values were linked to elevated HbA1c in DM2-DED patients. The potential of SII and HbA1c as early diagnostic indicators for ocular problems associated with diabetes mellitus is highlighted by their favorable connection in diagnosing DM2-DED.
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Affiliation(s)
- Amani Y. Alhalwani
- College of Science and Health ProfessionsKing Saud bin Abdulaziz University for Health SciencesJeddahSaudi Arabia
- Department of Biomedical ResearchKing Abdullah International Medical Research CenterJeddahSaudi Arabia
| | - Shatha Jambi
- College of Science and Health ProfessionsKing Saud bin Abdulaziz University for Health SciencesJeddahSaudi Arabia
- Department of Biomedical ResearchKing Abdullah International Medical Research CenterJeddahSaudi Arabia
| | - Anwar Borai
- College of Science and Health ProfessionsKing Saud bin Abdulaziz University for Health SciencesJeddahSaudi Arabia
- Department of Biomedical ResearchKing Abdullah International Medical Research CenterJeddahSaudi Arabia
- King Abdulaziz Medical CityJeddahSaudi Arabia
| | - Muhammad Anwar Khan
- College of Science and Health ProfessionsKing Saud bin Abdulaziz University for Health SciencesJeddahSaudi Arabia
- Department of Biomedical ResearchKing Abdullah International Medical Research CenterJeddahSaudi Arabia
| | - Hashem Almarzouki
- College of Science and Health ProfessionsKing Saud bin Abdulaziz University for Health SciencesJeddahSaudi Arabia
- Department of Biomedical ResearchKing Abdullah International Medical Research CenterJeddahSaudi Arabia
- King Abdulaziz Medical CityJeddahSaudi Arabia
| | - Mohieldin Elsayid
- College of Science and Health ProfessionsKing Saud bin Abdulaziz University for Health SciencesJeddahSaudi Arabia
- Department of Biomedical ResearchKing Abdullah International Medical Research CenterJeddahSaudi Arabia
| | | | - Nada O. Taher
- College of Science and Health ProfessionsKing Saud bin Abdulaziz University for Health SciencesJeddahSaudi Arabia
| | - Ali Alghamdi
- Faculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia
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Alhalwani AY, Abudawood K, Qadizadah ABEA, Jambi S, Sannan NS. Immunoglobulin A levels and its correlation with neutrophil-to-lymphocyte ratio as inflammatory biomarkers for dry eye disease in type 2 diabetes: a retrospective study. Front Immunol 2023; 14:1184862. [PMID: 37520541 PMCID: PMC10375287 DOI: 10.3389/fimmu.2023.1184862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Background The neutrophil-to-lymphocyte ratio (NLR) and immunoglobulin A (IgA) level are commonly used as biomarkers for inflammation. Patients with type 2 diabetes (T2D) may experience an imbalance of tear film and inflammation, which can result in dry eye disease (DED). This study aimed to assess the levels of IgA and explore its correlation with the NLR as potential inflammatory biomarkers for dry eye disease in patients with T2D. Methods A retrospective study was conducted at the cornea clinic and diabetes centre of King Abdulaziz Medical City (Jeddah, Saudi Arabia). The study included patients with DED and the number of available T2D-DED patients determined the sample size. Neutrophil, lymphocyte, IgA and CRP (C-reactive protein) laboratory values were obtained from medical records and correlational analyses were performed. Results The study included 85 patients with an average age of 54 ± 14.4 years for the DED group (n=32) and 62 ± 13.9 years for the T2D-DED group (n=53). The age difference between the two groups was statistically significant (p 0.0001). The NLR values of the T2D-DED and DED groups were 3.203 ± 0.66 and 2.406 ± 0.46, respectively, with no significant difference (p<0.285). Similarly, there were no significant differences in neutrophil and lymphocyte values between the two groups. The IgA levels showed no significant variation between T2D-DED and DED groups (p<0.364). Spearman's correlation analysis in the DED group showed a significant negative correlation between IgA and lymphocyte (p=0.011; r= - 0.471) values and significant positive correlations between IgA and neutrophil (p=0.014; r=0.309) and NLR (p=0.052; r= - 0.283) values. In the T2D-DED group, a significant correlation was found between IgA and CRP values (p=0.032; r=0.33). Conclusion Although diabetic patients may exhibit higher levels of NLR and IgA that correlate with disease severity, our study did not find significant differences in NLR and IgA values between the two groups. These findings may guide future research and enhance understanding of the disease's underlying mechanisms.
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Affiliation(s)
- Amani Y. Alhalwani
- College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Department of Biomedical Research, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
| | - Khulud Abudawood
- Department of Biomedical Research, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- College of Nursing, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | | | - Shatha Jambi
- Department of Biomedical Research, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Naif S. Sannan
- Department of Biomedical Research, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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Nguyen L, Magno MS, Utheim TP, Hammond CJ, Vehof J. The relationship between sedentary behavior and dry eye disease. Ocul Surf 2023; 28:11-17. [PMID: 36621639 DOI: 10.1016/j.jtos.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 12/30/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023]
Abstract
PURPOSE Sedentary behavior (SB) has been linked with low-grade systemic inflammation, which could play a role in the development of dry eye disease (DED). This cross-sectional study aims to investigate the association between SB and DED. METHODS We assessed 48,418 participants from the population-based Lifelines cohort (58% female, 18-96 years). Women's Health Study (WHS)-defined DED was the primary outcome. SB was assessed using the Marshall Sitting Questionnaire. The relationship between DED and SB was analyzed using logistic regressions, corrected for age, sex, BMI, smoking status, demographics, and 48 comorbidities. Any potential modifying effect of physical activity (PA) was also assessed, and the analyses were repeated excluding the most computer-intensive domains, investigating SB independent from screen exposure. RESULTS WHS-defined DED was present in 9.1% of participants. Greater SB was associated with an increased risk of DED (odds ratio (OR) 1.015 per hour/day, 95%CI 1.005-1.024, P = 0.004). The association between SB and DED was only significant for those with less than WHO-recommended PA (OR 1.022, 95%CI 1.002-1.042, P = 0.027), and not in participants meeting WHO's recommendation (OR 1.011, 95%CI 0.999-1.023, P = 0.076). Lastly, when excluding computer-related sitting, the relationship between SB and DED was attenuated, and no longer significant (OR 1.009, 95%CI 0.996-1.023, P = 0.19). CONCLUSIONS Greater sedentary time was tied to an increased risk of DED, especially for those with lower PA levels than WHO recommendations. However, as there was no significant association when computer-intensive sitting time was excluded, screen use could explain the observed relationship and should be noted as a possible key confounder.
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Affiliation(s)
- Long Nguyen
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
| | - Morten Schjerven Magno
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Tor P Utheim
- Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, Vestfold Hospital Trust, Tønsberg, Norway
| | - Christopher J Hammond
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Department of Twin Research & Genetic Epidemiology, King's College London, St Thomas' Hospital, London, United Kingdom; Department of Ophthalmology, King's College London, St Thomas' Hospital, London, London, United Kingdom
| | - Jelle Vehof
- Dutch Dry Eye Clinic, Velp, the Netherlands; Departments of Ophthalmology and Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Postbus 30.001, Groningen, the Netherlands; Department of Ophthalmology, Vestfold Hospital Trust, Tønsberg, Norway.
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Shirvani M, Soufi F, Nouralishahi A, Vakili K, Salimi A, Lucke-Wold B, Mousavi F, Mohammadzadehsaliani S, Khanzadeh S. The Diagnostic Value of Neutrophil to Lymphocyte Ratio as an Effective Biomarker for Eye Disorders: A Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5744008. [PMID: 36281463 PMCID: PMC9587911 DOI: 10.1155/2022/5744008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 11/28/2022]
Abstract
The neutrophil to lymphocyte ratio (NLR) reflects a dynamic relationship between the innate (neutrophils) and adaptive (lymphocytes) cellular immune response. This systematic review and meta-analysis was conducted to critically evaluate the literature regarding the use of the NLR as a reliable means to detect several ocular disorders. Our study was registered with the PROSPERO (ID: CRD42022314850). Three databases, including PubMed, Embase, Scopus, and the Web of Science, were searched on September 9, 2022, with no restrictions on the article's language. Finally, 32 articles were recognized as eligible for our meta-analysis. We found that patients with eye diseases had significantly elevated levels of NLR in comparison to healthy controls (SMD =0.53, 95% CI =0.35-0.71, P < 0.001). In subgroup analysis, patients with keratoconus (SMD =0.69; 95% CI =0.33-1.05, P < 0.001), glaucoma (SMD =0.56, 95% CI =0.25-0.87, P < 0.001), pterygium (SMD =0.14; 95% CI =0.01-0.26, P < 0.001), and idiopathic epiretinal membrane (SMD =0.14; 95% CI =0.01-0.26, P < 0.001) had higher levels of NLR compared to healthy controls. However, NLR levels of patients with dry eye disease were similar to healthy controls (SMD =0.32, 95% CI = -0.49-1.13, P = 0.435). It can be said that NLR is a valuable marker of systemic inflammation, which is significantly increased in many eye disorders, suggesting that inflammation plays a key role in the pathophysiology of these diseases.
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Affiliation(s)
- Mohammad Shirvani
- Geriatric Ophthalmology Research Center, Shahid Sadoughi University of Medical Science, Yazd, Iran
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farhad Soufi
- Islamic Azad University, Tehran Medical Branch, Tehran, Iran
| | - Alireza Nouralishahi
- Isfahan Eye Research Center, Feiz Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kimia Vakili
- Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirhosseinn Salimi
- Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Farideh Mousavi
- Nikukari Hospital, Tabriz University of Medical Science, Tabriz, Iran
| | | | - Shokoufeh Khanzadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
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9
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Kim KW, Hwang JS, Chang J, Shin YJ. Association of Dry Eye Diseases and Auditory Sensitivity. J Clin Med 2022; 11:jcm11144171. [PMID: 35887934 PMCID: PMC9318287 DOI: 10.3390/jcm11144171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/28/2022] [Accepted: 07/16/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to evaluate the association between dry eye and inner ear diseases in a Korean population. Methods: Data from the Korean National Health and Nutrition Survey (KNHANES V, 2010−2012), a national cross-sectional health examination and survey, were collected by the Korea Centers for Disease Control and Prevention. The association between dry eye and inner ear disease was determined using the chi-square test and logistic regression analysis. The individuals were divided into two age groups (<60 and ≥60 years). Results: In total, 17,542 individuals (n = 11,932 in the <60 years group and n = 5610 in the ≥60 years group) were enrolled. After adjusting for confounding factors, the logistic regression model revealed that the associated factors were dizziness and loss of balance experience (OR, 1.315; 95% CI, 1.143−1.513), self-awareness of abnormal voice (OR, 1.372; 95% CI, 1.120−1.679), subjective hearing discomfort (OR, 1.278; CI, 1.084−1.506), and tinnitus (OR, 1.265; 95% CI, 1.101−1.453). The inversely associated factor for dry eye was bilateral hearing loss (OR, 0.497; 95% CI, 0.367−0.672). The hearing threshold was lower in the dry eye group than in the non-dry eye group (p < 0.05). Conclusions: Tinnitus was associated with dry eye and bilateral hearing loss was inversely associated with dry eye. These results suggest that hypersensitivity of the senses and nerves, which is neuropathic hyperesthesia, is one of the main mechanisms of dry eye. Treatment of neuropathy may help in treating dry eye associated with dizziness or tinnitus.
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Affiliation(s)
- Kyung Wook Kim
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07442, Korea; (K.W.K.); (J.S.H.)
- Hallym BioEyeTech Research Center, Hallym University College of Medicine, Seoul 07442, Korea;
| | - Jin Sun Hwang
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07442, Korea; (K.W.K.); (J.S.H.)
- Hallym BioEyeTech Research Center, Hallym University College of Medicine, Seoul 07442, Korea;
| | - Jiwon Chang
- Hallym BioEyeTech Research Center, Hallym University College of Medicine, Seoul 07442, Korea;
- Department of Otorhinolaryngology, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07442, Korea
| | - Young Joo Shin
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07442, Korea; (K.W.K.); (J.S.H.)
- Hallym BioEyeTech Research Center, Hallym University College of Medicine, Seoul 07442, Korea;
- Correspondence: ; Tel.: +82-2-6960-1240
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10
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Oh HY, Lee MY, Lee YC, Shin HY. Impact of cardiovascular comorbidity on increased neutrophil-lymphocyte ratio in pseudoexfoliation syndrome. Medicine (Baltimore) 2022; 101:e29602. [PMID: 35839065 PMCID: PMC11132305 DOI: 10.1097/md.0000000000029602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 05/02/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The purpose of this study was to compare neutrophil-to-lymphocyte ratios (NLRs) of patients with pseudoexfoliation syndrome (PEX) according to the presence of cardiovascular disease (CVD) with those without CVD as controls. METHODS A total of 197 participants (97 patients with PEX and 100 participants without PEX regarded as the control group) were included in this retrospective study. The PEX group was divided into 2 subgroups, PEX with CVD (group 1) and PEX without CVD (group 2). NLRs were then compared to those of the control group. RESULTS The incidence of CVD was significantly (P = .015) higher in the PEX group than in the control group. NLR was significantly higher in the group 1 and group 2 compared with that of the control group (P = .048 and P = .002, respectively). In the PEX group, group 1 showed higher NLR than group 2 (P = .023). CONCLUSION Although the PEX group showed a higher incidence of CVD, the NLR was higher in the PEX group regardless of cardiovascular comorbidity than that in the control group.
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Affiliation(s)
- Hea Young Oh
- Department of Ophthalmology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Mee Yon Lee
- Department of Ophthalmology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young Chun Lee
- Department of Ophthalmology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hye-Young Shin
- Department of Ophthalmology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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11
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Martínez-Alberquilla I, Gasull X, Pérez-Luna P, Seco-Mera R, Ruiz-Alcocer J, Crooke A. Neutrophils and neutrophil extracellular trap components: Emerging biomarkers and therapeutic targets for age-related eye diseases. Ageing Res Rev 2022; 74:101553. [PMID: 34971794 DOI: 10.1016/j.arr.2021.101553] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/17/2021] [Accepted: 12/23/2021] [Indexed: 12/14/2022]
Abstract
Age-related eye diseases, including dry eye, glaucoma, age-related macular degeneration, and diabetic retinopathy, represent a major global health issue based on their increasing prevalence and disabling action. Unraveling the molecular mechanisms underlying these diseases will provide novel opportunities to reduce the burden of age-related eye diseases and improve eye health, contributing to sustainable development goals achievement. The impairment of neutrophil extracellular traps formation/degradation processes seems to be one of these mechanisms. These traps formed by a meshwork of DNA and neutrophil cytosolic granule proteins may exacerbate the inflammatory response promoting chronic inflammation, a pivotal cause of age-related diseases. In this review, we describe current findings that suggest the role of neutrophils and their traps in the pathogenesis of the above-mentioned age-related eye diseases. Furthermore, we discuss why these cells and their constituents could be biomarkers and therapeutic targets for dry eye, glaucoma, age-related macular degeneration, and diabetic retinopathy. We also examine the therapeutic potential of some neutrophil function modulators and provide several recommendations for future research in age-related eye diseases.
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Affiliation(s)
- Irene Martínez-Alberquilla
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain; Clinical and Experimental Eye Research Group, UCM 971009, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Xavier Gasull
- Neurophysiology Laboratory, Department of Biomedicine, Medical School, Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Patricia Pérez-Luna
- Department of Biochemistry and Molecular Biology, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Rubén Seco-Mera
- Department of Biochemistry and Molecular Biology, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Javier Ruiz-Alcocer
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain; Clinical and Experimental Eye Research Group, UCM 971009, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Almudena Crooke
- Department of Biochemistry and Molecular Biology, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain; Clinical and Experimental Eye Research Group, UCM 971009, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain.
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12
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He M, Wu T, Zhang L, Ye W, Ma J, Zhao C, Liu J, Zhou J. Correlation between neutrophil-to-lymphocyte ratio and clinical manifestations and complications of retinitis pigmentosa. Acta Ophthalmol 2022; 100:e278-e287. [PMID: 34080305 DOI: 10.1111/aos.14880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/04/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE The role of inflammation in retinitis pigmentosa (RP) has been receiving additional attention. However, the association between inflammation and the clinical manifestations and complications of RP is still unclear. This study aimed to evaluate the neutrophil-to-lymphocyte ratio (NLR) of RP complicated with cataract and explore the correlations between the NLR and specific clinical features of RP. METHODS This retrospective study included 79 RP patients complicated with cataract (125 eyes) and 63 age- and sex-matched patients (63 eyes) with age-related cataract (ARC). Patients' ocular examination results were collected and complete blood count results were used to calculate NLRs. The correlations between the NLR of RP patients and the parameters of ocular examinations were analysed. RESULTS The NLRs of RP patients with cataracts were significantly higher than those of ARC (1.93 ± 0.83 versus 1.65 ± 0.59, p = 0.029). The NLRs increased with the severity of posterior subcapsular cataract (PSC), zonular deficiency, poor preoperative best-corrected visual acuity (LogMAR>1), and visual field defects. Analysis of receiver operating characteristic curves suggested that NLR > 1.36 could predict higher degrees (PSC area >3%, >P1) of PSC (p = 0.002, 95% CI, 0.672-0.934), and that NLR > 2.12 could predict zonular weakness (p = 0.002, 95% CI, 0.665-0.928) in RP. CONCLUSION The NLRs in RP patients with cataract are not only higher but also associated with several clinical manifestations of RP. The NLR can be a predictive biomarker of higher degrees of PSC (>P1) and zonular weakness in RP before cataract surgery. These results suggest that systemic inflammation may play a role in the pathogenesis of RP.
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Affiliation(s)
- Mengmei He
- Department of Ophthalmology Xijing Hospital Eye Institute of Chinese PLA Fourth Military Medical University Xi’an China
| | - Tong Wu
- Department of Ophthalmology Xijing Hospital Eye Institute of Chinese PLA Fourth Military Medical University Xi’an China
| | - Luning Zhang
- Department of Ophthalmology Xijing Hospital Eye Institute of Chinese PLA Fourth Military Medical University Xi’an China
| | - Wei Ye
- Department of Ophthalmology Xijing Hospital Eye Institute of Chinese PLA Fourth Military Medical University Xi’an China
| | - Jiyuan Ma
- Department of Ophthalmology Xijing Hospital Eye Institute of Chinese PLA Fourth Military Medical University Xi’an China
| | - Chao Zhao
- Department of Ophthalmology Xijing Hospital Eye Institute of Chinese PLA Fourth Military Medical University Xi’an China
| | - Jiahua Liu
- Department of Ophthalmology Xijing Hospital Eye Institute of Chinese PLA Fourth Military Medical University Xi’an China
| | - Jian Zhou
- Department of Ophthalmology Xijing Hospital Eye Institute of Chinese PLA Fourth Military Medical University Xi’an China
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13
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Mohamed-Noriega K, Treviño-Herrera AB, Mohamed-Noriega J, Velasco-Sepúlveda BH, Martínez-Pacheco VA, Guevara-Villarreal DA, Rodríguez-Medellín DL, Sepúlveda-Salinas AG, Villarreal-Méndez G, González-Cortés JH, Elizondo-Omaña RE, Guzmán-López S, Mohamed-Hamsho J. Relationship of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratio With Visual Acuity After Surgical Repair of Open Globe Injury. Front Med (Lausanne) 2021; 8:697585. [PMID: 34881251 PMCID: PMC8645644 DOI: 10.3389/fmed.2021.697585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose: To assess the relationship and prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with poor final best-corrected visual acuity (BCVA) after surgical repair of open globe injuries (OGI) in adults. Design: Retrospective analysis of data from an ongoing prospective cohort of consecutive patients. Methods: In a tertiary university hospital, 197 eyes of 197 patients were included between 2013 and 2017. NLR and PLR were obtained from pre-operative blood tests to analyze its relationship with poor final BCVA. Results: Severe visual impairment (SVI) was defined as ≤20/200, and was observed in 96 (48.7%) patients after surgical repair of OGI. SVI patients had higher NLR (7.4 ± 6.6 vs. 4.0 ± 3.2, p < 0.001), and PLR (167 ± 92 vs. 139 ± 64; p = 0.021) than non-SVI. NLR ≥ 3.47 and PLR ≥ 112.2 were the best cut-off values for SVI, were univariate risk factors for SVI, and had sensitivity: 69.0, 71.4, and specificity: 63.6, 44.8, respectively. In multivariate analysis, only OTS, athalamia, and hyphema remained as risk factors. NLR had significant correlation with ocular trauma score (OTS) (r = −0.389, p < 0.001) and final BCVA (r = 0.345, p < 0.001). Limitations: Simultaneous trauma in other parts of the body that could influence the laboratory findings. Conclusion: Patients with SVI after a repaired OGI had increased pre-operative NLR and PLR levels. High NLR and PLR are risk factors for SVI in univariate analysis. It is confirmed that low OTS is a risk factor for SVI. High NLR and PLR could be used as a prognostic tool to identify patients at higher risk for SVI after repair of OGI.
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Affiliation(s)
- Karim Mohamed-Noriega
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Alan B Treviño-Herrera
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Jibran Mohamed-Noriega
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Braulio H Velasco-Sepúlveda
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Víctor A Martínez-Pacheco
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Dante A Guevara-Villarreal
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Delia L Rodríguez-Medellín
- Department of Human Anatomy, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Anna G Sepúlveda-Salinas
- Department of Human Anatomy, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Gerardo Villarreal-Méndez
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Jesús H González-Cortés
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Rodrigo E Elizondo-Omaña
- Department of Human Anatomy, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Santos Guzmán-López
- Department of Human Anatomy, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Jesús Mohamed-Hamsho
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
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14
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Elbeyli A, Kurtul BE, Ozcan SC, Ozarslan Ozcan D. The diagnostic value of systemic immune-inflammation index in diabetic macular oedema. Clin Exp Optom 2021; 105:831-835. [PMID: 34763621 DOI: 10.1080/08164622.2021.1994337] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
CLINICAL RELEVANCE Diabetic macular oedema (DME) is a significant cause of visual impairment and inflammation plays an important role in its pathophysiology. BACKGROUND This study evaluates the diagnostic value of systemic immune-inflammation index (SII) in the occurrence of DME in patients with non-proliferative diabetic retinopathy. METHODS In this prospective study, the SII was applied to 150 consecutive patients with non-proliferative diabetic retinopathy. The relationship between the SII and the occurrence of DME was examined. Patients with DME were also divided into two subgroups according to the presence of accompanying sub-retinal fluid. The SII value was calculated as follows: platelet count × (neutrophil/lymphocyte). The risk factors for DME were evaluated using multivariate logistic regression analysis. A receiver operating characteristic (ROC) curve analysis of SII for predicting DME was performed. RESULTS Patients with DME had significantly higher levels of SII than those without DME (599.7 ± 279.2 and 464. 9 ± 172.2, respectively, p < 0.001). However, The SII values were similar between sub-retinal fluid subgroups. Multivariate regression analysis indicated that SII, together with duration of diabetes, was an independent factor for DME occurrence [Odds ratio (OR) = 1.005, 95% confidence interval = 1.001-1.009, p = 0.04, and OR = 1.146, 95% CI = 1.049-1.252, p = 0.003, respectively]. ROC curve analysis revealed that the best cut-off value of SII was 399 (area under the curve: 0.633; sensitivity: 70%; specificity: 60%). CONCLUSION An elevated SII value is strongly associated with the development of DME. The SII may be a diagnostic biomarker for identifying DME to improve the risk stratification and management of non-proliferative patients with diabetic retinopathy.
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Affiliation(s)
- Ahmet Elbeyli
- Department of Ophthalmology, Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey
| | - Bengi Ece Kurtul
- Department of Ophthalmology, Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey
| | - Sait Coskun Ozcan
- Department of Ophthalmology, Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey
| | - Deniz Ozarslan Ozcan
- Department of Ophthalmology, Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey
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15
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Mun Y, Hwang JS, Shin YJ. Role of Neutrophils on the Ocular Surface. Int J Mol Sci 2021; 22:10386. [PMID: 34638724 PMCID: PMC8508808 DOI: 10.3390/ijms221910386] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/16/2021] [Accepted: 09/23/2021] [Indexed: 02/07/2023] Open
Abstract
The ocular surface is a gateway that contacts the outside and receives stimulation from the outside. The corneal innate immune system is composed of many types of cells, including epithelial cells, fibroblasts, natural killer cells, macrophages, neutrophils, dendritic cells, mast cells, basophils, eosinophils, mucin, and lysozyme. Neutrophil infiltration and degranulation occur on the ocular surface. Degranulation, neutrophil extracellular traps formation, called NETosis, and autophagy in neutrophils are involved in the pathogenesis of ocular surface diseases. It is necessary to understand the role of neutrophils on the ocular surface. Furthermore, there is a need for research on therapeutic agents targeting neutrophils and neutrophil extracellular trap formation for ocular surface diseases.
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Affiliation(s)
- Yongseok Mun
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07442, Korea; (Y.M.); (J.S.H.)
- Hallym BioEyeTech Research Center, Hallym University College of Medicine, Seoul 07442, Korea
| | - Jin Sun Hwang
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07442, Korea; (Y.M.); (J.S.H.)
- Hallym BioEyeTech Research Center, Hallym University College of Medicine, Seoul 07442, Korea
| | - Young Joo Shin
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07442, Korea; (Y.M.); (J.S.H.)
- Hallym BioEyeTech Research Center, Hallym University College of Medicine, Seoul 07442, Korea
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16
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Yıldız MB, Yıldız E. Evaluation of serum neutrophil-to-lymphocyte ratio in corneal graft rejection after low-risk penetrating keratoplasty. Int Ophthalmol 2021; 42:57-63. [PMID: 34387791 DOI: 10.1007/s10792-021-01999-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 07/31/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate systemic inflammatory parameters in patients with corneal graft rejection after low-risk penetrating keratoplasty. METHODS Patients undergoing penetrating keratoplasty with indications of keratoconus, pseudophakic bullous keratopathy, and Fuchs endothelial dystrophy were analyzed retrospectively. Patients who had an endothelial rejection attack within two years post-transplant were included in the rejection group (n = 20), whereas patients with at least two years of post-transplant follow-up without graft rejection or failure were included in the control group (n = 46). All patients' clinical features and preoperative laboratory parameters were obtained from hospital records. The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio, and platelet-to-lymphocyte ratio of the groups were calculated and compared. RESULTS There was no difference between the two groups in terms of age, sex, indication, postmortem time and storage time of grafts, graft diameter, follow-up time, and common systemic diseases (p > 0.05). The NLR was found to be significantly lower in the rejection group when compared with the control group (2.04 ± 1.17, 2.66 ± 0.91, respectively, p = 0.023). There was no significant difference between the groups in terms of MLR and PLR (p = 0.243, p = 0.101, respectively). CONCLUSIONS Although a high NLR value, which is an indicator of systemic inflammatory condition, is associated with many ocular diseases, NLR was found to be lower in patients with a rejection episode after transplant surgery when compared with the control group. Further studies are needed to clarify the role of these hematologic parameters in graft rejection.
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Affiliation(s)
- Merve Beyza Yıldız
- Haydarpaşa Numune Training and Research Hospital, Department of Ophthalmology, University of Health Sciences, Tıbbiye Street, Nu: 23, 34668, Uskudar/Istanbul, Turkey.
| | - Elvin Yıldız
- Haydarpaşa Numune Training and Research Hospital, Department of Ophthalmology, University of Health Sciences, Tıbbiye Street, Nu: 23, 34668, Uskudar/Istanbul, Turkey
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17
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Zhang P, Xue WW, Huang XB, Xu Y, Lu LN, Zheng KR, Zou HD. Prevalence and risk factors of diabetic retinopathy in patients with type 2 diabetes in Shanghai. Int J Ophthalmol 2021; 14:1066-1072. [PMID: 34282393 DOI: 10.18240/ijo.2021.07.16] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/18/2021] [Indexed: 01/02/2023] Open
Abstract
AIM To investigate the prevalence of diabetic retinopathy (DR) in residents of Shanghai and analyze the risk factors of DR. METHODS This study involved 7233 patients with diabetes in 2016. The demographic data of the participants were collected using a questionnaire survey. Physical examination, laboratory tests, and ophthalmological examinations were conducted. Two professional ophthalmologists diagnosed and graded DR by fundus examination and then combined the results with fundus images. The unconditional multivariate Logistic regression analysis was used to determine the risk factors. RESULTS In total, 6978 patients with type 2 diabetes in Shanghai with a mean age of 68.33±8.40y were recruited, including 2975 males (42.6%) and 4003 females (57.4%). Overall, 1184 patients were diagnosed with DR, with a prevalence rate of 16.97%. Regression analysis showed that duration of diabetes (OR 1.061, 95%CI 1.049-1.073), high systolic blood pressure (SBP; OR 1.071, 95%CI 1.037-1.106), increased glycosylated hemoglobin level (OR 1.234, 95%CI 1.162-1.311), high blood glucose level (OR 1.061, 95%CI 1.023-1.099), increased neutrophil-to-lymphocyte ratio (NLR; OR 1.132, 95%CI 1.053-1.217) and mean platelet volume (MPV; OR 1.077, 95%CI 1.016-1.142) were risk factors of DR. Conversely, hematocrit (HCT; OR 0.971, 95%CI 0.954-0.988) and mean corpuscular volume (MCV; OR 0.980, 95%CI 0.965-0.994) were protective factors. CONCLUSION The prevalence rate of DR in Shanghai is 16.97%. The duration of diabetes, high SBP, increased glycosylated hemoglobin, NLR, and MPV were determined as risk factors of DR.
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Affiliation(s)
- Pei Zhang
- Department of Ophthalmology, Shanghai Gonghui Hospital, Shanghai 200041, China
| | - Wen-Wen Xue
- Department of Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai 200040, China
| | - Xiao-Bo Huang
- Department of Ophthalmology, the Second Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu Province, China
| | - Yi Xu
- Department of Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai 200040, China
| | - Li-Na Lu
- Department of Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai 200040, China
| | - Kai-Rong Zheng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Hai-Dong Zou
- Department of Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai 200040, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
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18
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Eroglu FC, Gediz BS, Ozturk M, Kazancı B. Association Between Dry Eye Disease and Newly Diagnosed Obsessive-Compulsive Disorder. Cornea 2021; 40:817-821. [PMID: 33859092 DOI: 10.1097/ico.0000000000002724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/08/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the association between dry eye disease and patients with newly diagnosed obsessive-compulsive disorder (OCD). METHODS Thirty treatment-naive patients with OCD and 30 healthy controls were included in this prospective study. The Ocular Surface Disease Index, tear breakup time, Schirmer I test, corneal and conjunctival staining grade (Oxford scale), and neutrophil-to-leucocyte ratio values were obtained for all participants. RESULTS The comparison of the patients with OCD and healthy controls showed significantly higher values in Ocular Surface Disease Index (34.8 vs. 20.8, P = 0.001), corneal Oxford scoring (0.9 vs. 0.6, P = 0.02), and conjunctival Oxford scoring (0.8 vs. 0.5, P = 0.04), with consistently lower values in the Schirmer I test (15.7 vs. 18.8, P = 0.043) and tear breakup time (9.1 vs. 12.9, P = 0.001). The mean neutrophil-to-leucocyte ratio values were significantly higher in the OCD group compared with the controls (2.4 ± 0.9 vs. 1.6 ± 0.4, respectively; P = 0.001). CONCLUSIONS Our study showed a relation between dry eye disease and patients with newly diagnosed OCD who were not using any psychiatric drug. Our findings suggest that inflammation, which plays an important role in the pathogenesis of both diseases, may be responsible for this relationship.
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Affiliation(s)
- Fatma Corak Eroglu
- Department of Ophthalmology, University of Health Science, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey; and
| | - Berrak Sekeryapan Gediz
- Department of Ophthalmology, University of Health Science, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey; and
| | - Mehmet Ozturk
- Department of Psychiatry, University of Health Science, Ankara Training and Research Hospital, Ankara, Turkey
| | - Burcu Kazancı
- Department of Ophthalmology, University of Health Science, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey; and
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Nair AP, D'Souza S, Shetty R, Ahuja P, Kundu G, Khamar P, Dadachanji Z, Paritekar P, Patel P, Dickman MM, Nuijts RM, Mohan RR, Ghosh A, Sethu S. Altered ocular surface immune cell profile in patients with dry eye disease. Ocul Surf 2021; 21:96-106. [PMID: 33862224 DOI: 10.1016/j.jtos.2021.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/06/2021] [Accepted: 04/06/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE Aberrant inflammation and immune dysregulation are known pathogenic contributors in dry eye disease (DED). Aim of the study was to determine the proportions of immune cell subsets on the ocular surface (OS) of DED patients. METHODS 15 healthy controls (22 eyes) and 48 DED subjects (36 eyes with evaporative DED - EDED; 60 eyes with aqueous deficient DED - ADED) were included in the study. Tear break up time (TBUT), Schirmer's test 1 (ST1), corneal staining (CS) and ocular surface disease index (OSDI) scoring were recorded. OS wash was used to collect immune cells on the OS of study subjects. The cells immunophenotyped using flow cytometry include leukocytes, neutrophils, macrophages, natural killer-NK cells and T cell subsets (CD4; CD8; double positive-DP; gamma delta-γδ and NK T cells). RESULTS Significantly higher proportions of leukocytes, neutrophils, CD4 T cells, CD8 T cells, DP T cells and CD4/CD8 T cells ratio were observed in EDED and/or ADED patients. Significantly higher proportions of neutrophils and lower proportions of NK cells were observed in ADED subjects with corneal staining compared to those without and controls. Neutrophils/NK cells ratio was significantly higher in EDED and ADED subjects compared to controls. Correlation analysis revealed pathological relationships between proportions of leukocytes, neutrophils, CD4 T cells and Neutrophil/NK cells ratio with DED clinical parameters. CONCLUSION OS immune cell subset proportion changes in DED patients were associated with DED types and severity. The data suggests the potential for a new generation of therapies targeting immune cells on the ocular surface.
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Affiliation(s)
- Archana Padmanabhan Nair
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India; Manipal Academy of Higher Education, Manipal, India
| | - Sharon D'Souza
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Rohit Shetty
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Prerna Ahuja
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Gairik Kundu
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Pooja Khamar
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Zelda Dadachanji
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Prajakta Paritekar
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Pavitra Patel
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Mor M Dickman
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, the Netherlands
| | - Rudy Mma Nuijts
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Rajiv R Mohan
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, MO, USA; Mason Eye Institute, School of Medicine, University of Missouri, Columbia, MO, USA; Harry S Truman Veterans' Memorial Hospital, Columbia, MO, USA.
| | - Arkasubhra Ghosh
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India; Singapore Eye Research Institute, Singapore.
| | - Swaminathan Sethu
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India.
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Meng YF, Pu Q, Ma Q, Zhu W, Li XY. Neutrophil/Lymphocyte Ratio as an Inflammatory Predictor of Dry Eye Disease: A Case-Control Study. Ther Clin Risk Manag 2021; 17:259-266. [PMID: 33790566 PMCID: PMC8001663 DOI: 10.2147/tcrm.s298156] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/05/2021] [Indexed: 12/14/2022] Open
Abstract
Background The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been used as indicators of inflammation, however, their roles in dry eye disease (DED) patients require advanced study. Materials and Methods A total of 104 DED cases and 97 healthy controls from January 2020 to May 2020 were enrolled in this study. The dry eye related clinical variables, including Schirmer I test, tear break-up time (TBUT), corneal fluorescein staining (CFS) and Ocular Surface Disease Index (OSDI), were detected in all the participants. Besides, the NLR and PLR pattern in DED cases were detected and their potential value as inflammatory predictors of DED were evaluated. In advanced analyses, the correlation between NLR and DED severity was examined. Results The NLR and PLR were 2.59 ± 1.25 and 117.48 ± 54.68 in the DED group, respectively, while they were 2.20 ± 1.24 and 115.48 ± 54.33 in the control group, respectively. The NLR was higher in the DED group (p = 0.027), however, PLR was not significantly different compared with the control group (p = 0.951). In advanced analyses, it was found that more severe TBUT, CFS, and OSDI scores were detected in the high NLR group (NLR ≥2.145, p = 0.003, 0.013, and 0.017, respectively) compared with the low NLR group (NLR <2.145). Conclusion The NLR value, but not PLR, of DED patients was higher than that of healthy controls. The NLR could be used as an inflammatory predictor to estimate the severity of DED.
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Affiliation(s)
- Yi-Fang Meng
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.,Department of Ophthalmology, Changshu No. 2 People's Hospital, Changshu, Jiangsu, People's Republic of China
| | - Qi Pu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Qian Ma
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Wei Zhu
- Department of Ophthalmology, Changshu No. 2 People's Hospital, Changshu, Jiangsu, People's Republic of China
| | - Xin-Yu Li
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
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Yıldız F, Gökmen O. Haematologic indices and disease activity index in primary Sjogren's syndrome. Int J Clin Pract 2021; 75:e13992. [PMID: 33405348 DOI: 10.1111/ijcp.13992] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/03/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The present study was conducted to investigate the association between haematologic indices, neutrophil/lymphocyte ratio (NLR), mean platelet volume (MPV), platelet/lymphocyte ratio (PLR), disease activation, organ involvement, and inflammatory markers in the SS. METHODS The study was conducted with newly diagnosed and treatment-naive 41 primary SS patients who met ACR-2012 criteria and 96 healthy volunteers. Blood tests obtained before treatment were evaluated. Lymphocyte, neutrophil and platelet counts, mean corpuscular volume (MCV), platelet distribution width (PDW), plateletcrit (PCT), haematocrit (HCT), MPV, white blood cell count (WBC) values were harvested from CBC of the subjects and NLR, PLR were calculated over these values. The values were compared between groups and correlation with EULAR SS disease activity index (ESSDAI) was evaluated. RESULTS The study included a total of 41 patients with a mean age of 40.73 ± 12.0 years and 96 healthy subjects with a mean age of 40.0 ± 9.2 years. In inter-group comparisons, lymphocyte, platelet counts, and MPV values were significantly lower in the SS group compared with the control group (P < .01), and NLR was significantly higher in the SS group (P = .026). The mean ESSDAI scores in SS patients were 5.65 ± 0.86 SE. These scores were significantly higher in patients with neurological involvement. There was a positive correlation between ESSDAI and PLR. CONCLUSION NLR, PLR, and MPV may be used as indicators or with activity index in SS. ESSDAI scores were found to be high in patients with neurological involvement, and it was also found to be correlated with PLR.
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Affiliation(s)
- Fatih Yıldız
- Department of Rheumatology, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Onur Gökmen
- Department of Ophthalmology, Health Sciences University, Van Training and Research Hospital, Van, Turkey
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Ozarslan Ozcan D, Kurtul BE, Ozcan SC, Elbeyli A. Increased Systemic Immune-Inflammation Index Levels in Patients with Dry Eye Disease. Ocul Immunol Inflamm 2020; 30:588-592. [PMID: 32990489 DOI: 10.1080/09273948.2020.1821899] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE To evaluate the systemic immune-inflammation index (SII) levels, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in patients with dry eye disease (DED) and to compare with control subjects. METHODS This prospective study included 47 DED patients and 47 age- and sex-matched healthy controls. Ophthalmological examination, diagnostic DED tests, and routine complete blood cell count parameters were analyzed. The SII value was calculated as follows: platelet count × (neutrophil/lymphocyte). RESULTS The mean SII, NLR, and PLR levels were significantly higher in DED patients compared to controls (p < .001, p < .001 and p = .009, respectively). Using the receiver operating characteristics (ROC) curve analysis to predict patients with DED, the highest area under the curve (AUC) was determined SII (0.761 for SII, 0.727 for NLR, and 0.653 for PLR). CONCLUSIONS As a novel tool superior to other inflammatory markers, SII may be a cheap and reliable indicator of inflammatory status in DED patients.
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Affiliation(s)
- Deniz Ozarslan Ozcan
- The Department of Ophthalmology, Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey
| | - Bengi Ece Kurtul
- The Department of Ophthalmology, Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey
| | - Sait Coskun Ozcan
- The Department of Ophthalmology, Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey
| | - Ahmet Elbeyli
- The Department of Ophthalmology, Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey
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Bozkurt E, Muhafiz E, Sengul D, Uçak T, Atum M. Can the CRP/albumin Ratio be Used as a New Indicator of Activation in Patients with Uveitis? Ocul Immunol Inflamm 2020; 29:1017-1022. [PMID: 32125910 DOI: 10.1080/09273948.2020.1714061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Purpose: To evaluate whether the C-reactive protein (CRP)/albumin ratio (CAR) in patients with uveitis during an attack is a marker that can give information about the activity, severity and prognosis of the disease.Methods: This study included 35 patients with an uveitis attack and 35 healthy volunteers. The localization and severity of uveitis were recorded. Patients' complete blood count (CBC) during the attack, CRP, CAR, erythrocyte sedimentation rate(ESR), neutrophil/lymphocyte ratio(NLR), and platelet/lymphocyte ratio(PLR) were recorded.Results: The mean age was 34.1 ± 12.5 years for the 35 uveitis cases and 30.1 ± 4.1 years for the healthy volunteers. CRP and CAR were significantly higher in uveitis patients (p = .015 and 0.011, respectively). While CRP and CAR were significantly higher in severe anterior uveitis than mild anterior uveitis (p = .036 and 0.022, respectively), only CAR was significantly higher in severe posterior and panuveitis than mild ones(p = .017).Conclusion: CAR may be an important parameter in determining the activation of the uveitis.
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Affiliation(s)
- Erdinç Bozkurt
- Faculty of Medicine, Department of Ophthalmology, Kafkas University, Kars, Türkiye
| | - Ersin Muhafiz
- Faculty of Medicine, Department of Ophthalmology, Kafkas University, Kars, Türkiye
| | - Dilek Sengul
- Faculty of Medicine, Department of Ophthalmology, Kafkas University, Kars, Türkiye
| | - Turgay Uçak
- Department of Ophthalmology, Mengücek Training and Research Hospital, Erzincan, Türkiye
| | - Mahmut Atum
- Department of Ophthalmology, Sakarya Training and Research Hospital, Sakarya, Türkiye
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Evaluation of Neutrophil-Lymphocyte Ratios, Mean Platelet Volumes, and Platelet-Lymphocyte Ratios in Pterygium. BEYOGLU EYE JOURNAL 2019; 4:163-167. [PMID: 35187453 PMCID: PMC8842070 DOI: 10.14744/bej.2019.30164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 09/15/2019] [Indexed: 11/29/2022]
Abstract
Objectives: To assess the neutrophil-to-lymphocyte ratio (NLR), mean platelet volumes (MPV), platelet–lymphocyte ratios (PLR) and other complete blood count parameters (CBC) as indicators of inflammation in patients with pterygium. Methods: This study was carried out retrospectively in 111 consecutive pterygium patients and 106 control subjects. Laboratory and clinical parameters were obtained from the patient data management system. NLR and PLR were calculated by dividing neutrophil and platelet count by lymphocyte count. Results: A significant difference was found in NLR and lymphocyte values between the pterygium and control groups (p<0.05). However, there was no significant difference found in MPV, PLR and other parameters between groups (p>0.05). Conclusion: NLR may have an association with pterygium, which should be investigated at larger subgroups in further studies.
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Kurtul BE, Ozer PA. Neutrophil-to-lymphocyte ratio in ocular diseases: a systematic review. Int J Ophthalmol 2019; 12:1951-1958. [PMID: 31850181 DOI: 10.18240/ijo.2019.12.18] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 05/18/2019] [Indexed: 12/30/2022] Open
Abstract
AIM To summarize the results of studies investigating neutrophil-to-lymphocyte ratio (NLR) and to identify the role of NLR in ocular diseases. METHODS With the aim of identifying the studies related to NLR, a search was conducted on http://www.ncbi.nlm.nih.gov/pubmed by utilizing the key words "neutrophil lymphocyte ratio, ocular diseases, and eye diseases" up to February 2018. All of the original articles were assessed according to date of publications, countries, clinics and topics. Studies about ocular inflammatory diseases were evaluated according to their qualifications, review methods and results. RESULTS A total of 4473 publications, including original research articles and reviews were screened. The number of publications was shown a regular logarithmic increase over the years. The majority of studies were performed by clinics in Turkey and many of these publications were performed by oncology and cardiology clinics. A total of 75 publications were identified to be about ocular diseases. CONCLUSION Elevated NLR as a cheap, reproducible, and readily available marker could be used as a diagnostic and/or prognostic marker in ocular diseases.
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Affiliation(s)
- Bengi Ece Kurtul
- Department of Ophthalmology, Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay 31040, Turkey
| | - Pinar Altiaylik Ozer
- Department of Ophthalmology, Ufuk University Faculty of Medicine, Ankara 06830, Turkey
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Kurtul BE, Kabatas EU, Ozates S. The correlation of routine hematological indices with pterygium. Ther Adv Ophthalmol 2019; 11:2515841419848922. [PMID: 31317124 PMCID: PMC6620725 DOI: 10.1177/2515841419848922] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 04/15/2019] [Indexed: 01/05/2023] Open
Abstract
Purpose: Increased systemic/local inflammation and oxidative stress play a key role in the pathophysiology of pterygium, but there is limited information regarding routine hematological indices’ levels in patients with pterygium. In this study, we aimed to evaluate the levels of complete blood count parameters in patients with pterygium. Material and Method: In all, 61 patients with pterygium (pterygium group; mean age = 51.4 ± 13.8 years) and 55 healthy individuals (control group; mean age = 50.2 ± 13.1 years) were included in the study. Participants were given routine ophthalmic examinations; complete blood count parameters were assayed. Results: Compared to the control group, red cell distribution width level was significantly higher in patients with pterygium (p = 0.009), but the difference between the groups in terms of the other complete blood count parameters was not statistically significant. However, high-density lipoprotein cholesterol level was significantly lower in the pterygium group than control group (p = 0.015). In the pterygium group, low-density lipoprotein cholesterol levels were lower, but this difference was not statistically significant (p = 0.079). Conclusion: Red cell distribution width levels were significantly increased in patients with pterygium. Our data support the idea that inflammation cytokines and oxidative stress may play an important role in the pathogenesis of this disorder.
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Affiliation(s)
- Bengi Ece Kurtul
- Ophthalmology Department, Tayfur Ata Sökmen Medicine of Faculty, Hatay Mustafa Kemal University, 31001 Hatay, Turkey
| | - Emrah Utku Kabatas
- Department of Ophthalmology, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Serdar Ozates
- Department of Ophthalmology, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
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Icel E, Ucak T, Karakurt Y, Yilmaz H, Tasli NG, Turk A. The Relation of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio with High Axial Myopia. Ocul Immunol Inflamm 2019; 28:396-401. [PMID: 30994377 DOI: 10.1080/09273948.2019.1588334] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Purpose: To investigate the relation between high axial myopia and neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) values.Methods: Seventy-nine cases were enrolled, 50 myopic and 29 emmetropic. All participants were assigned into three groups: Group I (high myopia with no retinal involvement), Group II (high myopia with retinal involvement) and Group III (control). NLR and PLR values calculated from blood tests were compared among the groups.Results: Mean NLR levels were 2.23 ± 0.78 in Group I, 2.36 ± 1.06 in Group II, and 1.57 ± 0.33 in Group III. Mean PLR levels were 114.62 ± 23.21 in Group I, 145.16 ± 52.36 in Group II, and 91.42 ± 18.73 in Group III. NLR and PLR values in the high myopia groups were significantly higher than in the control group.Conclusion: NLR and PLR values in cases with high axial myopia were higher than in the emmetropic group. Higher inflammation in the degenerative myopic group in particular may be related to pathological chorioretinal changes.
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Affiliation(s)
- Erel Icel
- Faculty of Medicine, Department of Ophthalmology, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Turgay Ucak
- Faculty of Medicine, Department of Ophthalmology, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Yücel Karakurt
- Faculty of Medicine, Department of Ophthalmology, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Hayati Yilmaz
- Faculty of Medicine, Department of Ophthalmology, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Nurdan Gamze Tasli
- Faculty of Medicine, Department of Ophthalmology, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Adem Turk
- Faculty of Medicine, Department of Ophthalmology, Karadeniz Technical University, Trabzon, Turkey
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Postnikoff CK, Huisingh C, McGwin G, Nichols KK. Leukocyte Distribution in the Open Eye Tears of Normal and Dry Eye Subjects. Curr Eye Res 2018; 43:1253-1259. [PMID: 30005585 DOI: 10.1080/02713683.2018.1500611] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
PURPOSE Leukocytes accumulate in the eye with sleep, but little is known about the presence or absence of leukocytes in awake, open eye tears. This study sought to compare normal and dry eye subjects for daily variation in open eye leukocyte composition. MATERIALS AND METHODS Ten normal subjects and nine dry eye subjects were enrolled. Subjects were trained for self-collection of tear samples using an ocular surface wash with 5 mL of phosphate buffered saline per eye. Subjects performed washes at awakening, between 8 and 9 am, between 11 am and 12 pm, and between 4 pm and 5 pm on four separate days. Leukocytes were isolated from the wash and were counted with a cell counter before staining with an anti-CD45 antibody and viability stain. Stained leukocytes were then analyzed via flow cytometry. Side scatter characteristics were used to distinguish granulocytes from lymphocytes. Results were interpreted both by time of wash as well as time from awakening. RESULTS At awakening, dry eye subjects had approximately twice as many recovered leukocytes and had a statistically significantly higher granulocyte-to-lymphocyte ratio as compared to normals. Leukocytes were rapidly cleared from the eye with a significant decrease in leukocyte counts at the 8 am time point as compared to awakening. Leukocyte counts across all open eye time points appeared to be consistent, with no differences between normal and dry eye subjects. CONCLUSIONS There is a low level, constitutively expressed population of leukocytes in the open eye tears of normal and dry eye subjects. Higher levels of granulocytes in dry eye disease subjects warrants further investigation into this population of cells, and their role in homeostasis and dysregulation.
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Affiliation(s)
- Cameron K Postnikoff
- a School of Optometry , University of Alabama at Birmingham , Birmingham , Alabama , USA
| | - Carrie Huisingh
- a School of Optometry , University of Alabama at Birmingham , Birmingham , Alabama , USA
| | - Gerald McGwin
- a School of Optometry , University of Alabama at Birmingham , Birmingham , Alabama , USA
| | - Kelly K Nichols
- a School of Optometry , University of Alabama at Birmingham , Birmingham , Alabama , USA
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Evaluation of Neutrophil-to-Lymphocyte Ratio and Mean Platelet Volume in Patients with Active and Inactive Thyroid Orbitopathy. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2018; 52:26-30. [PMID: 32595367 PMCID: PMC7315080 DOI: 10.14744/semb.2017.07269] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 11/14/2017] [Indexed: 12/17/2022]
Abstract
Objectives: The aim of this study was to evaluate the neutrophil-to-lymphocyte ratio (NLR) and the mean platelet volume (MPV) in patients with active thyroid orbitopathy (TO) and to compare it with that of both healthy subjects and patients with inactive TO. Methods: Twenty patients with active TO (Group 1), 25 patients with inactive TO (Group 2), and 35 age- and sex-matched healthy subjects (Group 3) were included in this study. Patients with other systemic and ocular diseases, patients with a history of intraocular or orbital surgery, and patients using systemic drugs were excluded. The VISA (vision, inflammation, strabismus, appearance) classification scheme was used to discriminate between active and inactive TO. The neutrophil and lymphocyte counts and the MPV of all participants were recorded. The NLR was calculated by dividing the neutrophil count by the lymphocyte count, and the result was compared between groups. The optimal cut-off value was determined for NLR and MPV and the data were compared with a one-way analysis of variance test and the ’Bonferroni post-test. Results: The mean age was 45.4±13.4, 41.0±13.7, and 42.6±14.4 years in Group 1, 2, and 3, respectively (p=0.68). The NLR was 2.11 in Group 1, 1.56 in Group 2, and 1.47 in Group 3 (p=0.03). The ’Bonferroni post-test revealed a difference between Group 1 and Group 2 (p=0.01) and between Group 1 and Group 3 (p<0.001). The MPV was 10.76 fL in Group 1, 9.94 fL in Group 2, and 8.19 fL in Group 3 (p<0.001). The results of the ’Bonferroni post-test showed a difference between Group 1 and Group 2 (p=0.04), between Group 1 and Group 3 (p<0.001), and between Group 2 and Group 3 (p<0.001). The mean cut-off value obtained from receiver operating characteristic (ROC) analysis of NLR was 1.69 (sensitivity: 72%; specificity: 66%). The mean cut-off value obtained from ROC analysis of MPV was 9.95 (sensitivity: 63%; specificity: 66%). Conclusion: High NLR and MPV values may be indicative of active inflammation in patients with TO.”
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Celik T. Assessment of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Patients with Dry Eye Disease. Ocul Immunol Inflamm 2017; 26:1219-1222. [DOI: 10.1080/09273948.2017.1340486] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Tuba Celik
- Department of Ophthalmology, Bulent Ecevit University, Faculty of Medicine, Zonguldak, Turkey
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Jung JH, Lee YM, Lee EG, Yoo WH, Lee WS. Neutrophil-to-lymphocyte Ratio in Diagnosis of Systemic Sclerosis for Prediction of Interstitial Lung Disease. JOURNAL OF RHEUMATIC DISEASES 2017. [DOI: 10.4078/jrd.2017.24.3.138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Ji-Hyeon Jung
- Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine of Chonbuk National University Hospital, Jeonju, Korea
| | - Yu-Mi Lee
- Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine of Chonbuk National University Hospital, Jeonju, Korea
| | - Eun-Gyeong Lee
- Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine of Chonbuk National University Hospital, Jeonju, Korea
| | - Wan-Hee Yoo
- Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine of Chonbuk National University Hospital, Jeonju, Korea
| | - Won-Seok Lee
- Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine of Chonbuk National University Hospital, Jeonju, Korea
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