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Lendzioszek M, Bryl A, Poppe E, Zorena K, Mrugacz M. Retinal Vein Occlusion-Background Knowledge and Foreground Knowledge Prospects-A Review. J Clin Med 2024; 13:3950. [PMID: 38999513 PMCID: PMC11242360 DOI: 10.3390/jcm13133950] [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: 05/28/2024] [Revised: 06/28/2024] [Accepted: 07/03/2024] [Indexed: 07/14/2024] Open
Abstract
Thrombosis of retinal veins is one of the most common retinal vascular diseases that may lead to vascular blindness. The latest epidemiological data leave no illusions that the burden on the healthcare system, as impacted by patients with this diagnosis, will increase worldwide. This obliges scientists to search for new therapeutic and diagnostic options. In the 21st century, there has been tremendous progress in retinal imaging techniques, which has facilitated a better understanding of the mechanisms related to the development of retinal vein occlusion (RVO) and its complications, and consequently has enabled the introduction of new treatment methods. Moreover, artificial intelligence (AI) is likely to assist in selecting the best treatment option for patients in the near future. The aim of this comprehensive review is to re-evaluate the old but still relevant data on the RVO and confront them with new studies. The paper will provide a detailed overview of diagnosis, current treatment, prevention, and future therapeutic possibilities regarding RVO, as well as clarifying the mechanism of macular edema in this disease entity.
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Affiliation(s)
- Maja Lendzioszek
- Department of Ophthalmology, Voivodship Hospital, 18-400 Lomza, Poland
| | - Anna Bryl
- Department of Ophthalmology and Eye Rehabilitation, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Ewa Poppe
- Department of Ophthalmology, Voivodship Hospital, 18-400 Lomza, Poland
| | - Katarzyna Zorena
- Department of Immunobiology and Environment Microbiology, Medical University of Gdansk, Dębinki 7, 80-211 Gdansk, Poland
| | - Malgorzata Mrugacz
- Department of Ophthalmology and Eye Rehabilitation, Medical University of Bialystok, 15-089 Bialystok, Poland
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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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Qin G, Lin T, You Y, Shang M, He W, Pazo EE. Blood inflammatory biomarkers in participants with idiopathic epiretinal membrane: A retrospective case series study. Medicine (Baltimore) 2023; 102:e34225. [PMID: 37390242 PMCID: PMC10313294 DOI: 10.1097/md.0000000000034225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/15/2023] [Indexed: 07/02/2023] Open
Abstract
The objective was to evaluate the levels of monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with idiopathic epiretinal membrane (iERM). This retrospective case series study comprised of participants with iERM and participants with cataract. The values of MLR, NLR, PLR and from participants' peripheral blood were assessed among groups. The best cutoff value of MLR, NLR, and PLR in iERM was found by performing a receiver operating characteristic curve analysis and determining the optimum cutoff value for each variable. In total, 95 participants with iERM were included in the study group, and 61 participants with senile cataract were included as controls. The lymphocyte count in the iERM group was significantly lower than the control group (1.69 ± 0.63 vs. 1.95 ± 0.53, P = .003). The monocyte count in the iERM group was significantly higher than the control group (0.39 ± 0.11 vs. 0.31 ± 0.10, P < .001). The area under the curve of MLR, NLR, and PLR in differentiating patients with IERM and controls was 0.782, 0.645, and 0.657, respectively, according to receiver operating characteristic. The best cutoff value of MLR was > 0.18, with sensitivity and specificity of 74.7% and 75.4%, respectively. The NLR was > 2.06, with a sensitivity and specificity of 50.5% and 83.6%, respectively. The PLR was > 95.89, with a sensitivity and specificity of 86.3% and 41.0%, respectively. The findings of this study suggest that systemic inflammation may be associated with iERM. IERM patients may be prone to have high MLR, NLR, and PLR values.
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Affiliation(s)
| | - Tiezhu Lin
- He Eye Specialist Hospital, Shenyang, China
| | - Yue You
- Sinqi Eye Hospital, Shenyang, China
| | | | - Wei He
- He Eye Specialist Hospital, Shenyang, China
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Wang YC, Zhou CQ, Li RR, Cai Y, Wang MM, Yuan LF, He YQ. The role of serum metrics in anti- VEGF treatment for macular edema induced by retinal vein occlusion. BMC Ophthalmol 2023; 23:173. [PMID: 37095450 PMCID: PMC10123984 DOI: 10.1186/s12886-023-02921-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 04/13/2023] [Indexed: 04/26/2023] Open
Abstract
AIM To evaluate association between pretreatment serum metrics and best corrected visual acuity ( BCVA) of patients with macular edema secondary to retinal vein occlusion and its subtypes after intravitreal ranibizumab or conbercept implant. METHODS This prospective research included 201 patients(201 eyes) who were diagnosed with macular edema secondary to retinal vein occlusion at Heibei Eye Hospital between January 2020 and January 2021, who all received intravitreal anti- vascular endothelial growth factor treatment. Serum metrics were measured before the first treatment, and correlations between BCVA and each of four parameters- platelets, neutrophil- to- lymphocyte ratio(NLR), platelet- to- lymphocyte ratio(PLR) and monocyte- to- lymphocyte ratio(MLR)- were analyzed to identify predictors of effective intravitreal injection treatment outcomes. RESULTS The mean platelets was significantly different in the effective and ineffective group for RVO-ME (273.02 ± 41.49 × 109/L,214.54 ± 44.08 × 109/L P < 0.01),BRVO-ME (269.43 ± 49.52 × 109/L,214.72 ± 40.42 × 109/L P < 0.01), and CRVO-ME (262.32 ± 32.41 × 109/L,209.27 ± 42 0.91 × 109/L P < 0.01). The cutoff value of the platelets was 266.500, the area under the curve was 0.857,and the sensitivity and specificity were 59.8% and 93.6%, respectively. The mean PLR was significantly different in the effective and ineffective group for RVO-ME (154.66 ± 49.60, 122.77± 44.63 P < 0.01),BRVO-ME (152.24 ± 54.99, 124.72 ± 41.46 P = 0.003), and CRVO-ME (152.06±44.23, 118.67 ± 41.80 P = 0.001). The cutoff value of the platelets was 126.734, the area under the curve was 0.699, and the sensitivity and specificity were 70.7% and 63.3%, respectively. There were no statistical differencies between the effective and ineffective group(RVO- ME and its subtypes) in NLR and MLR. CONCLUSION Higher pretreatment platelets and PLR were associated with BCVA in patients with RVO- ME and its subtypes who were treated with anti- VEGF drugs. The platelets and PLR may be used as predictive and prognostic tools for effective intravitreal injection treatment outcomes.
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Affiliation(s)
- Yun-Chang Wang
- Heibei Eye Hospital, Number 399 quan bei dong da jie, Xingtai, Hebei Province, 054001, China.
| | - Chuan-Qi Zhou
- Heibei Eye Hospital, Number 399 quan bei dong da jie, Xingtai, Hebei Province, 054001, China
| | - Rong-Rong Li
- Heibei Eye Hospital, Number 399 quan bei dong da jie, Xingtai, Hebei Province, 054001, China
| | - Yi Cai
- Heibei Eye Hospital, Number 399 quan bei dong da jie, Xingtai, Hebei Province, 054001, China
| | - Meng-Meng Wang
- Heibei Eye Hospital, Number 399 quan bei dong da jie, Xingtai, Hebei Province, 054001, China
| | - Li-Fei Yuan
- Heibei Eye Hospital, Number 399 quan bei dong da jie, Xingtai, Hebei Province, 054001, China
| | - Yi-Qing He
- Heibei Eye Hospital, Number 399 quan bei dong da jie, Xingtai, Hebei Province, 054001, China
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Kazantzis D, Sergentanis TN, Machairoudia G, Dimitriou E, Kroupis C, Theodossiadis G, Theodossiadis P, Chatziralli I. Correlation Between Imaging Morphological Findings and Laboratory Biomarkers in Patients with Retinal Vein Occlusion. Ophthalmol Ther 2023; 12:1239-1249. [PMID: 36806996 PMCID: PMC10011245 DOI: 10.1007/s40123-023-00677-1] [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: 12/27/2022] [Accepted: 02/02/2023] [Indexed: 02/20/2023] Open
Abstract
INTRODUCTION The aim of this study was to investigate the possible correlation between peripheral blood biomarkers and morphological characteristics of retinal imaging in patients with retinal vein occlusion (RVO). METHODS Participants in this cross-sectional observational study were 65 consecutive patients (65 eyes) with treatment-naïve RVO, who underwent spectral-domain optical coherence tomography (SD-OCT) and fundus fluorescein angiography (FFA). In addition, peripheral blood samples were taken to evaluate full blood count and biochemical parameters. The association between imaging characteristics and laboratory parameters was examined. RESULTS Eyes with subretinal fluid presented significantly higher neutrophil-to-lymphocyte ratios (p = 0.028). Hyperreflective foci on SD-OCT were found to be associated with higher triglyceride levels (p = 0.024). The presence of cysts on SD-OCT was associated with significantly higher triglycerides (p = 0.010). Central subfield thickness (CST) higher than 464 μm was associated with higher lymphocyte count (p = 0.016) and higher urea (p = 0.015). No significant associations were found between laboratory parameters and intraretinal fluid, ellipsoid zone and external limiting membrane condition, or epiretinal membrane and macular ischemia. CONCLUSIONS Specific imaging morphological characteristics were found to be associated with laboratory parameters in patients with RVO. These findings may help reveal the pathophysiology of RVO and its correlation with the development of specific clinical signs, while they could guide individualized treatment.
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Affiliation(s)
- Dimitrios Kazantzis
- 2nd Department of Ophthalmology, Attikon University Hospital, National and Kapodistrian University of Athens, 1, Rimini Street, 12462, Haidari, Greece
| | - Theodoros N Sergentanis
- Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Genovefa Machairoudia
- 2nd Department of Ophthalmology, Attikon University Hospital, National and Kapodistrian University of Athens, 1, Rimini Street, 12462, Haidari, Greece
| | - Eleni Dimitriou
- 2nd Department of Ophthalmology, Attikon University Hospital, National and Kapodistrian University of Athens, 1, Rimini Street, 12462, Haidari, Greece
| | - Christos Kroupis
- Department of Clinical Biochemistry, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - George Theodossiadis
- 2nd Department of Ophthalmology, Attikon University Hospital, National and Kapodistrian University of Athens, 1, Rimini Street, 12462, Haidari, Greece
| | - Panagiotis Theodossiadis
- 2nd Department of Ophthalmology, Attikon University Hospital, National and Kapodistrian University of Athens, 1, Rimini Street, 12462, Haidari, Greece
| | - Irini Chatziralli
- 2nd Department of Ophthalmology, Attikon University Hospital, National and Kapodistrian University of Athens, 1, Rimini Street, 12462, Haidari, Greece.
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Pan M, Zhou P, Guo J, An G, Liu Z, Du L, Jin X. Elevated Neutrophil Counts, Triglycerides, Monocyte/High-Density Lipoprotein Ratios, and Lower High-Density Lipoprotein in Patients with Retinal Vein Occlusion. Ophthalmic Res 2022; 66:265-271. [PMID: 36223733 DOI: 10.1159/000527446] [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: 08/20/2021] [Accepted: 10/05/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of the study was to evaluate associations of peripheral blood immune cells and blood lipid profile levels with retinal vein occlusion (RVO). METHODS This retrospective study included 127 patients with RVO and 108 controls. Patients with RVO were divided into branch RVO (BRVO), central RVO (CRVO), ischemic RVO, or nonischemic RVO groups. Medical records were collected and analyzed. RESULTS The RVO group had higher mean neutrophil, triglyceride (TG), and monocyte/high-density lipoprotein (HDL) ratio (MHR) levels and lower HDL levels (p = 0.037, p < 0.001, p = 0.004, and p = 0.002, respectively). TG and MHR levels were significantly higher in the BRVO and CRVO groups compared with the control group (p < 0.001 and p = 0.016, respectively), but there was no difference in BRVO and CRVO group (p = 0.972 and p = 0.916, respectively). Mean HDL levels were significantly lower in the BRVO and CRVO groups than in the control group (p = 0.005), but the difference between the BRVO group and CRVO group was not significant (p = 0.290). Neutrophils, TG, and MHR were independent risk factors for RVO. HDL was an independent protective factor for RVO. Age was an independent risk factor for ischemic RVO. CONCLUSIONS Lower HDL, and higher neutrophil, TG, and MHR levels are associated with RVO. Age is an independent risk factor for ischemic RVO.
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Affiliation(s)
- Meng Pan
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, China,
| | - Pengyi Zhou
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, China
| | - Ju Guo
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, China
| | - Guangqi An
- Department of Ophthalmology, The Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Zhenhui Liu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, China
| | - Liping Du
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, China
| | - Xuemin Jin
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, China
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Marcinkowska A, Wolska N, Luzak B, Cisiecki S, Marcinkowski K, Rozalski M. Platelet-Derived Procoagulant Microvesicles Are Elevated in Patients with Retinal Vein Occlusion (RVO). J Clin Med 2022; 11:jcm11175099. [PMID: 36079028 PMCID: PMC9457368 DOI: 10.3390/jcm11175099] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022] Open
Abstract
The etiopathogenesis of retinal vein occlusion (RVO) is multifactorial, and the contribution of platelets to RVO development has not been fully elucidated. We aimed to analyze platelet function in RVO patients (n = 35) and controls (n = 35). We found a higher (p < 0.05) level of soluble P-selectin in RVO group vs. controls. Additionally, in RVO patients, the concentration of platelet-derived microvesicles was higher (p < 0.05), and the difference between groups was deeper for the fraction of platelet-derived microvesicles with the procoagulant phenotype (p < 0.0001) and for overall procoagulant microvesicles level (p < 0.0001). The results were similar for the total RVO group and for both RVO types (central- and branched-retinal vein occlusion). We did not find differences in simple platelet parameters (platelet count, mean platelet volume, platelet distribution width, platecrit, reticulated platelets) and inflammatory markers (platelet-lymphocyte ratio, neutrophil-lymphocyte ratio). Similarly, no differences were found for platelet aggregation-stimulated byadenosine diphosphate; collagen; arachidonic acid; and in multiparametric flow cytometry evaluation of P-selectin, PAC-1, and fibrinogen binding for both unstimulated and adenosine diphosphate-, collagen-, and thrombin receptor activating peptide-stimulated platelets. Our results suggest that platelets can contribute to developing RVO by enhancing procoagulant activity through providing a procoagulation surface via platelet-derived microvesicles. The direct role of platelets’ hyperreactivity in developing RVO is less apparent, which is consistent with the complexity and multifactorial background of this disorder.
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Affiliation(s)
- Adrianna Marcinkowska
- Department of Haemostasis and Haemostatic Disorders, Chair of Biomedical Sciences, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland
- Department of Ophthalmology, Karol Jonscher’s Municipal Medical Center, 93-113 Lodz, Poland
| | - Nina Wolska
- Platelet Signalling and Vascular Diseases, Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - Boguslawa Luzak
- Department of Haemostasis and Haemostatic Disorders, Chair of Biomedical Sciences, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland
| | - Slawomir Cisiecki
- Department of Ophthalmology, Karol Jonscher’s Municipal Medical Center, 93-113 Lodz, Poland
| | - Karol Marcinkowski
- Department of Haemostasis and Haemostatic Disorders, Chair of Biomedical Sciences, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland
| | - Marcin Rozalski
- Department of Haemostasis and Haemostatic Disorders, Chair of Biomedical Sciences, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland
- Correspondence:
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Complete Blood Count-Derived Inflammation Indices and Retinal Vein Occlusion: A Case-Control Study. Ophthalmol Ther 2022; 11:1241-1249. [PMID: 35503164 PMCID: PMC9114275 DOI: 10.1007/s40123-022-00511-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/08/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction This study evaluated complete blood count-derived inflammation indices in patients with retinal vein occlusion (RVO). Methods Participants in this case–control study were 54 patients with RVO and 54 age- and sex-matched control subjects. All participants underwent a thorough ophthalmic examination, as well as blood sample testing for complete blood count. Comparison of all parameters derived from complete blood count as well as calculation of specific indices was performed between patients with RVO and controls. Results Patients with RVO presented significantly higher white blood cell count (p = 0.033), neutrophil count (p = 0.003), neutrophil-to-lymphocyte ratio (NLR, p = 0.002), red cell distribution width (RDW, p = 0.009), mean platelet volume (MPV, p = 0.023), and systemic immune-inflammatory index (SII, p = 0.007) compared to controls. Receiver operator characteristic curve (ROC) analysis showed that NLR was superior to other inflammatory indices, having the greatest area under the curve. The optimal cutoff value for NLR to predict RVO was 2.29 with 46.2% sensitivity and 77.8% specificity. Conclusion Patients with RVO presented increased NLR, RDW, MPV, and SII, providing evidence that inflammation plays an important role in the pathogenesis of RVO. Complete blood cell count-derived indices can be easily calculated and may serve as an easy, simple, and cost-effective tool to evaluate the degree of systemic inflammation in patients with RVO, so as to potentially guide treatment.
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Liu Z, Perry LA, Penny‐Dimri JC, Raveendran D, Hu ML, Arslan J, Britten‐Jones AC, O’Hare F, Ayton LN, Edwards TL. The association of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio with retinal vein occlusion: a systematic review and meta-analysis. Acta Ophthalmol 2022; 100:e635-e647. [PMID: 34219390 DOI: 10.1111/aos.14955] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/17/2021] [Indexed: 12/17/2022]
Abstract
The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are emerging haematological inflammatory biomarkers. However, their significance in retinal vein occlusion (RVO) and its subtypes, branch and central RVO (BRVO and CRVO, respectively), is uncertain. This systematic review and meta-analysis aimed to clarify the association of NLR and PLR with RVO. We searched MEDLINE (Ovid), EMBASE (Ovid) and the Cochrane Library for studies investigating the association of NLR and PLR with RVO from inception to 2 December 2020. We used random-effects inverse-variance modelling to generate pooled effect measures. We used bivariate Bayesian modelling to meta-analyse the ability of NLR and PLR to differ between individuals with and without RVO and performed meta-regression and sensitivity analyses to explore inter-study heterogeneity. Eight studies published encompassing 1059 patients were included for analysis. Both NLR and PLR were significantly elevated in RVO, with pooled mean differences of 0.63 (95% confidence interval (CI) 0.31-0.95) and 21.49 (95% CI 10.03-32.95), respectively. The pooled sensitivity, specificity and area under the Bayesian summary receiver operating characteristic curve were, respectively, 0.629 (95% credible interval (CrI) 0.284-0.872), 0.731 (95% CrI 0.373-0.934) and 0.688 (95% CrI 0.358-0.872) for NLR; and 0.645 (95% CrI 0.456-0.779), 0.616 (95% CrI 0.428-0.761) and 0.621 (95% CrI 0.452-0.741) for PLR. Mean and variability of age and diabetes mellitus prevalence partially explained between-study heterogeneity. NLR and PLR are significantly elevated in RVO. Future research is needed to investigate the potential prognostic value and independence of these findings.
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Affiliation(s)
- Zhengyang Liu
- Department of Anaesthesia The Royal Melbourne Hospital Melbourne VIC Australia
- Royal Victorian Eye and Ear Hospital East Melbourne VIC Australia
- Centre for Eye Research Australia East Melbourne VIC Australia
- Department of Surgery (Ophthalmology) The University of Melbourne East Melbourne VIC Australia
| | - Luke A. Perry
- Department of Anaesthesia The Royal Melbourne Hospital Melbourne VIC Australia
| | | | - Dev Raveendran
- Department of Anaesthesia The Royal Melbourne Hospital Melbourne VIC Australia
| | - Monica L. Hu
- Royal Victorian Eye and Ear Hospital East Melbourne VIC Australia
- Centre for Eye Research Australia East Melbourne VIC Australia
- Department of Surgery (Ophthalmology) The University of Melbourne East Melbourne VIC Australia
| | - Janan Arslan
- Centre for Eye Research Australia East Melbourne VIC Australia
- Department of Surgery (Ophthalmology) The University of Melbourne East Melbourne VIC Australia
| | - Alexis Ceecee Britten‐Jones
- Centre for Eye Research Australia East Melbourne VIC Australia
- Department of Surgery (Ophthalmology) The University of Melbourne East Melbourne VIC Australia
- Department of Optometry and Vision Sciences The University of Melbourne Melbourne VIC Australia
| | - Fleur O’Hare
- Centre for Eye Research Australia East Melbourne VIC Australia
- Department of Surgery (Ophthalmology) The University of Melbourne East Melbourne VIC Australia
- Department of Optometry and Vision Sciences The University of Melbourne Melbourne VIC Australia
| | - Lauren N. Ayton
- Centre for Eye Research Australia East Melbourne VIC Australia
- Department of Surgery (Ophthalmology) The University of Melbourne East Melbourne VIC Australia
- Department of Optometry and Vision Sciences The University of Melbourne Melbourne VIC Australia
| | - Thomas L. Edwards
- Royal Victorian Eye and Ear Hospital East Melbourne VIC Australia
- Centre for Eye Research Australia East Melbourne VIC Australia
- Department of Surgery (Ophthalmology) The University of Melbourne East Melbourne VIC Australia
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Zuo W, Chen T, Song J, Ai M. Assessment of Systemic Immune-inflammation Index Levels in Patients with Retinal Vein Occlusion. Ocul Immunol Inflamm 2022; 31:491-495. [PMID: 35201964 DOI: 10.1080/09273948.2022.2032199] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess the predictive value of inflammatory markers calculated from complete blood counts in patients with retinal vein occlusion (RVO). METHODS This was a retrospective cross-sectional study with a total of 56 RVO patients and 56 age- and gender-matched controls involved. All subjects went through a routine ocular examination, and the peripheral venous blood samples were collected to analyze the differences in inflammatory markers between groups. RESULTS The systemic immune-inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR) values were significantly higher in RVO patients than those in the controls (p=0.002, p=0.004, respectively). According to the receiver operating characteristic (ROC) curve analysis, the areas under the curve (AUC) of SII was 0.666. The AUC of NLR was 0.657. CONCLUSION As a novel inflammatory indicator, SII is a more promising indicator than NLR and PLR in the prediction of RVO development.
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Affiliation(s)
- Wen Zuo
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ting Chen
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jiayi Song
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ming Ai
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
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11
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Qin G, He F, Zhang H, Pazo EE, Dai G, Yao Q, He W, Xu L, Lin T. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) are more prominent in retinal artery occlusion (RAO) compared to retinal vein occlusion (RVO). PLoS One 2022; 17:e0263587. [PMID: 35113973 PMCID: PMC8812939 DOI: 10.1371/journal.pone.0263587] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 01/21/2022] [Indexed: 11/18/2022] Open
Abstract
AIM To evaluate the association between the value of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to high-density lipoprotein ratio (MHR) and the development of retinal artery occlusion (RAO) and retinal vein occlusion (RVO). METHODS This retrospective study assessed 41 RAO, 50 RVO and 50 control (age and gender matched senile cataract) participants. The NLR, PLR and MHR parameters of patients' peripheral blood were analyzed. A receiver operating characteristics (ROC) curve analysis and the best cutoff value were used to specify the predictive value of NLR, PLR and MHR in RAO and RVO. RESULTS The NLR, PLR and MHR were significantly higher in RAO group compared to the control group (p<0.001, p<0.001 and p = 0.008; respectively). The NLR, PLR and MHR were also significantly higher in the RVO group compared to the control group (p<0.001, p = 0.001 and p = 0.012, respectively). The NLR and PLR were significantly higher in the RAO group compared to the RVO group (p<0.001 and p = 0.022, respectively). The optimal cut-off value of NLR to predict RAO was >2.99, with 90.2% sensitivity and 100% specificity. The PLR to predict RAO was > 145.52, with 75.6% sensitivity and 80.0% specificity. CONCLUSION Higher NLR, PLR and MHR are related to the occurrence of RAO and RVO. NLR and PLR are more prominent in RAO compared to RVO.
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Affiliation(s)
- Guanghao Qin
- He Eye Specialist Hospital, Shenyang, Liaoning Province, China
- Dalian Medical University, Dalian, Liaoning Province, China
| | - Fang He
- The 8th Medical Center of the PLA General Hospital, Beijing, China
| | - Hongda Zhang
- He Eye Specialist Hospital, Shenyang, Liaoning Province, China
| | | | - Guangzheng Dai
- He Eye Specialist Hospital, Shenyang, Liaoning Province, China
| | - Qingchi Yao
- He Eye Specialist Hospital, Shenyang, Liaoning Province, China
| | - Wei He
- He Eye Specialist Hospital, Shenyang, Liaoning Province, China
| | - Ling Xu
- He Eye Specialist Hospital, Shenyang, Liaoning Province, China
| | - Tiezhu Lin
- He Eye Specialist Hospital, Shenyang, Liaoning Province, China
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12
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Platelet and Thrombophilia-Related Risk Factors of Retinal Vein Occlusion. J Clin Med 2021; 10:jcm10143080. [PMID: 34300244 PMCID: PMC8306401 DOI: 10.3390/jcm10143080] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/11/2021] [Accepted: 07/08/2021] [Indexed: 11/17/2022] Open
Abstract
Retinal vein occlusion (RVO) is a heterogenous disorder in which the formation of a thrombus results in the retinal venous system narrowing and obstructing venous return from the retinal circulation. The pathogenesis of RVO remains uncertain, but it is believed to be multifactorial and to depend on both local and systemic factors, which can be divided into vascular, platelet, and hypercoagulable factors. The vascular factors include dyslipidaemia, high blood pressure, and diabetes mellitus. Regarding the platelet factors, platelet function, mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (PLCR) play key roles in the diagnosis of retinal vein occlusion and should be monitored. Nevertheless, the role of a hypercoagulable state in retinal vein occlusion remains unclear and requires further studies. Therefore, the following article will present the risk factors of RVO associated with coagulation disorders, as well as the acquired and genetic risk factors of thrombophilia. According to Virchow’s triad, all factors mentioned above lead to thrombus formation, which causes pathophysiological changes inside venous vessels in the fundus of the eye, which in turn results in the vessel occlusion. Therefore, a diagnosis of retinal vein occlusion should be based on both eye examination and general examination, including laboratory tests.
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13
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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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14
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Liu Z, Perry LA, Edwards TL. ASSOCIATION BETWEEN PLATELET INDICES AND RETINAL VEIN OCCLUSION: A Systematic Review and Meta-Analysis. Retina 2021; 41:238-248. [PMID: 33475270 DOI: 10.1097/iae.0000000000003022] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE Platelet count, mean platelet volume, platelet distribution width, and plateletcrit are standard indices of platelet activation that have been studied in retinal vein occlusion (RVO) and its subtypes: branch retinal vein occlusion and central retinal vein occlusion. This systematic review and meta-analysis aimed to assess the association between these platelet parameters and RVO. METHODS We searched for studies investigating the association between these platelet indices and RVO in multiple online databases from inception to August 2020. Mean differences and the associated confidence intervals were obtained and calculated for each included study and pooled using random-effects inverse variance modeling. Meta-regression was used to explore interstudy and intrastudy heterogeneity. RESULTS Thousand three hundred and twenty-five unique studies were screened, from which 24 studies encompassing 2,718 patients were included. Mean platelet volume and platelet distribution width were significantly elevated in RVO, with pooled mean differences of 0.45 fL (95% CI 0.24-0.66, P < 0.0001) and 1.43% (95% CI 0.57-2.29, P = 0.0011), respectively. Platelet count and plateletcrit were not significantly associated with RVO. Mean platelet volume was also independently elevated in branch retinal vein occlusion and central retinal vein occlusion. CONCLUSION Mean platelet volume and platelet distribution width are significantly elevated in RVO. Further research is required to explore the independence and potential prognostic significance of these associations.
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Affiliation(s)
- Zhengyang Liu
- Department of Anaesthesia, The Royal Melbourne Hospital, Melbourne, Australia
- Centre for Eye Research Australia, East Melbourne, Australia
- Department of Surgery (Ophthalmology), The University of Melbourne, East Melbourne, Australia ; and
- Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | - Luke A Perry
- Department of Anaesthesia, The Royal Melbourne Hospital, Melbourne, Australia
| | - Thomas L Edwards
- Centre for Eye Research Australia, East Melbourne, Australia
- Department of Surgery (Ophthalmology), The University of Melbourne, East Melbourne, Australia ; and
- Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
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15
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Koçak N, Eraydın B, Turunç M, Yeter V, Güngör İ. Serum Inflammatory Biomarkers in Patients with Nonarteritic Anterior Ischemic Optic Neuropathy. KOREAN JOURNAL OF OPHTHALMOLOGY 2020; 34:478-484. [PMID: 33307608 PMCID: PMC7738228 DOI: 10.3341/kjo.2020.0075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/20/2020] [Indexed: 12/15/2022] Open
Abstract
Purpose To evaluate the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) in patients with non-arteritic anterior ischemic optic neuropathy (NAION). Methods Fifty-six patients with NAION and 60 age-sex matched healthy controls were included in the study. Demographic characteristics and laboratory findings of the patients and the controls were obtained from the electronic medical records. NLR, PLR, MLR, and SII were calculated and compared between the groups. Cutoff values were also determined. Results Neutrophil, monocyte and platelet counts were higher in the NAION group than in the control group, but the difference was not statistically significant (p > 0.05). The mean NLR and SII were higher in the NAION group than in the control group (p = 0.004 and p = 0.011, respectively). In the receiver operating characteristic curve analysis, the areas under the curve for NLR were 0.67, and NLR >1.79 predicted NAION with a sensitivity of 71% and specificity of 59%. The areas under the curve for SII was 0.66, and SII of >417 predicted NAION with a sensitivity of 71% and specificity of 49%. There was no significant difference in PLR and MLR between the groups (p = 0.105 and p = 0.347, respectively). Conclusions The current study demonstrated that NAION patients had increased NLR and SII levels compared with control subjects. Elevated NLR and SII might serve as readily available inflammatory predictors in NAION patients.
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Affiliation(s)
- Nurullah Koçak
- Department of Ophthalmology, Ondokuzmayıs University Hospital, Samsun, Turkey
| | - Bilge Eraydın
- Department of Ophthalmology, Erbaa State Hospital, Tokat, Turkey
| | - Mustafa Turunç
- Department of Ophthalmology, Ondokuzmayıs University Hospital, Samsun, Turkey
| | - Volkan Yeter
- Department of Ophthalmology, Ondokuzmayıs University Hospital, Samsun, Turkey
| | - İnci Güngör
- Department of Ophthalmology, Ondokuzmayıs University Hospital, Samsun, Turkey
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16
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Luo Y, Wan J, Luo C, Liu H, Zhou Y, Chen J, Duan Y, Ning X, Zhou Z, Wang K, Li J, Xu H, Chen Z. Higher Aqueous Levels of Resistin and Lipocalin-2 Indicated Worse Visual Improvement following anti-VEGF Therapy in Patients with Retinal Vein Occlusion. Curr Eye Res 2020; 46:845-854. [PMID: 33103481 DOI: 10.1080/02713683.2020.1842462] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of this study was to investigate the aqueous humor levels of elastase-2, lactoferrin, lipocalin-2 (LCN-2), resistin, and thrombospondin-1 (TSP-1) in patients with retinal vein occlusion (RVO) and their relationship with visual prognosis following intravitreal anti-vascular endothelial growth factor (VEGF) therapy. MATERIALS AND METHODS 52 RVO patients (23 cases of central retinal vein occlusion (CRVO) and 29 cases of branch retinal vein occlusion (BRVO)) and 20 cases of senile cataract were enrolled in this study. All RVO patients underwent fundus examinations before and 6-8 months after intravitreal anti-VEGF treatment. Five milliliters of blood were collected from RVO patients before treatment for the measurement of lipids and coagulation factors. Sixty microliters of aqueous humor were collected during intravitreal injection of anti-VEGF or during cataract surgery. The levels of elastase-2, lactoferrin, LCN-2, resistin, and TSP-1 in aqueous humor were determined by Luminex xMAP multiple analysis. RESULTS The aqueous levels of resistin and LCN-2 were significantly higher but the level of TSP-1 was significantly lower in RVO patients compared to controls. Further, sub-group analysis showed that CRVO patients had significantly higher levels of resistin and LCN-2 than controls. The aqueous levels of resistin and LCN-2 were negatively correlated with visual improvement following anti-VEGF therapy in CRVO but not in BRVO patients. Visual improvement in RVO patients was not associated with blood lipid levels or any of the coagulation factors. CONCLUSION CRVO patients had significantly higher aqueous levels of resistin and LCN-2, which negatively impacted on visual improvement after anti-VEGF therapy.
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Affiliation(s)
- Yong Luo
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, China.,Aier Eye Hospital of Changsha, Changsha, Hunan Province, China
| | - Jianbo Wan
- Aier Eye Hospital of Changsha, Changsha, Hunan Province, China
| | - Chang Luo
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, China.,Aier Eye Institute, Changsha, Hunan, China
| | - HengWei Liu
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, China
| | - YuFan Zhou
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, China
| | - Juan Chen
- Aier Eye Hospital of Changsha, Changsha, Hunan Province, China
| | - Yiqin Duan
- Aier Eye Hospital of Changsha, Changsha, Hunan Province, China
| | - Xiangyan Ning
- Aier Eye Hospital of Changsha, Changsha, Hunan Province, China
| | - Zengchao Zhou
- Aier Eye Hospital of Changsha, Changsha, Hunan Province, China
| | - Kehua Wang
- Aier Eye Hospital of Changsha, Changsha, Hunan Province, China
| | - Jun Li
- Aier Eye Hospital of Changsha, Changsha, Hunan Province, China
| | - Heping Xu
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, China.,Aier Institute of Optometry and Vision Science, Changsha, Hunan, China.,Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - ZhongPing Chen
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, China.,Aier Eye Hospital of Changsha, Changsha, Hunan Province, China
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