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Gao Y, Lu RX, Tang Y, Yang XY, Meng H, Zhao CL, Chen YL, Yan F, Cao Q. Systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio in patients with type 2 diabetes at different stages of diabetic retinopathy. Int J Ophthalmol 2024; 17:877-882. [PMID: 38766329 PMCID: PMC11074207 DOI: 10.18240/ijo.2024.05.12] [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: 01/02/2024] [Accepted: 03/01/2024] [Indexed: 05/22/2024] Open
Abstract
AIM To investigate systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) levels in patients with type 2 diabetes at different stages of diabetic retinopathy (DR). METHODS This retrospective study included 141 patients with type 2 diabetes mellitus (DM): 45 without diabetic retinopathy (NDR), 47 with non-proliferative diabetic retinopathy (NPDR), and 49 with proliferative diabetic retinopathy (PDR). Complete blood counts were obtained, and NLR, PLR, and SII were calculated. The study analysed the ability of inflammatory markers to predict DR using receiver operating characteristic (ROC) curves. The relationships between DR stages and SII, PLR, and NLP were assessed using multivariate logistic regression. RESULTS The average NLR, PLR, and SII were higher in the PDR group than in the NPDR group (P=0.011, 0.043, 0.009, respectively); higher in the NPDR group than in the NDR group (P<0.001 for all); and higher in the PDR group than in the NDR group (P<0.001 for all). In the ROC curve analysis, the NLR, PLR, and SII were significant predictors of DR (P<0.001 for all). The highest area under the curve (AUC) was for the PLR (0.929 for PLR, 0.925 for SII, and 0.821 for NLR). Multivariate regression analysis indicated that NLR, PLR, and SII were statistically significantly positive and independent predictors for the DR stages in patients with DM [odds ratio (OR)=1.122, 95% confidence interval (CI): 0.200-2.043, P<0.05; OR=0.038, 95%CI: 0.018-0.058, P<0.05; OR=0.007, 95%CI: 0.001-0.01, P<0.05, respectively). CONCLUSION The NLR, PLR, and SII may be used as predictors of DR.
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Affiliation(s)
- Ying Gao
- Department of Ophthalmology, Sir Run Run Hospital, Nanjing Medical University, Nanjing 211112, Jiangsu Province, China
| | - Rong-Xin Lu
- Department of Thoracic Surgery, the First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Yun Tang
- Medical School, Nanjing University, Nanjing 210093, Jiangsu Province, China
| | - Xin-Yi Yang
- Department of Ophthalmology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
| | - Hu Meng
- Department of Ophthalmology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
| | - Chang-Lin Zhao
- Department of Ophthalmology, Sir Run Run Hospital, Nanjing Medical University, Nanjing 211112, Jiangsu Province, China
| | - Yi-Lu Chen
- Department of Ophthalmology, Sir Run Run Hospital, Nanjing Medical University, Nanjing 211112, Jiangsu Province, China
| | - Feng Yan
- Department of Ophthalmology, Taikang Xianlin Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210046, Jiangsu Province, China
| | - Qian Cao
- Department of Ophthalmology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
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Gao Y, Tang Y, Yu T, Ding Y, Chen Y, Ye W, Zhao C, Lu R. Relationship between lymphocytes and idiopathic macular hole. BMC Ophthalmol 2024; 24:187. [PMID: 38654253 DOI: 10.1186/s12886-024-03424-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 04/01/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND An idiopathic macular hole (IMH) is a full-thickness anatomic defect extending from the internal limiting membrane to the photoreceptor layer of the macula without any known cause. Recently, clinical laboratory markers of systemic inflammatory status derived from complete blood counts have been evaluated in ocular diseases. This study aimed to explore whether they could predict the development and progression of IMHs. METHODS A retrospective review of 36 patients with IMH and 36 sex-and-age-matched patients with cataracts was conducted. We collected complete blood counts of all participating individuals and calculated systemic immunoinflammatory indicators. The maximum base diameter of the IMH (BD), minimum diameter of the IMH (MIN), height of the IMH (H), area of the intraretinal cyst (IRC), and curve lengths of the detached photoreceptor arms were measured on optical coherence tomography (OCT) images. We used these values to calculate the macular hole index (MHI), tractional hole index (THI), diameter hole index (DHI), hole form factor (HFF), and macular hole closure index (MHCI). We performed a receiver operating characteristic (ROC) curve analysis of 30 patients with IMH who were followed up 1 month after surgery. RESULTS Lymphocyte counts were significantly higher in the IMH group. No other significant differences were observed between the IMH and control groups. Lymphocyte counts in the IMH group were significantly negatively correlated with MIN and BD and were significantly positively correlated with MHI, THI, and MHCI. However, lymphocyte counts were not significantly correlated with H, IRC, DHI, and HFF. In the ROC analysis, BD, MIN, MHI, THI, and MHCI were significant predictors of anatomical outcomes. According to the cut-off points of the ROC analysis, lymphocyte counts were compared between the above-cut-off and below-cut-off groups. Lymphocyte counts were significantly higher in the MIN ≤ 499.61 μm, MHI ≥ 0.47, THI ≥ 1.2, and MHCI ≥ 0.81 groups. There were no significant differences between the above-cut-off and below-cut-off BD groups. CONCLUSIONS Although inflammation may not be an initiating factor, it may be involved in IMH formation. Lymphocytes may play a relatively important role in tissue repair during the developmental and postoperative recovery phases of IMH.
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Affiliation(s)
- Ying Gao
- Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Yun Tang
- Medical School, Nanjing University, Nanjing, Jiangsu Province, China
| | - Ting Yu
- Department of Ophthalmology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, Jiangsu Province, China
| | - Ying Ding
- Department of Ophthalmology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, Jiangsu Province, China
| | - Yilu Chen
- Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Wei Ye
- Department of Ophthalmology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, Jiangsu Province, China.
| | - Changlin Zhao
- The Affiliated Eye Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China.
| | - Rongxin Lu
- Department of Thoracic Surgery, The First Affiliated Hospital With Nanjing Medical University, Nanjing, Jiangsu Province, China.
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Salvetat ML, Pellegrini F, Spadea L, Salati C, Zeppieri M. Non-Arteritic Anterior Ischemic Optic Neuropathy (NA-AION): A Comprehensive Overview. Vision (Basel) 2023; 7:72. [PMID: 37987292 PMCID: PMC10661278 DOI: 10.3390/vision7040072] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/25/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023] Open
Abstract
Non-arteritic anterior ischemic optic neuropathy (NA-AION) represents one of the most important causes of blindness or severely impaired vision in middle-aged and elderly people. Unilateral optic disc edema and abrupt, painless vision loss are its defining features. It is commonly assumed that NA-AION is caused by an ischemic infarction of the optic nerve head, and, although the exact pathogenesis is still unknown, several risk factors and comorbidities associated with its development have been found. NA-AION occurs generally in patients older than 50 years who have small optic discs and vasculopathy risk factors. Even though numerous treatment options have been proposed, no available effective medical or surgical therapy or prophylactic measure for NA-AION currently exists. The purpose of present-day therapeutic strategies is therefore to identify and possibly control any underlying modifiable risk factors, aiming to prevent the development of new NA-AION episodes in the affected and fellow eye. A thorough assessment of NAION, including its history, epidemiology, etiology, pathophysiology, risk factors, associated comorbidities, clinical findings, diagnostic tests, treatment choices, prognosis, and future research, is the goal of this work.
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Affiliation(s)
- Maria Letizia Salvetat
- Department of Ophthalmology, Azienda Sanitaria Friuli Occidentale, 33170 Pordenone, Italy; (M.L.S.)
| | - Francesco Pellegrini
- Department of Ophthalmology, Azienda Sanitaria Friuli Occidentale, 33170 Pordenone, Italy; (M.L.S.)
| | - Leopoldo Spadea
- Eye Clinic, Policlinico Umberto I, “Sapienza” University of Rome, 00142 Rome, Italy
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
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Salvetat ML, Pellegrini F, Spadea L, Salati C, Zeppieri M. Non-Arteritic Anterior Ischemic Optic Neuropathy (NA-AION): A Comprehensive Overview. Vision (Basel) 2023; 7:72. [DOI: : 10.3390/vision7040072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023] Open
Abstract
Non-arteritic anterior ischemic optic neuropathy (NA-AION) represents one of the most important causes of blindness or severely impaired vision in middle-aged and elderly people. Unilateral optic disc edema and abrupt, painless vision loss are its defining features. It is commonly assumed that NA-AION is caused by an ischemic infarction of the optic nerve head, and, although the exact pathogenesis is still unknown, several risk factors and comorbidities associated with its development have been found. NA-AION occurs generally in patients older than 50 years who have small optic discs and vasculopathy risk factors. Even though numerous treatment options have been proposed, no available effective medical or surgical therapy or prophylactic measure for NA-AION currently exists. The purpose of present-day therapeutic strategies is therefore to identify and possibly control any underlying modifiable risk factors, aiming to prevent the development of new NA-AION episodes in the affected and fellow eye. A thorough assessment of NAION, including its history, epidemiology, etiology, pathophysiology, risk factors, associated comorbidities, clinical findings, diagnostic tests, treatment choices, prognosis, and future research, is the goal of this work.
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Affiliation(s)
- Maria Letizia Salvetat
- Department of Ophthalmology, Azienda Sanitaria Friuli Occidentale, 33170 Pordenone, Italy
| | - Francesco Pellegrini
- Department of Ophthalmology, Azienda Sanitaria Friuli Occidentale, 33170 Pordenone, Italy
| | - Leopoldo Spadea
- Eye Clinic, Policlinico Umberto I, “Sapienza” University of Rome, 00142 Rome, Italy
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
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Koçak N, Erduran B, Yeter V. Predictive values of systemic inflammation biomarkers in proliferative vitreoretinopathy associated with primary rhegmatogenous retinal detachment. Clin Exp Optom 2023; 106:852-858. [PMID: 36375137 DOI: 10.1080/08164622.2022.2133596] [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: 02/20/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022] Open
Abstract
CLINICAL RELEVANCE Proliferative vitreoretinopathy (PVR) is still the leading cause of surgical failure after rhegmatogenous retinal detachment (RRD) repair. The factors that can predict the development of PVR remain to be elucidated. BACKGROUND This study evaluates the predictive values of the systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio in patients with primary RRD with and without PVR. METHODS A total of 150 patients with RRD and 51 age- and sex-matched healthy participants were included in the study. Patients who developed PVR within three months after surgery were enrolled as PVR cases (n = 75, Group 1), and those who did not develop PVR were enrolled in RRD without the PVR group (n = 75, Group 2). Ocular examination findings and medical records of all participants were analysed retrospectively. Peripheral blood samples were collected, and systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratios were calculated. The systemic immune-inflammation index calculation formula is: (Neutrophil/lymphocyte) × Platelet. RESULTS The median neutrophil-to-lymphocyte ratio and systemic immune-inflammation index levels were significantly higher in Group 1 patients compared to Group 2 and the control groups (p = 0.01, for both). However, the groups were similar regarding median platelet-to-lymphocyte ratio (p = 0.917). The optimal cut-off values of neutrophil-to-lymphocyte ratio and systemic immune-inflammation index were calculated as 1.72 (with 72% sensitivity and 48% specificity) and 407.9 (with 72% sensitivity and 49.3% specificity), respectively, for predicting PVR development in patients with RRD. CONCLUSION Neutrophil-to-lymphocyte ratio and systemic immune-inflammation index may be useful biomarkers for predicting the risk of PVR development in RRD patients.
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Affiliation(s)
- Nurullah Koçak
- Department of Ophthalmology, Ondokuzmayıs University Hospital, Samsun, Turkey
| | - Bilgehan Erduran
- Department of Ophthalmology, Ondokuzmayıs University Hospital, Samsun, Turkey
| | - Volkan Yeter
- Department of Ophthalmology, Ondokuzmayıs University Hospital, Samsun, Turkey
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Construction and functional enrichment analysis of the competitive endogenous RNA regulatory network for nonarteritic anterior ischemic optic neuropathy based on high-throughput sequencing. Funct Integr Genomics 2022; 22:1253-1267. [DOI: 10.1007/s10142-022-00914-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/26/2022] [Accepted: 11/03/2022] [Indexed: 11/11/2022]
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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: 0] [Impact Index Per Article: 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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Hu W, Su G, Zhu W, Zhou E, Shuai X. Systematic Immune-Inflammation Index Predicts Embolic Events in Infective Endocarditis. Int Heart J 2022; 63:510-516. [DOI: 10.1536/ihj.21-627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Wangling Hu
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Guanhua Su
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Wanyue Zhu
- Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Enqing Zhou
- First Clinical School, Tongji Medical College, Huazhong University of Science and Technology
| | - Xinxin Shuai
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
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Chien JY, Lin SF, Chou YY, Huang CYF, Huang SP. Protective Effects of Oroxylin A on Retinal Ganglion Cells in Experimental Model of Anterior Ischemic Optic Neuropathy. Antioxidants (Basel) 2021; 10:antiox10060902. [PMID: 34204966 PMCID: PMC8226497 DOI: 10.3390/antiox10060902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 12/13/2022] Open
Abstract
Nonarteritic anterior ischemic optic neuropathy (NAION) is the most common cause of acute vision loss in older people, and there is no effective therapy. The effect of the systemic or local application of steroids for NAION patients remains controversial. Oroxylin A (OA) (5,7-dihydroxy-6-methoxyflavone) is a bioactive flavonoid extracted from Scutellariae baicalensis Georgi. with various beneficial effects, including anti-inflammatory and neuroprotective effects. A previous study showed that OA promotes retinal ganglion cell (RGC) survival after optic nerve (ON) crush injury. The purpose of this research was to further explore the potential actions of OA in ischemic injury in an experimental anterior ischemic optic neuropathy (rAION) rat model induced by photothrombosis. Our results show that OA efficiently attenuated ischemic injury in rats by reducing optic disc edema, the apoptotic death of retinal ganglion cells, and the infiltration of inflammatory cells. Moreover, OA significantly ameliorated the pathologic changes of demyelination, modulated microglial polarization, and preserved visual function after rAION induction. OA activated nuclear factor E2 related factor (Nrf2) signaling and its downstream antioxidant enzymes NAD(P)H:quinone oxidoreductase (NQO-1) and heme oxygenase 1 (HO-1) in the retina. We demonstrated that OA activates Nrf2 signaling, protecting retinal ganglion cells from ischemic injury, in the rAION model and could potentially be used as a therapeutic approach in ischemic optic neuropathy.
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Affiliation(s)
- Jia-Ying Chien
- Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan;
| | - Shu-Fang Lin
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan;
| | - Yu-Yau Chou
- Department of Molecular Biology and Human Genetics, Tzu Chi University, Hualien 970, Taiwan;
| | - Chi-Ying F. Huang
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan;
- Institute of Biopharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Correspondence: (C.-Y.F.H.); (S.-P.H.); Tel.: +886-2-28267904 (C.-Y.F.H.); +886-3-8565301#2664 (S.-P.H.)
| | - Shun-Ping Huang
- Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan;
- Department of Molecular Biology and Human Genetics, Tzu Chi University, Hualien 970, Taiwan;
- Department of Ophthalmology, Taichung Tzu Chi Hospital, Taichung 472, Taiwan
- Correspondence: (C.-Y.F.H.); (S.-P.H.); Tel.: +886-2-28267904 (C.-Y.F.H.); +886-3-8565301#2664 (S.-P.H.)
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