Differentiating primary open-angle, exfoliative, and primary angle-closure glaucoma in moderate-stage cases using blood-based inflammatory indices and structural metrics

IF 2.6 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-09-25 DOI:10.1016/j.pdpdt.2025.105233

Atılım Armağan Demirtaş , Berna Yüce , Bediz Özen

{"title":"Differentiating primary open-angle, exfoliative, and primary angle-closure glaucoma in moderate-stage cases using blood-based inflammatory indices and structural metrics","authors":"Atılım Armağan Demirtaş , Berna Yüce , Bediz Özen","doi":"10.1016/j.pdpdt.2025.105233","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to evaluate the discriminative utility of systemic hematological inflammatory markers—namely, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR)—in differentiating between primary open-angle glaucoma (POAG), exfoliative glaucoma (XFG), and primary angle-closure glaucoma (PACG) in moderate-stage cases, as well as from healthy controls. In addition, the discriminative performance of structural (cup-to-disc ratio [C/D] and retinal nerve fiber layer [RNFL] thickness) parameters was also assessed.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted, including 166 participants aged 40–70 years (55 POAG, 51 XFG, 30 PACG, 30 controls). All subjects underwent comprehensive ophthalmologic evaluation, optical coherence tomography, and standard automated perimetry. Systemic inflammatory markers were calculated from complete blood counts. Differences between groups were evaluated, and ROC analyses were performed for each parameter.</div></div><div><h3>Results</h3><div>No significant differences in age, gender, or intraocular pressure were observed between groups. C/D ratio was significantly higher in all glaucoma subtypes compared to controls (<em>p</em> = 0.001), while RNFL thickness was lower in glaucoma patients but did not differ significantly between subtypes (<em>p</em> = 0.057). Inflammatory indices did not show significant intergroup differences (p > 0.05), but ROC analysis demonstrated modest diagnostic value in specific comparisons. LMR had the highest AUC (0.635) in distinguishing POAG from controls. NLR showed moderate performance in differentiating POAG from XFG (AUC=0.621) and XFG from PACG (AUC=0.627).</div></div><div><h3>Conclusions</h3><div>Systemic inflammatory indices such as NLR and LMR demonstrated modest but measurable discriminative value in differentiating glaucoma subtypes with moderate-stage and controls. Structural parameters (C/D ratio and RNFL thickness) confirmed expected differences between glaucoma and control eyes but did not reliably distinguish among glaucoma subtypes.</div></div>","PeriodicalId":20141,"journal":{"name":"Photodiagnosis and Photodynamic Therapy","volume":"56 ","pages":"Article 105233"},"PeriodicalIF":2.6000,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Photodiagnosis and Photodynamic Therapy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1572100025007641","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

This study aimed to evaluate the discriminative utility of systemic hematological inflammatory markers—namely, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR)—in differentiating between primary open-angle glaucoma (POAG), exfoliative glaucoma (XFG), and primary angle-closure glaucoma (PACG) in moderate-stage cases, as well as from healthy controls. In addition, the discriminative performance of structural (cup-to-disc ratio [C/D] and retinal nerve fiber layer [RNFL] thickness) parameters was also assessed.

Methods

A retrospective study was conducted, including 166 participants aged 40–70 years (55 POAG, 51 XFG, 30 PACG, 30 controls). All subjects underwent comprehensive ophthalmologic evaluation, optical coherence tomography, and standard automated perimetry. Systemic inflammatory markers were calculated from complete blood counts. Differences between groups were evaluated, and ROC analyses were performed for each parameter.

Results

No significant differences in age, gender, or intraocular pressure were observed between groups. C/D ratio was significantly higher in all glaucoma subtypes compared to controls (p = 0.001), while RNFL thickness was lower in glaucoma patients but did not differ significantly between subtypes (p = 0.057). Inflammatory indices did not show significant intergroup differences (p > 0.05), but ROC analysis demonstrated modest diagnostic value in specific comparisons. LMR had the highest AUC (0.635) in distinguishing POAG from controls. NLR showed moderate performance in differentiating POAG from XFG (AUC=0.621) and XFG from PACG (AUC=0.627).

Conclusions

Systemic inflammatory indices such as NLR and LMR demonstrated modest but measurable discriminative value in differentiating glaucoma subtypes with moderate-stage and controls. Structural parameters (C/D ratio and RNFL thickness) confirmed expected differences between glaucoma and control eyes but did not reliably distinguish among glaucoma subtypes.

查看原文本刊更多论文

用血液炎症指标和结构指标鉴别中期原发性开角型、剥脱型和原发性闭角型青光眼。

目的：本研究旨在评估系统性血液学炎症标志物——即中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和淋巴细胞与单核细胞比值（LMR）——在区分中度病例和健康对照的原发性开角型青光眼（POAG）、剥脱性青光眼（XFG）和原发性闭角型青光眼（PACG）中的鉴别作用。此外，还评估了结构参数（杯盘比[C/D]和视网膜神经纤维层[RNFL]厚度）的判别性能。方法：对166例40 ~ 70岁的患者进行回顾性研究，其中POAG 55例，XFG 51例，PACG 30例，对照组30例。所有受试者都接受了全面的眼科评估、光学相干断层扫描和标准的自动视野检查。通过全血细胞计数计算全身性炎症标志物。评估各组间差异，并对各参数进行ROC分析。结果：两组患者年龄、性别、眼压均无显著差异。与对照组相比，所有青光眼亚型患者的C/D比值均显著升高（p=0.001），而青光眼患者的RNFL厚度较低，但各亚型之间无显著差异（p=0.057）。炎症指标组间差异无统计学意义（p > 0.05），但ROC分析在特定比较中显示出适度的诊断价值。LMR鉴别POAG与对照的AUC最高（0.635）。NLR在区分POAG与XFG （AUC=0.621）和XFG与PACG （AUC=0.627）方面表现中等。结论：全身性炎症指标如NLR和LMR在区分青光眼亚型与中度青光眼和对照组方面具有适度但可测量的区别价值。结构参数（C/D比和RNFL厚度）证实了青光眼和对照眼之间的预期差异，但不能可靠地区分青光眼亚型。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.