Author: BEYZA TEZEL (Turkey)
Co-authors: Naciye Kabataş, Sinan Çalışkan, Osman Çelikay
Purpose
Uveitis is defined as a common intraocular inflammation which is usually associated with multiple systemic diseases. Acute anterior uveitis (AAU) is the most common sub-type of uveitis. Approximately %50 of AAU cases the etiology is not identifiable and these cases are called idiopathic AAU. Neutrophile to lymphocyte ratio (NLR), C-reactive protein (CRP) and CRP to albumin ratio (CAR) are the inflammatory parameters which have been used usually in monitoring the severity of systemic inflammatory diseases. Since the idiopathic AAU is not related to systemic disease, increased NLR and CAR is not expected. Studies have reported increased NLR in uveitis but the literature is limited in terms of evaluating CAR in uveitis patients. Although the only study evaluating CAR in uveitis have reported increased CAR in uveitis patients; anterior, posterior and panuveitis were evaluated together and idiopathic uveitis and the others related to systemic diseases were not subgrouped. In this study we aimed to investigate the NLR and CAR in idiopathic AAU patients and to compare the results with the healthy controls. We studied also the correlation between these two parameters
Setting/Venue
This study is conducted in Dıskapı Yıldırım Beyazıd Research and Education Hospital Ophthalmology Department Uvea unit in Ankara.
Methods
This study was conducted in accordance with the declaration of Helsinki. Ethical approval was obtained from Dıskapı Yıldırım Beyazıd Research and Education Hospital Human Research Ethics Committee. Retrospectivelly we reviewed the records of 103 patients diagnosed with uveitis who admitted to our clinic between January 2016 and January 2021. According to their conclusive diagnosis 37 idiopathic AAU patients and 35 age matched healthy controls were enrolled in study. All patients had routine ophthalmological assesment and we rewieved the results of complete blood count (CBC), CRP, renal and liver function tests which were performed during their acute anterior uveitis attack. NLR and CAR were calculated in uveitis and control groups.
Results
The mean age in the idiopathic AAU group was 35,08+/-8,56 while 33,51+/-6,80 in healthy subjects (p ˃0.05). Neutrophile and lymphocyte counts were 4,78+/-1,25 (1000/μL) and 1,73+/-0,65 (1000/μL) in the AAU group and 4,03+/-1,01 (1000/μL)and 2,37+/-0,62 (1000/μL)in the control group respectively (p˂0,0001). NLR was 3,05+1,20 in the AAU group and 1,77+/-0,54 in the control group(p˂0,0001). CRP was 5,31+/-2,35 in the AAU group while 3,12+/-0,86 in the control group (p˂0,0001). CAR was 1,23+/-0,55 in the AAU group and 0,69+/-0,18 in the control group (p˂0,0001). Correlation analyse showed no correlation between NLR and CAR (r=-0,17 p=0,316).
Conlusions
Increased NLR is detected not only in many systemic inflammatory diseases but also in certain ocular diseases such as keratoconus, retinal veno-occlusions, age related macular degeneration. Although in uveitis patients without systemic disease the immune response is too localized to be detected in the peripheric blood, studies from uvea clinics are recently indicating increased NLR in idiopathic uveitis. In one study the authors concluded Behcet patients with AAU attacks had significantly increased NLR compared with Behcet without AAU. CAR is used as a marker of inflammation and mortality risk indicator in cardio-vascular disease and septic shock. The only uveitis study in the literature indicated that increased CAR levels are correlated with the severity of uveitis regardless of localization of uveitis. In our study we detected significant increase in NLR and CAR in idiopathic AAU patients. Depending on our study results NLR and CAR can be used to monitor patients with idiopathic AAU.
Financial Disclosure
none
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