Assessment of Systemic Inflammatory Markers Linked to High-Density Lipoprotein Levels in Patients with Keratoconus: A Retrospective Case-Control Analysis - Scorecard - MDSpire
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Assessment of Systemic Inflammatory Markers Linked to High-Density Lipoprotein Levels in Patients with Keratoconus: A Retrospective Case-Control Analysis
Clinical Scorecard: Assessment of Systemic Inflammatory Markers Linked to High-Density Lipoprotein Levels in Patients with Keratoconus: A Retrospective Case-Control Analysis
At a Glance
Category
Detail
Condition
Keratoconus (KC), a progressive, bilateral ectatic corneal disorder with conical protrusion and thinning
Key Mechanisms
Systemic inflammation assessed via markers including platelet to HDL ratio (PHR), neutrophil/lymphocyte ratio (NLR), monocyte/HDL ratio (MHR), neutrophil/HDL ratio (NHR), and lymphocyte/HDL ratio (LHR); HDL's anti-inflammatory and antioxidant roles
Target Population
Patients diagnosed with progressive keratoconus undergoing corneal collagen cross-linking
Care Setting
Ophthalmology department with corneal tomography and systemic inflammatory marker evaluation
Key Highlights
PHR was significantly elevated in keratoconus patients compared to healthy controls (p = 0.004; adjusted p = 0.0215).
No significant correlations were found between systemic inflammatory markers and corneal topographic parameters or visual acuity.
Optimal PHR cutoff value for keratoconus diagnosis was 4807 with 74.8% sensitivity and 45.5% specificity (AUC: 0.616).
Guideline-Based Recommendations
Diagnosis
Diagnose keratoconus based on clinical signs (e.g., Vogt striae, Fleischer ring, corneal thinning) and corneal tomography parameters (high keratometry, posterior elevation).
Consider systemic inflammatory markers, especially PHR, as adjunctive biomarkers in keratoconus assessment.
Management
Manage progressive keratoconus with corneal collagen cross-linking to halt progression.
Exclude patients with systemic diseases or factors affecting inflammatory markers to ensure accurate assessment.
Monitoring & Follow-up
Monitor keratoconus progression via changes in Kmax (>1 diopter/year) and best corrected visual acuity (BCVA).
Systemic inflammatory markers may be monitored but showed no correlation with disease severity in this study.
Risks
Be aware that systemic inflammatory markers can be influenced by comorbid conditions; exclude such confounders in clinical evaluation.
PHR has moderate sensitivity and low specificity; should not be used as sole diagnostic tool.
Patient & Prescribing Data
Patients with progressive keratoconus undergoing corneal collagen cross-linking
Systemic inflammatory markers including PHR may serve as supplementary indicators but currently lack correlation with disease severity; treatment decisions remain based on clinical and tomographic findings.
Clinical Best Practices
Perform comprehensive ophthalmic examination including slit-lamp, fundoscopic evaluation, and corneal tomography for keratoconus diagnosis.
Use systemic inflammatory markers cautiously as adjuncts; PHR shows significant difference but limited diagnostic specificity.
Exclude patients with systemic inflammatory conditions or treatments that may confound inflammatory marker levels.
Apply ROC curve analysis to interpret PHR values with awareness of sensitivity and specificity limitations.
Follow ethical guidelines and obtain informed consent for retrospective analyses.
