Assessment of Systemic Inflammatory Markers Linked to High-Density Lipoprotein Levels in Patients with Keratoconus: A Retrospective Case-Control Analysis
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By
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Burçin Çakır
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Muhammed Muaz Osmanoğlu
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Büşra Güner Sönmezoğlu
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December 23, 2025
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.
Related Resources & Content
- Keratoconus definition and inflammatory marker studies
- HDL as inflammatory biomarker and related ratios
- Systemic inflammatory markers in neurological and psychiatric diseases
- Corneal collagen cross-linking in keratoconus management
Based on findings from:
Assessment of Systemic Inflammatory Markers Linked to High-Density Lipoprotein Levels in Patients with Keratoconus: A Retrospective Case-Control Analysis
Burçin Çakır, Muhammed Muaz Osmanoğlu, Büşra Güner Sönmezoğlu. Bmc Ophthalmology, 2025.
https://link.springer.com/article/10.1186/s12886-025-04511-z
This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.
