Systemic Inflammatory Biomarkers in Patients with Fuchs' Uveitis Syndrome: Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio.

OBJECTIVE: To evaluate the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in patients with Fuchs' uveitis syndrome (FUS). STUDY DESIGN: A case-control study. PLACE AND DURATION OF STUDY: Department of Ophthalmology, Haydarpasa Numune Training and Research Hospital, Turkey, between July 2016 and June 2019. METHODOLOGY: Twenty-eight patients with unilateral FUS and 30 healthy subjects were enrolled in the study. The NLR and PLR were calculated from complete blood counts tests; and compared between the groups. RESULTS: There were 28 patients (14 females, 14 males; median age: 33.5 (30-47.5) in the FUS group; and 30 patients (16 females, 14 males; median age 37.5 (33-41.8) in the healthy group. The NLR (1.7 v.s 1.2, p = 0.036 was found to be significantly higher and PLR was lower (100.27 ±37.13 v.s. 141.68 ±26.50 p <0.001) in the FUS group compared with the healthy controls. The median WBC (p <0.001), neutrophil (p <0.001), lymphocytes (p <0.001), and monocyte (p=0.041) values were found significantly higher in the FUS group compared with controls. The significant correlations were not seen between the number of anterior chamber cells; which are ocular inflammatory parameter and NLRs (r = 0.312, p = 0.106) and PLRs (r = 0.148, p = 0.453). CONCLUSION: The current study suggests that a slowly progressive immune-mediated process can affect peripheral blood inflammatory biomarkers and there is evidence of benign subclinical systemic inflammation in patients with FUS. Key Words: Fuchs uveitis syndrome, Neutrophil to lymphocyte ratio, Platelet to lymphocyte ratio.

Complete blood count parameters and neutrophil-to-lymphocyte ratio values as markers for differentiation between systemic infectious and non-infectious uveitis.

PURPOSE: To compare complete blood count (CBC) parameters and neutrophil/lymphocyte ratio (NLR) between patients with infectious uveitis (IU) and those with non-infectious uveitis (NIU) during the first acute uveitis attack (AUA). METHODS: The records of 119 patients admitted with the first AUA between 2016 and 2019 and whose diagnosis was unknown at the time of admission were retrospectively reviewed. The patients were divided into two groups, IU and NIU according to diagnoses after ocular and systemic workup. The IU group was also divided into subgroups as uveitis associated with local ocular infections and systemic infections. The complete blood count and associated indices of patients calculated from samples taken during the attack were compared between the groups. RESULTS: A total of 60 NIU cases (mean age: 43.5 ± 11.6 years) and 59 IU cases (43.3 ± 14.7 years) were examined. Twenty-six of the NIU cases were female and 34 were male, while 32 of the IU cases were female and 27 were male. The localization of uveitis was similar in the IU and NIU groups (anterior: 11 vs. 18, intermediate: 3 vs. 6, posterior: 28 vs. 14, panuveitis: 17 vs. 22). The NLR values were significantly increased in patients with IU compared to those with NIU (p = 0.047). When the NLR is compared between NIU and subgroups of IU, this value was only found significantly increased in uveitis due to a systemic infection (n = 12) (p < 0.001). The mean white blood cell (WBC) count (p < 0.001) and neutrophil values (p < 0.001) were also observed significantly higher in the uveitis associated with systemic infectious diseases when compared with uveitis associated with local ocular infections and NIU group. CONCLUSION: In the current study, NLR values are compared with autoimmune uveitis and systemic infectious uveitis for the first time in patients with AUA. This ratio has been found significantly higher in uveitis associated with systemic infections. The use of CBC parameters and indices, especially the NLR, may be instrumental in assessing patients presenting with first AUA, particularly when there is no clear explanation or underlying cause.

Intermediate Uveitis as the Initial and Only Presentation of Syphilis

We report a patient with unilateral syphilitic intermediate uveitis without dermatological, neurological, or any systemic involvement. He presented to our clinic with complaints of eye floaters and worsening visual acuity in the left eye. He had intermediate uveitis and cystoid macular edema in that eye and both venereal disease research laboratory and microhemagglutination assay for Treponema pallidum serological tests were confirmatory for syphilis. Ocular manifestations of syphilis have variable presentations, and it should be considered when diagnosing unexplained ocular inflammatory diseases, even if the patient's recent history and systemic evaluation are not compatible.

The choroid and lamina cribrosa is affected in patients with Parkinson's disease: enhanced depth imaging optical coherence tomography study.

PURPOSE: To compare lamina cribrosa (LC) and choroidal thicknesses using enhanced depth imaging optical coherence tomography (EDI-OCT) in patients with Parkinson's disease (PD) and healthy controls. METHODS: A total number of 44 eyes of 22 patients with PD and 50 eyes of 25 healthy subjects were utilized in this institutional cross-sectional study. After a complete ophthalmic examination, all eyes were imaged with OCT (RTVue-100 version 5.1 Fourier-domain optical coherence tomography; Optovue Inc., Fremont, CA, USA); LC and choroidal thickness were assessed. RESULTS: The mean LC thicknesses were 209.4 ± 40.2 µm in patients with PD and 292.5 ± 33.7 µm in control subjects. There was a significant difference in the mean LC thickness between the groups (p < 0.0001). The choroidal thickness measurements of the PD group at the subfoveal region and 1.5 mm temporal and 1.5 mm nasal to the fovea were 228.1 ± 44.3, 193.2 ± 41.4 and 188.4 ± 49.0 µm, respectively, whereas measurements for the controls were, respectively, 246.5 ± 38.2, 227.3 ± 34.7 and 216.7 ± 51.4 µm. The choroid was significantly thinner in eyes of the PD group compared to that of the controls (p = 0.001, p < 0.001, and p = 0.006). There was no significant correlation between the disease severity and OCT parameters. The duration of the disease showed a statistically significant negative correlation with LC (rs[94] = -0.700, p < 0.001), and average subfoveal and temporal and nasal choroid thicknesses (rs[94] = -0.282, p = 0.006; rs[94] = -0.324, p = 0.001, rs[94] = -0.240, and p = 0.020, respectively). CONCLUSIONS: Regardless of the disease severity, PD may cause atrophy and volume loss in the lamina cribrosa, and choroid. An enhanced depth imaging technique may be used as an additional modality in the diagnosis and follow-up of patients with PD.