Optik Nörit ve Non-Arteritik Anterior İskemik Optik Nöropatide Tam Kan Sayımından Elde Edilen İnflamatuar Biyobelirteçlerin Karşılaştırmalı Analizi

Yıl 2025, Cilt: 15 Sayı: 4, 448 - 458, 15.12.2025

Meryem Tuba Sönmez , Selda Çelik Dülger , Duygu Arslan Mehdiyev , Hikmet Saçmacı , Funda Uysal Tan

https://doi.org/10.16919/bozoktip.1758887

https://izlik.org/JA57CN88EX

Öz

Amaç: Demiyelinizan optik nörit (ON) ve non-arteritik anterior iskemik optik nöropati (NAION), farklı patofizyolojik mekanizmalara sahip olsalar da her iki durumda da sistemik inflamatuvar yanıtın rol oynadığı düşünülmektedir. Bu çalışmada, tam kan sayımından (CBC) türetilen sistemik inflamasyon indekslerinin (SII, SIRI, PIV) ON ve NAION alt gruplarında karşılaştırmalı olarak değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntemler: Kortikosteroid tedavisi öncesinde ölçülen hemogram parametrelerine göre hesaplanan SII, SIRI, PIV, NLR, PLR ve MLR değerleri; 18 demiyelinizan ON ve 25 NAION hastasında yaş ve cinsiyet açısından eşleştirilmiş sırasıyla 16 ve 11 sağlıklı kontrol grupları ile karşılaştırıldı. Ayrıca NAION grubunda SII ve PIV için ROC analizleri gerçekleştirildi.
Bulgular: NAION grubunda SII (p=0.015), PIV (p=0.004) ve SIRI (p=0.001) değerleri, kontrol grubuna kıyasla anlamlı şekilde yüksekti. ROC analizlerinde SII için AUC %70.1, PIV için ise %73.8 olarak bulundu; bu değerler NAION’u ayırt etmede orta düzeyde tanısal performansa işaret etmektedir. Demiyelinizan ON grubunda ise bu indeksler açısından kontrol grubuna göre anlamlı fark gözlenmedi. NAION ile ON hastaları karşılaştırıldığında, NAION grubunda SIRI ve monosit düzeylerinin daha yüksek olduğu saptandı.
Sonuç: CBC’den türetilen bileşik inflamasyon indeksleri, özellikle SII, SIRI ve PIV, NAION hastalarında anlamlı düzeyde yüksek bulunmuştur. Bu durum NAION’un sistemik inflamasyonla ilişkili fizyopatolojisini desteklemekte ve bu indekslerin tanı sürecine katkı sağlayabileceğini düşündürmektedir. Bulgular, bu parametrelerin potansiyel prognostik biyobelirteçler olarak da değerlendirilebileceğini ortaya koymaktadır. Ancak bu sonuçların klinik geçerliliğinin netleşmesi için daha büyük örneklemlerle yapılacak prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Optik nörit , non-arteritik anterior iskemik optik nöropati , tam kan sayımı , sistemik inflamasyon , SII , SIRI , PIV

Comparative Analysis of CBC-Derived Inflammatory Biomarkers in Optic Neuritis and Non-Arteritic Anterior Ischemic Optic Neuropathy

https://izlik.org/JA57CN88EX

Öz

Objective: Demyelinating optic neuritis (ON) and non-arteritic anterior ischemic optic neuropathy (NAION) represent distinct clinical entities with different pathophysiological mechanisms, yet both are believed to involve systemic inflammatory responses. This study aimed to compare systemic inflammatory indices derived from complete blood count (CBC), including the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV), in patients with ON and NAION.
Material and Methods: Inflammatory indices (SII, SIRI, PIV, NLR, PLR, and MLR) were calculated using CBC parameters obtained before corticosteroid treatment. A total of 18 patients with demyelinating ON and 25 with NAION were included, along with age- and sex-matched healthy control groups (16 for ON, 11 for NAION). ROC analyses were performed for SII and PIV in the NAION group to assess diagnostic performance.
Results: SII (p = 0.015), PIV (p = 0.004), and SIRI (p = 0.001) were significantly elevated in the NAION group compared to controls. ROC analyses demonstrated AUC values of 70.1% for SII and 73.8% for PIV, indicating moderate diagnostic utility in distinguishing NAION. No significant differences in these indices were observed between the ON group and their respective controls. In the direct comparison between disease groups, patients with NAION exhibited higher SIRI and monocyte levels than those with ON.
Conclusions: Composite inflammatory indices derived from CBC, particularly SII, SIRI, and PIV, were significantly elevated in patients with NAION. These findings support the role of systemic inflammation in NAION pathophysiology and highlight the potential diagnostic and prognostic value of these indices. Further prospective studies with larger cohorts are warranted to validate their clinical relevance.

Anahtar Kelimeler

Optic neuritis , non-arteritic anterior ischemic optic neuropathy , complete blood count , systemic inflammation , SII , SIRI , PIV

Etik Beyan

Ethics Statement: All protocols were approved by the local ethics committee for human research (AEŞH-EK1-2023-498) and this study was performed under the relevant guidelines and regulations established by Helsinki Guidelines.

Destekleyen Kurum

Yok

Kaynakça

• 1. De Lott LB. Optic Neuropathies. Continuum (Minneap Minn). 2025;31(2):381-406
• 2. Eggenberger E. Optic Neuritis. Continuum (Minneap Minn). 2025;31(2):407-35.
• 3. Ma R, Ren J, Chen X, Li X, Zhao Y, Ding Y. Association between pan-immune-inflammation value and coronary heart disease in elderly population: a cross-sectional study. Front Cardiovasc Med. 2025;12:1538643.
• 4. Fang X, Sun S, Yang T, Liu X. Predictive role of blood-based indicators in neuromyelitis optica spectrum disorders. Front Neurosci. 2023;17:1097490.
• 5. Li X, Jiang W, Li G, Ding Y, Li H, Sun J, et al. Inflammatory and Nutritional Markers as Indicators for Diagnosing and Assessing Disease Activity in MS and NMOSD. J Inflamm Res. 2024;17:10065- 78.
• 6. Fahmi RM, Ramadan BM, Salah H, Elsaid AF, Shehta N. Neutrophillymphocyte ratio as a marker for disability and activity in multiple sclerosis. Mult Scler Relat Disord. 2021;51:102921.
• 7. Yetkin MF, Mirza M. Neutrophil to-lymphocyte ratio as a possible predictor of prognosis in recently diagnosed multiple sclerosis patients. J Neuroimmunol. 2020;346:577307.
• 8. Wang S, Zhang L, Qi H, Zhang FL, Fang Q, Qiu L. Pan-ImmuneInflammatory Value Predicts the 3 Months Outcome in Acute Ischemic Stroke Patients after Intravenous Thrombolysis. Curr Neurovasc Res. 2023;20(4):464-71.
• 9. Bisgaard AK, Pihl-Jensen G, Frederiksen JL. The neutrophil-tolymphocyte ratio as disease actvity marker in multiple sclerosis and optic neuritis. Mult Scler Relat Disord. 2017;18:213-7.
• 10. Koçak N, Eraydın B, Turunç M, Yeter V, Güngör İ. Serum Inflammatory Biomarkers in Patients with Nonarteritic Anterior Ischemic Optic Neuropathy. Kore J Oftalmol. 2020;34(6):478-84.
• 11. Khan A, Roy P, Ley K. Breaking tolerance: the autoimmune aspect of atherosclerosis. Nat Rev Immunol. 2024;24(9):670-9.
• 12. Yan Y, Jia S, Huo X, Liu L, Sun L, Ma S, et al. Association between pan-immune-inflammation value and dyslipidemia in the United States population. Front Endocrinol (Lausanne). 2025;16:1518304.
• 13. Tuzimek A, Dziedzic EA, Beck J, Kochman W. Correlations Between Acute Coronary Syndrome and Novel Inflammatory Markers (Systemic Immune-Inflammation Index, Systemic Inflammation Response Index, and Aggregate Index of Systemic Inflammation) in Patients with and without Diabetes or Prediabetes. J Inflamm Res. 2024;17:2623-32.
• 14. Byun MJ, Nakasone ES, Shin HE, Lee H, Park JC, Lee W, et al. Advanced Nanoparticle Therapeutics for Targeting Neutrophils in Inflammatory Diseases. Adv Healthc Mater. 2025:2502092.
• 15. Obeagu EI. The diagnostic significance of neutrophil-tolymphocyte ratio and platelet-to-lymphocyte ratio in malaria: insights and implications–a narrative review. Ann Med Surg. 2025;87(6):3393-402.
• 16. Hu Y, Dai S, Qiao C, Ye Y, Ren J, Wang K, et al. Platelets in infection: intrinsic roles and functional outcomes. Front Immunol. 2025;16:1616783.
• 17. Yáñez A, Coetzee SG, Olsson A, Muench DE, Berman BP, Hazelett DJ, et al. Granulocyte-Monocyte Progenitors and MonocyteDendritic Cell Progenitors Independently Produce Functionally Distinct Monocytes. Immunity. 2017;47(5):890-902.e4.
• 18. Turan YB. The prognostic importance of the pan-immuneinflammation value in patients with septic shock. BMC Infect Dis. 2024;24(1):69.
• 19. Islam MM, Satici MO, Eroglu SE. Unraveling the clinical significance and prognostic value of the neutrophil-to-lymphocyte ratio, plateletto-lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, and delta neutrophil index: An extensive literature review. Turk J Emerg Med. 2024;24(1):8-19