{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T17:41:50Z","timestamp":1793122910215,"version":"4.5.0"},"reference-count":77,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antioxidants"],"abstract":"<jats:p>Aim: Our study aimed to evaluate serum oxidative stress-related biomarkers (three pro-oxidants: total oxidant status (TOS), indirect assessment of nitric oxide synthesis (NOx), and malondialdehyde (MDA), and three anti-oxidants: total anti-oxidant capacity (TAC), catalase (CAT), and thiols) in patients with keratoconus (KCN). Methods: We conducted a single-center, cross-sectional study with the prospective enrollment of adult patients attending an outpatient ophthalmology clinic between 1 January 2024, and 1 September 2025. The diagnosis of KCN was established based on the clinical signs and two or more aberrant Pentacam parameters. Results: We evaluated 44 subjects with KCN (median age, 26 years) and 38 without KCN (median age, 28 years), with similar age and sex distributions (p-values &gt; 0.09). All evaluated biomarkers showed statistically significant differences between subjects with KCN and those without KCN (p-values &lt; 0.001), with higher serum TOS, NOx, MDA, CAT, and oxidative stress index levels and lower levels of TACs and thiols in subjects with KCN than in those without KCN. Conclusions: Our findings indicate a systemic imbalance between pro-oxidant and anti-oxidant biomarkers in subjects with keratoconus.<\/jats:p>","DOI":"10.3390\/antiox15030287","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T10:33:02Z","timestamp":1772101982000},"page":"287","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Imbalance of Pro-Oxidant and Anti-Oxidant Biomarkers in Patients with Keratoconus"],"prefix":"10.3390","volume":"15","author":[{"given":"Ariadna Patricia","family":"Nicula","sequence":"first","affiliation":[{"name":"Medical Informatics and Biostatistics, Department 11\u2014Medical Education, Faculty of Medicine, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, Louis Pasteur Str., No. 6, 400349 Cluj-Napoca, Romania"},{"name":"Oculens Clinic, Calea Turzii, No. 134, 400347 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina Ariadna","family":"Nicula","sequence":"additional","affiliation":[{"name":"Oculens Clinic, Calea Turzii, No. 134, 400347 Cluj-Napoca, Romania"},{"name":"Medical Specialties, Department 1\u2014Maxillo-Facial Surgery and Radiology, Faculty of Dental Medicine, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, Clinicilor Str., No. 3-5, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorin","family":"Nicula","sequence":"additional","affiliation":[{"name":"Oculens Clinic, Calea Turzii, No. 134, 400347 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin Ursula","family":"Horvath","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, \u201cGeorge Emil Palade\u201d University of Medicine and Pharmacy Science and Technology, M\u00e1rton \u00c1ron Str., No. 26, 540058 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camelia Manuela","family":"M\u00eerza","sequence":"additional","affiliation":[{"name":"Pathophysiology, Department 1\u2014Morpho-Functional Sciences, Faculty of Medicine, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, Victor Babe\u015f Str., No. 2-4, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6185-7129","authenticated-orcid":false,"given":"Paul Mihai","family":"Boarescu","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical and Complementary Sciences, Faculty of Medicine and Biological Sciences, \u201c\u0218tefan cel Mare\u201d University of Suceava, Universit\u0103\u021bii Str., No. 13, 720229 Suceava, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2342-4311","authenticated-orcid":false,"given":"Sorana D.","family":"Bolboac\u0103","sequence":"additional","affiliation":[{"name":"Medical Informatics and Biostatistics, Department 11\u2014Medical Education, Faculty of Medicine, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, Louis Pasteur Str., No. 6, 400349 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana-Elena","family":"Bulboac\u0103","sequence":"additional","affiliation":[{"name":"Pathophysiology, Department 1\u2014Morpho-Functional Sciences, Faculty of Medicine, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, Victor Babe\u015f Str., No. 2-4, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1097\/00003226-200210000-00008","article-title":"Between-eye asymmetry in keratoconus","volume":"21","author":"Zadnik","year":"2002","journal-title":"Cornea"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1111\/j.1444-0938.2005.tb06687.x","article-title":"Between-eye asymmetry in keratoconus in an Indian population","volume":"88","author":"Chopra","year":"2005","journal-title":"Clin. 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