{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:57:03Z","timestamp":1787169423148,"version":"build-2736575974"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>It was aimed to compare the levels of inflammation-related parameters, such as neutrophil\/lymphocyte ratio (NLR) and platelet\/lymphocyte ratio (PLR), in patients with advanced keratoconus (KC) and healthy controls. Also, we evaluated the relationships between these parameters and several corneal topography values used in the KC diagnostic index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Forty patients with advanced and 40 healthy volunteers were included in this study. In the KC group, 20 patients were nonprogressive KC and 20 patients were progressive KC. In all participating individuals, we evaluated detailed ophthalmologic examination findings and complete blood count data, while corneal topographic measurements were also recorded in patients with KC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mean NLR value was 2.3 \u00b1 1.19 in the progressive KC group; nonprogressive KC values were 1.99 \u00b1 1.69 and 1.81 \u00b1 0.72 in the control group. Mean PLR value was 113.24 \u00b1 48.44 in the progressive KC group, nonprogressive KC values were 96.47 \u00b1 31.04 and 104.09 \u00b1 35.14 in the control group. No statistically significant difference was found between patients with progressive KC, nonprogressive KC, and healthy volunteers in terms of mean NLR and PLR values (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05). NLR values were found to demonstrate significant positive correlations with the corneal topography parameters, Symmetry Index front (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = 0.278,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.025), KC Vertex front (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = 0.247,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.048), and Baiocchi Calossi Versaci front (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = 0.273,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.028); there was no significant relationship between corneal topography parameters and PLR values.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Although there was no significant difference between the progressive KC, nonprogressive KC, and control groups in inflammation parameters such as NLR and PLR, a positive correlation was observed between the NLR value and some corneal topography findings used in the diagnosis of KC. The role of inflammation in the etiology of KC can be better understood by clinical studies and laboratory tests conducted with prospective studies involving a higher number of patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_3403_20","type":"journal-article","created":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T11:42:39Z","timestamp":1633434159000},"page":"2658-2662","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Assessing the role of systemic inflammation in the etiopathogenesis of advanced stage keratoconus"],"prefix":"10.4103","volume":"69","author":[{"given":"Ali H","family":"Reyhan","sequence":"first","affiliation":[{"name":"Department of Opthalmology, Kilis state Hospital, Kilis, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay\u015fe Sevgi","family":"Karada\u011f","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ad\u0131yaman University Training and Research Hospital, Ad\u0131yaman, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u015eerife \u015eule","family":"\u00c7\u0131nar","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ad\u0131yaman University Training and Research Hospital, Ad\u0131yaman, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,9,25]]},"reference":[{"key":"B1-20240828","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S0039-6257(97)00119-7","article-title":"Keratoconus","volume":"42","author":"Rabinowitz","year":"1998","journal-title":"Surv Ophthalmol"},{"key":"B2-20240828","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.18240\/ijo.2019.11.17","article-title":"The correlation between keratoconus and eye rubbing:A review","volume":"12","author":"Najmi","year":"2019","journal-title":"Int J Ophthalmol"},{"key":"B3-20240828","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/0039-6257(84)90094-8","article-title":"Keratoconus and related noninflammatory corneal thinning disorders","volume":"28","author":"Krachmer","year":"1984","journal-title":"Surv Ophthalmol"},{"key":"B4-20240828","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.ophtha.2014.08.026","article-title":"Reduced precision of the Pentacam HR in eyes with mild to moderate keratoconus","volume":"122","author":"Hashemi","year":"2015","journal-title":"Ophthalmology"},{"key":"B5-20240828","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1016\/j.ophtha.2008.08.004","article-title":"Keratoconus diagnosis with optical coherence tomography pachymetry mapping","volume":"115","author":"Li","year":"2008","journal-title":"Ophthalmology"},{"key":"B6-20240828","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.clae.2004.12.001","article-title":"Corneal wavefront aberration measurement to detect keratoconus patients","volume":"28","author":"Gobbe","year":"2005","journal-title":"Cont Lens Anterior Eye"},{"key":"B7-20240828","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.clae.2010.04.006","article-title":"Keratoconus:A review","volume":"33","author":"Romero-Jim\u00e9nez","year":"2010","journal-title":"Cont Lens Anterior Eye"},{"key":"B8-20240828","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/j.ajo.2006.07.026","article-title":"Baseline factors predictive of incident penetrating keratoplasty in keratoconus","volume":"142","author":"Gordon","year":"2006","journal-title":"Am J Ophthalmol"},{"key":"B9-20240828","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/S0161-6420(94)31313-3","article-title":"Prognostic factors for the progression of keratoconus","volume":"101","author":"Tuft","year":"1994","journal-title":"Ophthalmology"},{"key":"B10-20240828","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1136\/bjo.2008.144253","article-title":"Subclinical keratoconus and inflammatory molecules from tears","volume":"93","author":"Lema","year":"2009","journal-title":"Br J Ophthalmol"},{"key":"B11-20240828","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1001\/archopht.1994.01090220118033","article-title":"Lysosomal enzyme activities in con- junctival tissues of patients with keratoconus","volume":"112","author":"Fukuchi","year":"1994","journal-title":"Arch Ophthalmol"},{"key":"B12-20240828","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1001\/archopht.1989.01070020581044","article-title":"Lysosomal abnormalities in kerato- conus","volume":"107","author":"Sawaguchi","year":"1989","journal-title":"Arch Ophthalmol"},{"key":"B13-20240828","first-page":"4008","article-title":"Alpha 2 macroglobulin levels in normal human and keratoconus corneas","volume":"35","author":"Sawaguchi","year":"1994","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"B14-20240828","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1016\/j.ophtha.2004.11.050","article-title":"Inflammatory molecules in the tears of patients with keratoconus","volume":"112","author":"Lema","year":"2005","journal-title":"Ophthalmology"},{"key":"B15-20240828","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.exer.2011.12.010","article-title":"Levels of lactoferrin, secretory IgA and serum albumin in the tear film of people with keratoconus","volume":"96","author":"Balasubramanian","year":"2012","journal-title":"Exp Eye Res"},{"key":"B16-20240828","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1038\/bjc.2017.467","article-title":"Systemic inflammatory markers have independent prognostic value in patients with metastatic testicular germ cell tumours undergoing first-line chemotherapy","volume":"118","author":"Fankhauser","year":"2018","journal-title":"Br J Cancer"},{"key":"B17-20240828","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s13018-018-0745-x","article-title":"Predictive value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio for acute deep vein thrombosis after total joint arthroplasty:A retrospective study","volume":"13","author":"Yao","year":"2018","journal-title":"J Orthop Surg Res"},{"key":"B18-20240828","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1038\/bjc.2013.28","article-title":"Validation of the pre-treatment neutrophil-lymphocyte ratio as a prognostik factor in a large European cohort of renal cell carcinoma patients","volume":"108","author":"Pichler","year":"2013","journal-title":"Br J Cancer"},{"key":"B19-20240828","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/j.amjcard.2008.05.006","article-title":"Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome","volume":"102","author":"Tamhane","year":"2008","journal-title":"Am J Cardiol"},{"key":"B20-20240828","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1158\/1055-9965.EPI-14-0146","article-title":"Prognostic role of platelet to lymphocyte ratio in solid tumors:A systematic review and meta-analysis","volume":"23","author":"Templeton","year":"2014","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"B21-20240828","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1097\/ICO.0b013e31823f8c72","article-title":"What causes keratoconus?","volume":"31","author":"Sugar","year":"2012","journal-title":"Cornea"},{"key":"B22-20240828","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.jtos.2015.04.006","article-title":"Van der Lelij A. Cytokine expression in keratoconus and its corneal microenvironment:A systematic review","volume":"13","author":"Wisse","year":"2015","journal-title":"Ocul Surf"},{"key":"B23-20240828","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1038\/eye.2013.262","article-title":"Increased systemic oxidative stress in patients with keratoconus","volume":"28","author":"Toprak","year":"2014","journal-title":"Eye"},{"key":"B24-20240828","doi-asserted-by":"crossref","first-page":"16437","DOI":"10.1371\/journal.pone.0016437","article-title":"Subnormal cytokine profile in the tear fluid of keratoconus patients","volume":"6","author":"Jun","year":"2011","journal-title":"PloS One"},{"key":"B25-20240828","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1097\/00003226-200007000-00014","article-title":"Levels of collagen degradation products (telopeptides) in the tear \ufb01lm of patients with keratoconus","volume":"19","author":"Abalain","year":"2000","journal-title":"Cornea"},{"key":"B26-20240828","doi-asserted-by":"crossref","first-page":"8592","DOI":"10.1167\/iovs.11-7732","article-title":"Oxidative stress in keratoconus?","volume":"52","author":"Arnal","year":"2011","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"B27-20240828","doi-asserted-by":"crossref","first-page":"19294","DOI":"10.3390\/ijms140919294","article-title":"Oxidative stress in the pathogenesis of keratoconus and Fuchs endothelial corneal dystrophy","volume":"14","author":"Wojcik","year":"2013","journal-title":"Int J Mol Sci"},{"key":"B28-20240828","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/cxo.12038","article-title":"Effects of eye rubbing on the levels of protease, protease activity and cytokines in tears:Relevance in keratoconus","volume":"96","author":"Balasubramanian","year":"2013","journal-title":"Clin Exp Optom"},{"key":"B29-20240828","doi-asserted-by":"crossref","first-page":"e39313","DOI":"10.1371\/journal.pone.0039313","article-title":"Prevalence and associations of steep cornea\/keratoconus in Greater Beijing","volume":"7","author":"Xu","year":"2012","journal-title":"The Beijing Eye Study. PLoS One"},{"key":"B30-20240828","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/686791","article-title":"Association of high density lipoprotein with platelet to lymphocyte and neutrophil to lymphocyte ratios in coronary artery disease patients","volume":"2014","author":"Prajapati","year":"2014","journal-title":"J Lipids"},{"key":"B31-20240828","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1016\/j.tranon.2014.07.009","article-title":"The combination of platelet count and neutrophil lymphocyte ratio is a predictive factor in patients with esophageal squamous cell carcinoma","volume":"7","author":"Feng","year":"2014","journal-title":"Transl Oncol"},{"key":"B32-20240828","doi-asserted-by":"crossref","first-page":"571","DOI":"10.3109\/0886022X.2012.668741","article-title":"Neutrophil-to-lymphocyte ratio as a predictor of worsening renal function in diabetic patients (3-year follow-up study)","volume":"34","author":"Azab","year":"2012","journal-title":"Ren Fail"},{"key":"B33-20240828","first-page":"1","article-title":"Serum PLR and LMR in Beh\u00e7et's disease","volume":"96","author":"Jiang","year":"2017","journal-title":"Medicine (United States)"},{"key":"B34-20240828","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1089\/dia.2013.0097","article-title":"Neutrophil-to-lymphocyte ratio as a quick and reliable predictive marker to diagnose the severity of diabetic retinopathy","volume":"15","author":"Ulu","year":"2013","journal-title":"Diabetes Technol Ther"},{"key":"B35-20240828","first-page":"362","article-title":"The significance of the neutrophil\/lymphocyte ratio as a simple indicator of inflammation in age-related macular degeneration","volume":"24","author":"Ilhan","year":"2016","journal-title":"Ocul Immunol Inflamm"},{"key":"B36-20240828","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1080\/09273948.2017.1340486","article-title":"Assessment of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with dry eye disease","volume":"26","author":"\u00c7elik","year":"2018","journal-title":"Ocular Immunol Inflamm"},{"key":"B37-20240828","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1097\/IJG.0000000000000392","article-title":"Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as novel biomarkers of primary open-angle glaucoma","volume":"25","author":"Ozgonul","year":"2016","journal-title":"J Glaucoma"},{"key":"B38-20240828","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1080\/09273948.2019.1588334","article-title":"The relation of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio with high axial myopia","volume":"28","author":"Icel","year":"2020","journal-title":"Ocular Immunol Inflamm"},{"key":"B39-20240828","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1097\/ICO.0000000000000260","article-title":"Neutrophil-to-lymphocyte ratio may predict progression in patients with keratoconus","volume":"33","author":"Karaca","year":"2014","journal-title":"Cornea"},{"key":"B40-20240828","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1080\/09273948.2019.1611876","article-title":"May monocyte\/HDL cholesterol ratio (mhr) and neutrophil\/lymphocyte ratio (nlr) be an indicator of inflammation and oxidative stress in patients with keratoconus?","volume":"28","author":"Katipo\u011flu","year":"2020","journal-title":"Ocular Immunol Inflamm"},{"key":"B41-20240828","first-page":"1","article-title":"Serum Inflammation biomarkers in patients with keratoconus","author":"Bozkurt","year":"2020","journal-title":"Ocular Immunol Inflamm"},{"key":"B42-20240828","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1089\/jir.1998.18.555","article-title":"Proinflammatory cytokines lowering erythropoietin production","volume":"18","author":"Jelkmann","year":"1998","journal-title":"J Interferon Cytokine Res"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijo.IJO_3403_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:07:26Z","timestamp":1787166446000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijo.IJO_3403_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,25]]},"references-count":42,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_3403_20","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,25]]},"assertion":[{"value":"2020-10-31","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}