Neutrophil-to-Lymphocyte Ratio May Predict Progression in Patients With Keratoconus

Purpose: Neutrophil-to-lymphocyte ratio (NLR) is a new potential predictor of systemic inflammation in several diseases. In this study, we aimed to evaluate NLR in patients with keratoconus. Methods: This cross-sectional observational study included 54 patients with keratoconus and 25 age- and sex-matched control subjects. All participants underwent a detailed ophthalmological examination and corneal topography. The patients were divided into progressive and nonprogressive keratoconus groups on the basis of topographic parameters. Serum samples were obtained from all subjects, and the NLR was calculated. Results: The NLR was 3.27 +/- 1.37 in the progressive keratoconus group versus 1.87 +/- 0.39 and 1.87 +/- 0.52 in the nonprogressive and control groups, respectively (P < 0.01). There was a positive correlation between NLR and progression (P < 0.05). In the receiver-operating characteristic analysis, an NLR >= 2.24 predicted the presence of progression with 79% sensitivity and 81% specificity. Conclusions: The NLR is a simple and inexpensive marker of systemic inflammation. The NLR was found to be higher in patients with progressive keratoconus than in the nonprogressive group and controls.