Evaluation of serum YKL-40 and Galectin-3 as predictive biomarkers for proliferative vitreoretinopathy in rhegmatogenous retinal detachment: a prospective comparative study

To investigate the association between serum YKL-40 and Galectin-3 levels and the development of proliferative vitreoretinopathy (PVR) in patients with rhegmatogenous retinal detachment (RRD), and to evaluate their diagnostic and predictive value as potential biomarkers. Eighty-eight subjects were divided into three groups: RRD with PVR (n = 32), RRD without PVR (n = 36), and healthy controls (n = 20). Serum YKL-40 and Galectin-3 concentrations were determined using ELISA. Clinical variables such as symptom duration and macular status were recorded. Group comparisons and regression analyses were used to assess associations with PVR development, and ROC analysis evaluated diagnostic performance. Serum YKL-40 and Galectin-3 levels were significantly higher in RRD patients than in controls (both p < 0.001). YKL-40 was markedly elevated in PVR (+) cases compared with PVR(–) and controls (p < 0.001 and p = 0.001), whereas Galectin-3 differed significantly only between PVR(+) and controls (p < 0.001). In multivariate logistic regression, higher YKL-40 (OR = 1.081, 95% CI 1.022–1.142, p = 0.006), Galectin-3 (OR = 1.029, 95% CI 1.004–1.054, p = 0.021), and delayed surgery (> 7 days) (p < 0.01) were independent predictors of PVR. ROC analysis between PVR (+) and PVR (–) groups demonstrated good diagnostic accuracy for YKL-40 (AUC = 0.739, p = 0.001; cut-off 26.9 ng/mL) and moderate accuracy for Galectin-3 (AUC = 0.643, p = 0.045; cut-off 99.7 pg/mL). Elevated serum YKL-40 and Galectin-3 levels are associated with PVR development in RRD, reflecting underlying inflammatory and fibrotic activity. YKL-40 exhibited superior predictive performance, suggesting its potential as a systemic biomarker for identifying patients at risk of postoperative proliferation. Further studies incorporating intraocular biomarker profiling and targeted inhibition of these pathways may support novel adjunctive strategies to prevent PVR recurrence and improve surgical outcomes.