Diagnostic Value of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in HLA-B27-Associated Acute Anterior Uveitis

Varan Varadisai,1 Thanapong Somkijrungroj,1,2 Wijak Kongwattananon1,2 1Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; 2Center of Excellence in Retina, Department of Ophthalmology, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandCorrespondence: Wijak Kongwattananon, Center of Excellence in Retina, Department of Ophthalmology, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Rd., Pathum Wan, Bangkok, 10330, Thailand, Tel +662 256 4000, Email [email protected]: To evaluate the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as inflammatory markers in patients with HLA-B27-associated acute anterior uveitis (AAU) compared to healthy controls.Methods: This retrospective case-control study included 42 patients diagnosed with HLA-B27-associated AAU and 42 age- and sex-matched healthy controls. Ocular findings, uveitis activity, and hematologic parameters were extracted from medical records. The NLR and PLR were calculated and compared between groups to assess their diagnostic value.Results: Both NLR and PLR were significantly elevated in the HLA-B27 AAU group (Mean ± SD: 3.46 ± 2.08 and 171.53 ± 88.44) compared to controls (1.59 ± 0.61 and 123.94 ± 48.67, respectively) (p < 0.001 and p = 0.003). White blood cell count (WBC), neutrophil count, and platelet count were also significantly higher in the AAU group. Receiver operating characteristic (ROC) curve analysis showed that NLR had an area under the curve (AUC) of 0.798, with 71.4% sensitivity and 88.1% specificity, while PLR had an AUC of 0.679, with 64.3% sensitivity and 71.4% specificity.Conclusion: Patients with HLA-B27-associated AAU exhibited significantly higher NLR and PLR compared to controls. These hematologic markers reflect systemic inflammation but are not disease specific. NLR and PLR may serve as an adjunctive indicator in patients presenting with clinical signs of active HLA-B27 AAU.Keywords: neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, NLR, PLR, HLA-B27, HLA-B27 AAU, acute anterior uveitis, AAU