Systemic Immune-Inflammation Index and Unconjugated Bilirubin Levels Are Associated with Pseudoexfoliation Syndrome

Published date: Dec 08 2025

Journal Title: Journal of Ophthalmic and Vision Research

Issue title: ‎Volume 20 - 2025

Pages: 1 - 6

DOI: 10.18502/jovr.v20.17022

Rafiye Nur Abayrafiyenurabay@gmail.comKırşehir Ahievran Training and Research Hospital, Ophthalmology Department, Kırşehir

Zeynep Katipoğluzynp_nal@hotmail.comBalıkesir Atatürk City Hospital, Department of Ophthalmology, Altıeylül, Balıkesir

Purpose: To evaluate the systemic immune-inflammation index (SII) and unconjugated bilirubin levels in patients with pseudoexfoliation syndrome (PEX) and compare them with those of healthy individuals (controls).

Methods: The PEX group (n = 48) and the control group (n = 88) were retrospectively evaluated. The results of ophthalmic examinations and routine laboratory parameters were analyzed, and the SII was calculated as follows: SII = platelet count × (neutrophil/lymphocyte).

Results: The neutrophil-to-lymphocyte ratio (NLR) (P = 0.04) and SII (P = 0.03) were higher, and unconjugated bilirubin levels (P = 0.03) were significantly lower in the PEX group than in the control group. Univariate regression analysis showed that the unconjugated bilirubin levels (OR = 0.26; 95% CI, 0.07 to 0.95; P = 0.04) and SII (OR = 1.01; 95% CI, 1.00 to 1.01; P = 0.04) were correlated with PEX. Multivariate logistic regression analysis revealed that the correlation between bilirubin levels (OR = 0.02; CI, 0.01 to 0.25; P = 0.002) and SII (OR = 1.01; CI, 1.00 to 1.02; P = 0.001) remained statistically significant when adjusted for age, gender, and Charlson comorbidity index score.

Conclusion: High SII and low bilirubin values in patients with PEX were found to be correlated.

Keywords: Neutrophil-to-Lymphocyte Ratio, Pseudoexfoliation, Systemic Immune Inflammation Index, Unconjugated Bilirubin

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