To evaluate the predictive value of pan-immune-inflammation value (PIV) in the diagnosis of proliferative diabetic retinopathy (PDR) and its association with the stage of PDR.

This observational case-control study included participants who underwent routine complete blood count testing. Inflammation-related indices, including neutrophil-to-lymphocyte ratio, systemic immune-inflammation index (SII), and PIV, were derived and analyzed. Receiver operating characteristic curve (ROC) analysis was applied to assess the diagnostic performance of these indices in distinguishing patients with PDR, with sensitivity, specificity, area under ROC, and optimal threshold values calculated. In addition, binary logistic regression analysis was performed to evaluate the association between inflammatory indices and PDR stage.

This study included 205 patients: 60 with diabetes without retinopathy (mean age: 61.81±10.76y), 80 with PDR (mean age: 61.63±10.03y) and 65 healthy controls (mean age: 59.52±5.88y). The PDR group had significantly higher white blood cell (WBC, P<0.001), monocyte (MONO, P=0.009) and neutrophil (NEU) counts (P<0.001). SII and PIV had the highest sensitivity and area under ROC for predicting patients with PDR (0.822, 0.846, respectively). The optimal cut-off values for discriminating patients with PDR were determined to be >527.12 and >299.08 for SII and PIV, respectively. The logistic regression analysis demonstrated that a decrease in lymphocyte (LYM) count and an increase in platelet count (PLT), glycated haemoglobin (HbA1c), SII, and PIV were all significantly associated with the development of high-risk PDR (all P<0.05). PIV was more stable than independent MONO, LYM, PLT and NEU levels in predicting both the diagnosis and stage of PDR. The optimal cut-off value for PIV to discriminate patients with high-risk PDR was found to be >345.87 area under ROC=0.871, with sensitivity of 0.827 and specificity of 0.812.

PIV is a reliable, valuable, and inexpensive blood index that can be used for early detection and staging of PDR. PIV may therefore be essential to be used for the follow-up of diabetic patients.

To analyze the ocular findings of patients who received lifelong leptin therapy due to congenital leptin deficiency (CLD), an extremely rare condition.

A prospective, cross-sectional comparative study was performed on six patients with CLD and 13 healthy age- and sex-matched controls. The central corneal thickness (CCT), anterior chamber depth (ACD), axial length (AL), keratometry (K1, K2), optical coherence tomography (OCT), and OCT angiography parameters were compared between the leptin and control groups at the baseline visit. The change in these measurements in leptin patients over a two-year period was analyzed.

CLD patients had lower mean AL, ACD, and CCT (P≤0.012 for all). Mean K1, K2 (P≤0.047 for both), choroidal thickness (P≤0.001), and central ganglion cell layer (GCL) thickness (P=0.029) were higher in the leptin group. Perifoveal superficial capillary plexus (SCP) density was decreased in all quadrants except the temporal region (P<0.05), and parafoveal deep capillary plexus (DCP) density was decreased in the superior hemisphere, temporal quadrant (P≤0.036 for both) and nasal quadrant (P=0.048) in the leptin group. During the two-year follow-up, no changes in anterior and posterior segment measurements were observed in the leptin patients, except for subfoveal choroidal thickness (P<0.001).

CLD patients exhibit structural alterations in both the anterior and posterior segments of the eye, including notable changes in retinal and choroidal vasculature. However, there is limited evidence concerning the influence of leptin therapy on the eye.