Prognostic nutritional index in retinopathy of prematurity: a potential indicator of disease severity?

To evaluate the role of the Prognostic Nutritional Index (PNI) in predicting disease severity and the need for treatment of retinopathy of prematurity (ROP).

This retrospective cohort study included 406 preterm infants. The cases were divided into three groups: without ROP (group 1), with spontaneously regressed ROP (group 2), and with ROP requiring treatment (group 3). Patients' clinical and demographic data, including gestational age (GA), birth weight (BW), serum albumin levels, and PNI values, were obtained from medical records. Logistic regression was performed to identify predictors of severe ROP, and receiver operating characteristic (ROC) analysis was conducted to determine the discriminative power of PNI for the treatment requirement of ROP.

GA and BW differed in all groups (p = 0.001). Serum albumin level, lymphocyte and platelet counts, and PNI values were lower in groups 2 and 3 than in group 1 (p = 0.001). In ordinal regression analysis, GA (OR = 0.750, p = 0.001) and PNI (OR = 0.787, p = 0.001) showed a significant and inverse association with severe ROP. ROC analysis showed that PNI (AUC = 0.822, p = 0.001) had the highest predictive power at the optimum cut-off value of 34.02 with 78.2% sensitivity and 75.5% specificity for predicting the treatment requirement of ROP.

PNI is significantly associated with the severity of ROP and treatment requirements. This result supports the relationship between nutritional and immune status and ROP. Considering PNI with clinical parameters, such as GA and BW, will be very useful for the early determination of prognosis and treatment needs in ROP.