Inflammatory Markers as Predictors of Orbital Infection Severity

Area of Science:

• Ophthalmology
• Infectious Diseases
• Medical Diagnostics

Background:

• Orbital cellulitis (OC) is a serious infection requiring prompt diagnosis and management.
• Assessing the severity of OC is crucial for determining appropriate treatment strategies.

Purpose of the Study:

• To evaluate the effectiveness of inflammatory marker levels in classifying the severity of orbital cellulitis.
• To determine if specific inflammatory markers can differentiate between uncomplicated OC and complicated OC.

Main Methods:

• A retrospective cohort study analyzed data from 785 patients across two tertiary care centers.
• Patients were classified into uncomplicated OC and complicated OC (subperiosteal abscess, orbital abscess, or cavernous sinus thrombosis) groups.
• Levels of absolute neutrophil count (ANC), white blood cell count (WBC), platelet count, C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR) were recorded and analyzed using logistic regression.

Main Results:

• Patients with complicated OC exhibited significantly higher levels of platelet count, ANC, WBC, and NLR compared to those with uncomplicated OC (p < 0.001).
• Surgical management was associated with significantly higher levels of ANC, WBC, CRP, and NLR (p < 0.001).
• Elevated NLR and ANC levels at presentation correlated with worse visual acuity and relative afferent pupillary defect.

Conclusions:

• Neutrophil-to-lymphocyte ratio (NLR), absolute neutrophil count (ANC), and white blood cell (WBC) levels at presentation are valuable indicators of severe orbital infections.
• These inflammatory markers may assist clinicians in managing orbital cellulitis by identifying high-risk patients.