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Systemic Inflammatory Markers and Their Relationship With Optic Nerve Head Alterations in Pediatric Idiopathic

Eyupcan Sensoy1, Sanıye Uke Uzun1, Mehmet Emre Ayan1

  • 1The Departments of Ophthalmology.

Journal of Pediatric Ophthalmology and Strabismus
|June 18, 2026
PubMed

Insights

Systemic inflammatory markers like immature granulocyte counts may be elevated in pediatric idiopathic intracranial hypertension (IIH). Immature granulocyte count showed the strongest correlation with optic nerve damage in IIH patients.

Area of Science:

  • Ophthalmology
  • Pediatric Neurology
  • Immunology

Background:

  • Idiopathic intracranial hypertension (IIH) is a neurological condition characterized by increased intracranial pressure without a clear cause.
  • Pediatric IIH presents unique challenges, and understanding its underlying mechanisms, including potential inflammatory involvement, is crucial.
  • Optic nerve head involvement, assessed by retinal nerve fiber layer (RNFL) thickness, is a key indicator of disease severity in IIH.

Purpose of the Study:

  • To evaluate systemic hematological inflammatory markers in newly diagnosed pediatric patients with IIH.
  • To investigate the association between these inflammatory markers and optic nerve head involvement (RNFL thickness) in pediatric IIH.

Main Methods:

  • Retrospective analysis of 33 pediatric IIH patients and 32 age/sex-matched controls.
  • Calculation of various inflammatory indices including neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic inflammatory response index (SIRI).
  • Measurement of RNFL thickness via optical coherence tomography and correlation analysis with inflammatory markers and clinical parameters.

Main Results:

  • Elevated neutrophil and immature granulocyte counts, along with SIRI and pan-immune-inflammation value (PIV), were observed in pediatric IIH patients compared to controls (P < .05).
  • Immature granulocyte count demonstrated significant correlations with RNFL thickness and Frisén grade, indicating structural optic nerve involvement.
  • Immature granulocyte count exhibited the highest discriminative performance for identifying pediatric IIH (AUC = 0.689).

Conclusions:

  • Systemic inflammatory markers, particularly immature granulocyte counts, SIRI, and PIV, may be elevated in pediatric IIH.
  • Immature granulocyte count shows a notable correlation with structural optic nerve damage, suggesting its potential as an inflammatory indicator in pediatric IIH.
  • These findings suggest a link between systemic inflammation and the pathogenesis of pediatric IIH and associated optic nerve complications.
Abstract

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