Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Patients with Pterygium: A Retrospective CaseControl...

Background/Objectives: Inflammation is implicated in pterygium, but whether routine blood-count indices are associated with pterygium independently of age is unclear. We evaluated the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in systemically healthy patients with pterygium and systemically healthy controls undergoing strabismus surgery. Methods: This retrospective case-control study compared preoperative NLR and PLR in 100 patients undergoing pterygium surgery (2010-2019) and 86 systemically healthy adult controls undergoing strabismus surgery. Analyses included Holm-corrected Mann-Whitney tests, age- and sex-adjusted logistic regression, receiver operating characteristic (ROC) analysis, and age-restricted and age-matched sensitivity analyses. Results: Patients with pterygium were older (48.3 vs. 29.4 years) and had higher NLR (1.98 vs. 1.66) and PLR (128.1 vs. 114.3) (Holm-adjusted p = 0.006 and 0.005, respectively). After adjustment for age and sex, NLR remained associated with pterygium (odds ratio [OR] 3.18 per unit; 95% confidence interval [CI], 1.54-6.57; p = 0.002), whereas PLR did not (p = 0.106). In 39 age- and sex-matched pairs, differences were directionally similar but not statistically significant. Areas under the ROC curve (AUCs) were 0.632 for NLR and 0.637 for PLR. Neither index differed by pterygium grade or recurrence. Conclusions: NLR, but not PLR, was independently associated with pterygium after adjustment for age and sex, although this association was not confirmed in the small matched subsample. Neither index demonstrated sufficient diagnostic performance to serve as a biomarker. Prospective age-matched studies are needed.