Systemic Inflammatory and Metabolic Indices in Pseudoexfoliation Syndrome and Glaucoma: The Role of Pan-Immune-Inflammation Value and Triglyceride-Glucose Index.

ABSTRACT: PURPOSE: To determine whether the pan-immune-inflammation value (PIV) and triglyceride-glucose (TyG) index reflect a graded systemic inflammatory and metabolic burden across the pseudoexfoliation spectrum and to compare their discriminatory performance with conventional hematologic ratios.

ABSTRACT: METHODS: This retrospective cross-sectional study included 170 adults classified as controls (n = 60), pseudoexfoliation syndrome (PEXS; n = 60), or pseudoexfoliation glaucoma (PEXG; n = 50). Demographic variables, comorbidities, complete blood count parameters, and fasting triglyceride and glucose values were extracted from medical records. PIV and TyG indices were calculated using established formulas.

ABSTRACT: RESULTS: Both PIV and the TyG index demonstrated a significant, stepwise increase across groups (Control < PEXS < PEXG; p < 0.001). All pairwise comparisons were significant, with the highest values observed in the PEXG group. The neutrophil-lymphocyte ratio was elevated in the PEXS and PEXG groups versus controls (p ≤ 0.005) but did not differ significantly between PEXS and PEXG. The platelet-lymphocyte ratio and monocyte-lymphocyte ratio showed no significant group differences. Routine metabolic parameters, including fasting glucose and triglycerides, were comparable among groups.

ABSTRACT: CONCLUSIONS: PIV and the TyG index appear to sensitively reflect the systemic inflammatory-metabolic gradient across the pseudoexfoliation spectrum and showed stronger discriminatory performance than traditional hematologic ratios in this cross-sectional cohort. Given their simplicity, low cost, and accessibility, these indices represent promising candidate biomarkers for the pseudoexfoliation spectrum.