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

Purpose: To evaluate systemic hematological inflammatory markers in pediatric patients with newly diagnosed idiopathic intracranial hypertension (IIH) and to investigate their associations with optic nerve head involvement assessed by retinal nerve fiber layer (RNFL) thickness. Methods: This retrospective study included 33 pediatric patients with IIH and 32 age- and sex-matched controls. Complete blood count parameters were recorded at diagnosis. Derived inflammatory indices (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, systemic immune-inflammation index, systemic inflammatory response index [SIRI], and pan-immune-inflammation value [PIV]) were calculated. RNFL thickness was measured using optical coherence tomography, and associations with inflammatory markers, Frisén grade, and lumbar puncture opening pressure were analyzed. Results: Neutrophil and immature granulocyte counts, as well as the SIRI and PIV, were significantly higher in the pediatric IIH group compared with the control group (all P < .05). Immature granulocyte count showed moderate and significant correlations with average and temporal RNFL thickness and Frisén grade ( P ≤ .04). Neutrophil count correlated moderately with temporal RNFL and Frisén grade, whereas SIRI was weak and PIV was modestly associated with Frisén grade; PIV also correlated with temporal RNFL ( P ≤ .04). Receiver operating characteristic analysis indicated that immature granulocyte count had the highest discriminative performance for pediatric IIH (area under the curve = 0.689). Conclusions: This study indicates that inflammatory markers, including immature neutrophil and granulocyte counts, as well as SIRI and PIV, may be elevated in pediatric IIH. Among these, immature granulocyte count showed the most consistent correlation with disease-related structural findings, suggesting its potential role as an inflammatory indicator in IIH. These results highlight possible links between systemic inflammatory parameters and IIH and related optic nerve involvement.