Prospective observational study of the association between tear and serum CHI3L1 and PTX3 levels and the severity and prognosis of retinopathy of prematurity

BACKGROUND: To investigate the independent and combined associations of tear-fluid and serum chitinase-3-like protein 1 (CHI3L1) and pentraxin-3 (PTX3) with retinopathy of prematurity (ROP) severity and long-term neurovascular outcomes, and to evaluate their incremental predictive value beyond conventional risk factors. METHODS: = 201) subgroups based on treatment response and longitudinal neurovascular findings. Poor outcome was defined as posterior pole retinal fold involving the macula, retinal detachment, or posterior pole obscuration by fibrous tissue or a "white mass" at ≥6 months after intravitreal anti-VEGF therapy. Tear fluid and venous blood were collected within 24 h of the first ROP diagnosis; CHI3L1 and PTX3 were measured by enzyme-linked immunosorbent assay. Spearman correlation, multivariable logistic regression, and receiver operating characteristic (ROC) curves were employed to examine the associations. RESULTS: < 0.05). CONCLUSION: Tear and serum CHI3L1 and PTX3 are associated with ROP severity and may serve as a noninvasive early biomarker panel for risk assessment.