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New research · Ophthalmology
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 4d
ObservationalThe journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2026

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

Yuhong Jia, Jing Xie, Xiangrong Zuo … Ruihong Ma
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OphthalmologyObservational

Combined tear and blood biomarker panel predicts poor retinopathy of prematurity outcomes

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

Yuhong Jia … Ruihong Ma
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2026
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 (retinopathy of prematurity) severity and long-term neurovascular outcomes, and to evaluate their incremental predictive value beyond conventional risk factors.

Methods

This prospective cohort study enrolled 235 premature infants with retinopathy of prematurity (diagnosed January 2024-May 2025) and 110 gestational-age-matched controls.

n = 34
Results

higher combined biomarker score more strongly flagged infants headed for worse outcomes

AUC 0.85 (95% CI 0.78 to 0.92)
null = 00.780.92
CI excludes the null - significant
More results

Tear and serum CHI3L1 and PTX3 concentrations increased stepwise across control, mild-retinopathy of prematurity, and severe-retinopathy of prematurity groups (all p < 0.05), correlating positively with fundus stage (Spearman r = 0.610-0.779).

More results

Infants with unfavorable neurovascular outcomes had higher baseline levels than those with favorable outcomes ( p < 0.05).

“
Conclusion

Tear and serum CHI3L1 and PTX3 are associated with retinopathy of prematurity severity and may serve as a noninvasive early biomarker panel for risk assessment.

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