Serum prolactin levels as a biomarker for assessing diabetic retinopathy severity

Dear Editor, In July–September 2025 issue of the Journal of Clinical Ophthalmology and Research, Soni et al.[1] found lower serum prolactin levels in diabetic retinopathy (DR) patients. They suggested that serum prolactin might regulate DR development and progress.[1] They postulated that medications triggering hyperprolactinemia might provide potential therapeutic advantages.[1] In our opinion, the implication of the study finding in clinical set ups and research is challenged by the following influential study limitation. The cutoff value (COV) is customarily used to identify a value that shows the lowest threshold at which a particular health risk is forthcoming. To use a specific biomarker to early detect, predict the severity and stage progress of a given disease, and implement the required therapeutic modalities, it is paramount to refer to the predicted COV quantified by describing the receiver-operating characteristic (ROC) curve and measuring the area under ROC (AUROC).[2,3] If Soni et al.[1] were planned to illustrate the ROC curve and estimate the AUROC for the serum prolactin biomarker under study to generate COV with the best sensitivity and specificity, this step would importantly aid in the clinical and therapeutic use of the study finding.[1] Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.