Abstract
BackgroundTo investigate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in patients with diabetic macular edema (DME) treated monthly with ranibizumab.MethodsWe retrospectively analyzed the medical records of all patients who received intravitreal ranibizumab (IVR) treatment for DME at the First Affiliated Hospital of Nanchang University between December 2015 and December 2017. Clinicopathological parameters, including NLR, were evaluated to identify predictors of better outcomes of IVR monotherapy.ResultsNinety-one treatment-naïve eyes treated with IVR for DME were retrospectively analyzed in this study. Baseline best-corrected visual acuity (BCVA), neutrophils, NLR, monocyte-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were negatively correlated with the changes in BCVA at 24 weeks compared with the baseline, while baseline central retinal thickness and lymphocytes were positively correlated with the changes in BCVA at 24 weeks compared with the baseline. Multiple linear regression analysis revealed that NLR was independently associated with the mean change of BCVA between baseline and week 24. In addition, patients with NLR < 2.27 showed a better improvement in letter score than those with NLR > 2.27.ConclusionPretreatment NLR is independently associated with the BCVA in DME patients treated with IVR, and higher pretreatment NLR may contribute to inferior BCVA outcomes.
Highlights
To investigate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in patients with diabetic macular edema (DME) treated monthly with ranibizumab
Baseline best-corrected visual acuity (BCVA), neutrophils, NLR, monocyte-to-lymphocyte ratio (MLR), and platelet-tolymphocyte ratio (PLR) were negatively correlated with the changes in BCVA at 24 weeks compared with the baseline, while baseline central retinal thickness (CRT) and lymphocytes were positively correlated with the changes in BCVA at 24 weeks compared with the baseline
No correlation was found between baseline clinical factors and changes in CRT at 24 weeks compared with the baseline
Summary
To investigate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in patients with diabetic macular edema (DME) treated monthly with ranibizumab. Diabetic macular edema (DME) is one of the major causes of visual impairment and even blindness in diabetic patients, occurs at any stage of diabetic retinopathy (DR) [1]. Intravitreous injections of anti-vascular endothelial growth factor (anti-VEGF) agents remain the most popular firstline therapy for DME [2]. Ranibizumab was the first FADapproved anti-VEGF agent that has been shown to be beneficial and relatively safe for the treatment of DME [3]. Most DME patients improved their best-corrected visual acuity (BCVA) after monthly intravitreal ranibizumab (IVR) treatment, some DME patients’ postIVR BCVA did not improve significantly or even got worse [4, 5]. Many factors are involved in the pathogenesis of DR, including blood glucose and lipid metabolism disorder, inflammatory response mechanism, hemodynamic
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