The Usefulness of Monocyte-to-High Density Lipoprotein and Neutrophil-to-Lymphocyte Ratio in Diabetic Macular Edema Prediction and Early anti-VEGF Treatment Response

Yalınbaş, Duygu; Eroglu, Serap; Sariakçali, Barış; Bozali, Erman; Özeç, Ayşe Vural; Erdoğan, Haydar

doi:10.1080/09273948.2020.1849739

Cited by 7 publications

(8 citation statements)

References 25 publications

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“…In addition, some clinical studies suggest that NLR and MLR can be used as inflammatory markers for diabetic macular edema. [37,38] But we didn't find any significant difference in MLR, PLR, and NLR between iERM participants with macular edema and those without macular edema in this study. The possible explanation is that macular edema in iERM eyes might be due to the physical traction, and inflammation might play a comparable role in the iERM with or without macular edema.…”

Section: Me (contrasting

confidence: 63%

Blood inflammatory biomarkers in participants with idiopathic epiretinal membrane: A retrospective case series study

Qin

You²,

Shang

et al. 2023

Medicine

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The objective was to evaluate the levels of monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with idiopathic epiretinal membrane (iERM). This retrospective case series study comprised of participants with iERM and participants with cataract. The values of MLR, NLR, PLR and from participants’ peripheral blood were assessed among groups. The best cutoff value of MLR, NLR, and PLR in iERM was found by performing a receiver operating characteristic curve analysis and determining the optimum cutoff value for each variable. In total, 95 participants with iERM were included in the study group, and 61 participants with senile cataract were included as controls. The lymphocyte count in the iERM group was significantly lower than the control group (1.69 ± 0.63 vs. 1.95 ± 0.53, P = .003). The monocyte count in the iERM group was significantly higher than the control group (0.39 ± 0.11 vs. 0.31 ± 0.10, P < .001). The area under the curve of MLR, NLR, and PLR in differentiating patients with IERM and controls was 0.782, 0.645, and 0.657, respectively, according to receiver operating characteristic. The best cutoff value of MLR was > 0.18, with sensitivity and specificity of 74.7% and 75.4%, respectively. The NLR was > 2.06, with a sensitivity and specificity of 50.5% and 83.6%, respectively. The PLR was > 95.89, with a sensitivity and specificity of 86.3% and 41.0%, respectively. The findings of this study suggest that systemic inflammation may be associated with iERM. IERM patients may be prone to have high MLR, NLR, and PLR values.

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Section: Me (contrasting

confidence: 63%

Blood inflammatory biomarkers in participants with idiopathic epiretinal membrane: A retrospective case series study

Qin

You²,

Shang

et al. 2023

Medicine

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“…Therefore, the significance of anti-VEGF medications becomes apparent in the management of DME [16]. In recent years, a limited number of studies have been conducted to examine the impact of systemic inflammatory biomarkers on DME and the response to intravitreal therapy with anti-VEGF agents [17][18][19]. Inflammatory biomarkers related to WBCs, including the NLR, PLR, MLR, and SII can be easily obtained from the complete blood cell count.…”

Section: Discussionmentioning

confidence: 99%

“…Inflammatory biomarkers related to WBCs, including the NLR, PLR, MLR, and SII can be easily obtained from the complete blood cell count. These markers have been found to exhibit associations with diabetes and its accompanying complications [17]. The adhesion of neutrophils to the endothelial cell wall can lead to the advancement of inflammation and microangiopathy.…”

Section: Discussionmentioning

confidence: 99%

The Predictors of Early Treatment Effectiveness of Intravitreal Bevacizumab Application in Patients with Diabetic Macular Edema

Katić,

Kumrić

et al. 2024

Diagnostics

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The aim of this study was to establish whether multiple blood parameters might predict an early treatment response to intravitreal bevacizumab injections in patients with diabetic macular edema (DME). Seventy-eight patients with non-proliferative diabetic retinopathy (NPDR) and DME were included. The treatment response was evaluated with central macular thickness decrease and best corrected visual acuity increase one month after the last bevacizumab injection. Parameters of interest were the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), vitamin D, and apolipoprotein B to A-I ratio (ApoB/ApoA-I). The NLR (2.03 ± 0.70 vs. 2.80 ± 1.08; p < 0.001), MLR (0.23 ± 0.06 vs. 0.28 ± 0.10; p = 0.011), PLR (107.4 ± 37.3 vs. 135.8 ± 58.0; p = 0.013), and SII (445.3 ± 166.3 vs. 675.3 ± 334.0; p < 0.001) were significantly different between responder and non-responder groups. Receiver operator characteristics analysis showed the NLR (AUC 0.778; 95% CI 0.669–0.864), PLR (AUC 0.628; 95% CI 0.511–0.735), MLR (AUC 0.653; 95% CI 0.536–0.757), and SII (AUC 0.709; 95% CI 0.595–0.806) could be predictors of response to bevacizumab in patients with DME and NPDR. Patients with severe NPDR had a significantly higher ApoB/ApoA-I ratio (0.70 (0.57–0.87) vs. 0.61 (0.49–0.72), p = 0.049) and lower vitamin D (52.45 (43.10–70.60) ng/mL vs. 40.05 (25.95–55.30) ng/mL, p = 0.025). Alterations in the NLR, PLR, MLR, and SII seem to provide prognostic information regarding the response to bevacizumab in patients with DME, whilst vitamin D deficiency and the ApoB/ApoA-I ratio could contribute to better staging.

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“…Novel systemic inflammatory indices reflect body inflammation and immune cells' compensatory and procoagulant capabilities, which have been validated to be associated with multiple inflammatory diseases such as tumors, cardiovascular diseases, and DM and its complications [7][8][9]. There is a rich literature on the relationship between systemic inflammatory indices and DME [10][11][12]; however, the association with grade, stage, and severity of DME is yet to be further investigated.…”

Section: Introductionmentioning

confidence: 99%

Optical Coherence Tomography-Based Grading of Diabetic Macular Edema Is Associated with Systemic Inflammatory Indices and Imaging Biomarkers

Yanxia,

Xiongyi,

Min

et al. 2024

Ophthalmic Res

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Introduction: Objectives of the study were to investigate the correlation between OCT-based grading of diabetic macular edema (DME) and systemic inflammatory indices, imaging biomarkers, and early anti-VEGF treatment response. Methods: A total of 111 eyes from 111 patients with DME treated with intravitreous anti-VEGF therapy for 3 consecutive months every month were enrolled in this retrospective study. According to a protocol termed "TCED", DME was divided into early, progressive, severe and atrophic stages. The best-corrected visual acuity (BCVA), subretinal fluid (SRF) and the number of hyperreflective foci (HRF) in the whole retinal layers were analyzed at baseline and three months after the first injection. Peripheral blood inflammatory indices were calculated, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet (PLT)-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and C-reactive protein (CRP). Statistical analysis were performed to compare the visual and anatomical results and evaluate HRF and SRF in different stages of DME before and after treatment. Results: There were significant differences in systemic inflammatory indices among the four groups, including NLR, PLR, MLR, SII and CRP ( all P < 0.05). The CRP, NLR, PLR, MLR, and SII were significantly higher in the atrophic stage compared to the advanced stage (all P < 0.05). Conversely, the CRP, NLR, PLR, MLR, and SII were significantly lower in the advanced stage compared to the early stage (all P < 0.05). Except for the atrophic stage, BCVA and CRT were significantly improved after treatment in early, advanced and severe stages (all P < 0.05), especially in the severe stage. The decline in the proportion of SRF and HRF ≥ 20 were the most significant in the advanced stage after anti-VEGF treatment (P < 0.001, P = 0.016), but not in the early and severe stages (all P > 0.05). Conclusion: Systemic inflammatory indices and the decline in the proportion of SRF and HRF ≥ 20 were closely associated with different stages of DME based on "TCED". Meanwhile, the "TCED" grading system can predict visual and anatomical prognosis of DME after anti-VEGF treatment, which may be a biomarker for identifying risk stratification and management of DME.

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The Usefulness of Monocyte-to-High Density Lipoprotein and Neutrophil-to-Lymphocyte Ratio in Diabetic Macular Edema Prediction and Early anti-VEGF Treatment Response

Cited by 7 publications

References 25 publications

Blood inflammatory biomarkers in participants with idiopathic epiretinal membrane: A retrospective case series study

Blood inflammatory biomarkers in participants with idiopathic epiretinal membrane: A retrospective case series study

The Predictors of Early Treatment Effectiveness of Intravitreal Bevacizumab Application in Patients with Diabetic Macular Edema

Optical Coherence Tomography-Based Grading of Diabetic Macular Edema Is Associated with Systemic Inflammatory Indices and Imaging Biomarkers

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