Department of Ophthalmology, Dr. Abdurrahman Yurtaslan Oncology Research and Training Hospital, 06550, Yenimahalle, Ankara, Turkey.
Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey.
Ir J Med Sci. 2024 Feb;193(1):517-521. doi: 10.1007/s11845-023-03379-6. Epub 2023 May 29.
Vascular endothelial growth factor (VEGF) has a critical role in age-related macular degeneration (AMD), and intravitreal injection of anti-VEGF drugs is the mainstay of neovascular AMD treatment. Blood neutrophil-to-lymphocyte ratio (NLR) is shown to be a biomarker of inflammation in AMD. We aimed to investigate the role of NLR in predicting favorable short-term anti-VEGF treatment results in neovascular AMD patients.
A total of 112 patients diagnosed with exudative AMD and had taken 3 monthly intravitreal bevacizumab injections were analyzed retrospectively. Medical records were reached to obtain neutrophil and lymphocyte values to calculate NLR. Best-corrected visual acuity and central macular thickness (CMT) measurements were recorded at each visit. T test or Mann-Whitney U test was used to compare continuous variables, and chi-square test was used to compare categorical variables. Receiver operating characteristics curve (ROC) analysis was performed to determine cut-off, sensitivity, and specificity values. P value of ≤ 0.05 was considered statistically significant.
The mean age was 68.1 ± 7.2 years, and the mean NLR was 2.11 ± 0.81. The ROC analysis revealed a cut off value of 2.0 for NLR to predict at least 100 μm CMT change (sensitivity 87.1%; specificity 87.8%) and a cut off value of 2.4 for NLR to predict at least 0.1 logMAR visual improvement (sensitivity 77.2%; specificity 64.8%) after 3 monthly IVT bevacizumab injections.
NLR can provide additional prognostic information for the identification of patients with a good initial response to anti-VEGF therapy.
血管内皮生长因子（VEGF）在年龄相关性黄斑变性（AMD）中起着关键作用，玻璃体内注射抗 VEGF 药物是治疗新生血管性 AMD 的主要方法。中性粒细胞与淋巴细胞比值（NLR）已被证明是 AMD 炎症的生物标志物。我们旨在研究 NLR 在预测新生血管性 AMD 患者短期抗 VEGF 治疗效果中的作用。
回顾性分析了 112 例诊断为渗出性 AMD 且已接受 3 个月玻璃体腔内贝伐单抗注射的患者。查阅病历以获取中性粒细胞和淋巴细胞值以计算 NLR。每次就诊时记录最佳矫正视力和中心黄斑厚度（CMT）测量值。使用 t 检验或 Mann-Whitney U 检验比较连续变量，使用卡方检验比较分类变量。进行受试者工作特征曲线（ROC）分析以确定截断值、敏感性和特异性值。P 值≤0.05 被认为具有统计学意义。
平均年龄为 68.1±7.2 岁，平均 NLR 为 2.11±0.81。ROC 分析显示，NLR 预测 CMT 至少减少 100μm 的截断值为 2.0（敏感性 87.1%；特异性 87.8%），NLR 预测至少 0.1 logMAR 视力改善的截断值为 2.4（敏感性 77.2%；特异性 64.8%）。
NLR 可以为识别对抗 VEGF 治疗有良好初始反应的患者提供额外的预后信息。
