Liao Wu, Liu Fangmei, Liu Wenge, Xiao Chenhui
Department of Ophthalmology, Shantou University Medical College North Guangdong People's Hospital, 133# Huimin South Road, Wujiang District, Shaoguan, 512099, Guangdong, China.
Int Ophthalmol. 2024 Dec 6;44(1):447. doi: 10.1007/s10792-024-03372-7.
To assess serum inflammatory biomarker levels in patients with different subtypes of diabetic macular edema (DME).
We retrospectively analyzed 50 eyes from 37 treatment-naïve DME patients who underwent intravitreal injection therapy between June and December 2023. Based on the morphological characteristics of macular edema in optical coherence tomography (OCT), the eyes were categorized into the cystoid macular edema (CME) group (n = 25) and diffuse retinal thickening (DRT) group (n = 25). Additionally, 25 eyes with diabetes retinopathy but without DME served as the control group. Comprehensive clinical data were reviewed, including best-corrected visual acuity (BCVA), central macular thickness (CMT), macular cube volume (VOL) and hematological examination. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated.
NLR and SII levels were significantly higher in the CME group compared to the DRT group and control group (all P < 0.01). The optimal ROC cutoff value of NLR for CME was 2.27, with 88.0% sensitivity and 68.0% specificity. The optimal ROC cutoff value of SII for CME was 447.33, with 84.0% sensitivity and 60.0% specificity. After initial intravitreal injection therapy, BCVA and VOL significantly improved in each group (all P < 0.01). However, no significant correlation was found between systemic inflammatory marker levels and postoperative changes in BCVA, CMT and VOL (all P > 0.05).
Our study suggests that elevated NLR and SII levels are significantly associated with CME. Elevated serum inflammatory biomarkers may indicate a higher incidence of CME in these patients.
评估不同亚型糖尿病性黄斑水肿（DME）患者的血清炎症生物标志物水平。
我们回顾性分析了2023年6月至12月期间接受玻璃体腔注射治疗的37例初治DME患者的50只眼。根据光学相干断层扫描（OCT）中黄斑水肿的形态特征，将这些眼分为黄斑囊样水肿（CME）组（n = 25）和弥漫性视网膜增厚（DRT）组（n = 25）。此外，选取25只患有糖尿病视网膜病变但无DME的眼作为对照组。回顾了综合临床数据，包括最佳矫正视力（BCVA）、中心黄斑厚度（CMT）、黄斑立方体积（VOL）和血液学检查。计算中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和全身免疫炎症指数（SII）。
CME组的NLR和SII水平显著高于DRT组和对照组（所有P < 0.01）。CME的NLR的最佳ROC截断值为2.27，敏感性为88.0%，特异性为68.0%。CME的SII的最佳ROC截断值为447.33，敏感性为84.0%，特异性为60.0%。初次玻璃体腔注射治疗后，每组的BCVA和VOL均显著改善（所有P < 0.01）。然而，全身炎症标志物水平与术后BCVA、CMT和VOL的变化之间未发现显著相关性（所有P > 0.05）。
我们的研究表明，NLR和SII水平升高与CME显著相关。血清炎症生物标志物升高可能表明这些患者中CME的发生率较高。
