The Neutrophil to Lymphocyte Ratio and Other Full Blood Count Indices in Retinal Diseases: A Systematic Review of the Literature
Abstract
1. Introduction
2. Methods
3. Results
3.1. Diabetic Retinopathy
3.2. Age-Related Macular Degeneration
3.3. Retinal Vein Occlusion
3.4. Retinal Artery Occlusion
3.5. Uveitis
3.6. Ischemic Optic Neuropathy
3.7. Central Serous Retinopathy
3.8. Vitreomacular Disorders
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Author | Region | Year | Participants | Indices Analyzed | Key Findings |
---|---|---|---|---|---|
Ilhan | Turkey | 2014 | 81 patients with dry AMD, 84 patients with wet AMD and 80 age- and sex-matched controls | NLR | Patients with dry and wet AMD had increased NLR compared to controls. |
Kurtul | Turkey | 2016 | 40 patients with dry AMD, 40 patients with wet AMD and 40 controls | NLR | Patients with wet AMD had higher NLR values compared to patients with dry AMD but no difference between AMD groups and controls. |
Subhi | Denmark | 2017 | 164 patients with wet AMD, 33 with early AMD, 56 with geographic atrophy and 77 controls | NLR, MXD * | No significant change in NLR values among groups; MXD counts were increased in patients with new onset of wet AMD. |
Sengul | Turkey | 2017 | 100 patients with wet AMD and 100 age- and sex-matched controls | NLR, PLR | NLR and PLR values were higher among wet AMD patients compared to controls. NLR and PLR values were found to be inversely proportional to BCVA and directly proportional to CMT. |
Pinna | Italy | 2018 | 78 patients with AMD (both dry and wet) and 78 controls | NLR, PLR, MLR, MPV | No significant changes in NLR, PLR, MLR and MPV values between patients with AMD and controls. |
Erdem | Turkey | 2021 | 24 patients with wet AMD who received ranibizumab and 25 patients with wet AMD who received intravitreal aflibercept | NLR, PLR, MLR | The NLR, PLR and MLR decreased post-treatment in the aflibercept group but not in the ranibizumab group. |
Karahan | Turkey | 2021 | 60 patients with wet AMD, 60 patients with dry AMD and 71 controls | NLR, PLR, MLR | NLR and MLR values were higher among wet AMD patients compared to controls. ROC curve analyses revealed that the area under the curve (AUC) for the NLR and MLR was 0.920 and 0.717, respectively, for wet AMD. The sensitivity and specificity of the NLR were 64% and 93%, respectively, whereas for the MLR they were 63% and 75%, respectively. |
Naif | Saudi Arabia | 2022 | 90 patients with dry AMD and 270 controls | NLR | No significant changes in NLR values between patients with dry AMD and controls. |
Hu | China | 2022 | 65 patients with wet AMD, 37 patients with PCV and 110 controls | NLR, PLR, MLR | NLR, PLR and MLR values were significantly higher in patients with nAMD compared to PCV. |
Tricorache | Romania | 2023 | 91 patients with wet AMD and 90 controls | NLR, PLR | No significant changes in NLR values between patients with dry AMD and controls. |
Gökce | Turkey | 2024 | 112 patients with wet AMD who received 3 monthly loading bevacizumab injections | NLR | ROC analysis revealed a cutoff value of 2.0 for NLR to predict at least 100 μm CMT change (sensitivity of 87.1%; specificity of 87.8%) and cutoff value of 2.4 for NLR to predict at least 0.1 logMAR visual improvement (sensitivity of 77.2%; specificity of 64.8%) after 3 monthly IVT bevacizumab injections. |
Gunay | Turkey | 2024 | 33 patients with wet AMD and 43 age- and sex-matched controls | NLR, PLR, SII | No significant changes in NLR values between patients with wet AMD and controls. |
Author | Region | Year | Participants | Indices Analyzed | Key Findings |
---|---|---|---|---|---|
Dursun | Turkey | 2015 | 40 patients with RVO and 40 age- and sex-matched controls | NLR | Patients with RVO had increased NLR compared to controls. ROC curve analysis found an optimal cutoff of 1.87 for the NLR for the prediction of RVO with a sensitivity of 72.5% and specificity of 100%. |
Kumral | Turkey | 2016 | 30 patients with BRVO and 27 age- and sex-matched controls | NLR, Mean Platelet Volume (MPV) | NLR and MPV values did not differ significantly between BRVO patients and controls. |
Şahin | Turkey | 2019 | 111 patients with RVO and 88 age- and sex-matched controls | NLR, PLR | Patients with RVO had increased NLR and PLR values compared to controls. ROC curve analysis found that the optimal cutoff values of the NLR and PLR to predict retinal vein occlusion were 1.63 and 98.50, respectively. |
Zhang | China | 2019 | Patients with RVO who developed neovascular glaucoma (NVG) | NLR, PLR, MLR | Logistic regression analysis found that NLR can predict NVG development in patients with RVO. Multiple linear regression analysis found that NLR correlated with mean visual field defects in patients with NVG secondary to RVO. |
Zhu | China | 2019 | 81 patients with BRVO and 81 age- and sex-matched controls | NLR, PLR | In ROC analysis, a cutoff of 2.48 for the NLR and 110.2 for the PLR predicted BRVO. |
Pinna | Italy | 2021 | 127 patients diagnosed with RVO and 127 age- and sex-matched controls | NLR, Mean Platelet Volume (MPV) | NLR values did not differ between patients and controls. Patients with RVO had higher MPV values than controls. |
Kazantzis | Greece | 2022 | 54 patients with RVO and 54 age- and sex-matched controls | NLR, PLR, SII | Patients with RVO had increased NLR, PLR and SII values compared to controls. |
Zuo | China | 2022 | 56 patients with RVO and 56 age- and sex-matched controls | NLR, PLR, SII | Patients with RVO had increased NLR and SII values compared to controls. |
Chatziralli | Greece | 2022 | 53 patients with treatment-naïve macular edema secondary to RVO | Monocyte to Lymphocyte Ratio (MLR) | MLR could predict “favorable” response to anti-VEGF treatment in patients with macular edema secondary to RVO. |
Qin | China | 2022 | 50 patients with RVO and 50 controls | NLR, PLR, MHR | Patients with RVO had increased NLR, PLR and MHR values compared to controls. |
Timur | Turkey | 2023 | 60 patients with RVO and serous retinal detachment (SRD), 60 patients with RVO without SRD and 60 controls | NLR, PLR, SII | Patients with RVO and SRD had increased NLR and SII compared to patients without SRD. |
Kazantzis | Greece | 2023 | 65 patients with treatment-naïve RVO | NLR | Eyes with subretinal fluid (SRF) exhibited significantly higher values of NLR. |
Wang | China | 2023 | 64 patients with RVO and 64 age- and sex-matched controls | NLR, SII, SIRI ** | NLR, SII and SIRI values were increased in patients with RVO compared to controls and in patients with ischemic RVO compared to non-ischemic RVO. NLR values were correlated with higher IL-6 levels and SII values were correlated with IL-6 and VEGF levels in aqueous humor. |
Rao | China | 2023 | 315 patients with macular edema secondary to RVO treated with anti-VEGF injections | NLR, PLR, MLR | Higher pre-treatment PLR was associated with BCVA in patients with macular edema secondary to RVO. |
Doǧan | Turkey | 2023 | 30 patients with RVO and a serous macular detachment (SMD) and 30 patients with RVO and no SMD | NLR, PLR, SII | NLR and SII were significantly higher in patients with SMD compated to patients without SMD. The PLR values did not differ among the two groups. |
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© 2025 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Kazantzis, D.; Machairoudia, G.; Theodossiadis, P.; Chatziralli, I. The Neutrophil to Lymphocyte Ratio and Other Full Blood Count Indices in Retinal Diseases: A Systematic Review of the Literature. Medicina 2025, 61, 125. https://doi.org/10.3390/medicina61010125
Kazantzis D, Machairoudia G, Theodossiadis P, Chatziralli I. The Neutrophil to Lymphocyte Ratio and Other Full Blood Count Indices in Retinal Diseases: A Systematic Review of the Literature. Medicina. 2025; 61(1):125. https://doi.org/10.3390/medicina61010125
Chicago/Turabian StyleKazantzis, Dimitrios, Genovefa Machairoudia, Panagiotis Theodossiadis, and Irini Chatziralli. 2025. "The Neutrophil to Lymphocyte Ratio and Other Full Blood Count Indices in Retinal Diseases: A Systematic Review of the Literature" Medicina 61, no. 1: 125. https://doi.org/10.3390/medicina61010125
APA StyleKazantzis, D., Machairoudia, G., Theodossiadis, P., & Chatziralli, I. (2025). The Neutrophil to Lymphocyte Ratio and Other Full Blood Count Indices in Retinal Diseases: A Systematic Review of the Literature. Medicina, 61(1), 125. https://doi.org/10.3390/medicina61010125