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Systemic immune-inflammation index (SII) and low-grade inflammation score (INFLA-score) were calculated from baseline haematological parameters. Primary outcomes were incident diagnoses of cataract, primary open-angle glaucoma (POAG), age-related macular degeneration (AMD) and diabetic retinopathy (DR). Multivariable Cox proportional hazards models estimated HRs with 95% CIs. Secondary analyses assessed the associations with optical coherence tomography-derived retinal layer thicknesses and vascular features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a median 13.0-year follow-up, we identified 44\u2009906 cataract, 5803 POAG, 7388 AMD and 3319 DR incident cases. Both SII and INFLA-score demonstrated significant, dose-dependent associations with all ocular outcomes (all p&lt;0.05). Distinct exposure-response patterns emerged: J-shaped relationships for cataract and POAG (SII threshold &gt;500; INFLA-score threshold &gt;0), versus monotonically positive associations for AMD and DR. Elevated inflammatory markers also correlated with retinal thinning, especially in photoreceptor layers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Systemic inflammation biomarkers could predict incident age-related ocular diseases with disease-specific patterns while concurrently associating with quantifiable retinal structural and vascular pathologies. These findings suggest that anti-inflammatory strategies might have potential to mitigate ocular ageing processes, although further evidence on causal mechanisms and interventions is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2025-328553","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T17:20:12Z","timestamp":1778088012000},"page":"bjo-2025-328553","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Systemic inflammatory biomarkers as risk factors for age-related ocular diseases: a large-scale prospective cohort study"],"prefix":"10.1136","author":[{"given":"Zhiqian","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaimeng","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liguang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Fenghua Hospital of Traditional Chinese Medicine, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5588-1667","authenticated-orcid":false,"given":"Xiangjia","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"2026050610200705000_bjo-2025-328553v1.1","doi-asserted-by":"crossref","first-page":"e144","DOI":"10.1016\/S2214-109X(20)30489-7","article-title":"Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study","volume":"9","author":"Steinmetz","year":"2021","journal-title":"Lancet Glob Health"},{"key":"2026050610200705000_bjo-2025-328553v1.2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-021-00752-6"},{"key":"2026050610200705000_bjo-2025-328553v1.3","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-022-01446-5"},{"key":"2026050610200705000_bjo-2025-328553v1.4","doi-asserted-by":"crossref","unstructured":"Yang X , Zhao S , Wang S , et al . n.d. 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