{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T17:37:06Z","timestamp":1793900226256,"version":"4.8.0"},"reference-count":57,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Padjadjaran"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Ophthalmol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetic retinopathy (DR) is increasingly prevalent and a major cause of irreversible blindness, particularly in developing countries. Limited access to ophthalmologists often leads to delayed diagnosis, emphasizing the need for more affordable and widely accessible screening methods to facilitate early identification. Recently, several studies have demonstrated variability in findings regarding the relationship between leukocyte differential count ratio biomarkers and DR. This study aims to investigate the association between leukocyte differential count ratios\u2014NLR (Neutrophil-to-Lymphocyte Ratio), PLR (Platelet-to-Lymphocyte Ratio), MLR (Monocyte-to-Lymphocyte Ratio), and SII (Systemic Immune-Inflammation Index)\u2014and the stages of diabetic retinopathy (DR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive literature search was conducted across several databases up to September 2024, with a focus on identifying studies examining the relationship between the leukocyte differential count ratio profiles and diabetic retinopathy. Review Manager was used to conduct the meta-analyses. The Newcastle Ottawa Scale (NOS) were used to assess the included studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 38 studies were included in the systematic review and 27 studies were included in the meta-analysis. The mean differences in the NLR and PLR values were significantly different among the groups and were higher in the PDR group (0.68 (95%CI 0.42\u20130.95,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009\n                      <jats:italic>0.05<\/jats:italic>\n                      ) and 19.57 (95%CI 10.68\u201328.46,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009\n                      <jats:italic>0.05<\/jats:italic>\n                      ; respectively). These findings were followed by significant differences in SII value 202.53 (95% CI 196.19\u2013208.86\n                      <jats:italic>, p<\/jats:italic>\n                      \u2009&lt;\u2009\n                      <jats:italic>0.05).<\/jats:italic>\n                      Moreover, the MLR values were not significantly different among the groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u2009\n                      <jats:italic>0.05<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NLR, PLR, and SII are associated with both the presence and progression of DR, with increasing levels of NLR and PLR reflecting a higher risk and severity of the disease. However, it is still necessary to justify the need to combine them with other clinical parameters to confirm the diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12886-025-04075-y","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T02:28:40Z","timestamp":1746066520000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Exploring leukocyte differential count ratio profiles as inflammatory biomarkers in diabetic retinopathy: a systematic review and meta-analysis"],"prefix":"10.1186","volume":"25","author":[{"given":"Ohisa","family":"Harley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufilia Suci","family":"Amelia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsa","family":"Gustianty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanny N. M.","family":"Soetedjo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arief S.","family":"Kartasasmita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,1]]},"reference":[{"key":"4075_CR1","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.ajo.2017.06.019","volume":"181","author":"MB Sasongko","year":"2017","unstructured":"Sasongko MB, Widyaputri F, Agni AN, Wardhana FS, Kotha S, Gupta P, et al. Prevalence of Diabetic Retinopathy and Blindness in Indonesian Adults With Type 2 Diabetes. Am J Ophthalmol. 2017;181:79\u201387.\u00a0Available from: http:\/\/www.ajo.com\/article\/S0002939417302714\/fulltext. Cited 2024 Jun 27.","journal-title":"Am J Ophthalmol."},{"issue":"11","key":"4075_CR2","doi-asserted-by":"publisher","first-page":"1580","DOI":"10.1016\/j.ophtha.2021.04.027","volume":"128","author":"ZL Teo","year":"2021","unstructured":"Teo ZL, Tham YC, Yu M, Chee ML, Rim TH, Cheung N, et al. Global Prevalence of Diabetic Retinopathy and Projection of Burden through 2045: Systematic Review and Meta-analysis. Ophthalmology. 2021;128(11):1580\u201391.\u00a0Available from: http:\/\/www.aaojournal.org\/article\/S0161642021003213\/fulltext. Cited 2024 Jul 3.","journal-title":"Ophthalmology"},{"issue":"14","key":"4075_CR3","doi-asserted-by":"publisher","first-page":"937999","DOI":"10.3389\/fnagi.2022.937999","volume":"16","author":"L Bianco","year":"2022","unstructured":"Bianco L, Arrigo A, Aragona E, Antropoli A, Berni A, Saladino A, et al. Neuroinflammation and neurodegeneration in diabetic retinopathy. Front Aging Neurosci. 2022Aug;16(14):937999.","journal-title":"Front Aging Neurosci"},{"issue":"1","key":"4075_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12974-015-0368-7","volume":"12","author":"Y Yu","year":"2015","unstructured":"Yu Y, Chen H, Su SB. Neuroinflammatory responses in diabetic retinopathy. J Neuroinflammation. 2015;12(1):1\u201315.\u00a0Available from: https:\/\/jneuroinflammation.biomedcentral.com\/articles\/10.1186\/s12974-015-0368-7.\u00a0Cited 2024 Mar 7.","journal-title":"J Neuroinflammation"},{"key":"4075_CR5","doi-asserted-by":"crossref","unstructured":"Wu F, Phone A, Lamy R, Ma D, Laotaweerungsawat S, Chen Y, et al. Correlation of Aqueous, Vitreous, and Plasma Cytokine Levels in Patients With Proliferative Diabetic Retinopathy. Invest Ophthalmol Vis Sci. 2020;61(2). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/32084272\/. Cited 2024 Aug 17.","DOI":"10.1167\/iovs.61.2.26"},{"key":"4075_CR6","doi-asserted-by":"crossref","unstructured":"Almutairi NM, Alahmadi S, Alharbi M, Gotah S, Alharbi M. The Association Between HbA1c and Other Biomarkers With the Prevalence and Severity of Diabetic Retinopathy. Cureus. 2021;13(1). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/33564524\/. Cited 2024 Mar 7.","DOI":"10.7759\/cureus.12520"},{"issue":"11","key":"4075_CR7","doi-asserted-by":"publisher","first-page":"2462","DOI":"10.1007\/s00125-020-05234-0","volume":"63","author":"T Bek","year":"2020","unstructured":"Bek T. Systemic risk factors contribute differently to the development of proliferative diabetic retinopathy and clinically significant macular oedema. Diabetologia. 2020;63(11):2462\u201370.\u00a0Available from: https:\/\/link-springer-com.unpad.idm.oclc.org\/article\/10.1007\/s00125-020-05234-0. Cited 2024 Sep 15.","journal-title":"Diabetologia"},{"issue":"1\u20132","key":"4075_CR8","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1900\/RDS.2015.12.159","volume":"12","author":"AJ Jenkins","year":"2015","unstructured":"Jenkins AJ, Joglekar MV, Hardikar AA, Keech AC, O\u2019Neal DN, Januszewski AS. Biomarkers in Diabetic Retinopathy. Rev Diabet Stud. 2015;12(1\u20132):159.\u00a0Available from: https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC5397989\/. Cited 2024 Dec 8.","journal-title":"Rev Diabet Stud."},{"key":"4075_CR9","doi-asserted-by":"crossref","unstructured":"Frudd K, Sivaprasad S, Raman R, Krishnakumar S, Revathy YR, Turowski P. Diagnostic circulating biomarkers to detect vision-threatening diabetic retinopathy: Potential screening tool of the future? Acta Ophthalmol. 2022;100(3):e648\u201368. Available from:\u00a0https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/aos.14954. Cited 2024 Dec 8.","DOI":"10.1111\/aos.14954"},{"key":"4075_CR10","doi-asserted-by":"crossref","unstructured":"Dascalu AM, Serban D, Tanasescu D, Vancea G, Cristea BM, Stana D, et al. The Value of White Cell Inflammatory Biomarkers as Potential Predictors for Diabetic Retinopathy in Type 2 Diabetes Mellitus (T2DM). Biomedicines. 2023;11(8). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/37626602\/. Cited 2024 Aug 15.","DOI":"10.3390\/biomedicines11082106"},{"key":"4075_CR11","doi-asserted-by":"crossref","unstructured":"Dascalu AM, Georgescu A, Costea AC, Tribus L, El Youssoufi A, Serban D, et al. Association Between Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) With Diabetic Retinopathy in Type 2 Diabetic Patients. Cureus. 2023;15(11). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/38090430\/. Cited 2024 Mar 8.","DOI":"10.7759\/cureus.48581"},{"key":"4075_CR12","doi-asserted-by":"crossref","unstructured":"Tabakoglu NT, Celik M. Investigation of the Systemic Immune Inflammation (SII) Index as an Indicator of Morbidity and Mortality in Type 2 Diabetic Retinopathy Patients in a 4-Year Follow-Up Period. Medicina. 2024;60(6):855. Available from: https:\/\/www.mdpi.com\/1648-9144\/60\/6\/855\/htm. Cited 2024 Nov 12.","DOI":"10.3390\/medicina60060855"},{"key":"4075_CR13","doi-asserted-by":"crossref","unstructured":"Li J, Wang X, Jia W, Wang K, Wang W, Diao W, et al. Association of the systemic immuno-inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio with diabetic microvascular complications. Front Endocrinol (Lausanne). 2024;15. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/38660516\/. Cited 2024 Aug 15.","DOI":"10.3389\/fendo.2024.1367376"},{"key":"4075_CR14","doi-asserted-by":"crossref","unstructured":"Wang H, Guo Z, Xu Y. Association of monocyte-lymphocyte ratio and proliferative diabetic retinopathy in the U.S. population with type 2 diabetes. J Transl Med. 2022;20(1). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/35562757\/. Cited 2024 Mar 10.","DOI":"10.1186\/s12967-022-03425-4"},{"issue":"1","key":"4075_CR15","doi-asserted-by":"publisher","first-page":"153","DOI":"10.18231\/j.ijceo.2021.030","volume":"7","author":"M Abdullah","year":"2021","unstructured":"Abdullah M. Comparative study on neutrophil-lymphocyte ratio (NLR) among diabetic cases with and without diabetic retinopathy. Indian J Clin Exp Ophthalmol. 2021;7(1):153\u20136.","journal-title":"Indian J Clin Exp Ophthalmol"},{"key":"4075_CR16","doi-asserted-by":"publisher","first-page":"1797","DOI":"10.2147\/OPTH.S110749","volume":"10","author":"M Akdo\u011fan","year":"2016","unstructured":"Akdo\u011fan M, Yasemin UB, Huysal K. The association of hematologic inflammatory markers with atherogenic index in type 2 diabetic retinopathy patients. Clin Ophthalmol. 2016;10:1797.\u00a0\u00a0Available from: https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC5033587\/. Cited 2024 Nov 11.","journal-title":"Clin Ophthalmol."},{"key":"4075_CR17","unstructured":"Atli H, Onalan E, Yakar B, Duzenci D, Donder E. Predictive value of inflammatory and hematological data in diabetic and non-diabetic retinopathy. Eur Rev Med Pharmacol Sci. 2022;26(1):76\u201383.\u00a0Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/35049022\/. Cited 2024 Mar 8."},{"key":"4075_CR18","doi-asserted-by":"publisher","unstructured":"Bhattacharyya S, Jain N, Verma H, Sharma K. A cross-sectional study to assess neutrophil lymphocyte ratio as a predictor of\u00a0microvascular complications in type 2 diabetes mellitus patients. J Clin of Diagn Res. 2021; 15(8):OC59-OC62. https:\/\/doi.org\/10.7860\/JCDR\/2021\/47046\/15266.","DOI":"10.7860\/JCDR\/2021\/47046\/15266"},{"key":"4075_CR19","doi-asserted-by":"crossref","unstructured":"Chittawar S, Dutta D, Qureshi Z, Surana V, Khandare S, Dubey TN. Neutrophil-lymphocyte ratio is a novel reliable predictor of nephropathy, retinopathy, and coronary artery disease in Indians with type-2 diabetes. Indian J Endocrinol Metab. 2017;21(6):864. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/29285450\/. Cited 2024 Mar 10.","DOI":"10.4103\/ijem.IJEM_197_17"},{"key":"4075_CR20","doi-asserted-by":"crossref","unstructured":"Cardoso CRL, Leite NC, Salles GF. Importance of hematological parameters for micro- and macrovascular outcomes in patients with type 2 diabetes: the Rio de Janeiro type 2 diabetes cohort study. Cardiovasc Diabetol. 2021;20(1). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/34229668\/. Cited 2024 Aug 15.","DOI":"10.1186\/s12933-021-01324-4"},{"issue":"5","key":"4075_CR21","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1055\/s-0035-1547257","volume":"123","author":"H Ciray","year":"2015","unstructured":"Ciray H, Aksoy AH, Ulu N, Cizmecioglu A, Gaipov A, Solak Y. Nephropathy, but not Angiographically Proven Retinopathy, is Associated with Neutrophil to Lymphocyte Ratio in Patients with Type 2 Diabetes. Exp Clin Endocrinol Diabetes. 2015;123(5):267\u201371.\u00a0\u00a0Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/25853704\/. Cited 2024 Dec 8.","journal-title":"Exp Clin Endocrinol Diabetes"},{"issue":"4","key":"4075_CR22","doi-asserted-by":"publisher","first-page":"219","DOI":"10.5336\/ophthal.2024-103341","volume":"33","author":"L Dogan","year":"2024","unstructured":"Dogan L, Ozer \u00d6, Guclu E. The Effect of Systemic Inflammatory Biomarkers and Dyslipidemia on the Prognosis of Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus: Retrospective Research. Turkiye Klinikleri J Ophthalmol. 2024;33(4):219\u201328.\u00a0Available from: https:\/\/www.turkiyeklinikleri.com\/article\/en-the-effect-of-systemic-inflammatory-biomarkers-and-dyslipidemia-on-the-prognosis-of-diabetic-retinopathy-in-patients-with-type-2-diabetes-mellitus-retrospective-research-108623.html. Cited 2024 Dec 8.","journal-title":"Turkiye Klinikleri J Ophthalmol"},{"key":"4075_CR23","doi-asserted-by":"crossref","unstructured":"El-Tawab SS, Ibrahim IK, Megallaa MH, Mgeed RMA, Elemary WS. Neutrophil\u2013lymphocyte ratio as a reliable marker to predict pre-clinical retinopathy among type 2 diabetic patients. Egypt Rheumatol Rehab. 2023;50(1):1\u20139. Available from: https:\/\/erar.springeropen.com\/articles\/10.1186\/s43166-023-00177-x  . Cited 2024 Mar 10.","DOI":"10.1186\/s43166-023-00177-x"},{"key":"4075_CR24","doi-asserted-by":"crossref","unstructured":"Fawwad A, Butt AM, Siddiqui IA, Khalid M, Sabir R, Basit A. Neutrophil-to-lymphocyte ratio and microvascular complications in subjects with type 2 diabetes: Pakistan\u2032s perspective. Turk J Med Sci. 2018;48(1):157\u201361. Available from: https:\/\/journals.tubitak.gov.tr\/medical\/vol48\/iss1\/26. Cited 2024 Aug 16.","DOI":"10.3906\/sag-1706-141"},{"issue":"5","key":"4075_CR25","doi-asserted-by":"publisher","first-page":"877","DOI":"10.18240\/ijo.2024.05.12","volume":"17","author":"Y Gao","year":"2024","unstructured":"Gao Y, Lu RX, Tang Y, Yang XY, Meng H, Zhao CL, et al. Systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio in patients with type 2 diabetes at different stages of diabetic retinopathy. Int J Ophthalmol. 2024;17(5):877\u201382.\u00a0Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/38766329\/. Cited 2024 Aug 15.","journal-title":"Int J Ophthalmol"},{"key":"4075_CR26","doi-asserted-by":"crossref","unstructured":"He X, Qi S, Zhang X, Pan J. The relationship between the neutrophil-to-lymphocyte ratio and diabetic retinopathy in adults from the United States: results from the National Health and nutrition examination survey. BMC Ophthalmol. 2022;22(1). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/35978314\/. Cited 2024 Aug 15.","DOI":"10.1186\/s12886-022-02571-z"},{"key":"4075_CR27","doi-asserted-by":"crossref","unstructured":"Huang Q, Wu H, Wo M, Ma J, Song Y, Fei X. Clinical and predictive significance of plasma fibrinogen concentrations combined monocyte-lymphocyte ratio in patients with diabetic retinopathy. Int J Med Sci. 2021;18(6):1390. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/33628095\/. Cited 2024 Mar 10.","DOI":"10.7150\/ijms.51533"},{"key":"4075_CR28","doi-asserted-by":"crossref","unstructured":"Ilhan C, Citirik M, Uzel MM, Tekin K. The optimal cutoff value of neutrophil\/lymphocyte ratio for severe grades of diabetic retinopathy. Beyoglu Eye J. 2019;4(2):76. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/35187437\/.\u00a0 Cited 2024 Aug 15.","DOI":"10.14744\/bej.2019.85698"},{"key":"4075_CR29","doi-asserted-by":"crossref","unstructured":"Ilhan C, Citirik M, Uzel MM, Kiziltoprak H, Tekin K. The usefulness of systemic inflammatory markers as diagnostic indicators of the pathogenesis of diabetic macular edema. Arq Bras Oftalmol. 2020;83(4):299\u2013304. Available from: https:\/\/www.scielo.br\/j\/abo\/a\/Zw3dpDXsGtPMYx9HgGVSjvd\/?format=html&lang=en. Cited 2024 Sep 15.","DOI":"10.5935\/0004-2749.20200051"},{"key":"4075_CR30","doi-asserted-by":"crossref","unstructured":"Lei C, Gu J, Liu L, Zhang K, Zhang M. The correlation between peripheral complete blood count parameters and diabetic macular edema in proliferative diabetic retinopathy patients: a cross-sectional study. Front Endocrinol (Lausanne). 2023;14. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/37538792\/. Cited 2024 Aug 15.","DOI":"10.3389\/fendo.2023.1190239"},{"key":"4075_CR31","doi-asserted-by":"crossref","unstructured":"Mahajan M, Prasad MK, Ashok C, Guria RT, Marandi SV, et al. The Correlation of the Neutrophil-to-Lymphocyte Ratio With Microvascular Complications in Patients With Diabetes Mellitus. Cureus. 2023;15(9). Available from: https:\/\/www.cureus.com\/articles\/170152-the-correlation-of-the-neutrophil-to-lymphocyte-ratio-with-microvascular-complications-in-patients-with-diabetes-mellitus. Cited 2024 Mar 10.","DOI":"10.7759\/cureus.44601"},{"key":"4075_CR32","doi-asserted-by":"crossref","unstructured":"Moursy EY, Megallaa MH, Mouftah RF, Ahmed SM. Relationship Between Neutrophil-Lymphocyte Ratio and Microvascular Complications in Egyptian Patients with Type 2 Diabetes. Am  J Inter Med. 2015;3(6):250\u20135. Available from: \u00a0https:\/\/www.sciencepg.com\/article\/10.11648\/j.ajim.20150306.16. Cited 2024 Dec 8.","DOI":"10.11648\/j.ajim.20150306.16"},{"key":"4075_CR33","unstructured":"\u00d6zt\u00fcrk ZA, Kuyumcu ME, Yesil Y, Savas E, Yildiz H, Kepek\u00e7i Y, et al. Is there a link between neutrophil-lymphocyte ratio and microvascular complications in geriatric diabetic patients? J Endocrinol Invest. 2013;36(8):593\u20139. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/23511196\/. cited 2024 Nov 11."},{"key":"4075_CR34","doi-asserted-by":"crossref","unstructured":"Rajendrakumar AL, Hapca SM, Nair ATN, Huang Y, Chourasia MK, Kwan RSY, et al. Competing risks analysis for neutrophil to lymphocyte ratio as a predictor of diabetic retinopathy incidence in the Scottish population. BMC Med. 2023;21(1). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/37563596\/. Cited 2024 Mar 9.","DOI":"10.1186\/s12916-023-02976-7"},{"key":"4075_CR35","unstructured":"Sari DA, Delfi, Virgayanti V, Sari MD. Evaluation of Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Predictor Factors on Diabetic Retinopathy. European Modern Stud J. 2021;5(5):168\u201376. Available from: https:\/\/journal-ems.com\/index.php\/emsj\/article\/view\/369. Cited 2024 Dec 8."},{"key":"4075_CR36","doi-asserted-by":"crossref","unstructured":"Tang Y, Li L, Li J. Association between neutrophil-to-lymphocyte ratio and diabetic retinopathy in patients with type 2 diabetes: a cohort study. Front Endocrinol (Lausanne. 2024;15. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/39055056\/.  Cited 2024 Aug 15.","DOI":"10.3389\/fendo.2024.1396161"},{"issue":"11","key":"4075_CR37","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1089\/dia.2013.0097","volume":"15","author":"SM Ulu","year":"2013","unstructured":"Ulu SM, Dogan M, Ahsen A, Altug A, Demir K, Acart\u00fcrk G, et al. Neutrophil-to-lymphocyte ratio as a quick and reliable predictive marker to diagnose the severity of diabetic retinopathy. Diabetes Technol Ther. 2013;15(11):942\u20137.\u00a0Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/23919588\/. Cited 2024 Mar 8.","journal-title":"Diabetes Technol Ther"},{"key":"4075_CR38","doi-asserted-by":"crossref","unstructured":"Wan H, Wang Y, Fang S, Chen Y, Zhang W, Xia F, et al. Associations between the Neutrophil-to-Lymphocyte Ratio and Diabetic Complications in Adults with Diabetes: A Cross-Sectional Study. J Diabetes Res. 2020;2020. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/32405503\/. Cited 2024 Aug 15.","DOI":"10.1155\/2020\/6219545"},{"key":"4075_CR39","doi-asserted-by":"crossref","unstructured":"Wang JR, Chen Z, Yang K, Yang HJ, Tao WY, Li YP, et al. Association between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and diabetic retinopathy among diabetic patients without a related family history. Diabetol Metab Syndr. 2020;12(1). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/32636938\/. Cited 2024 Mar 10.","DOI":"10.1186\/s13098-020-00562-y"},{"issue":"2","key":"4075_CR40","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/j.jdiacomp.2014.11.006","volume":"29","author":"RT Wang","year":"2015","unstructured":"Wang RT, Zhang JR, Li Y, Liu T, Yu KJ. Neutrophil-Lymphocyte ratio is associated with arterial stiffness in diabetic retinopathy in type 2 diabetes. J Diabetes Complications. 2015;29(2):245\u20139.","journal-title":"J Diabetes Complications."},{"key":"4075_CR41","doi-asserted-by":"publisher","first-page":"3827","DOI":"10.2147\/DMSO.S437580","volume":"16","author":"S Wang","year":"2023","unstructured":"Wang S, Pan X, Jia B, Chen S. Exploring the Correlation Between the Systemic Immune Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), and Type 2 Diabetic Retinopathy. Diabetes, Metabolic Syndrome and Obesity. 2023;16:3827\u201336.\u00a0Available from: https:\/\/www.dovepress.com\/exploring-the-correlation-between-the-systemic-immune-inflammation-ind-peer-reviewed-fulltext-article-DMSO. Cited 2024 Nov 12.","journal-title":"Diabetes, Metabolic Syndrome and Obesity."},{"key":"4075_CR42","doi-asserted-by":"crossref","unstructured":"Xiaodong L, Xuejun X, Xiaojuan S, Yu H, Mingchao X. Characterization of peripheral blood inflammatory indicators and OCT imaging biological markers in diabetic retinopathy with or without nephropathy. Front Endocrinol (Lausanne). 2023;14. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/37465123\/. Cited 2024 Mar 10.","DOI":"10.3389\/fendo.2023.1160615"},{"issue":"1","key":"4075_CR43","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1159\/000535199","volume":"67","author":"C Yanxia","year":"2024","unstructured":"Yanxia C, Xiongyi Y, Min F, Xiaoyun K. Optical Coherence Tomography-Based Grading of Diabetic Macular Edema Is Associated with Systemic Inflammatory Indices and Imaging Biomarkers. Ophthalmic Res. 2024;67(1):96\u2013106.\u00a0Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/38211574\/. Cited 2024 Dec 8.","journal-title":"Ophthalmic Res"},{"issue":"4","key":"4075_CR44","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1080\/09273948.2020.1849739","volume":"30","author":"D Yalinbas Yeter","year":"2022","unstructured":"Yalinbas Yeter D, Eroglu S, Sariakcali B, Bozali E, Vural Ozec A, Erdogan H. The Usefulness of Monocyte-to-High Density Lipoprotein and Neutrophil-to-Lymphocyte Ratio in Diabetic Macular Edema Prediction and Early anti-VEGF Treatment Response. Ocul Immunol Inflamm. 2022;30(4):901\u20136.\u00a0Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/33596398\/. Cited 2024 Mar 10.","journal-title":"Ocul Immunol Inflamm"},{"issue":"8","key":"4075_CR45","doi-asserted-by":"publisher","first-page":"10009","DOI":"10.3390\/ijerph120810009","volume":"12","author":"S Yue","year":"2015","unstructured":"Yue S, Zhang J, Wu J, Teng W, Liu L, Chen L. Use of the Monocyte-to-Lymphocyte Ratio to Predict Diabetic Retinopathy. Int J Environ Res Public Health. 2015;12(8):10009\u201319.\u00a0\u00a0Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/26308022\/. Cited 2024 Mar 8.","journal-title":"Int J Environ Res Public Health"},{"key":"4075_CR46","doi-asserted-by":"publisher","first-page":"3617","DOI":"10.2147\/DMSO.S378284","volume":"15","author":"J Zeng","year":"2022","unstructured":"Zeng J, Chen M, Feng Q, Wan H, Wang J, Yang F, et al. The Platelet-to-Lymphocyte Ratio Predicts Diabetic Retinopathy in Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes. 2022;15:3617\u201326.\u00a0Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/36444389\/. Cited 2024 Mar 8.","journal-title":"Diabetes Metab Syndr Obes"},{"issue":"7","key":"4075_CR47","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.18240\/ijo.2021.07.16","volume":"14","author":"P Zhang","year":"2021","unstructured":"Zhang P, Xue WW, Huang XB, Xu Y, Lu LN, Zheng KR, et al. Prevalence and risk factors of diabetic retinopathy in patients with type 2 diabetes in Shanghai. Int J Ophthalmol. 2021;14(7):1066\u201372.\u00a0Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/34282393\/. Cited 2024 Nov 11.","journal-title":"Int J Ophthalmol."},{"issue":"3","key":"4075_CR48","doi-asserted-by":"publisher","first-page":"984","DOI":"10.21037\/apm-22-102","volume":"11","author":"Y Zhu","year":"2022","unstructured":"Zhu Y, Cai Q, Li P, Zhou Y, Xu M, Song Y. The relationship between peripheral blood inflammatory markers and diabetic macular edema in patients with severe diabetic retinopathy. Ann Palliat Med. 2022;11(3):984\u201392.\u00a0Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/35365028\/. Cited 2024 Mar 10.","journal-title":"Ann Palliat Med"},{"issue":"4","key":"4075_CR49","doi-asserted-by":"publisher","first-page":"234","DOI":"10.4103\/jcsr.jcsr_24_22","volume":"11","author":"N Gollakota","year":"2022","unstructured":"Gollakota N, Deme S, Kakarla B, Rao MN, Raju YS, Uppin M, et al. Role of neutrophil-to-lymphocyte ratio in predicting microvascular complications in type 2 diabetes mellitus. J Clin Sci Res. 2022;11(4):234\u20139.\u00a0Available from:\u00a0https:\/\/journals.lww.com\/jcsr\/fulltext\/2022\/11040\/role_of_neutrophil_to_lymphocyte_ratio_in.7.aspx. Cited 2024 Nov 11.","journal-title":"J Clin Sci Res"},{"key":"4075_CR50","doi-asserted-by":"crossref","unstructured":"Shi Q, Wang Q, Wang Z, Lu J, Wang R. Systemic inflammatory regulators and proliferative diabetic retinopathy: A bidirectional Mendelian randomization study. Front Immunol. 2023;14:1088778. Available from: https:\/\/finngen.gitbook.io\/documentation\/v\/r7\/. Cited 2024 Aug 17.","DOI":"10.3389\/fimmu.2023.1088778"},{"issue":"1","key":"4075_CR51","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-020-79139-8","volume":"11","author":"HU Kim","year":"2021","unstructured":"Kim HU, Park SP, Kim YK. Long-term HbA1c variability and the development and progression of diabetic retinopathy in subjects with type 2 diabetes. Scientific Reports. 2021;11(1):1\u201310. Available from: https:\/\/www.nature.com\/articles\/s41598-021-84150-8. Cited 2025 Mar 20.","journal-title":"Scientific Reports"},{"key":"4075_CR52","doi-asserted-by":"crossref","unstructured":"Hermann JM, Hammes HP, Rami-Merhar B, Rosenbauer J, Sch\u00fctt M, Siegel E, et al. HbA1c Variability as an Independent Risk Factor for Diabetic Retinopathy in Type 1 Diabetes: A German\/Austrian Multicenter Analysis on 35,891 Patients. PLoS One. 2014;9(3):e91137. Available from: https:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0091137. Cited 2025 Mar 20.","DOI":"10.1371\/journal.pone.0091137"},{"key":"4075_CR53","doi-asserted-by":"crossref","unstructured":"Matsushita Y, Takeda N, Nakamura Y, Yoshida-Hata N, Yamamoto S, Noda M, et al. A Comparison of the Association of Fasting Plasma Glucose and HbA1c Levels with Diabetic Retinopathy in Japanese Men. J Diabetes Res. 2020;2020(1):3214676. Available from: https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1155\/2020\/3214676. Cited 2025 Mar 20.","DOI":"10.1155\/2020\/3214676"},{"key":"4075_CR54","doi-asserted-by":"crossref","unstructured":"Yumnamcha T, Guerra M, Singh LP, Ibrahim AS. Metabolic Dysregulation and Neurovascular Dysfunction in Diabetic Retinopathy. Antioxidants (Basel). 2020;9(12):1\u201322. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/33302369\/. Cited 2024 Mar 7.","DOI":"10.3390\/antiox9121244"},{"key":"4075_CR55","doi-asserted-by":"crossref","unstructured":"Ogura S, Kurata K, Hattori Y, Takase H, Ishiguro-Oonuma T, Hwang Y, et al. Sustained inflammation after pericyte depletion induces irreversible blood-retina barrier breakdown. JCI Insight. 2017;2(3). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/28194443\/. Cited 2024 Apr 14.","DOI":"10.1172\/jci.insight.90905"},{"key":"4075_CR56","doi-asserted-by":"crossref","unstructured":"Figueras-Roca M, Molins B, Sala-Puigdollers A, Matas J, Vinagre I, R\u00edos J, et al. Peripheral blood metabolic and inflammatory factors as biomarkers to ocular findings in diabetic macular edema. PLoS One. 2017;12(3):e0173865. Available from:\u00a0https:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0173865. Cited 2024 Sep 15.","DOI":"10.1371\/journal.pone.0173865"},{"issue":"6","key":"4075_CR57","doi-asserted-by":"publisher","first-page":"2521","DOI":"10.4103\/IJO.IJO_345_23","volume":"71","author":"CU Bhutia","year":"2023","unstructured":"Bhutia CU, Kaur P, Singh K, Kaur S. Evaluating peripheral blood inflammatory and metabolic biomarkers as predictors in diabetic retinopathy and diabetic macular edema. Indian J Ophthalmol. 2023;71(6):2521\u20135.\u00a0Available from:\u00a0https:\/\/journals.lww.com\/ijo\/fulltext\/2023\/71060\/evaluating_peripheral_blood_inflammatory_and.37.aspx. Cited 2024 Mar 8.","journal-title":"Indian J Ophthalmol"}],"container-title":["BMC Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12886-025-04075-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12886-025-04075-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12886-025-04075-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T02:28:57Z","timestamp":1746066537000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcophthalmol.biomedcentral.com\/articles\/10.1186\/s12886-025-04075-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,1]]},"references-count":57,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["4075"],"URL":"https:\/\/doi.org\/10.1186\/s12886-025-04075-y","relation":{},"ISSN":["1471-2415"],"issn-type":[{"value":"1471-2415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,1]]},"assertion":[{"value":"28 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"265"}}