Changes of some peripheral blood cells in patients with non-arteritis central retinal artery occlusion_Chinese Journal of Ocular Fundus Diseases

Authors：

Wang Xiaotang , Lei Tao , Gu Lulu ,  Wang Runsheng , Zhang Bo , Ma Teng

Department of Ophthalmology, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an 710004, China;

Corresponding?author：

Wang Runsheng, Email: wangrunsheng0602@126.com

Keywords：

Non-arteritis central retinal artery occlusion; Peripheral blood; Blood cells; Inflammation

DOI：

10.3760/cma.j.cn511434-20240226-00080

Video：

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Objectives To explore the changes of some peripheral blood cells related to inflammation in patients with non-arteritis central retinal artery occlusion (NA-CRAO). Methods A retrospective clinical study. From July 2019 to July 2021, a total of 218 patients with NA-CRAO hospitalized (NA-CRAO group) in Department of Ophthalmology, Xi'an People's Hospital (Xi'an Fourth Hospital) and 218 patients with routine physical examination (control group) during the same period were included in the study. There were no significant differences in age (t=0.60), sex composition ratio (χ²=0.83) and body mass index (t=0.77) between the two groups (P＞0.05). 0.2 ml fasting peripheral blood was collected from the subject, and white blood cells (WBC), neutrophils (NEUT), lymphocytes (LYMPH), red blood cells (RBC), RBC distribution width (RDW), platelets (PLT), mean PLT volume (MPV), and large PLT ratio (PLCR) were detected. The NEUT/LYMPH ratio (NLR) and PLT/LYMPH ratio (PLR) were calculated. t test was used to compare measurement data between groups. Multiple logistic regression analysis was performed for blood cells with P＜0.05. The receiver operating characteristic curve (ROC curve) was used to calculate the area under the curve (AUC) and 95% confidence interval (95%CI) of each inflammatory indicator, and the optimal cutoff value was determined according to the Jorden index (sensitivity+specificity－1). Results Compared with control group, WBC, NEUT, NLR, RDW, PLR were increased in NA-CRAO group, while RBC and LYMPH were decreased, with statistical significance (t=9.68, 12.43, 9.47, 3.64, 5.54, 5.18, 0.46; P＜0.001). There was no significant difference in PLT, MPV and PLCR between the two groups (t=0.32, 1.56, 0.84; P＞0.05). Multivariate logistic regression analysis showed that NLR was a possible risk factor for the occurrence of NA-CRAO (odds ratio=2.51, 95%CI 0.780-0.859, P=0.031). ROC curve analysis showed that the AUC predicted by NLR was 0.819, the optimal critical value was 3.05, and the sensitivity and specificity were 59.2% and 92.7%, respectively. Conclusions In peripheral blood cells of NA-CRAO patients, NEUT is significantly increased and LYMPH is decreased. NLR is a possible risk factor for NA-CRAO.

Citation： Wang Xiaotang, Lei Tao, Gu Lulu, Wang Runsheng, Zhang Bo, Ma Teng. Changes of some peripheral blood cells in patients with non-arteritis central retinal artery occlusion. Chinese Journal of Ocular Fundus Diseases, 2024, 40(8): 593-597. doi: 10.3760/cma.j.cn511434-20240226-00080 Copy

1.	雷濤, 王潤生, 張博, 等. 尿激酶動脈溶栓對非動脈炎性視網膜中央動脈阻塞患者的療效和安全性[J]. 眼科新進展, 2023, 43(3): 198-202. DOI: 10.13389/j.cnki.rao.2023.0040.Lei T, Wang RS, Zhang B, et al. Efficacy and safety of urokinase in arterial thrombolytic therapy of non-ar-teritic central retinal artery occlusion[J]. Rec Adv Ophthalmol, 2023, 43(3): 198-202. DOI: 10.13389/j.cnki.rao.2023.0040.
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5.	Elbeyli A, Kurtul BE, Ozcan DO, et al. Assessment of red cell distribution width, platelet/lymphocyte ratio, systemic immuneinflammation index, and neutrophil/lymphocyte ratio values in patients with central retinal artery occlusion[J]. Ocul Immunol Inflamm, 2022, 30(7-8): 1940-1944. DOI: 10.1080/09273948.2021.1976219.
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8.	Balta S, Demirkol S, Unlu M, et al. Neutrophil to lymphocyte ratio may be predict of mortality in all conditions[J]. Br J Cancer, 2013, 109(12): 3125-3126. DOI: 10.1038/bjc.2013.598.
9.	Atum M, Alag?z G. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with retinal artery occlusion[J]. J Ophthalmic Vis Res, 2020, 15(2): 195-200. DOI: 10.18502/jovr.v15i2.6737.
10.	Guven S, Kilic D. Neutrophil to lymphocyte ratio (NLR) is a better tool rather than monocyte to high-density lipoprotein ratio (MHR) and platelet to lymphocyte ratio (PLR) in central retinal artery occlusions[J]. Ocul Immunol Inflamm, 2021, 29(5): 997-1001. DOI: 10.1080/09273948.2020.1712433.
11.	Qin G, He F, Zhang H, et al. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) are more prominent in retinal artery occlusion (RAO) compared to retinal vein occlusion (RVO)[J/OL]. PLoS One, 2022, 17(2): e0263587[2022-02-03]. https://pubmed.ncbi.nlm.nih.gov/35113973/. DOI: 10.1371/journal.pone.0263587.
12.	陳意珊, 陳星, 區靜怡, 等. 白細胞、中性粒細胞/淋巴細胞比值及紅細胞分布寬度聯合檢測在2019新型冠狀病毒肺炎中的應用價值[J]. 實驗與檢驗醫學, 2022, 40(4): 405-408. DOI: 10.3969/j.issn.1674-1129.2022.04.006.Chen YS, Chen X, Ou JY, et al. Application value of WBC, NLR and RDW in the patients with 2019 novel coronavirus pneumonia[J]. Experimental and Laboratory Medicine, 2022, 40(4): 405-408. DOI: 10.3969/j.issn.1674-1129.2022.04.006.
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19.	Rasoulinejad SA. Is there an association between mean platelet volume and diabetic retinopathy? A case-control study[J]. Caspian J Intern Med, 2021, 12(2): 129-134. DOI: 10.22088/cjim.12.2.129.
20.	Bakogiannis C, Sachse M, Stamatelopoulos K, et al. Platelet-derived chemokines in inflammation and atherosclerosis[J/OL]. Cytokine, 2019, 122: 154157[2017-12-01]. https://pubmed.ncbi.nlm.nih.gov/29198385/. DOI:10.1016/j.cyto.2017.09.013.
21.	張婭萍, 俞磊, 馬波, 等. 平均血小板體積在視網膜中央動脈阻塞中的臨床意義[J]. 中國眼耳鼻喉科雜志, 2018, 18(6): 400-402. DOI: 10.14166/j.issn.1671-2420.2018.06.010.Zhang YP, Yu L, Ma B, et al. Clinical significance of mean platelet volume in patients with central retinal artery occlusion[J]. Chin J Ophthalmol and Otorhinolaryngol, 2018, 18(6): 400-402. DOI: 10.14166/j.issn.1671-2420.2018.06.010.

1. 雷濤, 王潤生, 張博, 等. 尿激酶動脈溶栓對非動脈炎性視網膜中央動脈阻塞患者的療效和安全性[J]. 眼科新進展, 2023, 43(3): 198-202. DOI: 10.13389/j.cnki.rao.2023.0040.Lei T, Wang RS, Zhang B, et al. Efficacy and safety of urokinase in arterial thrombolytic therapy of non-ar-teritic central retinal artery occlusion[J]. Rec Adv Ophthalmol, 2023, 43(3): 198-202. DOI: 10.13389/j.cnki.rao.2023.0040.
2. Chen CS, Lee AW. Management of acute central retinal artery occlusion[J]. Nat Clin Pract Neurol, 2008, 4(7): 376-383. DOI: 10.1038/ncpneuro0811.
3. Ammirati E, Moroni F, Norata GD, et al. Markers of inflammation associated with plaque progression and instability in patients with carotid atherosclerosis[J/OL]. Mediators Inflamm, 2015, 2015: 718329[2015-04-16]. https://pubmed.ncbi.nlm.nih.gov/25960621/. DOI: 10.1155/2015/718329 .
4. Gong H, Song Q, Wang L. Manifestations of central retinal artery occlusion revealed by fundus fluorescein angiography are associated with the degree of visual loss[J]. Exp Ther Med, 2016, 11(6): 2420-2424. DOI: 10.3892/etm.2016.3175.
5. Elbeyli A, Kurtul BE, Ozcan DO, et al. Assessment of red cell distribution width, platelet/lymphocyte ratio, systemic immuneinflammation index, and neutrophil/lymphocyte ratio values in patients with central retinal artery occlusion[J]. Ocul Immunol Inflamm, 2022, 30(7-8): 1940-1944. DOI: 10.1080/09273948.2021.1976219.
6. Zou XL, Lin XJ, Ni X, et al. Baseline red blood cell distribution width correlates with disease activity and therapeutic outcomes in patients with systemic lupus erythematosus, irrespective of anemia status[J]. Clin Lab, 2016, 62(10): 1841-1850. DOI: 10.7554/Clin.Lab.2016.160213.
7. 賀林鋒, 戚本玲. NLR作為動脈粥樣硬化預測指標的研究進展[J]. 中國老年學雜志, 2022, 7(42): 3350. DOI: 10.3969/j.issn.1005-9202.2022.13.063.HE LF, Qi BL. Research progress of neutrophil to lymphocyte ratio as a predictor of atherosclerosis[J]. Chinese Journal of Gerontology, 2022, 7(42): 3350. DOI: 10.3969/j.issn.1005-9202.2022.13.063.
8. Balta S, Demirkol S, Unlu M, et al. Neutrophil to lymphocyte ratio may be predict of mortality in all conditions[J]. Br J Cancer, 2013, 109(12): 3125-3126. DOI: 10.1038/bjc.2013.598.
9. Atum M, Alag?z G. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with retinal artery occlusion[J]. J Ophthalmic Vis Res, 2020, 15(2): 195-200. DOI: 10.18502/jovr.v15i2.6737.
10. Guven S, Kilic D. Neutrophil to lymphocyte ratio (NLR) is a better tool rather than monocyte to high-density lipoprotein ratio (MHR) and platelet to lymphocyte ratio (PLR) in central retinal artery occlusions[J]. Ocul Immunol Inflamm, 2021, 29(5): 997-1001. DOI: 10.1080/09273948.2020.1712433.
11. Qin G, He F, Zhang H, et al. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) are more prominent in retinal artery occlusion (RAO) compared to retinal vein occlusion (RVO)[J/OL]. PLoS One, 2022, 17(2): e0263587[2022-02-03]. https://pubmed.ncbi.nlm.nih.gov/35113973/. DOI: 10.1371/journal.pone.0263587.
12. 陳意珊, 陳星, 區靜怡, 等. 白細胞、中性粒細胞/淋巴細胞比值及紅細胞分布寬度聯合檢測在2019新型冠狀病毒肺炎中的應用價值[J]. 實驗與檢驗醫學, 2022, 40(4): 405-408. DOI: 10.3969/j.issn.1674-1129.2022.04.006.Chen YS, Chen X, Ou JY, et al. Application value of WBC, NLR and RDW in the patients with 2019 novel coronavirus pneumonia[J]. Experimental and Laboratory Medicine, 2022, 40(4): 405-408. DOI: 10.3969/j.issn.1674-1129.2022.04.006.
13. Paliogiannis P, Fois AG, Sotgia S, et al. Neutrophil to lymphocyte ratio and clinical outcomes in COPD: recent evidence and future perspectives[J/OL]. Eur Respir Rev, 2018, 27(147): 170113[2018-02-07]. https://pubmed.ncbi.nlm.nih.gov/29436405/. DOI: 10.1183/16000617.0113-2017.
14. Hayreh SS. Acute retinal arterial occlusive disorders[J]. Prog Retin Eye Res, 2011, 30(5): 359-394. DOI: 10.1016/j.preteyeres.2011.05.001.
15. Wagner DD, Burger PC. Platelets in inflammation and thrombosis[J]. Arterioscler Thromb Vasc Biol, 2003, 23(12): 2131-2137. DOI: 10.1161/01.ATV.0000095974.95122.
16. Onsrud M, Thorsby E. Influence of in vivo hydrocortisone on some human blood lymphocyte subpopulations. I. effect on natural killer cell activity[J]. Scand J Immunol, 1981, 13(6): 573-579. DOI: 10.1111/j.1365-3083.1981.tb00171.x.
17. Buyukkaya E, Karakas MF, Karakas E, et al. Correlation of neutrophil to LYMPocyte ratio with the presence and severity of metabolic syndrome[J]. Clin Appl Thromb Hemost, 2014, 20(2): 20(2): 159-163. DOI: 10.1177/1076029612459675.
18. Pinna A, Porcu T, Paliogiannis P, et al. Complete blood cell count measures inretinal artery occlusions[J]. Acta Ophthalmol, 2021, 99(6): 637-643. DOI: 10.1111/aos.14699. DOI: 10.1111/aos.14699.
19. Rasoulinejad SA. Is there an association between mean platelet volume and diabetic retinopathy? A case-control study[J]. Caspian J Intern Med, 2021, 12(2): 129-134. DOI: 10.22088/cjim.12.2.129.
20. Bakogiannis C, Sachse M, Stamatelopoulos K, et al. Platelet-derived chemokines in inflammation and atherosclerosis[J/OL]. Cytokine, 2019, 122: 154157[2017-12-01]. https://pubmed.ncbi.nlm.nih.gov/29198385/. DOI:10.1016/j.cyto.2017.09.013.
21. 張婭萍, 俞磊, 馬波, 等. 平均血小板體積在視網膜中央動脈阻塞中的臨床意義[J]. 中國眼耳鼻喉科雜志, 2018, 18(6): 400-402. DOI: 10.14166/j.issn.1671-2420.2018.06.010.Zhang YP, Yu L, Ma B, et al. Clinical significance of mean platelet volume in patients with central retinal artery occlusion[J]. Chin J Ophthalmol and Otorhinolaryngol, 2018, 18(6): 400-402. DOI: 10.14166/j.issn.1671-2420.2018.06.010.

Chinese Journal of Ocular Fundus Diseases

Changes of some peripheral blood cells in patients with non-arteritis central retinal artery occlusion

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