Systemic Inflammation and Structural Retinal Damage on OCT in Acute Non-Arteritic Central Retinal Artery Occlusion-A...

Central retinal artery occlusion (CRAO) is an acute ophthalmic emergency causing irreversible vision loss due to retinal ischemia. Inflammation is increasingly recognized as a contributor to vascular occlusions, but the relationship between systemic inflammatory biomarkers and structural retinal damage in CRAO remains unclear. This retrospective study included 37 patients with non-arteritic CRAO presenting within 168 h of symptom onset. Optical coherence tomography (OCT) classified ischemic severity as mild, moderate, or severe based on inner retinal morphology. Systemic inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and systemic inflammation response index (SIRI), were calculated from admission blood tests, and associations were analyzed using ordinal logistic regression. Increasing severity correlated with higher NLR and SII values (p < 0.05). Univariable analysis showed significant associations for NLR, SII, neutrophil count, white blood cell count, and central macular thickness (CMT). Multivariable regression identified NLR (OR = 8.398, p = 0.007) and CMT (OR = 1.052, p = 0.001) as independent predictors of greater ischemic damage. Other indices were not significant. These findings indicate that NLR is the primary systemic inflammatory predictor of OCT-defined severity in acute CRAO, with CMT providing complementary structural information.