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Original Research

Open Access

Factors influencing ranibizumab efficacy and prognosis of patients with retinal vein occlusion and macular edema based on systemic inflammatory indexes and OCT parameters

  • Ruyi Zhao1
  • Fangyuan Han1
  • Lili Fu1
  • Wei Tan1,*,

1Department of Ophthalmology, The First People’s Hospital of Zunyi (the Third Affiliated Hospital of Zunyi Medical University), 563000 Zunyi, Guizhou, China

DOI: 10.22514/jomh.2024.079 Vol.20,Issue 5,May 2024 pp.126-134

Submitted: 09 March 2024 Accepted: 08 May 2024

Published: 30 May 2024

*Corresponding Author(s): Wei Tan E-mail:


This study aimed to investigate the effects of ranibizumab on optical coherence tomography (OCT) parameters and the peripheral blood systemic inflammation index in men diagnosed with retinal vein occlusion accompanied by macular edema (BRVO-ME) and explore the relevant factors affecting visual prognosis. The clinical data of men diagnosed with BRVO-ME who underwent vitreous cavity injections of ranibizumab were retrospectively analyzed, and they were stratified into a good prognosis group (defined as a difference ≤−0.3) and a poor prognosis group (defined as a difference >−0.3) based on the difference between the logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) and pre-treatment logMAR BCVA at 6 months post-treatment. After 6 months of ranibizumab treatment, there were significant reductions (p < 0.05) observed in logMAR BCVA, intraocular pressure, center macular thickness (CMT), outer hyperreflective retinal foci (HRFs), inner HRFs, outer membrane (ELM) integrity, elliptical zone (EZ) integrity, as well as serum neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and systemic immune-inflammatory index (SII) levels. Disease duration, ELM integrity, BCVA, outer HRF and serum SII emerged as independent risk factors influencing the prognosis of visual acuity subsequent to ranibizumab treatment in BRVO-ME eyes (p < 0.05). A nomogram prediction model incorporating these risk factors exhibited favorable differentiation and accuracy. In conclusion, disease duration, BCVA, ELM integrity, presence of outer HRF and elevated serum SII were identified as independent risk factors influencing visual prognosis following ranibizumab treatment in male patients with BRVO-ME. Furthermore, the nomogram developed based on OCT parameters and serum SII exhibited favorable differentiation and accuracy.


Retinal vein occlusion; Ranibizumab; Macular edema; Optical coherence tomography; Inflammation

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Ruyi Zhao,Fangyuan Han,Lili Fu,Wei Tan. Factors influencing ranibizumab efficacy and prognosis of patients with retinal vein occlusion and macular edema based on systemic inflammatory indexes and OCT parameters. Journal of Men's Health. 2024. 20(5);126-134.


[1] Klein R. The 15-year cumulative incidence of retinal vein occlusion. Archives of Ophthalmology. 2008; 126: 513.

[2] Kramer CK, de Azevedo MJ, da Costa Rodrigues T, Canani LH, Esteves J. Smoking habit is associated with diabetic macular edema in type 1 diabetes mellitus patients. Journal of Diabetes and its Complications. 2008; 22: 430.

[3] Chatziralli I. Ranibizumab for the treatment of diabetic retinopathy. Expert Opinion on Biological Therapy. 2021; 21: 991–997.

[4] Haybar H, Pezeshki SMS, Saki N. Evaluation of complete blood count parameters in cardiovascular diseases: an early indicator of prognosis? Experimental and Molecular Pathology. 2019; 110: 104267.

[5] Kurtul BE, Çakmak Aİ, Elbeyli A, Özarslan Özcan D, Özcan SC, Cankurtaran V. Assessment of platelet-to-lymphocyte ratio in patients with retinal vein occlusion. Therapeutic Advances in Ophthalmology. 2020; 12: 251584142097194.

[6] Goodyear MDE, Krleza-Jeric K, Lemmens T. The declaration of Helsinki. The BMJ. 2007; 335: 624–625.

[7] Ogura Y, Roider J, Korobelnik JF, Holz FG, Simader C, Schmidt-Erfurth U, et al. Intravitreal aflibercept for macular edema secondary to central retinal vein occlusion: 18-month results of the phase 3 GALILEO study. American Journal of Ophthalmology. 2014; 158: 1032–1038.

[8] Campochiaro PA, Heier JS, Feiner L, Gray S, Saroj N, Rundle AC, et al. Ranibizumab for macular edema following branch retinal vein occlusion. Ophthalmology. 2010; 117: 1102–1112.e1.

[9] Marcinkowska A, Wolska N, Luzak B, Cisiecki S, Marcinkowski K, Rozalski M. Platelet-derived procoagulant microvesicles are elevated in patients with retinal vein occlusion (RVO). Journal of Clinical Medicine. 2022; 11: 5099.

[10] Sastry S, Cuomo F, Muthusamy J. COVID-19 and thrombosis: the role of hemodynamics. Thrombosis Research. 2022; 212: 51–57.

[11] Qin G, He F, Zhang H, Pazo EE, Dai G, Yao Q, 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). PLOS ONE. 2022; 17: e0263587.

[12] Timur İEE, Tarım B, Şeker ED, Uğurlu N. The relation between serum inflammatory marker levels and serous retinal detachment in macular edema secondary to retinal vein occlusion. Photodiagnosis and Photodynamic Therapy. 2023; 42: 103591.

[13] Imazeki M, Noma H, Yasuda K, Motohashi R, Goto H, Shimura M. Anti-VEGF therapy reduces inflammation in diabetic macular edema. Ophthalmic Research. 2021; 64: 43–49.

[14] Ryu G, Park D, Lim J, van Hemert J, Sagong M. Macular microvascular changes and their correlation with peripheral nonperfusion in branch retinal vein occlusion. American Journal of Ophthalmology. 2021; 225: 57–68.

[15] Suzuki N, Hirano Y, Tomiyasu T, Kurobe R, Yasuda Y, Esaki Y, et al. Collateral vessels on optical coherence tomography angiography in eyes with branch retinal vein occlusion. British Journal of Ophthalmology. 2019; 103: 1373–1379.

[16] Brar M, Sharma M, Grewal SS, Grewal D. Quantification of retinal microvasculature and neurodegeneration changes in branch retinal vein occlusion after resolution of cystoid macular edema on optical coherence tomography angiography. Indian Journal of Ophthalmology. 2019; 67: 1864.

[17] Segal O, Yavnieli R, Mimouni M, Rabina G, Geffen N, Moisseiev E, et al. Optical coherence tomography biomarkers predicting visual acuity change after intravitreal bevacizumab injections for macular edema secondary to branch retinal vein occlusion. Ophthalmologica. 2022; 245: 19–24.

[18] Kim J, Chun Y, Lee J, Moon N, Yi D. Comparison of vessel density reduction in the deep and superficial capillary plexuses in branch retinal vein occlusion. Ophthalmologica. 2020; 243: 66–74.

[19] Algahtani FH, AlQahtany FS, Al-Shehri A, Abdelgader AM. Features and incidence of thromboembolic disease: a comparative study between high and low altitude dwellers in Saudi Arabia. Saudi Journal of Biological Sciences. 2020; 27: 1632–1636.

[20] Walzik D, Joisten N, Zacher J, Zimmer P. Transferring clinically established immune inflammation markers into exercise physiology: focus on neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune-inflammation index. European Journal of Applied Physiology. 2021; 121: 1803–1814.

[21] Park SY. Nomogram: an analogue tool to deliver digital knowledge. The Journal of Thoracic and Cardiovascular Surgery. 2018; 155: 1793.

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