Retinal artery occlusion (RAO), including central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO), is an ophthalmic emergency and an important marker of systemic vascular disease. Inflammation plays a key role in RAO pathogenesis; however, subtype-specific inflammatory profiles remain insufficiently characterized. We conducted a retrospective observational study of 363 patients diagnosed with RAO at Renmin Hospital of Wuhan University between January 2020 and April 2024 (CRAO, n = 320; BRAO, n = 43). Peripheral inflammatory biomarkers, including leukocyte count, neutrophil percentage, lymphocyte percentage, monocyte percentage, eosinophil percentage, C-reactive protein (CRP, mg/L), and neutrophil-to-lymphocyte ratio (NLR), were compared between CRAO and BRAO using independent-sample t tests or Mann–Whitney U tests, as appropriate. Sex- and age-stratified analyses were performed to explore subgroup patterns. A modest shift was observed between BRAO, CRAO patients in term leukocyte counts (6.57 ± 2.19 vs. 5.95 ± 1.66 × 10⁹/L; p = 0.03) and lymphocyte (30.75 ± 8.62% vs. 27.32 ± 7.52%; p = 0.01), but lower neutrophil percentages (58.33 ± 9.08% vs. 61.92 ± 8.07%; p = 0.01). These between-group differences were small, and group-level means largely remained within conventional reference ranges. Monocyte and eosinophil percentages did not differ significantly between groups. CRP levels (mg/L) showed no statistically significant difference, although greater variability was observed in the CRAO group. In patients with available absolute counts, BRAO demonstrated a higher NLR than CRAO. Sex- and age-stratified analyses revealed consistent subtype-related differences, with more pronounced neutrophil–lymphocyte shifts in males and steeper age-related changes in CRAO. CRAO and BRAO exhibit distinct systemic inflammatory profiles. CRAO is characterized by higher leukocyte and lymphocyte levels, suggesting broader systemic inflammatory involvement, whereas BRAO demonstrates relative neutrophil predominance and higher NLR, consistent with a more localized inflammatory response. These findings support the concept that CRAO and BRAO are immunologically distinct entities and may benefit from subtype-specific evaluation and management strategies. Prospective, multi-center studies are warranted to validate these observations and clarify their clinical implications.
Mahdi et al. (Thu,) studied this question.