Association between optical coherence tomography biomarkers and systemic inflammatory indices in neovascular age-related macular degeneration

Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible central vision loss in elderly individuals. Increasing evidence indicates that systemic inflammation contributes to nAMD pathogenesis. Optical coherence tomography (OCT) enables detailed evaluation of retinal microstructural changes; however, the relationship between OCT biomarkers and systemic inflammatory markers remains unclear. This study aimed to investigate the association between OCT biomarkers and systemic inflammatory indices in patients with nAMD. This retrospective case–control study included 80 treatment-naïve patients with nAMD and 80 age-matched healthy controls. All participants underwent comprehensive ophthalmologic examination and spectral-domain OCT imaging. OCT biomarkers assessed were intraretinal cysts (IRCs) and hyperreflective foci (HRFs). Systemic inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR), were obtained from routine complete blood counts. Statistical analyses and receiver operating characteristic (ROC) curve analysis were performed. NLR and MLR values were significantly higher in patients with nAMD compared with controls (p < 0.05). ROC analysis demonstrated moderate diagnostic performance for NLR (AUC = 0.757) and MLR (AUC = 0.651). An NLR cut-off value of 2.23 showed a sensitivity of 58.8% and specificity of 81.3%. HRFs were significantly associated with the presence of SRF, whereas IRCs were associated with a lower frequency of SRF. No significant correlations were observed between OCT biomarkers and systemic inflammatory indices. Systemic inflammatory markers, particularly NLR and MLR, are elevated in nAMD and may serve as adjunctive biomarkers. OCT biomarkers primarily reflect localized retinal pathology and appear largely independent of systemic inflammatory status. These findings support the complementary roles of systemic and imaging-derived biomarkers in the clinical evaluation of nAMD.