Abstract
OBJECTIVE: This study aimed to evaluate changes in systemic inflammatory indices and retinal structural parameters in newly diagnosed diabetic retinopathy (DR) patients before and after intravitreal anti-VEGF treatment. MATERIAL AND METHODS: A total of 308 participants (157 DR patients and 151 healthy controls) were enrolled. Systemic inflammatory status was assessed using hematologic indices derived from routine complete blood count parameters. Optical coherence tomography (OCT) was used to measure macular thickness. DR patients were evaluated at three time points: before treatment, 1 month, and 3 months after anti-VEGF injection. RESULTS: Baseline inflammatory indices (NLR, MLR, PLR, and SII) and macular thickness were significantly higher in the DR group compared to controls (p < 0.001). Following treatment, a progressive decrease in both inflammatory indices and macular thickness was observed. Pretreatment NLR and SII values showed high diagnostic performance in differentiating DR (AUC: 0.925 and 0.838, respectively). Multivariate analysis revealed that NLR, MLR, and HbA1c were independent predictors of macular thickness. CONCLUSION: Systemic inflammatory activity is closely associated with both the onset and progression of DR. The evaluation of inflammatory indices such as NLR and SII together with OCT findings may support diagnosis and treatment follow-up in clinical practice.