Diagnostic significance of neutrophil-to-lymphocyte ratio in non-arteritic anterior ischemic optic neuropathy: a meta-analysis

We aimed to determine the association of neutrophil-to-lymphocyte ratio (NLR) with non-arteritic anterior ischemic optic neuropathy (NAION).

We conducted a systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Scopus and Web of Science were searched from the establishment of the database to May 5, 2022 to find the relevant studies. The quality of the included literature was evaluated with the Newcastle–Ottawa scale (NOS). The results are reflected in the form of standard mean difference (SMD) and 95% confidence interval (CI).

Finally, six articles were included in our study. Compared with healthy controls, patients’ NLR levels were significantly higher (SMD = 0.47; CI 95% = 0.30–0.65, p<0.001). The included studies were not statistically heterogeneous (I² = 0.0%, p = 0.60); thus, the analysis used the fixed-effect model. The pooled sensitivity of NLR was 0.69 (95% CI 0.60–0.67), and the pooled specificity was 0.59 (95% CI 0.50–0.67). The pooled positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR) of NLR were 1.71(95%CI 1.48–1.98), 0.50 (95%CI 0.41–0.62), and 3.38 (95%CI 2.57–4.44), respectively.

Our findings suggest NLR to be a potential marker of NAION, while also implicating a role for inflammation in underlying pathophysiology.