Clinical Research Papers:

The diagnostic value of white blood cell, neutrophil, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio in patients with primary angle closure glaucoma

Shengjie Li, Wenjun Cao _, Jianping Han, Binghua Tang and Xinghuai Sun

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Oncotarget. 2017; 8:68984-68995. https://doi.org/10.18632/oncotarget.16571

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Shengjie Li1, Wenjun Cao1,2, Jianping Han1, Binghua Tang1 and Xinghuai Sun2,3,4,5

1 Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China

2 Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China

3 State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China

4 Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China

5 Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China

Correspondence to:

Wenjun Cao, email:

Xinghuai Sun, email:

Keywords: primary angle closure glaucoma, white blood cell, neutrophil, neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio

Received: January 23, 2017 Accepted: March 16, 2017 Published: March 25, 2017


Objective: Inflammatory mechanisms may have a role in the pathogenesis of primary angle closure glaucoma (PACG). The objective of this study was to investigate the diagnostic value of white blood cell (WBC), neutrophil, neutrophil to lymphocyte ratio (NLR), and lymphocyte to monocyte ratio (LMR) in patients with PACG and its association with glaucoma severity.

Method: The study was retrospectively assessed in 771 consecutive PACG patients and 770 control subjects, laboratory parameters and clinical parameters were obtained from a medical data platform. Patients were divided into three groups with different severity based on perimetry, i.e. mild (mean deviation (MD) ≤6.00 dB), moderate (12 dB≥ MD>6 dB) and severe (MD>12 dB). We developed a nomogram to specifically identify individual patient’s risk.

Results: The mean levels of neutrophil, NLR and WBC was higher in PACG than control group, and lowest in the mild PACG group, followed by moderate PACG and severe PACG (p<0.05). The AUROC value of NLR and LMR was found to be 0.719, 0.699, respectively. Multiple linear regressions showed that there was a significant correlation between WBC and MD (B=0.151, p<0.001), neutrophil and MD (B=0.143, p=0.003), NLR and MD (B=0.144, p=0.001), LMR and MD (B=-0.100, p=0.034). Logistic regression analyses revealed that WBC (OR=1.208, 95%CI=1.179-1.238), neutrophil (OR=1.598, 95%CI=1.541-1.656), NLR (OR=2.313, 95%CI=2.200-2.431), and LMR (OR=0.682, 95%CI=0.666-0.699) were associated with PACG.

Conclusion: Our study suggested that WBC, neutrophil, NLR, and LMR was related with PACG, and NLR and LMR may be useful as biomarkers.

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