Serum NLR, PLR and MNV characteristics as predictors of anti-VEGF plus glucocorticoid efficacy in nAMD

Aim To evaluate the combined predictive value of serum neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and macular neovascularization (MNV) characteristics for treatment efficacy in neovascular age-related macular degeneration (nAMD) patients receiving anti-VEGF plus glucocorticoid therapy.Patients and methods This retrospective study included 145 patients (153 eyes) with nAMD receiving conbercept combined with dexamethasone implant. Patients were categorized as Inactive (n = 89) or Active (n = 64) based on post-treatment MNV activity. Baseline NLR, PLR, and MNV morphology were assessed. Multivariate logistic regression identified independent predictors, and ROC analyses evaluated predictive value.Results Patients with persistent MNV activity showed significantly higher baseline NLR, PLR, MNV area, and fractal dimension (all p < 0.001). Multivariate analysis identified baseline visual acuity, MNV type, fluid volumes, MNV morphological parameters, and inflammatory markers as independent predictors. The combined model incorporating inflammatory markers and MNV characteristics demonstrated superior performance (AUC = 0.92, 95% CI: 0.87–0.96) with 79.69% sensitivity and 91.01% specificity.Conclusion Combining serum inflammatory markers with MNV morphological characteristics enhanced predictive value for treatment response in nAMD patients receiving combination therapy. This integrated approach may facilitate personalized treatment strategies in nAMD management.