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. 2026 Feb 20;105(8):e47804. doi: 10.1097/MD.0000000000047804

Red blood cell distribution width/albumin ratio (RAR): A novel predictor of retinal vein occlusion in the Turkish population (STROBE)

Mustafa Yildirim a,*, Mert Bilgili b, Kamber Kaşali c, Büşra Medetoğlu a, Elif Temur a
PMCID: PMC12928973  PMID: 41731769

Abstract

The purpose of this study was to assess how the red cell distribution width (RDW)-albumin ratio (RAR), an indicator of nutrition, oxidative stress, and inflammation, relates to the severity of retinal vein occlusion (RVO). 55 patients with RVO who presented to the Ophthalmology Polyclinic of Atatürk University Research Hospital between January 2025 and April 2025 and 30 healthy controls were evaluated. While 37 of the patient group had branch RVO (BRVO), 18 had central RVO (CRVO). Fundus fluorescein angiography was used to differentiate between ischemic and non-ischemic retinal vein occlusion in the patient group. All patients underwent comprehensive physical examinations, which included a thorough medical history and laboratory assessments such as complete blood count parameters, hemogram, RDW, and serum albumin levels. When the demographic and biochemical characteristics of the participants were compared by gender, no statistically significant differences were found between the groups. Similarly, although albumin levels and the RDW/albumin ratio (RAR) showed differences between the groups, these differences were not statistically significant (P = .108 and P = .109, respectively). RDW-CV values showed a statistically significant difference between the groups (P = .006). It was observed that RDW-CV values were significantly higher in the ischemic occlusion group. Although albumin levels differed between the groups, this difference was not statistically significant (P = .118). However, a significant difference in the RDW/albumin ratio (RAR) was observed between the groups (P = .016). This difference was found to be due to the comparison between the control group and the ischemic occlusion group, where RAR values were higher in the ischemic group. RAR demonstrates a significant association with RVO and offers a simple, cost-effective, safe, and readily available laboratory marker for assessing RVO severity. It can be considered that especially ischemic type RVO may be associated with high RAR level.

Keywords: inflammation, ischemia, RDW-albumin ratio, retinal vein occulusion

1. Introduction

Retinal vein occlusion (RVO) is the second prevalent retinopathy following diabetic retinopathy and is a retinal vascular disease that can lead to vision loss or blindness. RVO has been associated with risk factors such as systemic hypertension, hyperlipidemia, diabetes mellitus, glaucoma, and smoking, but its pathogenesis has not been clearly explained.[1] Vascular occlusion occurs as a result of intravascular thrombosis at the level of the lamina cribrosa.[2] Depending on the location of thrombosis, it is divided into 2 types: branch RVO (BRVO) and central RVO (CRVO).[3] Although BRVO occlusion is more common, it has a milder course than central occlusion.[4] Although cardiovascular risk factors are seen in a significant number of patients with RVO, it is reported that they also have biochemical and hematological problems.[3]

Local and systemic inflammation play an indirect role in the development of RVO by triggering hypercoagulability and atherosclerosis.[5] It has been shown that inflammation, particularly driven by the interaction between immune and inflammatory cells mediated by inflammatory cytokines, plays a significant role in the development of RVO. Many cytokines and growth factors, including interleukin-8, interleukin-6, placental growth factor, pentraxin 3, interferon-inducible 10-kDa protein, erythropoietin, and platelet-derived growth factor, have been reported to be elevated in RVO.[6] The inflammatory response occurs through the coordinated activation of signaling pathways by resident tissue cells and inflammatory cells such as neutrophils, macrophages, and circulating lymphocytes, which collectively regulate the levels of inflammatory mediators. In recent years, complete blood count has emerged as a useful tool for assessing inflammatory status.

Red cell distribution width (RDW) is a widely utilized laboratory marker that reflects the degree of anisocytosis by measuring the variation in the size of circulating erythrocytes.[7] While RDW was initially used primarily to differentiate between various types of anemia, recent studies have highlighted its prognostic value in a range of systemic conditions, including kidney disease, diabetes, cardiovascular, and respiratory disorders.[8] Elevated RDW levels have been associated with poor clinical outcomes in these diseases and are thought to be influenced by factors such as inflammation and oxidative stress. Similarly, albumin is a key plasma protein involved in maintaining nutritional status and plasma osmotic balance.[9] Hypoalbuminemia has been identified as a significant predictor of adverse outcomes in patients with malignancies, critical illnesses, and thromboembolic disorders.[10]

The RDW-to-albumin ratio (RAR) is a novel and straightforward inflammatory marker. It has been suggested that a robust inflammatory response can result in a marked increase in RAR.[11] Recent research indicates that evaluating RAR independently may offer superior prognostic accuracy compared to assessing RDW and albumin separately.[12,13] Studies have shown that the RAR has a stronger predictive value for mortality in stroke patients compared to either RDW or albumin alone.[14] In addition, the RAR has been suggested as a valuable marker for risk stratification, especially in emergency situations, owing to its simple measurement process and its independence from factors like blood pressure and heart rate.[14]

The purpose of this study was to assess how the RAR, an indicator of nutrition, oxidative stress, and inflammation, relates to the severity of RVO.

2. Materials and methods

In the study, 55 patients with retinal vein occlusion who applied to the Ophthalmology Polyclinic of Atatürk University Research Hospital between January 2025 and April 2025 and 30 healthy controls were evaluated. While 37 of the patient group had BRVO, 18 had CRVO. The age range of the patient and control groups was determined as 50 to 75. While anterior segment and fundus examination was performed in the patient and control groups, optic coherance tomography (Optovue) and fundus fluorescein angiography (FFA, Kowa, Japan) were additionally applied to the patient group. Patients with hematological disorders that could cause abnormal RDW and albumin levels (such as thalassemia and hemoglobinopathies), as well as those with other systemic diseases (such as diabetes mellitus), were excluded from the study. FFA was used to differentiate between ischemic and non-ischemic RVO in the patient group. The following findings were used to identify ischemic RVO: retinal neovascularization, iris and angle neovascularization, preretinal hemorrhage due to retinal neovascularization, and areas of retinal capillary nonperfusion >5 disc diameters in BRVO or >10 disc diameters in CRVO, as determined by FFA.

All patients underwent comprehensive physical examinations, which included a thorough medical history and laboratory assessments such as complete blood count parameters, hemogram, red cell distribution width (RDW), and serum albumin levels. A 10 cc IV venous blood sample was taken from both groups. The samples were sent to the Atatürk University Biochemistry laboratory for evaluation without delay. According to the blood results, RDW, Albumin and RAR levels were compared between the groups. The patient and control groups were compared based on age, gender, RDW, albumin, and RAR values.

2.1. Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration (as revised in 2013) and its later amendments or comparable ethical standards. Ethics committee approval was received from Atatürk University Faculty of Medicine Ethics Committee. (B.30.2.ATA.0.01.00/748) Informed consent forms for the study were obtained from the patients.

3. Statistical analysis

The analyses were performed using the IBM SPSS 20 statistical software. Data were expressed as mean, standard deviation, median, minimum, maximum, percentage, and count. The normality of continuous variables was assessed using the Shapiro–Wilk test. For comparisons between 2 independent groups, an Independent Samples t-test was used when the normality assumption was met, while the Mann–Whitney U test was applied when the normality assumption was not satisfied. When comparing continuous variables across more than 2 independent groups, if the normality assumption was met, ANOVA was used, and if not, the Kruskal-Wallis test was employed. Following ANOVA, post hoc tests were performed using the Tukey test when variances were homogeneous, and the Tamhane T2 test when variances were not homogeneous. Following the Kruskal–Wallis test, post hoc tests were performed using the Kruskal–Wallis 1-way ANOVA (k samples) test. The statistical significance level was set at P < .05.

4. Results

While there were 30 (54.54%) male and 25 (45.46%) female patients in the patient group, there were 16 (53.3%) male and 14 (46.7%) female individuals in the control group. In the patient group, a history of cataract surgery was observed in 68 eyes of 55 patients, while in the control group, 36 eyes of 30 patients had undergone cataract surgery. In both groups, intraocular pressures were within the normal range (8–22 mm Hg). In the control group, the vision levels of individuals were bilaterally 10/10 (Snellen chart), while in the patient group, those with CRVO had the lowest vision level of 1 mps and the highest of 1/10. In patients with BRVO, the lowest vision level was 1/10 and the highest was 6/10. According to the performed FFA, it was observed that 7 out of 37 BRVO patients and 7 out of 18 CRVO patients had the ischemic type of RVO.

When the demographic and biochemical characteristics of the participants were compared by gender, no significant differences were observed between the groups. The average age of men and women was similar (61 ± 15 and 61 ± 14 years, respectively; P = .990). Although RDW-CV values were slightly higher in women (13.5 ± 1.8), this difference was not statistically significant (P = .682). Similarly, albumin levels were approximately 4.3 ± 0.4 in both genders, showing no significant difference (P = .816). The RDW/albumin ratio (RAR) was measured as 3.13 ± 0.5 in men and 3.23 ± 0.81 in women, and this difference was also not statistically significant (P = .986). No statistically significant difference was found between the groups in terms of age (P = .12).

Although RDW-CV values were higher in the central and branch occlusion groups than in the control group, the difference between the groups was not statistically significant (P = .061). Similarly, although albumin levels and the RDW/albumin ratio (RAR) showed differences between the groups, these differences were not statistically significant (P = .108 and P = .109, respectively) (as shown in Table 1).

Table 1.

Comparison of patients with branch retinal vein occulusion-central retinal vein occulusion-central and the control group.

BRVO- CRVO
Control BRVO CRVO
Mean Standard Med Min Max Mean Standard Median Min Max Mean Standard Median Min Max F, Kruskal–Wallis H P
RDW-CV 12.9 0.8 12.9 11.5 14.9 13.6 1.8 13.2 11.5 23.2 13.6 1.6 13.5 11.7 19.2 5.594 .061
ALBUMIN 4.3 0.3 4.3 3.6 4.8 4.3 0.4 4.3 3.1 5 4.1 0.4 4.2 3.4 4.8 4.443 .108
RAR 3.01 0.29 3.03 2.53 3.7 3.22 0.82 3.06 2.3 7.48 3.33 0.67 3.25 2.43 5.48 4.440 .109
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F = analysis of variance (ANOVA); Kruskal–Wallis H = Kruskal–Wallis Test.

BRVO = branch retinal vein occulusion, CRVO = central retinal vein occulusion, RAR = Red Cell Distribution Width/Albumin, RDW-CV = Red Cell Distribution Width- Coefficient of Variation.

The average ages in the non-ischemic and ischemic occlusion groups were similar. RDW-CV values showed a statistically significant difference between the groups (P = .006). post hoc analysis revealed that this difference was significant between the control group and the ischemic occlusion group (as shown in Fig. 1). It was observed that RDW-CV values were significantly higher in the ischemic occlusion group. Although albumin levels differed between the groups, this difference was not statistically significant (P = .118). On the other hand, there was a significant difference in the RDW/albumin ratio (RAR) between the groups (P = .016). This difference was found to be due to the comparison between the control group and the ischemic occlusion group, where RAR values were higher in the ischemic group (as shown in Table 2).

Figure 1.

Figure 1.

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RAR levels in patients with ischemic-nonischemic retinal vein occulusion and in the control group. RAR = red cell distribution width/Albumin.

Table 2.

Comparison of patients with ischemic and nonischemic retinal vein occlusion with the control group.

Ischemic- Nonischemic RVO
Control Non-ischemic RVO Ischemic RVO
Mean Standard Median Minimum Maximum Mean Standard Median Minimum Maximum Mean Standard Median Minimum Maximum F, Kruskal-Wallis H P post-hoc
RDW-CV 12.9 0.8 12.9 11.5 14.9 13.2 0.7 13.2 11.5 15.2 14.7 2.9 13.8 12.7 23.2 10.307 .006 Control-Ischemic RVO
ALBUMIN 4.3 0.3 4.3 3.6 4.8 4.3 0.4 4.3 3.4 5 4.1 0.5 4.2 3.1 4.7 4.268 .118
RAR 3.01 0.29 3.03 2.53 3.7 3.09 0.4 3.06 2.3 4.2 3.75 1.27 3.3 2.74 7.48 8.269 .016 Control-Ischemic RVO
Open in a new tab

F = analysis of variance (ANOVA); Kruskal–Wallis H = Kruskal–Wallis test.

RAR = red cell distribution width/Albumin, RDW-CV = red cell distribution width - coefficient of variation, RVO = retinal vein occlusion.

5. Discussion

Previous studies have demonstrated that the RAR serves as a significant prognostic biomarker for mortality and disease severity in various cardiovascular conditions, including stroke, coronary artery disease, acute coronary syndrome, atrial fibrillation and heart failure.[14–17] Furthermore, higher RAR levels have been linked to an increased risk of mortality in various chronic diseases, chronic obstructive pulmonary disease, including cancers, diabetes mellitus and chronic kidney disease.[18–20] Many of these conditions involve pathophysiological mechanisms such as inflammation and arteriosclerosis, which are also critically implicated in the development of RVO. Therefore, a potential association between RAR and RVO may be hypothesized. As far as we are aware, this study is the first to explore the relationship between the RAR and RVO.

RVO is a prevalent retinal vascular disorder and a leading cause of significant visual loss.[21] Ischemic changes in the retina are known to trigger inflammatory responses and promote leukocyte adhesion to the vessel walls, resulting in impaired blood flow and vascular congestion.[22] Previous studies have reported elevated levels of inflammatory mediators, such as pentraxin 3 (PTX3), vascular endothelial growth factor, interleukin-6 (IL-6), monocyte chemoattractant protein-1, and soluble intercellular adhesion molecule-1, in the vitreous of patients with ischemic CRVO.[21,22] Moreover, increased plasma concentrations of PTX3 have been observed in RVO, and elevated serum soluble intercellular adhesion molecule-1 levels have been associated with a range of inflammatory conditions.[21,23,24]

RDW was initially utilized as a parameter for identifying different types of anemia, as it primarily reflects the variation in the size of circulating red blood cells. However, in recent years, accumulating evidence has highlighted the broader clinical relevance of RDW across a wide range of diseases. Several studies have identified RDW as a significant prognostic marker in various clinical conditions, including heart failure, pulmonary embolism, and inflammatory bowel disease, where it correlates with disease severity.[25] Furthermore, elevated RDW has been associated with adverse neurological outcomes in post-cardiac arrest patients.[26] In this study, a statistically significant difference was observed between the RDW levels between the groups.

Serum albumin is a key contributor to plasma oncotic pressure, playing a crucial role in maintaining blood viscosity and inhibiting aggregation and platelet activation.[27,28] Reduced albumin levels can lead to elevated blood viscosity and impaired endothelial function, while inflammation-driven hypoalbuminemia may further exacerbate ischemic processes.[27,29] Although there was a difference in serum albumin levels between the groups in this study, this difference was not statistically significant.

In the study by An et al, which evaluated RAR in patients with age-related macular degeneration (AMD), a positive linear correlation between AMD and RAR was reported.[30] Higher RAR values, compared to lower ones, were shown to be significantly associated with an increased likelihood of AMD prevalence.

In the study by Lai et al, which evaluated RAR in patients with BRVO, significantly higher RDW and RAR levels were reported in patients with BRVO.[31] The study demonstrated a positive correlation between RAR and the risk of BRVO, suggesting that RAR may potentially serve as an independent risk factor. They also stated that this could be useful in identifying high-risk populations.

In another study by Gu et al, which evaluated RAR in diabetic retinopathy patients over 40 years of age, it was observed that the prevalence of retinopathy increased across higher quartiles of RAR.[32] Each 1-unit increase in RAR was associated with approximately a 2.69-fold higher likelihood of retinopathy. RAR was shown to have a nonlinear relationship with retinopathy, and it was suggested that RAR could be used as a risk stratification tool in clinical and public health settings.

The precise biological pathways connecting elevated RAR with increased mortality risk are not yet fully understood, but they are thought to involve chronic inflammation and malnutrition. An increased RAR typically reflects a combination of elevated RDW and reduced albumin levels, which may result from inflammation-related disruptions in erythropoiesis, red blood cell lifespan, and membrane integrity.[33] Several studies suggest that elevated RDW may be influenced by the enhanced activity of pro-inflammatory cytokines such as IL-6 and TNF-α within the systemic inflammatory milieu.[34] In this study, RAR values were found to be significantly higher in ischemic RVO cases.

Both RDW and albumin have been proposed as composite biomarkers that reflect inflammation, oxidative stress, and nutritional status. Their combined evaluation through the RAR may offer valuable insights into the cumulative effects of inflammation and nutritional deficiencies on the risk of vision loss in patients with RVO. The RAR profile in RVO could serve as an indicator of overall disease burden and may help predict complications such as disease progression and potential blindness.

6. Conclusion

The RAR demonstrates a significant association with RVO and offers a simple, cost-effective, safe, and readily available laboratory marker for assessing RVO severity. Elevated RAR levels appear to be linked with a higher likelihood of ischemic events. As an alternative to complex and invasive diagnostic procedures, RAR may serve as a practical initial screening tool for identifying ischemia in RVO cases, potentially guiding treatment strategies and follow-up planning.

6.1. Study limitations

Retrospective design and relatively small number of cases constitute the limitations of the study.

Author contributions

Data curation: Mert Bilgili, Büşra Medetoğlu, Elif Temur.

Formal analysis: Mert Bilgili, Kamber Kaşali.

Investigation: Mustafa Yildirim, Büşra Medetoğlu, Elif Temur.

Methodology: Mustafa Yildirim, Mert Bilgili.

Software: Mert Bilgili, Kamber Kaşali.

Supervision: Kamber Kaşali.

Validation: Kamber Kaşali.

Visualization: Mustafa Yildirim.

Writing – original draft: Mustafa Yildirim.

Writing – review & editing: Mustafa Yildirim.

Abbreviations:

BRVO
branch retinal vein occlusion
CRVO
central retinal vein occlusion
FFA
fundus fluorescein angiography
RAR
RDW-albumin ratio
RDW
red cell distribution width
RVO
retinal vein occlusion

Before the procedure, all patients or their relatives were informed about the procedure and an informed consent form was signed The study was conducted in accordance with the principles of the Declaration of Helsinki and was approved by the Clinical Research Ethics Committee of Atatürk University Faculty of Medicine Health Practice and Research Hospital. (Date:27.12.2024, number: (B.30.2.ATA.0.01.00/748).

The authors have no funding and conflicts of interest to disclose.

The datasets generated during and/or analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request.

How to cite this article: Yildirim M, Bilgili M, Kaşali K, Medetoğlu B, Temur E. Red blood cell distribution width/albumin ratio (RAR): A novel predictor of retinal vein occlusion in the Turkish population (STROBE). Medicine 2026;105:8(e47804).

Contributor Information

Mert Bilgili, Email: mertbilgili_339@outlook.com.

Kamber Kaşali, Email: kmbrkasali76@gmail.com.

References

  • [1].Hayreh SS, Zimmerman B, McCarthy MJ, Podhajsky P. Systemic diseases associated with various types of retinal vein occlusion. Am J Ophthalmol. 2001;131:61–77. [DOI] [PubMed] [Google Scholar]
  • [2].Cugati S, Wang JJ, Rochtchina E, Mitchell P. Ten-year incidence of retinal vein occlusion in an older population: the blue mountains eye study. Arch Ophthalmol. 2006;124:726–32. [DOI] [PubMed] [Google Scholar]
  • [3].Hayreh S. Retinal vein occlusion. Indian J Ophthalmol. 1994;42:109–32. [PubMed] [Google Scholar]
  • [4].Prisco D, Marcucci R. Retinal vein thrombosis: risk factors, pathogenesis and therapeutic approach. Pathophysiol Haemost Thromb. 2002;32:308–11. [DOI] [PubMed] [Google Scholar]
  • [5].Kesler A, Shalev V, Rogowski O, et al. Comparative analysis of homo cysteine concentrations in patients with retinal vein occlusion versus thrombotic and atherosclerotic disorders. Blood Coagul Fibrinolysis. 2008;19:259–62. [DOI] [PubMed] [Google Scholar]
  • [6].Noma H, Yasuda K, Shimura M. Cytokines and pathogenesis of central retinal vein occlusion. J Clin Med. 2020;9:3457. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [7].Förhécz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohászka Z, Jánoskuti L. Red cell distribution width in heart failure: prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J. 2009;158:659–66. [DOI] [PubMed] [Google Scholar]
  • [8].Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: a simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2015;52:86–105. [DOI] [PubMed] [Google Scholar]
  • [9].Yeşil A, Şenateş E, Erdem ED, Demirtunç R, Övünç AOK. Red cell distribution width: a novel marker of activity in inflammatory bowel disease. Gut Liver. 2011;5:460. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [10].Artigas A, Wernerman J, Arroyo V, Vincent JL, Levy M. Role of albumin in diseases associated with severe systemic inflammation: pathophysiologic and clinical evidence in sepsis and in decompensated cirrhosis. J Crit Care. 2016;33:62–70. [DOI] [PubMed] [Google Scholar]
  • [11].Xu W, Huo J, Chen G, et al. Association between red blood cell distribution width to albumin ratio and prognosis of patients with sepsis: a retrospective cohort study. Front Nutr. 2022;9:1019502. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [12].Long J, Xie X, Xu D, et al. Association between red blood cell distribution width-to-albumin ratio and prognosis of patients with aortic aneurysms. Int J General Med. 2021;14:6287–94. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [13].Donmez M, Ayata O. Prognostic significance of the red cell distribution width/albumin ratio in the prediction of the severity of acute biliary pancreatitis: a preliminary report. Cureus. 2022;14:e30183. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [14].Zhao N, Hu W, Wu Z, et al. The red blood cell distribution width-albumin ratio: a promising predictor of mortality in stroke patients. Int J General Med. 2021;14:3737–47. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [15].Chen C, Cai J, Song B, et al. Relationship between the ratio of red cell distribution width to albumin and 28-day mortality among Chinese patients over 80 years with atrial fibrillation. Gerontology. 2023;69:1471–81. [DOI] [PubMed] [Google Scholar]
  • [16].Li D, Ruan Z, Wu B. Association of red blood cell distribution width-albumin ratio for acute myocardial infarction patients with mortality: a retrospective cohort study. Clin Appl Thromb Hemost. 2022;28:10760296221121286. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [17].Ni Q, Wang X, Wang J, Chen P. The red blood cell distribution width-albumin ratio: A promising predictor of mortality in heart failure patients-A cohort study. Clin Chim Acta. 2022;527:38–46. [DOI] [PubMed] [Google Scholar]
  • [18].Kimura H, Tanaka K, Saito H, et al. Impact of red blood cell distribution width-albumin ratio on prognosis of patients with CKD. Sci Rep. 2023;13:15774. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [19].Liu J, Wang X, Gao TY, et al. Red blood cell distribution width to albumin ratio associates with prevalence and long-term diabetes mellitus prognosis: an overview of NHANES 1999-2020 data. Front Endocrinol. 2024;15:1362077. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [20].Qiu Y, Wang Y, Shen N, et al. Association between red blood cell distribution width-albumin ratio and hospital mortality in chronic obstructive pulmonary disease patients admitted to the intensive care unit: a retrospective study. Int J Chron Obstruct Pulmon Dis. 2022;17:1797–809. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [21].Noma H, Funatsu H, Harino S, Mimura T, Eguchi S, Hori S. Vitreous inflammatory factors in macular edema with central retinal vein occlusion. Jpn J Ophthalmol. 2011;55:248–55. [DOI] [PubMed] [Google Scholar]
  • [22].Noma H, Mimura T, Masahara H, Shimada K. Pentraxin 3 and other inflammatory factors in central retinal vein occlusion and macular edema. Retina. 2014;34:352–9. [DOI] [PubMed] [Google Scholar]
  • [23].Gearing AJ, Newman W. Circulating adhesion molecules in disease. Immunol Today. 1993;14:506–12. [DOI] [PubMed] [Google Scholar]
  • [24].Park KS, Kim JW, An JH, Woo JM. Elevated plasma pentraxin 3 and its association with retinal vein occlusion. Korean J Ophthalmol. 2014;28:460–5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [25].Melchio R, Rinaldi G, Testa E, et al. Red cell distribution width predicts mid-term prognosis in patients hospitalized with acute heart failure: the RDW in Acute Heart failure (RE-AHF) study. Intern Emerg Med. 2019;14:239–47. [DOI] [PubMed] [Google Scholar]
  • [26].Fontana V, Spadaro S, Villois P, et al. Can red blood cell distribution width predict outcome after cardiac arrest. Minerva Anestesiol. 2018;84:693–702. [DOI] [PubMed] [Google Scholar]
  • [27].Karahan O, Acet H, Ertaş F, et al. The relationship between fibrinogen to albumin ratio and severity of coroner artery disease in patients with ST- elevation myocardial infarction. Am J Emerg Med. 2016;34:1037–42. [DOI] [PubMed] [Google Scholar]
  • [28].Joles JA, Willekes-Koolschijn N, Koomans HA. Hypoalbuminemia causes high blood viscosity by increasing red cell lysophosphatidylcholine. Kidney Int. 1997;52:761–70. [DOI] [PubMed] [Google Scholar]
  • [29].Rezkalla SH, Kloner RA. Coronary no-reflow phenomenon: from the experimental laboratory to the cardiac catheterization laboratory. Catheter Cardiovasc Interv. 2008;72:950–7. [DOI] [PubMed] [Google Scholar]
  • [30].An N, Zeng B, Liu Z, et al. Red blood cell distribution width-to-albumin ratio and its association with age-related macular degeneration: a population-based cross-sectional study. Front Med (Lausanne). 2025;12:1510756. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [31].Lai XJ, Yang SY, Lei CY, Xiao RH, Zhang MX. Correlations between inflammatory biomarkers in peripheral blood and branch retinal vein occlusion. Int J Ophthalmol. 2025;18:1908–13. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [32].Gu J, Qiu S, Sun Z. Nonlinear association between red cell distribution width-to-albumin ratio and retinopathy: a cross-sectional study. J Multidiscip Healthc. 2025;18:4691–701. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [33].Weiss G, Ganz T, Goodnough LT. Anemia of inflammation. Blood. 2019;133:40–50. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [34].Miyamoto K, Inai K, Takeuchi D, Shinohara T, Nakanishi T. Relationships among red cell distribution width, anemia, and interleukin-6 in adult congenital heart disease. Circ J. 2015;79:1100–6. [DOI] [PubMed] [Google Scholar]

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