Aggregate index of systemic inflammation and glaucoma status: population-based evidence with clinical validation.

Objective: Glaucoma is a major cause of irreversible visual impairment, but evidence on the association between the aggregate index of systemic inflammation (AISI) and glaucoma remains limited, particularly with clinical validation. Methods: We analyzed National Health and Nutrition Examination Survey (NHANES) data from participants aged 40 years and older. Weighted multivariable logistic regression models were used to examine the association between AISI and glaucoma. The primary outcome was composite glaucoma, defined as the presence of either self-reported glaucoma or examination-based glaucoma; the two definitions were also analyzed separately in sensitivity analyses. Additional sensitivity analyses excluded participants with extreme AISI values and, separately, participants with a white blood cell (WBC) count >10 × 10 Results: The primary analysis included 5,455 participants, among whom 431 had composite glaucoma. After full adjustment, each doubling of AISI was associated with higher odds of composite glaucoma (OR = 1.20, 95% CI: 1.05-1.37, Conclusions: Higher AISI was associated with higher odds of glaucoma among adults. As a blood-cell-derived inflammatory index based on routine peripheral blood counts, AISI may provide complementary evidence linking systemic inflammatory burden with glaucoma status. The clinical validation sample further supported this association.