The study compared which markers best predict whether patients with diabetic macular edema (swelling in the center of the retina) will respond to treatment with anti-VEGF injections. The researchers examined systemic inflammatory markers, renal function, and retinal structural features detected using OCT (ocular specialized imaging). Among 81 patients (28 poor responders and 53 responders), they found that systemic inflammatory markers (neutrophil-to-lymphocyte ratio, systemic immune-inflammatory index, and platelet-to-lymphocyte ratio) had no significant predictive value. Conversely, specific retinal structural abnormalities—disorganization of the inner layers of the retina and disruption of the ellipsoid zone—were strong predictors of poor response to treatment. The developed predictive model combining renal function and these two OCT markers achieved excellent discrimination with an area under the curve of 0.869 in the training set and 0.887 in the validation set. The conclusion of the study confirms that the basic structural integrity of the retina detected by OCT has a stronger predictive value for the response to anti-VEGF treatment than systemic inflammatory indicators.