Abstract: Lipid metabolism-related composite indicators, by integrating basic blood lipid parameters and relevant variables, offer a more sensitive quantification of systemic insulin resistance, oxidative stress, and endothelial function, thereby overcoming the limitations associated with single lipid parameters. In the context of blinding ocular diseases, these indicators demonstrate distinct pathological implications. The triglyceride-glucose (TyG) index, functioning as a surrogate marker for insulin resistance, is positively correlated with the severity of diabetic retinopathy and the extent of microvascular injury. The apolipoprotein B/non-high-density lipoprotein cholesterol (ApoB/non-HDL-C) ratio, reflecting ectopic lipid deposition and local inflammation, aids in predicting the risk of neovascular age-related macular degeneration. Elevated non-HDL-C levels indicate lipid metabolic dysregulation within the optic nerve and its microenvironment in glaucoma. And the total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio exhibits superior diagnostic efficacy and a significant association with visual prognosis in non-arteritic anterior ischemic optic neuropathy. Despite current challenges such as the lack of unified diagnostic thresholds and the need to further elucidate causal mechanisms, risk assessment systems based on these composite indices are emerging as pivotal tools for facilitating early diagnosis, stratified screening, and precise prevention and treatment of ophthalmic diseases.

Key words: Lipid metabolism, Composite indicators, Disease risk