Objective: This study investigates the potential of blood biomarkers in the early diagnosis of glaucoma, focusing on erythrocyte osmotic fragility (EOF) as a novel indicator. We used Least Absolute Shrinkage and Selection Operator (LASSO) regression to evaluate EOF's predictive utility for glaucoma diagnosis. Methods: We included 195 confirmed glaucoma patients and an equal number of age- and sex-matched healthy controls. Blood samples were analyzed for various parameters, including white blood cell count, neutrophil count, red blood cell (RBC) count, and EOF. Key differential markers were identified, and a predictive model was constructed using LASSO regression models. Results: LASSO regression analysis identified HCT, NEUT, LYMPH, MCV, MCHC, and EOF as critical blood biomarkers discriminating glaucoma patients from healthy controls. Incorporating EOF into the model significantly enhanced its predictive performance, with EOF showing a positive correlation with the likelihood of glaucoma. Conclusions: EOF is a promising predictive biomarker for glaucoma. Combining EOF with other blood biomarkers significantly improves the accuracy of glaucoma diagnosis.

The authors have declared no competing interest.

This research project was supported by the National Natural Science Foundation of China (82371059 (H.Z.), 82371060 (B.G.)), the Department of Science and Technology of Sichuan Province, China (2023JDZH0002 (H.Z.)), and Sichuan Provincial People Hospital (30320230095 (J.Y.), 30420220062 (J.Y.)), Natural Science Foundation of Sichuan Province (2024NSFC1719 (J.Y.),30420230353 (J.Y.)).

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Ethics committees of Sichuan Provincial People Hospital gave ethical approval for this work

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