The results of ROC curve analysis in this study showed that the area under the curve (AUC) of ATX for diagnosing optic neuropathy in DR patients was 0.867, indicating that serum ATX levels have certain clinical value in diagnosing optic neuropathy in DR patients and can be used as an independent factor and potential marker for neuropathy, providing potential for disease management. This evidence concerns the gene ENPP2 and neuropathy.