Longitudinal associations of ocular biometric parameters with onset and progression of diabetic retinopathy in Chinese adults with type 2 diabetes mellitus

Abstract

AimsTo investigate the associations of ocular biometric parameters with incident diabetic retinopathy (DR), incident vision-threatening DR (VTDR) and DR progression.MethodsThis community-based prospective cohort study recruited participants with type 2 diabetes aged 35–80 years from 2017 to 2019 in Guangzhou, China. Refractive error and ocular biometric parameters were measured at baseline, including axial length (AL), axial length-to-corneal radius (AL/CR) ratio, corneal curvature (CC), lens thickness (LT), anterior chamber depth (ACD), lens power and corneal diameter (CD).ResultsA total of 1370 participants with a mean age of 64.3±8.1 years were followed up for two consecutive years. During the follow-up period, 342 out of 1195 (28.6%) participants without DR at baseline had incident DR, 15 out of 175 (8.57%) participants with baseline DR had DR progression and 11 of them progressed to VTDR. After multiple adjustments, a longer AL (OR=0.76; 95% CI, 0.66 to 0.86; p<0.001) and a larger AL/CR ratio (OR=0.20; 95% CI, 0.07 to 0.55; p=0.002) were associated with significantly reduced risks of incident DR but were not associated with incident VTDR or DR progression. Refractive status and other ocular biometric parameters investigated, including ACD, CC, CD, lens power and LT were not associated with any of the DR outcomes (all p>0.05).ConclusionsA longer AL and a larger AL/CR ratio are protective against incident DR. These parameters may be incorporated into future DR risk prediction models to individualise the frequency of DR screening and prevention measures.

Progressive Peripapillary Choroid Thinning and Retinal Neurodegeneration in Patients With Diabetes

“…This may partly explain why patients with DM with high myopia have a lower risk of developing DR, as the choroidal blood flow of highly myopic eyes is much lower than that of emmetropic eyes. 17,29 Our results highlight the potential value of longitudinal changes in OCT ocular parameters on monitoring and early prediction of DR onset. Currently, the monitoring and evaluation of DR onset are based on ocular and systemic risk factors that were identified through crosssectional studies and fluctuate with various confounding factors.…”

“…This may partly explain why patients with DM with high myopia have a lower risk of developing DR, as the choroidal blood flow of highly myopic eyes is much lower than that of emmetropic eyes. 17,29…”

“…According to previous findings, we performed four multivariable models: model 1 adjusted for age, sex, AL, model 2 further adjusted for glycosy-lated hemoglobin level, systolic blood pressure, diastolic blood pressure, total cholesterol, best-corrected visual acuity, model 3 further adjusted for DM duration, and model 4 additionally adjusted for average values of systolic blood pressure, diastolic blood pressure, and total cholesterol during the 3-year period. 4,[12][13][14][15][16][17] A P value of ,0.05 was considered statistically significant. All analyses were performed using Stata Version 17.0 (Stata Corporation, College Station, TX).…”

The relationship between refractive error and the risk of diabetic retinopathy: a systematic review and meta-analysis

“…It is well known that the occurrence and progression of DR are correlated with a longer period of diabetes, higher blood glucose, blood pressure, and serum glycosylated hemoglobin levels ( 6 ). In addition to these systemic risk factors, some studies ( 7 , 8 ) have found that ocular biological parameters can also influence the occurrence and progression of DR, although this assertion is controversial. Lim et al ( 7 ) discovered that diabetic patients with myopic refractive errors and long eye axes had a decreased risk of developing DR, particularly proliferative diabetic retinopathy.…”

Corneal topographic indices of scheimpflug camera in type 2 diabetic and non-diabetic elderly populations

“…Some studies found no difference in keratometric readings between diabetic and non-diabetic groups [ 8 , 9 ]. A small number of studies reported that the corneal curvature radius changes in diabetic people [ 10 ]. According to other studies, diabetic patients have higher keratometry values while corneal topography indices do not differ between diabetics and non-diabetics [ 11 – 13 ].…”