Association between ocular biometrical parameters and diabetic retinopathy in Chinese adults with type 2 diabetes mellitus

PurposeTo investigate the association between ocular biometrical parameters and diabetic retinopathy (DR) in ocular treatment naive patients with diabetes. MethodsThis cross-sectional study recruited type 2 diabetes mellitus patients with no history of ocular treatment in Guangzhou, China. The ocular biometrical parameters were obtained by Lenstar, including corneal diameter, central corneal thickness (CCT), corneal curvature (CC), anterior chamber depth (ACD), lens thickness (LT), and axial length (AL). The lens power and axial length-to-cornea radius ratio (AL/CR ratio) were calculated. Spherical equivalent (SE) was determined by auto-refraction after pupil dilation. Multivariate logistic regression analyses were performed to explore the associations of ocular biometry with any DR and vision threatening DR (VTDR). ResultsA total of 1838 patients were included in the final analysis, involving 145 5(79.2%) patients without DR and 383(20.8%) patients with DR. After adjusting confounding factors, any DR was independently associated with AL (OR = 0.84 per 1 mm increase, 95%CI: 0.74, 0.94), lens power (OR = 0.9951 per 1 D increase, 95%CI: 0.9904, 0.9998), and AL/CR ratio (OR = 0.26 per 1 increase, 95%CI: 0.10-0.70). Similarly, the presence of VTDR was independently related to AL (OR = 0.67 per 1 mm increase, 95%CI: 0.54-0.85), lens power (OR = 0.99 per 1 D increase, 95%CI: 0.98, 0.997), and AL/CR ratio (OR = 0.04 per 1 increase, 95%CI: 0.01, 0.25). The CC, corneal diameter, and refractive status were not significantly correlated with presence of DR or VTDR. ConclusionLonger AL, deeper ACD, higher lens power, and higher AL/CR ratio may be protective factors against DR. Considering the high prevalence of myopia in the Chinese juvenile population, it is worth paying attention to how the incidence of DR in this generation may change over time.