Prevalence and Risk Factors of Fundus Pathology in Patients with Type 2 Diabetes in a Northeastern Chinese Cohort

ABSTRACTPurpose To assess the prevalence of and risk factors for fundus pathology in patients with type 2 diabetes mellitus (T2DM) in a cohort from northeastern China.Methods Patients were included from the Fushun Diabetic Retinopathy Cohort Study. Patients aged ≥ 30 years with T2DM were recruited between July 2012 and May 2013. Fundus pathology included retinal vascular occlusion (RVO), age-related macular degeneration (AMD), macular pathology, pathologic myopia (PM) and glaucomatous optic atrophy (GOA).Results A Total of 1998 patients with gradable fundus photographs were included in this study, of whom 388 (19.42%) had fundus pathology regardless of whether they had diabetic retinopathy (DR). There were 187 (9.36%) patients with AMD, 97 (4.85%) with GOA, 67 (3.35%) with macular pathology, 35 (1.75%) with PM and 23 (1.15%) with RVO. Advanced age was significantly associated with AMD (odds ratio (OR), 95% confidence interval (CI): 1.03, 1.01–1.05), macular pathology (OR, 95% CI: 1.06, 1.03–1.09) and GOA (OR, 95% CI: 1.06, 1.04–1.09). A wider central retinal arteriolar equivalent was protective against PM (OR, 95% CI: 0.78, 0.66–0.92). Wider central retinal venular equivalent was a protective factor for PM (OR, 95% CI: 0.75, 0.68–0.82) and GOA (OR, 95% CI: 0.93, 0.87–0.99).Conclusions One-fifth of these patients in northeast China with T2DM had fundus pathology regardless of whether they had DR, indicating the importance of early screening and long-term follow-up.KEYWORDS: Fundus pathologyprevalencerisk factorstype 2 diabetes mellitus AcknowledgmentsWe thank Claire Barnes, PhD, from Liwen Bianji (Edanz) (www.liwenbianji.cn) for editing the English text of a draft of this manuscript.Disclosure statementNo potential conflict of interest was reported by the author(s).Author contributionsWei Lin, Zhong Lin and Yu Wang were the major contributors to the study design and drafting of the manuscript. Liang Wen, Dong Lin, Fenghua Wang and Yuanbo Liang collected and reviewed the data. Wei Lin and Zhong Lin analyzed and interpreted the data. All authors reviewed and approved the final manuscript.Statement of ethicsThis study was approved by the Ethics Committee of Fushun Eye Hospital (FSKJHT201025) and was conducted in accordance with the tenets of the Declaration of Helsinki. Written informed consent was obtained from all participants for their clinical records to be used in this study.Additional informationFundingThe study was supported by the Wenzhou Basic Medical and Health Technology Project (Y20210995), Innovation Project of School of Ophthalmology and Optometry, Eye Hospital of Wenzhou Medical University (YNCX3201905), and Liaoning Provincial Natural Science Foundation of China (20170540328).