PURPOSE
The incidence and risk factors for diabetic retinopathy (DR) in southern China remain unclear. This project aims to explore the onset and progression of DR and their determinants through a prospective cohort in South China.
METHODS
The Guangzhou Diabetic Eye Study (GDES) recruited patients with type 2 diabetic registered in the community health centres in Guangzhou, China. Comprehensive examinations were performed including visual acuity, refraction, ocular biometry, fundus imaging, blood and urine tests.
RESULTS
A total of 2305 eligible patients were included in the final analysis. In total, 14.58% of the participants had any DR and 4.25% had vision-threatening DR (VTDR), among which 76 (3.30%), 197 (8.55%), 45 (1.95%) and 17 (0.74%) were classified as mild NPDR, moderate NPDR, severe NPDR and PDR, respectively. There were 93 (4.03%) patients with diabetic macular edema (DME). The presence of any DR was independently associated with a longer duration of DM, higher degree of HbA1c, insulin treatment, higher average arterial pressure, higher concentration of serum creatinine, presence of urinary microalbumin, older age, and lower BMI (all P <0.001). For VTDR, 7 factors were significant: older age, a longer duration of DM, higher concentration of HbA1c, use of insulin, lower BMI, higher concentration of serum creatinine, and high albuminuria (all P < 0.05). These factors were also independently associated with DME (all P <0.001).
CONCLUSIONS
The GDES is the first large-scale prospective cohort study of the diabetic population in southern urban China, which will help to identify novel imaging and genetic biomarkers for DR in this population.