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Incidence, progression and regression of diabetic retinopathy in a northeastern Chinese population
  1. Zhong Lin1,2,
  2. Liang Wen3,
  3. Yu Wang3,
  4. Dong Li3,
  5. Gang Zhai3,
  6. Nived Moonasar4,
  7. Fenghua Wang5,
  8. Yuanbo Liang1,2
  1. 1The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
  2. 2National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
  3. 3Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
  4. 4Caribbean Eye Institute, Valsayn, Trinidad and Tobago
  5. 5Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
  1. Correspondence to Dr Yu Wang, Fushun Eye Hospital, Province, Liaoning, China; fsyanbing{at}


Aim To determine the incidence, progression and regression of diabetic retinopathy (DR), with corresponding risk factors, in a northeastern Chinese population of patients with type 2 diabetes.

Methods Among 2006 patients who completed baseline examinations in 2012–2013 and underwent re-examination after a mean interval of 21.2 months, 1392 patients with gradable fundus photographs for both baseline and follow-up examinations were included. Incidence was defined as new development of any DR among patients without DR at baseline. An increase of ≥2 scales (concatenating Early Treatment Diabetic Retinopathy Study levels of both eyes) in eyes with DR at baseline was defined as progression, while a reduction of ≥2 scales was defined as regression.

Results The age- and sex-standardised incidence, progression and regression were 5.8% (95% CI 4.7% to 6.9%), 26.8% (95% CI 24.8% to 28.8%) and 10.0% (95% CI 8.6% to 11.3%), respectively. In addition to poor blood glucose control, wider central retinal venular equivalent was associated with both incidence (relative risk (RR) 2.17, 95% CI 1.09 to 4.32, for ≥250 µm vs <210 µm) and progression (RR 2.00, 95% CI 1.02 to 3.96, for ≥250 µm vs <210 µm). Patients without insulin therapy (RR 0.64, 95% CI 0.43 to 0.97) and patients with wider central retinal arteriolar equivalent (RR 1.14, 95% CI 1.02 to 1.26, per 10 µm increase) were likely to exhibit DR regression.

Conclusion We determined the incidence, progression and regression of DR among northeastern Chinese patients with type 2 diabetes. Retinal vessel diameters, in addition to blood glucose level, influence the natural evolution of DR.

  • diabetic retinopathy
  • incidence
  • progression
  • regression

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  • Contributors YW had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: ZL, LW and YW. Acquisition, analysis or interpretation of data: ZL, LW, DL and GZ. Drafting of the manuscript: ZL and NM. Critical revision of the manuscript for important intellectual content: all authors. Administrative, technical or material support: YW, YL and FW. Study supervision: YW. YW is the guarantor.

  • Funding This study was supported by the Zhejiang Provincial Natural Science Foundation of China (LQ18H120004), the Wenzhou Basic Medical and Health Technology Project (Y2020364) and the Liaoning Provincial Natural Science Foundation of China (20170540328).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.