Refractive Errors, Ocular Biometry and Diabetic Retinopathy: A Comprehensive Review.

Area of Science:

• Ophthalmology
• Diabetology
• Genetics

Background:

• Diabetic retinopathy (DR) is a leading cause of vision loss in diabetic patients.
• The relationship between refractive status, specifically myopia, and DR development is not fully understood.

Purpose of the Study:

• To summarize the association between diabetic retinopathy and refractive status, including ocular biometric parameters.
• To review proposed mechanisms for the protective effect of high myopia against diabetic retinopathy.

Main Methods:

• A systematic review and literature search were conducted.
• Databases searched included MEDLINE, EMBASE, Web of Science, and Scopus.
• Reference lists of relevant publications were also reviewed.

Main Results:

• Myopia appears to delay the onset and slow the progression of diabetic retinopathy.
• Increased axial length, a characteristic of myopia, is linked to a reduced risk of DR and vision-threatening DR.
• Potential protective mechanisms include posterior vitreous detachment, altered retinal blood flow and oxygenation, choroidal thinning, and changes in cytokine profiles.

Conclusions:

• High myopia may act as a protective factor against the development and advancement of diabetic retinopathy.
• Further research is needed to elucidate the precise mechanisms by which myopia, axial length, and ocular biometrics influence DR onset and progression.