Differential associations between body mass index with diabetes and vision-threatening diabetic retinopathy in an adult Chinese population

PurposeTo investigate the associations between body mass index (BMI) with diabetes mellitus (DM) and vision-threatening diabetic retinopathy (VTDR).MethodsThis was a longitudinal study which included DM-free participants aged ≥40 years from the Lingtou Eye Cohort Study at baseline (2008–2010). Physical and ocular examinations were performed at baseline and annual follow-ups under standardised protocol. Two 45° non-mydriatic colour digital retinal photographs were obtained for each eye at all study visits, and presence of VTDR at the 2016 follow-up was graded by a deep-learning algorithm (LableMe) with proved high accuracy for detection of VTDR.ResultsA total of 2934 participants were included with a mean (SD) age of 59.5 (7.3) years (58.3% men). Participants with incident DM (441/2934, 15%) were significantly older (p