Relationship Between Refractive Error And Diabetic Retinopathy:A Systematic Review And Meta-Analysis

Objective:To determine the relationship between refractive error and diabetic retinopathy by systematic review and meta-analysis.Methods:Articles published in Pubmed, Embase, EBSCOhost and reference lists of retrieved articles until November,2014 were identified. We used Stata12.0 software to conduct meta-analysis.Results:Eight studies involving 28264 participants were included in the meta-analysis. The pooled OR of the relationship between any myopia and diabetic retinopathy based on 6 included studies was 0.77(95%CI=0.64～0.91, P<0.05), mainly for high myopia which was more relevant with the prevalence of diabetic retinopathy(OR=0.40,95%CI=0.11～0.69, P<0.05). However, no significant association were found between low myopia or hyperopia and diabetic retinopathy incidence. The pooled ORs and 95% CIs were 0.81(0.61-1.01) and 1.09 (0.97-1.21), respectively. The pooled OR of the association between any myopia and the prevalence of sight-threatening diabetic retinopathy was 0.66(95% CI,0.41-0.90). Considerable heterogeneity was found among studies reperted the association between any myopia and Vision-threatening Diabetic Retinopathy (I2=47.6%). After excluding the studies which devoted significantly to heterogeneity, the pooled OR was 0.94(95% CI,0.59-1.29) with no evidence of heterogeneity(I2=16.6%) for any myopia and Vision-threatening Diabetic Retinopathy. There was no evidence of publication bias as indicated by a nonsignificant Egger’s test (P>0.05) and Begg’s test (P>0.05).Conclusions:Individuals with myopia, especially high myopia may suffer less from diabetic retinopathy. More large-scale studies are in need to further investigate associations like this.