Asian patients who don’t have diabetes have a lower chance of developing diabetic retinopathy (DR) at just about a 3% risk, while nearly two-thirds of those without DR showed regression, or complete disappearance of the condition, at six years, new research in the British Journal of Ophthalmology reports.

The paper also found higher diastolic blood pressure, wider retinal arteriolar caliber and lower high-density lipoprotein cholesterol were associated with an increased risk of incident retinopathy, while Malay ethnicity was tied to a greater likelihood of regression. The investigative team from Singapore and Australia also suggests modifiable risk factors such as heavier weight and higher glycaemia are linked to a lower regression risk.

“These data support the concept that non-DR may be a transient manifestation of microvascular dysfunction and that maintaining healthy weight and glycemic levels may be important in its management,” the researchers wrote in their paper.

The study included 4,374 participants without diabetes who were part of the Singapore Epidemiology of Eye Disease study. The subjects underwent retinal photography at baseline and at the six-year follow-up.

Over the investigation period, retinopathy occurred in 2.5% of individuals. Of these, only 1% progressed, while about 68% regressed. While higher diastolic blood pressure (risk ratio=1.02) and wider retinal arteriolar caliber (risk ratio=1.36) were associated with a higher risk of incident retinopathy, a higher level of high-density lipoprotein (risk ratio=0.56) was tied to a lower risk of incident retinopathy.

The researchers also found Malays were more likely to experience retinopathy regression than those of Chinese heritage (risk ratio=1.63). Also, overweight status (risk ratio=0.47) and higher glycosylated hemoglobin levels (risk ratio=0.58) were associated with lower likelihoods of retinopathy regression.

Gupta P, Lamoureux EL, Sabanayagam C, et al. Six-year incidence and systemic associations of retinopathy in a multi-ethnic Asian population without diabetes. Br J Ophthalmol. January 19, 2021. [Epub ahead of print].