Effect of Ocular Perfusion Pressure on Incidence of Diabetic Retinopathy in Type 2 Diabetes: A Two-Year Prospective Study

Purpose: To investigate the association between mean ocular perfusion pressure (MOPP), estimated cerebrospinal fluid pressure (CSFP), and changes in diabetic retinopathy (DR) in a Southern Chinese population with type 2 diabetes (T2DM). Methods: A total of 1224 subjects from the Guangzhou Diabetic Eye Study were enrolled. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and intraocular pressure (IOP) were measured. MOPP was calculated with the formula: MOPP = 2/3 [DBP + 1/3 (SBP - DBP)] - IOP. CSFP was calculated using the formula: CSFP = 0.44 x body mass index (kg/m2) + 0.16 x DBP - 0.18 x age (years) - 1.91. Incidence, progression, and regression of DR were graded based on sevenfield 45 degrees conventional fundus photographs at baseline and during two-year follow-up examinations according to the United Kingdom National Diabetic Eye Screening Results: Higher MOPP was associated with DR incidence in the multivariate model (per 1 mm Hg increase: relative risk, 1.05; 95% confidence interval, 1.01-1.09; P = 0.02) and was not associated with DR development and DR regression in two-year follow-up of T2DM patients. However, CSFP was not associated with DR changes (incidence, progression, or regression). Conclusions: The higher MOPP is an independent risk factor for DR incidence among T2DM patients in a Southern Chinese cohort. Monitoring MOPP and managing blood pressure can be part of a comprehensive approach to prevent or delay the onset of DR in T2DM patients. Translational Relevance: MOPP might be an indicator for the detection of DR incidence.