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Comment on: ‘The role of blood pressure stability in diabetic retinopathy development’

Eye (2026)Cite this article

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In the context of the escalating global prevalence of chronic diseases such as type 2 diabetes mellitus, it is pertinent to examine the study by Shih et al., which associates blood pressure (BP) with diabetic retinopathy (DR) [1]. Given the implications of BP targets for clinical guidelines and population-level management, careful consideration of the study’s generalizability is warranted, particularly as findings derived from a homogeneous cohort may not directly translate to more diverse settings.

Shih et al. report that BP stability influences DR development, revealing a non-linear (U- and J-shaped) association between BP and DR. This challenges the presumed benefit of very low BP in type 2 diabetes, suggesting that both sustained hypertension and excessively low BP may be harmful [2,3,4], though thresholds and implications may vary across populations and healthcare systems.

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References

  1. Shih CC, Shih LN, Lin HA, Hsieh YT. The role of blood pressure stability in diabetic retinopathy development. Eye (Lond, Engl). 2026;40:245–51. https://doi.org/10.1038/s41433-025-04136-y.

    Article  Google Scholar 

  2. Noroozi M, Ghasemirad H, Ghaedi A, Kargar M, Alipour M, Mahmoudvand G, et al. Visit-to-visit variability of blood pressure and risk of diabetic retinopathy: a systematic review and meta-analysis. Am J Cardiovasc Dis. 2024;14:281–94. https://doi.org/10.62347/DFSZ9202.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Costa Hoffmeister M, Hammel Lovison V, Priesnitz Friedrich E, da Costa Rodrigues T. Ambulatory blood pressure monitoring and vascular complications in patients with type 1 diabetes mellitus—systematic review and meta-analysis of observational studies. Diab Res Clin Pract. 2024;217:111873. https://doi.org/10.1016/j.diabres.2024.111873.

    Article  Google Scholar 

  4. Do, DV, Wang, X, Vedula, SS, Marrone, M, Sleilati, G, Hawkins, BS, et al. Blood pressure control for diabetic retinopathy. Cochrane Database of Systematic Reviews 2023, Art. No.: CD006127. https://doi.org/10.1002/14651858.CD006127.pub3.

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Authors and Affiliations

  1. Grupo de investigación en Visión y Salud Ocular (VISOC), Hospital Universitario del Valle, Universidad del Valle, Cali, Colombia

    Maira Alejandra García -Mendoza & Francisco Javier Bonilla-Escobar

  2. Oftalmosanitas Cali S.A.S., Cali, Colombia

    Maira Alejandra García -Mendoza

  3. Department of Ophthalmology, University of Washington, Seattle, WA, USA

    Francisco Javier Bonilla-Escobar

  4. Fundación Somos Ciencia al Servicio de la Comunidad, Fundación SCISCO/Science to Serve the Community Foundation, SCISCO Foundation, Cali, Colombia

    Francisco Javier Bonilla-Escobar

  5. Servicio de Oftalmología, Grupo de Investigación en Visión y Salud Ocular, VISOC, Universidad del Valle, Cali, Colombia

    Edgar Lozano-Cruz

  6. Oftalmosanitas Cali S.A.S.; Clínica de Oftalmología de Cali, Cali, Colombia

    Edgar Lozano-Cruz

Authors
  1. Maira Alejandra García -Mendoza
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  2. Francisco Javier Bonilla-Escobar
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  3. Edgar Lozano-Cruz
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Contributions

Conceptualisation: MAGM, FJBE. Investigation: MAGM, FJBE. Supervision: ELC. Writing—original draft: MAGM, FJBE. Writing—review & editing: MAGM, FJBE, ELC.

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Correspondence to Maira Alejandra García -Mendoza.

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García -Mendoza, M.A., Bonilla-Escobar, F.J. & Lozano-Cruz, E. Comment on: ‘The role of blood pressure stability in diabetic retinopathy development’. Eye (2026). https://doi.org/10.1038/s41433-026-04502-4

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