Introduction Diabetic retinopathy (DR) is a common and specific retinal microvascular complication in individuals with diabetes mellitus (DM), and one of the leading causes of vision impairment and blindness among individuals with DM worldwide (1, 2). With the rapid growth of the global population with DM, the burden of DR continues to rise, posing significant public health challenges, particularly in low- and middle-income countries (3–5).