Non-alcoholic fatty liver disease (NAFLD) is becoming more and more prevalent in type 2 diabetes mellitus（T2DM). Evidences connecting NAFLD to diabetic retinopathy (DR) are increasing, but the results are various. Thus, we undertook a meta-analysis to explore the effect of NAFLD on DR in patients with T2DM.
PubMed, Embase, Cochrane and Scopus database were searched for until Sep30,2019. Original studies analyzing the association between NAFLD and DR in the type 2 diabetic population were included. This meta-analysis was processed by RevMan 5.3 software. Subgroup analyses based on countries were carried out. The pooled odds ratios and 95% confidence intervals were used to evaluate the association between NAFLD and DR incidence. I test was used to assess heterogeneity of studies.
We retrieved 414 articles, and 9 studies involving 7,170 patients were included in the final analysis. The pooled effects estimate suggested that NAFLD was not associated with the risk of DR in T2DM patients. Subgroup analysis suggested that in China, Korea and Iran, the T2DM patients with NAFLD had an decreased risk for DR compared with the non-NAFLD individuals. However, in Italy and India, the T2DM patients with NAFLD had an increased risk for DR compared with the non-NAFLD individuals. In addition, no relevance between NAFLD and DR was found in America.
On the whole, there was no association between NAFLD and DR in T2DM individuals. However, subgroup analysis showed that the difference of country may have an influence on the result.

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