BackgroundGrowing evidence suggests positive association between sodium intake and the risk of obesity. Evidence on this topic is lacking from Finland, despite the population's historically high sodium intake and long-standing national salt reduction initiatives.AimsTo examine whether sodium intake and spot urine sodium concentration are associated with general or abdominal obesity in Finnish adults.MethodsWe used cross-sectional, population-based data of the National FinHealth 2017 Study (men=2222, women=2792, ≥18 years-old). Sodium intake was estimated using a validated food frequency questionnaire. A subsample of participants provided spot urine samples (men=558; women=702). General and abdominal obesity were assessed using body mass index and waist circumference. Associations on sex-specific quartiles were examined using multinomial logistic regression, adjusting for key sociodemographic and lifestyle confounders. Spot urine samples were validated against 24-h urine collections.ResultsWomen in the highest quartile of sodium intake had higher odds of general obesity (OR 4.30, 95% CI 2.60-7.12) and abdominal obesity (OR 3.42, 95% CI 2.11-5.56) compared with the lowest quartile. Men in the highest quartile of urine sodium concentration had higher odds of general obesity (OR 6.05, 95% CI 2.83-12.93) and abdominal obesity (OR 4.68, 95% CI 2.44-8.96) compared with the lowest quartile. Spot urine samples showed moderate agreement with 24-h urine collections, with a Spearman's rho of 0.45.ConclusionIn this cross-sectional analysis, higher dietary sodium intake and urine sodium concentration were associated with higher odds of general and abdominal obesity. Prospective studies are needed to confirm causality and to better understand underlying biological mechanisms.

Cost of Illness of Metastatic Non-Small Cell Lung Cancer in Morocco: A Multicentric Retrospective Observational Study.

Aim: To investigate the data sources available in Mexico for real-world research. Materials & methods: A systematic literature review on PubMed, EMBASE and VHL using a combination of controlled vocabulary and keywords for the concepts of electronic health records, epidemiologic studies and Mexico was performed. Results: A total of 331 articles and 89 conference abstracts reporting real-world studies were identified. These included 320 data sources: 142 unique named databases, 172 unnamed databases from specified providers, and 26 electronic medical record datasets. The main data sources came from healthcare institutions (35%), followed by government agencies (26%). The most frequent database design corresponded to surveys (34%) and disease registries (20%). Most databases included cohort studies (43%), population-based (25%) and cross-sectional studies (18%). Specific diagnostic tests (28%), access (22%) and pharmacological treatment (21%) were the most common issues analyzed in databases at patient-level data. Neoplasms, cardiac disorders and infections/infestations were the most common therapeutic areas analyzed in databases. Conclusion: In Mexico, the use of databases has increased, driven by governmental and nongovernmental organisations and companies. However, further efforts are still needed to improve the quality and knowledge of real-world evidence.

Individuals with normal coronary arteries may develop coronary artery disease (CAD). Coronary computed tomography (CT) angiography (CCTA) offers a non-invasive method to assess the development of CAD. In a post-hoc observational study of the Scottish Computed Tomography of the HEART (SCOT-HEART) trial, we identified patients with normal coronary arteries on initial CCTA who subsequently underwent clinically indicated CT. Images were visually assessed for the presence, severity, and type of CAD. Normal coronary arteries on baseline CCTA were present in 524 patients (mean age 53 ± 10 years, 38% male). After a median of 9.3 (Interquartile range, IQR: 9.3-10.8) years, 31 (6%) underwent repeat CCTA and 162 (31%) underwent chest CT. There were no differences in baseline clinical characteristics amongst those who did or did not have repeat CCTA, but those with subsequent chest CT were older and had higher cardiovascular risk scores. CAD was identified on 48% (n = 15) of CCTA and 25% (n = 41) of chest CT. Median time to CT scan on which CAD was identified was 8.1 (IQR: 6.9-9.7) years. There was no difference in all-cause mortality or combined CAD death or non-fatal myocardial infarction in patients who had CAD identified on subsequent CT. However, they were more likely to undergo invasive coronary angiography (adjusted hazard ratio [aHR] 4.94, 95% confidence interval [CI]: 1.95, 12.51; p < 0.001) and revascularization (aHR 19.99, 95% CI: 1.69, 237.1; p = 0.018), adjusted for age and sex. One third of patients with previously normal CCTA will develop CAD on clinically indicated CT imaging over a 10-year period. Question In patients with normal coronary arteries on coronary computed tomography angiography (CCTA), the risk of developing CAD in the future is uncertain. Findings Among 524 patients with normal coronaries, CAD was identified on 48% of CCTA and 25% of chest CT during 10 years of follow-up. Clinical relevance A substantial proportion of patients with initially normal coronary arteries on CCTA later develop CAD, highlighting the need for clinicians to be alert for the development of new CAD in patients with initially normal coronary arteries.

Adults with intellectual disabilities (IDs), particularly those who reside in community living arrangements (CLAs), are at high risk for these chronic diseases. Sedentary behaviour (SB) is an emergent, independent risk factor for several chronic diseases including cardiovascular and metabolic conditions. SB may represent a potent behavioural target to mitigate chronic disease risk in adults with ID who live in CLAs. Limiting the development of interventions to address SB is a lack of understanding of device-estimated SB patterns. Also not clear are the individual-level determinants of SB in this high-risk group of CLA residents with ID. The current study sought to address these knowledge gaps. A cross-sectional observational study design was used to characterize SB patterns and individual-level determinants of SB in adults with ID living in CLAs. Thirty-eight adults from 24 different CLAs wore activPAL devices for 1 week to enable device estimates of SB. activPAL data were processed, and the study outcomes of daily time spent in SB, SB bout lengths, sedentary breaks and prolonged SB were generated. Participants also completed an online survey to assess individual factors, which included demographics, independence, programming and health status. Univariate statistics were used to describe SB patterns and logistic regression models were used to ascertain the association between individual factors and SB variables. On average, the sample were aged 44.79 years (SD = 14.9), and 60.53% were male. The sample were highly sedentary: 47.37% engaged in prolonged SB, the daily average time in SB was 7.46 h (SD = 2.18), and an average of 32.4 daily SB bouts (95% CI = 28.9, 35.9) lasted 17.7 min (95% CI = 13.8, 21.7). Participants requiring more assistance with ADLs were more likely to have longer uninterrupted sedentary bouts (95% CI = 0.169, 1.721; β = 0.945; p = 0.018) and total daily duration of SB (95% CI = 4.58, 20.21; β = 12.394; p = 0.003). Those with less than a high school education had sedentary bouts that were ~15 min longer (95% CI = 3.21, 25.69; p = 0.013). Adults with ID living in CLAs spent almost 8 h of their waking day in SB. Those with lower levels of independence and education were more likely to have higher levels of SB. CLAs may represent a critical opportunity for targeted, place-based interventions to reduce time spent in SB.

PurposeTo evaluate the incidence of postoperative retinal displacement (RD) following three surgical techniques-pars plana vitrectomy (PPV), scleral buckling (SB), and pneumatic retinopexy (PR)-for macula-off rhegmatogenous retinal detachment (RRD).MethodsIn this retrospective observational study, 183 eyes with primary macula-off RRD were treated between June 2021 and June 2023 at a tertiary care retina center. Patients underwent one of three surgical techniques: PPV, SB, or PR. RD was assessed using fundus autofluorescence imaging and correlated with early face-down positioning (EFP) and other clinical variables.ResultsRD incidence varied by technique: 36.3% after PPV, 21.2% after SB, and 8.1% after PR. In PPV cases, gas tamponade was associated with higher RD rates than silicone oil (68.4% vs. 29.8%, p = 0.010), and perfluorocarbon liquid (PFCL) use was associated with increased RD (44.1% vs. 0%, p = 0.009). Adherence to EFP had no significant protective effect (p = 0.985). Metamorphopsia was more frequent in patients with RD (p = 0.040); final visual acuity was similar across groups.ConclusionsRD is most common after PPV and least frequent after PR. Surgical choices, particularly tamponade type and PFCL use, significantly influence RD risk and should guide surgical planning.

To compare the maturation rate and developmental potential of immature oocytes subjected to and spared from cumulus-oocyte complex (COC) denudation. This single-center prospective observational study was conducted between 15 November-15-December 2025. Germinal vesicle (GV) oocytes were allocated to two groups: Group 1 included oocytesobtained from follicles >10 mm and identified as GV following denudation, whereas group 2 included immature oocytes retrieved from non-dominant follicles with diameter <10 mm, and assessed under an inverted microscope immediately after oocyte retrieval and placed into culture medium without being denuded. All immature oocytes were cultured separately in Continuous Single Culture-NX Complete medium, supplemented with gentamicin and human serum albumin, for 24 hours. COCs in group 2 were subsequently denuded and evaluated for nuclear maturation. Oocytes reaching metaphase II (MII) underwent intracytoplasmic sperm injection. The primary outcome was the MII maturation rate; secondary outcomes included 2PN formation rate and cleavage-stage embryo rate. A total of 885 oocytes were retrieved from 52 patients. Group 1 included 84 denuded GV oocytes, and group 2 comprised 141 non-denuded COCs. After 24 hours of culture, maturation rates in groups 1 and 2 were 3/84 (2.37%) and 52/141 (36.9%), respectively. In group 1, only one oocyte was fertilized, and the resulting embryo arrested on day 3. In group 2, the fertilization and day-3 embryo rates were 23/48 (47.9%) and 14/23 (73.4%), respectively. Non-denuded immature oocytes demonstrated significantly higher maturation, fertilization, and embryo development rates compared with denuded oocytes.

Correlation of mRENAL score with clinical outcomes after CT-guided renal cell carcinoma cryoablation: A retrospective observational study

People living with schizophrenia often experience high levels of stigma and are consistently at risk of internalizing it. Internalized stigma has a negative impact on several clinical and recovery outcomes in people with schizophrenia, but the effect of internalized stigma on important patient reported outcomes that are gaining increasing scientific and clinical relevance, such as life engagement, has not yet been extensively investigated. This study aims to investigate the relationship between several different socio-demographic, clinical, functional and medication-related variables and life engagement, with the hypothesis that internalized stigma, alongside other factors, could represent an individual predictor of reduced life engagement. Ninety-four participants diagnosed with schizophrenia were included in this cross-sectional study and were investigated with validated instruments assessing life engagement, schizophrenia symptoms severity, global clinical severity, internalized stigma, psychosocial functioning, antipsychotic-related side effects, attitude toward medications, and subjective well-being. Predictors of life engagement were assessed using a stepwise multivariate linear regression analysis. Greater global clinical severity (β = .685, p < .001), fewer years of education (β = -.240, p < .001), and greater stigma endorsement (β = .180, p = .005) emerged as individual predictors of reduced patient life engagement, explaining a large proportion of the observed variance (Adjusted R2 = .649, p = .001). Internalized stigma, among other well-recognized variables, appears to represent an individual predictor of worse patient life engagement in people living with schizophrenia. This finding should strengthen the notion that stigma, and internalized stigma in particular, represent important dimensions and treatment targets in the clinical management of schizophrenia, also in the perspective of improving patient-reported outcomes.

Coronary arterial calcification predicts coronary events, but although intracranial arterial calcification on CT (CT-IAC) is a frequent finding in older individuals, few longitudinal studies have assessed whether its severity or site predict dementia. We did a population-based study in patients with transient ischemic attack (TIA) or stroke to assess these associations. In a matched case-control study of patients with minor stroke/transient ischemic attack nested in the population-based OXVASC (Oxford Vascular Study), severity (qualitatively and semiautomated volume) and location (intimal or internal elastic lamina) of CT-IAC in cases who developed dementia on follow-up was compared with that in age-/sex-matched controls who did not (logistic regression adjusted for other risk factors). In OXVASC (cases/controls=200/200; mean age=78.0±9.3 years), dementia was independently associated with severity of internal carotid artery CT-IAC on visual assessment (bilateral severe-adjusted OR [aOR], 2.02 [95% CI, 1.26-3.23], P=0.004) and quantitative volume (top versus bottom tertile-aOR, 2.35 [95% CI, 1.33-4.16], P=0.003), driven mainly by individuals with very high calcification volumes (≥600 mm3 versus 0-299 mm3-aOR, 6.23 [95% CI, 1.24-31.24], P=0.026). Similar trends were observed for CT-IAC in the internal carotid artery and vertebrobasilar artery combined (top versus bottom tertile-aOR, 2.59[95% CI, 1.43-4.68], P=0.002), including after exclusion of recurrent stroke (aOR, 2.60 [95% CI, 1.33-5.08], P=0.005) and patients with moderate/severe white matter disease (aOR, 3.19 [95% CI, 1.54-6.62], P=0.002). Internal carotid artery CT-IAC of the internal elastic lamina independently predicted dementia after adjusting for qualitative (aOR, 1.84 [95% CI, 1.11-3.05, P=0.019) or quantitative (aOR, 1.78 [95% CI, 1.06-2.99], P=0.029) CT-IAC severity. Severity of CT-IAC independently predicts future dementia after stroke/ transient ischemic attack. The extent of any nonlinearity and calcification- or dementia-subtype differences should be determined in larger studies.

The beneficial effects of exercise in cancer patients are increasingly understood, whereas the inclusion of structured oncological exercise as a standard of care remains a challenge. Herein, we evaluate the innovative, supervised Oncological Exercise Therapy (OTT) integrated into the standard of clinical care and report patient characteristics, exercise participation and attendance, and effects on patient-reported outcomes (PROs) and physical performance. An observational study was conducted to analyze patient and exercise cohort data collected between 2012 and 2020 on the OTT. Cancer patients were encouraged to attend the personalized OTT intervention for a minimum of three months. Demographic, medical and treatment-related patient data were documented at enrollment. Exercise attendance was measured up to one year after enrollment, and exercise efficacy was evaluated between 6 and 24 weeks of exercise and included strength and endurance assessments and PROs on quality of life, fatigue, and psychosocial distress. Most of the n = 1660 enrolled patients (median age: 54 years [18-86]) were female (70%), diagnosed with breast cancer (40%), without metastasis (80%) and were receiving anticancer treatment (65%). One-third (32%) exercised for an average of 19 ± 10 sessions in a 19-week (± 13 weeks) period. Only 1% of patients reached the recommended average of ≥ 2 weekly sessions on the OTT. Older age and shorter travel distance were associated with increased exercise attendance. Exercise improved strength and endurance performance and PROs, indicating more pronounced effects in patients with greater exercise attendance. Innovative exercise programs can be established as standard of cancer care in hospital settings. These real-world data suggest a beneficial effect of exercise in cancer patients on PROs and physical outcomes, with more pronounced effects in patients with greater exercise attendance. Therefore, strategies to increase exercise attendance appear crucial to maximize benefits derived from real-world exercise interventions in cancer patients.

Regulatory authorities have raised concerns about potential teratogenic and neurodevelopmental disorders (NDDs) risks associated with paternal valproate use during spermatogenesis, leading to restrictions. We aimed to investigate the association between paternal valproate exposure during spermatogenesis and the risk of NDDs in offspring in Sweden and Norway. We conducted a population-based cohort study of two nationwide cohorts from Sweden and Norway, including all singleton live births (≥22 gestational weeks) from 2007 to 2020. Paternal monotherapy exposure to valproate, lamotrigine or levetiracetam was defined as ≥1 prescription filled for only one of these medications during the 3 months prior to conception. NDDs were identified from health registers from age 1 through 2022. Cox proportional hazards models were used to estimate adjusted HRs (aHRs), accounting for relevant confounders. A random-effects meta-analysis combined results from both countries. The Swedish cohort included 1588 children with paternal valproate and 3093 with lamotrigine/levetiracetam monotherapy, while the Norwegian cohort included 463 and 1109, respectively. Compared with paternal lamotrigine/levetiracetam monotherapy, paternal valproate exposure was not associated with increased pooled risk of any NDD (aHR, 1.06; 95% CI 0.81 to 1.22), including autism spectrum disorder (aHR, 1.29; 95% CI 0.89 to 1.85), attention-deficit/hyperactivity disorder (aHR, 0.98; 95% CI 0.76 to 1.25), intellectual disability (aHR, 1.20; 95% CI 0.65 to 2.21; Sweden only) or psychological development disorders (aHR, 1.28; 95% CI 0.84 to 1.97). Findings remained consistent in dose-response analyses and when restricted to fathers with epilepsy. In this large Nordic study, paternal valproate use during spermatogenesis was not associated with increased risk of NDDs in offspring, suggesting current regulatory restrictions may warrant re-evaluation.

To describe changes in early respiratory support for infants born at <30 weeks' gestational age (GA) in England and Wales. Retrospective cohort study using data from the National Neonatal Research Database of all infants born at <30 weeks GA, admitted to neonatal units in England and Wales from 2016 to 2021. Methods of respiratory support used in the delivery room and days 1 and 7 of care were determined. Success of the initial non-invasive respiratory support strategy was assessed by any use of mechanical ventilation in the first 7 days of care. 24 107 babies were included. Use of continuous positive airway pressure (CPAP) and high-flow nasal cannula (HFNC) as the highest method of respiratory support for stabilisation increased during the study period (CPAP: 17.3% to 28.8%; HFNC: 0% (first recorded in 2016) to 0.7%). CPAP use increased in the most preterm (<25 weeks GA; 0.7% to 4.8%), the extremely preterm (<28 weeks GA; 7.2% to 17.5%) and the very preterm (28-29 weeks GA; 29.3% to 44.1%) cohorts. Among those initially stabilised with non-invasive ventilation in this study, 2763 (48.0%) infants required mechanical ventilation in the first week. In England and Wales, use of non-invasive respiratory support for initial stabilisation has increased among babies born at <30 weeks GA. 48% of those stabilised with non-invasive ventilation required mechanical ventilation in the first week. A higher quality evidence base for interventions that reduce mechanical ventilation could improve respiratory management in this population.

Evaluation of a mental health screening tool to determine the need for psychological interview for patients offered neuromodulation implant therapies for pain.

This multicenter, longitudinal, observational real-world study evaluated the efficacy and safety of switching to intravitreal aflibercept 8mg (Afl 8) in pretreated eyes with neovascular age-related macular degeneration (nAMD) within the Swiss Retina Research Network. A total of 283 eyes from 245 patients previously treated with other anti-vascular endothelial growth factor (anti-VEGF) agents (aflibercept 2mg, faricimab, and ranibizumab) were included, with 1-year efficacy outcomes analyzed in 246 eyes and safety assessed in all treated eyes. We recorded demographics, baseline functional and anatomical parameters-including spectacle-corrected visual acuity (VA) and optical coherence tomography (OCT) data-treatment history and outcomes over 12months after switching to Afl 8. The main outcome measures were change in VA, central subfield thickness (CST), presence of intra- and subretinal fluid (IRF/SRF) and pigment epithelial detachment (PED), treatment intervals, and adverse events. Twelve months after the switch to Afl 8, mean VA remained stable, while mean CST decreased from 329.1 to 302.8µm (p < 0.001). The portion of eyes without retinal fluid increased from 29.9% at baseline to 47.5% after 12months. In parallel, the mean treatment interval was extended by 32.3% from 7.1 to 9.4weeks (p < 0.001). At 1 year, 35.4% of eyes reached intervals of 8-11weeks, while 20.2% achieved intervals of 12weeks or longer. Intraocular inflammation was reported in 11 cases (3.9%). In pretreated nAMD eyes with high treatment demand, switching to Afl 8 resulted in a significant anatomical improvement and longer treatment intervals in a majority of patients. These real-world results highlight the therapeutic potential of Afl 8, with no new or unexpected safety issues.

Romosozumab (ROMO) is a monoclonal antibody targeting sclerostin (SOST), a key regulator of bone metabolism. It has been demonstrated that changes in SOST levels can affect distinct niches within the bone marrow that support haematopoiesis. This study investigated the effect of ROMO on complete blood count (CBC) parameters. We conducted a 12-month prospective observational study in post-menopausal women with severe osteoporosis treated with ROMO 210 mg/monthly over one year between October 2023 and April 2025. CBC values were assessed at baseline, 6 and 12 months. Absolute changes in CBC were assessed with a mixed model for repeated measures. A total of 113 women (mean age of 73.4±9.7 years) were included. Neutrophils levels slightly decreased over time, with a significant decrease at 6 months (p=0.022), that was not sustained at 12 months (p=0.500). Haemoglobin and lymphocytes levels showed no significant differences over the period of the study. In the overall trend across time points, there was a statistically significant decrease in the neutrophil-to-lymphocyte ratio (NLR) over the 12 months (2.0 ± 1.1 at baseline, 1.8 ± 1.1 at month 6, and 1.8 ± 1.2 at month 12; p=0.034), with a small effect size (Cohen's δ = 0.22). In post-menopausal women with severe osteoporosis, 12 months of ROMO treatment was associated with a statistically significant reduction in NLR, reflecting a potential modulation of systemic inflammation, though the clinical relevance of this modest shift remains uncertain and warrants further investigation.

Although retrospective chart-review studies are typically performed using waiver of written informed consent, many institutional review boards (IRB) do not approve such waiver for chart-review studies using prospective enrollment, which could introduce selection bias in participant characteristics and outcomes, thereby impairing representativeness and validity. We aim to determine this bias in a chart-review prostate cancer (PCa) study using prospective enrollment. Using an IRB-approved chart-review protocol with waiver of written informed consent for prospective enrollment, we identified 2,202 patients scheduled for initial prostate biopsy from 2007-2021 at Durham Veterans Affairs Healthcare System. These patients were simultaneously approached for enrollment into a separate minimal-risk prospective observational study protocol requiring blood collection and written consent. 1,238 subjects provided written consent to the blood collection protocol; 964 did not. Patients who provided written consent differed in several key characteristics, including younger age, but had a similar racial distribution. Importantly, participants providing written consent had a significantly lower risk of PCa (multivariable OR=0.41,95%CI=0.31-0.54,p<0.001). As such, patients who provided written consent had younger age, similar race and lower PCa risk and therefore might not accurately represent the full eligible population. To minimize selection bias, waiver of written consent should be allowed for chart-review studies using prospective enrollment.

To evaluate the initial clinical experience with the Saroa surgical system for pulmonary anatomical resection and to assess its perioperative safety. This retrospective observational study included 45 consecutive patients who underwent pulmonary anatomical resection using the Saroa surgical system. Pulmonary anatomical resections included lobectomy (n = 26) and segmentectomy (n = 19). Robot-related lung and vascular injuries were defined as the safety-specific endpoints. The median age was 69 years, and 24 patients (53.3%) were male. The cohort comprised 36 patients with primary lung cancer, seven with metastatic lung tumors, and two with benign lung tumors. The median total operative time was 199min, and the median console time was 145min, accounting for approximately 70-75% of the total operative time. The median estimated intraoperative blood loss was 40 mL. Postoperative complications occurred in 15.6% of patients and were limited to postoperative air leaks. No perioperative mortalities were observed. In this initial clinical experience, Saroa-assisted pulmonary anatomical resection was performed safely without robot-related lung or vascular injuries. This suggests that the incorporation of haptic feedback does not compromise surgical safety during early clinical use.

Antimicrobial resistance (AMR) is a global public health challenge, with hospital wastewater serving as an important reservoir and dissemination pathway for resistant pathogens. Wastewater Treatment Plants (WWTPs) are critical in reducing microbial load and limiting the environmental release of multidrug-resistant (MDR) organisms. This study aimed to isolate and characterize antibiotic-resistant bacteria from hospital wastewater before and after treatment, and to assess the effectiveness of the effluent treatment plant (ETP) in reducing resistant organisms. An analytic observational study was conducted at the ETP of Maharishi Markandeshwar Medical College and Hospital, Himachal Pradesh, between August 2022 and October 2022. Pretreatment and posttreatment wastewater samples were collected on alternate days and processed using standard microbiological methods. Bacterial isolates were identified, and their antimicrobial susceptibility patterns were determined. Data were analyzed using IBM SPSS Statistics v28. Pretreatment samples predominantly contained Staphylococcus aureus (24.42%), Escherichia coli (18.42%), Enterococcus faecalis (17%), Pseudomonas aeruginosa (16.82%), Klebsiella pneumoniae (8.57%), Proteus mirabilis (11.42%), and Bacillus subtilis (3.35%). Posttreatment samples showed a marked reduction in bacterial load, with elimination of B. subtilis and P. mirabilis. Antimicrobial susceptibility testing revealed significant improvement in sensitivity among surviving isolates, particularly E. coli (88% sensitivity) and K. pneumoniae (82% sensitivity). Hospital wastewater is a potential reservoir of MDR pathogens that may persist beyond treatment and contribute to environmental dissemination. Effluent treatment significantly reduced bacterial burden and resistance rates, highlighting the importance of WWTPs in mitigating AMR. Strengthening treatment technologies and implementing strict monitoring are essential to prevent community exposure to resistant pathogens.

Purpose: Given the substantial damage to visual function caused by diabetic retinopathy, this study explored the changes in the fundus microcirculation of diabetic patients without diabetic retinopathy to provide a basis for the prevention and early detection of diabetic retinopathy. Methods: This clinical observational study included 162 eyes of diabetic patients without clinical diabetic retinopathy and 108 healthy eyes. Retinal and choroidal parameters, namely, the foveal avascular zone (FAZ) and vessel density of the superficial capillary plexus (SCP), deep capillary plexus (DCP), full retina and large and middle choroidal vessel (LMCV) layers, were measured in the central and peripheral areas of 24 × 20 mm2 ultrawide-field swept-source optical coherence tomography angiography (UWF-SS-OCTA) images. The Mann‒Whitney U test or Wilcoxon signed-rank test was used for comparisons between groups, and the Kruskal‒Wallis H test was used for comparisons among multiple groups, followed by Bonferroni correction for multiple comparisons. Results: The FAZ in the diabetic group was greater than that of the control group. The diabetic group had lower vessel densities in the SCP (0–3, 4–6, and 13–24 mm diameter ranges), DCP (0–3, 4–6 and 7–12 mm diameter ranges), full retina (0–3 and 4–6 mm diameter ranges), and LMCV layers (4–6 and 13–24 mm diameter ranges) (p < 0.05). Significant differences (p < 0.05) were observed between the vascular density of the SCP (diameter ranges 0–3 and 7–12 mm), DCP, full retina, and LMCV layers (4–6 mm range) in all disease duration groups and those in the control group. Pairwise comparison showed that the vascular density decreased more significantly in the group > 15 y group (p < 0.05). Conclusion: Decreased retinal choroidal microcirculation occurs in diabetic patients before clinical retinopathy develops and becomes more pronounced with increasing disease duration, suggesting that diabetic patients should undergo regular fundus examinations to detect and potentially prevent diabetic retinopathy as early as possible.