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Abstract This study focused on assessing predominantly peripheral lesions (PPL) in Egyptian patients with early diabetic retinopathy (DR) using ultrawide field imaging. The prevalence of PPL was found to be 33.5%. Interestingly, PPL were more prevalent in eyes with mild non-proliferative DR (NPDR) compared to moderate NPDR, indicating an association between lesion distribution and DR severity. Several systemic factors showed significant associations with PPL presence. Hypertension exhibited a higher prevalence among the PPL group, while neuropathy and renal problems were more prevalent in the no PPL group. However, cardiopathy didn’t show a statistically significant difference between the groups. Furthermore, eyes with PPL had lower rates of center involving diabetic macular edema (Ci-DME) but exhibited higher rates of peripheral chorioretinal atrophy, white without pressure (WWOP), and lower rates of glaucoma compared to eyes without PPL. The study found no substantial association between PPL presence and various treatment options. Additionally, while there were no significant differences in the mean age of patients between the two groups, the PPL group showed a slightly lower mean hemoglobin A1C level and a slightly larger visible retinal area compared to the no PPL group. These findings suggest potential correlations between PPL presence, systemic conditions, and specific ocular characteristics in patients with early DR |