This study leverages data from three large population-based cohorts to explore the association between type 2 diabetes and the risk of stroke, as well as the mediating role of retinal microvascular parameters.

Although the findings were negative, they still offer a novel perspective. Please note the following issues:

1. In the MESA and ARIC studies, measurement of some covariates was not conducted concurrently with exposure and mediation, which may lead to time-varying confounding bias.

The study did not assess the temporal changes in CRVE and CRAE, and their association with stroke occurrence, which could be crucial for understanding the disease progression.

1. The results may be limited to specific populations, restricting their generalizability and transferability. Furthermore, even with negative findings, the study failed to provide clear preventive or therapeutic strategies for stroke related to type 2 diabetes.

2. Despite the large sample size, it may still be insufficient to detect all potential associations, and measurement errors in retinal microvascular parameters could affect the accuracy of the results.

3. The study did not consider genetic or molecular factors that may play a role in the association between type 2 diabetes and stroke.

The author's revision did not address the numerous limitations of this study, and multiple reviewers have expressed confusion regarding the background information, population selection, and model adjustments.

Considering the novelty of the perspective, it might be more appropriate for this study to be published in the format of a Research Letter.