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Introduction Diabetic retinopathy (DR) is a leading cause of blindness and visual disability, worldwide. The aim of the study was to investigate the correlation between tears and plasma levels of activity of tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) in patients with diabetic retinopathy. Method Patients with T2DM and DR (n=26) were enrolled in this study. Blood and tears samples were obtained from both groups and analysed for PAI-1 and tPA activities. Anthropometric measurements were also obtained. Results There was no correlation between serum and tear PAI-1 levels with a Spearman's coefficient of 0.028 (p=0.928). We were also unable to detect significant correlations between serum and tear tPA levels. However, there was a significant positive correlation between levels of tears PAI-1 and BMI (r=0.555, p=0.026). Conclusion This present study demonstrated no significant correlations between tears and serum PAI-1 and tPA, which was most likely due to the small sample size. However, the significant correlation between tear PAI-1 levels with BMI could indicate the potential role of tear biomarkers in diabetic retinopathy in obese patients. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.