Diabetic Macular Oedema in Diabetic Patients Attending the Endocrinology Clinic at University College Hospital, Ibadan
Authors: Oluleye T.S , Babalola Y.O , Majekodunmi O.I , Ijaduola M.A , Fasanmade A.A , Alonge T.O , Adebusoye S.O 
Published: January 2025

Abstract

Background:
Diabetic macular oedema (DME), a significant threat to vision among diabetics, often eludes the early detection due to patients’ delayed ophthalmologist visits. Our efforts to increase screening participation through physician referral promotion and cost reduction have not yielded significant results. Faced with the persistent challenge of low screening rates, we sought to explore innovative alternatives to increase DME detection. The first involved implementing ophthalmologist-led screening programmes, while the second focused on promoting sponsored on-site screenings at diabetic clinics. These strategies aim to integrate DME screenings more seamlessly into routine diabetes management, potentially increasing the likelihood of early detection. By making screenings more convenient and readily available within existing care pathways, we anticipate these approaches could significantly improve participation rates and consequently lead to earlier intervention for DME amongst diabetic patients.

Aim:
To determine the prevalence of DME in visually asymptomatic diabetic patients through comprehensive screening and to evaluate the potential benefits of early detection in improving the visual outcomes and patient care.

Methods:
A cross-sectional study was conducted from 2020 to 2023, involving 225 consecutive diabetic patients who consented to participate while attending the diabetic clinic. The Joint University of Ibadan/University College Hospital Institutional Review Board provided ethical approval for the research. The study collected the data on patient demographics and medical history. Thereafter, they underwent comprehensive ocular examinations. All findings were systematically documented for analysis using the IBM Statistical Package for the Social Sciences software version 26.0.

Results:
A total of 225 diagnosed diabetic patients (450 eyes) were examined in the study. The duration of diabetes mellitus amongst participants ranged from two months to 30 years. The sex distribution shows a male-to-female ratio of 1:2.6, indicating a higher proportion of female participants. The age range of the study population is 31–87 years. Regarding diabetic control, 32% of participants had a fasting blood sugar (FBS) level higher than 120 mg/dL. Visual acuity (VA) assessments revealed that 16.9% (n = 38) of participants had VA worse than 6 / 12. Out of the total participants, 42 (18.9%) had DME in at least one eye, while 180 (81.1%) had no DME. DME was observed in 32 right eyes (14.7%) and 32 left eyes (14.9%). A statistically significant association was found between DME and visual impairment (χ2 = 11.2, P = 0.001), with a higher proportion of DME patients (33.3%) having visual impairment compared to those without DME (13.1%). Patients with DME were 3.6 times more likely to have best-corrected VA worse than 6 / 12 in the better eye compared to those without DME.

Conclusion:
This study reveals a significant prevalence of DME and its strong association with visual impairment. Our findings underscore the need to take screening services directly to diabetic clinics and the urgency of implementing routine eye screening protocols for all diabetic patients in our medical facilities to enable the early detection and timely intervention.