Abstract
Purpose :
Diabetic macular edema (DME) is a leading cause of vision loss among people of working age with diabetes. It is a major public health issue. Optical coherence tomography (OCT) technology allows for accurate assessment of DME but systematic reviews on the prevalence of DME diagnosed based on OCT are lacking. A systematic review and meta-analysis was performed to assess the global prevalence of DME diagnosed with OCT.
Methods :
Three electronic databases (EMBASE, CINAHL and PubMed) were searched on May 25, 2020 using key words such as “diabetic macular edema”, “prevalence” and “optical coherence tomography”. The quality of retrieved studies was evaluated using the Joanna Briggs Institute Checklist for Prevalence Studies. Pooled prevalence estimates and 95% confidence intervals (CI) were calculated using a random-effects model following the assessment of heterogeneity (I2).
Results :
The search found 1524 studies. After removing duplicates, 1245 studies remained. After abstract screening and full-text assessment based on pre-established criteria, six studies were included in the meta-analysis. The sample size of included studies ranged from 75 to 978 patients, with a mean age of 50.6-68.2 years. Four studies had more females (51.1%-61.5%). The other two studies had predominantly males (64.5% and 74.4%). Three studies were conducted in developed countries and three studies in developing countries. The prevalence of DME ranged from 4.0% to 48.7% among individual studies. The associated I2 value was 98.9%, suggesting that the random effects model was appropriate to combine individual studies. The pooled prevalence of DME was 17.9% (95% CI: 5.4%-35.5%) overall, 18.6% (95% CI 7.7%-32.8%) in developed countries and 17.7% (95% CI: 1.0%-47.7%) in developing countries. In comparison, using fundus photography exams, a meta-analysis published in 2012 reported a pooled prevalence of DME of 6.81%.
Conclusions :
The prevalence of DME diagnosed based on OCT was 18%, which was 2-3 times higher than the prevalence of DME diagnosed with fundus photography. Modern OCT technology allows for early detection of DME before significant vision loss. Given the global pandemic of diabetes mellitus and obesity, there is an increasing need to inform physicians and educate people with diabetes regarding early detection and treatment of DME based on OCT.
This is a 2021 ARVO Annual Meeting abstract.