Prevalence of diabetic macular edema based on optical coherence tomography in people with diabetes: A systematic review and meta-analysis

Diabetic macular edema (DME) is a leading cause of vision loss among people with diabetes. Optical coherence tomography (OCT) allows for accurate assessment and early detection of DME. Meta-analyses on DME prevalence diagnosed with OCT are lacking. We performed a meta-analysis to assess the global prevalence of OCT-diagnosed DME. We searched five electronic databases (EMBASE, CINAHL, Web of Science, Scopus, and MEDLINE) on May 29, 2020 and updated the search on March 19 and June 22, 2021. The quality of retrieved studies was evaluated using the Joanna Briggs Institute Checklist for Prevalence Studies. A random-effects model was used to pool prevalence estimates. Countries were classified into low-to-middle-income and high-income countries using World Bank data for subgroup analyses. Seven studies were included in this meta-analysis. The pooled prevalence of DME was 5.47% (95% CI: 3.66%–7.62%) overall, 5.81% (95% CI: 0.07%–18.51%) in low-to-middle-income countries and 5.14% (95% CI: 3.44%–7.15%) in high-income countries. We reported approximately 5.5% of people with diabetes have DME, with a statistically nonsignificantly lower prevalence in high-income countries versus low-to-middle-income countries. Given the global pandemic of diabetes, there is a need to inform physicians and educate people with diabetes regarding early detection and treatment of DME using OCT.