Epidemiological and clinical aspects of macular oedema in Douala

Abstract

Background: Macular oedema is the accumulation of fluid and other substances in the macula of the retina leading to thickening of the retinal tissue and decrease in visual function. It is a sign and could occur in a wide variety of ocular pathologies including diabetes and retinal vein occlusion among others. We have not found studies on macular oedema globally irrespective of aetiology. Research objective: To determine the epidemiological, clinical and therapeutical aspects of macular oedema in hospitals in Douala. Methodology: We conducted a multicenter longitudinal analytic study at four hospitals in Douala over a period of 8 months. Consenting patients received for consultation who had macular oedema irrespective of aetiology confirmed on macular cross sectional OCT were included. Excel 2013, and Epi Info version 7.2.4.0 were used for data analysis. The Chi-square test was used to compare categorical variables and the calculation of the Odds ratio and the Pearson test for linear correlation. A significance threshold was set at 5% (p<0.05). Results: A total of 14,261 patients were received during our study period, amongst which 116 had macular oedema (152 eyes) thus a prevalence of 0.81%. The mean age of patients with macular oedema was 54.87±1.57 years with a sex ratio of 0.9 and its prevalence among children less than 16 years was 0.05%. Diabetes was the most common comorbidity (73.68%). Majority of eyes (57.24%) were visually impaired with most visual impairment moderate (25.66%). Most patients (68.97%) had unilateral eye involvement. Hard exsudates was the most common finding on fundoscopy (51.97%). The mean central macular thickness was 334.22 ± 10.4μm with extremities of 44 μm and 1074 μm. Majoriy of eyes (67.76%) had clinically significant MO. There was a negative correlation between visual acuity and central macular thickness (r= -0.434, p=0.001). The 3 common aetiologies of macular oedema were diabetes mellitus (57.24%), retinal vein occlusion (9.21%) and uveitis (6.58%). Conclusion: Macular oedema is more common in older adults and usually leads to visual impairment. Diabetes is its most frequent aetiology.