Corneal Endothelial Cell Density and Morphology in Patients with Type 2 Diabetes in Maiduguri, Borno State

The corneal endothelium is a monolayer of cells critical to corneal clarity, and its density and morphology can be affected by systemic conditions including diabetes mellitus. Evidence on corneal endothelial changes in diabetic patients from the North East geopolitical zone of Nigeria is lacking. This study examines corneal endothelial cell density, coefficient of variation, and hexagonality in patients with type 2 diabetes compared to non-diabetic controls at the University of Maiduguri Teaching Hospital. A cross-sectional comparative design will be employed, recruiting 150 diabetic patients and 150 age- and sex-matched controls. Specular microscopy will be used to measure endothelial cell density (ECD), average cell area, polymegethism, and pleomorphism. Diabetes duration, glycated hemoglobin (HbA1c), and systemic medication use will be documented. Independent t-tests and Pearson's correlation analysis will assess differences and associations. The study expects to find significantly lower ECD and higher coefficient of variation in diabetic patients, with worse values correlating with longer disease duration and poorer glycemic control. Findings will contribute to the evidence base for pre-surgical corneal assessment in diabetic patients and will inform protocols for monitoring corneal health in diabetic eye care pathways in the North East zone. This research provides a regionally grounded analysis of diabetic corneal endotheliopathy in Nigeria. Keywords: corneal endothelium, specular microscopy, diabetes, Maiduguri, endothelial cell density