Longitudinal Assessment of Diabetic Macular Oedema Treatment Outcomes Using Anti-VEGF Therapy at Lagos University Teaching Hospital

Diabetic macular oedema (DMO) is the leading cause of vision loss in working-age diabetic patients globally, and anti-vascular endothelial growth factor (anti-VEGF) therapy has become the standard of care. However, real-world treatment outcomes in Nigerian tertiary settings remain poorly characterised. This study evaluates longitudinal treatment outcomes of anti-VEGF therapy for DMO at Lagos University Teaching Hospital (LUTH), Idi-Araba, South West Nigeria. A prospective cohort study will be conducted among 80 eyes with centre-involving DMO confirmed on optical coherence tomography (OCT). All eligible patients will receive intravitreal anti-VEGF injections at baseline and monthly as per a treat-and-extend protocol for 12 months. Primary outcomes will include change in best-corrected visual acuity (BCVA) from baseline at 6 and 12 months, and central macular thickness change on OCT. Secondary outcomes will cover number of injections administered, glycaemic control status as HbA1c, and treatment-related complications. Multivariable analysis will identify predictors of good treatment response. While randomised trial data from high-income countries robustly supports anti-VEGF efficacy for DMO, real-world outcomes in Nigeria are influenced by injection interval compliance, cost of therapy, glycaemic control quality, and loss to follow-up. This study provides rigorous prospective evidence from the largest teaching hospital in West Africa and will influence clinical protocols for DMO management in Nigeria. Recommendations will address patient financial support mechanisms for anti-VEGF therapy and integration of OCT monitoring into routine diabetic eye care. Keywords: diabetic macular oedema, anti-VEGF, intravitreal injection, LUTH Lagos, treatment outcomes