Background: Diabetic retinopathy (DR) is the most prevalent microvascular consequence of diabetes mellitus, and it can result in blindness that is irreversible. Due to delayed diagnosis and limited access to diabetic care, the situation is even worse in developing countries. Scientific evidence on the prevalence of DR and its associated factors among diabetes patients in low-income countries, such as Ethiopia, is limited. This study aimed to determine the prevalence of DR and associated factors among adult diabetes patients in southeast Ethiopia. Methods: A hospital-based cross-sectional study was conducted among diabetes patients who visited Madda Walabu University Goba Referral Hospital. Fundus and slit-lamp examination were performed for screening of DR. Multivariate binary logistic regression was computed to identify factors associated with DR. Results: A total of 256 patients (144 men, 56.2%) aged 50.15±15.71 years were included in the study. The prevalence of any DR was 19.9% (95% CI 15.4%–25.3%), mild nonproliferative diabetic retinopathy (NPDR) 10.9% (95% CI 7.6%–15.4%), moderate NPDR 5.9% (95% CI 3.5%–9.5%), severe NPDR 0.9% (95% CI 0.2%–3.9%), and proliferative DR 2.3% (95% CI 1.0%–5.1%). Duration of diabetes ≥10 years (AOR 10.22, 95% CI 1.70–61.44), central obesity (AOR 5.42, 95% CI 1.38–21.19), overweight/obese (AOR 2.65, 95% CI 1.02–6.92), lower high-density lipoprotein (HDL) cholesterol (AOR 5.82, 95% CI 1.86–18.24), moderate triglyceride:HDL cholesterol ratio (AOR 4.13, 95% CI 1.13–15.15), and urban dwelling (AOR 2.84, 95% CI 1.04–7.78) were significantly associated with DR. Conclusion: One in every five DM patients had DR. Sociodemographic, anthropometric, and blood lipids were independently associated with DR. To reduce the burden of diabetes, strategies that focus on lifestyle modifications targeted at identified modifiable risk factors are essential.
