[Features of macular ganglion cell complex in normal black subject in Lomé]. / Caractéristiques du complexe de cellules ganglionnaires chez le sujet normal à Lomé.

PURPOSE: To determine the features of the macular ganglion cell complex and its correlations in normal black subjects in Lomé. MATERIALS AND METHODS: We conducted a descriptive, analytical, retrospective study over 32 months from November 2014 to June 2017. This study was based on records of healthy patients with normal IOP, optic discs and ganglion cell complexes (GCC). The 3D - OCT 2000 (Topcon Corporation, Tokyo, Japan) was used with standard image acquisition protocols. RNFL and the GCC parameters were analyzed. Univariate linear regression tests were used, with the Pearson correlation coefficient (r2) to assess correlations between the various parameters. RESULTS: A total of 277 eyes of 155 patients were examined - 146 right eyes and 131 left eyes. The mean age of the patients was 37.7±15.2 (5-60) years. The mean RNFL thickness was 108.3±7.1µm, 134.8±11.1µm in the lower quadrant, 128.3±13.8µm in the upper, 92.2±12.8µm in the nasal and 77.9±11.6µm in the temporal quadrant. There was 6% asymmetry in the macular fibers, with a mean thickness of 33.1±3.5µm superiorly and 35.3±3.8µm inferiorly. There was 2% asymmetry in the macular cells, with a mean thickness of 71.6±5.7µm superiorly and 70.5±5.2µm inferiorly. The macular GCC thickness showed 1% asymmetry, with a mean thickness of 105.0±7.1µm superiorly and 106.1±6.7µm inferiorly. The thickness of the superior macular GCC was strongly correlated with the inferior (r2=0.8; p <0.05). The thickness of the macular GCC was weakly correlated with age (r2=0.05; p =0.0003), gender (r2=0.01; p =0.2), optic nerve head surface area (r2=0.2; p < 0.05) and RNFL thickness (r2=0.15; p <0.05) CONCLUSION: The results of this study will help to establish a normative database for GCC parameters in normal black Africans.

[Accuracy of Optical Coherence Tomography versus Ultrasound in pachymetry]. / Fiabilité de la pachymétrie par OCT comparée à la pachymétrie par ultrasons.

PURPOSE: Measuring the central corneal thickness is an important step in the diagnosis and monitoring of glaucoma. Ultrasound pachymetry was the gold standard before the advent of OCT. The purpose of this study is to assess the reliability of OCT pachymetry compared to ultrasound pachymetry in black patients. PATIENTS AND METHODS: Pachymetry was performed as part of a glaucoma work-up. Ultrasonic pachymetry was measured using the Alcon Ocuscan by the same operator and OCT pachymetry using the Topcon 2000 OCT. The Student's t-test was used to compare means with statistical significance of 5%. The Pearson's correlation coefficient (r2) was used to measure correlations. RESULTS: One-hundred thirty-five right eyes and 135 left eyes, corresponding to 270 eyes of 135 patients, were examined. There was a female predominance (59 men/76 women), with a gender ratio of 0.78. The mean age was 42.3±17.3 [8-86] years. In the right eye, the mean OCT pachymetry was 522.4±36.8µ versus 528.2±37.9µ for ultrasonic pachymetry (P=1.00). In the left eye, the mean OCT pachymetry was 522.0±33.8µ versus 524.9±42.5µ for ultrasonic pachymetry (P=1.00). The overall mean OCT pachymetry was 522.2±35.2µ versus 526.5±40.2µ, with a non-significant difference (P=1.00). There was a strong correlation between ultrasonic pachymetry and OCT pachymetry (r2=0.83; P<0.05). On the other hand, there was a very low correlation between pachymetry and age (r2=0.09; P<0.05). Pachymetry decreased by 5µ per 10 years, corresponding to corneal thinning of 0.5µ per year. CONCLUSION: OCT pachymetry can be a reliable alternative to ultrasound pachymetry and could be performed at the same time as the OCT for glaucoma assessment.

Inflammatory and regulatory CCL and CXCL chemokine and cytokine cellular responses in patients with patent Mansonella perstans filariasis.

Mansonella perstans (Mp) filariasis is present in large populations in sub-Saharan Africa, and to what extent patent Mp infection modulates the expression of immunity in patients, notably their cellular cytokine and chemokine response profile, remains not well known. We studied the spontaneous and inducible cellular production of chemokines (C-X-C motif) ligand 9 (CXCL9) [monokine induced by interferon (IFN)-γ (MIG)], CXCL-10 [inducible protein (IP)-10], chemokine (C-C motif) ligand 24 (CCL24) (eotaxin-2), CCL22 [macrophage-derived chemokine (MDC)], CCL13 [monocyte chemotactic protein-4 (MCP-4)], CCL18 [pulmonary and activation-regulated chemokine (PARC)], CCL17 [thymus- and activation-regulated chemokine (TARC)] and interleukin (IL)-27 in mansonelliasis patients (Mp-PAT) and mansonelliasis-free controls (CTRL). Freshly isolated peripheral mononuclear blood cells (PBMC) were stimulated with helminth, protozoan and bacterial antigens and mitogen [phytohaemagglutinin (PHA)]. PBMC from Mp-PAT produced spontaneously (without antigen stimulation) significantly higher levels of eotaxin-2, IL-27, IL-8, MCP-4 and MDC than cells from CTRL, while IFN-γ-IP-10 was lower in Mp-PAT. Helminth antigens activated IL-27 and MCP-4 only in CTRL, while Ascaris antigen, Onchocerca antigen, Schistosoma antigen, Entamoeba antigen, Streptococcus antigen, Mycobacteria antigen and PHA stimulated MIG release in CTRL and Mp-PAT. Notably, Entamoeba antigen and PHA strongly depressed (P < 0·0001) eotaxin-2 (CCL24) production in both study groups. Multiple regression analyses disclosed in Mp-PAT and CTRL dissimilar cellular chemokine and cytokine production levels being higher in Mp-PAT for CCL24, IL-27, IL-8, MCP-4, MDC and PARC (for all P < 0·0001), at baseline (P < 0·0001), in response to Entamoeba histolytica strain HM1 antigen (EhAg) (P < 0·0001), Onchocerca volvulus adult worm-derived antigen (OvAg) (P = 0·005), PHA (P < 0·0001) and purified protein derivative (PPD) (P < 0·0001) stimulation. In Mp-PAT with hookworm co-infection, the cellular chemokine production of CXCL10 (IP-10) was diminished. In summary, the chemokine and cytokine responses in Mp-PAT were in general not depressed, PBMC from Mp-PAT produced spontaneously and selectively inducible inflammatory and regulatory chemokines and cytokines at higher levels than CTRL and such diverse and distinctive reactivity supports that patent M. perstans infection will not polarize innate and adaptive cellular immune responsiveness in patients.

[Optic disc features on OCT in glaucomatous and normal black Africans]. / Caractéristiques de la papille chez les sujets glaucomateux et normaux à l'OCT dans une population Noire Africaine.

PURPOSE: To determine the correlations between the size of the optic disc and glaucomatous defects in black Africans. DESIGN: Retrospective observational study. METHODS: The study was conducted over a two-year period from November 2014 to October 2016, based on records of black Togolese patients who had undergone optic nerve head (ONH) OCT or ganglion cell complex OCT for assessment of glaucoma. The population was divided into 3 groups (I, II and III) depending on the size of the ONH. The ONH was considered small (Group I) if its size was less than the mean -1 SD, medium (Group II) if its size was within 1 SD of the mean, and large (Group III) if its size was greater than the mean+1 SD. Glaucomatous lesions were qualitatively identified on RNFL and or GCC. The ONH parameters were compared in the 3 groups. The Chi-square test was used to compare the percentages, and the t test to compare the means with statistical significance of 5%. The Pearson correlation coefficient (r2) was used to measure correlations. RESULTS: A total of 586 eyes of 298 patients were examined, 314 glaucomatous eyes and 272 healthy eyes. The mean age was 41.0±15.7 [6; 86] years. There were 159 men vs. 137 women, with a sex ratio of 1.2. The mean surface area of the ONH was 2.80±0.55mm2. Small ONH's (Group I) were defined as a surface area of less than 2.25mm2, medium-sized ONH's (Group II) as an area between 2.25 and 3.35mm2 and large ONH's (Group III) as an area greater than 3.35mm2. Small ONH's represented 14.7%, (86 eyes), medium-sized 68.6% (408 eyes) and large ONH's 16.8% (98 eyes). The mean surface area of the neuroretinal rim, cup, the cup-disc ratio and the RNFL thickness were statistically significant in the 3 groups. Similarly, all these parameters were significant in groups of glaucomatous or non-glaucomatous eyes, except for the surface area of the cup. The RNFL thickness was weakly correlated with the surface area of the ONH (r2=0.39), moderately correlated with the surface area of the neuroretinal rim (r2=0.57). The surface area of the ONH was strongly correlated with the surface area of the cup (r2=0.7). The neuroretinal rim surface area was strongly correlated with the cup-disc ratio (r2=0.66). CONCLUSION: The size of the ONH was correlated with the size of the cup, but it was not correlated to the surface area of the neuroretinal rim or the thickness of the nerve fibers. Analysis of the RNFL and GCC is essential for the diagnosis, especially in the case of large ONH's.

[OCT topographic characteristics of the optic nerve in patients clinically suspected to have large optic disc cupping in Togo]. / Les caractéristiques topographiques à l'OCT du disque optique chez des patients cliniquement suspects de grande excavation papillaire (GEP) au Togo.

PURPOSE: To describe topographic characteristics of optic discs clinically suspected of large cupping. MATERIALS AND METHODS: This is retrospective study conducted from the January 2 to December 31 on the OCT registry and data base of a private ophthalmologic center in Lomé (Togo). We included records of patients with large cupping - CDR (cup-to-disc ratio) ≥ 0.4 -clinically observed and having undergone OCT-optic disc analysis. RESULTS: Three hundred and thirty-five patients (619 eyes) were studied, with a mean age of 41.87 years±17.51 years [6 years and 80 years] and a sex-ratio of 1.01 with a slight female predominance. The mean clinical CDR was 0.51±0.126 [0.4 and 0.9] (95 % CI [0.503 to 0.531]). The clinical CDR was ≥ 0.7 in 7.75 % of cases. The mean neuroretinal rim area was 1.63±0.43 mm2 [0.34 and 2.85 mm2]. The mean cup area was 1.43±0.54 mm2 [0.13 and 4.29 mm2], and the mean cup volume 0.47±0.28 mm3 [0.01 and 1.72 mm3]. The mean global CDR on OCT was 0.46±0.13 [0.21 and 0.87], of which 30.85 % (191 cases) had CDR <0.4. The CDR on OCT was >0.7 in 40 (6.46 %) eyes vs. 48 (7.75 %) eyes on clinical examination. CONCLUSION: On the average, optics discs exhibit large size and large cup volume. Topographic evaluation of the optic disc by the means of OCT offers important data and gives way to etiological research of large cupping in the black African.