[Contribution of Optical Coherence Tomography in the evaluation of the iridocorneal angle in Cameroon]. / Apport de la tomographie en cohérence optique dans l'évaluation de l'angle irido-cornéen du camerounais.

INTRODUCTION: Our work was aimed at determining the sensitivity and specificity of anterior segment OCT (AS-OCT) in the evaluation of the iridocorneal angle (ICA) in Cameroon. METHODOLOGY: We conducted a cross-sectional, analytical study from January 2 to June 30, 2019 in Yaoundé. One hundred and twenty five patients over 35 years of age underwent three-mirror manual glass gonioscopy and AS-OCT. The angle was defined as occludable on manual gonioscopy if the posterior trabecular meshwork, was not visible and on OCT if there was contact between the iris root and the posterior surface of the peripheral cornea. Quantitative parameters (angle opening distance, angle recess area, and trabecular-iris space area) in the nasal and temporal quadrants were recorded for the analysis. RESULTS: Men accounted for 56.20% of the 96 patients selected (192 eyes). The mean age was 54.78±10 years. The prevalence of occludable angles was 18.75% (18/96 patients) and 28.125% (27/96 patients) on manual and automated gonioscopy respectively. Schaeffer-Etienne grades ≤ 2 were identified in 43/192 (21.94%) nasal quadrants and 33/192 (19.18%) temporal quadrants. The area under the curve (AUC) was maximal for the 500 µm goniometric parameters (> 0.8). An Angle Opening Distance ≤ 333.50 µm was found in 52/192 nasal quadrants (27.10%) and 53/192 (27.60%) temporal. The sensitivity and specificity of AS-OCT in the detection of occludable angles at 500 µm, were 62.8% and 83.2% respectively in the nasal quadrant, and 66.7% and 80.5% respectively in the temporal quadrant. There was a positive correlation between goniometric parameters on AS-OCT and gonioscopy (P=0.01). CONCLUSION: Given its higher specificity, AS-OCT should be a supplemental examination in the analysis of an angle which appears closed on manual gonioscopy.

[Ocular abnormalities of children born prematurely at the Yaoundé Gynaeco-Obstetrics And Pediatric Hospital]. / Anomalies oculaires des enfants nés prématurément à l'Hôpital gynéco-obstétrique et pédiatrique de Yaoundé.

PURPOSE: To identify ocular abnormalities in premature children in order to treat reversible visual disorders and help prevent low vision and blindness in this population at risk. METHODOLOGY: This was a cross-sectional, analytical study carried out from November 1, 2018 to July 31, 2019 at the Yaoundé Gyneco-Obstetric And Pediatric Hospital, including premature children, aged 3 to 15 years. The variables studied were age, sex, prenatal, birth and past ophthalmological history, visual acuity, oculomotor examination and fundus examination. For statistical analysis, we used the epi-info software 3.5.4, the Chi2 test, odds ratio and a 95% confidence interval with a significance P<0.05. RESULTS: Of the 50 patients examined, the mean age was 6.02 years±2.58. Of the 22 optically corrected patients, hyperopia and hyperopic astigmatism were predominant (70.5%) (n=31). Distance visual acuity, measured in 31 cooperative patients (62 eyes), was between 3/10 and 8/10 in 14 eyes (22.6%), and<3/10 in two eyes (3.2%). Strabismus was present in 21 patients (42%), of which 13 cases were esotropia (61.9%). Tropical endemic limbo-conjunctivitis was found in eight eyes (8%). There were no cases of retinopathy of prematurity. Very low birth weight (<1500g) and neonatal resuscitation were associated with strabismus. CONCLUSION: Ocular abnormalities in preterm infants are dominated by strabismus, which is associated with very low birth weight and neonatal resuscitation.

[Characteristics of post-traumatic blindness at the Yaoundé Army Training, Application and Referral Hospital]. / Caractéristiques de la cécité post-traumatique à l'hôpital d'instruction, d'application et de référence des armées de Yaoundé.

PURPOSE: To study the characteristics of blindness after ocular trauma. METHODOLOGY: In this retrospective descriptive study, we considered the files of patients who had consulted the service for ocular trauma between January 2008 and December 2014. Included were patients of both sexes and all ages whose monocular or binocular vision with best optical correction was strictly below 1/20. Statistical analysis was performed with EPI Info version 3.5.4 software, and the Chi2 test was used with statistically significant values of P≤0.05. RESULTS: Over the period from 2008 to 2014, we found 100 cases of blindness (101 eyes) resulting from 591 cases of ocular trauma, for a frequency of 16.92 %. Among them, 75 men with a median age of 35.5±19.8 years. Children younger than 15 years accounted for 11 % of the series. The blindness was monocular in 99 % and binocular in 1 %, distributed as follows: 55 cases (55 %) category V, 27 (27 %) category IV and 18 (18 %) category III according to the CIM-10. In the anterior segment, cataract was responsible for category III and IV blindness, while in the posterior segment, retinal detachment was found in all categories. In all age ranges irrespective of sex, category V blindness was most frequent. CONCLUSION: Blindness following ocular trauma is frequent in our context. It can be avoided. Consequently, it is essential to put in place strategies for prevention of ocular trauma via education of the population through public awareness campaigns.

[What is the cost of treatment of diabetic retinopathy by argon laser in Yaoundé?] / Quel coût pour le traitement de la rétinopathie diabétique par laser argon à Yaoundé ?

PURPOSE: To evaluate the total cost of treatment of diabetic retinopathy by argon laser for a patient when indicated. PATIENTS AND METHOD: Prospective cross-sectional and descriptive survey, carried out in the angiography and laser center of the Yaoundé Central Hospital from October 2014 to October 2015. All consecutive diabetic patients with retinopathy and suitable indication for argon laser treatment were included. The costs related to the initial and final fluorescein angiography, the appointment for follow-up, round-trip transportation costs from the patient's home and the cost of laser treatment were included. RESULTS: Included were 43 (13 %) patients out of 330 with diabetic retinopathy. The mean age was 55.67±8.40years. There were 25 women (58.1 %) and 18 men (41.9 %) for a M/F ratio of 0.7. Unemployed patients were represented by 28 (65.1 %) versus 15 employed (34.9 %). Twenty-seven patients (62.8 %) were self-pay for all their expenses, 14 (32.6 %) were assisted by their families, and 2 (4.6 %) were insured. On average, the total expenditure was 86002±67197 f CFA per eye, corresponding to 131±102 euros with an exchange rate of 1 euro for 656 f CFA. CONCLUSION: The cost of treatment of diabetic retinopathy by argon laser is high, mostly increased by the additional costs related to transportation in our area. The creation of satellite centers in the 10 regions of Cameroon would reduce these costs.

Sickle cell retinopathy and other chronic complications of sickle cell anemia: A clinical study of 84 Sub-Saharan African cases (Cameroon).

OBJECTIVE: Sickle retinopathy is a severe complication of sickle cell disease than can lead to blindness. We aim to describe the epidemiology of sickle retinopathy in homozygous sickle cell (SS) African patients and to analyze its association with non-ophthalmologic disease complications of sickle cell anemia. METHODS: We conducted a nested study within the CADRE cohort in Cameroon. Eighty-four consecutive SS outpatients, aged 10 years and older, with no visual symptoms, underwent an ophthalmologic examination. Mean age was 23±10 years. Clinical and biological features were compared between patients with and without sickle retinopathy. We compared the prevalence of the clinical complications and main biological characteristics in patients with and without sickle retinopathy using a univariate logistic regression. The same analysis was used to compare the patients with non-proliferative sickle retinopathy to those with proliferative sickle retinopathy. Statistical analyses were done using the R software (version 3.1.2). RESULTS: Fifty-two patients (62%) displayed sickle retinopathy, among them 23 (27%) had a non-proliferative sickle retinopathy, and 29 (35%) had proliferative sickle retinopathy. Patients with proliferative sickle cell retinopathy had a mean age of 28±11 years. Sickle retinopathy was associated with higher hemoglobin level (P=0.047) and fewer leg ulcers (P=0.018). Proliferative SR was associated with increasing age (P=0.008) and male sex (P=0.025) independently of the hemoglobin level. CONCLUSIONS: Sickle retinopathy is particularly frequent in sub-Saharan sickle cell SS patients, which advocates for early systematic screening.

Anterior Chamber Live Loa loa: Case Report.

We reported a case of unusual intraocular Loa loa in a 27-year-old patient who presented with painful red eye. Biomicroscopy revealed a living and active adult worm in the anterior chamber of the right eye. After surgical extraction under local anesthesia, parasitological identification confirmed L. loa filariasis.