[Congenital ocular anomalies at the University Hospital Campus in Lomé, Togo]. / Les anomalies congénitales oculaires au Centre Hospitalier Universitaire-Campus de Lomé, Togo.

INTRODUCTION: congenital ocular anomalies are rare clinical entities. The purpose of this study is to describe the epidemiological and clinical features of congenital ocular anomalies at the University Hospital Campus in Lomé. METHODS: we conducted a retrospective study at the Department of Ophthalmology of the University Hospital Campus in Lomé, over a 3-year period, from January 2016 to December 2018. It involved children with congenital ocular anomalies. The study variables were: sex; age at diagnosis; type of congenital ocular anomalies; laterality. RESULTS: out of 2621 children assessed during the study period, 103 (3.9%) had congenital ocular anomalies. Of these, 60 (58.2%) were boys and 43 (41.8%) girls. The average age at diagnosis was 16 ± 5.2 months (ranging from 1 months to 5 years). The most common congenital ocular anomaly was cataract (53.4%). Unilateral alterations were predominant (56.3%). Congenital ocular anomalies were isolated (82.5%); associated with systemic anomalies (11.7%); associated with each other (5.8%). CONCLUSION: these results show that the epidemiological and clinical features of congenital ocular anomalies are similar to those reported in the literature. However, in our Hospital, the frequency of congenital ocular anomalies and patients' age at diagnosis are high. Early diagnosis is essential to ensure adequate management and preserve visual function.

Ocular and Mucocutaneous Sequelae among Survivors of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Togo.

AIM: The aim of this study was to assess ocular and mucocutaneous sequelae among SJS/TEN survivors and identify risk factors of ocular sequelae. PATIENTS AND METHOD: Late complications among SJS/TEN survivors were assessed using 2 methods: a retrospective assessment of medical records only or a retrospective assessment of medical records and physical examination of survivors who were contacted by phone. RESULTS: Between January 1995 and December 2017, 177 cases of SJS/TEN (138 cases of SJS, 29 cases of TEN, and 10 cases SJS/TEN overlap) were admitted into two university hospitals of Lomé (Togo). There were 113 women and 64 men, with an average age of 31.7±13.0 years (range: 5 to 80 years). The most used drugs were antibacterial sulfonamides (35.6%) and nevirapine (24.3%). HIV serology was positive in 68 (59.1%) of the 115 patients tested. Sixty-four (52,5%) of the 122 patients, who had been examined by an ophthalmologist during the acute stage, had acute ocular involvement, which was mild in 27.9% of patients, moderate in 13.1%, and severe in 11.5%. We recorded 17 deaths (i.e., three cases of SJS, 12 of TEN, and two of SJS/TEN overlap), including 11 cases of HIV infected patients. Of the 160 SJS/TEN survivors, only 71 patients were assessed 6 months after hospital discharge. Among them, forty-three (60.6%) patients had sequelae. Concerning mucocutaneous sequelae, the main lesions were diffuse dyschromic macules (38.0% of patients) and ocular sequelae were dominated by decreased visual acuity (14.1% of patients). In multivariate analysis, exposure to sulfadoxine (odds adjusted ratio = 5.95; 95%CI= [1.36-31.35]) and moderate (adjusted odds ratio = 5.85; 95%CI = [1.23-31.81]) or severe (adjusted odds ratio = 48.30; 95%CI = [6.25-1063.66]) ocular involvement at acute stage were associated with ocular sequelae. CONCLUSION: Ocular and mucocutaneous sequelae are common in SJS/TEN survivors. Exposure to sulfadoxine and severity of acute ocular involvement are risk factors of ocular sequelae.

[Juvenile myasthenia gravis in sub-Saharan Africa: a case study of two consanguine sisters born from consanguinity in Togo]. / Myasthénie juvénile oculaire en Afrique Subsaharienne: cas de deux sœurs germaines issues d'un mariage consanguin au Togo.

Myasthenia gravis is a rare acquired autoimmune pathology causing neuromuscular transmission impairment. Juvenile onset of myasthenia gravis is often characterized by ocular involvement. We report two cases of ocular juvenile myasthenia gravis (JMG) in two siblings. They were two young girls, XA and XB, aged 11 and 9 years, of Malian origin, residing in Togo, born from first-degree of consanguinity presenting to Ophthalmology due to progressive decrease in visual acuity. XA showed visual acuity 8/10 on both eyes while XB showed improvement in visual acuity from 3/10 to 7/10 using a pinhole occluder, suggesting ametropia. XA had a 2-year history of bilateral ptosis lifting the upper eyelid of 7 mm, while XB had a 3-year history of bilateral ptosis with no lifting of the upper eyelid. Ice pack test was strongly positive in both patients. They had Cogan's lid twitch with paresis of the oculomotor nerve without diplopia. The dosage of acetylcholine receptor autoantibodies was normal. The diagnosis of JMG associated with ametropia was suspected. Ametropia was corrected by glasses and a specific treatment with pyridostigmine was initiated, but both patients were lost to follow-up. Autoimmune myasthenia gravis with inaugural ophthalmologic manifestation is rare but it can occur among children living in sub-Saharan Africa. Studies should be conducted to establish the features of this disease.

Descriptive Epidemiology of Cancers in Togo from 2009 to 2016

Background: Cancer is a global public health problem. According to World Report on Cancer in 2000, developing countries are becoming increasingly affected. Methods: This retrospective and descriptive 8-year study of all histological confirmed cancers was conducted using data from the anatomical pathology laboratory registry of Togo's only laboratory. The parameters were frequency, site and histological type as well as age and gender. Results: We found 1,738 cancers in patients aged from 4 months to 109 years (mean, 50.4 ± 4. The sex ratio (M/F) was 1.3. The most frequent localizations of the cancers were the prostate (10.3%) followed by the breast (9.9%), the stomach (8.4%) and the cervix (7.2%). In women, the median age was 47.4 ± 2.9 years, and the most common cancers were breast cancer (21.2%), followed by cervical cancer (16.3%). In men, the median age was 53.2 ± 7.3 years and the most frequent cancers were prostate cancer (18.5%), non-Hodgkin's lymphoma (13.2%) and stomach cancer (10.7%). In children, Burkitt's lymphoma (41.8%), retinoblastoma (11.6%) and nephroblastoma (9.6%) were the most important cancers. Conclusion: Cancers are frequent in Togo, those of the prostate, breast and cervix being most important with a worse prognosis. Emphasis should be placed on early detection and diagnosis.

[Risk factors for retinal detachment in Togo]. / Facteurs de risque du décollement de rétine au Togo.

INTRODUCTION: Retinal detachment poses management problems in developing countries due to the shortage of technical equipment. Prevention passes through knowledge and elimination of risk factors. This study aimed to identify the risk factors for retinal detachment in people living in Togo. METHODS: We conducted a retrospective and descriptive study in the Department of Ophthalmology at the Chu-Campus and in an ophthalmology office in Lomé from 2 January 2011 to 31 December 2015. The medical records of patients with retinal detachment were included in the study. The diagnosis of retinal detachment was confirmed based on funduscopic exam or ocular ultrasound. RESULTS: in total, 116 eyes of 100 patients had retinal detachment of whom 40 in the RE, 44 in the LE and 16 bilaterally. The average age of patients was 46.65 ± 16.46 years [07 years; 87 years], with a male predominance and with a sex-ratio = 0.32 (W/M). Diabetic patients accounted for 17% and patients with sickle cell disease accounted for 16%. Myopic patients accounted for 5%, pseudophakic patients accounted for 17.2% and aphakic patients accounted for 3.4%. Four patients had retinal tear (14.28% of rhegmatogenous detachment) including 2 superotemporal tears, 1 inferior nasal tear and 1 inferior temporala tear. 35 eyes (52.2%) had total retinal detachment while 24 eyes (35.8%) had partial retinal detachment. Twenty eyes had vitreoretinal proliferations, 5 eyes had itreous hemorrhage and 6 eyes had hyalite. Diabetes and sickle cell disease were the risk factors for tractional RD (p=0.006 and p=0.0003) while cataract surgery was the risk factor for rhegmatogenous RD (p=0.0097). CONCLUSION: Diabetes, sickle cell anemia and eye surgery were the major risk factors for RD. A better management of these pathologies and ophthalmologist's mastery of cataract surgery may prevent retinal detachment.

Evaluation of the Histo-Epidemiological Profile of Solid Childhood Cancers in Togo.

BACKGROUND: Cancer is a subject of continuing concern, more common in adults than in children, but often with a poor outcome in the latter. Our study set itself the objective to describe the epidemiological and histological aspects of solid cancers in children in Togo. MATERIALS AND METHODS: This descriptive, cross-sectional study focused on cases of solid cancers in children diagnosed from 2010 to 2014 (5 years) at the pathology laboratory of the Tokoin teaching hospital. Data were collected from the records of that laboratory. RESULTS: We collected 66 cases of childhood cancer representing 5% of all solid cancers. The annual incidence was 13.2 cases. The sex ratio (M/F) was 1.4; mean age was of 7.2±1.6 years. The age group most affected was that of 5-9 years (40.9%). Four histological groups of solid childhood cancers were listed: lymphoma (n=34 cases; 51.5%), embryonic cancer (n=17 cases; 25.8%), sarcomas (n=13 cases; 19.7%) and carcinoma (n=2 cases; 3%). The most common histological types were Burkitt lymphoma (36.4%), nephroblastoma (10.6%) and retinoblastoma (10.6%). CONCLUSIONS: This study shows that solid cancers in children are relatively frequent in Togo with a male predominance. They are still largely dominated by Burkitt lymphoma, followed by retinoblastoma and nephroblastoma.

[Management and functional results of traumatic cataract in the central region of Togo]. / Prise en charge et résultats fonctionnels des cataractes traumatiques dans la région centrale du Togo.

INTRODUCTION: Traumatic cataract is a serious condition because it can cause partial or total vision loss. Our study aims to assess the postoperative functional outcomes of patients undergoing surgery for traumatic cataract in the Central region of Togo. METHODS: We conducted a retrospective study based on the analysis of medical records of patients who underwent surgical treatment for traumatic cataract in hospital based and outreach eye care services between 1 January 2009 and 30 June 2011. RESULTS: Out of a total of 1086 cases with cataract undergoing surgery during this period, 131 (12.06%) had traumatic cataract. The average age was 30.01 ± 16.61 years, ranging betrween 5 and 70 years, 85% of patients underwent implantation with good or average success rates of 66% after correction in the first postoperative day (according to WHO classification). At two months follow up, 85% of patients had visual acuity above 3/10. CONCLUSION: Despite micro-ophthalmic surgery advances, access to traumatic cataract surgery remains difficult for both the patient and the practitioner, especially in developing countries. For these reasons priority must be given to ocular trauma prevention.