RESUMO
The objective of this work is to assess the current situation in the ophthalmology department of the tertiary care center for the conservative treatment of retinoblastoma in Niger. This was a retrospective study from January 2016 to October 2022 (6years and 10months). Retinoblastoma represents 43.27% of pediatric cancers, of which 10.92% of cases are bilateral. The mean age of our patients is 36months, with the range between 2-3years, with extremes ranging from 1month to 132months. The male sex represents 65.55% (n=78), with a sex ratio of 1.9. The distance traveled varies from 1355 kilometers in the furthest region (Diffa) from the capital to 113 kilometers in the nearest region (Tillabéry). Neighboring countries such as Mali and Benin represent 5.88% (n=5). It should be noted that 58% saw traditional healers before coming to the medical center. The most common clinical signs are leukocoria 39.5% (n=47), proptosis 34.45% (n=41) and exorbitism in 15.97% (n=19). An orbital/brain CT was ordered in 54.62% (n=65) of cases. We used the TNM classification; extraocular extension occurred in 47.90% (n=57) and intraocular cases 27.73% (n=33). Neoadjuvant chemotherapy was used in (63.03% n=74). Histology was carried out in (26.89% n=32), with the result obtained in 14days on average. The visit to traditional practitioners as well as the remoteness of certain regions contribute to the delay in diagnosis in our context. The continued implementation of the early diagnosis campaign program could reverse the trend.
RESUMO
AIM: The purpose of this study was to identify risk factors associated with the severity of acute ocular involvement in Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) in sub-Saharan Africa. PATIENTS AND METHOD: A retrospective study was carried out at the dermatology department in collaboration with the ophthalmology department for SJS/TEN patients between January 2000 and December 2016 in Lomé (Togo). The severity of acute ocular involvement was evaluated using the Power classification, and the drug eruption score was assessed using de Bastuji-Garin classification. RESULTS: A total of 107 cases of SJS/TEN (84 cases of SJS, 20 cases of TEN and 3 cases of overlap syndrome) were analyzed. There were 71 women and 36 men, with an average age of 32.3±12.5 years (range: 5 to 75 years). Sulfonamides (37.4%) were the most commonly used drugs followed by nevirapine (22.4%). HIV serology was positive in 46 (58.2%) of the 79 patients tested. A total of 54 (50.5%) patients had acute ocular involvement, which was mild in 29.9% of patients, moderate in 13.1% and severe in 7.5%. In multivariate analysis, exposure to sulfadoxine was the sole factor associated with moderate or severe acute ocular involvement in SJS/TEN (adjusted odds ratio=3.3; 95% CI=[1.1; 10.2]). CONCLUSION: Exposure to sulfadoxine was identified in our study as a risk factor associated with the severity of acute ocular involvement in SJS/TEN. Multicenter studies should be conducted in sub-Saharan Africa to confirm this associated risk factor.