Prevalence and severity of diabetic retinopathy in Northwest Cameroon as identified by teleophthalmology.

OBJECTIVE: Diabetic retinopathy is a common ocular complication of diabetes mellitus, which can lead to significant visual impairment. The present study is the first to characterize the prevalence and severity of diabetic retinopathy and other ocular pathologies in a population of patients with diabetes who live in Northwest Cameroon using teleophthalmology. MATERIALS AND METHODS: A retrospective review of the electronic charts of patients at the Banso Baptist Hospital and in neighboring communities between July 1, 2007 and June 30, 2008 was completed. The eyes of 253 consecutive patients with diabetes mellitus who attended mobile teleophthalmology clinics in Northwest Cameroon were included in the study. Eyes were graded for diabetic retinopathy using stereoscopic seven-field digital retinal images obtained by a mobile team in Cameroon and graded by ophthalmologists in Canada utilizing Early Treatment Diabetic Retinopathy Study criteria. RESULTS: Diabetic retinopathy was identified in 20.6% of eyes (18.2% nonproliferative, 2.4% proliferative) and in 24.3% of patients. About 8.0% of eyes demonstrated evidence of macular edema. Additional nondiabetes-related ocular pathologies were identified in 14.6% of eyes. CONCLUSIONS: Diabetic retinopathy was found to be common in people with diabetes who attended teleophthalmology clinics in Northwest Cameroon. The prevalence of treatable disease including macular edema and retinal neovascularization suggests that improved patient access to laser photocoagulation and vitreoretinal surgery would be beneficial in reducing vision loss in this vulnerable population. As the prevalence of diabetes increases across sub-Saharan Africa, the challenge of diagnosing and managing the complications of diabetes will increase.

Identification of ocular and auditory manifestations of congenital rubella syndrome in mbingo.

Purpose. Congenital rubella syndrome (CRS) is a global cause of preventable hearing impairment, blindness, and intellectual impairment. The present study sought to identify ocular and auditory manifestations of CRS in school-aged children in Mbingo, Cameroon. Design. Cross sectional study. Subjects. Students at two schools, one for children with hearing impairment, were screened for cataract, congenital glaucoma, and pigmentary retinopathy. Methods. Students underwent seven-field digital fundus photography through a dilated pupil using a Topcon NW200 nonmydriatic camera. Images were assessed by retina specialists in Canada via teleophthalmology. Clinical evidence was integrated to form case definitions for CRS based on Center for Disease Control and Prevention guidelines. Serological evidence of rubella infection was obtained using standardized IgG antibody titers. Main Outcome Measure. Number of probable and suspicious cases of CRS. Results. Between September 2009 and May 2010, 320 students participated. There were 28 (10.2%) probable cases, 104 (37.8%) suspects, and 143 (52.0%) unaffected. Rubella IgG serology was positive in 79 (48.7%) of children with hearing impairment and 11 (7.4%) of children with normal hearing. Conclusions. The present study identified 28 probable cases of CRS. Furthermore, 92.6% of students with normal hearing did not possess rubella IgG antibodies making future cases of CRS likely without intervention.