Associations between ocular biometry and anthropometric measurements in a Nigerian population.

PURPOSE: The study aimed at determining the associations between ocular biometry and anthropometric measurements in a Nigerian adult population. SUBJECTS AND METHODS: Participants were healthy members of staff and students of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife. The height and weight were measured, and the body mass index (BMI) was calculated. Ocular axial length (AL), anterior chamber depth (ACD), keratometric readings (K) and corneal radius of curvature were measured with the IOL Master. Data were analysed with SPSS version 16 (IBM Corporation), and associations between ocular biometric variables and anthropometric measurements were explored. RESULTS: Three hundred and fifty healthy participants aged 18-60 years (mean age: 34.8 ± 11.2 years) were enrolled. Height was significantly positively correlated with AL (r = 0.37, P< 0.01) and ACD (r = 0.17, P = 0.01) and negatively correlated with K (r = -0.28, P< 0.01). A significant positive correlation was found between weight and AL (r = 0.13, P = 0.02) while the BMI was only negatively correlated with ACD (r = -0.11, P = 0.04). In multivariate analysis, the relationship between height and AL (R2 = 0.58, P< 0.01) as well as ACD (R2= 0.11, P< 0.01) persisted. The relationship between weight and AL and that between BMI and ACD were totally abolished after controlling for age and height. CONCLUSION: The body height is independently associated with ocular AL and ACD while the body weight and BMI are not independently associated with any of the ocular biometric indices studied.

Distribution of phthisis bulbi and status of fellow eyes at a tertiary eye-care centre in Nigeria: a ten-year review.

BACKGROUND: Phthisis bulbi is an irreversible cause of visual loss with insufficient evidence about its aetiology and status of patients' fellow eyes. OBJECTIVES: To identify the distribution of patients with phthisis bulbi and determine the status of their fellow eyes at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. METHODS: We analysed data retrospectively retrieved from medical records of patients diagnosed with phthisis bulbi at initial clinic visit from January 2008 to December 2017. Information abstracted included biodata, laterality of phthisical eye, duration and aetiology of phthisis bulbi, visual acuity, and morbidities present in fellow eyes. RESULTS: Seventy-nine patients presented with unilateral phthisis bulbi. The mean age was 51±21.2 years and forty (50.6%) were males. The commonest aetiologies of phthisis bulbi were trauma 37 (46.8%), infection 17 (21.5%) and uveitis/inflammation 11 (13.9%). Seventy (88.6%) patients had morbidities in their fellow eye such as glaucoma 26 (32.9%), refractive errors 23 (29.1%) and cataract 22 (27.9%). Forty (50.6%) patients were either visually impaired or blind in their fellow eye (p=0.001). CONCLUSION: The commonest cause of phthisis bulbi was trauma. Approximately nine out of ten patients had ocular morbidities in their fellow eye. A thorough follow-up of patients with phthisis bulbi is recommended.

Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020.

OBJECTIVES: Retinopathy of prematurity (ROP) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for ROP between 2017 and 2020 as well as the outcome of these activities in Nigeria. DESIGN: Descriptive case study. SETTING: Neonatal intensive care units in Nigeria. PARTICIPANTS: Staff providing services for ROP, and 723 preterm infants screened for ROP who fulfilled screening criteria (gestational age <34 weeks or birth weight ≤2000 g, or sickness criteria). METHODS AND ANALYSIS: A WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity-building, national and international collaborative activities between 2017 and 2018. A national protocol for ROP was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017-2018 and to assess challenges in service provision. RESULTS: In 2017 only six of the 84 public neonatal units in Nigeria provided ROP services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any ROP; and 29 (22.8%) developed type 1 ROP. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challenges included lack of equipment to regulate oxygen and to document and treat ROP, and lack of data systems. CONCLUSION: ROP screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and ROP treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential.

Intraocular pressure variation after conventional extracapsular cataract extraction, manual small incision cataract surgery and phacoemulsification in an indigenous black population.

INTRODUCTION: intraocular pressure changes have been reported following the various cataract surgical technique. This study aims to compare the intra-ocular pressure (IOP) variation following conventional extra-capsular cataract extraction (ECCE), manual small incision cataract surgery (MSICS) and phacoemulsification in an indigenous black population. METHODS: a comparative cross-sectional study of adult patients aged 40 years and above who had pressure was measured with Goldman's applanation tonometer pre-operatively and 1st day, 1st week, 1st month as well as 3rd month post-operative periods and recorded. Data was analyzed using SPSS version 21. Mean IOP changes between study groups were compared using ANOVA. P-value of < 0.05 was taken as statistically significant. RESULTS: total of 82 patients consisting of 20(24.4%) ECCE, 32(39%) MSICS and 30(36.6%) phacoemulsification with mean preoperative 13.4mmHg, 13.5mmHg and 14.1 mmHg (p = 0.657) respectively was studied. Mean IOP increased from baseline at 1st day post-operative period in the ECCE and MSICS groups (13.4 ± 3.0mmHg to 13.7 ± 4.5mmHg (p = 0.84) and 13.5 ± 3.1mmHg to 15.3 ± 5.1mmHg (P = 0.48) respectively), and decrease in the phacoemulsification group (14.1 ± 2.6mmHg to 13.9 ± 3.5mmHg (p = 0.378). There was a decline in IOP in all the 3 study groups by one week post-operative period; the difference was significant only in the ECCE group (p = 0.032). By 3rd month postoperatively, there was a reduction in mean IOP when compared with pre-operative IOP the difference being greatest in the ECCE group. CONCLUSION: ECCE, MSICS, and Phacoemulsification cause a decline in IOP below preoperative levels at 3rd month postoperatively in the MSICS group.

Burden of family caregivers of ophthalmic patients in a university teaching hospital in south-west Nigeria.

Background: The family provides support in the care of their ill members and suffers some burden during caregiving. This study assessed the burden of family caregivers and associated factors in an ophthalmic clinic situated in a university teaching hospital in southwest Nigeria. Methods: This was a descriptive cross-sectional study where consenting family caregivers of ophthalmic patients completed a semi-structured questionnaire containing information on their socio-demographic characteristics and caregiving burden using the Zarit burden interview. Descriptive and inferential statistics analyses were done. Results: A total of 273 caregivers completed the study. The caregivers were parents (23.5%), spouses (20.1%), siblings (3.3%), children (35.9%) and other relatives (14.2%) with mean age (SD) of 38.9 (14.9) years (range 8-79 years). Majority (81.2%) experienced caregiver burden with prayer (89%) as a coping strategy. Financial support (56%) was a major caregiver need with majority (59.3%) satisfied with their relatives' hospital care. Neither the patients nor their caregivers were on health insurance scheme. Statistical significant factors associated with caregivers' burden included young age (AOR=4.63, 95%CI=1.55-13.90; p=0.01), higher education (AOR=5.51, 95%CI=2.30-13.2, p=0.01), being employed (AOR=1.72, 95CI=1.30-4.76, p=0.04), longer caregiving (AOR=3.37, 95%CI=1.27-7.02, p=0.02), and having patient on hospital admission (AOR=1.90, 95%CI=1.26-3.09, p=0.02). Conclusion: Family caregivers of ophthalmic patients experienced significant burden. Hence, they need more assistance from the health care institutions and community, including policy makers, so that they can cope with their caregiving activities. Enrollment in the social health insurance scheme will reduce out of pocket payment of hospital bills.

Outcome of trabeculectomy with Ologen versus Mitomycin C: A comparative prospective study in Bangladesh.

AIMS:: To compare the efficacy and safety of trabeculectomy with Ologen versus Mitomycin C in primary glaucoma. MATERIALS AND METHODS:: This is a prospective study of patients aged 18 years and above, diagnosed with primary glaucoma randomised to having trabeculectomy with Ologen or Mitomycin C. The primary outcome measure was success of trabeculectomy defined as intraocular pressure >5 mmHg but ≤21 mmHg. Complete success was defined as intraocular pressure achieved without anti-glaucoma medication and qualified success was defined as intraocular pressure achieved with additional anti-glaucoma medication. RESULTS:: At the end of 12 months follow-up, the postoperative mean intraocular pressure in the Ologen group was 12.8 ± 1.6 mmHg and 13.4 ± 2.2 mmHg in the Mitomycin C group. The Ologen group achieved complete success in 86.5% and qualified success in 13.5% of the patients, while the Mitomycin C group achieved complete and qualified success in 85.5% and 14.5%, respectively. There was no statistically significant difference in the success rate of both the groups ( p = 0.57). Furthermore, no significant intraocular pressure difference was noted between the two groups at the end of 12 months follow-up ( p = 0.14). CONCLUSION:: Trabeculectomy augmented with Ologen appeared to be as successful and safe as trabeculectomy augmented with Mitomycin C, with no reported adverse reaction to Ologen.

Choroidal detachment with exudative retinal detachment following Ahmed valve implantation in Sturge-Weber syndrome.

Ahmed glaucoma valve implant appears to be a relatively useful drainage device in eyes with glaucoma secondary to Sturge-Weber syndrome (SWS). However, early postoperative choroidal and exudative retinal detachment may occur from a rapid expansion of the choroidal hemangioma with effusion of fluid into the suprachoroidal and subretinal spaces. We report the case of a ten-year-old boy who had SWS with choroidal haemangioma and secondary glaucoma. He had Ahmed glaucoma valve implantation on account of the secondary glaucoma which had been refractory to both conventional medical and surgical managements. He developed choroidal and exudative retinal detachment postoperatively. However, he responded to conservative treatment and further surgical management was not required. Ahmed glaucoma valve in the treatment of glaucoma secondary to SWS is useful, but the risk of choroidal effusion with exudative retinal detachment is still present. Surgeons should be alert to this likely complication and be prepared for prompt management.

Relationship between Refraction, Anthropometrics, and Educational Status in a Nigerian Young Adult Population.

PURPOSE: The study aimed at determining the relationship between refraction and anthropometric measurements and the relationship between the level of education and refractive status in a Nigerian young adult population. MATERIALS AND METHODS: Healthy volunteers from the students and staff of a teaching hospital in South-Western Nigeria were studied. Demographic profiles including participants' highest educational status, parental educational level, and the age at first formal school enrollment were documented. The height and weight of the participants were measured. Noncycloplegic objective refraction was determined with autorefractor, and the spherical equivalent refraction (SER) of the right eye was used for analysis. SPSS 16 was used to explore the relationships between refraction, height, weight, and body mass index and the educational status of the participants. RESULTS: Two hundred and thirty-nine adults with a mean age of 28.4 ± 6.5 years comprising 116 males and 123 females were studied. The mean height, weight, body mass index, and right eye SER were 1.7 ± 0.1 m, 64.4 ± 12.2 kg, 23.6 ± 4.3 kg/m2, and -0.8 ± 1.4 D, respectively. Height was negatively correlated with the SER (R = -0.3, P < 0.01) in males but not in females. Refraction was not significantly related to weight or body mass index. Participants with higher levels of education were more likely to be myopic. Higher parental education and early formal school enrollment were significantly associated with myopia. CONCLUSION: This study demonstrated a significant positive relationship between height and myopia in male participants but not in females. Individual as well as parental higher levels of education have also shown a positive association with myopic tendency.

Burden of prostate cancer in southwestern Nigeria.

OBJECTIVES: To determine the pattern of presentation, prevalent age, hospital incidence, and outcome of management of prostate cancer in our environment. METHOD: Patients with histopathology evidence of prostate cancer managed between January 1991 and December 2007 were studied. Information entered into a pro-forma sheet and analyzed included the age of patients, clinical features, investigations, histopathology diagnosis, outcome of management, and duration of follow-up. RESULTS: During the period, 189 patients aged 46-99 years (mean, 68.0; 9.8 SD) confirmed and managed for prostate cancer were studied. The average hospital incidence (2002-2004) was 182.5 per 10(5) male admissions with 15.1-month mean duration of symptoms. Most 178 (94.2%) patients presented with advanced diseases, with 1 or multiple complications in 172 (91.0%), obstructive lower urinary tract symptoms 156 (82.5%), distant metastasis 97 (51.3%), lower back pain 95 (50.3%), weight loss 95 (50.3%), hematuria 86 (45.5%), anemia 77 (40.7%), renal failure 74 (39.2%), and inability to walk 42 (22.2%). Eighty-nine (47.0%) patients were farmers, 111 (58.7%) indulged in alcohol, and 46 (24.3%) smoked cigarettes. Mean prostate-specific antigen results available in 53 patients was 106.0 ng/mL (187.2SD) and digital rectal examination was valuable in diagnosis. Adenocarcinoma (186 [98.4%]) was the main histopathology type and most patients 136 (71.9%) had bilateral orchidectomy with or without antiandrogens. Mean duration of follow-up was 83.7 weeks. CONCLUSIONS: The burden of prostate cancer in our developing community is worrisome. It is prevalent between 46 and 99 years in our community. Presentation is late, often with urinary retention and other complications. In our setting, treatment is still essentially palliative with orchidectomy, which we found to be beneficial, acceptable, and the most affordable to our patients.