Causes of visual impairment and blindness among Yemenis with diabetes: a hospital-based study.

We assessed the causes of visual impairment and blindness in 694 diabetic patients attending our eye centre in Sana'a, Yemen from 2001 to 2005 by review of their medical records. The mean age of the patients was 53.9 (SD 11.52) years, range 13-95 years, and 382 (55%) were males. According to the World Health Organization definitions, 273 (39.3%) patients had visual impairment and 109 (15.7%) were blind. Cataract, proliferative diabetic retinopathy (PDR) and diabetic maculopathy were the main causes of visual impairment and blindness. Patients with PDR and maculopathy were significantly more likely to have visual impairment compared to patients without retinopathy (RR = 1.99, 95% CI: 1.74-2.28 and RR = 1.84, (95% CI: 1.60-2.13 respectively) and be blind (RR = 4.69, 95% CI: 3.70-5.95 and RR = 2.53, 95% CI: 1.92-3.34 respectively). Diabetic retinopathy is a public health problem in Yemen and national screening and educational programmes are highly needed to reduce the risk of visual impairment and blindness among diabetics.

Causes of visual impairment and blindness among Yemenis with diabetes: a hospital-based study

We assessed the causes of visual impairment and blindness in 694 diabetic patients attending our eye centre in Sana'a, Yemen from 2001 to 2005 by review of their medical records. The mean age of the patients was 53.9 [SD 11.52] years, range 13-95 years, and 382 [55%] were males. According to the World Health Organization definitions, 273 [39.3%] patients had visual impairment and 109 [15.7%] were blind. Cataract, proliferative diabetic retinopathy [PDR] and diabetic maculopathy were the main causes of visual impairment and blindness. Patients with PDR and maculopathy were significantly more likely to have visual impairment compared to patients without retinopathy [RR = 1.99, 95% CI: 1.74-2.28 and RR - 1.84, [95% Cl: 1.60-2.13 respectively] and be blind [RR - 4.69, 95% Cl: 3.70-5.95% and RR= 2.53, 95% CI: 1.92-3.34 respectively]. Diabetic retinopathy is a public health problem in Yemen and national screening and educational programmes are highly needed to reduce the risk of visual impairment and blindness among diabetics

Profile of childhood blindness and low vision in Yemen: a hospital-based study.

ABSTRACT A retrospective review of records determined the frequency and causes of low vision and blindness in all children aged < 16 years attending an ophthalmic practice in Sana'a, Yemen between January and December 2001. Of the 1104 children studied, 45 (4.1%) were found to have bilateral blindness and 115 (10.4%) were unilaterally blind; 48 children (4.3%) were bilaterally visually impaired and 109 (9.9%) were unilaterally visually impaired. The main causes of bilateral blindness included cataract, glaucoma and retinal disorders. The most common causes of bilateral low vision included refractive errors, keratoconus and retinal disorders. These results provide a basis for planning blindness prevention programmes in Yemen.

Causes of blindness in people aged 50 years and over: community-based versus hospital-based study.

The causes of blindness in Yemen were determined in people aged 50+ years in both a community- and hospital-based study and documented using WHO/PBL criteria. In the community sample of 707 individuals in a rural area of Taiz governorate the prevalence of bilateral blindness was 7.9% and the main causes were cataract (71.4%) and age-related macular degeneration (ARMD) (14.3%). Corneal opacities and uncorrected aphakia were rare (1 case each) and there were no cases of diabetic retinopathy. Unilateral blindness was found in 8.6% of the community sample. In a case-notes review of 1320 new patients attending an eye clinic in Sana'a, bilateral blindness was documented in 26.5% and unilateral blindness in 9.0% (main causes: cataract, glaucoma, ARMD, diabetic retinopathy, corneal opacities and trauma.

Causes of blindness in people aged 50 years and over: community-based versus hospital-based study

The causes of blindness in Yemen were determined in people aged 50+ years in both a communityand hospital-based study and documented using WHO/PBL criteria. In the community sample of 707 individuals in a rural area of Taiz governorate the prevalence of bilateral blindness was 7.9% and the main causes were cataract [71.4%] and age-related macular degeneration [ARMD] [14.3%]. Corneal opacities and uncorrected aphakia were rare [1 case each] and there were no cases of diabetic retinopathy. Unilateral blindness was found in 8.6% of the community sample. In a case-notes review of 1320 new patients attending an eye clinic in Sana'a, bilateral blindness was documented in 26.5% and unilateral blindness in 9.0% [main causes: cataract, glaucoma, ARMD, diabetic retinopathy, corneal opacities and trauma

Profile of childhood blindness and low vision in Yemen: a hospital-based study

A retrospective review of records determined the frequency and causes of low vision and blindness in all children aged <16 years attending an ophthalmic practice in Sana'a, Yemen between January and December 2001. Of the 1104 children studied, 45 [4.1%] were found to have bilateral blindness and 115 [10.4%] were unilaterally blind; 48 children [4.3%] were bilaterally visually impaired and 109 [9.9%] were unilaterally visually impaired. The main causes of bilateral blindness included cataract, glaucoma and retinal disorders. The most common causes of bilateral low vision included refractive errors, keratoconus and retinal disorders. These results provide a basis for planning blindness prevention programmes in Yemen

Causes of blindness and visual impairment in the West of Scotland.

AIMS: To determine the overall reported incidence and causes of registrable blindness and visual impairment in the West of Scotland and any trends that have occurred in the previous 16 years since data from the same area were published. METHODS: Data for analysis were obtained from BP1 registration forms returned to the Resource Centre for the Blind serving the Strathclyde region in the West of Scotland between 1 April 1996 and 31 March 1997. RESULTS: A total of 1595 visually handicapped people were registered during the study year. Of these, 99 forms (6.2%) were excluded from further analysis because of insufficient information. The remaining 1496 completed BP1 Forms were in respect of 530 males and 966 females. Of these, 253 males and 450 females were legally blind (total 703 or 47.0%) and 277 males and 516 females were partially sighted (total 793 or 53.0%). The five leading causes of blindness, in decreasing frequency, were age-related macular degeneration (ARMD), glaucoma, diabetic retinopathy, myopic degeneration, and optic atrophy. ARMD and diabetic retinopathy were the most common causes of blindness in those over 65 years and persons of working age, respectively. CONCLUSIONS: In adults, cataract is no longer a significant cause of registrable visual impairment. The proportions of registrations owing to glaucoma, diabetic retinopathy, and myopia have not significantly changed since 1983 and the proportion owing to macular degeneration has increased. In children, congenital glaucoma, cataract, and corneal infection were no longer causes of registration, but impairment of vision caused by brain damage is now a significant contributor.

Regionalisation of retinopathy of prematurity (ROP) screening improves compliance with guidelines: an audit of ROP screening in the Northern Region of England.

AIMS: This project was designed to determine whether a coordinated regional strategy can improve the implementation of national guidelines for screening for retinopathy of prematurity (ROP), and to identify causes for failure of compliance. METHODS: Retrospective case note audit relating to two periods, 1990-1 and 1994, involving all 17 neonatal intensive care units in the Northern Region of England. Between the two periods, a regional strategy was instituted in an endeavour to improve compliance. Babies born in or admitted to the units during the study periods who were eligible for ROP screening were included. Screening performance was assessed against a standard of 100% compliance with the guidelines. In the second audit period compliance with subsidiary standards was also measured, and reasons for failure were identified. RESULTS: Compliance improved from 47% (262/558) in the first audit cycle to 73% (264/360) in the second. Subgroup analysis in this second cycle indicated better compliance (93.3%) in higher risk babies (< or = 29 weeks' gestational age). Babies transferred between units, discharged home before screening, or who failed to qualify for screening on one of the two defined criteria, were more likely to be missed. CONCLUSION: A carefully implemented regional approach to screening resulted in a higher uptake for babies most at risk. Simple recommendations are made to achieve further improvement in compliance with the guidelines. The wider implications for screening in other conditions and in other areas and specialties are highlighted.

Visual impairment in children with acute nontraumatic coma.

PURPOSE: To determine the incidence and severity of visual impairment in children following acute nontraumatic coma. METHODS: An 18-month prospective epidemiologic study of acute nontraumatic coma was undertaken in the former Northern NHS Region of England. Children aged >1 month and <16 years were included in the study if they had a Glasgow Coma Score of < or = 12 for >6 hours or if they died within 6 hours of the onset of decreased levels of consciousness. For survivors, ophthalmologic assessments were performed 6 weeks and 12 months after presentation. RESULTS: Two hundred eighty-seven children were included in the study, of whom 127 died. Of the 137 examined survivors, 35 had visual abnormalities suspected by the examining neurologist during the ophthalmic assessment. Of these, visual impairment was confirmed in 10 children at the 6-week assessment by the pediatric ophthalmologist. At the 1 2-month assessment, visual impairment remained stable in 9 children and improved in 1. CONCLUSION: In this study, 6.6% of children surviving acute nontraumatic coma had visual impairment that persisted at the 12-month follow-up examination. Incidence of visual impairment in acute nontraumatic coma is 0.97 per 100,000 children per year.

Genetic heterogeneity in familial exudative vitreoretinopathy; exclusion of the EVR1 locus on chromosome 11q in a large autosomal dominant pedigree.

BACKGROUND/AIMS: Familial exudative vitreoretinopathy (FEVR) is associated with mutations in the Norrie disease gene in X linked pedigrees and with linkage to the EVR1 locus at 11q13 in autosomal dominant cases. A large autosomal dominant FEVR family was studied, both clinically and by linkage analysis, to determine whether it differed from the known forms of FEVR. METHODS: Affected members and obligate gene carriers from this family were examined by slit lamp biomicroscopy, indirect ophthalmoscopy, and in some cases fluorescein angiography. Patient DNAs were genotyped for markers at the EVR1 locus on chromosome 11q13. RESULTS: The clinical evaluation in this family is consistent with previous descriptions of FEVR pedigrees, but linkage analysis proves that it has a form of FEVR genetically distinct from the EVR1 locus on 11q. CONCLUSION: This proves that there are at least three different loci associated with comparable FEVR phenotypes, a situation similar to that existing for many forms of retinal degeneration.