Risk factors for pterygium recurrence after surgical excision with combined conjunctival autograft (CAG) and intraoperative antimetabolite use.

BACKGROUND: To identify the determinants of recurrence following primary pterygium excision combined with conjunctival autograft (CAG) and intraoperative use of Mitomycin C (MMC) or 5-Fluorouracil (5-FU). METHODS: A randomized controlled clinical trial comparing 5-FU (50 mg/ml) plus CAG versus MMC (0.01%) plus CAG in preventing recurrence of primary pterygium following excision. RESULTS: A total of 80 eyes of 80 subjects were studied, with 46 eyes in the 5-FU group and 34 eyes in the MMC group. The mean age was 50.7 +/- 13.1 years with a male: female ratio of 0.95:1. Mean follow up period was 35.2 +/- 29.1 weeks. The overall recurrence rate was 10%, with a rate of 8.7% in the 5-FU group and 11.8% in the MMC group. The mean age of the patients who had a recurrence was 38.1 +/- 13.3 years compared to 52.1 +/- 12.4 years in those without a recurrence (p = 0.003). The median size of the pterygium in patients who had a recurrence was 3.2mm, while the median size in patients who did not have a recurrence was 3.0mm (p = 0.8). Five (12.8%) males had a recurrence compared to three (7.3%) females (p = 0.48); while 10.5% of fleshy pterygia recurred compared to none (0%) of the non-fleshy pterygia (p = 1.00). CONCLUSION: Younger age remains a risk factor for recurrence when both CAG and antimetabolites are combined in the treatment of pterygium, while the effect of gender, size and morphology of the pterygium may be diminished by such combination.

Outcome of trabeculectomy with 5-fluorouracil using releasable suture technique in a Nigerian Tertiary Hospital.

BACKGROUND: Trabeculectomy has undergone a series of modifications in recent times most of which are aimed at improving the efficacy of the procedure while reducing complications. The use of releasable sutures is one of such modifications. OBJECTIVE: To assess the efficacy and complications associated with the use of releasable sutures and 5-Fluorouracil(5-FU) in trabeculectomy among indigenous African patients with primary open angle glaucoma. METHODS: This was a chart review of 22 eyes of 17 patients diagnosed with primary open angle glaucoma. All the eyes included in the review had trabeculectomy with 5-Fluorouracil using releasable suture technique with postoperative clinic follow- up visit for a minimum period of 72 weeks. Information sought included patient's demographics, preoperative antiglaucoma medications, pre- and post- operative intraocular pressure, and associated complications. RESULTS: There were 17(13 M, 4 F) patients with 22 eye surgeries. Their mean age was 49.8 ± 9.3 years. The mean preoperative intraocular pressure was 27.7 ± 5.9 mmHg. The intraocular pressure on the first post-operative day was 10.6 ± 11.1 mmHg. The mean pressure before the removal of the releasable suture was 14.1 ± 10.8 mmHg and after removal was 6.0 ± 7.2 mmHg, (p > 0.0001). The mean intraocular pressure at 72 weeks of follow up was 16.9 ±5.6 mmHg. A qualified success rate of 81.8% was achieved in terms of intraocular pressure control. There were two eyes complicated by blebitis and an eye complicated by malignant glaucoma. CONCLUSION: The use of releasable suture in trabeculectomy helped in maintaining the intraocular pressure at a lower level in the early postoperative period and in reducing postoperative shallowing of the anterior chamber. The procedure appears to be associated with some sight- threatening complications such as endophthalmitis.

Survey of blindness and low vision in Egbedore, South-Western Nigeria.

BACKGROUND: Developing efficient and cost-effective eye care programmes for communities in Nigeria has been hampered by inadequate and inaccurate data on blindness and low vision. OBJECTIVE: To determine the prevalence and causes of blindness and low vision among adults 50 years and older in South-Western Nigeria in order to develop viable eye care programme for the community. METHODS: Twenty clusters of 60 subjects of age 50 years and older were selected by systematic random cluster sampling. Information was collected and ocular examinations were conducted on each consenting subject. Data were recorded in specially designed questionnaire and analysed using descriptive statistical methods. RESULTS: Out of the 1200 subjects enrolled for the study, 1183(98.6%) were interviewed and examined. Seventy five (6.3%)) of the 1183 subjects were bilaterally blind and 223(18.9%) had bilateral low vision according to WHO definition of blindness and low vision. Blindness was about 1.6 times commoner in men than women. Cataract, glaucoma and posterior segment disorders were major causes of bilateral blindness. Bilateral low vision was mainly due to cataract, refractive errors and posterior segment disorders. CONCLUSION: The prevalence of blindness and low vision in this study population was high. The main causes are avoidable. Elimination of avoidable blindness and low vision calls for attention and commitment from government and eye care workers in South Western Nigeria.

The dangers of bunk beds to the eye - a case report and preventive measures.

This is to illustrate the case of a 14 year old male student of a secondary school who fell off the top of an unguarded bunk bed in his hostel while sleeping and sustained a fracture of the left orbital margin, severe periorbital echymosis and conjunctivitis. He was managed conservatively. Two weeks post injury; the swelling resolved. At 2 months post injury, he improved tremendously and his visual acuity in the affected eye was 6/6. The swelling resolved and his anterior and posterior segments were normal. The patient was lucky to have had an intact eyeball. If it had been a penetrating eye injury, it could have been disastrous. Blinding eye injuries may be irreversible.Unguarded bunk beds may be dangerous to the eye. A recommendation of minimal standard for bunk-beds for children or no bunks at all in schools is suggested.

Visual outcome of cataract surgery in University College Hospital, Ibadan Nigeria.

BACKGROUND: Cataract is a leading cause of avoidable blindness, while cataract surgery is the commonest major surgical procedure worldwide. OBJECTIVE: To evaluate the visual outcome and causes of poor vision in patients who had cataract extraction at a major hospital in Nigeria. METHODS: A retrospective study of the case notes of patients who had cataract extraction in the Eye Clinic of University College Hospital, Ibadan between July and Dec. 2004 was done. The visual outcome was analyzed using the WHO categorization of visual outcome and those with poor visual outcome evaluated for the cause of such poor outcome. RESULTS: Forty-seven (40.2%) of the eyes had good outcome before refraction and the number increased to 80 (67.8%) after correcting for postoperative refractive error. The highest single cause of poor visual outcome was uncorrected refractive error, 32 (47%) eyes. Other causes included posterior capsule opacification 7 (18.4%) eyes, preexisting ocular co-morbidity such as glaucoma, optic atrophy and maculopathy 6 (15.9%) eyes. CONCLUSIONS: This review showed that uncorrected refractive error and posterior capsular opacification were the major causes of poor visual outcome after cataract surgery. Preoperative biometry for all patients, meticulous intra operative cortical clean up, adoption of the cataract surgery outcome tally sheet and better patient selection will help improve the outcome of our cataract surgeries.

The effect of timolol maleate on tear film break-up time in Nigerians.

The aim of this study was to evaluate the effect of Timolol maleate on tear film break-up time in a Nigerian population. 192 eyes of 96 subjects were examined in a hospital based case-control study after being administered pre-coded questionnaires. The mean tear film break-up time was measured. There was significant difference (t = 10.164, P < 0.001) in the mean break-up time of cases (10.45 secs) and controls (30.18 secs). Half of the cases had some ocular discomfort with the instillation of Timolol maleate, a significant number of them having just been commenced on the medication (chi2 = 8.889, P = 0.003). Long-term instillation of Timolol maleate impairs tear film stability. The ocular discomfort experienced by patients on Timolol may contribute to poor drug compliance observed in patients on chronic drug therapy. Regular screening of patients on Timolol maleate for tear film instability and dry eyes is important and drug manufacturers should explore the possibility of incorporating artificial tears in Timolol maleate preparation.

Combined central retinal artery and vein occlusion complicating orbital cellulitis.

Orbital Cellulitis is a dreaded ophthalmologic disease. It may destroy vision and the eye and may even become life threatening. Often visual loss is the result of exposure and subsequent destruction of ocular tissue commonly the cornea and the uvea. We report a case of combined central retinal artery and vein occlusion complicating orbital cellulitis in a 35 year old patient who was 37 weeks pregnant resulting in loss of vision in the affected eye. There have been few case reports of this type of complication of orbital cellulitis.

A systematic review of network meta-analyses among patients with nonvalvular atrial fibrillation: A comparison of efficacy and safety following treatment with direct oral anticoagulants.

BACKGROUND: Direct oral anticoagulants (DOACs) are indicated for the prevention of stroke and systemic embolism (SE) in patients with nonvalvular atrial fibrillation. While no head-to-head randomized controlled trials (RCTs) exist that evaluate the efficacy and safety of DOACs, network meta-analyses (NMAs) based mainly on RCTs for each DOAC and using various methodologies have been published. This systematic literature review summarizes the evidence on stroke/SE bleeding events, mortality, and other adverse events from NMAs that reported indirect comparisons of DOACs. METHODS: Searches were conducted in PubMed, Embase, and the Cochrane Database of Systematic Reviews to identify NMAs published between January 2010 and March 2017 that compared vitamin K antagonists or DOACs using RCT data. Comparisons on stroke/SE and major bleeding (MB), as well as secondary outcomes, for DOAC versus DOAC comparisons were extracted and summarized using apixaban as the reference. RESULTS: Twenty-two NMAs were included in the final summary: All assessed MB; 15 assessed stroke/SE. No statistically significant differences were observed for apixaban compared with any DOAC in the 15 NMAs that assessed stroke/SE. Apixaban was associated with a lower risk for MB compared with rivaroxaban in 16 of 20 NMAs and dabigatran 150 mg in 13 of 16 NMAs. Four of 6 NMAs showed lower risk for GI bleeding for apixaban compared with rivaroxaban and dabigatran 150 mg; however, this outcome was not assessed by most NMAs. CONCLUSION: This systematic literature review of NMAs showed varying levels of bleeding risk among DOACs, with apixaban generally having a lower risk than rivaroxaban and dabigatran 150 mg.

Conjunctival hyperaemia and other ocular adverse effects on healthy African subjects after single dosing with 0.004% Travoprost.

Conjunctival hyperaemia and ocular adverse effects induced by a single dose of 0.004% travoprost in healthy subjects were evaluated. A randomized, double-blind cross-over placebo controlled study was done. Conjunctival hyperaemia was evaluated clinically at 12, 24, 36 and 72 hours after dosing and volunteers reported all ocular adverse effects. 15 out of 20 subjects (70%) dosed with travoprost compared with 2 out of 20 (10%) dosed with placebo developed clinically moderate hyperaemia. However, significant difference in hyperaemia in the two groups occurred only at 24 hours (P < 0.048). The hyperaemia cleared by 72 hours. Travoprost may cause significantly short-term conjunctival hyperaemia even after a single dose in the eyes of healthy African subjects.

Visual standards in commercial driving.

OBJECTIVES: The study was carried out to review the ocular factors involved in road traffic accidents (RTA) in order to reduce associated injuries and possibly suggest a standard for driving. MATERIALS AND METHODS: The study was carried out in the eye clinic of Ladoke Akintola University of Technology Teaching Hospital, Osogbo between May and June 2004. A stratified random sample technique was used to select 99 drivers (198 eyes) from 6 motor park units. Information obtained included age, sex, past history of road traffic accident (RTA), visual acuity and field, colour vision and ability to read number plate tests. RESULTS: Six drivers (6.1%) were visually impaired. There were 5 cases of monocular blindness. Twenty (20.20%) drivers had accidents in the past, 24(24.24%) could not read number plate at 20.5meters, 6 (6.1%) were colour blind while 36 had visual field loss within 120 degrees horizontally. All the six drivers that had visual field loss encroaching within 20 degrees of fixation had accidents in the past. CONCLUSION: This study has shown that there is need to improve on the standard of vision testing before licenses are issued or renewed. Where visual acuity alone is used, it must be done properly by testing one eye at a time. However, a comprehensive eye test using a battery of tests comprising visual acuity, colour vision, visual field and number plate test at 20.5 meters before first issue of driving license and at renewals will be better. Drivers with visual impairment or inability to read number plate test at 20.5 meters should be disqualified from driving commercial vehicles. Drivers with monocular blindness or visual field loss encroaching within 20 degrees of fixation must also not be allowed to drive commercial vehicles. However, further large scale studies will be necessary in order to prove all these propositions scientifically.

LONG TERM OUTCOMES OF AUGMENTED TRABECULECTOMY WITH 5-FLUOROURACIL IN NIGERIA.

BACKGROUND: Glaucoma in sub-Saharan Africa has been described as a surgical disease because of the high cost of medical treatment, poor compliance and unavailability of medications. AIM: This study reports the long-term outcomes and complication rates following trabeculectomy with 5-fluorouracil in a case series of Nigerians. DESIGN OF STUDY: This was a retrospective, observational, non-comparative case series. SETTING: University College Hospital, Ibadan, Nigeria. METHODOLOGY: Each patient had complete ophthalmic evaluation. The post-operative intraocular pressure (IOP), visual acuity outcomes and post operative complications were assessed. The World Glaucoma Association consensus on surgical outcome was used to evaluate surgical outcome. RESULTS: Of the 292 patients who presented with glaucoma during this period, a total of 47 eyes of 31 patients (10.6%) had trabeculectomy with 5-FU. The mean presenting intraocular pressure (IOP) was 31.8±12.2mmHg. At three years post-operatively, 48.5% achieved complete success without medications while 90.9% achieved success with or without medications at an IOP cut off of ≤21mmHg. At the same time point of 3 years and an IOP cut off of ≤15mmHg, 63.6% achieved success with or without medications. At a mean post-operative period of 43± 19.6 months, (range 12-86 months), mean IOP had reduced from a preoperative mean of 31.8±12.2mmHg to 15.4±4.7mmHg (P<0.001). CONCLUSION: Trabeculectomy with 5-Fluorouracil is effective in the long term in reducing IOP with minimal complications in this population of Nigerians.

Neovascular glaucoma in a Nigerian African population.

OBJECTIVE: To determine the ocular and systemic factors associated with neovascular glaucoma (NVG) in an African population. DESIGN: Hospital based cross sectional study. SETTING: Eye clinic, Department of Ophthalmology, University College Hospital, Ibadan, Nigeria. SUBJECTS: Sixty one consecutive patients with clinical diagnosis of NVG seen between January 1995 and December 1999 had a complete ocular evaluation. RESULTS: Among the 61 subjects studied with an identifiable aetiological factor presumably causing neovascular glaucoma, 82% had associated posterior segment diseases producing ischaemia. These were retinal venous obstruction (78.7%), retinal arterial occlusion (1.6%). Those with no identifiable vaso-occlusive disease had couching (11.5%), aphakia with vitreous loss (3.3%) and chronic uveitis (1.6%). Systemic arterial hypertension was present in 62.3% while diabetes mellitus was present in only 8.3% of the subjects studied. Chronic uveitis and penetrating eye injury were infrequently diagnosed. Chronic open angle glaucoma was present in the other eye of 37.7% of subjects. Neovascular glaucoma was unilateral in 95.1% of subjects. 84.4% of affected eyes were blind on presentation. Males outnumbered females among subjects with NVG above 40 years, while females outnumbered males in the subjects below 40 years of age. Eyes of that were couched constitute a significant proportion of subjects with neovascular glaucoma. CONCLUSION: Medical conditions such as systemic hypertension, diabetes and ocular conditions like retinal vein, retinal artery occlusion, couching and glaucoma were associated with NVG. Most of these ocular and systemic associations should be identified early and treated to prevent neovascular glaucoma in the other eye of the subject.

Corneal diameters in infants born in two hospitals in Ibadan, Nigeria.

OBJECTIVES: To measure the horizontal corneal diameters in infants at birth and compare with values reported in other studies. DESIGN: A cross-sectional hospital based study. SUBJECTS: All the healthy infants born within the period of one month in these hospitals were eligible for enrolment into the study. Horizontal corneal diameter measurements were performed with indirect caliper in both eyes of each of the 342 healthy full term infants and 25 preterm healthy infants born in these two hospitals. These results were evaluated according to the age of the infants RESULTS: The corneal diameter in term infants was found to range from 9.00 mm to 12.50 mm during the first week of life with a mean of 10.26 mm (SD +/-0.59 mm, n = 64). This is higher than what was reported for Caucasian infants (P < 0.01). Mean horizontal corneal diameter in all male infants aged 1-238 days was 11.06 mm (SD 0.75 mm, n = 187), slightly higher than 10.93 mm (SD 0.22 mm, n = 154) in all females, though this difference was not statistically significant. Horizontal corneal diameter increased progressively with age, from a mean value (SD) of 10.26 mm (0.72) to a mean value (SD) of 12.0 mm at 34 weeks of age. There was no significant difference in the mean corneal diameter of the right and left cornea. A few infants had corneal diameters of 12.50 mm and had no congenital glaucoma. Mean corneal diameter in preterm infants less than 37 weeks of gestation was 8.90 mm at birth (SD 1.25 mm, n = 25). CONCLUSION: The horizontal diameter increased with age from birth to the 34 weeks of age. Changes after this period were not studied. The values obtained in these African infants were slightly higher than those reported from other populations.

Presumed hereditary retinal degenerations: Ibadan experience.

BACKGROUND: Retinitis pigmentosa (RP) is a hereditary retinal degenerative condition with no known treatment. Associated ocular conditions, such as cataract and glaucoma, when present further worsen vision, but these conditions are often treatable. There are, however, no known reports of cataract or glaucoma surgery in subjects with RP in Nigeria. This study describes the clinical presentation of RP, the prevalence of associated treatable disorders and the characteristics of patients with severe visual impairment and blindness. METHOD: A retrospective review of 52 cases presumed and diagnosed to have. RP was performed on patients who presented at the Eye Clinic, University College Hospital, Ibadan over a three-year period. The cases were classified into clinical types; those with associated treatable eye conditions were identified and those with severe visual impairment and blindness were further evaluated. RESULTS: Retinitis pigmentosa was an uncommon clinical condition in patients who presented at the Eye Clinic being 0.69% (n = 52) of a total of 7,520 new outpatients recorded during a 3-year period. Typical RP were 44 in number representing 84.0% of these cases. Those diagnosed with very early onset RP, with severe visual impairment and nystagmus may have been congenital Leber's amaurosis. Retinitis pigmentosa with systemic features and atypical RP were uncommon. However, 34.5% had cataract (mostly posterior subcapsular cataract), while 11.4% had high intraocular pressure and these were mostly in couched eyes. Risk factors for severe visual disability and blindness were cataract, age and secondary glaucoma as a result of couching. CONCLUSION: Treatable ocular conditions associated with RP are not uncommon. RP patient tend to have cataract which if neglected may result in total blindness.

Modified bare sclera method for the treatment of primary pterygium: a preliminary report.

INTRODUCTION: The bare sclera technique is still in use by many surgeons worldwide in spite of the attendant high recurrence rate. Any modification of this well known procedure may be more widely acceptable if associated with lower recurrence. METHOD: The bare sclera technique was modified by performing a partial thickness sclerectomy from the pterygium bed. This modified technique was applied to 23 eyes of 17 patients with primary pterygium. The subjects were followed up for varying periods between 8 to 31months to determine the recurrence rate of pterygium after surgical excision and other complications. RESULTS: Initial observation showed that the recurrence occurred in two eyes of two patients of a series who were followed up for a minimum of six months and up to thirty-one months. Two other eyes developed suture granuloma. There were no other complications observed in the remaining twenty eyes of fifteen patients. CONCLUSION: Partial thickness sclerectomy when performed with standard bare sclera technique seems promising and may improve the results of pterygium excision by bare sclera method.

Ocular findings seen among the staff of an institution in Lagos, Nigeria.

BACKGROUND: The degree to which ocular morbidity affects workers productivity in the developing countries has not been studied adequately. A federal government research institute based in Lagos introduced an annual health screen for all its workers, which included eye tests. This provided an opportunity to study the pattern of ocular conditions among workers who were 30 years and above, and to determine the effect of eye diseases on the workers productivity. STUDY DESIGN: Detailed eye examination including refraction, was done on every respondent at the institution's clinic by an ophthalmologist. A questionnaire on ocular health status and occupational history was administered independently by an ophthalmic nurse. Sickness absenteeism, use of the clinic were obtained from clinic records, and the results were analysed. RESULTS: The common ocular conditions were uncorrected or poorly corrected refractive error, uncorrected or poorly corrected presbyopia and allergic. conjunctivitis. Glaucoma, maculopathy and optic atrophy were causes of severe visual impairment or blindness in 1.9 % of the subjects. Absenteeism and clinic use were more common in subjects with ocular morbidity than those with non-ocular morbidity. Subjects with ocular morbidity had more illnesses, absenteeism and used the clinic more. CONCLUSION: Ocular problems which reduce worker's productivity are prevalent among the staff of the institution studied. They are mostly unrecognised.

Tear break-up time in eyes with pterygia and pingueculae in Ibadan.

BACKGROUND: Ultraviolet (UV) rays and chronic irritation to dust have been implicated in the pathogenesis of degenerative conditions of the cornea and conjunctiva like pterygium and pinguecula. It has been postulated that exposure to these environmental factors cause corneal and conjunctival drying by disruption of the tear film. While some researchers have found tear film dysfunction in eyes with pterygia and pingueculae, others have found no such abnormalities. The differences in findings may be due to different methods of investigation, or differences based on geography and climate. STUDY DESIGN: The tear film has been studied using tear break-up time (TBUT) in adults with pterygia and pingueculae disorders, TBUT was measured in 73 eyes with pterygia and 74 eyes with pinguecula and were compared to TBUT in 74 eyes of age and sex matched normal controls. Abnormal TBUT was defined as TBUT less than 15 secs. Unstable tear film was defined as TBUT less than 10 secs. RESULTS: The mean TBUT was lower in eyes with pterygia (17.90 secs) than in control eyes (19.86 secs), although the mean difference was not statistically significant. Abnormal TBUT, defined as TBUT less than 15 secs, was found in 29 eyes out of 73 eyes with pterygia (39.7%), compared with 13 eyes out of 74 eyes with pingueculae (17.6%) and in 17(23.0%) of 74 control eyes (X2 = 10.01, df = 2, P = 0.0006). A TBUT of less than 15 secs was more significantly associated with eyes with pterygia compared to control eyes. Unstable tear film (TBUT less than 10 secs) was found in 12(16.4%) eyes with pterygia, compared to 4(5.4%) eyes with pingueculae and 4(5.4%) control eyes. Unstable tear film was significantly associated with eyes with pterygia (P = 0.027). CONCLUSION: Tear film abnormalities are associated with pterygium but not with pinguecula in the subjects studied. TBHT may vary in different populations.

Blindness and low vision in adults in Ozoro, a rural community in Delta State, Nigeria.

BACKGROUND: The objective of this article is to determine the prevalence and causes of blindness and low vision in Ozoro, a rural town of Delta State in Nigeria, in order to provide baseline information for planning a prevention of blindness programme. METHODS: A cross sectional study using a stratified random sampling method was used to select the compounds. The five communities in the town formed the different sub-groups or strata. Visual acuity were recorded for all adults 40 years and older. Persons who had visual acuity less than 6/18 were further examined to determine the cause of low vision or blindness. The WHO definition of visual impairment according to visual acuity was used as criteria for classification. RESULTS: A total of 815 persons (coverage of 51.7%) were examined using a modified WHO PBL record of blindness form. The prevalence of blindness (VA < 3/60 in the better eye) for people of 40 years and above was 6.3% (95% CI, 4.6% to 8%) and low vision VA 6/24 to 3/60 in the better eye was 25.2%. The estimated prevalence of bilateral blindness for all ages was 1.3% and low vision was 5%. The rate of blindness and low vision increased with age being highest in subjects who were 60 years and above. The main causes of blindness and low vision were cataract, accounting for 60% of all bilateral blindness and 51.7% of all low vision. Other causes of blindness include, posterior segment diseases (11.7%). Glaucoma was presumed to be cause of blindness in 9.8% of cases; others were uncorrected aphakia 5.9%, and globe abnormalities 5.9%. Refractive error was the second major cause of low vision accounting for 22% of bilateral low vision. CONCLUSION: The magnitude of blindness and low vision in this oil rich Ozoro community in Delta State is high and majority are avoidable causes of blindness.

Leukocyte migration inhibition studies and neutrophil cell function during aging in Nigerians.

In this study, in vitro cell-mediated immune response was analysed in 150 healthy Nigerians between 6 and 95 years old by the leukocyte migration inhibitory factor (L-MIF) test. Lymphocytes were activated with the mitogen concanavalin A and candida, measles virus and mycobacterial antigens. Nonspecific cellular immune capacity was studied by the Nitroblue tetrazolium (NBT) test. Numerical estimates of leukocytes and lymphocyte subpopulations were done. Mean L-MIF activity obtained with the four lymphocyte activators decreased with rising age indicating a progressive decline in cellular immune function with age. There was no significant age-related change in formazan positivity rate for both unstimulated and stimulated NBT tests. No age-related change in number was observed for any of the leucocyte and lymphocyte subpopulations. These results show that cell-mediaging response in Nigerians immunity declines, but phagocyte function is unchanged during aging. Lymphocyte depletion or numerical alteration in resting T cell subsets could not be demonstrated to be responsible for depressed cell-mediated immunity in aging Nigerians.