A situational report on low vision services in tertiary hospitals in South-East Nigeria.

BACKGROUND: The prevalence of functional low vision in southeast Nigeria is reportedly the highest in the country. AIM: This study evaluated the state of low vision services and perceptions of providers and users of the service in tertiary hospitals in the region, to facilitate advocacy and planning. METHODS: This was a cross-sectional survey of available low vision services in the nine tertiary hospitals in Southeast Nigeria utilizing mixed methods. Data were collected on human resources, service delivery, and low vision equipment and devices. In-depth interviews were conducted to determine the perceptions of providers and users of the service. RESULTS: Varying levels of low vision services were actively provided in three of the nine hospitals surveyed. Services, equipment, and devices were suboptimally available. The three functional centers had a combined output of 61 patients seen within 6 months preceding the study and had at most two-thirds of required equipment. Low vision devices (LVDs) were available in varying degrees in only four (44%) of the hospitals. Twenty-one (7.6%) of the 278 eye care personnel had some low vision training across seven hospitals. The challenges highlighted by providers were mainly inadequate funding (infrastructure, training, and equipment), communication gaps, and bureaucracy. Poor awareness, affordability, acceptability, and accessibility of LVDs were major constraints for users. CONCLUSION: Low vision services are available in some tertiary facilities in southeast Nigeria. Improved funding and better awareness of the availability of low vision services by eye care providers and the general public are needed to strengthen services.

Scalable radiotherapy data curation infrastructure for deep-learning based autosegmentation of organs-at-risk: A case study in head and neck cancer.

In this era of patient-centered, outcomes-driven and adaptive radiotherapy, deep learning is now being successfully applied to tackle imaging-related workflow bottlenecks such as autosegmentation and dose planning. These applications typically require supervised learning approaches enabled by relatively large, curated radiotherapy datasets which are highly reflective of the contemporary standard of care. However, little has been previously published describing technical infrastructure, recommendations, methods or standards for radiotherapy dataset curation in a holistic fashion. Our radiation oncology department has recently embarked on a large-scale project in partnership with an external partner to develop deep-learning-based tools to assist with our radiotherapy workflow, beginning with autosegmentation of organs-at-risk. This project will require thousands of carefully curated radiotherapy datasets comprising all body sites we routinely treat with radiotherapy. Given such a large project scope, we have approached the need for dataset curation rigorously, with an aim towards building infrastructure that is compatible with efficiency, automation and scalability. Focusing on our first use-case pertaining to head and neck cancer, we describe our developed infrastructure and novel methods applied to radiotherapy dataset curation, inclusive of personnel and workflow organization, dataset selection, expert organ-at-risk segmentation, quality assurance, patient de-identification, data archival and transfer. Over the course of approximately 13 months, our expert multidisciplinary team generated 490 curated head and neck radiotherapy datasets. This task required approximately 6000 human-expert hours in total (not including planning and infrastructure development time). This infrastructure continues to evolve and will support ongoing and future project efforts.

MORNING GLORY SYNDROME IN A NIGERIAN - A CASE REPORT.

Morning glory syndrome is an uncommon congenital excavated optic disc anomaly that can impair vision and may be associated with ocular and non-ocular abnormalities. It has a characteristic fundoscopic appearance which consists of a large excavated disc with radial vessels and a central turf of glial tissue situated within a funnel shaped excavation of the posterior fundus. It is more common in Caucasians than in blacks. We report a case of this uncommon congenital anomaly of the optic disc in a Nigerian male.

Ophthalmic disorders in Adult Lymphoma Patients in Africa

Context: Ocular manifestations of lymphoma are rare events. Most reports of ocular involvement in lymphoma are case reports or reports of a few patients. Aims: To determine the ophthalmic disorders in adult; African; lymphoma patients. Settings and Design: A prospective study of ocular disorders in adult patients with lymphoma was conducted at the University of Benin Teaching Hospital; Benin City; Nigeria; between July 2004 and June 2007. Materials and Methods: The patients were interviewed and examined by the authors and the ocular findings recorded. Statistical Analysis: Data was analyzed on computer with the aid of the Instat GraghPadT v2.05a statistical package software. The mean; standard deviation; Mann-Whitney U-statistic and P value were calculated. Results: A total of 111 patients with hematological malignancies were seen over a period of three years of which 62 (55.85) had lymphomas. Of these; 51(82.3) were non-Hodgkin's lymphoma and 11(17.7) were Hodgkin's lymphoma. Ocular disorders occurred in 16 patients (31.4) with non-Hodgkin's lymphoma and none of the patients with Hodgkin's lymphoma (Mann-Whitney U-statistic is equal to 7.500; U' is equal to161.50; P ; 0.0001). The ocular disorders due to non-Hodgkin's lymphoma were seen as - proptosis in six patients (11.8); retinopathies in three (5.9); conjunctival infiltration in three (5.9); optic atrophy in two (3.9); keratoconjunctivitis in one (two per cent); desquamating nodular lid lesions in one (two per cent); papilloedema in one (two per cent); and upper lid mass in one (two per cent). Four patients (6.5) had monocular blindness. Conclusions: Ophthalmic disorders are relatively common in non-Hodgkin's lymphoma. Ophthalmic evaluation is needed in these patients for early identification and treatment of potentially blinding conditions