ABSTRACT
A cross-sectional survey of eye disease supported by the African Programme for Onchocerciasis Conffol (APOC) was carried out in October 1998, in Raja, Sudan, a Savanna ecological zone to determine the prevalence and distribution of onchocercal eye disease. Detailed eye examination including measurement of visual field using the Wu-Jones computerized Motion Sensitivity Screening Test (MSST) were carried out. A total of 481 individuals were examined, of which 379 underwent detailed eye examination. A high prevalence of blindness (8.1%) from all causes was recorded. Onchocerciasis-induced eye disease was responsible for blindness in 56.40/o of all blind persons. Of the 38 persons who had visual impairment, 13 (2.7%) were severely affected. As many as 91 (24.0%) persons had microfilariae (mfs) in the anterior chamber (AC) and /or cornea with the highest prevalence of 29.3Yo and 28.8% respectively, recorded among the young and active individuals. This age group (15-24yeus) also had the highest prevalence (15.3%) of flufff corneal opacities. Sclerosing keratitis was present in 46 (12.1%) subjects while iridocyclitis was diagnosed in 9.0% with the highest prevalenc e of 25 .0o/o noted in the 45 - 54 age group. Prevalence of blinding cataract was 54.1% while that of glaucoma was12.2%. Presumed optic nerye disease, a known pathway to onchocercal blindness was observed in 19.6% with one third of this percentage already at the advanced stage. Another common pathway to blindness, chorioretinitis, affected 15.2% of the subjects of which 7.2% had reached advanced stages.Prevalence of abnormal visual fields was 6.6Yo. Posterior segment oncho disease was found to be the main ocular pathology in 15.6% subjects followed closely by 13.5% whose main cause was anterior segment oncho lesion. Both sexes were almost equally affected. Ocular findings in this area particularly among the young conform to high intensity levels of onchocerciasis infection and therefore require urgent effective intervention to forestall further devastating oncho-induced blindness and alleviate the socio-economic burden imposed on this population.
Subject(s)
Onchocerciasis , Onchocerciasis, Ocular , Chorioretinitis , Eye DiseasesABSTRACT
La toxoplasmose oculaire represente l'effet pathogene de toxoplasma gondii; elle determine chez les sujets immunocompetents une chorioretinite d'allure necrosante volontiers temporel avec des aspects en rosace; une atteinte du segment anterieur parfois. Sa frequence chez un immunodeprime comme dans l'infection par le VIH serait de 30 fois plus elevee que chez le sujet immunocompetent. Ce present travail est consacre aux differents aspects anatomocliniques observes chez 24 malades presentant une toxplasmose oculaire d'age moyen de 32;09 ans avec des extremes a 14 ans et 57 ans; atteignant les deux sexes dans les proportions de 41;66 pour cent de femmes contre 58;33 pour cent d'hommes. Les lesions etaient dans 91;66 pour cent (22 malades) exclusivement des chorioretinites; deux cas de participation du segment anterieur etaient observes; 66;66 pour cent de localisations temporales sont notees (16 malades); 29;16 pour cent d'atteintes nasales (7 malades) et une seule localisation justapaillaire; 14 localisations droites sont notees contre 10 du cote gauche; 8 lesions eatient evolutives (33;33 pour cent) contre 16 lesions cicatricielles (66;66 pour cent); le dye test de Sabin Feldman etait positif chez tous les malades par contre les lgM etaient variables. La toxoplasmose doit etre recherchee devant toute chorioretinite dans nos milieux car le diagnostic ophtalmoscopique est de haute predictivite