Ocular disorders among stroke patients in Federal Teaching Hospital, Lokoja, Nigeria

Objectives:To determine the pattern of ocular disorders among stroke patients in Federal Teaching Hospital, Lokoja (FTHL).Materials and Methods:Consecutive new stroke patients seen at the Federal Teaching Hospital, Lokoja over a 3-month period were studied. Data was collected with the use of a structured questionnaire divided into four major sections: bio-data, visual history, results of ocular assessment and NEI VFQ-25 quality of life questionnaire. Data analysis was done using SPSS for Windows, version 23.0. Univariate analyses were presented in the form of frequencies, percentages, means, ranges, and standard deviations, charts and tables.Results:Eighty-three patients were recruited with an age range of 40-71 years, a mean age of 55.3(±7.1) years. Thirty-nine patients (47.0%) were between the ages of 51 and 60 years. Thirty-four (41.0%) patients were females while 49(59.0%) were males. Of 46 (55.4%) patients that had neuro-imaging, stroke was ischaemic in 37(80.4%) and haemorrhagic in 9(19.6%). Of the 63 patients with left sided stroke, 2 (2.4%), 4(4.8%) and 57(68.7%) had severe, moderate and mild and normal visual impairment respectively while of the 20 patients with right sided stroke, 3(3.6%) each had severe and moderate visual impairment and 14(16.9%) had normal or mild visual impairment. Other ocular abnormalities included corneal anaesthesia and macular hole in 2(1.2%).Conclusion:Anterior and posterior segments, together with neuro-ophthalmic disorders were found among stroke patients in this study. Many of the ocular abnormalities are as a result of long-standing uncontrolled hypertension which caused the stroke. It is recommended that awareness should be created among the populace about uncontrolled hypertension. It is also advised that internists should refer hypertensive patients for routine ophthalmic screening.

Effectiveness of Whole-Exome Sequencing for the Identification of Causal Mutations in Patients with Suspected Inherited Ocular Diseases

ABSTRACT Background: Genetic eye disorders, affecting around one in 1000 people, encompass a diverse group of diseases causing severe visual deficiency. The recent adoption of next-generation sequencing techniques, including whole-exome sequencing (WES), in medicine has greatly enhanced diagnostic rates of genetically heterogeneous diseases. Objectives: The objectives of the study were to assess the diagnostic yield of WES in a cohort of Mexican individuals with suspected genetic eye disorders and to evaluate the improvement of diagnostic rates by reanalysis of WES data in patients without an initial molecular diagnosis. Methods: A total of 90 probands with ocular anomalies of suspected genetic origin were ascertained. Patients underwent WES in leukocytic DNA. Bioinformatics analysis and Sanger sequencing were used to confirm the disease-causing variants. Only variants identified as pathogenic or likely pathogenic were considered as causal. Results: Initial analysis revealed causal mutations in 46 cases (51%). Reanalysis of WES data 12 months after first analysis resulted in the identification of additional causal variants in 6 patients (7%), increasing the molecular diagnostic yield to 58%. The highest diagnostic rates by disease categories corresponded to hereditary retinal dystrophies (77%) and to anomalies of the anterior segment of the eye (47%). Conclusion: Our study demonstrates that WES is an effective approach for genetic diagnosis of genetic ocular diseases and that reanalysis of WES data can improve the diagnostic yield.

Consanguinity and ocular disorders in India: Electronic medical records driven big data analytics

Purpose: To describe the distribution of ocular disorders in patients with a family history of consanguinity presenting to a multi?tier ophthalmology hospital network in India. Methods: This cross?sectional hospital?based study included 2,805,267 new patients presenting between August 2010 and April 2021. Patients with a family history of consanguinity were included as cases. The sociodemographic and clinical data were collected using an electronic medical record system. Results: Overall, 20,445 (0.73%) new patients were documented to have a family history of consanguinity. The prevalence rates were 4.04% in children (age: <16 years) and 0.21% in adults. The mean age of the patients was 11.87 ± 11.06 years. The majority of the patients were males (56.48%) and students (54.43%) by profession. The majority (93.05%) of the patients were in the 0–30?years age bracket, with over half of them (53.71%) presenting in the first decade of life. A significant number of patients were from higher socioeconomic status (73.48%) and the rural region (47.62%). The most common degree of consanguinity documented was second degree (3.95%). The most common ocular disorders associated with a high proportion of consanguinity were congenital hereditary endothelial dystrophy (CHED) (100%), corneal macular dystrophy (83.78%), xeroderma pigmentosum (80.95%), and ocular albinism (73.59%). A tenth of the patients (9.8%) reported a similar history of ocular disorders among the family members and more commonly among the siblings (70.4%). Conclusion: Consanguineous marriages are not uncommon in India. They cause ocular disorders that cause visual impairment in a significant majority of those affected in their early decades of life. Genetic counseling plays a role in prevention.

Current Status of Nanoparticles Loaded Medication in the Management of Diabetic Retinopathy.

Diabetes Mellitus (DM) is a chronic metabolic disorder affecting a vast majority of the human population causing marked morbidity and mortality. Diabetic retinopathy (DR) is a complication of diabetes that affects the eyes and vision. It is a leading cause of visual impairment and blindness in people. In this review, various nano-delivery systems to effectively deliver antidiabetic compounds in treating angiopathy and retinopathy in diabetes mellitus are discussed. This has been used to overcome many complications in traditional treatment of bioactive compounds with a lower potential antidiabetic effect due to the lower stability of those compounds in gastrointestinal systems and during absorption. Several bioactive compounds loaded into nanodelivery systems are currently in clinical trials, and once these compounds are commercially marketed, nano bioactive compounds will be available as novel medicines to treat many chronic diseases, including diabetes mellitus. DR is driven by prolonged hyperglycaemic episodes arising from suboptimal glycaemic control in patients with either Type I or II diabetes mellitus. Elevated blood glucose levels alter the regulation of a number of biochemical pathways leading to superoxide production and oxidative stress in retina. Mitochondrial dysfunction, inflammation, and hypoxia-driven Vascular Endothelial Growth Factor (VEGF) secretion giving rise to vascular and neuronal apoptosis, neovascularization and elevated vasopermeability, respectively. Several medicines loaded with nanoparticles have been developed to enhance the target effectiveness and bioavailability of medicinal compounds with antidiabetic effects in various animal and human models. Bioactive compounds have been loaded into nanoparticles for oral delivery in various antidiabetic animal models, and the results have shown improved stability, bioavailability, and sustained antidiabetic effects. Nanocarriers used in the delivery of drugs are very precise and ensure targeted drug delivery at the disease site. The antidiabetic activity of triamcinolone acetonide-loaded lipid nanocapsules, humanin peptide with elastin like polypeptide nanoassembly, loaded poly lactic-co-glycolic acid nanoparticles, anti-VEGF-aptamer modified C-Dots as hybrid nano-composite, axitinib, apatinib loaded poly lactic-co-glycolic acid nanoparticles, mulberry leaf extract mediated silver nanoparticles, resveratrol coated gold nanoparticles, fenofibrate-loaded biodegradable nanoparticles, nano-delivery of doxorubicin, insulin-loaded chitosan nanoparticles, silk fibroin nanoparticles, fluorescent silicon nanoparticles-based theranostic probes, topical curcumin nanocarriers, nanoparticles loaded-palmitoyl ethanolamide, hyaluronic acid coated albumin nanoparticles, nilvadipine loaded nanoparticles, cilostazol ophthalmic nanodispersions, naringenin-loaded sulphobutylether-β-cyclodextrin/chitosan nanoparticles, emodin-loaded magnesium silicate hollow nanocarriers, yttrium oxide nanoparticles are discussed in this review.

La endoftalmitis endógena por Candida, un marcador pronóstico / Endogenous Candida endophthalmitis, a prognostic marker

La candidiasis es la causa más común de endoftalmitis endógena. La afectación ocular se produce entre los 3 y los 15 días siguientes a la fungemia. Las dos formas características de presentación son la coriorretinitis candidiásica, que afecta a la coroides y a la retina sin afectar claramente al vítreo, y la endoftalmitis candidiásica, con presencia de lesiones vítreas redondeadas, de aspecto algodonoso (perlas vítreas), características de esta infección. Los síntomas visuales precoces más habituales son la visión borrosa y los flotadores. Se recomienda entonces realizar fondo de ojo en las 2 primeras semanas del diagnóstico de candidemia para prevenir complicaciones oculares y usar la afectación ocular como indicador de probable infección fúngica invasiva. La anfotericina B, el fluconazol, el voriconazol, el posaconazol y el ravuconazol, así como las equinocandinas entre las que se encuentran la caspofungina han demostrado su utilidad en el tratamiento de la coriorretinitis, pero la efectividad disminuye en los casos de afectación vítrea si no se asocian a vitrectomía(AU)

Candidiasis is the most common cause of endogenous endophthalmitis. Ocular damage occurs within 3 and 15 days after fungemia. The two characteristic forms of presentation are Candida chorioretinitis, affecting the choroid and the retina with no clear impact on the vitreous, and Candida endophthalmitis, with the presence of rounded cottony vitreous lesions (vitreous pearls), characteristic of this infection. The most common early visual symptoms are blurred vision and floaters. It is thus recommended to perform funduscopy within the first two weeks after the candidemia diagnosis to prevent ocular complications and use the ocular damage as an indicator of probable invasive fungal infection. Amphotericin B, fluconazole, voriconazole, posaconazole and ravuconazole, as well as echinocandins, among them caspofungin, have proven useful in the treatment of chorioretinitis, but effectiveness is lower in vitreous damage cases when they are not associated to vitrectomy(AU)

A Study Of Ocular Disorders In School Going Children.

Background: Ocular disorders are often neglected in children. At the school going age. They find difficulties in their day to day activities. Refractive Error affects a large proportion of school going children. This can be easily diagnosed and corrected with spectacles. If not corrected, they become a major cause of low vision or even blindness. In India, children younger than 15 years constitute about 42% of the population and out of it 30% lose their eyesight partially due to amblyopia before the age of 20 years. So we have selected this study. Methodology: This was a cross sectional study. The study was conducted in Dhiraj Hospital & Eye camps for school children during November 2014 to October 2015. We have examined 350 children. We have used snellen’s distant vision chart, torch light, direct ophthalmoscope and ishihara’s colour vision chart in the camps. We referred children who needed detailed examination to Dhiraj hospital where we did cycloplegic refraction. They were examined with auto refractometer , direct and indirect ophthalmoscopy and they were called for Post mydriatic test and also for follow up of other ocular disorders. Results: Our study was conducted in schools of Vadodra district and in Eye Opd of Dhiraj Genral hospital attached with SBKS MIRC pipariya , dist. Vadodara in Gujarat state. We have examined 350 children and done their complete follow up. We found refractive error in 130 (37.14%) in children. Amongst them Refractive error -130 and other disorders like Lacrimal sac disorder – 6, Meibomian gland dysfunction (MGD) – 9, Conjunctivitis- 12 , amblyopia -3 ,squint -1, Others (Normal)- 189. P value was significant in case of refractive error. Conclusion: Ocular disorders in school going children vary from place to place, mal nutrition, lack of attendance from parents & teachers on their complains of eye disorders, in some areas where treatment facility in private or government set up is not available so their problems are neglected. Climate condition also play significant role. The present study indicates that the school age is a high risk group for developing refractive errors. Most of the children were unaware of their problem. Thus prevalence of undetected refractive error was more. Allergic conjunctivitis was another issue of concern. More studies, resources and manpower are needed to detect uncorrected refractive error and achieve the goal of vision 2020.

Trastornos neurológicos en niños con síndrome de Down / Prevalence of neurological disorders among children with Down syndrome

Background: Neurological disturbances are common problems in children with Down Syndrome (DS). Aim: To determine the prevalence of neurological disorders affecting children with Down Syndrome. Patients and Methods: Review of medical records of253 children aged from 1 day to 23 years affected with DS, attended at a public hospital and a University clinic. Results: The overall prevalence of neurological disorders was 38.7%. The most common problems were ocular motor disorders in 26% of cases and epilepsy in 12%. Conclusions: Neurological disorders are more common in children with DS than in the general population. Motor ocular disorders and epilepsy are the predominant disturbances detected.

Ocular disorders in children with learning disabilities in special education schools of Pune, India.

Aim: The aim was to study and treat ocular disorders in children with learning disabilities (cLDs) and explore associations with their perinatal history. Materials and Methods: cLDs attending 11 special schools were examined by a team consisting of an ophthalmologist, optometrist, and a social worker in 2007 and followed up in 2008. The students‘ intelligence quotient (IQ) and their medical histories were noted. Distant visual acuities were measured using Kay pictures or Snellen's tumbling E chart and complete ocular examination was performed. Students were assessed at the pediatric ophthalmology unit and low vision center, if needed. Statistical analysis was done with SPSS and the Chi-square test for ordinal data. Results: A total of 664 students were examined, 526 of whom were <16 years of age; 323 (61.4%) were male. A total of 326 (60%) had moderate-to-severe learning disabilities (IQs <50), and the mean IQ was 45.4. Two hundred and thirty-eight (45.3%) had ocular disorder; 143 (27.3%) had an uncorrected refractive error, followed by strabismus in 83 (15.8%), nystagmus in 36 (6.8%), optic atrophy in 34 (6.5%), and congenital anomalies in 13 (2.5%), 103 children had more than one abnormality. Only 12 of the 143 students with refractive errors were using spectacles. A total of 132 (48.7%) children with a history of perinatal insult had ocular problems. Ocular disorders were also common in those with a history of epilepsy, Down's syndrome, and cerebral palsy. Conclusion: Nearly half the cLDs in this study had ocular disorders and one-fourth had their vision improved.

Childhood eye diseases in southwestern Nigeria: a tertiary hospital study

BACKGROUND: Eye diseases are important cause of medical consultation in children, with the spectrum varying in different localities. This study aimed to determine the spectrum of childhood eye diseases in a tertiary hospital serving rural and semi-rural communities. METHODS: We conducted a retrospective review of all patients less than 15 years old who presented to the eye clinic of Wesley Guild Hospital Ilesa, Nigeria between January 2001 and December 2006. Data on age at presentation, age at onset of disease, sex and diagnosis were collected and analyzed using SPSS. A p value less than 0.05 was considered statistically significant. RESULTS: We evaluated the reports of 286 children, with a male:female ratio of 1:1.1. Children aged 11-15 years made up the largest group (p=0.013). Ocular trauma (21.7 percent), allergic conjunctivitis (17.8 percent), infections of the eye and its adnexa (15.4 percent) and refractive errors (14.3 percent) were the most common conditions. Ocular injury was more common in males (p=0.002) and children aged 6-10 years, and 87.1 percent of these cases were a closed globe injury. Infections were seen more commonly among females and children aged 0-5 years, with keratitis representing 40.9 percent of these cases. Congenital eye disease represented 13.3 percent of childhood eye diseases. CONCLUSION: The prevalent childhood eye diseases recorded here can lead to absenteeism from school and are potentially blinding. Health education aimed at the prevention of ocular trauma and prompt presentation for the management of other eye diseases should be encouraged.

The Epidemiological Study on the Ocular Disorders of the Rural Aged Population

OBJECT: It is to evaluate the priority area for effective eye care service to the aged population of rural comniunity at present and in future. METHOD: Number of aged group surveyed on 60 and over 60 years age that, counted 531 among the total 580 patients. Visual acuity was tested and refractive error was measured by Retinornax (Nikon, Japan) . Ocular examination was performed to determine the causes of visual impairment. This survey was conducted under the auspices of the Korean Foundation for Prevention of Blindness with assistance of the Seoul National University Postgraduate School of Public Health from 1994 to 1996 at the Public Health Center of Chun-Cheon, Kang-Won Do(Province). RESULTS: Age distribution showed the sixties (60-69) 49,3%, the seventies (70-79) 33.9%, and the eighties (80) 16.8%. Proportion of visual acuity of 0.7 or upper in the better eyes constituted 32.2% and of 0.2 or worse 19.4%. Causes of visual impairnnente consisted of refractive errors 35. 9%, cataract 35. 9%, macular degeneration 7, 4%, and corneal opacity 3.9% in order. Contributed modes of care were spectacles 27.9%, surgeries 23.9% (cataract, operation, pterygium removal etc.), and medical treatment 23.9%. DISCUSSION: Surgery of the aged population in rural comrnunity of Chun-Cheon revealed the most. prevalent. causes of visual impairment as the refractive errors and cataract. It is suggested that. the most effective eye care would be provided systemically based 0 the result of the epidemiological study on the various ocular disorders.