Comparative Analysis of Ocular Morbidity in Riverine and Upland Communities in Rivers State, Nigeria

Aims/Objective:A community-based cross-sectionall comparative study was carried out to compare the pattern of ocular morbidity between residents in upland and riverine communities in Rivers State.Methods:The sample size was calculated using the formula for comparative studies, based on alpha of 0.05, beta of 0.20, the proportion of eye disorder of 40.4% from a community-based study in Rivers State. A minimum sample size of 84 per group was attained.Data on age, sex, visual acuity, cup-disc ratio, intra-ocular diagnosis were obtained using an interviewer-based pro forma. Collected data were entered into Microsoft Excel and exported to the United States Centers for Disease Control and Prevention(CDC) Epi Info version 7 software for statistical analysis. The Pearson's Chi square/Fisher's exact tests were used as appropriate to determine significant differences in demographic and eye examination findings between the two groups (riverine versus upland) while Chi-square homogeneity was performed to determine significant differences in the individual ocular diagnosis across the groups. Statistical significance was set at P≤0.05. Results:A total of eighty-six (86) participants per group were involved in the study, making a total of one hundred and seventy-two participants. The mean age was 37.9 (±18.1) and age range of 1-90years. Males comprised 30.2% of the sample population while females were 69.8%. The commonest causes of ocular morbidity in both communitieswere Refractive error. Allergic conjunctivitis and cataract were more common in the Riverine community compared to the upland one. Conclusion:Our study shows that the pattern of ocular morbidity may differ based on land surfaces. Ocular morbidity appears to be more prevalent in Riverine areas than upland.Government interventions and eye care service providers should take cognizance of this while planning intervention programs at the State and National levels

Ocular Diseases in HIV-positive Patients in a Tertiary Hospital in Nigeria

Aims:To determine the pattern of ocular disorders in HIV-positive patients in a tertiary ospital in Nigeria.Study Design:A cross-sectional hospital based study on confirmed HIV positive adult patients attending the HIV clinic in University of Port Harcourt Teaching Hospital.Duration of Study:November and December 2011. Methodology:Consecutive patients within the inclusion criteria were recruited until the required sample size was met. The visual acuity was tested using the Snellen’s chart and the illiterate E-chart. Ocular examination of the adnexial and anterior segments were done using a pen torch and a slit lamp biomicroscope. Fundoscopy was done using a direct and indirect ophthalmoscope as well as with a 90D lens. Other information such as CD4 count and HIV serotype were retrieved from the patient’s case notes. The data was analysed using EPI-info version 7.0. Statistical methods such as the frequency and chi-square were used to test the significance of association.Level of significance was drawn at P<0.05.Results: A total of 411 patients were enrolled in this study. The age range was between 18-69 years with a mean age of 36.9 years. There was a female preponderance with a male to female ratio of 1:2. Ocular disorders were seen in 37.1% of patients studied. The commonest manifestation was the ocular adnexial manifestation and conjunctival microvasculopathy ranked highest (15.6%) in this group. Herpes zoster ophthalmicus was seen in 5 (1.2%) patients, presumed squamous cell carcinoma in 12(2.9%) and Kaposi sarcoma in 3(0.7%). Chorioretinitis was found in 12(2.9%), retinal microvasculopathy in 19(4.6%) and maculopathy in 15(3.6%). There was no case of CMV retinitis. Conclusion: Ocular findings seen in HIV-positive patients were mostly adnexial and occurred in 37% of the study population

Outcome of Micropulse Laser in Treatment of Open Angle Glaucoma in a Peripheral Hospital in Rivers State, Nigeria: Our Initial Experience

Aims:To determine the Intraocular Pressure (IOP) and visual acuity changes before and after Micropulse laser treatment among patients with open angle glaucoma.Study Design:A quasi-experimental study design.Place and duration of Study:The Ophthalmic Specialists, a peripheral ophthalmologist group practice in Rivers State between February 2018 and December 2018.Methodology:Twelve eligible patients with moderate and advanced open angle glaucoma on medical (topical) treatment were recruited after they gave informed consent. Baseline visual acuity (VA) and intra ocular pressure (IOP) were obtained prior to the use of the micropulse laser treatment. Following the laser treatment, VA and IOP were assessed at oneday, one week, one month and 6 month post laser. p=.05 was regarded as statistically significant.Results:A total of 12 patients were followed up for 6 months. Mean age was 37.42±7.00 years. Age range was 24-46 years with M: F ratio =1.4:1. Mean change in visual acuity across the time periods was statistically significant (p=0.0001). Mean IOP change over 6 months was 10.46mmHg (38.20%, p=0.0001). Median number of drugs used by participants dropped from 3 to 1. (P=0.002)Conclusion:Micropulse Trans-scleral cyclophotocoagulation is a safe and effective way of managing glaucoma. It caused a mean drop in IOP of 10.46mmHg (38.20%) over 6 months in our study

Corneal Endothelial Cell Density and Morphology in Nigerians.

AIM: To determine the mean density and describe the morphology of corneal endothelial cells in adult Nigerians in Port Harcourt. Study Design: A population-based cross-sectional study. Place and Duration: A study conducted among adult Nigerians aged ≥ 18 years in Port Harcourt city Local Government Area, Rivers State, Nigeria between January and April 2014. Methodology: Participants were selected using multi-stage cluster random sampling technique. An interviewer-based semi-structured questionnaire was administered to obtain demographic data. All participants had ocular examinations done including visual acuity measurement, anterior segment examination, fundoscopy, and non-contact specular microscopy. Results: Four hundred and eighty (n=480) subjects were studied. There were 212 males (44.2%) and 268 females (55.8%) with a mean age of 43.0±14.2 years and range 18-91 years. The mean Endothelial Cell Density (ECD) was 2791±221 cells/mm2. Males had a tendency to have a higher ECD (2882±220 cells/mm2) than females (2784±215 cells/mm2, p=0.490) in ages less than 40 years. Conclusions: The mean ECD obtained in adult Nigerians was 2791±221 cells/mm2. No statistically significant difference was found in ECD between males and females. The degree of polymegathism of corneal endothelial cells increased with age in the study population but this was also not statistically significant (p=0.141).