[Profile of neovascular glaucoma in Senegalese patients]. / Profil du glaucome néovasculaire chez les patients sénégalais.

OBJECTIVE: To describe the etiologies, clinical presentation and therapeutic management of neovascular glaucoma (NVG) in Senegalese patients. PATIENTS AND METHODS: We retrospectively studied the records of patients followed for NVG between 1993 and 2016. We included eyes with Iridis rubeosis with or without ocular hypertension. We recorded age, sex, medical and ophthalmologic history, results of the eye examination, treatment modalities broken up into hospitalisation, procedural interventions and number of antiglaucoma medications prescribed. The data analysis was performed by epi-info 7. RESULTS: Forty-eight eyes of 44 patients were included. The mean age was 59.7 years and sex ratio 2.1. Etiologies were type 2 diabetes in 31.8 % cases and central retinal vein occlusion in 16.6 % cases. All eyes were blind. Eye pain was present in 75 % of eyes, a limbal flush in 29.1 % of eyes and mydriasis in 31.25 % of eyes. Mean intraocular pressure was 49.7mmHg. Corneal edema occured in 54.1 % of eyes. Fundus examination showed proliferative retinopathy in 14.5 %. Treatment required hospitalisation for 43.75 % of patients. Therapeutic procedures were cyclocryoapplication for 31.25 % of eyes, retrobulbar xylo-alcohol injection for 14.5 % of eyes and panretinal laser photocoagulation (PRP) for 12.5 % eyes. Antiglaucoma preparations were used in dual therapy for 29 % of eyes, in triple therapy and quadruple therapy for 25 % of eyes each. DISCUSSION: The etiologies are comparable to those described in the literature. The diagnosis was late and treatment limited by adverse economic conditions. CONCLUSION: NVG in Senegalese patients is an affection of men in their sixties. It is responsible for irreversible painful blindness for which treatment is difficult - thus the interest in prevention by strict monitoring and prompt treatment of any retinal ischemia.

[Central corneal thickness in Senegalese melanoderms with primary open angle glaucoma]. / Épaisseur cornéenne centrale chez le mélanoderme sénégalais atteint de glaucome primitif à angle ouvert.

PURPOSE: To measure the central corneal thickness (CCT) in Senegalese melanoderms with primary open angle glaucoma (POAG) and to determine its effect on visual impairment, intraocular pressure, optic nerve and perimetric damage. PATIENTS AND METHODS: We studied retrospectively the records of patients followed for POAG between May and July 2012. We recorded CCT measured by ultrasonic pachymetry and results of the first clinical examinations, including best-corrected visual acuity (CVA), intraocular pressure (IOP) by Goldmann tonometry, cup-to-disc ratio (C/D), and visual fields by automated perimetry according to the classification of Hodapp. RESULTS: Two hundred and thirty-four eyes of 117 patients were enrolled. Mean age was 56.53 ± 11.29 years and gender ratio was 2.77. Mean CCT was 525.40 ± 39.63 µm for all eyes, right and left (P=0.734). Women had a mean CCT of 521.20 ± 36.20 µm and men 526.91 ± 40.79 µm (P=0.332). Corneas were thinner in patients over 50 years (P=0.0047), in eyes having a CVA<3/10 (P=0.01) or a C/D ≥ 0.8 (P=0.043). CCT had no correlation with frequency of ocular hypertension (P=0.16) or advanced visual field defect (P=0.33). CONCLUSION: CCT of glaucomatous Senegalese is independent of laterality and sex, but decreased with age. A thin cornea is a risk for visual loss and optic cup enlargement, thus the importance of systematic measurement of CCT.