ABSTRACT
The aim of this study was to analyze the use of the diagnostic B-scan ultrasound. Should it be made accessible to all surgical centers in Sub-Saharan Africa in order to (i) avoid unnecessary cataract surgery and (ii) evaluate extraocular pathology? This study was conducted in Kinshasa from 2006 to 2019. Three hundred and twenty-three patients were included and separated into two groups. Group 1 included 262 patients with dense cataract. Group 2 consisted of 61 patients with pathologies of the ocular adnexa, and all were examined with a B-scan ultrasound. In group 1, there were 437 systematically screened eyes. Three hundred and ninety-eight eyes (91.08%) showed no abnormalities, 13 (2.97%) retinal detachments were identified, and 15 (3.43%) demonstrated a detached posterior hyaloid membrane. In the second group, 61 patients were examined (group 2). In 20 of them, surgery was performed for biopsy, tumor excision, mucoceles drainage, and palliative treatment. The need for routine B-scan examinations in dense cataract patients seems to be limited and can most likely be replaced by a thorough application of locally available examination techniques. B-scan application is recommended to manage orbital patients in the most cost-effective way.
ABSTRACT
PURPOSE: The prevalence of diabetes mellitus is increasing worldwide especially in developing countries. Foot ulcerations in patients with diabetic neuropathy have a high impact in the overall amputation rate. In the present study we looked for the severity of diabetic retinopathy in patients with diabetic foot syndrome in a diabetic care unit in a sub-Sahara megacity (Kinshasa, Democratic Republic of Congo). METHOD: Forty-one patients with diabetes-related foot ulcerations (26 male, 15 female, mean age 45.6 years) were enrolled in the study. All patients underwent visual acuity evaluation and slit lamp biomicroscopy. Incidence and stage of retinopathy were evaluated by retinal funduscopy and documented by fundus photography. RESULTS: Twenty-seven eyes showed no signs of diabetic retinopathy. Forty-seven eyes were diagnosed as non-proliferative diabetic retinopathy (16 mild, 16 moderate, 15 severe). Seven eyes showed proliferative diabetic retinopathy. One patient had a unilateral central venous occlusion. In this case the classification of diabetic retinopathy was not possible because of the massive retinal bleedings. CONCLUSION: It was evident that there is a considerable discrepancy between partly extensive foot ulcerations and only mild to moderate diabetic retinopathy in most of the patients. This indicates that neuropathy-induced foot problems and microangiopathy-induced diabetic retinopathy are diabetic complications whose formal pathogenesis is only loosely correlated. Additional risk factors in local African conditions compared to Europe may play a major role in this discrepancy.
