[Functional outcomes and prognostic factors of firearm-related ocular trauma among soldiers in the conflict zones of Cameroon]. / Résultats fonctionnels et facteurs pronostiques des traumatismes oculaires par armes à feu chez les militaires en zones de conflits au Cameroun.

PURPOSE: To study prognostic factors and functional visual outcomes of soldiers after firearm-related ocular trauma in the conflict zone. MATERIALS AND METHODS: A cross-sectional analytical study was carried out from January 2017 to December 2022 in the ophthalmology departments of three military hospitals. Soldiers with firearm-related ocular trauma were selected. Epidemiological and clinical data, prognostic factors and functional outcomes were studied. Statistical analyses were performed using IBM-SPSS version 23.0 software. Univariate and multivariate analyses were performed, and a P-value<0.05 was considered statistically significant. RESULTS: A total of 162 eyes of 136 patients were included. The mean age was 28.93±6.52 years. All patients were male. Improvised firearms were the most frequent cause (77%). Bilateral involvement was observed in 26 patients (19.1%). The mean visual acuity of the affected eyes was 1.66±1.04logMAR on admission. Closed globe injuries predominated (72%). The most frequent anatomical lesions of the globe were hyphema (23.4%) and vitreous hemorrhage (19.7%). The mean final visual acuity was 1.38±1.17logMAR, and blindness was observed in 50% of eyes. Factors influencing final visual acuity were type of trauma, initial visual acuity, hyphema and vitreous hemorrhage. CONCLUSION: Blindness due to firearm-related eye injuries in the conflict zone of Cameroon is common. Wearing protective glasses or visors might reduce its frequency.

[Contribution of Optical Coherence Tomography in the evaluation of the iridocorneal angle in Cameroon]. / Apport de la tomographie en cohérence optique dans l'évaluation de l'angle irido-cornéen du camerounais.

INTRODUCTION: Our work was aimed at determining the sensitivity and specificity of anterior segment OCT (AS-OCT) in the evaluation of the iridocorneal angle (ICA) in Cameroon. METHODOLOGY: We conducted a cross-sectional, analytical study from January 2 to June 30, 2019 in Yaoundé. One hundred and twenty five patients over 35 years of age underwent three-mirror manual glass gonioscopy and AS-OCT. The angle was defined as occludable on manual gonioscopy if the posterior trabecular meshwork, was not visible and on OCT if there was contact between the iris root and the posterior surface of the peripheral cornea. Quantitative parameters (angle opening distance, angle recess area, and trabecular-iris space area) in the nasal and temporal quadrants were recorded for the analysis. RESULTS: Men accounted for 56.20% of the 96 patients selected (192 eyes). The mean age was 54.78±10 years. The prevalence of occludable angles was 18.75% (18/96 patients) and 28.125% (27/96 patients) on manual and automated gonioscopy respectively. Schaeffer-Etienne grades ≤ 2 were identified in 43/192 (21.94%) nasal quadrants and 33/192 (19.18%) temporal quadrants. The area under the curve (AUC) was maximal for the 500 µm goniometric parameters (> 0.8). An Angle Opening Distance ≤ 333.50 µm was found in 52/192 nasal quadrants (27.10%) and 53/192 (27.60%) temporal. The sensitivity and specificity of AS-OCT in the detection of occludable angles at 500 µm, were 62.8% and 83.2% respectively in the nasal quadrant, and 66.7% and 80.5% respectively in the temporal quadrant. There was a positive correlation between goniometric parameters on AS-OCT and gonioscopy (P=0.01). CONCLUSION: Given its higher specificity, AS-OCT should be a supplemental examination in the analysis of an angle which appears closed on manual gonioscopy.

[Epidemiological and clinical profile of age-related macular degeneration in Cameroon]. / Profil épidémiologique et clinique de la dégénérescence maculaire liée à l'âge en milieu camerounais.

PURPOSE: To determine the epidemiological and clinical characteristics of age-related macular degeneration in patients in Yaoundé. METHODOLOGY: A multicenter, analytical and cross-sectional study was carried out from March 2017 to June 2018 in four hospitals in the city of Yaoundé. Included were all consenting patients aged at least 40 years with an established diagnosis of AMD both clinically and by imaging. The data were analyzed with CSPro software version 7.0. Chi2 and Student's "t" tests in univariate mode and logistic regression in multivariate mode were used with a significance of P≤5%. RESULTS: Of the 9,989 patients who were seen during the 16-month study period, 38 met our inclusion criteria - a frequency of 0.4%. The sex ratio was 0.3, and the mean age was 68±11 years. As a function of geographic origin, AMD is more common in patients from the forest and mountain areas. The systemic comorbidities associated recorded were hypertension (47.4%) and diabetes (21.1%). After optical correction, 60 of 76 eyes (78.9%) had useful visual acuity according to WHO criteria, and the rate of blindness was 9.2%. Fundus examination revealed fewer lesions than optical coherence tomography, which demonstrated miliary drusen in 57 (75%) eyes, serous drusen in 27 (35.5%), retinal atrophy in 19 (25%) and neovascularization in 3 (3.9%). The clinical forms were dominated by age-related maculopathy, found in 45 eyes (69.2%), followed by atrophic AMD in 17 (26.2%) and finally by exudative AMD in 3 (4.6%), for a total of 65 out of 76 eyes. Age was related to the risk of MLA and atrophic AMD (P≤0.05). CONCLUSION: AMD is an uncommon pathology in our setting, predominant in women over the age of 60 years.

[Retinal vein occlusions treated by intravitreal bevacizumab injections at the Hospital of Instruction, Application and Reference of the Armed Forces of Yaoundé]. / Occlusions veineuses rétiniennes traitées par injections intra-vitréennes de bévacizumab à l'hôpital d'instruction, d'application et de référence des armées de Yaoundé.

OBJECTIVE: To assess the anatomical and functional results of intravitreal bevacizumab injections in retinal vein occlusions at the Hospital of Instruction, Application and Reference of the Armed Forces of Yaoundé. PATIENTS AND METHODS: A prospective and descriptive study was conducted from October 2016 to August 2017 at the Hospital of Instruction, Application and Reference of the Armed Forces of Yaoundé. All eyes with edematous or mixed retinal vein occlusion were treatment naive and received at least 3 intravitreal injections spaced at least 28 days apart of bevacizumab 25mg/ml at a dose of 0.05ml per session according to the strategy of 3 injections or "3 I". At least 3 months after the final injection, visual acuity and macular thickness, assessed by optical coherence tomography, were analyzed with the IBM-SPSS 22 software. The Student's test was used to compare means, with a significance P<5%. RESULTS: We included nineteen eyes of 18 patients with a mean age of 62.83±9.57 years. The male to female sex ratio was 0.8. Branch vein occlusion was predominant in 14 (73.68%) eyes. The edematous type was noted in 17 (89.5%) eyes. Serous retinal detachment was present in 6 (31.6%) eyes. The mean number of injections was 4.2±1.2. The mean baseline visual acuity changed from +0.9 Log MAR (40 ETDRS) to +0.6 Log MAR (55 ETDRS) at 6 months, while the mean macular thickness went from 550.16±180µm to 338.58±127µm, with statistically significant differences. CONCLUSION: Intravitreal bevacizumab injections proved to be effective in the management of edematous retinal vein occlusions in our practice setting despite the lack of market authorization for this indication.