Aspects épidémiologiques, cliniques, thérapeutiques et évolutifs des maladies thyroïdiennes à Bouaké (Côte d'Ivoire) / Epidemiological, clinical, therapeutic and evolutionary aspects of thyroid deseases in Bouake (Ivory Coast)

Contexte : la maladie thyroïdienne représente la plus fréquente endocrinopathie dans le monde après le diabète sucré. En Afrique, elle constitue un véritable problème de santé publique et sa prise en charge est souvent entravée par les moyens d'investigations. Le but était d'étudier le profil des affections thyroïdiennes à Bouaké. Méthodes : il s'agissait d'une étude rétrospective, descriptive, menée dans le service de consultation de Médecine Interne du Centre Hospitalier Universitaire de Bouaké du 1er janvier 2020 au 31 décembre 2021. Elle a porté sur les dossiers de 104 patients suivis pour une pathologie thyroïdienne. Résultats : Sur 2560 patients reçus, la pathologie thyroïdienne concernait 104 patients ; soit une fréquence de 4,1%. Il s'agissait de 93 femmes et 11 hommes avec un sex-ratio (H/F) de 0,12 L'âge moyen était de 42,03 ans ±15 ans. Dans plus de la moitié des cas (55,8%), le délai de consultation était supérieur à 06 mois. Sur le plan fonctionnel, 58 patients (55,8%) présentaient une hyperthyroïdie avec comme principales étiologies la maladie de Basedow (60,3%, n=35) et le goitre multinodulaire toxique (24,1%, n=14). L'hypothyroïdie était retrouvée chez 10 patients (9,6%), le plus souvent post thyroïdectomie (60%). Les goitres et nodules euthyroïdiens étaient retrouvés chez 36 patients (34,6%) dominés par le goitre multinodulaire euthyroïdien (36,1%, n=13) et le goitre simple (27,8%, n=10). Le traitement des hyperthyroïdies reposait essentiellement sur les antithyroïdiens de synthèse dans 96,7%. Seulement 1 patient hyperthyroïdien avait subi une thyroïdectomie. La majorité des patients (82,2%) étaient perdus de vue. Conclusion : La pathologie thyroïdienne au CHU de Bouaké est une maladie fréquente de la femme jeune. Les hyperthyroïdies dominent le tableau des thyréopathies avec comme principale étiologie la maladie de Basedow. On note un taux élevé de perdu de vue, d'où l'intérêt d'une éducation de nos patients.

Context: Thyroid disease is the most common endocrinopathy observed in the world. In Africa, thyroid diseases remain a real public health problem and their care is often hampered by the means of investigation. The purpose of this work was to study the profile of thyroid affections in Bouake. Methods: This was a descriptive study with retrospective data collection, carried out over the period from 1 January 2020 to 31 December 2021 at the Internal Medicine consultation at the University Hospital of Bouake. All epidemiological, clinical and therapeutic and evolutionary data from patients followed for thyroid pathology were collected. It focused on the records of 104 patients followed for thyroid disease. Results: Out of a total of 2560 consultations, 104 patients were involved in thyroid pathology, prevalence of 4.1%. They were 93 women and 11 men with a sex ratio of 0.12. The average age was 42.03±15.64 years. In more than half of the patients (55.8%) the evolution of the clinical symptomatology was more than six months. A total of 58 patients (55.8%) had hyperthyroidism. The etiologies of hyperthyroidism were dominated by Grave's disease and toxic multinodular goiter, with 60.3% and 24.1% of hyperthyroidism respectively. Hypothyroidism was confirmed in 10 patients (9.6%), among then 6 (60%) had undergone total thyroidectomy. The multinodular goiter was found in 36 patients and was dominated by multinodular goiter (36.1%) and single goiter (27.8%). The treatment of hyperthyroidism was exclusively with synthetic antithyroid drugs. Hypothyroidism was treated with hormone replacement therapy. The majority of patients (82.2%) were lost in view. Conclusion: The thyroid pathology at the University Hospital Center of Bouake is a frequent illness of the young woman. Hyperthyroidism were frequently found with as main etiology Grave's disease The majority of patients (82.2%) were lost in view hence the interest of patient's education.

Actualités au cours de l'évolution de l'infection à VIH sida dans un centre de référence: à propos de 327 cas colligés dans le service de médecine interne du CHU de Bouake, Côte d'Ivoire / News during the evolution of HIV/AIDS infection in a reference center about 327 cases collected in the internal medicine department of the Bouake teaching hospital, Ivory Coast

Introduction : Les maladies opportunistes surviennent chez les personnes vivant avec le VIH (PvVIH) dans les situations de prise en charge tardive. En absence de traitements efficace, la multiplication du virus est inévitable et les personnes concernées sont confrontées à une baisse de leur immunité [1]. C'est dans cette situation que des infections opportunistes se déclarent. Objectif: contribuer à une meilleure connaissance des affections opportunistes liées au VIH Méthode : L'étude s'est déroulée dans le service de Médecine Interne du CHU de Bouaké du 1er janvier 2017 au 31 décembre 2020. C'était une étude rétrospective et transversale qui a concerné les dossiers de patients infectés par le VIH hospitalisés dans ledit service. Résultats : L'analyse a noté 327 cas de dossiers complets sur 3815. La prévalence hospitalière était de 8,5%. L'âge moyen était de 36,2 ans et le sex ratio de 0,83. 65,3% des patients n'ont découvert leur statut sérologique que pendant l'hospitalisation dont les motifs étaient dominés par l'altération de l'état général (36,8%) suivi du coma (19,2%). 84,5% des patients avaient le VIH1. Le taux moyen de CD4 était de 50,5% cellules/mm3 . Les affections opportunistes étaient dominées par la tuberculose (41,8% des cas) et la plus létale était la maladie de Kaposi digestif dans 100% des cas. Conclusion: les patients étaient hospitalisés au stade d'altération de l'état général et de coma d'où la forte létalité. La tuberculose était la principale affection opportuniste. Ces résultats montrent avec beaucoup d'intérêt l'importance de la sensibilisation de la population sur le VIH et la nécessité du dépistage précoce.

Introduction: Opportunistic diseases occur in people living with HIV (PvHIV) in situations of late treatment. In the absence of effective treatments, the multiplication of the virus is inevitable and the people concerned are confronted with a drop in their immune defenses [1, 2]. It is in this situation that opportunistic infections occur Objective: to contribute to a better understanding of opportunistic infections linked to HIV. Method: The study took place in the Internal Medicine department of the Bouake University Hospital from January 1, 2017 to December 31, 2020. It was a retrospective and cross-sectional study which concerned the files of patients infected with HIV hospitalized in the said department. Results: The analysis noted 327 cases of complete records out of 3815. The hospital prevalence of 8.5%. The mean age was 36 years and the sex ratio 0.83. 65.3% of patients only discovered their serological status during hospitalization, the reasons for which were dominated by deterioration in general condition (36%) followed by coma (19.2%). 84.5% of patients had HIV1. The average CD4 count was 50.5% cell/mm3. Opportunistic diseases were dominated by tuberculosis (38% of cases) and the most lethal was digestive Kaposi in 100% of cases. Conclusion: Most of our patients were without social security and did not know their HIV status. These patients were hospitalized at the stage of impaired general condition and coma, hence the high lethality observed. The main opportunistic infections were tuberculosis, cerebral toxoplasmosis and digestive mycoses. These results show with great interest the importance of sensitizing the general population on HIV AIDS and the need for early detection of these opportunistic diseases.

[Efficacy against Malaria Vectors of Long-Lasting Insecticide-Treated Mosquito Nets after 17 Months of Use in the City of Bouaké, in the Center of Côte d'Ivoire]. / Efficacité contre les vecteurs du paludisme de moustiquaires imprégnées d'insecticide à longue durée d'action après 17 mois d'utilisation dans la ville de Bouaké, au centre de la Côte d'Ivoire.

Malaria remains a public health problem in Côte d'Ivoire despite a 95% coverage rate with long-lasting insecticide-treated mosquito nets (LLINs) since 2015. A study was conducted in Bouaké to determine the residual efficacy of LLINs used during 17 months (N = 30) and of stored and unpacked LLINs (N = 8). The physical integrity of LLINs and their biological efficacy on populations of Anopheles gambiae (sensitive and resistant to insecticides) were assessed. The study revealed that 57% (17/30) of LLINs recovered from households have a hole. The proportional hole indices indicated that 70% (21/30) of LLINs were in good condition, 20% (6/30) were repairable and 10% (3/30) were unusable.This study also showed that the LLINs used and stored were effective on the sensitive Kisumu strain but ineffective on resistant populations of An. gambiae of Bouaké. Average knock-down and mortality rates induced by LLINs used on the populations of An. gambiae from Bouaké were 23% and 9%, respectively. The resistance of mosquitoes to insecticides and the alteration of the physil integrity of mosquito nets are probably major factors to be taken into account in estimating the efficacy of LLINs in the field.

Le paludisme demeure un problème de santé publique en Côte d'Ivoire malgré un taux de couverture en moustiquaires imprégnées à longue durée d'action (MILDA) de 95 % depuis 2015. Une étude a été menée à Bouaké afin de déterminer l'efficacité résiduelle de MILDA utilisées pendant 17 mois (n = 30) et celle de MILDA stockées et non déballées (n = 8). Pour ce faire, l'intégrité physique des MILDA et leur efficacité biologique sur des populations d'Anopheles gambiae (sensibles et résistants aux insecticides) ont été évaluées. L'étude a révélé que 57 % (17/30) des MILDA récupérées dans les ménages sont trouées et que les indices proportionnels de trous les plaçaient dans la catégorie des moustiquaires en bon état pour 70 % (21/30) d'entre elles, réparables pour 20 % (6/30) d'entre elles, inutilisables pour les 10 % (3/30) restants. Cette étude a également montré que les MILDA utilisées et stockées étaient efficaces sur la souche sensible Kisumu, mais inefficaces sur les populations résistantes d'An. gambiae de terrain. Les taux moyens de knock-down et de mortalité induits par les MILDA utilisées sur les populations d'An. gambiae de Bouaké étaient respectivement de 23 et 9 %. La résistance des moustiques aux insecticides et l'altération de l'intégrité physique des moustiquaires sont probablement des facteurs majeurs à prendre en compte dans l'estimation de l'efficacité des MILDA sur le terrain.

Kinetics of maternally-derived serogroup A, C, Y and W-specific meningococcal immunoglobulin G in Malian women and infants.

A prospective, randomised, controlled observer-blind trial measuring the efficacy and immunogenicity of trivalent influenza vaccine (TIV) and the immunogenicity of quadrivalent meningococcal conjugate vaccine (MCV) in pregnant women and their infants up to 6 months of age was conducted in Mali. Here we reported the immunogenicity of MCV, which was used as a comparator vaccine to TIV, in this population. Third-trimester pregnant Malian women were randomized to receive TIV or MCV. Blood samples were collected from women prior to vaccination, 28 days post-vaccination, at delivery and 3 and 6 months post-delivery and from infants at birth and 3 and 6 months of age. Meningococcal-specific serogroup (Men) A, C, Y and W-specific antibodies were measured by enzyme linked immunosorbent assay in a randomly selected subset of 50 mother-infant pairs where the mother had received MCV. At birth, 94.0% (47/50) of infants had MenA specific IgG levels ≥ 2 µg/mL decreasing to 72.9% and 30.4% at 3 and 6 months of age. For MenC, 81.3% (39/48) of infants had MenC specific IgG levels ≥ 2 µg/mL at birth decreasing to 29.4% and 17.8% at 3 and 6 months of age. For MenY, 89.6% (43/48) of infants had MenY specific IgG levels ≥ 2 µg/mL at birth decreasing to 64.6% and 62.5% at 3 and 6 months of age. For MenW, 89.6% (43/48) of infants had MenW specific IgG levels ≥ 2 µg/ml at birth decreasing to 62.5% and 41.7% at 3 and 6 months of age. Maternal immunization with MCV conveyed protective levels of IgG at birth through to 3 months of age in the majority of infants.

[Selective laser trabeculoplasty in African blacks]. / Trabéculoplastie sélective chez le mélanoderme africain.

INTRODUCTION: The treatment of primary open angle glaucoma (POAG) is preferably medical. However, when medical therapy fails, alternative or complementary treatments may be considered. In this regard, selective laser trabeculoplasty is a widely popular procedural treatment whose accepted benefits have been very little studied in African blacks. The objective of this study was to assess the efficacy of selective laser trabeculoplasty on the reduction of intraocular pressure (IOP) in African blacks with POAG. METHODS: We conducted a retrospective study of black patients treated with selective laser trabeculoplasty between March 2010 and March 2011. All patients had POAG with trabecular meshwork accessible over 360°. The treatment protocol consisted of a 360°treatment in two sessions (180°/session) 15 days apart. Success was defined as decrease from the initial IOP≥3mm Hg without additional medications. RESULTS: We included 44 patients, corresponding to 82 eyes. The mean age of the patients was 55.94±11.66 years with extremes of 19 years and 76 years. The mean intraocular pressure before laser treatment (initial IOP) was 18.43±4.81mm Hg. After laser treatment, the mean pressure reduction was (i) 3.81mm Hg (20.67%) at 15 days ; (ii) 4.08mm Hg (22.14%) at 1 month; (iii) 4.45mm Hg (24.14%) at 3 months; and (iv) 4.95mm Hg (26.86%) at 6 months. The success rate after laser treatment was 67.60% at 15 days, 83.78% at 1 month, 72.09% at 3 months and 80.43% at 6 months. CONCLUSION: Selective laser trabeculoplasty is effective in African blacks. Its efficacy is comparable to that of a carbonic anhydrase inhibitor or even a prostaglandin. It could be a complementary or substitutive alternative to POAG medications in African blacks.

Les intoxications accidentelles domestiques de l'enfant au CHU Gabriel Touré

Les intoxications accidentelles domestiques de l'enfant sont des urgences médicales pédiatriques fréquentes dans les pays en développement. Le but de notre travail était d'étudier les aspects épidémiologiques, étiologiques, cliniques et thérapeutiques des intoxications aiguës accidentelles domestiques chez les enfants âgés de 0 à 15 ans admis aux urgences pédiatriques du CHU Gabriel Touré. Méthode: Il s'agissait d'une étude descriptive à collecte prospective qui s'est déroulée du 01 janvier 2014 au 31 décembre 2014. Ont été inclus tous les patients âgés de 0 à 15 ans admis aux urgences pédiatriques pour intoxications aiguës accidentelles. Résultats: Cent cas d'intoxications accidentelles aiguës ont étés colligés. Les enfants âgés de moins de cinq ans représentaient 94%. La majorité des mères était des femmes au foyer et avait la garde des enfants (83%). Quarante-neuf pour cent des mères n'étaient pas scolarisées. Le lieu de stockage du produit était intradomiciliaire dans 96% des cas. Le produit était pris par l'enfant lui-même (88%). Un geste sur le lieu de l'accident était rapporté dans 68% des cas, l'ingestion de lait (72 %) et de l'eau (10%) avaient été les premiers gestes utilisés. L'hôpital était le lieu du premier recours (72%). La durée entre la prise du produit et l'admission à l'hôpital était de 1 à 5 heures dans 58% des cas. Les vomissements (37 cas), l'agitation (17 cas) et la détresse respiratoire (16 cas) étaient les symptômes les plus rencontrés. La soude caustique (18%) et l'eau de javel (17 %) étaient les produits d'intoxication les plus retrouvés. Les produits domestiques (48%) suivis des médicaments (33%) venaient en tête parmi les familles de toxiques. L'évolution était bonne avec une guérison sans séquelle (93%). Conclusion Les intoxications aiguës accidentelles aux produits domestiques sont courantes au Mali. Le délai d'admission à l'hôpital reste toujours long, les gestes inappropriés apportés aux patients sur le lieu de l'accident aggravent souvent le tableau mais sont largement effectués par les parents avant le recours aux soins de santé

[Relationship between human immunodeficiency virus (HIV-AIDS) and conjunctival squamous cell carcinoma: A clinical epidemiological study of 26 cases in the ophthalmology department of the university hospital of Treichville-Abidjan (Abidjan-Côte d'Ivoire)]. / Relation entre le virus de l'immunodéficience acquis (VIH-sida) et Carcinome épidermoïde conjonctival (CEC) : étude épidémioclinique de 26 dossiers au service d'ophtalmologie du CHU de Treichville (Abidjan-Cote d'Ivoire).

PURPOSE: To describe the epidemiological and clinical parameters of conjunctival squamous cell carcinomas and their association with HIV-AIDS in the ophthalmology department of the university hospital of Treichville. PATIENTS ET METHODS: This is a prospective and descriptive cross sectional study carried out in the ophthalmology department of the university hospital of Treichville from July 2007 to June 2011. Twenty-six (26) patients who were selected presented with a tumor of the globe and/or adnexa. A CT scan was performed in advanced cases. Histopathological examination of the surgical specimen was performed in all cases. HIV serology was performed after informed consent. All patients were referred to the oncology department of the university hospital of Treichville where a unit of care for HIV-positive patients with malignant tumors is available. Statistical analysis was performed using the software program EPI info version 6.0. RESULTS: We note a slight predominance of female patients 15 (57.69%) vs. 11 (42.3%) male patients. The mean age was 42.32 years, and 13 patients (50%) were between 25 and 45 years of age. Intraorbital tumors were the most common reason for consultation, i.e. 38.46%. Seventeen patients (65.38%) had no particular history. Nine patients (34.61%) were already on antiretroviral treatment on admission. Three patients, i.e. 11.54%, had already had tumor biopsy and/or evisceration. The mean duration of the disease before consultation in ophthalmology was 14.28 months. Localized limbal conjunctival tumors were found in 11 cases (42.38%). Advanced tumors with regional or cerebral extension accounted for 34.61% of cases. Six patients (23.078%) were HIV negative vs. 20 (76.92%) HIV positive patients. CD4 lymphocyte typing was performed in 17 patients (85%), and 45% had a CD4 count below 200. Only five patients were able to receive neoadjuvant chemotherapy, but three of them died. The average length of follow-up was 29 months. COMMENT: This study allowed us to establish a statistically significant link between HIV positive status of patients and the occurrence of squamous cell carcinoma, (P=10(-4)), as well as the decline in CD4 count and disease progression (p=10(-3)). CONCLUSION: The poor prognosis of conjunctival carcinoma reflects the low socioeconomic status of patients, physician under-staffing in our health care facilities, the prohibitive cost of anticancer drugs and the link between this disease and HIV-AIDS.

[Cataracts related to the extended application of dermocorticosteroids. A study of 8 cases in Abidjan]. / Cataractes liées à l'application prolongée de dermocorticoïdes: étude de 8 cas à Abidjan.

INTRODUCTION: Cataract induced by corticosteroids is an entity, which has been well described for a relatively long time, but this eventuality caused by the cutaneous application of corticosteroids remains inadequately reported. The purpose of this study was to describe cataract as one of the complications of the misuse of cutaneous application of corticosteroids. MATERIALS AND METHODS: In eight patients seen for visual loss, bilateral cataract was discovered. The only probable etiology in these cases appeared to be the cutaneous application of corticosteroids. Indeed, the work-up and careful history performed did not uncover any other etiology. RESULTS: Eight patients, six women and two men, exhibited cataracts related to the application of topical corticosteroids. The age of the patients ranged between 39 and 45 years. The cataracts were bilateral and posterior subcapsular alone or combined. The period of use of corticosteroids ranged from 5 to 10 years. The products used consisted of a variety of chemicals including corticosteroids mainly in the form of traditionally manufactured soap, but also as ointment or other types of mixtures. CONCLUSION: Topical corticosteroids induce posterior subcapsular cataract. The mechanism of action is direct access to the eye without any hepatic-first pass effect on the corticosteroid in question. The increasingly frequent use of corticosteroids in African blacks for skin lightening raises concern regarding the risk of epidemic cataracts in young women attempting to lighten their skin to be beautiful. Increased public awareness should be undertaken to prevent this growing and harmful phenomenon.

Evaluation of the prevalence of trachoma 12 years after baseline surveys in Kidal Region, Mali.

OBJECTIVE: After prevalence surveys in all eight regions, Mali started a national programme to control trachoma in 1998. In the sparsely populated desert region of Kidal, where active trachoma prevalence was 46.2% in children under 10, no interventions beyond routine eye-care services were implemented. We estimated the prevalence of trachoma in Kidal, 12 years after baseline mapping surveys, to determine whether interventions to control trachoma were warranted. METHODS: A total of 2165 individuals from 477 households were examined for clinical trachoma signs in a cluster survey using the WHO simplified grading system. Individual and household risk factors for trachoma were assessed. RESULTS: The prevalence of follicular trachomatous inflammation (TF) in children 1-9 years of age was 15.6% (95% CI 11.8-19.5%). Trachomatous trichiasis (TT) was observed in 4 persons for an overall prevalence in all ages of 0.16% (95% CI 0.0-0.35%). Estimated household latrine coverage in the region was 33.1% (95% CI 14.0-52.2%). Residents of 52.8% of surveyed households reported access to a water source outside geographical boundaries of their communities. CONCLUSIONS: In the absence of control interventions, the prevalence of clinical signs of trachoma among children was substantially lower than estimates 12 years earlier. The current prevalence of active trachoma remains above the threshold adopted by WHO, yet there is little evidence of chronic blinding trachoma.

[Anterior segment analysis using OCT3]. / Méthodologie d'analyse du segment antérieur par OCT-3.

PURPOSE: Optical coherence tomography has been used for many years, in particular in the field of the retinal imaging, and is a promising technique in the analysis of the anterior segment, providing a similar resolution to histology for ocular tissue. MATERIAL AND METHODS: We present a collection of images obtained with the OCT3 (Carl Zeiss Meditec, Dublin, CA), with parameters set to obtain good-quality images of the iris and corneal structures. RESULTS: The OCT provides detailed analysis of the cornea, precise assessment of the dimensions and locations of corneal lesions - in the anterior-posterior plane as well as transversally or obliquely - with 10-microm precision, and the study of the iridocorneal angle and its dynamics. DISCUSSION: Using the highly precise OCT3 for retinal imaging, it is possible to obtain good-quality anterior segment imaging, which makes the device highly versatile and thus increases reasons for acquiring this type of apparatus. CONCLUSIONS: OCT3 users should not neglect this potential of the device, already in wide use for examining the retina.

[Central serous chorioretinopathy: a study of six cases observed in Abidjan between 2003 and 2005, suggesting a role played by the Ivorian political-military crisis]. / Choriorétinopathie séreuse centrale: étude de 6 cas observés à Abidjan entre 2003 et 2005, rôle évoqué de la crise ivoirienne.

OBJECTIVE: This study aimed to show that central serous chorioretinopathy is present in Ivory Coast and that the emotional and psychosocial context plays an important role in this disorder's pathogenesis. PATIENTS AND METHOD: The authors report six central serous chorioretinopathy cases based on angiographic diagnosis, five in Black African subjects and one in a European subject. These cases were observed over a period of 2 years during the Ivorian political-military crisis. RESULTS: In a center where angiography has been a current practice since 1999, up to 2002 479 angiographies were done without a single central serous chorioretinopathy case being diagnosed. After the beginning of the political-military crisis, six cases of central serous chorioretinopathy were observed out of 417 angiographies over a period of 2 years. All the patients were males, between 20 and 50 years old, five were Black Africans and one was a white European. Their professions varied (a contractor, a soldier, a business executive, for example). The angiography showed break points in ink spots in the majority of the cases, with one case showing multiple break points. All the patients were emotionally distraught because of the uncertainty of the political situation. CONCLUSION: This study confirms that central serous chorioretinopathy does indeed exist in the Black African subject, as it exists in the leucoderma subject without discrimination. This study emphasizes the anxiety and extreme emotional context as an initiating factor in the occurrence of central serous chorioretinopathy.

[Central corneal thickness and potential error in Goldmann applanation tonometry of the Black African patient suffering from primary open-angle glaucoma: 340 eyes surveyed]. / Epaisseur cornéenne centrale et erreur potentielle de la tonométrie à aplanation de Goldmann chez le patient noir africain atteint de glaucome primitif à angle ouvert. A propos de 340 yeux.

INTRODUCTION: Goldmann applanation tonometry is the reference method for measuring IOP. This tonometric model is influenced by corneal thickness, which varies according to race. Most studies have been conducted on Caucasian or Black American subjects. Studies on Black African subjects being rare, the goal of our study was to measure the central corneal thickness and its impact on Goldmann applanation tonometry on Black African subjects suffering from primary open-angle glaucoma (POAG). PATIENTS AND METHODS: Our retrospective study focused on POAG eyes. The central corneal thickness was measured using an ultrasonic pachymeter (Quentel Médical). RESULTS: 340 eyes from 170 patients made up the sample. The mean age of our patients was 44.4 +/- 12.7 years, with a mean central corneal thickness of 519.6 +/- 32.6 microm. Of our patients, 57.6% had a central corneal thickness less than 527 microm, 30.6% between 527 and 560 microm, and 11.8% had a central corneal thickness greater than 560 microm. DISCUSSION AND CONCLUSION: Compared to Black American and Caucasian subjects, the Black African glaucoma subject differs in the early age of glaucoma onset and the thinness of the cornea. Corneal thickness evaluation induces a potential error in IOP measurement on Black African glaucoma subjects. On the Black African subject, Goldmann tonometry is therefore affected by an error rate estimated at 69.4% (57.6% underevaluation and 11.8% overevaluation). Pachymetry is therefore a necessity for the Black African glaucoma patient requiring IOP adjustment.

[Ocular biometric values of the black African patient and theoretical consideration of the role of these values in various pathologies: analysis of 325 eyes]. / Valeurs biométriques de l'oeil du sujet africain de race noire et hypothèse du rôle dans certaines pathologies: à propos de 325 yeux.

INTRODUCTION: The international literature seldom refers to eye measurements of the black African patient. Therefore, the various patterns where biometry elements are used as constituents deserve reconsideration as they may not correspond to the eye of the black patient of our region. This study provides true measurements for the black African patient in Ivory Coast. It also establishes hypotheses by extrapolating the role of measurements in pathologies such as glaucoma. MATERIAL: and method: The study included 325 eyes of 217 male and female patients. All the patients underwent ocular keratometrics and echo biometrics to measure the depth of the anterior chamber, the width of the lens, and the total axial length with the ultrascan biometer using the contact method in A echometrics. RESULTS: The mean keratometry in women was significantly higher than in men (43.99 +/- 1.62 diopters vs 43.46 +/- 1.45 diopters). The anterior chamber was deeper in men (2.69 mm +/- 0.54 vs 2.53 mm +/- 0.48). The men's eyes were significantly longer, with an axial length of 23.26 mm +/- 1.07 vs 22.56 mm +/- 0.90. CONCLUSION: Significant biometric differences between men's and women's eyes, on the one hand, and between black African and white patients' eyes, on the other hand, can be observed. The reasons for these differences are several: they are natural, socioeconomic, and technical. If standard implant of a different power for black and white patients can be imagined, can we also infer that the biometrics of a black African patient predisposes him to a disorder such as glaucoma more than a white patient? Further in-depth studies could provide an answer to this question.

[Internal carotid artery dissection on arterial fibromuscular dysplasia causing a central retinal artery occlusion: a case report]. / Oblitération de l'artère centrale de la rétine secondaire à une dissection de la carotide interne sur fibrodysplasie artérielle.

INTRODUCTION: We report a case of a 66-year-old woman presenting a central retinal artery occlusion with no cardiovascular risk factor, with assessment using supra-aortic artery ultrasonography showing total internal carotid artery thrombosis. OBSERVATION: When vascular thrombosis risk factors are absent, more in-depth assessment such as a supra-aortic artery angioscan can provide the diagnosis of arterial dissection on arterial fibromuscular dysplasia. CONCLUSION: Central retinal artery occlusion is a rare but severe pathology. Therefore it is very important not to neglect the etiological assessment, because it can be the revealing element of a severe pathology.

[Sickle cell beta-thalassemia leading to serious ischemic retinopathy: a study of 18 patients in Abidjan]. / Les bêtathalasso-drépanocytoses pourvoyeuses de rétinopathies ischémiques graves. A propos de 18 patients étudiés à Abidjan.

The authors in this study intended to demonstrate that S-beta thalassemia can lead to severe ocular hemorrhagic risks, as is true of the sickle cell form. Both forms are also comparable in terms of the risk of aseptic necrosis of the femoral head. Out of the 18 patients studied, 13 (72.2%) had sickle cell retinopathy. Three of 13 patients had already developed new vessels and risked intravitreous hemorrhage. The authors recommend that more vigilance be mounted for the detection of S-beta thalassemia so as to benefit from rigorous and systematic follow-up and early treatment. Retinal argon laser photocoagulation is only effective if a clear diagnosis is made early.

[Retinopathy as a sickle-cell trait: myth or reality?]. / La rétinopathie chez le porteur du trait drépanocytaire AS: mythe ou réalité?

INTRODUCTION: The retinopathy of sickle cell diseases is an ischemic retinopathy that occurs frequently in the major forms of HbSS and HbSC sickle cell diseases. The retinopathy of sickle trait HbAS has not been described extensively. PATIENTS AND METHODS: The aim of this study was to describe the retinal characteristics and thus gain better knowledge of sickle trait HbAS retinopathy. Seventy HbAS patients had a complete ocular examination including fluorescein angiography. RESULTS: Seventy percent of the patients had retinal lesions, with 49.3% non-vasoproliferative lesions, 22.7% prevasoproliferative lesions and 2.7% neovascular lesions. DISCUSSION AND CONCLUSION: Retinopathy is associated with the HbAS sickle cell trait, but it is less serious than in the major forms of sickle cell syndrome.

[Epidemiology of eye injuries in Abidjanian children]. / Epidémiologie des traumatismes oculaires de l'enfant à Abidjan.

Eye injuries, most of them preventable, are particularly severe in Africa, because of the risks of infection and delay in treatment. We report a 16-month (March 1997-June 1998) prospective observational survey of eye injuries in children up to the age of 15 years at Treichville-Abidjan University Hospital. During this period, 62 children were treated for these injuries. Ocular traumas represented 4% (n = 245) of new admissions in ophthalmology, and 29% of these injuries occurred in children. The sex ratio was 5:2 boys to girls, and their mean age was 8.66 +/- 3.56 years. Eye injuries occurred most often during play (84%, n = 52). More than 85% (n = 53) of children were alone or without adult supervision at the time of the injury. The causal agent was most often wood (35%) followed by metal (29%). The mean time from injury to hospital admission was 1.8 +/- 0.77 day. Only 19% of patients were admitted the day of injury. Most patients (66%) first sought treatment in a primary care centre. More than 70% (n = 44) of injuries necessitated hospitalisation. Open eyeball wounds were the most common injury (53%) and were associated with endophthalmitis in 16%. The mean recovery of visual acuity was 0.1. At admission, 40 of the injured eyes (64.5%) had monocular blindness; six recovered, for a final blindness rate of 55%. Injuries associated with wooden objects had a final blindness rate of 77% and play-related injuries 63%. The primary posttraumatic sequelae were corneal scars. Eyeball phthysis (14.5%) was secondary to 8 open wounds of the eyeball and one postcontusion retinal detachment. Eye injuries remain a major cause of monocular blindness in children in Cote d'Ivoire. Most of them can be prevented by relatively simple measures including supervision of children and rapid hospitalisation when injury occurs.