[Overview of visual impairment at the Yalgado Ouédraogo University Medical Center: Study of 501 cases]. / Les profils de la déficience visuelle au centre hospitalier universitaire Yalgado Ouédraogo : à propos de 501 cas.

OBJECTIVE: To determine the main causes of visual impairment according to age in patients admitted to the ophthalmology department. MATERIALS AND METHODS: This was a retrospective study of 501 cases of visual impairment. Included were patients of both sexes whose best-corrected visual acuity in the better eye was strictly less than 5/10. The parameters studied were age, gender, place of residence, corrected visual acuity in the better eye, and diagnosis. The data were entered and processed with the Epi info 7.2 software. RESULTS: Subjects over 50 were the most prevalent (48.5%). In patients over 50 years of age, cataracts (54.32%) were the leading cause of visual impairment, followed by glaucoma (24.69%) and non-glaucomatous optic neuropathy (26.19%). Trauma (17.62%) was frequently found in patients aged 16 to 50 years. Tropical endemic limbo-conjunctivitis (25.00%) was the leading cause of visual impairment in subjects aged 5 to 15 years. CONCLUSION: This study confirms the results of the literature, which have shown that cataracts are the leading cause of visual impairment in developing countries. A major effort to raise awareness, provide information and therapeutic care would reduce the incidence of visual impairment.

[Preliminary selective laser trabeculoplasty (SLT) intraocular pressure results in glaucoma patients in Burkina Faso]. / Résultats tonométriques préliminaires de la trabéculoplastie sélective au laser (SLT) chez les glaucomateux au Burkina Faso.

INTRODUCTION: Glaucoma is the leading cause of irreversible blindness in the world. The purpose of our study was to evaluate the tonometric results of SLT treatment in patients with glaucoma. MATERIALS AND METHODS: This was a prospective study of patients with glaucoma who were seen from October 1, 2017 to July 31, 2018. All patients underwent SLT of the inferior 180°. Intraocular pressure (IOP) was measured before and then at 1, 15, 30, 60, 90 and 120days after treatment. RESULTS: We studied 35 eyes of 31 patients. The mean age was 59.3 (±8.4years), range 43-77years. The mean IOP prior to SLT was 20.1mmHg (±7mmHg). One day after the laser, this decreased to 17.6mmHg (±8.4), for a percentage of drop of 12.4%. At 30days, it was 15.3mmHg (±5.4mmHg), i.e. a 23.9% decrease. After 60 and 90days, there was a drop of 13.9% and 15.4%, respectively. At 120days, 43.3% of treated eyes had a decrease of at least 20%. The main complication was increased IOP in 14.2% of cases. CONCLUSION: SLT reduces IOP and the number of glaucoma medications in patients. It appears to be a viable alternative in our countries. These results should be confirmed with a larger cohort and longer follow-up.

[Causes of childhood blindness and visual impairment in Ouagadougou: About 398 cases]. / Causes de cécité et déficiences visuelles chez l'enfant à Ouagadougou : à propos de 398 cas.

INTRODUCTION: Childhood blindness is a public health problem in developing countries. The goal of this study was to focus on the epidemiological and clinical patterns of moderate to severe, uni- or bilateral childhood blindness and severe visual impairment in the ophthalmology department of Yalgado Ouedraogo university hospital (YOUH) in Ouagadougou, Burkina Faso. MATERIALS AND METHODS: We conducted a descriptive, cross-sectional analytic study based on retrospective data in the ophthalmology department of YOUH from January 1, 2010 to December 31, 2014. It included cases of childhood blindness and severe visual impairment (World Health Organisation: WHO) in children 0-15 years of age. The studied variables were sociodemographic and clinical data, visual outcomes, and avoidable aspects of their blindness (WHO). RESULTS: The prevalence of uni- or bilateral childhood blindness and severe visual impairment was 4.36% (398 cases out of 9125 children). The male/female ratio was 1.70. The mean age was 9±4 years old; 54% of children were school-age boys and girls; the most frequent causes among the 398 patients were traumatic (46.98%), infectious (12.31%) or congenital (10.05%). Most of the ocular injuries occured in boys (P<0.05) and school children (P<0.05). The injured structures resulting in childhood visual impairment were primarily the lens (30.65%) and the globe (27.64%). Childhood blindness and severe visual impairment were considered avoidable in 80.65% of cases. The type of visual disability was related to age, especially school age (P<0.0001) and to avoidability (P<0.05). CONCLUSION: Given the high prevalence of childhood blindness and severe visual impairment, early, effective management and preventive strategies should be employed.

[What do we know about diabetic retinopathy at the Sourô Sanou university medical center in Bobo-Dioulasso (CHUSS)?] / Que savons-nous de la rétinopathie diabétique au centre hospitalier universitaire Sourô Sanou de Bobo-Dioulasso (CHUSS) ?

INTRODUCTION: Ocular damage is one of the numerous complications of diabetes. Proliferative diabetic retinopathy can result in blindness. The purpose of our work was to study the aspects of diabetic retinopathy on fundus examination in diabetic patients in Bobo-Dioulasso in a hospital environment. METHODS: This is a descriptive, cross-sectional, prospective study from March 1st to August 31st 2014 of diabetic patients in the Sourô Sanou university hospital. We used the Francophone Diabetes Society's classification. RESULTS: We included 246 patients (487 eyes). The frequency of diabetic retinopathy (DR) was 47.1%, and the frequency of diabetic maculopathy 8.9%. Proliferative DR and severe Non-Proliferative DR represented 3.3% of eyes, and blindness occurred in 3%. Among diabetics with DR, the mean age was 55.75 years (standard deviation 11.04 years); the median duration of diabetes was 36 months, and 99.1% of the diabetic patients were categorized as type 2. There was a statistically significant association between diabetic retinopathy and duration of diabetes progression, history of neuropathy, presence of proteinuria on 24hour urines, hypercreatininemia, and also between triglyceride levels and diabetic maculopathy. CONCLUSION: Diabetic retinopathy affects almost half of diabetic patients at the Sourô Sanou university hospital. An earlier, multidisciplinary management approach might prevent this.

Epidemiological profile of patients with uveitis in Boko and Parakou, in northern Bénin.

To describe the epidemiology of uveitis in northern Bénin. This retrospective study carried out from records describing 10 years of uveitis care in 2 eye clinics in northern Bénin. The sample of 623 eyes with uveitis in 489 patients accounted for 1.0% of all consultations. A male predominance was observed with a sex-ratio of 1.5 (297 m/192 F). The patients' mean age was 35.7 ± 16.1 years, and the age range most often affected was 20-39 years. The uveitis was anterior in 32.3 %, posterior in 29.0 %, intermediate in 28.1% and total (panuveitis) in 10.6%. The cause was undetermined in 85.7 % of cases and identified in 14.3%, including toxoplasmosis in 47 cases (7.5%) and herpes zoster in 20 cases (3.2%). Outpatients accounted for all cases, and all received topical corticosteroids. Some complications were observed. Uveitis has a prevalence rate of 1% in northern Bénin. It caused blindness in 9.8% of affected eyes and impaired vision in 49.3%.

[What remains today of neonatal conjunctivitis in prefecture of Kozah in Togo?]. / Que reste-t-il aujourd'hui des conjonctivites néonatales dans la préfecture de la Kozah au Togo ?

AIM: The purpose of this study is to screen the neonatal conjunctivitis in order to evaluate its incidence and especially to seek for the causative germs. PATIENTS AND METHODS: We have realized cross-sectional study in three health centers of the prefecture of Kozah from March 24 to May 12, 2009. All the newborns followed in these centers are examined in the search of signs of conjunctivitis. A biological diagnosis of conjunctival secretions was carried out at the suspect newborns. RESULTS: During the study period, 348 newborns were examined including 185 boys and 163 girls corresponding to a sex-ratio (M/F) of 1.1. The middle age was 3.7 days. Twenty-eight newborns presented conjunctivitis, that is to say a rate of incidence of 8%. The cases of conjunctivitis were observed the first four days of life in 39.3% of cases. Eighteen of the newborns presenting conjunctivitis were vaginal deliveries (64.3%) against ten (35.7%) by caesarian. All the mothers of the ill newborns had a syndrome of sexually transmissible infection (STI) during the third quarters of pregnancy. After biological diagnosis, Staphylococcus aureus was found in 25% of the cases. CONCLUSION: Despite the common herd of neonatal conjunctivitis prophylaxis by Crede's method, its remains in the prefecture of Kozah. In hope for neonatal conjunctivitis eradication, treatment of STI on pregnant women associated to education and communication on the prevention of the infection in neonatal health care centers and at home by hygiene rule application are necessary.

[Eales disease: a case report in Burkina Faso]. / Maladie de Eales : à propos d'un cas au Burkina Faso.

The authors report the first case of Eales disease described in Burkina Faso. A 21-year-old man presented myodesopsia with acute visual acuity decrease in the right eye at 1/50, vitreous haemorrhage, and retinal phlebitis of the large trunks. In the left eye, visual acuity was 10/10 P2, with phlebitis associated with retinal haemorrhages, vascular occlusion, and retinal ischaemia. Laboratory investigations found a positive TST at 20mm but the Koch bacillus was not isolated. The patient received treatment for tuberculosis, corticosteroids, retinal argon laser photocoagulation, and vitrectomy in the right eye. The clinical, immunopathological, and therapeutic aspects of Eales disease are discussed.

Etude radiologique des retinoblastomes en milieu africain burkinabe

Objectif : Decrire les aspects radiologiques du retinoblastome et analyser l'apport de l'imagerie medicale dans cette affection en milieu africain burkinabe. Methode : Etude retrospective menee entre janvier 2005 et decembre 2008; incluant 15 cas suspects de retinoblastome apres exploration par echographie et tomodensitometrie (TDM). Resultats : Le groupe comprenait 9 garcons et 6 filles; d'age median de 2;2 ans. Le retinoblastome etait de forme exophytique; unilateral chez 11 patients (73;3) et bilateral dans 4 cas (26;7). Les calcifications intratumorales etaient retrouvees dans 93;3des cas a l'echographie. Le scanner precisait les extensions loco-regionales et a permis de decouvrir deux cas de retinoblastomes trilateraux. Conclusion : La TDM demeure la technique la mieux appropriee pour le diagnostic du retinoblastome en imagerie. Son cout eleve constitue une limite a son accessibilite dans la plupart des pays pauvres. L'echographie peut etre une alternative lorsque des calcifications intratumorales sont mises en evidence

[Contribution of indocyanine green angiography in sickle cell retinopathy]. / Apport de l'angiographie au vert d'indocyanine dans la rétinopathie drépanocytaire.

PURPOSE OF THE STUDY: This was a prospective, nonrandomized observational study to search for choroidal abnormalities associated with sickle cell retinopathy and to assess the contribution of indocyanine green angiography (ICG) in this disease. PATIENTS AND METHOD: From July to October 2000, 26 patients with sickle cell disease (SS, SC, and thalassemia) were recruited, most followed in the pediatric department. After an ophthalmologic clinical examination, fluorescein angiography and indocyanine green angiography(ICG) were performed. RESULTS: The average age was 14.3 years (range, 9-24 years). There were 17 SS forms (65.4%), five SC forms (19.2%), and four beta-thalassemia forms (15.4%). The ICG was well tolerated. In 24 cases (92.3%), we observed rarefaction of the choriocapillaris out of the posterior pole with no difference depending on the genotype. We noted neither hypo- nor hyperfluorescence of the choroid at the retinal ischemic areas, the black spots were clearly delimited, and photocoagulation scars appeared larger than in fluorescein angiography. DISCUSSION: Our ICG study did not show anomalies of the choroidal circulation but rarefaction of the choriocapillaris was observed in most patients, a striking finding. This lower visibility or nonperfusion could be explained by anatomical modifications or by a centripetal reduction in the density of the choriocapillaris concomitant to the microvascular occlusive phenomena in the ischemic retina. CONCLUSION: This study is the first to use ICG in sickle cell retinopathy. The rarefaction of the choriocapillaris observed may be related to the systemic disease. However, it must be compared with the choriocapillaris of normal subjects at the same age.

[Epidemiology and prognostic factors for sickle cell retinopathy in Ouagadougou (Burkina Faso)]. / Etude épidémiologique et facteurs pronostiques de la rétinopathie drépanocytaire à Ouagadougou (Burkina Faso).

INTRODUCTION: The frequency of sickle cell disease varies from 5% to 20% in Africa. PATIENTS AND METHOD: This retrospective study investigated 173 patients in an ambulatory setting from August 2000 to July 2006. The study included 98 women and 75 men, aged 15-62 years, with a mean age of 26.7 years. RESULTS: Only 89 patients (71 SC and 18 SS) were seen in ophthalmology, 44 (49%) had sickle cell retinopathy with 26 (29%) cases nonproliferative and 18 cases proliferative (20%). Among the 71 SC patients, 35 (50%) had sickle cell retinopathy, with 40% the proliferative form. Of the 18 SS patients, nine had a retinopathy (50%), with four cases proliferative. DISCUSSION: Retinopathy is a frequent complication of sickle cell disease, which can lead to blindness, and its management better accessibility to the ophthalmologic examination and preventive treatment by laser photo coagulation.

[Lacquer cracks complicated with choroidal neovascularization in pseudoxanthoma elasticum: the first case report in Burkina Faso]. / Stries angioïdes compliquées de néovascularisation choroïdienne dans le cadre d'un pseudoxanthome élastique: 1er cas décrit au Burkina Faso.

Lacquer cracks are breaks in the Bruch membrane by alteration of the elastic layer. They are often associated with pseudoxanthoma elasticum. The authors report the first case in Burkina Faso involving a 51-year-old woman who was seen for visual acuity loss. She had pseudoxanthoma elasticum associated with lacquer cracks complicated by choroidal neovascularization in both eyes. She was treated with laser photocoagulation of the neovessels in the left eye, and no recurrence was reported after 6 months.