[Knowledge, attitudes and practices regarding glaucoma in the urban and suburban population of Lomé (Togo)]. / Connaissances, attitudes et pratiques relatives au glaucome dans la population urbaine et semi-urbaine de Lomé (Togo).

PURPOSE: One of the main constraints in the prevention of blindness is the lack of awareness of people regarding eye diseases. This study was undertaken to determine the level of knowledge, the attitudes and practices regarding glaucoma in the population of Lomé. METHODS: An interview using a questionnaire was conducted among an opportunistic sample of 767 people living in the capital city of Lomé and in some of its suburbs. The interview targeted people aged 20 to 65 years; the questions were either closed or open. The interviews were conducted either in French or in the local languages where needed and in the latter case with the help of a translator. Variables measured included education status, e.g., schooling years, economic status and professional situation. RESULTS: The knowledge of eye diseases accounted for 84% among the population studied; the most well-known being myopia, cataract, presbyopia, and glaucoma in decreasing order. Glaucoma was known by 228 people (29.7%) among whom 25% were aware of glaucoma blindness cases; 61.5% declared that glaucoma was a serious condition; 4.4% admitted the use of traditional eye-healers; 56.1% were not confident in the local doctors for the treatment of glaucoma. CONCLUSION: The high proportion of people who are not confident in the capabilities of national doctors to efficiently treat glaucoma is worrying. This situation requires the set up of a rational national strategic action plan (e.g., health education) aimed at reducing the burden of glaucoma blindness in the country.

[The distribution of cup disc ratios in a general population of Southern Togo aged 40 years and over]. / Distribution de l'excavation papillaire dans une population générale de 685 personnes âgées de plus de 40 ans et habitant le Sud Togo.

PURPOSE: Clinical reports and epidemiological surveys have raised the key issues of both the burden of glaucoma blindness and the high prevalence of the disease among the populations of Togo. This population survey aimed to collect data on the distribution of cup disc ratios. PATIENTS AND METHODS: The study population of 685 persons was selected in a remote rural area. All participants aged over 40 years were included. Eye assessment was conducted in the local health facilities using a visual acuity chart, an ophthalmoscope and light magnification for exploration of the anterior segment. RESULTS: The mean age of participants was 49.70 years (range, 40-99 years); men accounted for 61.8% and women 38.2%. Mean cup disc ratios were not different in both eyes, with 0.38 in the right eye and 0.37 in the left. Cup disc ratios over 0.5 represented 29.3% in the right eye and 29.8% in the left one; a cut-off point over 0.7 gave an abnormal cup ratio prevalence of 9.2% in the right eye and 9.3% in the left eye. In 92% of cases, the appearance of the cupping was round, and was elliptic in 7.6% of patients. We found that 75% of discs had a central round cupping. The temporal location was noted in 22% of cases while nasal locations were recorded in 2.4%. CONCLUSION: This survey has noted the various patterns of cup discs, with the mean cup disc ratio similar to what is usually described in similar studies. Further population-based surveys using the cut-off ratios found here are needed to determine the prevalence of glaucoma in this rural area.

[Retinal complications in AIDS patients at the Lomé (Togo) University Hospital]. / Les complications rétiniennes chez des patients atteints de SIDA au CHU de Lomé (Togo).

BACKGROUND: The purpose of this study was to describe retinal complications observed in patients presenting with AIDS at Lome teaching hospital. MATERIAL: All patients who met WHO AIDS clinical case diagnostic in Africa, admitted for various signs in hospital, were followed between December 1996 and May 1997 for ocular examinations. RESULTS: We surveyed 94 patients; 41 (43.6%) had retinal lesions. Retinal complications were cotton whool spots (30 cases), retinal hemorrhages (4 cases), papilloedema (4 cases), cytomegalovirus retinitis (8 cases). Mortality in patients with retinal complications occurred 10 months after the clinical diagnosis of AIDS. CONCLUSION: This study has found a high retinal morbidity contrasting with other studies in Africa. This could be explained by the longer period of follow-up larger than in previous similar studies.

[Retinal involvement in drepanocytosis in Togo. Correlation between age, genotype and retinopathy]. / Atteinte rétinienne au cours de la drépanocytose au Togo. Corrélation entre âge, génotype et rétinopathie.

PURPOSE: To evaluate different retinal complications, study correlation with age and links with genotypic forms in Togolese sickle cell patients. MATERIAL AND METHOD: Patients were recruited between 1994 and 1996 at the hospital, genotypic diagnosis by electrophoresis, systematic angiofluorography were performed and laser photocoagulation of retinal neovascularisation if needed. RESULTS: A total number of 190 patients were recruited, 84 (44.21%) had retinopathy, while 106 (55.79%) were normal. The SC form was most affected with 50 patients (26.3%), followed by the SS group in 11.05% (21 patients), and AS trait, 2.65% (5 patients). Patients most affected by proliferative retinopathy were aged 35-44 years (n = 30; 15%), 25-34 years in 23.8% and 15-24 years in 20.6%. CONCLUSION: Young Togolese sickle cell patients aged 35 to 44 year-old and the SC forms appear to have a relative high risk of proliferative retinopathy in this study.

[The optic disk in Togolese patients with glaucoma]. / La papille chez le glaucomateux togolais.

BACKGROUND: We conducted this retrospective study to analyze the main characteristics of the disc cuppings in patients diagnosed with chronic open angle glaucoma. METHODS: Data of 489 patients seen in our department and presenting chronic open angle glaucoma were collected. All these patients entered our glaucoma criteria and had disc cupping examination by color stereophotography during the follow up period of 36 months. RESULTS: The sample for the whole comprised 489 patients, of whom 327 where men (67%) and 162 female (33%). Most of the patients are young, 68.97% less than 45 years old. The disc cuppings had various distributions: 28% at 0.4; 25.8% at 0.5; 19.3% at 0.6; 13.2% at 0.7; 10.7% at 0.8; and 4.3% at 0.9. The mean cupping in the left eye (0.6) was greater than that of the right eye (0.52); p = 0.001. There were also differences in the values of the mean cupping with the age (p = 0.0001). However, there was a correlation between the cuppings and the result of the automatic perimetry. CONCLUSION: This study demonstrated the importance of disc cup examination for the diagnosis, follow-up, and treatment of chronic open angle glaucoma in our populations.

[Retinal complications in hemoglobinopathies: report of 32 cases]. / Etude des complications rétiniennes au cours des hémoglobinopathies: à propos de 32 cas.

Hemoglobinopathies especially sickle cell disease causes neovascularization in the retina and lead to hemorrhage. To gain insight into the features and incidence of this retinopathy, a study was carried out in Lome, Togo, in 32 subjects (mean age: 31.1 years) presenting hemoglobinopathy. There were 25 patients with SC disease, 3 with SS, 2 with AC, and 2 with A2F. All were examined by the same ophthalmologist and underwent fluorescein angiography. Retinopathy was observed in 22 of the 32 patients including 21 of the 25 patients (84%) with SC and one patient with AC who presented macular hemorrhage. The main findings in patients with SC were formation of new blood vessels in the peripheral retina characteristic of proliferating retinopathy in 11 cases, black sun spots characteristic of non-proliferating retinopathy in 3 cases, and evidence of vitreous hemorrhage in 2 cases. These findings confirm the high incidence and seriousness of retinal complications in patients with SC disease. Prevention is necessary and requires systematic screening to allow early detection of complications which can be treated by laser photocoagulation.