A Study of the Prevalence and Pattern of Sickle Cell Retinopathy among Eye Clinic Attendees in a Nigerian Tertiary Hospital.

Background: Sickle Cell Disease (SCD) is the first and the most common group of haemoglobinopathies in the world. It affects virtually all body systems including the eyes. Proliferative Sickle cell Retinopathy (PSR) is a cause of visual loss in the working age group which has an impact on the economy and quality of life. This study aimed to describe the pattern of presentation of Sickle Cell Retinopathy (SCR)to improve understanding of the disease presentation. Methodology: The ophthalmic surgical records of patients diagnosed with sickle cell disease at the retinal unit, department of Ophthalmology at the Lagos University Teaching Hospital between the year 2011-2020 were reviewed retrospectively. Results: A total of 64 patients (108 eyes) records were reviewed in this study. The Prevalenceof sickle cell retinopathy was 5.4% of all retina cases within the study period. Age ranged from 10-70 years; the mean age was 36.28 years ± 13.66. There were 25 females and 39 males (F:M= 1:1.6). SCR was most common in patients with HbSC 40 (62.5%). Common presenting symptoms were loss of vision34 (53.1%) and floaters 34 (53.1%). Goldberg stage III 26 (20.3%) and stage IV 27 (21.1%) were the most common stages of proliferative disease at presentation. A significant association was seen between Haemoglobin genotype SC and the occurrence of sickle cell retinopathy with 90% of the patients with Haemoglobin genotype SC having had PSR. The majority of the patients25 (39.1%) had no treatment, and 13 (20.3%) had laser photocoagulation only. Conclusion: Sickle cell retinopathy is not uncommon in Nigeria and many patients only present in tertiary health facilities when they have severe symptoms such as loss of vision. This may be attributed to the late diagnosis and referral. Routine screening is recommended to ensure early detection and treatment to prevent avoidable blindness.

Coronavirus Disease 2019 Virus among ophthalmologists in Nigeria: Knowledge, attitude, and perceptions

Background: Globally, there is still much to learn about the evolving coronavirus disease 2019 (COVID-19) virus, its transmission, prevention, and treatment. Therefore, this study investigates the knowledge, perception, and screening practices of COVID-19 infection in the ophthalmology practice in Nigeria. Materials and Methods: This survey was a descriptive, cross-sectional survey conducted among practising ophthalmologists and ophthalmologists in training in Nigeria in an online survey. Data compiled were then analyzed using the IBM SPSS software version 22.0 with two-tailed P < 0.05 considered to indicate statistical significance. Results: A total of 206 ophthalmologists/ophthalmologists in training were recruited for this study. Most of the respondents, 97 (47.1%), practiced in centres in South-West Nigeria and were board-certified ophthalmologists 96 (46.6%). In general, the majority of the respondents, 182 (88.3%), had good knowledge regarding the COVID-19 virus, its transmission, prevention as it regards the ophthalmic practice, 134 (74.8%) either agreed or strongly agreed that the ophthalmologist is at a higher risk of contracting the virus from infected patients even if the patient is asymptomatic. COVID-19 infection was perceived as very serious by the majority of the respondents, 135 (65.5%), although 128 (62.1%) felt that all routine cases should be seen only following a low-risk assessment. Conclusion: As the world races toward complete vaccination of the population against this fatal infection, continued training is required to ensure the best practices among ophthalmologists to bridge the present knowledge gaps, corrects myths, misconceptions, and ensure the safety of both the patient and the ophthalmologist.

Ocular manifestations of leukaemia: A teaching hospital experience.

BACKGROUND: Knowledge of the ophthalmic manifestations of leukaemia is important not only because of the frequency with which changes are seen but because the eye often reflects the disease state of the illness, and once identified, prompt referral, early treatment can be instigated, blindness can be averted and a life may be saved. These manifestations are often overlooked because of the underestimation of the magnitude of the ocular sequelae which may be blinding. AIM: This study aims to describe the ophthalmic findings in adult leukaemic patients at two teaching hospitals in Lagos, Nigeria. PATIENTS AND METHODS: This was a clinic-based, comparison multicentre study conducted at Lagos University Teaching Hospital and Lagos State University Teaching Hospital over a 9-month period of May 2012-January 2013. The cases were newly diagnosed leukaemic patients (acute and chronic) from the haematology clinics. Controls were escorts of apparently normal patients. Detailed ocular examination was carried out after written informed consent was obtained. Analysis was done using SPSS 17. RESULTS: A total of 160 eyes in 80 individuals examined comprised forty cases and forty controls. The results of the cases were compared with the age- and sex-matched controls. Leukaemic-related ophthalmic manifestations were present in 56 eyes (70.0%) of the cases studied. Findings in cases were periorbital oedema in 8 eyes (10%), subconjunctival haemorrhage in four eyes (5%), intraretinal haemorrhage as found in 25 eyes (31.3%), retinal venous tortuosity in 21 eyes (26.3%), Roth spots in 19 eyes (23.8%) and retinal infiltrates in 17 eyes (21.3%). CONCLUSION: Ophthalmic disorders occur in adult patients living with leukaemia. Prompt initial and periodic ophthalmic evaluation is recommended in all leukaemic patients.

Visual impairment and ocular morbidities among schoolchildren in Southwest, Nigeria.

AIM: The purpose of this study was to determine the prevalence of visual impairment and ocular morbidities among primary and secondary schoolchildren aged 5 years to

Two cases of Vogt-Koyanagi-Harada's disease in sub-Saharan Africa.

Vogt-Koyanagi-Harada's (VKH) disease has been reported to be rare in sub-Saharan Africa. Two Nigerians with the disease are presented in this report. The first patient, a 32-year-old pregnant Nigerian woman presented with a 1-month history of bilateral blurring of vision, persistent headache, and alopecia. Presenting visual acuity was 1 m counting fingers in both eyes. Examination revealed vitiligo and poliosis with bilateral panuveitis as well as bilateral exudative retinal detachment. A clinical assessment of complete VKH disease was made. The patient commenced systemic and topical steroids that resulted in remarkable recovery of vision and control of inflammation. The second patient, a 56-year-old Nigerian woman presented with severe headache, tinnitus, and visual loss in both eyes of 2 weeks duration. There was associated redness of both eyes and photophobia. Examination showed visual acuity of Hand motion (HM) and counting fingers at 1 meter (CF). in the right and left eye, respectively, with bilateral panuveitis and bilateral exudative retinal detachment. Subsequent follow-up showed poliosis, vitiligo, and sunsetting fundus appearance. The patient improved with systemic and topical corticosteroids. Developing a high index of suspicion is necessary in diagnosing VKH disease, even in sub-Saharan Africa. Prompt institution of appropriate treatment prevents blindness.