ABSTRACT
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.
Subject(s)
Glaucoma, Angle-Closure , Tomography, Optical Coherence , Male , Humans , Adult , Middle Aged , Tomography, Optical Coherence/methods , Glaucoma, Angle-Closure/diagnosis , Glaucoma, Angle-Closure/epidemiology , Anterior Eye Segment/diagnostic imaging , Cross-Sectional Studies , Cameroon/epidemiology , Intraocular Pressure , Gonioscopy , Trabecular Meshwork , Iris/diagnostic imagingSubject(s)
Diagnostic Imaging , Diagnostic Techniques, Ophthalmological/instrumentation , Equipment and Supplies , Pediatrics , Retina/diagnostic imaging , Adolescent , Age of Onset , Artifacts , Child , Child, Preschool , Cohort Studies , Diagnostic Imaging/instrumentation , Diagnostic Imaging/methods , Equipment and Supplies/standards , Female , Humans , India/epidemiology , Infant , Infant, Newborn , Learning Curve , Male , Ophthalmology/education , Ophthalmology/instrumentation , Ophthalmology/methods , Pediatrics/education , Pediatrics/instrumentation , Pediatrics/methods , Predictive Value of Tests , Retina/pathology , Retinal Diseases/diagnosis , Retinal Diseases/epidemiology , Retrospective Studies , Telemedicine/instrumentation , Telemedicine/methodsABSTRACT
OBJECTIVES: High Blood Pressure (HBP) is a worldwide public health problem. It can be particularly severe in the Black race. Recent studies in Cameroon, showed an alarming prevalence, leading us to want to study the epidemiological, clinical, therapeutic and evaluative aspects of severe, (BP op to 180/110mmHg), recently diagnosed HBP in Yaounde. Our objective was to determine its clinical presentation and evolution. METHODS: We conducted nine months prospective cohort study, from January to September 2016. We recruited from the active population participants who voluntarily accepted blood pressure screening offered in various localities in Yaounde, and were aged from 18 years and above. RESULTS: Of a total of 6519 people who participated in the screening, 1875 (28.8%.), presented a HBP and 363 (5.6%) had severe HBP. Our cohort comprised 153 (42.1%) of these individuals with sustained severe hypertension, not on medication, who accepted the invitation to participate in the study. The range of 45-54 years and 55-64 years were the most represented; the sex ratio was 0.9. The cardiovascular risk factors number range from 5 to 8 with a median of 6. Systolic BP ranged from 184 to 225mmHg with a median of 200mmHg; while the diastolic BP ranged between 111-132.5mmHg with a median of 119mmHg. Kidney injury (77.8%) was the main complications. We identified 3 clinical forms: hypertensive emergencies 121 (79.1%) cases and hypertensive crises 32 (20.9%) cases. In these two groups, 33 (21.6%) patients presented with "super HBP" (a blood pressure>250/150mmHg). The average rate of BP control over 6 month was 39%. The main cause of poor BP control was lack of therapeutic compliance. We registered one death at the 3rd month of follow up due to acute kidney injury. CONCLUSION: Severe HBP prevalence in Yaounde is high in the active fraction of the population insidiously affected. Particularly, unsuspected renal impairment appears to be the major complication. The bad blood pressure control is linked to poor therapeutic observance and persistence.
Subject(s)
Hypertension , Adult , Aged , Cameroon/epidemiology , Female , Humans , Hypertension/diagnosis , Hypertension/epidemiology , Hypertension/therapy , Male , Middle Aged , Prospective Studies , Severity of Illness Index , Urban Health , Young AdultABSTRACT
But. Décrire les expériences visuelles des patients au cours de la chirurgie de la cataracte sous anesthésie péribulbaire. Patients et méthodes. Nous avons mené une étude transversale pendant une période d'un mois au CHU-IOTA (Bamako). Étaient inclus les adultes opérés de la cataracte sous anesthésie péribulbaire sans sédation. Les patients étaient interrogés 1 à 4 heures après l'intervention sur les sensations visuelles de l'Åil opéré, durant la chirurgie. Résultats. Deux cent sept (207) patients (105 hommes et 102 femmes) ont été retenus. Leur âge moyen était de 62,94 ans ± 12,5. L'acuité visuelle préopératoire des patients était comprise entre 1/10 et la perception lumineuse. Cent cinquante-huit (76,3%) patients ont rapporté des phénomènes visuels observés pendant l'intervention. Il s'agissait de la lumière (rapportée par 76,3% de patients), des couleurs (31,9%), des instruments (22,7%), des doigts du chirurgien (25,1%), de l'eau (27,1%) et des mouvements vagues (19,8%). Parmi eux, 38% étaient effrayés par ces sensations visuelles. Conclusion. Plus de trois-quarts de patients ont des expériences visuelles au cours de la chirurgie de la cataracte sous anesthésie péribulbaire. Certains sont effrayés par ces phénomènes visuels. Il est important de faire un counseling préopératoire approprié afin de réduire le stress des patients
Subject(s)
Anesthesia , Cataract , Cataract Extraction , Mali , Ophthalmologic Surgical Procedures , PatientsABSTRACT
We reported a case of unusual intraocular Loa loa in a 27-year-old patient who presented with painful red eye. Biomicroscopy revealed a living and active adult worm in the anterior chamber of the right eye. After surgical extraction under local anesthesia, parasitological identification confirmed L. loa filariasis.
