[Development of oculoplastic surgery in Kinshasa (capital of Democratic Republic of Congo)]. / Entwicklung der okuloplastischen Chirurgie in Kinshasa (Hauptstadt der Demokratischen Republik Kongo).

The partnership between Saint Joseph Hospital in Kinshasa (Capital city of DRC) and University Eye Clinic Rostock, Germany exists since 2000. The ophthalmologists from Rostock University performed 12 visits of St. Josef Hospital with the aim to perform oculoplastic surgery in complicated cases as well as to teach the local ophthalmologists. There they performed about 150 surgeries (entropion, ectropion, ptosis, repair of lid injuries, eye lid reconstruction and tumour management, lacrimal surgery) in joint teams. The programme of on-site training was established during this time. Meanwhile, the Kinshasa colleagues are able to perform the basic techniques by themselves. Two colleagues have obtained advanced training in oculoplastics in Rostock. The fruitful cooperation enabled the development of oculoplastic surgery in St. Josef Hospital in Kinshasa. The further education and training proccesses will support the continuous advancement in ophthalmological health care in DRC.

[Diabetic retinopathy and diabetic foot syndrome in patients of a sub-Saharan megacity (Kinshasa, DR Congo)]. / Diabetische Retinopathie und diabetisches Fußsyndrom bei Diabetikern in Kinshasa (Demokratische Republik Kongo).

PURPOSE: The prevalence of diabetes mellitus is increasing worldwide especially in developing countries. Foot ulcerations in patients with diabetic neuropathy have a high impact in the overall amputation rate. In the present study we looked for the severity of diabetic retinopathy in patients with diabetic foot syndrome in a diabetic care unit in a sub-Sahara megacity (Kinshasa, Democratic Republic of Congo). METHOD: Forty-one patients with diabetes-related foot ulcerations (26 male, 15 female, mean age 45.6 years) were enrolled in the study. All patients underwent visual acuity evaluation and slit lamp biomicroscopy. Incidence and stage of retinopathy were evaluated by retinal funduscopy and documented by fundus photography. RESULTS: Twenty-seven eyes showed no signs of diabetic retinopathy. Forty-seven eyes were diagnosed as non-proliferative diabetic retinopathy (16 mild, 16 moderate, 15 severe). Seven eyes showed proliferative diabetic retinopathy. One patient had a unilateral central venous occlusion. In this case the classification of diabetic retinopathy was not possible because of the massive retinal bleedings. CONCLUSION: It was evident that there is a considerable discrepancy between partly extensive foot ulcerations and only mild to moderate diabetic retinopathy in most of the patients. This indicates that neuropathy-induced foot problems and microangiopathy-induced diabetic retinopathy are diabetic complications whose formal pathogenesis is only loosely correlated. Additional risk factors in local African conditions compared to Europe may play a major role in this discrepancy.

[Exophthalmias in Zaire]. / L'étude des exophtalmies au Zaïre.

PURPOSE: To determinate the frequencies of causes of exophthalmos in Zaïre. METHODS: In a retrospective study, the records of 129 patients with exophthalmos seen from 1986 to 1994 were reviewed. All patients were examined ophthalmologically and most of them medically. X-Rays, orbital CT Scan, were performed most frequently. RESULTS: The sex distribution was: 79 (61%) male patients and 50 (39%) female patients. The sex ratio being 1.50/1. The ages of patients ranged from one to 68 years. Unilateral exophthalmos was frequent (76% of cases). Tumors were present in 42% patients, followed by inflammatory diseases in 26% of patients, thyroid eye disease in 9% and traumatic aetiology in 1.6%; the etiology was not determined in 14%. Retinoblastoma (8%), lymphoma (7%) and rhabdomyosarcoma (5%) were the most frequent tumors seen. Orbital cellulitis (26%) was frequently associated with adjacent sinus infection. CONCLUSION: The etiologic factors found in this study could be compared to those published in the World with the exception of orbital cellulitis and retinoblastoma that showed a high incidence in this study.