PREVALENCE, PATTERN AND RISK FACTORS FOR RETINAL VASCULAR OCCLUSIONS IN A TERTIARY HOSPITAL IN JOS, NIGERIA.

INTRODUCTION: Retinal vascular occlusions are the second most common retinal vascular diseases following diabetic retinopathy. They are associated with several systemic and ocular pathologies and are significant causes of visual loss. OBJECTIVE: This study aims to determine the prevalence, pattern and risk factors for retinal vascular occlusions in a tertiary hospital in Jos, Nigeria. METHODOLOGY: A retrospective review of all cases of retinal vascular occlusions seen in the eye clinic from January 2011 to December 2014 was carried out. The patients were identified from the clinic register and their case folders retrieved. The following data were then extracted from the files; patients' age, sex, presenting visual acuity, presence of any systemic disorders and type of retinal vascular occlusion. Data analysis was done using Epi Info 7. RESULTS: Three thousand eight hundred and twenty one new patients were seen during the study period and there were 52 (1.36%) cases of retinal vascular occlusions. Only the case files of 44 (84.6%) patients were available and were analysed. These were made up of 17 (39%) males and 27 (61%) females. These had a total of 46 retinal vascular occlusions made up of 37 (80.4%) retinal vein occlusions, 8 (17.4%) central retinal artery occlusions and a case (2.2%) of combined central retinal artery and vein occlusion. Hypertension and diabetes were the most common systemic risk factors while glaucoma was the most common ocular association. CONCLUSION: Retinal vascular occlusions are uncommon in our centre but lead to severe visual loss and are associated with significant systemic pathologies.

Cataract blindness, surgical coverage, outcome, and barriers to uptake of cataract services in Plateau State, Nigeria.

PURPOSE: The purpose was to estimate the prevalence of blindness due to cataract, assess visual outcomes of cataract surgery, and determine the cataract surgical coverage rate and barriers to uptake of services among individuals aged 50 years or older in Plateau State, Nigeria. MATERIALS AND METHODS: A population-based, cross-sectional survey of 4200 adults 50 years or older was performed. Multistage stratified random sampling, with probability proportional to size was used to select a representative sample. The Rapid Assessment of Cataract Surgical Services protocol was used. Statistical significance was indicated by (P < 0.05). RESULTS: The cohort comprised 4115 subjects (coverage: 98%). The prevalence of bilateral blindness due to cataract was 2.1%, [95% confidence intervals (CI): 1.7-2.5%] in the entire cohort, 2.4% in females (95% CI: 1.8-3.8%); and 1.8% in males (95% CI: 1.2-2.4%) (χ(2) = 0.85, P > 0.05). The prevalence of monocular blindness due to cataract was 5.9% (95% CI: 5.2-6.6%). The cataract surgical coverage for subjects with visual acuity (VA) less 3/60 was 53.8% in the entire cohort; 60.5% for males and 48% for females (χ(2) = 2.49, P > 0.05). The couching coverage for subjects who were blind was 12%. A total of 180 eyes underwent surgical intervention (surgery or couching) for cataract, of which, 48 (26.7%) eyes underwent couching. The prevalence of bilateral (pseudo) aphakia was 1.5%, (95% CI: 1.2-1.9%) and 2.7% (95% CI: 2.2-3.2%) for unilateral (pseudo) aphakia. Visual outcomes of the 180 eyes that underwent surgical intervention were good (VA ≥ 6/18) in 46 (25.6%) eyes and poor (VA < 6/60) in 105 (58.3%) eyes. Uncorrected aphakia was the most common cause of poor outcome (65.1%). Most subjects who underwent cataract surgery were not using spectacles 74 (71.2%). Cost and lack of awareness were the main barriers to uptake of cataract surgery services. CONCLUSION: Couching remains a significant challenge in Nigeria. The outcomes of cataract surgery are poor with the lack of aphakic correction being the main cause of the poor outcomes.