[Childhood ocular tumors: epidemiological and histopathological aspects at the Yaoundé gynaeco obstetric and pediatric hospital]. / Les tumeurs oculaires primitives de l'enfant : aspects épidémiologiques et histopathologiques à l'hôpital gynéco-obstétrique et pédiatrique de Yaoundé

UNLABELLED: The ocular tumours encountered in ophthalmologic consultations affect all age groups. The purpose of our study is to help improve knowledge of ocular and orbital tumours in children in Cameroon, by analysing the epidemiologic and histopathologic aspects of these tumours at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital (HGOPY). We therefore conducted a retrospective descriptive cross-sectional study examining files of cases treated from 2003 through 2009. We found that tumours accounted for 0.36% of all consultations of children aged from 0 to 15 years in the HGOPY and affected an average of three children a year, mainly those younger than 10 years (90% of the cases) and 65% boys. Overall, 75% of the tumours were retinoblastomas (75%), 15% conjunctival naevi, 5% epidermoid carcinomas of conjunctiva (5%) and angioneurofibromas of the optic nerve (5%). CONCLUSION: Ocular tumours are rare in children attending hospitals in Cameroon. They are mainly retinablastinomas and affect boys more often than girls.

[Diabetic retinopathy in black Africans: an angiographic study]. / Rétinopathie diabétique du Noir africain : étude angiographique.

INTRODUCTION: Diabetes mellitus is an important public health issue worldwide. This retrospective and descriptive study took place at the diabetic retinopathy (DR) prevention and management project at the Central Hospital in Yaoundé between November 2007 and December 2008. Our aim was to analyse the characteristics of diabetic retinopathy in black Africans. MATERIALS AND METHOD: Our sample included all patients with diabetes, irrespective of age or insulin- dependence, with the results of at least fasting blood sugar test and fluorescein angiography imaging. The images were interpreted according to the Early Treatment of DR Study classification by one of the 3 project ophthalmologists. We used Epi-Info version 3.5.1 for the statistical analysis, comparing results with the Chi-square test (significance set at p < 0.05). RESULTS: Of 472 subjects with diabetes, 274 (58%) did not have DR, and 198 (42%, 393 eyes) did: 113 men (57%) and 85 women (43%). The mean age was 58.6 years with a mean duration of diabetes of 12.8 years. 128 subjects (64.7%) had non-proliferative DR (NPDR) in both eyes; 53 (26.8%) proliferative DR (PDR) in both eyes and 14 (7.1%) were discordant, with NPDR in one eye and PDR in the other. Macula edema was found in 21 angiographies (10.6%). In all, 6.9% of the subjects were blind. CONCLUSION: Fluorescein angiography is an invasive complementary examination that helps to diagnose retinal pathologies, to perform laser photocoagulation, and to assess its results. It cannot, however, replaced direct or indirect funduscopy with dilated pupil. Every patient with known diabetes must systematically undergo a complete ophthalmologic exam with funduscopy and angiography to prevent the onset or control existing DR.

[Ocular disorders causing blindness in working-age outpatients: a prospective study at the African Institute of Tropical Ophthalmology (IOTA, Bamako, Mali)]. / Les affections oculaires cécitantes du sujet en âge d'activité professionnelle: Institut d'ophtalmologie tropicale de l'Afrique (IOTA, Bamako, Mali).

UNLABELLED: The objective of this study was to determine the different groups of ocular disorders causing low vision or blindness among working-age patients consulting at the African Institute of Tropical Ophthalmology (IOTA) in Bamako, Mali. METHODS: This prospective study took place from 1 February through 8 April, 2003, at IOTA. It included all new patients aged between 18 and 50 years, regardless of whether they worked, but excluding students. RESULTS: 828 patients were recruited: 384 men (46.4%) and 444 women (53.6%). The average age was 35.7 years. The rate of bilateral blindness was 5.8%, of low vision 8.5%, and of blindness in one eye 11.5%. Men and women did not differ significantly in rates of bilateral blindness (p = 0.77) or low vision (p = 0.24), but blindness in a single eye affected men (67.4%) more often than women (32.6%, p = 0.01). While the frequency of bilateral blindness and low vision increased with age, blindness in one eye affected all ages. We observed no significant differences according to ethnic group in the prevalence of bilateral blindness and low vision, both observed most frequently among housewives, farmers and low-income workers, most illiterate. The major causes of bilateral blindness were cataracts 29.2%, glaucoma 22.9%, trachoma 14.6%, ocular manifestations linked to HIV/AIDS 8.3%, and non-glaucomatous optical neuropathies 8.3%. Half the cases (50.5%) of blindness in one eye resulted from ocular trauma, and five cases from HIV/AIDS (5.3%). Low vision resulted from impaired refraction 22.9%, cataract 17.2%, trachoma 15.7%, glaucoma 10% and corneal opacities 5.7%. DISCUSSIONS: The high rate of blindness and low vision are associated with the study site: a reference center whose population was composed completely of patients with vision problems. The causes of blindness and low vision have not changed over time except for the ocular manifestations of HIV/AIDS, which is among the most important current causes of blindness, because of the lack of antiretroviral treatments in sub-Saharan Africa. If nothing stops this pandemic, it will soon modify epidemiological data about blindness. CONCLUSION: Blindness and visual deficiencies, already a public health problem, will become an important socioeconomic burden in sub-Saharan Africa and may even stop progress among low-income countries.