Sickle cell retinopathy and other chronic complications of sickle cell anemia: A clinical study of 84 Sub-Saharan African cases (Cameroon).

OBJECTIVE: Sickle retinopathy is a severe complication of sickle cell disease than can lead to blindness. We aim to describe the epidemiology of sickle retinopathy in homozygous sickle cell (SS) African patients and to analyze its association with non-ophthalmologic disease complications of sickle cell anemia. METHODS: We conducted a nested study within the CADRE cohort in Cameroon. Eighty-four consecutive SS outpatients, aged 10 years and older, with no visual symptoms, underwent an ophthalmologic examination. Mean age was 23±10 years. Clinical and biological features were compared between patients with and without sickle retinopathy. We compared the prevalence of the clinical complications and main biological characteristics in patients with and without sickle retinopathy using a univariate logistic regression. The same analysis was used to compare the patients with non-proliferative sickle retinopathy to those with proliferative sickle retinopathy. Statistical analyses were done using the R software (version 3.1.2). RESULTS: Fifty-two patients (62%) displayed sickle retinopathy, among them 23 (27%) had a non-proliferative sickle retinopathy, and 29 (35%) had proliferative sickle retinopathy. Patients with proliferative sickle cell retinopathy had a mean age of 28±11 years. Sickle retinopathy was associated with higher hemoglobin level (P=0.047) and fewer leg ulcers (P=0.018). Proliferative SR was associated with increasing age (P=0.008) and male sex (P=0.025) independently of the hemoglobin level. CONCLUSIONS: Sickle retinopathy is particularly frequent in sub-Saharan sickle cell SS patients, which advocates for early systematic screening.

[Amblyopia and strabismus in our environment]. / L'amblyopie chez le strabique en milieu camerounais.

PURPOSE: This study aimed to identify the characteristics of amblyopia in a group of strabismic patients in our environment in order to improve management. METHODS: A prospective study was carried out in the General Hospital, Douala, from July 1991 to July 2003. All strabismic patients had a complete ophthalmological examination including an oculomotor evaluation and skiascopy after cycloplegia. RESULTS: 330 patients were examined. The mean age at initial consultation was 13.97 years +/- 12.21. The prevalence of amblyopia was 80.46% in esotropia and 59.40% in exotropia. The precocity of strabismus, eccentric fixation, torticollis, presence of a vertical element and nystagmus were aggravating factors for amblyopia. CONCLUSION: In order to carry out early and coherent management of strabismus, it is important to train and inform all those who are involved in the care process.