[Congenital ocular anomalies at the University Hospital Campus in Lomé, Togo]. / Les anomalies congénitales oculaires au Centre Hospitalier Universitaire-Campus de Lomé, Togo.

INTRODUCTION: congenital ocular anomalies are rare clinical entities. The purpose of this study is to describe the epidemiological and clinical features of congenital ocular anomalies at the University Hospital Campus in Lomé. METHODS: we conducted a retrospective study at the Department of Ophthalmology of the University Hospital Campus in Lomé, over a 3-year period, from January 2016 to December 2018. It involved children with congenital ocular anomalies. The study variables were: sex; age at diagnosis; type of congenital ocular anomalies; laterality. RESULTS: out of 2621 children assessed during the study period, 103 (3.9%) had congenital ocular anomalies. Of these, 60 (58.2%) were boys and 43 (41.8%) girls. The average age at diagnosis was 16 ± 5.2 months (ranging from 1 months to 5 years). The most common congenital ocular anomaly was cataract (53.4%). Unilateral alterations were predominant (56.3%). Congenital ocular anomalies were isolated (82.5%); associated with systemic anomalies (11.7%); associated with each other (5.8%). CONCLUSION: these results show that the epidemiological and clinical features of congenital ocular anomalies are similar to those reported in the literature. However, in our Hospital, the frequency of congenital ocular anomalies and patients' age at diagnosis are high. Early diagnosis is essential to ensure adequate management and preserve visual function.

[Juvenile myasthenia gravis in sub-Saharan Africa: a case study of two consanguine sisters born from consanguinity in Togo]. / Myasthénie juvénile oculaire en Afrique Subsaharienne: cas de deux sœurs germaines issues d'un mariage consanguin au Togo.

Myasthenia gravis is a rare acquired autoimmune pathology causing neuromuscular transmission impairment. Juvenile onset of myasthenia gravis is often characterized by ocular involvement. We report two cases of ocular juvenile myasthenia gravis (JMG) in two siblings. They were two young girls, XA and XB, aged 11 and 9 years, of Malian origin, residing in Togo, born from first-degree of consanguinity presenting to Ophthalmology due to progressive decrease in visual acuity. XA showed visual acuity 8/10 on both eyes while XB showed improvement in visual acuity from 3/10 to 7/10 using a pinhole occluder, suggesting ametropia. XA had a 2-year history of bilateral ptosis lifting the upper eyelid of 7 mm, while XB had a 3-year history of bilateral ptosis with no lifting of the upper eyelid. Ice pack test was strongly positive in both patients. They had Cogan's lid twitch with paresis of the oculomotor nerve without diplopia. The dosage of acetylcholine receptor autoantibodies was normal. The diagnosis of JMG associated with ametropia was suspected. Ametropia was corrected by glasses and a specific treatment with pyridostigmine was initiated, but both patients were lost to follow-up. Autoimmune myasthenia gravis with inaugural ophthalmologic manifestation is rare but it can occur among children living in sub-Saharan Africa. Studies should be conducted to establish the features of this disease.

[Risk factors for retinal detachment in Togo]. / Facteurs de risque du décollement de rétine au Togo.

INTRODUCTION: Retinal detachment poses management problems in developing countries due to the shortage of technical equipment. Prevention passes through knowledge and elimination of risk factors. This study aimed to identify the risk factors for retinal detachment in people living in Togo. METHODS: We conducted a retrospective and descriptive study in the Department of Ophthalmology at the Chu-Campus and in an ophthalmology office in Lomé from 2 January 2011 to 31 December 2015. The medical records of patients with retinal detachment were included in the study. The diagnosis of retinal detachment was confirmed based on funduscopic exam or ocular ultrasound. RESULTS: in total, 116 eyes of 100 patients had retinal detachment of whom 40 in the RE, 44 in the LE and 16 bilaterally. The average age of patients was 46.65 ± 16.46 years [07 years; 87 years], with a male predominance and with a sex-ratio = 0.32 (W/M). Diabetic patients accounted for 17% and patients with sickle cell disease accounted for 16%. Myopic patients accounted for 5%, pseudophakic patients accounted for 17.2% and aphakic patients accounted for 3.4%. Four patients had retinal tear (14.28% of rhegmatogenous detachment) including 2 superotemporal tears, 1 inferior nasal tear and 1 inferior temporala tear. 35 eyes (52.2%) had total retinal detachment while 24 eyes (35.8%) had partial retinal detachment. Twenty eyes had vitreoretinal proliferations, 5 eyes had itreous hemorrhage and 6 eyes had hyalite. Diabetes and sickle cell disease were the risk factors for tractional RD (p=0.006 and p=0.0003) while cataract surgery was the risk factor for rhegmatogenous RD (p=0.0097). CONCLUSION: Diabetes, sickle cell anemia and eye surgery were the major risk factors for RD. A better management of these pathologies and ophthalmologist's mastery of cataract surgery may prevent retinal detachment.