[Clinical profile of corneal sensitivity in diabetic patients: A case-control study]. / Profil clinique de la sensibilité cornéenne chez les patients diabétiques : étude cas-témoins.

PURPOSE: To evaluate the corneal sensitivity of black diabetic patients and identify factors associated with changes in corneal sensitivity. METHODOLOGY: We conducted a cross-sectional comparative case-control study at the National Obesity Center of the Yaounde Central Hospital and the Djoungolo District Hospital from March 1 to July 31, 2022. Corneal sensitivity was measured using the Cochet-Bonnet esthesiometer in all diabetic patients over 18 years of age, matched for age and sex to a clinically healthy control population. Data were analyzed using SPSS version 23.0 software. A P-value of less than 5% was considered significant. RESULTS: A total of 111 diabetic and 111 non-diabetic patients participated in the study. The mean age was 53.46±12.74 years for diabetics and 52.85±11.77 years for non-diabetics (P=0.901). The mean duration of diabetes was 6.4±5.30 years. Corneal sensitivity in diabetics was lower (44.56±9.59mm) compared to non-diabetics (53.59±6.30mm) with a statistically significant difference (P=0.000). Factors associated with decrease in corneal sensitivity in diabetics were duration of diabetes and poor glycemic control. CONCLUSION: Decrease in corneal sensitivity related to diabetes is a complication to be systematically screened for during the ophthalmologic follow-up of diabetic patients.

Profil évolutif de la limboconjonctivité endémique des tropiques à l'hôpital gynéco-obstétrique et pédiatrique de Yaoundé / Gynecological cancer in oncology practice in Lomé

Introduction. La limbo-conjonctivite endémique des tropiques (LCET) est une kérato-conjonctivite allergique récidivante du jeune enfant qui s'améliore après la puberté mais peut persister. Le but de cette étude était de déterminer le profil évolutif de la LCETdans notre pratique. Méthodologie. Étude longitudinale descriptive menée dans l'unité d'ophtalmologie de l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé. Tous les dossiers de LCET reçus de janvier 2011 à décembre 2019 avec un recul d'aumoins deux ans de suivi ont été recensés. Les patients qui ont accepté de participer après apptéléphonique ont été inclus de janvier à mai 2021.Les variables d'étudeétaient: âge, sexe, acuité visuelle (AV), caractéristiques de la LCET selon Diallo, pronostic fonctionnel et anatomique en post puberté (plus de 15 ans). Résultats. Au total,30 patients (60 yeux) ont été étudiés. Le sex-ratio était de 2. La moyenne d'âge était de 15 ans ± 9 ans. Initialement, le prurit était le maitre symptôme (96,7%). Après un recul moyen de cinq ans, l'AV était utile chez tous les patients (100%) et la LCET stade 2 plus représentée (60%). Le nombre moyen de récidives était de trois. Les patients post pubertaires on eu une amélioration anatomique dans 56.7% des caset une aggravation dans 10%des casConclusion. Notre travail confirme l'amélioration post pubertaire globale de la LCET, nonobstant quelques formes graves depronosticpéjoratif pour la fonction visuelle.

Introduction. Tropical endemiclimbo-conjunctivitis (TELC) is a recurrent allergic kerato-conjunctivitis in young children which improves after puberty but may persist. The aim of this study was to determine the evolutionof TELCin our setting. Methodology. This was a longitudinal descriptive study conducted in the ophthalmology unit of the Yaoundé Gyneco-Obstetric and Pediatric Hospital. All TELC files received from January 2011 to December 2019 with a follow-up of at least two years of follow-up were identified. Patients who agreed to participate after a phone call were included from January to May 2021. The variables of interest were: age, sex, visual acuity (VA), TELC classification according to Diallo, functional and anatomical prognosis in post puberty (more than 15 years).A totalof30 patients (60 eyes) were recruited. The sex ratio was 2. The average age was 15 ± 9 years. Initially, pruritus was the main symptom (96.7%). After an average follow-up of five years, VA was usefulin all patients (100%) and TELCstage 2 was the most frequent stage (60%). The mean number of recurrences was three. Postpubertal patients had anatomical improvement in 56.7% of cases and worsening in 10%of cases. Conclusion. Our study confirms the overall postpubertal improvement ofTELC, except some serious forms with poor prognosis ofvisual function

[Epidemiological and clinical profile of age-related macular degeneration in Cameroon]. / Profil épidémiologique et clinique de la dégénérescence maculaire liée à l'âge en milieu camerounais.

PURPOSE: To determine the epidemiological and clinical characteristics of age-related macular degeneration in patients in Yaoundé. METHODOLOGY: A multicenter, analytical and cross-sectional study was carried out from March 2017 to June 2018 in four hospitals in the city of Yaoundé. Included were all consenting patients aged at least 40 years with an established diagnosis of AMD both clinically and by imaging. The data were analyzed with CSPro software version 7.0. Chi2 and Student's "t" tests in univariate mode and logistic regression in multivariate mode were used with a significance of P≤5%. RESULTS: Of the 9,989 patients who were seen during the 16-month study period, 38 met our inclusion criteria - a frequency of 0.4%. The sex ratio was 0.3, and the mean age was 68±11 years. As a function of geographic origin, AMD is more common in patients from the forest and mountain areas. The systemic comorbidities associated recorded were hypertension (47.4%) and diabetes (21.1%). After optical correction, 60 of 76 eyes (78.9%) had useful visual acuity according to WHO criteria, and the rate of blindness was 9.2%. Fundus examination revealed fewer lesions than optical coherence tomography, which demonstrated miliary drusen in 57 (75%) eyes, serous drusen in 27 (35.5%), retinal atrophy in 19 (25%) and neovascularization in 3 (3.9%). The clinical forms were dominated by age-related maculopathy, found in 45 eyes (69.2%), followed by atrophic AMD in 17 (26.2%) and finally by exudative AMD in 3 (4.6%), for a total of 65 out of 76 eyes. Age was related to the risk of MLA and atrophic AMD (P≤0.05). CONCLUSION: AMD is an uncommon pathology in our setting, predominant in women over the age of 60 years.

[Retinal vein occlusions treated by intravitreal bevacizumab injections at the Hospital of Instruction, Application and Reference of the Armed Forces of Yaoundé]. / Occlusions veineuses rétiniennes traitées par injections intra-vitréennes de bévacizumab à l'hôpital d'instruction, d'application et de référence des armées de Yaoundé.

OBJECTIVE: To assess the anatomical and functional results of intravitreal bevacizumab injections in retinal vein occlusions at the Hospital of Instruction, Application and Reference of the Armed Forces of Yaoundé. PATIENTS AND METHODS: A prospective and descriptive study was conducted from October 2016 to August 2017 at the Hospital of Instruction, Application and Reference of the Armed Forces of Yaoundé. All eyes with edematous or mixed retinal vein occlusion were treatment naive and received at least 3 intravitreal injections spaced at least 28 days apart of bevacizumab 25mg/ml at a dose of 0.05ml per session according to the strategy of 3 injections or "3 I". At least 3 months after the final injection, visual acuity and macular thickness, assessed by optical coherence tomography, were analyzed with the IBM-SPSS 22 software. The Student's test was used to compare means, with a significance P<5%. RESULTS: We included nineteen eyes of 18 patients with a mean age of 62.83±9.57 years. The male to female sex ratio was 0.8. Branch vein occlusion was predominant in 14 (73.68%) eyes. The edematous type was noted in 17 (89.5%) eyes. Serous retinal detachment was present in 6 (31.6%) eyes. The mean number of injections was 4.2±1.2. The mean baseline visual acuity changed from +0.9 Log MAR (40 ETDRS) to +0.6 Log MAR (55 ETDRS) at 6 months, while the mean macular thickness went from 550.16±180µm to 338.58±127µm, with statistically significant differences. CONCLUSION: Intravitreal bevacizumab injections proved to be effective in the management of edematous retinal vein occlusions in our practice setting despite the lack of market authorization for this indication.

[Retinal manifestations of neuro-malaria or "malarial retinopathy" in Yaoundé]. / Atteintes rétiniennes du neuro-paludisme ou « rétinopathie paludique ¼ à Yaoundé.

AIM: Contribute to the improvement of diagnostic and prognostic approaches to treating children with neuro-malaria in Yaoundé. PATIENTS AND METHOD: A prospective and analytical study carried out in 2 hospitals of Yaoundé from October 2015 to March 2016. All patients aged 3 months to 15 years hospitalized for neuro-malaria in one of the 2 hospitals benefited from a fundus examination. The variables studied were: age, sex, Glasgow or Blantyre score, fundus examination and parasitaemia. For statistical analysis, we used the software R 3.3.0, Chi2, exact of Fisher or Kolmogorov-Smirnov tests with a significance P<5%. RESULTS: Out of the 178 children hospitalized during the study period, 44 had neuro-malaria (24.71%) and 26 (46 diseased eyes) among them presented retinal lesions at a frequency of 14.60%. The mean age was 5.54±3.49 years with a sex ratio of 1.09. The under 5-years-old were the most affected with 31 (70.45%) cases. The fundus lesions of 26 (59.09%) were retinal hemorrhages in 24 (54.54%), retinal whitening and vessel discoloration in 8 (18.18%) respectively. Papillary edema was associated in 4 (9.09%). Macular involvement was noted in 9 cases. These lesions were correlated with age, depth of coma, duration, and clinical course. The rate of parasitaemia did not affect their occurrence. CONCLUSION: Retinal lesions are frequent and serious during neuro-malaria in our environment, especially in children under five. They must therefore be an emphasis in the systematic exam to rule it out for a better prognostic evaluation and a fast and adequate multidisciplinary management.

Glaucome néovasculaire: étiologies et difficultés liées à sa prise en charge à Brazzaville

INTRODUCTION: Le glaucome neovasculaire (GNV) est lie a une neovascularisation de l'angle iridocorneen secondaire a une hypoxie prolongee de la retine. Dans les pays occidentaux; son traitement est bien codifie et le pronostic est bien meilleur qu'a Brazzaville ou le GNV se termine souvent par une enucleation suite a une phtise hyperalgique ou a un eclatement spontane de l'oil. OBJECTIF: enumerer les principales etiologies du GNV et discuter des difficultes liees a sa prise en charge a Brazzaville. MATeRIELS ET MeTHODES: etude transversale; multicentrique (CHU/Brazzaville; Clinique Medicale de Brazzaville); realisee sur une periode de 7 ans sur la base de dossiers de patients vus pour un GNV. Le GNV etait defini par l'association d'une rubeose irienne et d'un tonus oculaire superieure a 21 mm Hg. Les parametres suivant etaient analyses: motifs de consultation; presentations cliniques; etiologies et traitements.ReSULTATS : 25 dossiers ont ete retenus (correspondant a 30 yeux souffrant de GNV). La douleur oculaire etait le principal motif de consultation (92%; 23/25 patients). La cornee etait opaque avec gonoscopie et fond d'oeil impossibles dans 83;33% des cas (25/30 yeux). Les etiologies etaient: diabete sucre (88%; 22/25 patients); occlusion de la veine centrale de la retine (12%; 3/25 patients). Perdus de vue 7/25 patients correspondant a 7/30 yeux. Le traitement consistait en enucleation (69;56%; 16/23 yeux); photocoagulation retinienne (21;74%; 5/23 yeux); et injection retrobulbaire de Chlorpromazine (8;70%; 2/23 yeux). CONCLUSION: Le diabete sucre est la principale etiologie du GNV a Brazzaville. Le manque de moyens techniques et les consultations tardives n'offrent que peu d'alternative therapeutique a l'enucleation qui reste largement malheureusement utilisee