Background: Although proptosis is rare, it is nevertheless the main sign of orbital disease. Its discovery usually indicates a serious eye disease especially in children. Objective: To determine epidemiological and di...Background: Although proptosis is rare, it is nevertheless the main sign of orbital disease. Its discovery usually indicates a serious eye disease especially in children. Objective: To determine epidemiological and diagnostic aspects of childhood proptosis in Lome (Togo). Methods: Retrospective cross-sectional study conducted from June 2010 to May 2020, which is 10 years, in the ophthalmology department of CHU-campus of Lome. Files of patients between the age of 0 and 15 who presented a proptosis during the study period were taken into account in the study. Patients with a false proptosis or incomplete records during the study period were not taken into account in the study. Results: The study considered 42 children with an age average of 7.63 years ± 4.96 [4 days;15 years] and a sex-ratio of 1.33. The frequency of proptosis was 0.5% with an average progression of 383.7 days before the first consultation. The proptosis was unilateral in 80.95% of cases. The orbito-cerebral CT scan was done in 47.62% of cases. The proptosis in these patients was predominantly of grade 3 in 45% of cases. The tumor pathologies were at the forefront in 35.71%, dominated by retinoblastoma, and followed by infectious and inflammatory diseases in 14.29%. Conclusion: Childhood proptosis is rare and often indicative of infectious and tumor pathologies in our context. Its diagnosis is delayed, which shows the importance of an early and effective diagnosis. .展开更多
Objective: Maculopathies are more and more frequent. For the follow-up of its evolution and therapy, it seems important for us to determine the baseline in normal subjects by Optical Coherence Tomography (OCT). The go...Objective: Maculopathies are more and more frequent. For the follow-up of its evolution and therapy, it seems important for us to determine the baseline in normal subjects by Optical Coherence Tomography (OCT). The goal here is to determine the acceptable range of macular thickness in normal black subjects in Lomé. Methodology: This is a retrospective study over a 6-month period. It did not include all patients with retinopathy of any cause, maculopathy, and glaucoma. The analyzed variables were the average macular thickness, the central macular thickness, and the total macular volume. Results: Out of the 433 macular OCT performed, 191 patients were selected;a total of 338 eyes. These included 96 men and 95 women. A sex ratio was 1.01. The median age was 44.1 years with extremes ranging from 10 to 70 years. The average macular thickness was 263.4 μm for the right eye and 263.7 μm for the left eye. The central macular thickness was 174.1 μm for the right eye and 173.3 μm for the left eye. The total macular volume was 7.4 in both eyes. Discussion: No significant statistical difference existed between the two sexes. The average macular thickness found in this study was within the range of normality observed in the literature, which is between 216 and 288 μm. Conclusion: The average macular thickness of the normal subject in Lomé was 263.4 μm.展开更多
<strong>Background:</strong> Druses of the papilla constitute abnormal deposits of calcified hyaline material at the level of the head of the optic nerve. They can be superficial or deep. <strong>Aim...<strong>Background:</strong> Druses of the papilla constitute abnormal deposits of calcified hyaline material at the level of the head of the optic nerve. They can be superficial or deep. <strong>Aim:</strong> The aim of this study is to show the utility of ocular ultrasound in ophthalmology in underdeveloped countries for the characterization of optic disc druse. <strong>Case Presentation:</strong> Our study relates to a clinical observation of buried papillary druses diagnosed by ocular ultrasound. The ophthalmologic examination revealed an aspect of false papillary edema in the fundus. The ocular ultrasound revealed hyperechogenic deposits buried in the papillary margins, which suggests the deep papillary druses. <strong>Conclusion:</strong> Ocular ultrasound still has a prominent place in the diagnosis of certain eye conditions despite the new sophisticated means available to ophthalmology to date.展开更多
<strong>Background:</strong> Ocular coloboma is the product of an error in the fetal fissure closure, normally occurring between the fifth and sixth weeks of gestation <a href="#R1" target=&qu...<strong>Background:</strong> Ocular coloboma is the product of an error in the fetal fissure closure, normally occurring between the fifth and sixth weeks of gestation <a href="#R1" target="_blank">[1]</a>. It may involve the cornea, iris, zonula, ciliary body, choroid, retina and optic nerve. The incidence of this syndrome is 0.7 per 10,000 live-births <a href="#R1" target="_blank">[1]</a>. The aim of this observation is to present the first case of bilateral coloboma of the iris <a href="#R1" target="_blank">[1]</a>. This case was associated with an ametropia causing a decrease in visual acuity. <strong>Case Presentation:</strong> This was a clinical observation concerning a young 12-year-old patient who consulted for blurring of vision which had progressed for approximately 2 years. The ophthalmologic examination revealed an ametropia with a bilateral notch of the pupillary rim suggesting a bilateral coloboma. There was no association with another coloboma such as chorioretinal coloboma which is quite common and is accompanied frequently by visual symptoms. <strong>Conclusion:</strong> A visual impairment of the child can indicate ametropia. However, other congenital anomalies can be discovered as was the case in this clinical observation.展开更多
<strong>Background:</strong> Large papillary excavations constitute a true differential diagnosis of glaucoma in our environments. <strong>Aim:</strong> To present a clinical case of large papi...<strong>Background:</strong> Large papillary excavations constitute a true differential diagnosis of glaucoma in our environments. <strong>Aim:</strong> To present a clinical case of large papillary excavation simulating glaucomatous optic neuropathy in a young subject. <strong>Case Presentation:</strong> The ophthalmologic examination made it possible to note a visual acuity of LogMar 0.00, ocular hypertonia and a large papillary excavation in both eyes. The visual field noted bilateral perimetric involvement suggesting optic neuropathy. Optical coherence tomography (OCT) of the ganglion complex revealed an absence of involvement of the ganglion complex and the ganglion ridge essential to evoke optic neuropathy. An ocular hypotonizing treatment made it possible to normalize the intraocular pressure. <strong>Conclusion:</strong> The particularity of this observation lies in the fact that the perimeter involvement that preceded any involvement can simulate a glaucomatous involvement. Functional damage to the visual field must be correlated with structural damage to suggest glaucomatous damage in our ophthalmic patients.展开更多
<strong>Introduction:</strong> Glaucoma is a major cause of irreversible blindness worldwide. Early detection and awareness are essential to reduce the impact on eye health. The aim of this study is to ass...<strong>Introduction:</strong> Glaucoma is a major cause of irreversible blindness worldwide. Early detection and awareness are essential to reduce the impact on eye health. The aim of this study is to assess the knowledge, attitudes and practices of health care staff about glaucoma in Lomé. <strong>Materials and Methods:</strong> This was a prospective cross-sectional and descriptive study including health care staff in Lomé, from October 1st to December 31st, 2020, for a period of 3 months. After their agreement, the officers responded to questions based on a survey sheet. <strong>Results:</strong> A total of 169 agents from 3 centers in Lomé, i.e. the Sylvanus Olympio University Teaching Hospital, the Campus University teaching Hospital and the Bè Hospital were involved. 50.9% of the agents were male versus 49.1% female, i.e. a ratio of 1.04. The average age was 33.66 ± 10.45 years. 46.10% were doctors versus 53.90% paramedics. 58.60% had at most 5 years of experience against 41.40% who had more than 5 years of experience. 53.80% defined glaucoma as ocular hypertension while 17.20% defined it as optic nerve disease. 46.20% did not know that there were many types of glaucomas compared to 53.20% who knew that there are many types of glaucomas. 92.30% knew that glaucoma can lead to cause visual loss. Regarding attitudes and practices about glaucoma, 91.70% declared that the follow-up should be done by the ophthalmologist, 81.10% thought that it would be necessary to be checked by the doctor only every 6 months. Finally, 65.08% declared that they had to use eye drops for life for the treatment. <strong>Conclusion:</strong> Steps should be taken to educate staff more about glaucoma attitudes and practices and also plan for action in the population.展开更多
Objectives: To assess the factors influencing the ophthalmological follow-up of sickle cell patients in Togo. Materials and Methods: The national center of research and care for sickle cell patients (CNRSD) served as ...Objectives: To assess the factors influencing the ophthalmological follow-up of sickle cell patients in Togo. Materials and Methods: The national center of research and care for sickle cell patients (CNRSD) served as study setting. It was a descriptive and analytical study by interview over a three-month period from December 01, 2020 to March 02, 2021. Was included in the study, any patient with sickle cell disease genotype SS or SC, age ≥ 17 years, regularly followed at the CNRSD and having accepted the interview by a survey sheet. Excluded were patients with sickle cell trait genotype AS or AC or with a disability that prevented them from being interviewed. Results: Two hundred and fifty (250) patients with sickle cell disease were interviewed. The mean age was 29.1 years ± 11.12 years [17 years;67 years] and the sex ratio = 0.52. Nine patients over ten (9/10) attended at least secondary school. The jobless represented 25.60% of the total population followed respectively by students and laborers in 20.40% and 16% of cases. Twenty-four percent (24%) of patients were followed up in ophthalmology department. Statistically, there was no significant relationship between level of education (p = 0.4083), occupation (p = 0.6441) and knowledge of the ocular complications of sickle cell disease. Statistically, there was a significant relationship between knowledge of the ocular complications of sickle cell disease and compliance with ophthalmological follow-up (p = 0.0009). Conclusion: The knowledge of eye disorders related to sickle cell disease by patients with sickle cell disease improves their ophthalmological follow-up. Greater awareness on eye disorders related to sickle cell disease by medical staff towards patients with sickle cell disease would improve ophthalmological follow-up. .展开更多
Introduction: The frequency and severity of eye complications from diabetes make patient education essential, which is the basis for adequate management. What is the level of education of diabetic patients in Lom...Introduction: The frequency and severity of eye complications from diabetes make patient education essential, which is the basis for adequate management. What is the level of education of diabetic patients in Lomé? The aim of this study was to assess the knowledge, attitudes and practices of diabetic patients on the ocular complications of diabetes in Lomé. Methods: We conducted a cross-sectional study by surveys on diabetic patients from April 1 to June 31, 2020, in 6 diabetes management centers in Lomé. The correct response rate was established for each component. Knowledge: poor (≤ 50%), low (50% - 65%), medium (65% - 85%) and good (≥ 85%). Attitudes: harmful (≤ 50%), erroneous (50% - 65%), approximate (65% - 85%) and fair (≥ 85%). Practice: harmful (≤ 50%), inadequate (50% - 65%) and adequate (>65%). Results: Over the study period, 150 patients were enrolled. The mean age was 56.98 ± 13.37 years with a sex ratio of 1.1 (79 men/71 women). The overall level of knowledge was insufficient (50.6%) with 65.5% for general knowledge about diabetes and 35.8% for ocular complications of diabetes. Attitudes were approximate (68.7%). In the case of hyperglycemia, 31.3% of patients would confide in a diabetologist and 22.0% in a general practitioner. If decrease in vision, 84.3% of patients would contact the ophthalmologist. The level of practice was harmful (20.4%). For diabetic follow-up, 36.7% of patients have already seen an ophthalmologist, 41.3% have performed a fundus examination, 17.3% retinal angiography, 4% laser retinal photocoagulation and 2.7% intravitreal injection (IVT). An awareness session on the ocular complications of diabetes was followed by 52.7% of patients and 50.7% of patients followed a therapeutic education session. Conclusion: This study has shown that the level of knowledge was poor, attitudes approximate and practices harmful. It is therefore important to raise awareness about diabetes and its ocular complications with the aim to change behavior.展开更多
Aims: To describe the progression of Primary open angle glaucoma (POAG) on Optical Coherence Tomography (OCT) of the optic nerve head and retinal nerve fiber layers (RNFL). Method: We conducted a descriptive retrospec...Aims: To describe the progression of Primary open angle glaucoma (POAG) on Optical Coherence Tomography (OCT) of the optic nerve head and retinal nerve fiber layers (RNFL). Method: We conducted a descriptive retrospective study from January 1, 2015 to December 31, 2019, a period of 5 years from the files of patients followed for POAG and having carried out at least two OCT examinations of the optic nerve head (ONH), one automated visual field and Intraocular pression (IOP). The variables studied were: age, sex, mean IOP, glaucoma stage, progression of ONH parameters, and progression of RNFL parameters. Results: During the period, 112 eyes of 56 patients were included. The mean age was 48.96 ± 16.57 [12 - 83] years with a sex-ratio of 1.33 (32 M/27 F). The mean IOP was 21 ± 4.54 [10 - 36] mm Hg. According to the mean deviation (MD) of the visual field, 98 eyes or 87.5% were stage 1 of POAG, 10 eyes or 8.9% at stage 2 and 4 eyes or 3.6% at stage 3. The mean time between the 1st and 2nd OCT examination was 28.91 ± 11.07 [6 - 56] months, corresponding to an average of 2.18 OCT per patient in 5 years of follow-up. There was an average increase of 6.2% of the Cup area and an increase in the vertical Cup/Disc ratio of 1.79% per year. The thinning average of neuro-retinal ring area was 1.64% per year. The RNFL thickness had decreased on average by 4.28 μ or 0.93% per year. The lower quadrant had the highest fiber loss with 1.08% per year followed by the upper quadrant with a loss of 1.05% per year. Conclusion: OCT of the ONH and RNFL proves to be an essential tool in the follow-up of POAG. A subsequent study taking into account the OCT of the macular ganglion complex will enable to study its contribution in the follow-up of glaucomatous patients in the same population.展开更多
Background: There are few studies on the cost of glaucoma management in developing country, especially in Togo, there are no data on the cost of POAG management. Aims: To determine the annual direct cost of the manage...Background: There are few studies on the cost of glaucoma management in developing country, especially in Togo, there are no data on the cost of POAG management. Aims: To determine the annual direct cost of the management of POAG, to evaluate the annual economic weight of the management of POAG and to determine the factors associated with the annual economic weight of the management. Methods: We conducted a retrospective and descriptive study over a period of 12 months from January 1 to December 31, 2019 based on the records of patients followed for POAG in AFIA Eye Clinic in Lomé-Togo. The annual direct cost was defined by the sum of the costs of consultations, explorations and treatments. We defined the direct cost per patient and per year and related to the average annual income. It was said to be catastrophic at 20% or more of the estimated annual income. Chi 2 and Fisher tested the comparison of proportions. We conducted univariate and multivariate logistic regression to search correlations. Results: During the study period, 150 patient records were included. The average age was 47.24 ± 17.09 years and the sex ratio was 0.82. The cost of the diagnosis was 112.18 ± 22.26 €. The average cost of consultations was 19.46 ± 11.35 € and that of explorations was 92.71 ± 10.91 €. The annual cost of treatment per patient was 165.52 ± 110.16 €. The annual global direct cost of POAG management per patient was 277.69 ± 132.42 €. Compared to the annual income of 1166.29 €, the economic weight of the glaucoma management was 23.8%. This direct cost was catastrophic for 32.1% of patients in the study (44/150 of people with no care). Compared to the guaranteed inter-professional minimum wage (SMIG) of 640.30 €, the economic direct cost weight was 43.3%. Risk factors significantly associated with the direct cost were age over 40 (OR = 1.05 and p = 0.032), liberal profession (OR = 4.72 and p = 0.04), the absence of health insurance (OR = 6.68 and p = 0.017) and the use carbonic anhydrase inhibitors (OR = 7.展开更多
文摘Background: Although proptosis is rare, it is nevertheless the main sign of orbital disease. Its discovery usually indicates a serious eye disease especially in children. Objective: To determine epidemiological and diagnostic aspects of childhood proptosis in Lome (Togo). Methods: Retrospective cross-sectional study conducted from June 2010 to May 2020, which is 10 years, in the ophthalmology department of CHU-campus of Lome. Files of patients between the age of 0 and 15 who presented a proptosis during the study period were taken into account in the study. Patients with a false proptosis or incomplete records during the study period were not taken into account in the study. Results: The study considered 42 children with an age average of 7.63 years ± 4.96 [4 days;15 years] and a sex-ratio of 1.33. The frequency of proptosis was 0.5% with an average progression of 383.7 days before the first consultation. The proptosis was unilateral in 80.95% of cases. The orbito-cerebral CT scan was done in 47.62% of cases. The proptosis in these patients was predominantly of grade 3 in 45% of cases. The tumor pathologies were at the forefront in 35.71%, dominated by retinoblastoma, and followed by infectious and inflammatory diseases in 14.29%. Conclusion: Childhood proptosis is rare and often indicative of infectious and tumor pathologies in our context. Its diagnosis is delayed, which shows the importance of an early and effective diagnosis. .
文摘Objective: Maculopathies are more and more frequent. For the follow-up of its evolution and therapy, it seems important for us to determine the baseline in normal subjects by Optical Coherence Tomography (OCT). The goal here is to determine the acceptable range of macular thickness in normal black subjects in Lomé. Methodology: This is a retrospective study over a 6-month period. It did not include all patients with retinopathy of any cause, maculopathy, and glaucoma. The analyzed variables were the average macular thickness, the central macular thickness, and the total macular volume. Results: Out of the 433 macular OCT performed, 191 patients were selected;a total of 338 eyes. These included 96 men and 95 women. A sex ratio was 1.01. The median age was 44.1 years with extremes ranging from 10 to 70 years. The average macular thickness was 263.4 μm for the right eye and 263.7 μm for the left eye. The central macular thickness was 174.1 μm for the right eye and 173.3 μm for the left eye. The total macular volume was 7.4 in both eyes. Discussion: No significant statistical difference existed between the two sexes. The average macular thickness found in this study was within the range of normality observed in the literature, which is between 216 and 288 μm. Conclusion: The average macular thickness of the normal subject in Lomé was 263.4 μm.
文摘<strong>Background:</strong> Druses of the papilla constitute abnormal deposits of calcified hyaline material at the level of the head of the optic nerve. They can be superficial or deep. <strong>Aim:</strong> The aim of this study is to show the utility of ocular ultrasound in ophthalmology in underdeveloped countries for the characterization of optic disc druse. <strong>Case Presentation:</strong> Our study relates to a clinical observation of buried papillary druses diagnosed by ocular ultrasound. The ophthalmologic examination revealed an aspect of false papillary edema in the fundus. The ocular ultrasound revealed hyperechogenic deposits buried in the papillary margins, which suggests the deep papillary druses. <strong>Conclusion:</strong> Ocular ultrasound still has a prominent place in the diagnosis of certain eye conditions despite the new sophisticated means available to ophthalmology to date.
文摘<strong>Background:</strong> Ocular coloboma is the product of an error in the fetal fissure closure, normally occurring between the fifth and sixth weeks of gestation <a href="#R1" target="_blank">[1]</a>. It may involve the cornea, iris, zonula, ciliary body, choroid, retina and optic nerve. The incidence of this syndrome is 0.7 per 10,000 live-births <a href="#R1" target="_blank">[1]</a>. The aim of this observation is to present the first case of bilateral coloboma of the iris <a href="#R1" target="_blank">[1]</a>. This case was associated with an ametropia causing a decrease in visual acuity. <strong>Case Presentation:</strong> This was a clinical observation concerning a young 12-year-old patient who consulted for blurring of vision which had progressed for approximately 2 years. The ophthalmologic examination revealed an ametropia with a bilateral notch of the pupillary rim suggesting a bilateral coloboma. There was no association with another coloboma such as chorioretinal coloboma which is quite common and is accompanied frequently by visual symptoms. <strong>Conclusion:</strong> A visual impairment of the child can indicate ametropia. However, other congenital anomalies can be discovered as was the case in this clinical observation.
文摘<strong>Background:</strong> Large papillary excavations constitute a true differential diagnosis of glaucoma in our environments. <strong>Aim:</strong> To present a clinical case of large papillary excavation simulating glaucomatous optic neuropathy in a young subject. <strong>Case Presentation:</strong> The ophthalmologic examination made it possible to note a visual acuity of LogMar 0.00, ocular hypertonia and a large papillary excavation in both eyes. The visual field noted bilateral perimetric involvement suggesting optic neuropathy. Optical coherence tomography (OCT) of the ganglion complex revealed an absence of involvement of the ganglion complex and the ganglion ridge essential to evoke optic neuropathy. An ocular hypotonizing treatment made it possible to normalize the intraocular pressure. <strong>Conclusion:</strong> The particularity of this observation lies in the fact that the perimeter involvement that preceded any involvement can simulate a glaucomatous involvement. Functional damage to the visual field must be correlated with structural damage to suggest glaucomatous damage in our ophthalmic patients.
文摘<strong>Introduction:</strong> Glaucoma is a major cause of irreversible blindness worldwide. Early detection and awareness are essential to reduce the impact on eye health. The aim of this study is to assess the knowledge, attitudes and practices of health care staff about glaucoma in Lomé. <strong>Materials and Methods:</strong> This was a prospective cross-sectional and descriptive study including health care staff in Lomé, from October 1st to December 31st, 2020, for a period of 3 months. After their agreement, the officers responded to questions based on a survey sheet. <strong>Results:</strong> A total of 169 agents from 3 centers in Lomé, i.e. the Sylvanus Olympio University Teaching Hospital, the Campus University teaching Hospital and the Bè Hospital were involved. 50.9% of the agents were male versus 49.1% female, i.e. a ratio of 1.04. The average age was 33.66 ± 10.45 years. 46.10% were doctors versus 53.90% paramedics. 58.60% had at most 5 years of experience against 41.40% who had more than 5 years of experience. 53.80% defined glaucoma as ocular hypertension while 17.20% defined it as optic nerve disease. 46.20% did not know that there were many types of glaucomas compared to 53.20% who knew that there are many types of glaucomas. 92.30% knew that glaucoma can lead to cause visual loss. Regarding attitudes and practices about glaucoma, 91.70% declared that the follow-up should be done by the ophthalmologist, 81.10% thought that it would be necessary to be checked by the doctor only every 6 months. Finally, 65.08% declared that they had to use eye drops for life for the treatment. <strong>Conclusion:</strong> Steps should be taken to educate staff more about glaucoma attitudes and practices and also plan for action in the population.
文摘Objectives: To assess the factors influencing the ophthalmological follow-up of sickle cell patients in Togo. Materials and Methods: The national center of research and care for sickle cell patients (CNRSD) served as study setting. It was a descriptive and analytical study by interview over a three-month period from December 01, 2020 to March 02, 2021. Was included in the study, any patient with sickle cell disease genotype SS or SC, age ≥ 17 years, regularly followed at the CNRSD and having accepted the interview by a survey sheet. Excluded were patients with sickle cell trait genotype AS or AC or with a disability that prevented them from being interviewed. Results: Two hundred and fifty (250) patients with sickle cell disease were interviewed. The mean age was 29.1 years ± 11.12 years [17 years;67 years] and the sex ratio = 0.52. Nine patients over ten (9/10) attended at least secondary school. The jobless represented 25.60% of the total population followed respectively by students and laborers in 20.40% and 16% of cases. Twenty-four percent (24%) of patients were followed up in ophthalmology department. Statistically, there was no significant relationship between level of education (p = 0.4083), occupation (p = 0.6441) and knowledge of the ocular complications of sickle cell disease. Statistically, there was a significant relationship between knowledge of the ocular complications of sickle cell disease and compliance with ophthalmological follow-up (p = 0.0009). Conclusion: The knowledge of eye disorders related to sickle cell disease by patients with sickle cell disease improves their ophthalmological follow-up. Greater awareness on eye disorders related to sickle cell disease by medical staff towards patients with sickle cell disease would improve ophthalmological follow-up. .
文摘Introduction: The frequency and severity of eye complications from diabetes make patient education essential, which is the basis for adequate management. What is the level of education of diabetic patients in Lomé? The aim of this study was to assess the knowledge, attitudes and practices of diabetic patients on the ocular complications of diabetes in Lomé. Methods: We conducted a cross-sectional study by surveys on diabetic patients from April 1 to June 31, 2020, in 6 diabetes management centers in Lomé. The correct response rate was established for each component. Knowledge: poor (≤ 50%), low (50% - 65%), medium (65% - 85%) and good (≥ 85%). Attitudes: harmful (≤ 50%), erroneous (50% - 65%), approximate (65% - 85%) and fair (≥ 85%). Practice: harmful (≤ 50%), inadequate (50% - 65%) and adequate (>65%). Results: Over the study period, 150 patients were enrolled. The mean age was 56.98 ± 13.37 years with a sex ratio of 1.1 (79 men/71 women). The overall level of knowledge was insufficient (50.6%) with 65.5% for general knowledge about diabetes and 35.8% for ocular complications of diabetes. Attitudes were approximate (68.7%). In the case of hyperglycemia, 31.3% of patients would confide in a diabetologist and 22.0% in a general practitioner. If decrease in vision, 84.3% of patients would contact the ophthalmologist. The level of practice was harmful (20.4%). For diabetic follow-up, 36.7% of patients have already seen an ophthalmologist, 41.3% have performed a fundus examination, 17.3% retinal angiography, 4% laser retinal photocoagulation and 2.7% intravitreal injection (IVT). An awareness session on the ocular complications of diabetes was followed by 52.7% of patients and 50.7% of patients followed a therapeutic education session. Conclusion: This study has shown that the level of knowledge was poor, attitudes approximate and practices harmful. It is therefore important to raise awareness about diabetes and its ocular complications with the aim to change behavior.
文摘Aims: To describe the progression of Primary open angle glaucoma (POAG) on Optical Coherence Tomography (OCT) of the optic nerve head and retinal nerve fiber layers (RNFL). Method: We conducted a descriptive retrospective study from January 1, 2015 to December 31, 2019, a period of 5 years from the files of patients followed for POAG and having carried out at least two OCT examinations of the optic nerve head (ONH), one automated visual field and Intraocular pression (IOP). The variables studied were: age, sex, mean IOP, glaucoma stage, progression of ONH parameters, and progression of RNFL parameters. Results: During the period, 112 eyes of 56 patients were included. The mean age was 48.96 ± 16.57 [12 - 83] years with a sex-ratio of 1.33 (32 M/27 F). The mean IOP was 21 ± 4.54 [10 - 36] mm Hg. According to the mean deviation (MD) of the visual field, 98 eyes or 87.5% were stage 1 of POAG, 10 eyes or 8.9% at stage 2 and 4 eyes or 3.6% at stage 3. The mean time between the 1st and 2nd OCT examination was 28.91 ± 11.07 [6 - 56] months, corresponding to an average of 2.18 OCT per patient in 5 years of follow-up. There was an average increase of 6.2% of the Cup area and an increase in the vertical Cup/Disc ratio of 1.79% per year. The thinning average of neuro-retinal ring area was 1.64% per year. The RNFL thickness had decreased on average by 4.28 μ or 0.93% per year. The lower quadrant had the highest fiber loss with 1.08% per year followed by the upper quadrant with a loss of 1.05% per year. Conclusion: OCT of the ONH and RNFL proves to be an essential tool in the follow-up of POAG. A subsequent study taking into account the OCT of the macular ganglion complex will enable to study its contribution in the follow-up of glaucomatous patients in the same population.
文摘Background: There are few studies on the cost of glaucoma management in developing country, especially in Togo, there are no data on the cost of POAG management. Aims: To determine the annual direct cost of the management of POAG, to evaluate the annual economic weight of the management of POAG and to determine the factors associated with the annual economic weight of the management. Methods: We conducted a retrospective and descriptive study over a period of 12 months from January 1 to December 31, 2019 based on the records of patients followed for POAG in AFIA Eye Clinic in Lomé-Togo. The annual direct cost was defined by the sum of the costs of consultations, explorations and treatments. We defined the direct cost per patient and per year and related to the average annual income. It was said to be catastrophic at 20% or more of the estimated annual income. Chi 2 and Fisher tested the comparison of proportions. We conducted univariate and multivariate logistic regression to search correlations. Results: During the study period, 150 patient records were included. The average age was 47.24 ± 17.09 years and the sex ratio was 0.82. The cost of the diagnosis was 112.18 ± 22.26 €. The average cost of consultations was 19.46 ± 11.35 € and that of explorations was 92.71 ± 10.91 €. The annual cost of treatment per patient was 165.52 ± 110.16 €. The annual global direct cost of POAG management per patient was 277.69 ± 132.42 €. Compared to the annual income of 1166.29 €, the economic weight of the glaucoma management was 23.8%. This direct cost was catastrophic for 32.1% of patients in the study (44/150 of people with no care). Compared to the guaranteed inter-professional minimum wage (SMIG) of 640.30 €, the economic direct cost weight was 43.3%. Risk factors significantly associated with the direct cost were age over 40 (OR = 1.05 and p = 0.032), liberal profession (OR = 4.72 and p = 0.04), the absence of health insurance (OR = 6.68 and p = 0.017) and the use carbonic anhydrase inhibitors (OR = 7.
