Epidemiological, Clinical, Therapeutic and Evolutive Profile of Primary Open-Angle Glaucoma in a Cameroonian Population

Background: Sub-Saharan Africa has the highest prevalence of primary open-angle glaucoma (POAG), at 4.2%. The efficacy of medical treatment has been demonstrated and remains one of the treatments of choice for POAG. However, in sub-Saharan Africa, its effectiveness has many challenges, due to multiple factors, including cost and access to care. Thus, the present study aimed to determine the epidemiological, clinical, therapeutic and evolutive profile of primary open-angle glaucoma patients. Methodology: A descriptive cross-sectional study was carried out in two hospitals in western Cameroon. Epidemiological, clinical, therapeutic, and evolutionary data on intraocular pressure at one year after medical treatment were analyzed. SPSS version 23 software was used for statistical analysis, with a significant p-value set at 5%. Results: A total of 201 patients with POAG were included in the study. The population comprised 100 men and 101 women, with a mean age of 54 ± 12 years. At diagnosis, the mean intraocular pressure was 23.9 ± 8.70 mmHg for the right eye and 25.5 ± 9.57 mmHg for the left eye. The mean cup/disc ratio was 0.64 ± 0.2 [0.2-1] and 0.67 ± 0.19 [02-1] in the right and left eyes, respectively. Monotherapy was the most prescribed treatment [59.2%]. After one year of treatment, intraocular pressure was reduced by 15.5% with beta-blockers, 23.66% with prostaglandins, 19.11% with carbonic anhydrase inhibitors, 35, 92% with beta-blockers and carbonic anhydrase inhibitors, 25.92% with beta-blockers and prostaglandins, 48.03% with carbonic anhydrase inhibitors and prostaglandin agonists, and 38.77% with triple therapy. Taking glaucoma severity into account, a significant reduction in intraocular pressure at one year was observed in all participants [p 0.05]. However, the target pressure was obtained in 47%, 20% and 14% of eyes suffering of mild, moderate, and severe grade of POAG respectively. Conclusion: In the present study, there was a significant reduction in intraocular pressure after one year of medical treatment. However, the reduction in intraocular pressure does not allow the target pressure to be reached in severe forms. Thus, alternatives to the medical treatment of POAG should be discussed early in the present context. .

Central Corneal Thickness of Diabetic Patients in Yaoundé: Case Control Study

Background: To compare central corneal thickness (CCT) values measured in diabetic eyes and compare the CCT values in normal patients without diabetes. Methods: A total of 83 diabetic patients and 83 non-diabetic patients were prospectively enrolled in this comparative case series. CCT was measured using a Topcon CT-1P non-contact automated pachymeter, and values were compared. Results: Mean age was 57 ± 11 years, with a range of 23 and 80 years. The mean CCT was 508.87 ± 35.83 μm for diabetic patients and 513.41 ± 37.22 μm for non-diabetic patients. There was no statistically significant difference between the CCT of diabetic patients compared to non-diabetic patients (p = 0.260). We did not find a significant correlation between the CCT of diabetic patients and clinical characteristics of diabetes. However, there was a positive and statistically significant linear correlation between the CCT of diabetic patients and intra ocular pressure (IOP). Conclusion: The mean CCT in diabetic patients was lower than in non-diabetic control patients, although there was no statistically significant difference.

Ocular Findings in HIV-Positive Children in Two Hospital Facilities in Yaoundé, Cameroon

Background: HIV infection in children as well as adults remain a disease with potential multisystemic disorders despite the increased use of Highly Active Antiretroviral Therapy (HAART). The aim of this work was to determine the profile of eye diseases among HIV-positive children aged 5 to 15 years in the Mother and Child Centre of the Chantal Biya Foundation and the University Hospital Centre (UHC) in Yaoundé. Materials and Methods: an analytical study was conducted from June 1, to July 31, 2019. Our sample consisted of all children aged 5 - 18 years who were HIV positive and whose parent or legal guardian gave his or her consent. A complete clinical examination was performed. The following variables were collected: socio-demographic data, Immunological data. A comprehensive eye exam was also performed. Data were analysed by the Epi info 3.5.4 software. Results: A total of 53 children were retained for the study. The population consisted of 28 boys (52.3%), for a sex ratio of 1.12. The mean age was 12.7 ± 4.2 years [5 - 18 years]. And 84.9% of children had normal immune status. The average duration of HAART was 8.3 ± 3.9 years [0 to 16 years] with more than half (50.9%) of the children on treatment for more than 8 years. The main eye complaints were pruritus (11.32%), eye pain (11.32%) and tingling (9.43%). The frequency of ophthalmological manifestations was 52.8% with adnexal involvement the most frequent (34%), followed by anterior (7.5%) and posterior segment involvement (1.9%). Anterior segment involvement was marked by granulomatous anterior uveitis, keratouveitis and corneal ulcer. A cytomegalovirus retinitis and a macular scar of a unilateral retinitis were found in 2 patients. In a multivariate analysis, elevated CD4 count (>500) was associated with ocular manifestations. Conclusion: In the HAART era, an ocular examination is mandatory to prevent harmful eye diseases among children because ophthalmological diseases remain frequent. Although they are most often lesions of the annexes, corneal and chorioretinal involvement can be detrimental for the vision.