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Determinants of the Ophthalmological Follow-Up of Sickle Cell Patients at the National Center of Research and Care for Sickle Cell Patients in Lome-Togo

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Open Journal of Ophthalmology 2023年第4期13卷 341-351页

作者： Nidain Maneh Yawa Edebah Nagbe Mawuli Ayodele komi Santos Dadjo Amouzou Hezouwe Magnang Koffi Sylvain Kawilitetou Kokou Messan Amedome komi patrice balo Service d’Ophtalmologie du CHU-Campus Université de Lome Lomé Togo Service d’Ophtalmologie du CHU Sylvanus Olympio Université de Lome Lomé Togo Service d’Ophtalmologie CHP Université de Lomé FSS Aného Togo Département des sciences fondamentales CNRSD Lomé Togo Service d’ophtalmologie du CHU Université de Kara FSS Kara Togo

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. .

关键词： Ophthalmological Follow-Up Sickle Cell Patient Ocular Complications Lome

Epidemiological and Diagnostic Aspects of Childhood Proptosis in Lome (Togo) from 2010 to 2020

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Open Journal of Ophthalmology 2023年第4期13卷 333-340页

作者： Nidain Maneh Mawuli Ayodele komi Santos Koffi Sylvain Kawilitetou Dadjo Amouzou Kossi Dzidzinyo Kokou Vonor Didier Koffi Ayena patrice komi balo Ophthalmology Department of CHU-Campus University of Lome Lome Togo Ophthalmology Department of CHP-Aneho University of Lome Aneho Togo Ophthalmology Department of CHU Sylvanus Olympio University of Lome Lome Togo Ophthalmology Department CHR-Tomde University of Kara Kara Togo

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. .

关键词： Childhood Proptosis Tumors Infections Lome

Does Eye Camp Contribute to the Fight against Blindness? Experience of the Central Region in Togo

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Open Journal of Ophthalmology 2017年第3期7卷 196-203页

作者： Kassoula Batomaguela Nonon Saa Nidain Maneh Messan Kokou Amedome Kokou Vonor Kossi Dzidzinyo Koffi Didier Ayena komi patrice balo Eye Department of Sokode Faculty of Health Sciences University of Lome Lome Togo Eye Department of Lome Faculty of Health Sciences University of Lome Lome Togo Eye Department of Kara Faculty of Health Sciences University of Lome Lome Togo

Aim: To evaluate results of cataract surgery in Eye Camp in rural areas. Patients and Method: This study set about the retrospective analysis of cases and operating reports of patients over the age of 10, operated for cataract in Eye Camp and fixed strategy from January, 2010 to December, 2012. Postoperative data were specified and compared. Results: Out of a total of 1145 patients operated, 577 (50.40%) were men compared with 568 (49.60%) women. The general mean age was 62 years, similar in Eye Camp and in fixed strategy. Sixty percent of patients were operated in Eye Camp. After 4 weeks of follow-up, 77% of patients were met again, and 83% among them showed good results (corrected visual acuity = 3/10). This rate of good results was 80.43% in Eye Camp against 87.7% in fixed strategy. We noted 18.25% of complications among which 11.25% were in Eye Camp. The functional outcomes of both strategies get closer to WHO standards. Conclusion: Eye Camp in the Central Region of Togo is an interesting alternative that contributes to the fight against blindness, even if postoperative follow-up is still to be improved.

关键词： Cataract Surgery Eye Camp Functional Outcomes

Knowledge, Attitudes and Practices of Diabetic Patients on Ocular Complications of Diabetes in Lomé(Togo)

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Open Journal of Endocrine and Metabolic Diseases 2022年第9期12卷 197-210页

作者： Kokou Vonor Kossi Kodjo Kwam Dodji Godwin Yaovi Tété Koffi Didier Ayéna Méba Banla komi patrice balo Department of Ophthalmology Regional Hospital of Kara Kara Togo Departement of Ophthalmology Faculty of Health Sciences University of Lomé Togo Department of Internal Medicine and Endocrinology Sylvanus Olympio University Hospital of Lomé Lomé Togo

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.

关键词： Knowledge Attitudes Practices Eye Complications Diabetes Lomé

Contribution of the Fundus Examination in the Management of General Pathologies in Hospital in Lomé-Togo

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Open Journal of Internal Medicine 2019年第3期9卷 52-61页

作者： Nouhou Diori Adam Nonon Saa Kassoula Batomaguela Dzidzinyo Kossi Abbey Abbevi Elie Abdou Zakou Yacoubou Soumana Abdou Amza komi patrice balo Ophthalmology Department Teaching Hospital Sylvanus Olympio Lom&eacute Togo Ophthalmology Department Be District Hospital Lom&eacute Togo Clinique Lumière Niamey Niger Ophthalmology Department Lamord&eacute National Hospital Niamey Niger

Many general conditions have an impact on the fundus. The purpose of our work was to study the epidemiological profile of patients referred to our service for a review of the fundus and analyze the results. It was a retrospective study description of the examinations of the fundus during the period from January 2016 to December 2017. In the ophthalmology department of the Lomé University Hospital Center, during the study period, 1019 consultations were recorded, of which 727 were for fundus 6.84%. There were 336 men and 391 women, a sex ratio of 0.85. The age group 40 - 69 years accounted for 61.9%. The frequency of the main reasons for the request was hypertension 54.2% (N = 394);hypertension complicated or associated with other conditions (CKI, CKD, pregnancy and diabetes) accounted for 21.6% (N = 157), headache associated with a decrease in visual acuity 8.25% (N = 60), diabetes 6.46% (N = 47) and sickle cell disease 0.69% (N = 5). Hospitalized patients 52.41% (N = 381). The fundus was abnormal in 546 patients or 75.11%. Hypertensive retinopathy was found 80.21% cases in hypertensive patients, diabetic retinopathy 43.42 in diabetic patients. Diabetics Fundus examination in hospital practice found a retinal lesion in three-quarters of cases. It so important to ask the examination of the fundus most often in the current pactise.

关键词： Fundus Hypertensive Retinopathy Diabetic Retinopathy Headache Lomé

Progression of Primary Open Angle Glaucoma on Optical Coherence Tomography of the Optic Nerve Head

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Open Journal of Ophthalmology 2022年第4期12卷 345-351页

作者： Kokou Vonor Tchilabalo Tchodjoou Yaovi Tété Yawa Nagbé Roger Ahlonko Kuaovi-Koko Koffi Didier Ayéna Méba Banla komi patrice balo Service d’Ophtalmologie CHR Kara Tomdè Tomdè Togo Département d’Ophtalmologie Faculté des Sciences de la Santé Université de Lomé Lomé Togo Cabinet AFIA Lomé Togo

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.

关键词： POAG Progression OCT ONH-RNFL

Primitive Bilateral Ocular Melanoma in a Black Patient

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Open Journal of Ophthalmology 2017年第4期7卷 256-261页

作者： Essossinam Kpelao Nidain Maneh Harrefegena Bissa Koffi Amegbor Kadanga Anthony Beketi Abdel Kader Moumouni Agbeko Doleagbenou Thierry Alihounou Julienne Noudé Teclessou komi patrice balo Department of Neurosurgery University of Lome Lome Togo Department of Ophthalmology University of Lome Lome Togo Department of Maxillofacial Surgery and Stomatology University of Lome Lome Togo Department of Pathology University of Lome Lome Togo Department of Surgery Oueme and Plateau Teaching Hospital Porto-Novo Benin Department of Dermatology University of Lome Lome Togo

Introduction: Ocular melanoma develops at the expense of eyes’ melanocytes which give to the eyes their color. It is the first primitive intraocular tumor in the White race. It is rare, as that of the skin in black people. The bilateral cases are exceptional even in the white race, estimated at 0.2%. We present the case of bilateral ocular melanoma with bad prognosis in a black patient. Patient and observation: A 56-year-old black male patient, who had benefited 4 years earlier from an enucleation of the right eye for ocular melanoma, and admitted for bilateral exophthalmos which evolved for three months in a context of bilateral blindness. The cerebral Scanning had allowed to objectify a bilateral lateral-conical mass which evoked an inflammatory pseudo tumor. The failure of the medical treatment led to the exeresis of a conical, juxta-orbital and mid-muscular blackish mass, to the later apex respecting the surrounding structures. The histological examination ends again in a melanoma. No additional therapy was undertaken. The evolution 2 years later was marked by a local recurrence, multiple hepatic metastases and patient death. Conclusion: Bilateral ocular melanoma is exceptional in Black people. The etiologic factors as well as bilateralism mechanisms are still hypothetic. Its most effective treatment is local and the prognosis, bad in case of metastases due to the absence of an effective chemotherapy.

关键词： Bilateral Ocular Melanoma Black Patient

Epidemiology of Child’s Ocular Globe Injury: A Retrospective Study at the University Teaching Hospital-Campus of Lomé(Togo)

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Open Journal of Ophthalmology 2017年第1期7卷 8-13页

作者： Nidain Maneh Abou-Bakr Sidik Domingo Kassoula Batomaguela Nonon Saa Vonor Kokou Agba Aide Isabelle Ayena Koffi Didier Banla Meba balo komi patrice Faculty of Health Sciences University of Lome Lomé Togo Department of Ophthalmology The University Teaching Hospital Campus of Lomé Lomé Togo

Aim: To study clinical and epidemiological characteristics of child’s ocular injuries. Patients and Method: Retrospective study on medical records of children suffering from traumatic injuries of the ocular globe presented to the Campus Teaching Hospital (CHU Campus) of Lomé from 3 January 2015 to 30 June 2016 (18 months). Age, sex, nature of the traumatising agent, consultation delay and the width of the injury (zone I, II or III), the classification of ocular trauma, according to “Birmingham Eye Trauma Terminology (BETT) system”, connected lesions have been studied. Results: Twenty children about 46.51% children presented for ocular trauma have been suffering from a globe injury. The average age was 6.68 years with the extremes of 1 year and 12 years;the age bracket of 0 - 5 years was more represented (45%);predominance was more from the female with a sex-ratio = 0.67. Eighty percent of the children were from rural areas while twenty from urban areas. The delay of consultation was less than 24 hours in 40% of cases and 15% consulted between 24 h and 72 h after the trauma. Traumatisms were entirely unilateral and penetrating within a majority of 15 (75%) cases of which a “stick” is the traumatising agent of the most frequent (40%). The seat of the injury was the zone I (85.71%) and zone II (14.29%). Connected lesions were dominated by iris hernia 7 (35%) and traumatic cataract 6 (30%). Conclusion: children’s traumas were high predominantly and they came in majority from rural zones. Prevention through awareness remains the best treatment.

关键词： Child Injury Globe Ocular Lomé

Diagnosis of Large Papillary Excavations in Developing Countries: From Automated Visual Field to OCT of the Ganglion Complex. About a Case

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Open Journal of Ophthalmology 2021年第2期11卷 143-151页

作者： Kokou Messan Amedome Kassoula Batomaguéla Nonon Saa Kossi Dzidzinyo Kokou Vonor Nidain Maneh Koffi Didier Ayena komi balo Centre Hospitalier Universitaire de Kara Kara Togo Centre Hospitalier Universitaire Sylvanus Olympio de Lomé Lomé Togo Centre Hospitalier Régional de Kara Tomdè Kara Togo Centre Hospitalier Universitaire Campus de Lomé Lomé Togo Hô pital de Bè Lomé Lomé Togo

Background: Large papillary excavations constitute a true differential diagnosis of glaucoma in our environments. Aim: To present a clinical case of large papillary excavation simulating glaucomatous optic neuropathy in a young subject. Case Presentation: 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. Conclusion: 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.

关键词： Large Excavation Optic Neuropathy Glaucoma OCT Kara