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Birth Defects of the Child Optic Disc: Diagnostic Challenges and Prospects for Care

Open Journal of Ophthalmology 2024年第2期14卷 128-135页

作者： Prudence Ada Assoumou Davy Alex Mouinga Abayi Annick Kougou Ntoutoume Hélène Nyinko Aboughe Olive Matsanga tatiana harly mba aki Emmanuel Mve Mengome Owendo University Hospital Center Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Omar Bongo Ondimba Military Instructions Hospital Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Jeanne Ebori Foundation Mother and Child University Hospital Center Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon

Introduction: Congenital optic disc anomalies in children refer to structural variations of the optic nerve head present from birth. These deformations involve the size, shape, color, and vessels of the optic disc. Although often asymptomatic, these anomalies can impact the visual development of the child, underscoring the importance of a thorough fundus examination for early detection and appropriate medical follow-up. We present two cases of congenital optic disc anomalies in children, illustrating the diagnostic challenges and complexity of their management. Case 1: A 3-year-old girl presented with a white spot in her left eye present since birth. Uncorrected distance visual acuity was 2/10 in the right eye, while she could perceive hand movements at 2 meters with the left eye. Normal examination in the right eye showed leukocoria, microphthalmia, and a white mass at the center of the optic disc on fundus examination in the left eye. Ocular imaging, including ultrasound and optical coherence tomography (OCT), confirmed the diagnosis of persistent hyperplastic primary vitreous (PHPV) in its mixed form in the left eye. Management included prescribing full optical correction and functional rehabilitation, without resorting to surgery. The course was marked by persistent amblyopia leading to a poor prognosis. Case 2: A 7-year-old girl consulted for vision disturbance in her right eye. Visual acuity was finger counting at 2 meters in the right eye and 10/10 in the left eye. Anterior segment examination revealed no abnormalities in both eyes. However, fundus examination highlighted a large funnel-shaped excavation associated with central glial proliferation, wheel spoke vessels, and neuroretinal ring atrophy in the right eye. Optical coherence tomography (OCT) of the right eye confirmed the diagnosis of isolated unilateral Morning Glory syndrome. Management included full optical correction and orthoptic rehabilitation. The course was marked by the absence of ocular com

关键词： Optic Disc PHPV Morning Glory Diagnosis Treatment

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A Rare Cause of Leukocoria in Children: Persistent Hyperplastic Primary Vitreous

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Open Journal of Ophthalmology 2024年第1期14卷 63-68页

作者： Prudence Ada Assoumou Davy Alex Mouinga Abayi Yoan Mboussou Annick Kougou Ntoutoume Helene Nyinko Aboughe Olive Matsanga tatiana harly mba aki Emmanuel Mve Mengome Owendo University Hospital Center Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Omar Bongo Ondimba Military Instructions Hospital Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Médivision Clinic Libreville Gabon Jeanne Ebori Foundation Mother and Child University Hospital Center Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon

Introduction: Leukocoria, a whitish pupillary reflection, is a common warning sign of various pediatric ocular pathologies, including Persistent hyperplastic primary vitreous (PHVP). This case report describes the observation of a 3-year-old child with melanoderma, presenting with a white spot in the left eye since birth. Observation: Uncorrected distance visual acuity was 2/10 in the right eye and hand movements were perceived at 2 meters in the left eye. Examination of the anterior segment in the left eye revealed leukocoria and microphthalmia. The fundus examination was normal in the right eye but revealed a white mass extending from the center of the optic disc towards the temporal region in the left eye. Ocular imaging, including ocular ultrasound and optical coherence tomography, confirmed the diagnosis of PHVP, illustrated by a residual white mass at the center of the optic disc in the left eye. Conclusion: PHVP should be considered in the presence of leukocoria in a child, with urgent exclusion of retinoblastoma. This observation underscores the importance of early diagnosis for appropriate management. .

关键词： PHVP Leukocoria Amblyopia Ocular Imaging Childhood

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Diabetic Retinopathy: Diagnostic Challenges and Impact of Physical Activity

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Open Journal of Ophthalmology 2024年第2期14卷 136-142页

作者： Prudence Ada Assoumou Davy Alex Mouinga Abayi Daniella Nsame Annick Kougou Ntoutoume Hélène Nyinko Aboughe Olive Matsanga tatiana harly mba aki Emmanuel Mve Mengome Owendo University Hospital Center Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Omar Bongo Ondimba Military Instructions Hospital Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Endocrinology Department at the Libreville Hospital Center Department of Internal Medicine at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Jeanne Ebori Foundation Mother and Child University Hospital Center Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon

Introduction: Diabetes represents a major public health challenge, affecting over 463 million people according to the World Health Organization (WHO). Among its complications, diabetic retinopathy stands out as the leading cause of blindness in industrialized countries. Physical activity is now recognized as a cornerstone of diabetes management, and its impact on diabetic retinopathy is of growing interest. Observation: Mr. A.E, a 54-year-old man, presents with progressive deterioration of his vision. Family history of diabetes and hypertension is noted. He engages in one hour of physical activity daily, including treadmill running and indoor cycling. Despite recent optical correction, his visual acuity remains at 3/10 unimproved. Ocular imaging, notably fluorescein retinal angiography and optical coherence tomography, reveals proliferative diabetic retinopathy with bilateral macular edema. Blood tests, performed after physical activity, show normal values of blood glucose and HbA1c, delaying the initiation of treatment and promoting the progression of retinopathy. Despite appropriate management, no significant improvement in visual function is observed during follow-up. Conclusion: The management of diabetic retinopathy requires an approach integrating physical activity. A better understanding of the interaction between physical activity and diabetic retinopathy is needed to optimize prevention and treatment strategies.

关键词： Diabetes Retina Blood Glucose HbA1c Physical Activity

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Ocular Complications in Diabetic Patients: Prevalence, Impact on Quality of Life, and Implications for Healthcare

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Open Journal of Ophthalmology 2024年第2期14卷 149-158页

Introduction: Diabetes, a chronic disease characterized by persistent hyperglycemia, poses a major global health challenge. In Gabon, 10% of the population is affected by this condition, highlighting the need to actively understand and manage it. Ocular complications of diabetes, including diabetic retinopathy, glaucoma, and cataracts, have a devastating impact on patients quality of life and represent a crucial issue for healthcare systems. Methodology: This study conducted in Libreville from February 9, 2022, to April 15, 2022, was cross-sectional, longitudinal, and descriptive, with prospective data collection. Participants were diabetic patients regularly followed in the endocrinology department of CHUL, who were referred for a comprehensive ophthalmological examination at CHUO. Sampling was exhaustive, with strict inclusion criteria aimed at ensuring the representativeness of the study population. Results: The mean age of participants was 57.5 ± 13.2 years with a male-to-female ratio of 0.8. Personal histories were dominated by hypertension, while family histories were dominated by diabetes. Ocular complications of diabetes included refractive disorders (78.9%), cataracts (31.7%), glaucoma (78.9%), and diabetic retinopathy (13.7%). These ocular complications had a significant impact on participants’ quality of life, leading to impaired vision (78.9%), difficulties in carrying out daily activities (62.2%), the need for caregiver assistance (50.3%), high levels of stress and anxiety (68.9%), regular medication intake (71.4%), adherence to a specific diet (55.9%), and frequent blood glucose monitoring (74.5%). Conclusion: This study highlights the major impact of diabetic ocular complications on patients’ quality of life.

关键词： Ocular Complications Diabetes Quality of Life Prevalence Gabon

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Morning Glory Syndrome or Bindweed Flower Papilla Syndrome

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Open Journal of Ophthalmology 2024年第2期14卷 143-148页

作者： Prudence Ada Assoumou Davy Alex Mouinga Abayi Yoan Mboussou Annick Kougou Ntoutoume Hélène Nyinko Aboughe Olive Matsanga tatiana harly mba aki Emmanuel Mve Mengome Owendo University Hospital Center Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Omar Bongo Ondimba Military Instructions Hospital Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Mé division Clinic Libreville Gabon Jeanne Ebori Foundation Mother and Child University Hospital Center Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon

Introduction: Morning Glory Syndrome (MGS) is a rare anomaly of the optic nerve characterized by a flower-shaped excavation in the optic disc. This anatomical peculiarity is of growing interest due to its impact on vision and the therapeutic challenges it presents. Despite research advances, gaps persist, requiring thorough exploration to better understand this rare condition. We present the case of a young girl. Observation: A 7-year-old girl presented with persistent deterioration of vision in the right eye since birth. Visual acuity was counting fingers at 2 meters in the right eye and 10/10 in the left eye. Biomicroscopy was normal in both eyes, and fundus examination revealed a funnel-shaped excavation at the optic disc of the right eye, associated with central glial proliferation, thin blood vessels in a radial distribution, and atrophy of the neuroretinal rim. Additional tests confirmed the diagnosis of isolated unilateral Morning Glory Syndrome in the right eye. Combined treatment included appropriate optical correction and functional rehabilitation. Regular ophthalmological follow-up over a one-year period was established to monitor visual acuity evolution, optic disc stability, and detect any potential complications. The reserved prognosis was marked by the absence of ocular complications and maintenance of initial visual acuity in the right eye. Conclusion: The positive response to management underscores the importance of an integrated approach, early diagnosis, therapeutic adherence, and personalized strategies.

关键词： Morning Glory Anomaly Congenital Disc OCT

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Study of the Types of Refractive Disturbances Obseved during Hyperglycemia in Humans

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Open Journal of Ophthalmology 2022年第2期12卷 142-151页

作者： Angue tatiana harly mba aki Jean Fidèle Nnang Essone Nesta Ziza Ngaila Daniella Nsame Muriel Obono Akoma Olive Rosine Matsanga Félix Ovono Abessolo Department of Surgery and Specialties University of Health Sciences Libreville Gabon Ophthalmology Unit The Mother-Child University Hospital of Libreville Gabon Department of Physiology University of Health Sciences Libreville Gabon Department of Endocrinology and Metabolic Diseases Libreville Gabon Department of Biochemistry University of Health Sciences Libreville Gabon

Introduction: Refractive disturbances have been observed during hyperglycemia. However, there remains controversy as to the types of disturbances that it induces. Objective: To determine the types of refractive disturbances observed during hyperglycemia in humans. Population and Methods: This was an observational and cross-sectional study with an analytical purpose conducted from July to November 2021. Emmetropia, hypermetropia, and myopia as well as blood glucose levels were compared between day 0 (D0) and day 30 (D30) after initiation of hypoglycemic therapy in 222 people (444 eyes) with recently discovered hyperglycemia (Chi-2;p Results: At D0, the mean of blood glucose was 18.1 mmol/L ± 8.2 vs 6.9 mmol/L ± 3.0 at D30 (p = 0.001). At day 0, 80% (n = 355) of eyes were hypermetropic compared to 73.9% (n = 328) at D30 (p = 0.02). At D0, 14.2% of eyes (n = 63) were myopic compared to 11.3% (n = 50) at D30 (p = 0.02). Refraction improved from 0.75 to 1.5D for 34.5% (n = 18) of hypermetropic eyes and 10.2% (n = 2) of myopic eyes. Conclusion: Our results show that hypermetropia is the most common ametropia during hyperglycemia. Moreover, these data suggest that the normalization of blood glucose improves refraction.

关键词： Hyperglycemia Hypermetropia Myopia Hypoglycemic Treatment Libreville

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Bilateral Macular Hemorrhage Revealing Severe Thrombocytopenia in an AIDS Context about a Case Report

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Open Journal of Ophthalmology 2019年第1期9卷 28-33页

作者： Angue tatiana harly mba aki Synthia Mekyna Alex Mouigna Abayi Prudence Ada Assoumou Irène Mistoul Vouma Marjorie Emmanuel Mve Mengome Ophthalmology Unit CHU Angondje Gabon Department of Ophthalmology Faculty of Medicine Libreville Gabon Army Instruction Hospital Libreville Gabon Infectiology Service CHU Libreville Gabon

We report the clinical observation of an HIV-positive/AIDS patient with bilateral macular hemorrhage, which resulted in the identification of severe thrombocytopenia. Thrombocytopenia is a common hematologic anomaly during HIV infection. Its frequency increases with the decrease in CD4 T lymphocytes and the passage to the AIDS stage. Its pathophysiology in this context is complex and multifactorial. Hemorrhagic complications usually appear for platelets less than 50,000/mm3 and this risk is greater at a rate of less than 20,000/mm3. Retinal hemorrhages may go unnoticed, only macular localization results in clinical expression. OCT is of paramount importance in accurate topographic diagnosis of macular hemorrhages by locating their seats which can be pre, intra or under retinal. Management requires the balance of infectious and hematologic factors. Ophthalmic surgical treatments should be considered in a second step.

关键词： Thrombocytopenia HIV/AIDS Hemorrhage Macula

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Seroprevalence of HIV, Hepatitis B and C Viruses Infections among Candidates for Cataract Surgery

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Open Journal of Ophthalmology 2019年第2期9卷 47-53页

作者： Angue tatiana harly mba aki Emmanuel Anyunzoghe Emmanuel Anyunzoghe Patrice Emery Itoudi Bignoumba Stéphanie Ndjillekissa Ndjié Christian Agaya Emmanuel Mve Mengome Department of Ophthalmology Faculty of Medicine USS Libreville Gabon CHU Owendo Libreville Gabon Department of Epidemiology Biostatistics and Medical Informatics Faculty of Medicine USS Libreville Gabon Department of Hepato-Gastroenterology Libreville Gabon National Program to Fight Blindness Libreville Gabon

Introduction: The safety issue of mass surgeries in areas of higher endemicity for HIV, HBV and HCV is raised. Objective: The objective was to determine the frequency of HIV, HBV and HCV among people undergoing a cataract surgery during humanitarian surgical mission. Patients and Method: This prospective study was conducted at CHU Owendo from April to September 2018. Cataract-operated patients were the targeted population. Rapid screening tests were used for diagnosis. Parameters such as age, sex, frequency of HIV, HBV, HCV, and co-infections were analyzed. Sero-positivity was correlated with age and sex. A total of 1403 patients were included. Statistical analysis was performed with EPI Info 7.2 (Chi2 uncorrected, Mann-Whitnney and Wilcoxon, p Results: Patients mean age was 66.3 ± 11.6 years;42.1% of them were male. With 18.0% of the study population, HIV-positive people had mean age of 78.4 ± 9.3 years, compared to 61.2 ± 10.1 years for sero-negative (p < 0.001). HIV prevalence was 4.6% (95% CI = [3.7 - 5.9]), HBV was 2.9% (95% CI = [2.1 - 3.9]), and HCV was 11.8% (95% CI = [10.2 - 13.6]). Co-infections occurred in 1.2% (95% CI = [0.8 - 1.9]) of patients undergoing surgery. Conclusion: This study showed high prevalence of HIV, HBV and HCV among patients undergoing cataract surgery with predominance for HCV. Viral co-infections prevalence was also significant.

关键词： HIV HCV HBV Surgery Cataract Libreville

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Contribution at the Study of Neuroprotective Properties of Neuroglobin during Severe Chronic Glaucoma

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World Journal of Neuroscience 2020年第1期10卷 42-67页

作者： Jean Fidèle Nnang Essone tatiana harly mba aki Angue Mounir Belmalih Rosalie Nkiéma Ludmila Betty Eke Ndouo Emmanuel Anyunzoghe Nathan Ekegue Félix Ovono Abessolo Department of Physiology Faculty of Medicine and Health Sciences University of Health Sciences Owendo Libreville Gabon Physiological Functional Exploration and Physical Medicine Services Owendo University Hospital Center Owendo Libreville Gabon Department of Ophthalmology Faculty of Medicine and Health Sciences University of Health Sciences Owendo Libreville Gabon Mother-Child University Hospital Center Libreville Gabon Department of Biochemistry-Chemistry Faculty of Medicine and Health Sciences University of Health Sciences Owendo Libreville Gabon Department of Epidemiology Biostatistics and Medical Informatics Faculty of Medicine and Health Sciences University of Health Sciences Owendo Libreville Gabon Faculty of Pharmacy University of Health Sciences Owendo Libreville Gabon

Introduction: The mechanisms of overexpression of neuroglobin in patients with severe glaucoma (CG+) remain hypothetical. Objective: To study the anti-apoptotic, anti-hypoxic and anti-oxidant properties of neuroglobin in CG+. Population and Methods: The visual field, as well as plasma dosage of neuroglobin (CmNgb, ng/ml), hypoxia inductible factor-1alpha (CmHIF-1α, pg/ml), glutathione peroxidase (CmGpx, pg/ml), and cytochrome C oxidase (CmCyt C, pg/ml) were carried out in 45 CG+ and 45 controls (CG-). The chi-2 test compared the proportions, and Spearman’s test studied the correlations between quantitative variables (p Results: CmNgb was 4.1 in CG+, versus 2.3 in CG- (p = 1.52 × 10-5). CmGpx was 1144.7 in CG+, versus 752.8 in GC- (p = 0.0199). CmHIF-1α was 4.1 in CG+, versus 3.5 in CG- (p = 0.4530). CmCyt C was 2303.26 in CG+, versus 1750.44 in CG- (p = 0.0450). In CG+, there was a correlation between CmNgb and CmGpx (r = 0.417;p = 0.004), CmNgb and CmHIF-1α (r = 0.644;p = 1.8 × 10-6), and between CmHIF-1α and CmGpx (r = 0.447;p = 0.002), CmHIF-1α and CmCyt C (r = 0.371;p = 0.012). None correlation was found between CmNgb and CmCyt C (r = 0.126;p = 0.370), as well as CmGpx and CmCyt C (r = 0.102;p = 0.505). Conclusion: The variations of apoptosis, hypoxic, and oxidative stress biomarkers were found between CG+ and CG-, as well as their correlations, suggesting that neuroglobin overexpression is related to its anti-apoptotic, anti-oxidative, and anti-hypoxic properties.

关键词： Chronic Severe Glaucoma Neuroglobin Neuroprotective-Properties

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Heart Failure in Children in a Context of Sars-Cov 2 Infection: About Two Cases at the University Hospital Center of Libreville, Gabon

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Open Journal of Pediatrics 2022年第1期12卷 274-282页

作者： Ayo Bivigou Elsa Mpori Jamila mba aki tatiana Ondo mba Léo Békalé Joachim Kouna Philomene Cardiology Department University Hospital of Libreville Libreville Gabon Department of Internal Medicine and Medical Specialties Medical School University of Health Sciences Libreville Gabon Cardiology Unit Jeanne Ebori Mother and Child Foundation University Hospital Center Libreville Gabon Department of Ophthalmology University Hospital of Owendo Libreville Gabon Intensive Care Unit Jeanne Ebori Mother and Child Foundation University Hospital Center Libreville Gabon

This study reports two observations of heart failure diagnosed in the context of SARS-CoV 2 infection in children at the University Hospital Center of Libreville, Gabon. Long considered exempted from serious forms of Covid-19 infection, the fatal evolution of one of the two cases proves that there is an interest for a more rigorous approach in their management in a pandemic context. The multisystem inflammatory syndrome associated with this virus in children can be responsible for cardiac manifestations that can be life-threatening. Early diagnosis and treatment are necessary to reduce mortality. However, this approach is made difficult in our regions by the limited biomedical equipment and the absence of essential therapies as noted in these two observations.

关键词： Heart Failure Children Sars-Cov 2 Infection

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