The fellow eye of retinal detachment patients: Vision and clinical presentation

Background

The fellow eye of a retinal detachment is at risk of developing a retinal detachment and other visually debilitating disease.

Aim

To investigate the rate of bilaterality of retinal detachment (RD), the presenting visual acuity (VA), and the presence of ocular morbidity in the fellow eye of patients with RD.

Patients and Methods

A multicenter, prospective, cross-sectional study examining the fellow eye of consecutive patients who were diagnosed with different types of RD. The patients were seen within one year and examined in four Nigerian eye hospitals and clinics. Demographics, VA, and clinical findings at the presentation were reported on examination of the fellow eyes.

Results

Twenty-seven (11.4%) out of 237 patients (264 eyes) had an RD in the fellow eye. The mean age of all study patients was 46.2 ± 16.8 years, M/F: 161 (67.9%)/76 (32.1%). The rates of bilaterality for rhegmatogenous, exudative, and tractional RDs were 4.2%, 11.1%, and 31.1%, respectively. Diagnosis of RD in an eye was associated with a risk of developing fellow eye rhegmatogenous retinal detachment (RRD) (P < 0.001) and tractional RD (P < 0.001), respectively. RRD in an eye was associated with a 17% risk of developing RD in the fellow eye (β = -1.6, OR = 0.202, P < 0.001). The BCVA in the fellow eye of the three types of RD varied significantly (P < 0.001). The fellow eye was blind in 25.2% of RRD, 54.1% of tractional retinal detachment (TRD), and 11.1% of exudative retinal detachment (ERD). Bilateral RD eyes were blind in RRD (85.7%), TRD (71.1%), and ERD (50%). One hundred and seven eyes (40.5%) of the total 264 RD eyes studied had other fellow eye events at the presentation.

Conclusion

A patient with an RD in one eye is at significant risk of developing a blinding RD in the fellow eye. This risk varies with the type of RD and is highest with TRD. However, RRD, the commonest type of RD, can benefit from prophylactic treatment to the fellow eye RD predisposing lesions.

Visual Status of Patients with Retinitis Pigmentosa: A Multicenter Study

AIM

To determine the degree of visual loss associated with retinitis pigmentosa (RP) in Nigerians at first ophthalmic clinic presentation

METHODOLOGY

Multicenter, prospective, cross-sectional study in four collaborating retina clinics within Nigeria between January and December 2018. The primary outcome measure was the World Health Organization’s visual status classification at presentation. Clinical examination, including a Snellen’s visual acuity, refraction, anterior segment examination using a slit lamp biomicroscope, and dilated fundus examination using a +90D or +78D, was done in all consecutive RP patients. We analyzed the data using SPSS (version 22), P < 0.05.

RESULTS

Of 8614 patients seen within the study period, fiftyfour eyes of 27 patients diagnosed to have RP with a mean age of 44.1years ± 17.6 years (ranging between 5–73 years) constituted the study population. Eighteen (66.7%) were males and 9 (33.3%) females. The hospital-based prevalence of RP was 0.31%. Ten patients (37.0%) presented with myopia. RP was bilateral in all cases and non-syndromic. Bilateral low vision and blindness were noted in 44.4% and 22.2% of patients respectively.

CONCLUSION

About a quarter of patients with RP presenting to the retina clinics would have some degree of visual morbidity. Educating eye care providers and patients about the disease would improve understanding, encourage early clinic visits, manage visual morbidity and enhance rehabilitation when necessary.

Polypoidal Choroidal Vasculopathy Amongst Nigerians; A Multicenter Study

Objective

To investigate the prevalence and presentation of polypoidal choroidal vasculopathy (PCV) in Nigerians.

Methods

A cross-sectional, multicenter, hospital-based, descriptive study. Data were collected prospectively between January and December 2018, from consecutive patients diagnosed to have a retina disease at the general outpatient and retinal clinics of four eye departments in Nigeria. All participants had visual acuity, refraction, intraocular pressure, anterior segment examination, and dilated fundus examination. Some patients had fundus fluorescein angiography, optical coherence tomography (OCT), and OCT angiography (OCTA). Systemic comorbidity was determined by medical history and systemic evaluation. Diagnosis of PCV was based on clinical findings, and in some patients using OCT.

Results

A total of 8,614 patients were seen and 15 patients (18 eyes) were diagnosed to have PCV giving a yearly hospital-based prevalence of 0.17%. The mean age at presentation was 63.27 ± 11.5 years (range 44-84 years). There were nine females (60%). The male: female ratio was 1.5:1. Twelve (66.7%) of the 18 eyes were blind, 16.7% had severe visual impairment while 11.1% had mild visual impairment. Seven eyes (38.9%) had vitreous hemorrhage. Of the 12 blind eyes, 50% had vitreous hemorrhage (P = 0.463). Nine patients (60%) had systemic hypertensive as comorbidity (P = 0.016).

Conclusion

PCV is a cause of vision loss among Nigerians. Majority of the eyes were blind and 50% of blind eyes had vitreous hemorrhage. Since Indocyanine Green Angiography is the most appropriate imaging technology and is mostly unavailable in Nigeria, efforts should be made to address this need and improve the diagnostic accuracy.

Correlates of alcohol experimentation and drunkenness episodes among secondary-school students in Nigeria

Background: Alcohol is the most used substance among adolescents in Nigeria. While risk factors for alcohol use among adolescents are well documented in Europe and the US, they have received less attention in the literature on African countries. This study aimed to investigate the factors associated with alcohol experimentation and drunkenness episodes in a national sample of Nigerian adolescents. Methods: A total sample of 4,078 secondary-school students participated in the survey during the school year 2015-2016. The survey involved 32 secondary schools of six geopolitical zones (South-South, South-West, South-East, North-Center, North-West, and North-East) and two metropolitan cities (Abuja and Lagos) of Nigeria. Sociodemographic characteristics, parental alcohol use and permissiveness, friends' alcohol use, risk perceptions and beliefs were investigated as correlates of alcohol experimentation and drunkenness episodes through multilevel, mixed-effect logistic regression models. Results: The prevalence of alcohol experimentation was 34.0%, while the prevalence of drunkenness episodes was 13.4%. Results showed that male gender, family structure different from both parents' families, parental and friends' alcohol use, parental permissiveness to drink, low risk perceptions on drinking alcohol, and positive beliefs on consequences of alcohol use were associated with an increased probability of alcohol experimentation and drunkenness episodes. Family affluence and one-parent family structure were related to an increased probability of alcohol experimentation but not of drunkenness episodes. Conclusions: The majority of risk factors analyzed in this study generalize across drinking-behavior outcomes. Since the young population is dominant in Nigeria, alcohol use could become a big public health problem in the near future. High investment in adolescents' well-being by addressing the factors that contribute to drinking behavior might help to reduce the burden of the problem. Evidence-based prevention curriculum addressing knowledge, risk perceptions, beliefs on consequences of alcohol use, and parental behaviors should be implemented as widely and early as possible.

A Multi-Country Study of Harms to Children Because of Others' Drinking

OBJECTIVE

This study aims to ascertain and compare the prevalence and correlates of alcohol-related harms to children cross-nationally.

METHOD

National and regional sample surveys of randomly selected households included 7,848 carers (4,223 women) from eight countries (Australia, Chile, Ireland, Lao People's Democratic Republic [PDR], Nigeria, Sri Lanka, Thailand, and Vietnam). Country response rates ranged from 35% to 99%. Face-to-face or telephone surveys asking about harm from others' drinking to children ages 0-17 years were conducted, including four specific harms: that because of others' drinking in the past year children had been (a) physically hurt, (b) verbally abused, (c) exposed to domestic violence, or (d) left unsupervised.

RESULTS

The prevalence of alcohol-related harms to children varied from a low of 4% in Lao PDR to 14% in Vietnam. Alcohol-related harms to children were reported by a substantial minority of families in most countries, with only Lao PDR and Nigeria reporting significantly lower levels of harm. Alcohol-related harms to children were dispersed sociodemographically and were concentrated in families with heavy drinkers.

CONCLUSIONS

Family-level drinking patterns were consistently identified as correlates of harm to children because of others' drinking, whereas sociodemographic factors showed few obvious correlations.