A Comparative Analysis of Ganglion Cell Complex Parameters in Nigerian Negroes with Glaucoma and Macular Disease

Aim: To evaluate the differences between ganglion cell complex (GCC) of primary open angle glaucoma and ocular disorders affecting the macula.Methods and Materials: Forty-seven patients diagnosed with primary open angle glaucoma and 27 patients with macular diseases of different aetiology were enrolled in this pilot study. All patients underwent direct GCC analysis with the optical coherence tomographic scan, using the Optovue Fourier Domain RTVue-version. A comparison of the average GCC thickness, focal loss volume (FLV) and the global loss volume (GLV) of thetwo groups was made.Results: A total of 74 pairs of eyes were included in the study. This comprised 48 males and 26 females with a mean age of 53.8 ± 11.3 among glaucoma patients and 59.8 ± 9.8 among patients with macular disease. Eyes with macular disease (33.3%) and eyes with glaucoma(42.6%) had abnormal average GCC parameters. However, the mean average GCC value was significantly higher in eyes with macular disease (87.50 ± 20.73) when compared with eyes with glaucoma (76.55± 12.51) (p=0.01). A significantly higher percentage of eyes with macular disease (43.3%) had GLV values within normal range when compared with eyes with glaucoma (21.3%) (p=0.03). Abnormal FLV values were seen in both eyes with macular disease (83.3%) and eyes with glaucoma (80.9%) but the differences were not of statistical significance (p= 0.24).Conclusion: This pilot study demonstrated abnormal OCT GCC values in eyes with glaucoma as well as in eyes with macular disease. However, eyes with macular disease had significantly higher mean average GCC parameters but GLV parameters that were within normal values.Key words: glaucoma, macular disease, ganglion cell comple

Anterior Hyaloidal Fibrovascular Proliferation (AHFVP) in a Diabetic after Cataract Extraction, Resulting in Hyphaema and Vitreous Haemorrhage during YAG Laser Capsulotomy

Aim: To report a rare case of anterior hyaloidal fibrovascular proliferation (AHFVP) which occurred after cataract surgery on a non-vitrectomized diabetic eye. This complication resulted in vitreous haemorrhage and hyphaema following a YAG laser capsulotomy procedure.Method: A case report of a patient managed at the above eyedepartment. Clinical records as indicated in the patient’s case note were reported.Conclusion: Anterior hyaloidal fibrovascular proliferation is a complication which an eye surgeon should bear in mind when attending to diabetic eyes after cataract surgery. The potential danger of vitreous haemorrhage following YAG laser capsulotomy should also be borne in mind, as more centres inthe country aspire to acquire a YAG laser machine to performcapsulotomy

Ciliary Body Tumour Occurring in a Nigerian - A case report

Objective: To report the rare case of a 33-year-old female Nigerian who presented to our retina clinic with a chronic total retinal detachment and visual acuity of no light perception in her left eye. Re-attachment surgery in the eyewas not attempted as prognosis for return of vision was poor. She was later noted to harbor a progressively enlarging ciliarybody mass in the inferotemporal quadrant. Method: An observational case report was performed, withdocumentation of findings as patient was seen in the clinic.Conclusion: This is the first report of a ciliary body mass lesionin a Nigerian. The ciliary body mass could be a ciliary melanoma (ciliary body lesion being rarer than a choroidal mass) but other benign differential diagnoses must be borne in mind. Enucleation and histological assessment of the specimen will give the definitive diagnosis. Difficulties with patientacceptance of enucleating a non seeing eye though harboring a potentially harmful disease still abound in our environment

Outcome of Lens-Sparing Vitrectomy for Infantile Post-Traumatic Amblyogenic Vitreous Haemorrhage: A case report

The visual outcome after bilateral lens-sparing 3-port pars planavitrectomy in a case of post-traumatic vitreous haemorrhagein an infant is reported. Although it is possible to perform avitrectomy procedure via a pars plana approach in infantswithout compromise to the lens for the treatment ofamblyogenic vitreous opacity, such as vitreous haemorrhage,the visual outcome could be poor in cases associated withtrauma owing to possible structural damage to the macular,the optic nerve and other more posterior visual pathway

The Helicobacter pylori Genome Project : insights into H. pylori population structure from analysis of a worldwide collection of complete genomes

Helicobacter pylori, a dominant member of the gastric microbiota, shares co-evolutionary history with humans. This has led to the development of genetically distinct H. pylori subpopulations associated with the geographic origin of the host and with differential gastric disease risk. Here, we provide insights into H. pylori population structure as a part of the Helicobacter pylori Genome Project (HpGP), a multi-disciplinary initiative aimed at elucidating H. pylori pathogenesis and identifying new therapeutic targets. We collected 1011 well-characterized clinical strains from 50 countries and generated high-quality genome sequences. We analysed core genome diversity and population structure of the HpGP dataset and 255 worldwide reference genomes to outline the ancestral contribution to Eurasian, African, and American populations. We found evidence of substantial contribution of population hpNorthAsia and subpopulation hspUral in Northern European H. pylori. The genomes of H. pylori isolated from northern and southern Indigenous Americans differed in that bacteria isolated in northern Indigenous communities were more similar to North Asian H. pylori while the southern had higher relatedness to hpEastAsia. Notably, we also found a highly clonal yet geographically dispersed North American subpopulation, which is negative for the cag pathogenicity island, and present in 7% of sequenced US genomes. We expect the HpGP dataset and the corresponding strains to become a major asset for H. pylori genomics

Bilateral Simultaneous Macular Infarction with Spontaneous Visual Recovery in Genotype SS Hemoglobinopathy Patient

To report the rare and dramatic event of bilateral macular infarction in a sickle cell hemoglobinopathy (SS genotype) patient, resulting in bilateral severe reduction in visual acuity. Without any intervention, the patient’s vision gradually improved over the follow‑up period. Central visual field defects however persisted. A 21‑year‑old male Nigerian, presented with a 1‑week history of bilateral sudden painless loss of vision. His symptom was associated with fever, feeling of heaviness in the chest and head, and a dizzy spell. Visual acuity was reduced to 20/200 in both eyes and near acuity was; right eye: N24, left eye: N36. Funduscopy showed a pale, milky white, thickened retinal patch superotemporal to the fovea in both eyes. Fluorescein Angiograph: revealed features consistent with occlusion of the parafoveal terminal arterioles in both eyes. Although he did not receive any ocular treatment, and exchange blood transfusion was not done, he regained near‑normal visual acuity in both eyes over a 17‑month follow‑up period, central visual field defects persisted in both eyes. Visual recovery in this patient demonstrates that macular function could improve over time following macular ischemia, without any treatment. Patients and caring physicians should be aware of this possibility.Keywords: Macular infarction, macular ischemia, sickle cell, visual los

The challenges of vitreoretinal surgery in Nigeria

No Abstract.Annals of Ibadan Postgraduate Medicine Vol. 1 (2) 2004: pp. 9-1

Refractive aim and visual outcome after phacoemulsification: A 2‑year review from a Tertiary Private Eye Hospital in Sub‑Saharan Africa

Aim: To review the short‑term visual outcome of phacoemulsification in adults with uncomplicated cataracts in Eye Foundation Hospital, Lagos, Nigeria.Materials and Methods: A retrospective review of records of patients that had phacoemulsification between January 2012 and December 2013 in Eye Foundation Hospital, Lagos, Nigeria, was done. Preoperative visual acuity, refractive aim, intraoperative complications, postoperative unaided, and best‑corrected visual acuity at 1 and 3 months were analyzed. Only eyes of adults that had phacoemulsification for uncomplicated cataracts were included in the study, all pediatric cataracts and eyes with ocular comorbidities were excluded. Common ocular comorbidities excluded were corneal opacity/corneal scar, glaucoma, uveitis, pseudo exfoliation syndrome, moderate and severe nonproliferative diabetic retinopathy, macula edema, proliferative diabetic retinopathy, eye trauma, age‑related macular degeneration, previous corneal surgery, glaucoma surgery, and previous or simultaneous vitreoretinal surgery.Results: A total of 157 eyes of 119 patients who met the inclusion criteria were analyzed. There were 60 (50.4%) females and 59 (49.6%) males, with age range from 31 to 91 years and a mean of 65.3 ± 11.10 years. Only eyes with available data were analyzed at 1 and 3 months postoperatively. In 112 eyes (85.7%), the refractive aim was met, 21 eyes (14.3%) did not meet their refractive aim, 20 eyes (12.7%) were excluded, the refractive aim could not be determined from the records as surgeons did not specify, and in 4 eyes, the required information was missing from the case files. An unaided visual acuity of 6/18 and better was achieved in 134 eyes (85.4%) at 1 month and 126 eyes (85.9%) at 3 months whereas best‑corrected vision of 6/18 and better was achieved by 145 eyes (92.4%) at 1 month and 146 eyes (98.0%) at 3 months.Conclusion: Surgical outcomes after phacoemulsification are comparable with international benchmarks for good outcomes, with 85.4% of eyes achieving within 1 D of spherical equivalent of the refractive aim, 92.4% and 98.0% of eyes also achieving best‑corrected visual acuities of 6/18 and better at 1 and 3 postoperative months, respectively. Unaided vision of 6/18 and better was also achieved in 85.4% and 85.9% at 1 and 3 postoperative months, respectively.Key words: Best‑corrected visual acuity, phacoemulsification, refractive ai