Study of onchocerciasis-related visual impairment in North Kivu province of the Democratic Republic of Congo in Africa

Purpose:

The Objective of this study is to determine baseline data regarding onchocercal eye lesions and associated visual loss in the Nord Kivu province, an onchocerciasis hyperendemic tropical rain forest area in the Democratic Republic of Congo (DRC).

Methods:

A cross-sectional study was conducted in the Nord Kivu province of the DRC during which 2150 subjects were examined ophthalmologically. The eye examination included visual acuity (VA), slit-lamp examination, ophthalmoscopy, intraocular pressure, and visual field assessment by the confrontation test. Patients with suspicion of glaucoma were further evaluated by Humphreys automated perimeter.

Results:

39 (1.81%) out of 2150 subjects had onchocerciasis-related eye lesions and 4 (0.19%) were blind (VA <3/60). Chorioretinitis (0.88%) was the most frequent onchocerciasis lesion followed by keratitis (0.46%), microfilaria in the anterior chamber (0.28%), iridocyclitis (0.28%), secondary glaucoma (0.19%), complicated cataract (0.19%), and optic atrophy (0.19%). Visual impairment was discovered in 114 (5.3%) out of 2150 subjects, of whom 39 (0.19%) had blindness and 75 (3.4%) had low vision. Visual impairment was mostly caused by nononchocerciasis-related diseases like cataract (27.2%), retinal diseases (19.3%), glaucoma (15.8%), and iridocyclitis (15.8%) rather than because of onchocerciasis (9.6%) among all causes of visual impairment.

Conclusion:

Features of ocular onchocerciasis usually described in forest and savanna areas were relatively less common than expected in and around Goma, the capital of the Nord Kivu province of the DRC.

Hyperglycaemia as a risk factor for the development of retinopathy of prematurity: A cohort study

BACKGROUND

Retinopathy of prematurity (ROP) is a preventable cause of childhood blindness. Without treatment, over 45% of eyes can develop permanent visual loss. Hyperglycaemia has recently been described as a risk factor for the development of retinopathy of prematurity (ROP), a proliferative vascular disease of the retina that primarily affects premature infants. The characteristic neoproliferative growth of blood vessels in the retina is very well under stood with the clinical and experimental experiences with Diabetic retinopathy. The purpose of this study was to evaluate a possible relation between glucose levels in VLBW (Very Low Birth Weight) infants and development of ROP.

METHOD

All at risk infants of a Neonatal Intensive Care Unit (NICU) of a tertiary care centre in western India were included in the study. The blood sugar values of the neonates were recorded at multiple times during their first week of life. On completion of 31 weeks of gestational age or 04 weeks of birth age, the neonates were subjected to ROP screening as per standard protocols.

RESULT

A total of 103 neonates were included in the study and were subjected to ROP screening. A total of 32 neonates developed ROP at the end of the study. It was found with statistical significance that the neonates with higher average blood glucose values in the initial period of life had higher incidence of ROP at the time of screening with a Relative Risk of 2.506 (CI = 1.287, 4.882).

CONCLUSION

A high average blood glucose level in neonates during the first week of life is an indicator for developing ROP at a later date. These neonates should be kept under close follow up in order to facilitate timely detection and prompt intervention.