Aim. The aim of this study was to assess ocular and mucocutaneous sequelae among SJS/TEN survivors and identify risk factors of ocular sequelae. Patients and Method. Late complications among SJS/TEN survivors were assessed using 2 methods: a retrospective assessment of medical records only or a retrospective assessment of medical records and physical examination of survivors who were contacted by phone. Results. Between January 1995 and December 2017, 177 cases of SJS/TEN (138 cases of SJS, 29 cases of TEN, and 10 cases SJS/TEN overlap) were admitted into two university hospitals of Lomé (Togo). There were 113 women and 64 men, with an average age of 31.7±13.0 years (range: 5 to 80 years). The most used drugs were antibacterial sulfonamides (35.6%) and nevirapine (24.3%). HIV serology was positive in 68 (59.1%) of the 115 patients tested. Sixty-four (52,5%) of the 122 patients, who had been examined by an ophthalmologist during the acute stage, had acute ocular involvement, which was mild in 27.9% of patients, moderate in 13.1%, and severe in 11.5%. We recorded 17 deaths (i.e., three cases of SJS, 12 of TEN, and two of SJS/TEN overlap), including 11 cases of HIV infected patients. Of the 160 SJS/TEN survivors, only 71 patients were assessed 6 months after hospital discharge. Among them, forty-three (60.6%) patients had sequelae. Concerning mucocutaneous sequelae, the main lesions were diffuse dyschromic macules (38.0% of patients) and ocular sequelae were dominated by decreased visual acuity (14.1% of patients). In multivariate analysis, exposure to sulfadoxine (odds adjusted ratio = 5.95; 95%CI= [1.36-31.35]) and moderate (adjusted odds ratio = 5.85; 95%CI = [1.23-31.81]) or severe (adjusted odds ratio = 48.30; 95%CI = [6.25-1063.66]) ocular involvement at acute stage were associated with ocular sequelae. Conclusion. Ocular and mucocutaneous sequelae are common in SJS/TEN survivors. Exposure to sulfadoxine and severity of acute ocular involvement are risk factors of ocular sequelae.
Introductionle décollement de rétine pose un problème de prise en charge dans les pays en développement par manque de plateau technique. Sa prévention passe par la connaissance et l'éviction de ses facteurs de risque. Le but de l'étude était d'identifier les facteurs de risque du décollement de rétine chez le Togolais. Méthode: il s'est agi d'une étude rétrospective et descriptive, réalisée dans le service d'ophtalmologie du Chu-Campus et dans un cabinet privé d'ophtalmologie de Lomé du 2 Janvier 2011 à 31 Décembre 2015. Ont été inclus dans l'étude les dossiers des patients portant le diagnostic de décollement de rétine. Le diagnostic de décollement de rétine avait été retenu devant: la présence d'un décollement de rétine à l'examen du fond d'œil ou à l'échographie oculaire.Méthodesil s'est agi d'une étude rétrospective et descriptive, réalisée dans le service d'ophtalmologie du Chu-Campus et dans un cabinet privé d'ophtalmologie de Lomé du 2 Janvier 2011 à 31 Décembre 2015. Ont été inclus dans l'étude les dossiers des patients portant le diagnostic de décollement de rétine. Le diagnostic de décollement de rétine avait été retenu devant: la présence d'un décollement de rétine à l'examen du fond d'œil ou à l'échographie oculaire.Résultatsau total, 116 yeux de 100 patients avaient un décollement de rétine dont 40 à l'OD, 44 à l'OG et 16 bilatéraux (32yeux). L'âge moyen des patients était de 46,65 ± 16,46 ans [07 ans ; 87 ans], une prédominance masculine et avec un sex-ratio = 0,32 (F/H). Les diabétiques représentaient 17% et les patients drépanocytaires 16%. Les patients myopes représentaient 5%, les yeux pseudophaques représentaient 17,2% et les yeux aphaques 3,4%. Quatre déchirures rétiniennes (14,28 % des DR rhegmatogènes) étaient retrouvées dont 2 déchirures en supéro-temporal, une déchirure en inféro-nasal et une déchirure en inféro-temporal. Le décollement était total pour 35 yeux (52,2%) et partiel pour 24 yeux (35,8%). Vingt yeux présentaient des proliférations vitréo-rétiniennes, 5 yeux avaient un vitré hémorragique et 6 yeux une hyalite. Le diabète et la drépanocytose étaient les facteurs de risque du DR tractionnel (p=0,006 et p=0,0003), et la chirurgie de cataracte le facteur de risque du DR rhegmatogène (p=0,0097).Conclusionle diabète, la drépanocytose et la chirurgie oculaire étaient les facteurs de risque les plus importants du DR. Une meilleure prise en charge de ces pathologies et une maîtrise de la chirurgie de la cataracte par l'ophtalmologiste préviendraient le décollement de rétine.
Introduction: Glaucoma is a major cause of irreversible blindness worldwide. Early detection and awareness are essential to reduce the impact on eye health. The aim of this study is to assess the knowledge, attitudes and practices of health care staff about glaucoma in Lomé. Materials and Methods: This was a prospective cross-sectional and descriptive study including health care staff in Lomé, from October 1st to December 31st, 2020, for a period of 3 months. After their agreement, the officers responded to questions based on a survey sheet. Results: A total of 169 agents from 3 centers in Lomé, i.e. the Sylvanus Olympio University Teaching Hospital, the Campus University teaching Hospital and the Bè Hospital were involved. 50.9% of the agents were male versus 49.1% female, i.e. a ratio of 1.04. The average age was 33.66 ± 10.45 years. 46.10% were doctors versus 53.90% paramedics. 58.60% had at most 5 years of experience against 41.40% who had more than 5 years of experience. 53.80% defined glaucoma as ocular hypertension while 17.20% defined it as optic nerve disease. 46.20% did not know that there were many types of glaucomas compared to 53.20% who knew that there are many types of glaucomas. 92.30% knew that glaucoma can lead to cause visual loss. Regarding attitudes and practices about glaucoma, 91.70% declared that the follow-up should be done by the ophthalmologist, 81.10% thought that it would be necessary to be checked by the doctor only every 6 months. Finally, 65.08% declared that they had to use eye drops for life for the treatment. Conclusion:Steps should be taken to educate staff more about glaucoma attitudes and practices and also plan for action in the population.
Aims: To describe clinical and etiological features of proptosis. Materials and methods:We have conducted a retrospective and descriptive study based on patient's records during 15 years, from January 2001 to December 2015. All patients went through a comprehensive ophthalmologic examination, and orbito-cerebral CT scan. T3, T4, TSH thyroid's hormone dosage was realized upon on the clinical request. The clinical features and the etiologies of proptosis were analyzed.Results: During the period, 46 cases of proptosis were identified. The mean age was 41.2 ± 18.8 [1;79] years. There were 15 men against 31 women with a sex ratio of 0.48. The proptosis was unilateral in 32 cases and bilateral in 14 cases. The proptosis was scaled as grade I was in 22 cases (47.8%), grade II in 20 cases (43.5%) and grade III in 4 cases (8.7%). The proptosis was axial in 38 cases (82.6%). It was painful in 21 cases (45.6%). It was reducible in 23 cases (50%) and pulsatile in one case (2.2%). The etiologies of the proptosis were hyperthyroidism in 16 cases (34.8%) , orbital cellulitis in 12 cases (26.1%), idiopathic orbital inflammatory disease in 9 cases (19.6%), orbital tumors in 8 cases (17.4%) and carotido-cavernous fistula in one case (2.1%). Women were more involved by hyperthyroidism (81.3%), and it was associated with a bilateral proptosis (81.3%), of grade II (68.8%), axial (93.8%) not painful (93.7%) and reducible (93.8%) Conclusion: proptosis is a relatively frequent symptom that can reveal several diseases, some of them can be life threatening.
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