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Pattern of Congenital Ocular Anomalies Among Children Seen at a West African Tertiary Eye Care Centre

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Pattern of Congenital Ocular Anomalies Among Children Seen at a West African Tertiary Eye Care Centre Trends in Ophthalmology Open Access Journal DOI: 10.32474/TOOAJ.2020.02.000144 ISSN: 2644-1209 Research Article Pattern of Congenital Ocular Anomalies among Children Seen at a West African Tertiary Eye Care Centre Kareem Olatunbosun Musa1*, Sefinat Abiola Agboola2, Olapeju Ajoke Sam-Oyerinde2, Salimot Tolani Salako2, Chinwendu Nwanyieze Kuku2, Chinyei Joan Uzoma2 1Department of Ophthalmology (Guinness Eye Centre), Lagos University Teaching Hospital/ College of Medicine of the University of Lagos 2Department of Ophthalmology (Guinness Eye Centre), Lagos University Teaching Hospital, Idi-Araba, Lagos *Corresponding author: Department of Ophthalmology (Guinness Eye Centre), Lagos University Teaching Hospital/ College of Medicine of the University of Lagos, Idi-Araba, Lagos Received: December 21, 2019 Published: January 10, 2020 Abstract Purpose: To describe the pattern of presentation of congenital ocular anomalies among children seen at Department of Ophthalmology (Guinness Eye Centre), Lagos University Teaching Hospital, Lagos, Nigeria. Methods: A retrospective chart review of children below the age of 16 years who were diagnosed of any type of congenital ocular anomaly at the Pediatric Ophthalmology Clinic of Lagos University Teaching Hospital (LUTH) between January, 2012 and December, 2018 was done. Information concerning age at presentation, gender, affected eye(s), visual acuity and type of congenital anomalyResults: were retrieved from the case files. Seven hundred and forty-five eyes of 470 patients with congenital anomalies which constituted 13.6% of all the new pediatric ophthalmic consultations were studied. Two hundred and seventy-five (58.5%) children had bilateral ocular involvement while 262 (55.7%) presented within the first year of life. The median age was 0.92 years with an interquartile range of 2.67 years. There were 255 (54.5%) males with a male to female ratio of 1.2:1. Congenital cataract was the most common congenital ocular anomaly documented in 224 (30.1%) eyes of 133 patients. This was followed by congenital squint (131 eyes, 17.6%), congenital glaucoma (91 eyes, 12.2%) and corneal opacity (52 eyes, 7.0%). Overall, cataract, squint, glaucoma, corneal opacity, nasolacrimal ductConclusion: obstruction and ptosis accounted for 79.0% of the congenital ocular anomalies documented in this study. anomalies observed. Congenital ocular anomalies accounted for 13.6% of Paediatric ophthalmic consultations in this study. Congenital cataract, squint, glaucoma, corneal opacity, nasolacrimal duct obstruction and ptosis were the most common congenital ocular Keywords: Congenital Ocular Anomalies; Children; West African; Tertiary Eye Care Introduction region. Congenital cataract and glaucoma had been reported to be Congenital anomalies are structural or functional anomalies the most common anomalies in developing countries [2-8] while anophthalmos, microphthalmos and coloboma are predominant at birth, or sometimes may only be detected later in infancy [1]. that occur during intrauterine life and can be identified prenatally, in developed nations [9]. Severe visual loss arising from some of these ocular anomalies in early childhood could adversely affect Congenital ocular anomalies contribute significantly to childhood their development, mobility, education, social life and employment visual impairment and blindness [2,3]. Some of these anomalies opportunities [2]. In addition, accompanying parents and/or care have only cosmetic significance while others cause no symptoms givers lose valuable time and resources seeking interventions in combination, or as part of a systemic malformation syndrome and may be an incidental finding [3]. They may occur in isolation, for these children. It is therefore imperative that they are better characterized in order to aid appropriate intervention strategy [4]. The aetiology of congenital ocular anomalies may be genetic, and resource allocation. Therefore, this study sought to describe pattern of congenital ocular anomalies varies from region to environmental or more commonly, idiopathic [4]. Globally, the Copyright © All rights are reserved by Musa KO et al. 174 Tr Ophtha Open Acc J . Volume 2 - Issue 4 Copyrights @ Musa KO et al. the pattern of congenital ocular anomalies among children seen at Guinness Eye Centre, Lagos University Teaching Hospital with a as unilateral (42 patients, 21.5%) congenital ocular anomaly. This view to determining the most common anomalies in this Centre. was followed by congenital squint (131 eyes, 17.6%), congenital Materials and Methods glaucoma (91 eyes, 12.2%) and corneal opacity (52 eyes, 7.0%). Overall, cataract, squint, glaucoma, corneal opacity, nasolacrimal ocular anomalies documented in this study. The most common age of 16 years who were diagnosed of any type of congenital duct obstruction and ptosis accounted for 79.0% of the congenital A retrospective review of the case files of children below the ocular anomaly at the Paediatric Ophthalmology Clinic of Lagos type of congenital squint was congenital esotropia (119, 90.8%) University Teaching Hospital (LUTH) between January, 2012 The causes of congenital corneal opacity were Peter’s anomaly and December, 2018 was done. Information concerning age at while congenital exotropia was documented in 12 (9.2%) eyes. presentation, gender, affected eye(s), visual acuity and type of (16, 30.8%); sclerocornea (12, 23.1%); congenital hereditary approval was obtained from Health Research Ethics Committee of endothelial dystrophy (9, 17.3%); anterior segment dysgenesis (2, congenital anomaly were retrieved from the case files. Ethical 3.8%);Table 1 others: Laterality (6, 11.5%) and demographic and undocumented characteristic (7, 13.5%). of the patients. Demographic Characteristics/ the Lagos University Teaching Hospital (Approval Number: ADM/ Frequency Percentage Statistical Package for Social Sciences (SPSS) version 20 (IBM Corp. Laterality DCST/HREC/APP/1915). Data obtained was analyzed using the Age group (years) Armonk, NY). Data was presented in tables. The quantitative visual acuity was classified into normal vision, visual impairment and revision (ICD-11) as much as possible [10]. Normality of numerical <16-10 -5 411 87.48.9 blindness using the International Classification of Disease, 11th variables was ascertained using Shapiro-Wilk test. The association 42 11-15Total 17 1003.6 and Fishers exact was used as appropriate. A p-value of less than between categorical variables was analyzed using chi-square test Gender 470 Male Results0.05 was considered to be statistically significant. Female 255 54.3 Total 215 45.7100 Seven hundred and forty-five eyes of 470 patients with all the new Paediatric ophthalmic consultations during the years Laterality 470 congenital anomalies were studied. This accounted for 13.6% of Bilateral bilateral ocular involvement while ocular affectation was unilateral under review. Two hundred and seventy-five (58.5%) children had Unilateral (left eye) 275 58.521.9 Unilateral (right eye) 10392 19.6 in 195 (41.5%) children (Table 1). Only 43 (9.1%) presented within Total 100 the first month of life while 262 (55.7%) presented within the first year of life. Overall, majority (87.4%) presented within the Table 2: Presenting visual acuity distribution470 in the affected eyes presentation was a nine-hour old neonate with bilateral congenital of the patients. first five years of life as shown in Table 1. The youngest patient at with bilateral congenital cataract. The median age was 0.92 years Visual acuity Frequency Percentage lid eversion while the oldest patient was a 15 year old teenager Blinks to light with an interquartile range of 2.67 years (p <0.001 for Shapiro- Fixates and follow light 63 8.5 Wilk test). There were 255 (54.5%) males with a male to female 184 24.7 ratio of 1.2:1. There was no statistically significant association 98 the presenting visual acuity (VA) distribution in the affected eyes of thousands) At least 6/24 (hundreds and between gender and age at presentation (p = 0.37). Table 2 shows 13.1 of visual behavior of the patients, hundreds and thousands as well Poorly fixate and does not follow light 151 20.3 the patients. They were documented using qualitative assessment thousands) Worse than 6/24 (hundreds and 6/6 – 6/12 39 5.2 as Snellen chart. Sixty-eight (9.1%) eyes were blind (VA < 3/60), 67 (9.0%) had moderate/severe visual impairment (VA <6/18 42 5.6 to 3/60) while 151 (20.3%) had poor light fixation and did not <6/12 – 6/18 225 0.7 follow light. Thirty-four (50.0%) out of the 68 blind eyes as well impairment were due to congenital cataract making it the most <6/18 – 6/60 6 0.83 as 32 (47.8%) out of the 67 eyes with moderate/severe visual blinding and visually impairing congenital ocular anomaly in this <6/60 – 3/60 68 9.1 study Congenital cataract was the most common congenital ocular Unavailable<3/60 9 Total 67 100 anomaly documented in 224 (30.1%) eyes of 133 patients (Table 3). 745 It was also the most common bilateral (91 patients, 33.1%) as well Citation: Musa KO, Agboola SA, Sam-Oyerinde OA, Salako ST, Kuku CN, Uzoma CJ. Pattern of Congenital Ocular Anomalies among Children Seen . 175 at a West African Tertiary Eye Care Centre. Tr Ophtha Open Acc J 2(4)- 2020. TOOAJ.MS.ID.000144. DOI: 10.32474/TOOAJ.2020.02.000144 Tr Ophtha Open Acc J . Volume 2 - Issue 4 Copyrights @ Musa KO et al. Table 3: Types of congenital anomalies. Type of Congenital Anomalies Bilateral n (%) Unilateral n (%) Total (patients) n (%) Total (eyes) n (%) Cataract 91 (33.1) 42
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