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Resume But Etablir le profil epidemio-clinique et tomographique des trous maculaires chez le sujet beninois. Patients et methodes Cette etude transversale a concerne les patients consecutifs recus pour exploration maculaire pendant la periode allant de janvier 2016 a aout 2017 au centre d’exploration de la retine Saint Antoine de Padoue Cotonou (Benin). Ont ete inclus tous les patients qui ont presente un trou maculaire et ayant eu un OCT maculaire. Pour definir les types de trou maculaire, nous avons utilise la nouvelle classification 2013 DUKER et analyse pour chaque cas : l’âge le sexe, les antecedents, l’œil atteint, l’œil adelphe, l’acuite visuelle, le type de trou, le diametre du trou, l’etat du cortex vitreen, l’œdeme des berges, l’epaisseur maculaire moyenne, l’existence de traction vitreo-maculaire, de membrane epi-maculaire, l’epaisseur de la choroide retrofoveolaire. Ont ete exclus tous les patients ayant presente un pseudo-trou maculaire ou un trou lamellaire. Resultats Pendant cette periode d’etude, 401 patients ont beneficie d’une procedure d’OCT maculaire au Centre d’exploration de la retine avec 22 patients ayant presente un trou maculaire, dont 15 femmes et 07 hommes soit un ratio de 2,14. L’âge moyen des patients etait de 61 ± 10 ans avec un âge median de 63 ans. Le diametre moyen des trous etait de 705 μm ± 232 μm. Aucun trou de petite taille n’a ete releve. L’epaisseur maculaire centrale moyenne est de 272 μm ± 39 μm. L’etat de l’œil adelphe a note dans 52,4 % des cas la presence d’une traction vitreo-maculaire. Le profil etiologique des TM a retrouve dans 72,7 % une origine primaire et une origine secondaire (diabetique et traumatique) respectivement dans 13,6 % et 9,09 %. Discussion La majorite des trous maculaires observes etaient de grands trous maculaires, ce qui pourrait s’expliquer par l’evolution progressive de ces trous maculaires et un depistage tardif. L’etat de l’œil adelphe avec plus de la moitie avec une traction, traduit le risque potentiel de bilateralisation. Conclusion Le trou maculaire est une pathologie de l’interface vitreo-maculaire observee dans notre contexte avec un profil de grand trou maculaire. A l’OCT, les donnees retrouvees restent comparables aux donnees de la litterature.

Resume But Etudier les aspects tomographiques et etiologiques des membranes epimaculaires a Cotonou. Patients, materiels et methode Il s’agit d’une etude descriptive et analytique, avec recueil retrospectif des donnees. Elle s’est deroulee au Centre d’Exploration de la Retine de Cotonou, et a concerne tous les patients ayant beneficie d’OCT maculaire entre le 1er janvier 2016 et le 30 juin 2018. Resultats Parmi les 604 sujets recus, 32 patients (5,3 %) ont presente une membrane epimaculaire. La membrane avec decollement posterieur du vitre et contraction representait 44,74 % des cas. 42,31 % des yeux adelphes presentaient un decollement posterieur du vitre. La plupart des membranes etait idiopathique. La retinopathie diabetique proliferante et l’uveite posterieure etaient les principaux facteurs de risque des membranes secondaires. Conclusion La membrane epimaculaire est une affection cecitante. Le risque de bilateralisation est important, et l’acces des patients a l’OCT reste un souci dans les pays en voie de developpement.

Resume Introduction L’injection intravitreenne (IVT) d’un medicament vise a obtenir une concentration elevee dans le segment posterieur. Nous avons mene une etude retrospective de notre pratique des IVT dans le but d’evaluer la securite de la technique et la tolerance a court et moyen terme et d’analyser les indications et les complications. Patients et methodes Cette etude retrospective analytique a porte sur des patients consecutifs traites par IVT pendant la periode allant de janvier 2015 a juin 2016 a la clinique ophtalmologique la Lumiere de Cotonou avec comme indicateur de securite base sur les incidents et/ou accidents au cours de la procedure d’IVT. Ont ete inclus tous les patients ayant eu une ou plusieurs IVT quelles que soient l’indication et la nature du produit injecte et qui ont beneficie d’un bilan ophtalmologique complet avant l’injection et ont ete suivis a une semaine (S1), 1 mois (M1) apres traitement. Resultats Pendant cette periode d’etude, nous avons realise 124 injections intravitreennes sur 49 patients en toute securite. Les indications ont ete dans 53,06 % les œdemes maculaires diabetiques et 26,53 % des œdemes maculaires avec occlusions veineuses. La principale complication observee est l’hypertonie oculaire dans 60 % principalement liee a l’IVT de Triamcinolone. Dans 51,02 %, la molecule utilisee est le Ranibizumab suivi du Bevacizumab 28,54 % et dans 20,40 % du Triamcinolone. Conclusion L’injection intravitreenne est une pratique courante dans notre activite avec une securite de realisation. Les indications sont multiples et l’hypertonie oculaire comme complication essentielle. La difficulte d’approvisionnement et de conservation des principales molecules (anti-VEGF) utilisees reste a resoudre.

Introduction: Blindness and severe visual impairments have huge consequences on the socioeconomic development of individuals and human communities.

To establish the epidemiological and tomographic profile of macular holes in the Beninese subject.This cross-sectional study included consecutive patients seen for macular testing during the period from January 2016 to August 2017 at the St. Anthony of Padua Retinal Testing Center in Cotonou (Benin). All patients who had a macular hole and macular OCT were included. To define macular hole types, we used the 2013 DUKER New Classification and analyzed for each case: age sex, history, involved eye, fellow eye, visual acuity, hole type, hole diameter, status of the vitreous cortex, edge edema, mean macular thickness, presence of vitreomacular traction, epimacular membrane, and retrofoveal choroidal thickness. Patients with a pseudo-macular hole or lamellar hole were excluded.During this study period, 401 patients underwent a macular OCT procedure at the Retinal Testing Center, with 22 patients having a macular hole, of which 15 women and 07 men for a sex ratio of 2.14 women to men. The mean age of the patients was 61±10 years, with a median age of 63 years. The mean diameter of the holes was 705μm±232μm. No small holes were found. The mean central macular thickness was 272μm±39μm. In 52.4% of cases, the condition of the felloweye indicated the presence of vitreomacular traction. The etiological profile of the macular hole found in 72.7% a primary origin, and a secondary origin (diabetic and traumatic) in 13.6% and 9.09% respectively.The majority of the macular holes observed were large macular holes, which could be explained by the progressive course of these macular holes as well as late detection. Over half of the fellow eyes showed vitreomacular traction, reflecting the potential risk of bilateralization.Macular hole is a pathology of the vitreomacular interface, tending to be large in our geographic context. On OCT, the data found remain comparable those reported in the literature.

To study the tomographic appearance and etiologies of epimacular membranes in Cotonou.This was a descriptive, analytical study with retrospective data collection. It took place at the Cotonou Retinal Testing Center and included all patients who underwent macular OCT testing between January 1, 2016 and June 30, 2018.Of the 604 subjects examined, 32 patients (5.3%) exhibited an epimacular membrane. Epimacular membrane in combination with posterior vitreous detachment and contraction accounted for 44.74% of cases. 42.31% of the fellow eyes had developed a posterior vitreous detachment. The majority of the membranes were idiopathic. Proliferative diabetic retinopathy and posterior uveitis were the main risk factors for secondary membranes.Epimacular membrane is a potentially blinding condition. The risk of bilateral involvement is significant, and patient access to OCT remains a concern in developing countries.

Resume Introduction Le but de notre etude est de presenter les aspects socio-economiques de la prise en charge du glaucome primitif a angle ouvert dans les conditions d’acces aux soins du Benin. Patients et methode Il s’agissait d’une etude multicentrique descriptive et analytique, documentaire du 1 er janvier 2011 au 30 juin 2013 et prospective du 1 er mai au 31 juillet 2013. Elle a concerne les patients âges de plus de 15 ans et mis sous traitement apres diagnostic de glaucome primitif a angle ouvert pendant la periode d’etude. Resultats Sur 15 592 patients, 227 etaient glaucomateux soit 1,5 % de prevalence hospitaliere, avec une predominance masculine a 64 %. Le traitement medicamenteux etait la regle avec une duree moyenne de 7,4 ± 7,4 mois. Un total de 10,6 % des patients ont effectue un suivi regulier. Le cout moyen mensuel du traitement medicamenteux anti-glaucomateux etait de 17,8 ± 10,8 euros. Celui des consultations et examens paracliniques au moment du diagnostic etait de 79,5 ± 59,9 euros. Le cout moyen du transport a chaque visite etait 1,6 euros. Le glaucome stabilise a ete plus couteux. Un total de 17,6 % des patients etaient accompagnes lors des consultations dont l’attente etait toujours superieure a une heure. Le revenu moyen mensuel des patients etait 187,7 euros. La perte de revenus en rapport avec les delais d’attente n’a pas ete evaluee. Un total de 72,7 % des patients ont assure eux-memes leur prise en charge avec 58,3 % du revenu moyen mensuel. Discussion Le patient ne peut logiquement se payer lui-meme son traitement. Il urge que les praticiens aient plus recours au traitement chirurgical de moindre cout.

Intravitreal injections of medication are designed to obtain a high concentration in the posterior segment. We conducted a retrospective study of our practice of intravitreal injections to assess safety of the technique and short- and medium-term tolerability, and to analyze indications and the complications.This analytic retrospective study focused on consecutive patients treated with intravitreal injections for the period of January 2015 to June 2016 in the "Lumière" ohthalmology clinic in Cotonou, with incidents or accidents during the injection procedure as a measure of safety. Included were all patients undergoing one or more intravitreal injections regardless of the type of product injected, who had undergone a complete ophthalmologic work-up prior to injection and who had been followed at one week (W1) and 1 month (M1) after treatment.During the study period, we safely performed 124 intravitreal injections on 49 patients. The indications were diabetic macular edema in 53.06% and macular edema due to vein occlusions in 26.53%. The main complication observed was ocular hypertension in 60%, mainly related to triamcinolone injection. In 51.02%, the drug used was Ranibizumab, followed by Bevacizumab in 28.54% and Triamcinolone in 20.40%.The main goal of intravitreal injection is to achieve instantly effective concentrations in the center of the globe. Intravitreal injection is a safe, feasible practice in our context. The male predominance observed in our series is explained by the low socio-economic status of women in our context as well as the economically difficult accessibility of important drugs such as anti-VEGF. Significant improvements in D7 and D30 visual acuity in our patients highlights the beneficial effects of the presence of the active molecule in the vitreous cavity for these indications.Intravitreal injection is a common practice in our context, which is being performed safely. The indications are many, and ocular hypertension is a significant complication. The difficulties in terms of supply and preservation of the main drugs used (anti-VEGF) remains to be resolved.

Objective: To study the epidemiology and clinical aspects of the hypertensive retinopathy among pregnant women with hypertension in the CHUD-B. Material and methods: The study was multicenter and analytical. It concerned all pregnant women admitted to the CHDU-B from April 1st to July 31, 2012, four months. Results: Out of 1327 pregnant women, 158 (11.90%) have presented an arterial hypertension associated with pregnancy. Among these 158 pregnant women with hypertension, 112 have benefited from the ophthalmological examination, for a participation rate of 70.88%. 48 had retinopathy hypertensive either a prevalence of 42.86%. The average age of pregnant women was 28 ± 7.76 years. These women were in the majority illiterate (38%) with a predominance of craftswomen and housewives (66.97% ). The HTA was severe in 54.17% of cases and the hypertensive retinopathy was statistically linked to the severity and chronicity of the HTA. Conclusion: The hypertensive retinopathy during pregnancy is common and affects women around the thirties. It is often related to the severity and chronicity of the HTA.

Resume But Etudier la correlation entre hypertonie oculaire et glaucome primitif a angle ouvert chez des patients beninois. Methode L’etude a ete realisee dans le service d’ophtalmologie du centre national hospitalier universitaire de Cotonou. Elle a ete retrospective, descriptive et analytique. Elle s’est etendue sur une periode de trois ans allant du 1er janvier 2007 au 31 decembre 2009. Elle a pris en compte tous les dossiers de patients ayant presente une hypertonie oculaire et chez qui la recherche de glaucome primitif a angle ouvert a ete effectuee. Resultats Parmi les 9406 patients recus en consultation pendant la periode d’etude, 129 (correspondant a 258 yeux) presentaient une hypertonie oculaire, soit 1,37 %. L’âge des patients etait compris entre 11 ans et 82 ans, avec une moyenne d’âge de 54,48 ans ± 13,94 ans. Le sexe masculin predominait (57 %), avec un ratio de 1,3. Tous les patients (100 %) ont consulte pour baisse visuelle de loin et/ou de pres. Un nombre important d’yeux (80 yeux soit 31,00 %) avait une acuite visuelle de loin inferieure ou egale a 3/10. Les valeurs du tonus oculaire etaient comprises entre 22 mmHg et 62 mmHg, avec une moyenne de 28,13 mmHg ± 6,06 mmHg. Les rapports cup/disc variaient de 0,3 a 1 avec un cup/disc moyen de 0,46 ± 0,34. L’examen du champ visuel au perimetre automatise a montre des alterations d’origine glaucomateuse chez 170 yeux (65,89 %). Hypertonie oculaire, excavation papillaire glaucomateuse et alteration du champ visuel etaient associees dans 58,13 % des cas avec un coefficient de correlation r superieur a 0,87. Discussion Bien que l’hypertonie oculaire ne permette pas de confirmer le diagnostic de glaucome primitif a angle ouvert, elle en constitue un facteur de risque essentiel. Conclusion Nous avons montre dans ce travail que dans 58,13 % des cas, il existe une correlation entre hypertonie oculaire et glaucome primitif a angle ouvert. Des efforts doivent donc etre entrepris pour sensibiliser nos populations sur l’existence de cette affection grave qu’est le glaucome primitif a angle ouvert et sur son depistage qui commence par la mesure du tonus oculaire.

The purpose of our study is to present the socioeconomic aspects of the management of primary open angle glaucoma in Benin.The study was a multicentric descriptive, record review from January 1st, 2011 to June 30th, 2013 and prospective from May 1st to July 31st, 2013. It included patients over 15 years of age, and treated for a diagnosis of primary open angle glaucoma during the study period.Of 15,592 patients, 227 were diagnosed with glaucoma, for a 1.5% hospital prevalence with male predominance (64%). Medical treatment was the rule, with an average duration of 7.4 ± 7.4 months. A total of 10.6% of the patients were followed regularly. The average monthly cost of medications was 17.8 ± 10.8 euros. That of the consultations and diagnostic tests was an average of 79.5 ± 59.9 euros. The average cost of transportation to each visit was 1.6 euros. Stable glaucoma was more costly. A total of 17.6% of the patients were accompanied to visits for which the waiting time was always longer than one hour. The monthly average income of the patients was 187.7 euros. Loss of income associated with waiting was not evaluated. A total of 72.7% of the patients were self-insured, corresponding to 58.3% of their average monthly income.Patients cannot logically afford their medication. Practitioners should rely more on lower-cost surgical treatments.

Introduction Cemento-ossifying fibroma is a rare benign tumor which can affect both jaw bones, particularly the mandible. Case reports We report two cases of cemento-ossifying fibroma which illustrate the radiological and anatomic features of these tumors. Differential diagnosis between cementifying fibroma and ossifying fibroma was particularly difficult. The cementifying fibroma was treated by surgical resection followed by immediate reconstruction with an iliac bone graft. The ossifying fibroma was treated by enucleation-resection. Discussion The clinical, radiological and histological features of cementifying and ossifying fibroma allow distinction. Surgical treatment is achieved by enucleation resection for small-sized ossifying fibromas and mono-bloc resection with bone reconstruction for large-sized cementifying and ossifying fibromas.

Cervicofacial cellulitises are dominated by dental affections. The aim of this study is to describe etio-epidemiological and therapeutic aspects of cervicofacial cellulitis of dental cause at the CNHU-HKM in Cotonou (Benin).It's a retrospective study from 1998 to 2007 included patients with inflammatory cervicofacial tumefaction of dental cause. A glycaemia, a HIV serology and a blood formula numeration are realized. Some patients practiced standard oral and dental radio. Patients were hospitalized and received mono, bi or triple antibiotic. Lancing with swab of pus for cytobacteriological and antibiogram examination was realized for some of patients. Dental cares were been systematic.68 cases whose 53 dental cause where been collected 77.94%. Bracket concern patients between 0-20 and 20-40 years old (64.15%). Males were, more concerned. Dental traumatisms find again (18.88%), tooth decay (56.60%) and 24.53% patients practiced dental extraction. Anti inflammatory practiced by 67.92% patients associated to antibiotic in 41.51% cases. The three latest molar were concerned to 26 patients. Among those last 22 had attack of mandibular teeth. Treatment consisted in lancing drainage to 2/3 patients in 83.40% cases associated to tri antibiotic. Evolution has been favourable with recovery to 86.67%; 6 decreases to 13.33% cases.Cervicofacial cellulitises are dangerous, rapidly responsible of deceases by extension. A better oral and dental hygiene would improved prognosis.

Sinonasal inverted papilloma is a rare benign tumor with a high recurrence rate and potential malignant transformation. The purpose of this study was to analyze the clinical and radiological aspects and to identify the suitable surgical approaches to be used in developing countries.In 3 years, 7 cases have been analyzed in a retrospective study. Patients presented with unilateral nasal obstruction and epitasis, a whitish unilateral polypoid mass, sinonasal opacity with osteolysis on CT scan or on sinus X-ray. Using these data we adopted the Krouse staging which classifies the disease in four stages and accordingly the appropriate surgical approach was used. The diagnosis was confirmed by histological examination of the biopsied specimen.Average age 48.28 years, predominant sex male. Symptom: unilateral nasal obstruction 5, bilateral nasal obstruction 1, epistaxis 5. The average time-delay before consultation was 73 months. The combined endonasal endoscopic and vestibular was the most commonly used approach (4 cases). The results were satisfying. After a minimal follow up of 2 years, one case of recurrence was detected after 4 years.CT scan is an essential tool for the diagnosis and detecting the extension of sinonasal inverted papillomas. Better results were obtained with a surgical approach that combined a vestibular approach and an endonasal endoscopic approach in our region.

To study the correlation between high intraocular pressure and the primitive glaucoma with opened angle among beninese patients.Our study was accomplished in the ophtalmological department of the university national hospital center of Cotonou. It was retrospective with descriptive and analytical aim and extended over a period of 3 years going from January 1st, 2007 till December 31st, 2009. It took into account all the patients' files having presented high intraocular pressure and to whom the search for primitive glaucoma with opened angle was carried out.Among 9406 patients received in consultation during the period of study, 129 (corresponding with 258 eyes) presented high intraocular pressure that is 1.37%. The age of the patients was included between 11 years and 82 years, with a medium age of 54.48 years ±13.94 years. Male subjects prevailed (57%), with a sex ratio of 1.3. All the patients (100%) consulted for visual decline by far, by near or both at the same time. A significant number of eyes (80 eyes - 31%) had a vision by far lower or equal with 3/10. The values of ocular pressure were included between 22 mmHg and 62 mmHg, with an average of 28.13 mmHg ±6.06 mmHg. The ratios cup/disc varied from 0.3 to 1 with a medium cup/disc of 0.46±0.34. The examination of the field of vision with the automatic perimeter showed deteriorations of glaucoma type in 170 eyes (65.89%). High ocular pressure, optic disc glaucoma excavation and visual field defects were associated in 58.13% of the cases with a coefficient of correlation (r) higher than 0.87.Although the high intraocular pressure does not allow to confirm the diagnosis of primitive glaucoma with opened angle, it constitutes an essential risk factor.We showed in this study that in 58.13% of the cases, there is a correlation between the high intraocular pressure and the primitive glaucoma with opened angle. Efforts must be made to sensitize our populations on the existence of this serious affection that is primitive glaucoma with opened angle and on its early tracking which begins with the measure of the eye pressure.

Cemento-ossifying fibroma is a rare benign tumor which can affect both jaw bones, particularly the mandible.We report two cases of cemento-ossifying fibroma which illustrate the radiological and anatomic features of these tumors. Differential diagnosis between cementifying fibroma and ossifying fibroma was particularly difficult. The cementifying fibroma was treated by surgical resection followed by immediate reconstruction with an iliac bone graft. The ossifying fibroma was treated by enucleation-resection.The clinical, radiological and histological features of cementifying and ossifying fibroma allow distinction. Surgical treatment is achieved by enucleation resection for small-sized ossifying fibromas and mono-bloc resection with bone reconstruction for large-sized cementifying and ossifying fibromas.

Haemorrhagic cysts of the parathyroid gland are rare. Our case report concerns a presentation with a constrictive cervical haematoma, confirmed by ultrasound-guided aspiration. The haematoma, rapidly recurred, indicating exploration of the neck and haemostasis. Histological examination of excised tissue showed the haemorrhagic nature of the cyst.