FACULTY OF CLINICAL SCIENCES
Permanent URI for this communityhttps://repository.ibadanedu.com/handle/123456789/265
Browse
1040 results
Search Results
Item Comparative evalaution of macular thickness in sickle cell and non-sickle cell disease patients at the University College Hospital Ibadan, Oyo State, Nigeria.(Wolters Kluwer - Medknow, 2025) Avuru, C. J.; Babalola, Y. O.; Ugalahi, M. O.; Sarimiye, T. F.; Olawoye, O. O.; Olaniyi, J. A.; Oluleye, T. S.Purpose: The purpose of this study was to determine the macular thickness of participants with sickle cell disease (SCD) and compare with their age and sex matched participants without SCD at the University College Hospital (UCH), Ibadan, to provide baseline data for adult Nigerians with SCD and how they compare with those without the disease. Materials and Methods: This was a hospital based comparative study conducted at the UCH, Ibadan. Patients with SCD aged 18 years and above were age and sex matched with non SCD controls (Haemoglobin AA genotype). All participants underwent a full ophthalmic examination, refraction, A scan biometry, and macular thickness were measured with an Optovue iScan spectral domain optical coherence tomography machine. Data from the left eye of each participant were analysed with IBM Statistical Package for Social Sciences (SPSS) version 25.0. Results: Seventy participants were recruited into the study and 30 (42.9%) were males. The mean age of all the subjects in the study was 35.9 ± 11.0. Group 1 (SCD) comprised 19 (27.1%) Hb SS and 16 (22.9%) Hb SC while Group 2 (non SCD) were 35 (50%) Hb AA subjects. The SCD group had a lower mean macular thickness (MMT) of 271.1 ± 20.2 microns compared to the non SCD group with an MMT of 278.5 ± 13.5 microns, but this was not statistically significant (P = 0.076). Macular thickness was generally lower in the SCD group in all the ETDRS map regions of the macular compared to the non SCD group with values ranging from 3.0 microns to 11.5 microns but statistically significant difference was observed only in the inner inferior macular (P = 0.026) and inner temporal macular (P = 0.046) regions. There was no statistically significant difference in distant visual acuity between non SCD and SCD participants (P = 0.605). Conclusion: This study observed focal macular thinning in SCD compared to non SCD. However, focal macular thinning was not associated with poorer distant visual acuity in patients with SCD.Item The African Critical Illness Outcomes Study (ACIOS): a point prevalence study of critical illness in 22 nations in Africa.(Elsevier Ltd, 2025) Baker, T.; Osinaike, B. B.; Scribante, J.; Elhadi, M.; Owoo, C.; Sottie, D.; Khalid, K.; Hewitt-Smith, A.; Belachew, F. K.; Kwizera, A.; Ademuyiwa, A.; Babalola, Y. O.Background Critical illness represents a major global health-care burden and critical care is an essential component of hospital care. There are few data describing the prevalence, treatment, and outcomes of critically ill patients in African hospitals. Methods: This was an international, prospective, point prevalence study in acute hospitals across Africa. Investigators examined all inpatients aged 18 years or older, regardless of location, to assess the coprimary outcomes of critical illness and 7-day mortality. Patients were classified as critically ill if at least one vital sign was severely deranged. Data were collected for the available resources at each hospital and care provided to patients. Findings: We included 19 872 patients from 180 hospitals in 22 African countries or territories between September, 2023 and December, 2023. The median age was 40 (IQR 29-59) years, and 11078/19862 (55-8%) patients were women. There were 967/19780 (4-9%) deaths. On census day, 2461/19743 (12-5%) patients were critically ill, with 1688/2459 (68.6%) cared for in general wards. Among the critically ill, 507/2450 (20.7%) patients died in hospital. Mortality for non-critically ill patients was 458/17205 (2-7%). Critical illness on census day was independently associated with subsequent in-hospital mortality (adjusted odds ratio 7: 72 [6.65-8.95]). Of the critically ill patients with respiratory failure, 557/1151 (48-4%) were receiving oxygen; of the patients with circulatory failure, 521/965 (54-0%) were receiving intravenous fluids or vasopressors; and of patients with low conscious level, 387/784 (49.4%) were receiving an airway intervention or placed in the recovery position. Interpretation: One in eight patients in hospitals in Africa are critically ill, of whom one in five dies within 7 days. Most critically ill patients are cared for in general wards, and most do not receive the essential emergency and critical care treatments they require. Our findings suggest a high burden of critical illness in Africa and that improving the care of critically ill patients would have the potential to save many lives.Item Terson syndrome: A sequel of Posterior Communicating Artery Aneurysm and a Quartet of other cases.(Wolters Kluwer - Medknow, 2025) Babalola, Y. O.; Oluleye, T. S.; Majekodunmi, O. I.; Ijaduola, M. A.This is a case series of Terson syndrome (TS) in five patients including one with features of a posterior communicating artery aneurysm. The first is a 28-year-old female who presented to the eye clinic with poor vision in both eyes for 2 weeks duration and drooping of the left upper lid. On ocular examination, she had a bilateral vitreous haemorrhage (VH). She gave an antecedent history of headaches, loss of consciousness, and seizures. Magnetic resonance angiography confirmed the diagnosis of a posterior communicating artery aneurysm. Four other patients were seen at the retina clinic with bilateral VH with a history of traumatic brain injury in keeping with TS. The second patient was a 34-year-old male referred from the neurosurgical unit on account of visual loss in both eyes. He had a preceding history of a fall with loss of consciousness and moderate head injury and best corrected visual acuity of counting fingers and hand movement, respectively, in the right and left eye. Bilateral VH was present in both eyes. The third patient was a 60-year-old male with a 2-month history of poor vision in both eyes after a head injury associated with loss of consciousness. The visual acuity was hand movement, and he had VH in both eyes. The fourth patient was a 10-year-old female who presented with poor vision for two months duration with an antecedent history of a pedestrian road traffic accident and a history of loss of consciousness. The best corrected visual acuity at presentation was 6/36 in both eyes. Ocular examination revealed bilateral VH. The fifth case was a 31-year-old male who presented with a reduction of vision in both eyes for 7 months duration with an antecedent history of a fall 2 months before the onset of symptoms. A diagnosis of TS was made in all five patients based on the clinical history and signs. The second patient was managed with bilateral vitrectomy, whereas the remaining four patients were managed conservatively.Item Pattern of ocular disorders in patients with Diabetes Mellitus at an endocrinology clinic of a tertiary centre in Ibadan, Sub-Saharan Africa(The Nigerian Medical Association, Rivers State Branch, 2025) Babalola, Y. O.; Adebusoye, S. A.; Esan, A.; Akande, T. O.; Adeleye, J. O.; Olusanya, B. A.Background: Diabetes mellitus causes various systemic complications including ocular disorders. Diabetic retinopathy, diabetic macula oedema and ocular conditions such as cataract and primary open angle glaucoma may lead to blindness. This study determined the spectrum of ocular disorders associated with diabetes mellitus in patients attending a tertiary hospital in Ibadan, Nigeria. Method: This is a cross-sectional study of 270 consecutive diabetic patients attending the Endocrinology clinic at the the University College Hospital, Ibadan, Nigeria. Data analysis was by SPSS version 22. Result: Two hundred and seventy patients were recruited between January 2018 and December 2022. There were 77 (22.85%) males and 192 (71.7%) females. The age range was 18 to 85 years and mean of 59.5+_ 11.8 years. One hundred and nine (40.4%) had tertiary level education. Two hundred and twenty (81.5%) never had an eye examination; 41 (17.4%) had diabetic retinopathy and 25 (9.3%) had diabetic macula oedema. Uncorrected refractive error was the commonest ocular diagnosis in 79(14.6%) closely followed by visually significant cataract in 75 (13.9%). One hundred and sixty-six (61.5%) patients were unaware of the visually debilitating effect of DM while 50 (18.5%) had undergone ocular screening. Conclusion: Diabetic retinopathy, refractive errors and diabetic macula oedema are the ocular abnormalities with the highest frequency in our clinic population. There is paucity of awareness of ocular complications of diabetes mellitus in our populace and the vast majority had never had ocular screening. Creating awareness and screening for ocular disorders is key in preventing visual impairment.Item Pattern of Ocular Disorders in Patients with Diabetes Mellitus at an Endocrinology Clinic of A tertiary Centre in Ibadan, Sub-Saharan Africa(Nigerian Medical Association, 2025) Babalola, Y.O.A 15-year-old boy presented himself to the retina clinic with a six-year history of poor vision in both eyes. Ocular symptoms started with deterioration in the vision of both eyes associated with ocular pain. There was no history of antecedent trauma, headaches, seizures, or loss of consciousness. The general and systemic examinations were normal. On ocular examination, the corrected visual acuity was 6/24 and 6/6 in the right and left eyes, respectively. The anterior segment examination was normal except for a relative afferent pupillary defect in the right eye. Examination of the posterior segment revealed bilateral optic atrophy worse in the right eye and cup disc ratios of 0.3 bilaterally. The vessels were within normal limits with epiretinal membranes in both eyes. Yellowish chorioretinal lesions were present temporal to the disc in both eyes. There was a positive history of tuberculosis in the father and brother. A diagnosis of bilateral optic atrophy and epiretinal membranes secondary to presumed ocular tuberculosis was made.Item Diabetic Macular Oedema in Diabetic Patients attending the endocrinology clinic at University College Hospital, Ibadan(Wolters Kluwer - Medknow, 2024) Oluleye, T. S.; Babalola, Y. O.; Majekodunmi, O. I.; Ijaduola, M. A.; Fasanmade, A. A.; Alonge, T. O.; Adebusoye, S. O.Background: Diabetic macular oedema (DME), a significant threat to vision among diabetics, often eludes the early detection due to patients’ delayed ophthalmologist visits. Our efforts to increase screening participation through physician referral promotion and cost reduction have not yielded significant results. Faced with the persistent challenge of low screening rates, we sought to explore innovative alternatives to increase DME detection. The first involved implementing ophthalmologist-led screening programmes, while the second focused on promoting sponsored on-site screenings at diabetic clinics. These strategies aim to integrate DME screenings more seamlessly into routine diabetes management, potentially increasing the likelihood of early detection. By making screenings more convenient and readily available within existing care pathways, we anticipate these approaches could significantly improve participation rates and consequently lead to earlier intervention for DME amongst diabetic patients. Aim: To determine the prevalence of DME in visually asymptomatic diabetic patients through comprehensive screening and to evaluate the potential benefits of early detection in improving the visual outcomes and patient care. Methods: A cross-sectional study was conducted from 2020 to 2023, involving 225 consecutive diabetic patients who consented to participate while attending the diabetic clinic. The Joint University of Ibadan/University College Hospital Institutional Review Board provided ethical approval for the research. The study collected the data on patient demographics and medical history. Thereafter, they underwent comprehensive ocular examinations. All findings were systematically documented for analysis using the IBM Statistical Package for the Social Sciences software version 26.0. Results: A total of 225 diagnosed diabetic patients (450 eyes) were examined in the study. The duration of diabetes mellitus amongst participants ranged from two months to 30 years. The sex distribution shows a male-to-female ratio of 1:2.6, indicating a higher proportion of female participants. The age range of the study population is 31–87 years. Regarding diabetic control, 32% of participants had a fasting blood sugar (FBS) level higher than 120 mg/dL. Visual acuity (VA) assessments revealed that 16.9% (n = 38) of participants had VA worse than 6 / 12. Out of the total participants, 42 (18.9%) had DME in at least one eye, while 180 (81.1%) had no DME. DME was observed in 32 right eyes (14.7%) and 32 left eyes (14.9%). A statistically significant association was found between DME and visual impairment (χ2 = 11.2, P = 0.001), with a higher proportion of DME patients (33.3%) having visual impairment compared to those without DME (13.1%). Patients with DME were 3.6 times more likely to have best-corrected VA worse than 6 / 12 in the better eye compared to those without DME. Conclusion: This study reveals a significant prevalence of DME and its strong association with visual impairment. Our findings underscore the need to take screening services directly to diabetic clinics and the urgency of implementing routine eye screening protocols for all diabetic patients in our medical facilities to enable the early detection and timely intervention.Item Diabetic Macular Oedema in Diabetic Patients attending the endocrinology clinic at University College Hospital, Ibadan.(Wolters Kluwer - Medknow, 2023) Sarimiye, T. F.; Ijaiya-Olatoke, N.; Babalola, Y. O.; Majekodunmi, O.; Ijaduola, M. O.; Olawoye, O. O.; Oluleye, T. S.Purpose: To evaluate the rate of postoperative intraocular pressure (IOP) elevation and its management in patients who have undergone scleral buckle surgery as a primary intervention for retinal detachment. Materials and Methods: This was a retrospective review of hospital files of scleral buckle surgeries for retinal detachment from January 2016 to December 2021 at the University College Hospital Ibadan. All patients with a previous history of glaucoma, vitreoretinal surgery, or a combination of vitrectomy and scleral buckling procedures were excluded from the review. An IOP of ≥22 mmHg after surgery was considered elevated. Results: A total of 148 patients’ charts were reviewed with 125 patients (131 eyes) included in the study. There were 81 males (64.8%) and the mean age of patients was 45.2 (±18.8) years, with a range of 5–81 years. Rhegmatogenous retinal detachment accounted for 97.7% (128 eyes) of all cases and 118 eyes(90.1%) were recent detachments. Seventy‑nine eyes (60.3%) recorded elevated IOP postscleral buckle surgery. The mean elevated IOP postbuckle surgery was 27.9 (±6.2) mmHg and the mean antiglaucoma medications prescribed was 2.4 (±2) with a range of 2–5 medications. Four eyes (5.1%) needed surgical intervention for the elevated IOP. The last follow‑up mean IOP was 14.3 (±4.1) mmHg. Conclusion: Elevated IOP frequently complicates scleral buckle procedure and medical treatment is usually sufficient. As a common complication, this should be considered in advance when planning for the procedure, especially in low-income countries like Nigeria where scleral buckling surgery is still in common practice.Item Best Vitelliform Macular Dystrophy presenting with choroidal neovascular membrane in an adolescent: case report and review of literature.(West African College of Surgeons., 2025) Babalola, Y.O.An 11-year-old boy presented to the retina outpatient clinic with a -5-year history of poor vision in the left eye. The best corrected visual acuity at presentation was 6/5 and 6/36, respectively, in the right and left eyes. Ocular examination revealed normal anterior segments in both eyes. Binocular indirect ophthalmoscopy of the right eye revealed a pink disc with a cup disc ratio (CDR) of 0.3, normal vessels while the macula had a yellowish lesion with a scrambled egg appearance and surrounding dome-shaped subretinal fluid with a flat retina and no treatable peripheral retinal lesions. The left eye had a pink disc with CDR O.3, normal vessels with a hyperpigmented lesion at the macula surrounded by a small cuff of subretinal fluid with a flat retina and no treatable peripheral retinal lesions. Optical coherence tomography scan revealed subretinal fluid in both eyes with an active choroidal neovascular membrane in the left eye. He was advised on the need for left intravitreal anti-vascular endothelial growth factor injections.Item Macula lesions in retinitis pigmentosa(Nigerian Medical Association (NMA), Akwa Ibom State Branch, 2025) Babalola, Y. O.; Adebusoye, S. O.Aim: To describe the pattern of macula lesions in patients with retinitis pigmentosa attending a Retina outpatient clinic in Ibadan, Nigeria. Methodology: A retrospective review of patients with retinitis pigmentosa seen at the Retina clinic of the University College Hospital, Ibadan, Nigeria between May 2018 and June 2022. Data analysis was by SPSS (version 23) and statistical significance was placed at p < 0.05 Results: Forty-six (2.4%) of 1911 patients seen at the retina clinic during the study period had a diagnosis of retinitis pigmentosa. There were 24 (55.8%) males and 19 (44.2%) females. The mean age was 39.4 ± 19.2 years (range of 9 to 78 years). Eighty-six percent of patients were of the Yoruba ethnic group. The most common ocular complaint was poor vision which was present in forty patients (93.0%), followed by poor night vision in 26 (74.3%) patients and loss of peripheral vision in 11 (47.8%) patients. Visual impairment was present in 72.2% of patients. Maculopathy accounted for 61.3 percent of patients with visual impairment. Fifty-three (68.9%) eyes had macula lesions. This accounted for 62. 8% of all patients with RP. The macula lesions include atrophic maculopathy, cystoid macula oedema and epiretinal membrane. Atrophic maculopathy was the most common maculopathy. Coexisting ocular morbidities such as cataract dominantly of the posterior subcapsular morphology was present in 33 (42.3%) eyes while glaucoma was present in two eyes of a single patient. Conclusion: Macula lesions in retinitis pigmentosa may be a main cause of visual impairment in this population. Atrophic maculopathy is the most prevalent macula lesion associated with RPin this study.Item A case of Usher syndrome presenting with a right lamellar hole.(Wolters Kluwer Medknow, 2023) Babalola, Y.O.A 23-year-old lady presented to the Eye Clinic with poor night vision since childhood, worse in the right eye. There was an associated history of difficulty hearing noticed by her mother, which has progressively worsened. The presenting visual acuity was hand movement in the right eye and 6/60 in the left eye, respectively. She gave a history of recent and frequent involvement in domestic and road traffic accidents, which precipitated her presentation to the eye clinic. There were no concurrent systemic illnesses. Binocular indirect ophthalmoscopy revealed bilateral widespread bone spicule pigmentation, waxy disc pallor, and attenuated vessels with bilateral atrophic changes worse in the left eye. The optical coherence tomography scan revealed a lamella hole in the right eye. The otorhinolaryngologist made a diagnosis of sensorineural deafness. A diagnosis of Usher syndrome with a right lamellar hole was made in light of the clinical findings.