Ophthalmology
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Item Intravitreal anti-vascular endothelial growth factor for retinopathy of prematurity in Ibadan: Method of administration.(Wolters Kluwer Medknow, 2020) Babalola, Y. O.; Oluleye, T. S.; Majekodunmi, O.; Ijaduola, M.Purpose: To outline the method of administration of intravitreal antivascular endothelial growth factor (anti VEGF) for retinopathy of prematurity (ROP) for the purpose of improved eye care among neonates. Background: ROP is a major potential, but largely preventable cause of blindness in the pediatric population. ROP has been shown to be a two stage event with an initial disruption to normal retinal vessel growth, which is then accompanied by the second stage of vessel development. Preterm infants have undeveloped retinas, with avascular areas at the periphery. Subsequently, as the infant grows, these undeveloped retinas lacking an adequate supply of oxygen then stimulate angiogenic factors for the development of new vessels. Some predisposing risk factors include inappropriate oxygen therapy and lower birth weights. Initially, ROP was documented to be sporadic in most regions of Africa, but due to the recent advancement in medical facilities and personnel training, more preterm babies are surviving, thereby increasing the rate of ROP. Our hospital, the University College Hospital, Ibadan, has been assessing preterm babies for signs of ROP in conjunction with the neonatologists for the last four years, with various stages of ROP being diagnosed and treated. Intravitreal use of anti VEGF has been accepted as a valuable therapy in preventing the development of advanced cases of ROP. The purpose of this study is to describe the method of administration of this important medication. Conclusion: Intravitreal anti VEGF may prevent avoidable blindness in babies with ROP. However, to prevent devastating complications, appropriate techniques and the guidelines given in this study should be considered to minimize complications.Item Learning styles of fresh clinical students in Ophthalmology at the University of Ibadan, Nigeria – A pilot study(Wolters Kluwer Medknow, 2020) Oluleye, T. S.; Babalola, Y. O.; Olusanya, B. A.; Majekodunmi, O. I.; Ijaduola, M. A.Background: The College of Medicine, University of Ibadan, Nigeria, is using a new curriculum for its learners. Therefore, knowing the learning styles of the learners will help the teachers formulate appropriate teaching strategies. The aim of the pilot study was to determine the learning styles of the 1st-year clinical students rotating through ophthalmology with a view to recommending appropriate teaching strategies to the teachers for the smooth running of the new curriculum. Methodology: The first fifty set of students sent to the department of ophthalmology for ophthalmology rotation was used as a pilot. A total of 47 students completed the study. Three students voluntarily did not participate in the study. Design: VARK questionnaire assisted testing of learning styles was used for the study. It consists of 16 questions with four options testing each domain of visual (V), auditory (A), write or reading (R), and kinesthetic (K) ways of learning. Multiple responses were allowed. The total responses were computed at the end to give an idea of the learning styles of the students. Results: A total of 1192 responses were received from 47 students (25 males and 22 females), with a male to female ratio of 1.1:1. The Auditory and kinesthetic ways of learning were responsible for 669 (56%) responses. There was no statistically significant difference among the sexes. Conclusion: The most preferred learning styles were the auditory and kinesthetic ways of learning. Teachers should consider direct instructions and more hands-on teaching of their students while formulating a teaching plan.Item Retinochoroidal coloboma in a female Nigerian.(Ophthalmological Society of Nigeria, 2020) Babalola, Y. O.; Oluleye, T. S.We report a case of retinochoroidal coloboma in a 32 year old Nigerian female who first presented to the eye outreach clinic with a history of poor vision in the left eye of two years duration. The best corrected visual acuity was 6/5 and light perception with accurate light projection in the right and left eyes respectively. She was subsequently referred to the retina clinic for Neodymium:yttrium- aluminium- garnet (Nd:YAG) laser capsulotomy on account of a left posterior capsular opacity after cataract surgery at the eye outreach clinic with a best corrected visual acuity of 6/5 and 6/36 respectively in the right and left eye. Dilated binocular indirect ophthalmoscopy of the left eye revealed a large, wedge shaped, excavated retinochoroidal defect with hyperpigmented edges involving the nasal retina extending across approximately five clock hours from 7 to 10 o’clock. The apex of the coloboma was approximately three disc diameters away from the optic nerve head and extended peripherally up to the ora serrata. The right fundus was normal. Retinochoroidal colobomas may occur in the absence of the known blinding sequelae like retinal detachment, choroidal neovascular membrane amongst others. Our patient had a cataract in the same eye with the retinochoroidal coloboma with subsequent visual gain post-surgery and increasing myopia.Item Retinopathy of prematurity in a tertiary facility: An initial report of a screening programme(Paediatric Association of Nigeria, 2020) Olusanya, B. A.; Oluleye, T. S.; Tongo, O. O.; Ugalahi, M. O.; Babalola, Y. O.; Ayede, A. I.; Baiyeroju, A. M.Retinopathy of prematurity (ROP) screening in Nigeria is at a nascent stage and at the moment there are no National guidelines for ROP screening in Nigeria. Thus it is desirable for screening programs to report findings amongst screened preterm infants in order to facilitate the development of national ROP screening criteria and guidelines. The aim of this report is to describe the frequency, severity and risk factors for retinopathy of prematurity (ROP) among preterm and very low-birth-weight babies screened within the first year of initiating an ROP screening program at a Nigerian tertiary facility. Methods: A cross-sectional study of infants born at less than 34 weeks gestational age; or with birth weight less than 1500g between May 2016 and May 2017. ROP screening examinations were performed by ophthalmologists with the use of an indirect ophthalmoscope, after pupillary dilation, in collaboration with the neonatology team. Information on gestational age at birth, birth weight, oxygen therapy and presence of other risk factors were recorded and analyzed. Results: A total of 74 infants were screened during the period. There were 36 (48.6%) males. Mean gestational age at birth was 29.6 (±2.35) weeks. Mean birth weight was 1.26 (±0.27) kg with a range of 800 to 1950g. ROP was detected in 9 (12.2%) infants. Two (22.2%) of these had Threshold ROP. There was no significant difference between the mean birth weight and mean gestational age of the infants who had ROP compared to those without ROP. The two infants with Threshold ROP were treated with intravitreal Bevazicumab and had regression of ROP. Conclusion: Retinopathy of pre maturity was diagnosed in at risk infants in this facility. There is, therefore, a need to establish ROP screening programs in all neonatal units across the country. In addition, established programs need to evaluate their screening criteria with a view towards developing country-specific screening guidelines.Item Comparison of clinical outcome between 23G and 25 G vitrectomy in diabetic patients.(Oman Ophthalmic Society, 2017) Taleb, E. A.; Nagpal, M. P.; Mehrotra, N.; Bhatt, K.; Goswami, S.; Babalola, Y. O.; Noman, A.PURPOSE: To compare the clinical outcomes and complications between 23 G and 25 G vitrectomy in patients with diabetic vitreous hemorrhage (VH). MATERIALS AND METHODS: A retrospective comparative study comprising 69 eyes (36 eyes in 23 G group and 33 eyes in 25 G group) of 65 patients who underwent vitrectomy with air tamponade for diabetic vitreous hemorrhage (VH) with at least 6 months of follow up was conducted. RESULTS: There were no significant differences between the two groups in age, gender, bilaterality, type of diabetes, presence of hypertension, lens status, and previous argon laser photocoagulation state (P > 0.05). Best corrected visual acuity (BCVA) of both groups at postoperative 1 month logarithm of the minimum angle of resolution (logMAR) (1.06 ± 0.99, 0.90 ± 0.96), 3 months logMAR (1.07 ± 0.93, 0.83 ± 0.85), and 6 months logMAR (1.03 ± 0.89, 0.83 ± 0.85) significantly improved from the preoperative BCVA logMAR (2.03 ± 0.83, 2.15 ± 0.99) for 23 G group, 25 G group, respectively (P < 0.0001). There was no significant difference in BCVA between the two groups preoperatively and at 1, 3, and 6 months postoperatively (P = 0.566, 0.506, 0.333, and 0.445, respectively), incidence of intraoperative wound suturing (21.4%, 15.2%), postoperative hypotony (0.0%, 0.0%), early postoperative VH (POVH) (11.1%, 15.2%), late POVH (5.6%, 0.0%), retinal detachment (2.8%, 6.1%), neovascular glaucoma (92.8%, 9.1%), and endophthalmitis (0.0%, 0.0%) for 23 G group, 25 G group, respectively (P > 0.05). CONCLUSION: 25 G vitrectomy is as effective for PDR as 23 G vitrectomy.Item Optic disc coloboma in two Nigerian siblings; Case report & Review of Literature(Wolters Kluwer ‑ Medknow, 2017) Babalola, Y. O.; Olawoye, O. O.; Idam, P.We report two cases of bilateral asymmetric optic disc coloboma (ODC) in siblings. The index patient is a 9 year old Nigerian girl with severe cognitive deficit who presented with a poor vision of 3 years’ duration. She had a history of childhood febrile convulsions and delayed developmental milestones. Her visual acuity could not be assessed because she had a cognitive deficit and expressive aphasia. Ocular examination revealed a very large excavated right optic disc with only a strip of remnant neuro retinal rim superiorly, and a smaller left optic disc with inferior disc excavation, superior wedge of the pink neuro retinal rim as well as a temporal optic disc pit. No systemic features of syndromes associated with ODCs and intellectual disability were present in both patients. The younger sibling an 8 year old girl later presented to the eye clinic with a 5 month history of poor vision in the left eye. Ocular examination revealed visual acuity of 6/6 in the right eye and counting fingers in the left eye. Dilated binocular indirect ophthalmoscopy revealed a right large excavated colobomatous disc and a left small disc with infero temporal disc coloboma.Item Iridoschisis in a Nigerian patient; A case report(Wolters Kluwer - Medknow, 2016) Olawoye, O. O.; Babalola, Y. O.We report iridoschisis in a female who presented at the age of 85 years with a ten year history of complaints of gradual and progressive deterioration in vision in both eyes (left eye worse than the right eye). The examination was notable for the presence of peripheral anterior synechiae inferiorly and few loose iris fibrils some of which were adherent to the corneal endothelium in both eyes while others floated within the aqueous humor. The anterior chamber was shallow and there was marked inferior/inferotemporal sectoral iris atrophy with splitting of the anterior layer of the iris. The pupils were slightly irregular in but reactive in both eyes and there were lenticular opacities in both eyes.Item Chloroquine retinopathy: pattern of presentation in Ibadan, Sub-Sahara Africa(Macmillan Publishers Limited, 2016) Oluleye, T. S.; Babalola, Y. O.; Ijaduola, M.Background: Self-medication with chloroquine is common in Ibadan, Sub-Sahara Africa. Retinopathy from chloroquine is not uncommon. The aim was to determine the pattern of presentation. Methodology: Cases of Chloroquine retinopathy seen at the Retina and Vitreous Unit of the University College Hospital, Ibadan between 2008 and 2014 were reviewed. Information on age, sex, duration of chloroquine use, and visual loss were retrieved. Visual acuity at presentation, anterior, and posterior segment findings were documented. The results were analyzed using proportions and percentages. Results: Fourteen cases were seen during the study period. Mean age was 50.7 years. Male to female ratio was 3.5: Average duration of visual loss before presentation was 2.7 years. Average duration of self-medication with chloroquine was 5.3 years. Presenting visual acuity showed 2(14%) cases of bilateral blindness(VAo3/60 in both eyes); 5(35.7%) cases of uniocular blindness; three cases of bilateral low vision(VA worse than 6/18 but better than 3/60). Anterior segment examination showed abnormal sluggish pupillary reaction in those with severe affectation. Dilated fundoscopy showed features ranging from mild macular pigmentary changes and bulls eye maculopathy to overt extensive retinal degeneration involving the posterior pole, attenuation of retinal vessels, optic atrophy, and beaten bronze appearance of atrophic maculopathy. Conclusion: Chloroquine retinopathy is not uncommon in Ibadan, Sub-Sahara Africa. Bulls eye maculopathy, extensive retinal, and macular degeneration with optic atrophy are the main presentations. Public health education is imperativeItem Health seeking behaviours of patients attending primary eye care centre in Nigeria.(OALib, 2015) Megbeleyin, E. O.; Babalola, Y. O.Purpose: To determine health seeking behaviour in relation to non-orthodox eye medication use among patients attending a primary eye health center in Nigeria. Materials and Methods: It was a cross-sectional study of consecutive respondents. Participants’ socio-demographic profile, types and pattern of harmful traditional eye medications (HTEMs) use were obtained using a pre-tested questionnaire. Data analysis was by SPSS version 20.0. Results: Of the 303 patients enrolled in the study, 153 (50.5%) were males and 150 (49.5%) were females. The age range was from 13 years old to 94 years old with a mean of 53.8 ± 17.05 years old. Majority of the subjects (74.3%) used orthodox medical outfits for their eye care needs. The prevalence of use of HTEMs was 11.9%. Common forms of TEMs used were herbs 24 (66.7%), sugar water 3 (8.3%), breast milk 3 (8.3%) and onions 6 (16.7%). There was statistically significant association between age and use of HTEMs (p = 604.27, 2 χ =< 0.001, 95% CI = 0.000 - 0.010), and health seeking behaviour (p = 808.70, 2 χ =< 0.001, 95% CI = 0.000 - 0.010). Conclusion: Eye care providers and health care managers must have good knowledge of the various factors that negatively influence utilization of eye care services and be responsive to them.Item Indications for intravitreal bevacizumab in Ibadan, Subsaharan Africa.(Bentham Science Publishers, 2014) Oluleye, T. S.; Babalola, Y. O.Background: Angiogenesis is a contributing factor in some retinal diseases, hence the role of vascular endothelial growth factor (VEGF) as a common pathway in proliferative retinopathies. Bevacizumab has been found to be effective in the treatment of these diseases. The aim of this study was to review all cases of intravitreal bevacizumab given in the retinal unit of the University College Hospital, Ibadan from July, 2010 to June 2012, pointing out the common indications. Methods: After obtaining ethical approval from the University College Hospital/University of Ibadan Review Board for the study, all cases of intravitreal injections of bevacizumab recorded in the retinal register during the study period (July 2010 to June 2012) were retrieved. Age, sex, diagnoses and indication for injection were recorded in the data sheet prepared for the study. Results were analyzed using proportions and percentages. Results: A total of one hundred and thirty four injections of bevacizumab were given in the study period. The most common indication was cystoid macular edema from retinal vein occlusion ([26(19.4%)] followed by wet age related maculopathy [23(17.1%)] and sickle cell retinopathy [(22(16.4)]. Emerging indications included idiopathic polypoidal choroidal vasculopathy [8(6%) and retinal macroaneurism with macular edema [6(4.5%)]. Conclusion: Cystoid macular edema from vascular occlusion and wet age related macular degeneration are the major indications for intravitreal bevacizumab injection in Ibadan.