Scholarly works in Ophtalmology

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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.
Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020
(BMJ, 2021) Ademola-Popoola, D. S.; Fajolu, I. B.; Gilbert, C.; Olusanya, B. A.; Onakpoya, O. H.; Ezisi, C. N.; Musa, O.; Chan, R. V. P.; Okeigbemen, V. W.; Rilwan, C. M.; Malik, N. J. A.; Adio, A. O.; Bodunde, O. T.; Rafindadi, A. L.; Oluleye, T. S.; Tongo, O. O.; Badmus, S. A.; Adegbara, O. V.; Tapas, R. P.; Ezenwa, B. N.; Obajolowo, T. S.; Olokoba, L. B.; Olatunji, V. A.; Babalola, Y. O.; Ugalahi, M. O.; Adenekan, A.; Adesiyun, O. O.; Sahoo, J.; Miller, M. T.; Uhumwangho, O. M.
Objectives Retinopathy of prematurity (R0P) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for R0P between 2017 and 2020 as well as the outcome of these activities in Nigeria. Design Descriptive case study. Setting Neonatal intensive care units in Nigeria. Participants Staff providing services for R0P, and 723 preterm infants screened for R0P who fulfilled screening criteria (gestational age <34 weeks or birth weight <2000 g, or sickness criteria). Methods and analysis A WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity building, national and international collaborative activities between 2017 and 2018. A national protocol for R0P was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017-2018 and to assess challenges in service provision. Results In 2017 only six of the 84 public neonatal units in Nigeria provided R0P services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any R0P; and 29 (22.8%) developed type 1 R0P. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challengesincluded lack of equipment to regulate oxygen and to document and treat R0P, and lack of data systems. Conclusion R0P screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and R0P treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential.
Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020
(BMJ, 2021) Ademola-Popoola, D. S.; Fajolu, I. B.; Gilbert, C.; Olusanya, B. A.; Onakpoya, O. H.; Ezisi, C. N.; Musa, O.; Chan, R. V. P.; Okeigbemen, V. W.; Rilwan, C. M.; Malik, N. J. A.; Adio, A. O.; Bodunde, O. T.; Rafindadi, A. L.; Oluleye, T. S.; Tongo, O. O.; Badmus, S. A; Adegbara, O. V.; Tapas, R. P.; Ezenwa, B. N.; Obajolowo, T. S.; Olokoba, L. B.; Olatunji, V. A.; Babalola, Y. O.; Ugalahi, M. O.; Adenekan, A.; Adesiyun, O. O.; Sahoo, J.; Miller, M. T.; Uhumwangho, O. M.
Objectives Retinopathy of prematurity (R0P) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for R0P between 2017 and 2020 as well as the outcome of these activities in Nigeria. Design Descriptive case study. Setting Neonatal intensive care units in Nigeria. Participants Staff providing services for R0P, and 723 preterm infants screened for R0P who fulfilled screening criteria (gestational age <34 weeks or birth weight <2000 g, or sickness criteria). Methods and analysis A WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity building, national and international collaborative activities between 2017 and 2018. A national protocol for R0P was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017-2018 and to assess challenges in service provision. Results In 2017 only six of the 84 public neonatal units in Nigeria provided R0P services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any R0P; and 29 (22.8%) developed type 1 R0P. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challengesincluded lack of equipment to regulate oxygen and to document and treat R0P, and lack of data systems. Conclusion R0P screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and R0P treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential.
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.
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 prematurity 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.
Refractive amblyopia among children in Ibadan: the need for amblyopia screening programmes
(2015) Olusanya, B. A.; Ugalahi, M. O.; Okoli, C. E.; Baiyeroju, A. M.
Background: The prevalence and burden of amblyopia in developing countries is probably underestimated, and little is known about the pattern of amblyopia in West Africa. Aim: To determine the relative frequency and types of amblyopia among children with refractive errors seen in the eye clinic of a tertiary hospital over a 2 year period. Methods: A cross-sectional study conducted at the eye clinic of the University College Hospital, Ibadan, Nigeria between January 2012 and December 2013. Case notes of children with refractive errors seen during this period were retrieved and information including socio-demographic data, presenting visual acuity and visual acuity with correction were recorded. Amblyopia was defined as best corrected visual acuity worse than 6/9 or a difference of >2 Snellen chart lines between both eyes in the absence of any ocular pathology that could explain the visual impairment. Results: A total of 250 eligible patients who had refractive errors were included in the study. Visual acuity was corrected to 6/9 or better in 224 (89.6%) children while 26(10.4%) of them had amblyopia. Among the 26 children with amblyopia, 21 (80.8%) children had amblyopia in both eyes and majority (65.4%) had isoamctropic amblyopia. Of the 47 amblyopic eyes, 36 (76.6%) eyes had moderate amblyopia while 11 (23.4%) eyes had severe amblyopia. Conclusion'. There is a high relative frequency of amblyopia in this study and we recommend preschool eye examinations for all children to ensure early detection and management of amblyopia, thereby reducing the burden of amblyopia in our populace.
Trabeculectomy for congenital glaucoma in University College Hospital, Ibadan: a 7 year review of cases
(Wolters Kluwer - Medknow, 2015-12) Olusanya, B. A.; Ugalahi, M. O.; Malomo, M. O.; Baiyeroju, A.
Introduction: Congenital glaucoma is an uncommon ocular condition affecting about 1/15,000 live births. About two third of cases are bilateral with a higher prevalence in males. The definitive treatment requires surgery which could be trabeculectomy, trabeculotomy, goniotomy, drainage tubes or a combination of trabeculotomy and trabeculectomy. Aim: To determine the outcome of trabeculectomy in patients with congenital glaucoma seen at the University College Hospital Ibadan between 2007 and 2013. Methods: The medical records of all patients with congenital glaucoma seen between the years 2007 and 2013 were retrieved. Inclusion criteria were patients who had trabeculectomy with or without anti-metabolites within this period. The main outcome measures assessed were postoperative intraocular pressure (IOP) and corneal clarity. Data was analyzed with the statistical Package for Social Sciences version 21. Results: Thirty-four eyes of 18 patients were reviewed out of which 16 patients had bilateral trabeculectomy while two had unilateral trabeculectomy. The mean preoperative IOP was 26.31 mmHg while the mean IOP in the immediate postoperative period, at 3 months after surgery and at last follow-up visit were 13.31 mmHg, 12.78 mmHg and 15.89 mmHg respectively. IOP was <21 mmHg in 81.82% of the eyes as at last clinic visit. All eyes had cloudy corneas preoperatively while 38.24% had minimal residual corneal opacity (Haab’s striae) as at last follow-up visit. Conclusion: In the absence of equipment for other surgical options, trabeculectomy is an effective surgical approach in the management of congenital glaucoma in the short term.
Delays in uptake of surgery for childhood cataract at a child eye health tertiary facility in sub-Saharan Africa
(SAGE Publishing, 2019) Ugalahi, M. O.; Olusanya, B. A.; Fagbemi, O. O.; Baiyeroju, A. M.
Background: Timely uptake of surgery is vital in the control of childhood blindness due to cataract. The aim of this study is to determine the uptake of surgery as well as the frequency and reasons for rescheduling of surgery for childhood cataract in a tertiary hospital in southwest Nigeria. Methods: A retrospective study of children with childhood cataract seen at the Paediatric Ophthalmology unit of the University College Hospital, Ibadan between 2011 and 2015. Demographic and clinical information was retrieved from case records. Caregivers of children who did not have surgery were contacted by telephone to elicit reasons why surgery was not done. Results: A total of 164 children were included in the study; 90 (54.9%) were male. The median age at presentation was 4 years with a range of 2–180 months. A total of 64 (39.0%) children had unilateral cataract. All patients were scheduled for surgery, but 123 (75%) underwent surgery. Surgery was rescheduled in 42 (34.1%) of those who had surgery. Reasons for rescheduling included financial constraints, illness, delay in paediatrician evaluation to ascertain fitness for anaesthesia and strike actions by health workers in the hospital. Conclusion: Three quarters of the children had surgery, though it had been rescheduled, at least once, in about onethird of them. Delayed uptake of surgery was mainly due to inability to afford treatment and strike actions. The need for improved coverage of health insurance especially for the paediatric age group in developing countries cannot be overemphasized. This is because good vision is an integral part of child development.
Congenital aniridia: clinical profile of children seen at the University College Hospital, Ibadan, South-West Nigeria
(SAGE Publishing, 2021) Ugalahi, M. O.; Ibukun, F. A.; Olusanya, B. A.; Baiyeroju, A. M.
Purpose: To describe the clinical features of patients younger than 16 years with aniridia presenting to the Paediatric Ophthalmology unit of the Eye Clinic, University College Hospital, Ibadan, Nigeria. Methods: The is a retrospective review of children with aniridia seen between May 2015 and April 2019 at the Paediatric Ophthalmology unit of the Eye Clinic, University College Hospital in Ibadan. Data on demographic characteristics, presenting complaints, ocular and systemic examination findings, and interventions were collected and descriptively summarised. Results: A total of 28 eyes of 14 patients were studied. The mean age was 6.37 ± 4.98 years. Seven (50%) patients were male. Aniridia was diagnosed in first-degree relatives of nine patients. The most common complaint at presentation was poor vision in 11 (78.6%) patients. Objective visual acuity assessment was obtained in 22 (78.6%) eyes. Presenting visual acuity was worse than 20/60 in all 22 eyes and worse than 20/400 in 8 (36.4%) eyes. Refraction was performed in 17 (60.7%) eyes and revealed a mean spherical equivalent of −3.93 ± 5.99 diopters. Twenty (71.4%) eyes had corneal opacities, and lenticular opacities were seen in 15 (62.5%) of 24 eyes. Mean intraocular pressure (IOP) at presentation was 21.62 ± 10.4 mmHg; 12 (41.4%) eyes had elevated IOP at presentation. Ten (35.7%) eyes had cataract surgery and six (21.4%) eyes had glaucoma surgery. Conclusion: Familial aniridia was common in this study, and most of the patients presented with moderate to severe visual impairment. The common ocular associations were refractive error, cataract, corneal opacity and glaucoma.
Common forms of strabismus in a tertiary eye clinic in Southwest Nigeria
(Wolters Kluwer - Medknow, 2019-12) Olusanya, B. A.; Ugalahi, M. O.; Ayeni, O.; Fawole, O. I.; Baiyeroju, A. M.
Background: Strabismus occurs worldwide and is associated with undesirable psychosocial impact and negative social prejudice. However, there is a dearth of information on the different subtypes of strabismus in Nigerian patients. The aim of this study is to describe the common forms of strabismus among patients of an eye clinic in southwestern Nigeria. Methods: We retrospectively reviewed all new patients seen at the eye clinic of our hospital between January 1999 and December 2008. Patients with a diagnosis of strabismus were identified from the clinic registers and their case records were reviewed. Information on age, gender, cause, and type of squint as well as associated ocular/systemic disease was retrieved from the case records. Results: A total of 240 patients had strabismus, giving a relative frequency of 1.2%. Mean age of patients with strabismus was 19.8 (±19.7) years while male-to-female ratio was 0.98:1. Esotropia (53.8%) was more common than exotropia (44.2%). The mean age of patients with esotropia was 12.8 years compared with 27.9 years for patients with exotropia (P < 0.001). Sensory strabismus was the most common form of strabismus, occurring in 83 (34.5%) patients, while accommodative esotropia was found in only 5.8% patients. Conclusion: The relative frequency of strabismus in this study is fairly similar to other reports from Nigeria and Africa. Secondary strabismus was quite common whereas primary forms of strabismus such as accommodative esotropia appear to occur less frequently among our patients in comparison to Caucasian populations.

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