Baseline characteristics of Ghanaian children and adults enrolled in PIVOT, a randomised clinical trial of hydroxyurea in HbSC disease in sub-Saharan Africa.

HbSC disease is a common form of sickle cell disease with significant morbidity and early mortality. Whether hydroxyurea is beneficial for HbSC disease is unknown. Prospective Identification of Variables as Outcomes for Treatment (PIVOT, Trial ID PACTR202108893981080) is a double-blind, randomised, placebo-controlled phase II trial of hydroxyurea for people with HbSC, age 5-50 years, in Ghana.

A qualitative study on the effect of a decision aid on knowledge of cataract surgery in patients in developing countries.

Background: Despite cataract surgery being a safe procedure with a low incidence of perioperative complications rates, poor knowledge, concerns about the effectiveness of treatment and cost-benefit analysis of the procedure significantly hinder cataract surgery uptake rates in Africa. This study describes the effect of a decision aid on knowledge and decision conflict on cataract patients in Africa.

Methods And Analysis: 120 patients with cataracts reporting to a tertiary hospital in Ghana were randomly assigned to receive a decision aid containing information on the possible outcomes of cataract surgery or a control booklet containing general knowledge about cataracts without information about cataract surgery.

Levels of anti-insulin antibodies in diabetic retinopathy patients: an observational cross-sectional study.

This study evaluated the levels of anti-insulin antibodies (AIAs) and the influence of some antidiabetic medications on AIA in diabetes mellitus (DM) patients with retinopathy. An observational cross-sectional study. A lower titer of AIA IgG was observed in the diabetic retinopathy (DR) and DM-only study categories compared with the control group [DR = 86 (5-560), DM-only = 50 (5-500), versus control = 200 (7-565); p = 0.

Readability and Quality of Online Information on Sickle Cell Retinopathy for Patients.

Purpose: This study aims to evaluate the readability and quality of Internet-based health information on sickle cell retinopathy.

Design: Retrospective cross-sectional website analysis.

Methods: To simulate a patient's online search, the terms "sickle cell retinopathy" and "sickle cell disease in the eye" were entered into the top 3 search engines (Google, Bing and Yahoo).

Prospective identification of variables as outcomes for treatment (PIVOT): study protocol for a randomised, placebo-controlled trial of hydroxyurea for Ghanaian children and adults with haemoglobin SC disease.

Background: Haemoglobin SC (HbSC) is a common form of sickle cell disease (SCD), especially among individuals of West African ancestry. Persons with HbSC disease suffer from the same clinical complications and reduced quality of life that affect those with sickle cell anaemia (HbSS/Sβ). Retrospective anecdotal data suggest short-term safety and benefits of hydroxyurea for treating HbSC, yet rigorous prospective data are lacking regarding optimal dosing, clinical and laboratory effects, long-term safety and benefits, and appropriate endpoints to monitor.

A Survey of the Management of Diabetic Macular Oedema in Sub-Saharan Africa.

Background: There is minimal information about the availability of treatment for Diabetic macular oedema (DMO) in sub-Saharan Africa (SSA). The principal aim of this survey was to determine the 'real world' management of DMO amongst ophthalmologists working in SSA.

Methodology: Questionnaires were distributed to members of retinal and ophthalmological societies in SSA.

International collaboration for the development of clinical guidelines in low and middle-income countries: case study on the development of a national framework and clinical guidelines for diabetic retinopathy in Ghana.

Background: Diabetic retinopathy is a leading cause of blindness in many countries across the world. Ghana has seen a rise in diabetic retinopathy and is working on various strategies to prevent blindness. Clinical guidelines are seen as a promising strategy for improving quality and reducing cost of care.

Utilization of eye health services and diabetic retinopathy: a cross-sectional study among persons living with diabetes visiting a tertiary eye care facility in Ghana.

Background: There have been a major advance made in screening, early diagnosis, and prompt treatment of Diabetic Retinopathy among Person living with diabetes (PLWD). However, screening services remain a challenge in Low-Middle-Income-Countries where access to eye care professionals is inadequate. This study assesses the utilization of Eye Health Service prevalence (UEHS) among PLWD and associated factors and further quantifies its association with Non-Proliferative Diabetic Retinopathy (NPDR).

Situational analysis of diabetic retinopathy treatment Services in Ghana.

Background: Although the equitable distribution of diabetic retinopathy (DR) services across Ghana remains paramount, there is currently a poor understanding of nationwide DR treatment services. This study aims to conduct a situation analysis of DR treatment services in Ghana and provide evidence on the breadth, coverage, workload, and gaps in service delivery for DR treatment.

Methods: A cross-sectional study was designed to identify health facilities which treat DR in Ghana from June 2018 to August 2018.

Prevalence, Causes, and Factors Associated with Visual Impairment and Blindness among Registered Pensioners in Ghana.

Purpose: To determine the prevalence, causes, and factors associated with presenting visual impairment and blindness among pensioners.

Design: A nationwide cross-sectional study. This study was part of the analysis on data obtained in the pensioners' medical survey conducted among members of the National Pensioners Association in Ghana.

Safety of intravitreal ziv-aflibercept in choroido-retinal vascular diseases: A randomised double-blind intervention study.

Aim: To evaluate the safety of 1.25mg and 2mg intravitreal ziv-aflibercept (IVZ) in Ghanaian eyes with choroido-retinal vascular diseases.

Design: Prospective, randomised, double blind, interventional study.

Case series of six patients diagnosed and managed for idiopathic intracranial hypertension at a tertiary institution eye centre.

Background: Idiopathic Intracranial Hypertension (IIH) occurs secondary to raised intracranial pressure (ICP) of unknown etiology and is diagnosed when all other causes of raised ICP have been excluded. It can leave devastating sequelae such as permanent visual loss, hence the need for timely diagnosis and treatment. Anecdotally, one or two cases of idiopathic intracranial hypertension (IIH) previously presented at the Eye Centre, KBTH yearly.

The past, present and future management of sickle cell retinopathy within an African context.

Sickle cell retinopathy is a potentially blinding condition that affects young people in the working age group. This review looks at the past, present and future management of sickle cell retinopathy within an African context. After Sickle cell disease was first reported in 1910, some reports from Africa were pivotal in describing the retinal changes associated with the disease.

Challenges with starting vitreoretinal services in the developing world.

Service development and improvement within ophthalmology has taken a whole new dimension with the constant improvement of equipment, and the development of therapies that significantly improve the management of our patients and as such alters their visual prognosis for the better. This improvement and increased reliance on both diagnostic and surgical equipment with the concomitant use of intravitreal therapies has arguably been felt more in the field of retinal diseases.

Corneal collagen cross-linking for treating keratoconus.

Background: Keratoconus is a condition of the eye that affects approximately 1 in 2000 people. The disease leads to a gradual increase in corneal curvature and decrease in visual acuity with consequent impact on quality of life. Collagen cross-linking (CXL) with ultraviolet A (UVA) light and riboflavin (vitamin B2) is a relatively new treatment that has been reported to slow or halt the progression of the disease in its early stages.

Orbital presentation of a nasal midline destructive lesion in a young boy.

Midline Destructive Lesions (MDL) are well known to cause nasal problems. There is a long differential diagnosis of such lesions. However, in the pediatric population, the 2 main diseases to be aware of are Non-Hodgkin's T-cell lymphoma and granulomatosis with polyangiitis (previously known as Wegener's granulomatosis).

Rare case of post-cataract-surgery Prevotella endophthalmitis diagnosed by polymerase chain reaction DNA sequencing.

We report the presentation, diagnosis, and management of endophthalmitis caused by the opportunistic Prevotella species. The case was referred to us following uneventful phacoemulsification and intraocular lens implantation. Accurate identification of this rare cause of endophthalmitis was made using bacterial polymerase chain reaction DNA sequencing.

Ten-year experience of pulsed intravenous cyclophosphamide and methylprednisolone protocol (PICM protocol) in severe ocular inflammatory disease.

Aims: Severe ocular inflammation is a blinding ophthalmological emergency. This study evaluates the efficacy and patient tolerance of a validated regime of pulsed intravenous cyclophosphamide and methylprednisolone ('PICM protocol') for these patients.

Methods: 26 patients with severe inflammatory eye disease (43 eyes: 22 uveitis, 21 scleritis/sclerokeratitis; median age 52 years (IQR 40.

High rate of incomplete resection after primary excision of eyelid BCC: multi-staged resection rarely needs more than two procedures.

Purpose: Small, well-demarcated, biopsy-proven periocular basal cell carcinomas (BCC) are often excised in a single stage with immediate reconstruction when histology or location is considered low-risk. We investigated margin clearance in patients undergoing primary excision and immediate reconstruction (PER) versus multi-staged fast paraffin excision (MSE) and reviewed risk factors for incomplete excision.

Methods: Retrospective, interventional, comparative case series of periocular BCCs excised over a 3-year period (2006-2008).

Beware the ornamental plant.

A keen female gardener presented to the emergency department of the hospital with a large corneal abrasion, conjunctival injection, an anterior chamber reaction and a hypopyon. She put it down to trauma that day while gardening, as she had been pruning her patio plant. The Euphorbia species of ornamental plants have been known to cause an intense reactive anterior uveitis and kerato-conjunctivitis caused by the milky sap it produces.