Browsing by Author "Ntim-Amponsah, C.T."

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Alternate Eye Care Services in a Ghanaian District
(Ghana Medical Journal, 2005-03) Ntim-Amponsah, C.T.; Amoaku, W.M.K.; Ofosu-Amaah, S.
OBJECTIVE: To determine eye care services sought outside the regular hospital system and their providers. STUDY SETTING: Akwapim South district METHOD: Questionnaire survey and in depth interviews. RESULTS: We recruited 1,537 persons with a previous history of eye disease and alternate service providers (21 chemical shop attendants and 55 herbalists). There was no significant difference between patronage of the regular and the alternative providers (p value 0.78). Most of the herbalists were trained by relations; parents (29/55) and grandparents (10/55). Two thirds had some formal education and 96% practiced part-time. Over 75% claimed they treated cataracts, eye injuries, and "kooko" and 28% also treated red eyes. Chemical shop attendants were all literates, sold only antibiotic eye drops, and 64% practiced full time. CONCLUSIONS: Herbalists and chemical sellers provided substantive eye care along the regular hospital services but some of their practices may be harmful.
Causes of childhood visual impairment and unmet low-vision care in blind school students in Ghana
(International Ophthalmology, 2008-10) Ntim-Amponsah, C.T.; Amoaku, W.M.K.
The purpose of this study was to determine the causes of childhood visual impairment and blindness in students of a school for blind children, to determine how many students had some residual vision, and to evaluate any unmet low-vision care. A survey of students in the blind school was conducted in two parts in May-June and then October 2003. The sample consisted of 201 students who became blind before the age of 16. Information was obtained from student interviews, doctors' referral notes and ophthalmic examination of all students who consented. Students with residual vision had low-vision assessments. These investigations were supplemented with active participation of the investigators in Parent-Teacher Association meetings and focus group discussions with parents. One hundred and ninety-nine students consented and were recruited, whereas two declined. Ninety-six became visually impaired within their first year of life and 33 by the age of 5 years. Pathology of the cornea and then the lens were the commonest causes of blindness. One hundred and eight students were totally blind, whereas 87 (43.7%) had some residual vision and formed the target for the second part of the study. Fifty-one out of 77 of this target group who turned up for low-vision examination had useful residual vision by the World Health Organisation (WHO) low-vision examination chart. Spectacle magnifiers aided two students to read normal print at N5 and N8, respectively. Different visual aids would help enhance the residual vision in some of the others. Emotional trauma was apparent in parents and teachers. Children who became blind later in life remained in shock for a longer time and adapted less well to their visual impairment. Visual impairment in the population is not uncommon. Some causes are preventable. There is a significant unmet need for low-vision care, particularly amongst children in Ghana, and perhaps many countries in the West Africa subregion. It is hoped that the findings from this study will help spur sustained interventions. © Springer Science+Business Media B.V. 2007.
Combined trabeculotomy and trabeculectomy: outcome for primary congenital glaucoma in a West African population.
(Eye, 2011) Essuman, V.A.; Braimah, I.Z.; Ndanu, T.A.; Ntim-Amponsah, C.T.
PURPOSE: To evaluate the surgical outcome of combined trabeculotomy-trabeculectomy in Ghanaian children with primary congenital glaucoma. MATERIALS AND METHODS: A retrospective case series involving 19 eyes of 12 consecutive children with primary congenital glaucoma who had primary trabeculotomy-trabeculectomy from 12 August 2004 to 30 June 2008, at the Korle-Bu Teaching Hospital, Ghana. Main outcome measures were preoperative and postoperative intraocular pressures, corneal diameter, corneal clarity, bleb characteristics, duration of follow-up, surgical success, and complications. RESULTS: A total of 19 eyes of 12 patients met the inclusion criteria. Six of the patients were males. Mean age at diagnosis was 4.4 (range 2-8) months. Mean age at surgery was 5.9 months (range 3-16). Eight (67%) infants had bilateral disease. Mean duration of follow-up was 13.1 (range 5-38) months. The preoperative mean horizontal corneal diameter was 13.4 ± 1.1(range 12-16) mm. Complete success (intraocular pressure <21 mm Hg) was obtained in 15 (79%) eyes. The probability of success was 94.4, 83.3, 66.7, 44.4, 38.9, 33.3, and 13.3% at 3, 6, 9, 12, 15, 18, and 21 months, respectively (Kaplan-Meier analysis). All eyes had corneal oedema preoperatively. Seventeen eyes (90%) had clear cornea at their last follow-up. Mean preoperative and postoperative intraocular pressures were 30.3 ± 8.8 and 18.1 ± 6.8 mm Hg respectively (P<0.001, t-test). Twelve (63%) eyes had well-functioning blebs at the last follow-up. One eye (5%) developed seclusio pupillae and cataract postoperatively. CONCLUSION: The overall success for combined trabeculotomy-trabeculectomy in Ghanaian children with primary congenital glaucoma was 79%. The probability of success reduced from more than 66% in the first 9 months postoperatively to below 45% after that.
Contribution of Refractive Errors to Visual Impairment in Patients at Korle-Bu Teaching Hospital
(Ghana Medical Journal, 2007-06) Ntim-Amponsah, C.T.
Objective: To determine the contribution of refractive error to visual impairment in visually impaired patients attending Korle-Bu Teaching Hospital, Ghana. Method: This study was conducted over a period of 1 year beginning October 2002 at Korle-Bu Teaching Hospital. Every 4th consecutive new case attending the eye clinic, aged 6 years and above was selected and interviewed using a structured questionnaire. A Snellen’s chart was used to determine the unaided visual acuity, visual acuity with spectacles where the patient was wearing one, and visual acuity with pin hole with or without spectacles. Improvement in visual acuity by 2 or more lines on the Snellen’s chart when looking through the pin hole was regarded as an indication of refractive error. Results: A total of 1,069 respondents, 594 female and 475 male were recruited into the study. One hundred and fifteen (115) patients (10.76%) were found to have impaired vision (Visual acuity worse than 6/18 to PL in the better eye). The vision of 51 of those with impaired vision improved when looking through the pin hole. Refractive error with Visual Acuity worse than 6/18 was present in 4.8% of all patients who attended the eye clinic. Refractive error was present in 44.3% of patients with visual impairment. Conclusion: Visual impairment was a common presentation and uncorrected refractive error was a major cause of visual impairment.
Dermis-fat grafts and enucleation in children in a West African population
(2013-03-03) Essuman, V.A.; Tagoe, N.N.; Ndanu, T.A.; Ntim-Amponsah, C.T.
Dermis-fat grafts and enucleation in Ghanaian children: 5 years' experience
(Ghana medical journal, 2014-12) Essuman, V.A.; Tagoe, N.N.; Ndanu, T.A.; Ntim-Amponsah, C.T.
BACKGROUND: Enucleation in young children often results in retarded orbital growth ipsilaterally. The need for an implant that will naturally grow with the child, like Dermis-fat Graft (DFG), for managing the anophthalmia has been of interest over the years.OBJECTIVE: To evaluate the use of DFG as an implant for volume replacement post-enucleation.STUDY DESIGN: A prospective non-comparative case series involving 18 consecutive children who had DFG either primarily or secondarily in conjunction with enucleation for intraocular pathologies, from December 2007 to September 2012, at the ophthalmology unit, Korle-Bu. Data from patients who had a minimum of three months follow up(FUP) were analysed.OUTCOME MEASURES: Complete covering of DFG with healthy conjunctiva, increase in volume of DFG, and presence or absence of complications.RESULTS: Fifteen patients were analysed, aged nine months to ten years (mean (SD), 3.7±2.7years). Eight (53.3%) were females. Thirteen (86.7%) DFGs were secondary and 2(13.3%) primary. Indications for enucleation were intraocular retinoblastoma (n=10, 66.7%), unexplained retinal detachment mimicking retinoblastoma (n=3,20.0%), anterior staphyloma (n=1,6.7%) and medulloepithelioma (n=1,6.7%). Fourteen (93.3%) patients showed increase in volume of DFG. Time for Conjunctival reepithelialisation of the dermal surface was four to fourteen weeks (mean/median=5.5/4.0). Complications encountered were infection (n=1,6.7%), infection with necrosis (n=1,6.7%), melanosis /keratinization (n=2, 13.3%) and cysts(n=2,13.3%). The patients were followed up for 3 to 54 months (mean/median 20.13 /16.00).CONCLUSION: DFG for management of post-enucleation anophthalmia in Ghanaian children showed 93.3% success.
Epidemiology and recurrence rate of pterygium post excision in Ghanaians
(Ghana medical journal, 2014) Essuman, V.A.; Ntim-Amponsah, C.T.; Vemuganti, G.K.; Ndanu, T.A.
To determine the epidemiology and recurrence rate of pterygium after excision using bare sclera technique.DESIGN: Prospective non-comparative study.SETTING: Ophthalmology unit, Korle-Bu Teaching Hospital, Accra, Ghana.METHODS: The study involved 60 consecutive patients with primary apterygial from July 1998 to December 2000 who had bare sclera excision after informed consent. They were post-operatively followed up for 30-months.RESULTS: Thirty-five patients (58%) were females. The patients' ages ranged from 17-75 years, mean (±12.6). Overall recurrence was 22(37%). The main complications encountered include were granuloma 20 %(n=12), restriction in medial rectus muscle motility 2(3%), persistent vascularisation at excision site 2(3%) and adherence leucoma with uveitis 1(2%). No significant association was found between recurrence and pterygium morphology, calcification, allergy and occupation (indoor or outdoor).CONCLUSION: The recurrence rate after pterygium excision using bare sclera technique in Ghanaians is high (37%).
Epidemiology of Glaucoma: A Population Study in the Akwapim South District of Ghana
(University of Ghana, 2003-04) Ntim-Amponsah, C.T.; Amoako, W.M.K.; Oosu-Amaah, S.; University of Ghana, College of Health Sciences, School of Public Health
Modem Eye care in Ghana is making progress in prevention of blindness from cataract, onchocerciasis and trachoma, but stuck with glaucoma that remains the leading cause of permanent blindness in Ghana. This project addresses issues on the epidemiology of glaucoma by determining the magnitude of the burden of Primary Open Angle Glaucoma by a prevalence study in the Akwapim South district of Ghana. It looks at the factors related to advanced damaging effect on vision, socio-cultural and alternate eye care factors that influence eye care. A total of 1.843 people aged 30 years and above were screened in a crosssectional population survey. A prevalence of 6.6% with a 95% confidence interval of 5.46 to 7.76 and an exponential trend line for prevalence/age relationship was found in the 30-64year age group. A case- control study recruiting 123 patients with early features of glaucoma (control) and 93 patients with advanced glaucoma (cases) was also carried out for risk-factor analysis. Highest level of intra ocular pressure before treatment was the single most important factor associated with advanced visual loss and this was overwhelmingly significant. Adjusted Odd’s ratio of glaucoma by multiple logistic regression model showed that intraocular pressure> 31mmHg in a patient was nearly 3 times more likely to present with advanced glaucoma (OR 2.66, 95% confidence interval 1.45, 4.91, p value 0.0017). Other factors which were tested but showed weak associations that did not reach significant level were age, sex, family history of glaucoma, occupation, and ethnicity. Data was collected in the population by questionnaire on demographic data and awareness, knowledge and health seeking behaviour related to eye care. The details of the questionnaire included age, gender, and occupation, the respondent's definition/understanding of blindness, causes of blindness known, or cause of action taken in face of an eye disease, past history of eye disease and the individual's knowledge and attitudes to glaucoma Cataract ranked as the most common cause of blindness respondents were aware of (77.2% of respondents) followed closely by eye injuries (71.9%). More than half the respondents were also aware of “kooko” (55.7%) and old age related (54.7%). Only 3.6% were aware that glaucoma causes blindness and 1% (23/1785) of the population knew it may be hereditary. About 3.6% (64/1785) were aware of glaucoma as an eye disease but only 0.8% (15/1785) knew that the disease glaucoma is related to optic nerve damage and, or intraocular pressure. A person in the higher occupational levels was 9 times more likely to understand glaucoma than the lower levels (OR 0.11, 95% Cl 0.04-0.3, Pvalue 0.0001). “Kooko" is the indigenous name for piles however it turned out to be an ubiquitous disease that can affect any part of the body including the eye. Nearly half (47%) of respondents used hospital/clinic services while the other half (49%) used chemical stores1, herbalists, or self-prescribed medication from the last 2 service providers. This data confirms the view that significant eye care services are also provided by chemical sellers and herbalists. It also indicates that the people patronised the services of these alternate service providers as much as they patronised the hospitals and clinics using chi square test (P value 0.78). Information was collected independently by questionnaire and interviews from 21 chemical sellers and 60 herbalists identified by informants. The chemists sold only antibiotic eye drops that were used as first line treatment for all cases they saw. The herbalists claimed they treat cataract 82%, eye injuries 82%, kooko 75%, and Apollo 28%2 of respondents. None of them were aware of or treated glaucoma. The routes of administration of the herbal medicine for eye disease were instillation into the eye and nose 50%, instillation into the eye 25%, oral and eye 10%, oral and nasal, and ocular 10% and only oral only 5% of respondents. Although glaucoma prevalence is high in the Akwapim South district the level of awareness is low in the population, chemical sellers, and herbalists who provide about half of eye care services in the district. The level of the initial intra ocular pressure is the most important factor in determining extent of visual damage.
Evaluation of risk factors for advanced glaucoma in Ghanaian patients
(Eye, 2005-05) Ntim-Amponsah, C.T.; Amoaku, W.M.K.; Ewusi, R.K.; Idirisuriya-Khair, R.; Nyatepe-Coo, E.; Ofosu-Amaah, S.
Purpose: This study was to determine factors associated with individuals presenting late with advanced glaucomatous optic nerve damage. Methods: A case-control study recruiting 123 patients with early features of primary open angle glaucoma (control) and 93 patients with advanced glaucoma (cases) was carried out for risk-factor analysis. Exposures of interest included those already established as major risk factors for glaucoma. These were initial intraocular pressure (IOP), age, and family history. In addition, occupation, ethnic origin, history of diagnosis of diabetes mellitus, hypertension, sickle cell disease, and previous eye examination were of interest. Results: Univariate analysis showed that initial IOP>31mmHg, age of > 60 years, absence of family history of glaucoma, occupational grouping, ethnicity, and male sex were associated with advanced glaucoma at presentation. Adjusted odds ratio or by multiple logistic regression model showed that initial IOP>31mmHg in a patient was more likely to present with advanced glaucoma (OR 2.66, 95% confidence interval (CI) 1.45, 4.91; P-value 0.0017) than lower pressures. Patients aged 60-69 years (OR 2.53, 95% CI 1.01, 6.31; P-value 0.0473) and 70-90 years (OR 5.16, 95% CI 1.97, 13.51; P-value 0.0008) were more likely to present with advanced glaucoma than younger ones. Conclusions: Subjects with initial IOP>31 mmHg were nearly three times more likely to present with advanced glaucoma than those with IOP<32mmHg. Subjects over the age of 60 years were more than two times likely to present with advanced glaucoma than younger subjects. © 2005 Nature Publishing Group All rights reserved.
Prevalence of glaucoma in an African population
(Eye, 2004-06) Ntim-Amponsah, C.T.; Amoaku, W.M.K.; Ofosu-Amaah, S.; Ewusi, R.K.; Idirisuriya-Khair, R.; Nyatepe-Coo, E.; Adu-Darko, M.
Purpose. To determine the prevalence of primary open-angle glaucoma (POAG) in a Ghanaian population aged 30 years and above and to describe any ethnic variations in glaucoma prevalence in this population. Method. A cross-sectional prevalence survey for POAG was carried out on residents of 30 years and above in the Akwapim-South district of Ghana. The principal investigator examined all glaucoma suspects and those diagnosed as glaucoma in the initial screening to determine all definite cases of POAG. All cases had intraocular pressure measurements. Glaucoma cases and suspects and some normal subjects had fundus biomicroscopy with 78 D Volk lens, and Humphrey FDT N-30 visual fields plotted. Results. A total of 1843 people aged 30 years were screened from the population. The standardized age-specific prevalence was 7.7% (30 years and above) and 8.5% (40 years and above). The best-fit trend line for prevalence/age relationship was exponential. No gender or ethnic difference in prevalence was found. Conclusions. The prevalence of POAG in this population is high and comparable to those in black populations in Barbados and St. Lucia. © 2004 Nature Publishing Group All rights reserved.
Prevalence of refractive error and other eye diseases in schoolchildren in the Greater Accra region of Ghana
(Journal of Pediatric Ophthalmology and Strabismus, 2007-09) Ntim-Amponsah, C.T.; Ofosu-Amaah, S.
Purpose: To determine the prevalence of refractive error and other eye diseases in schoolchildren in the Greater Accra region of Ghana. Methods: Research assistants tested visual acuity (VA) using a Snellen chart in students randomly selected from 24 schools (ie, 8 metropolitan, 8 urban, and 8 rural). An ophthalmologist examined students with VA of 6/12 or worse in either eye and students with other eye problems. Results: Nine hundred fifty-seven students aged 6 to 22 years were screened: 67 had myopia with VA of 6/12 or worse in the better eye, 3 were unilaterally blind (2 from squint or amblyopia, 1 from a hypoplastic disk), and 4 had unilateral low vision from macular scars. Other eye diseases observed were congenital glaucoma (1), vernal conjunctivitis (2), and infective conjunctivitis (6). The prevalence of refractive error reducing vision to at least 6/12 was 7.0%. The prevalence of squint and amblyopia was 0.2%. Conclusion: The most common eye defect in the students was refractive error. Squint and amblyopia were rare.
A Prospective Trial Of Postoperative Lodoxamide (Alomide) On Pterygium Recurrence
(Ghana Medical Journal, 2015-12) Essuman, V.A.; Ntim-Amponsah, C.T.; Vemuganti, G.K.; Ndanu, T.A.
Background: To compare pterygium recurrence after bare sclera excision with and without topical lodoxamide. Design: Randomised double-blind study. Methods: The study involved 61 patients with primary pterygia who had bare sclera excision after informed consent. They were post-operatively treated by either of 2 treatment groups for 4 weeks, with a 30-months follow-up: Controls/placebo = Guttae prednisolone 1% with chloramphenicol 0.5% plus guttae distilled water. Test group = Guttae prednisolone 1% with chloramphenicol 0.5% plus guttae lodoxamide 0.1%. Results: Sixty patients were analysed. Control Group had 20 females and 10 males, aged 28-69.5 years, mean 42.0(± 10.9). Test Group had 15 males and 15 females, aged 17-75 years, mean 46.0(±12.6). Recurrence for the Test Group was 11(37%) within 30 months and 11(37%) for the Control Group within 30 months (OR=1.00, CI: 0.35-2.858). Main complications encountered were granuloma: 7(11.7%) from the controls and 5(8.3%) from the test group; restriction in the motility of medial rectus muscle: 1(1.7%) from each group; persistent vascularisation at site of excision: 1(1.7%) from each group and adherence leukoma with uveitis 1(1.7%) from the control group, the latter also had persistent peripheral corneal epithelial defect later resulting in a dellen. No significant difference was found between the treatment groups with respect to recurrence, type and time of complications, orientation and morphology of pterygium, P>0.05. Conclusion: The recurrence of pterygium is high (about one third) with or without the use of adjuvant lodoxamide.
Response to Dr Rao
(Eye (London, England), 2011-07) Essuman, V.A.; Braimah, I.Z.; Ndanu, T.A.; Ntim-Amponsah, C.T.
Retinopathy in severe malaria in Ghanaian children - overlap between fundus changes in cerebral and non-cerebral malaria
(2010-08-12) Essuman, V.A.; Ntim-Amponsah, C.T.; Astrup, B.S.; Adjei, G.O.; Kurtzhals, J.A.L.; Ndanu, T.A.; Goka, B.
Abstract Background In malaria-endemic areas, reliably establishing parasitaemia for diagnosis of malaria can be difficult. A retinopathy with some features unique to severe malaria with a predictive value on prognosis, has been described. Detection of this retinopathy could be a useful diagnostic tool. This study was designed to determine the diagnostic usefulness of retinopathy on ophthalmoscopy in severe malaria syndromes: Cerebral malaria (CM) and non-cerebral severe malaria (non-CM), i.e. malaria with respiratory distress (RD) and malaria with severe anaemia (SA), in Ghanaian children. Secondly, to determine any association between retinopathy and the occurrence of convulsions in patients with CM. Methods and subjects A cross-sectional study of consecutive patients on admission with severe malaria who were assessed for retinal signs, at the Department of Child Health, Korle-Bu Teaching Hospital, Accra, from July to August 2002 was done. All children had dilated-fundus examination by direct and indirect ophthalmoscopy. Results Fifty-eight children aged between six months and nine years were recruited. Twenty six(45%) had CM, 22 with convulsion; 26(45%) had SA and six(10%) had RD. Any retinopathy was seen in: CM 19(73%), SA 14(54%), RD 3(50.0%), CM with convulsion 15(68%) and CM without convulsion 4(100%). Comparison between CM versus non-CM groups showed a significant risk relationship between retinal whitening and CM(OR = 11.0, CI = 2.2- 56.1, p = 0.001). There was no significant association with papilloedema(OR = 0.9, CI = 0.3 - 3.0, p = 0.9), macular whitening(OR = 1.6, CI = 0.5 - 4.8, p = 0.4), macular haemorrhage(OR = 0.28, CI = 0.03 - 2.7 p = 0.2), retinal haemorrhage(OR = 1.9, CI = 0.6 - 5.6, p = 0.3), vessel abnormality(OR = 1.9, CI = 0.6 - 6.1, p = 0.3) and cotton wool spots(OR not calculated, p = 0.08). Tortuous and engorged retinal veins, not previously described as a feature of CM, was the most common vascular abnormality(15/58 = 26%) and was detected even in the absence of papilloedema. Conclusion Retinal whitening, a sign suggestive of retinal ischaemia, was significantly more common in CM than in non-CM syndromes. However, the high prevalence of any retinopathy in the latter suggests that the brain and the retina may be suffering from ischaemia in both CM and non-CM.
Retinopathy in severe malaria in Ghanaian children - overlap between fundus changes in cerebral and non-cerebral malaria.
(Malaria Journal, 2010) Essuman, V.A.; Ntim-Amponsah, C.T.; Astrup, B.S.; Adjei, G.O.; Kurtzhals, J.A.; Ndanu, T.A.; Goka, B.
Background: In malaria-endemic areas, reliably establishing parasitaemia for diagnosis of malaria can be difficult. A retinopathy with some features unique to severe malaria with a predictive value on prognosis, has been described. Detection of this retinopathy could be a useful diagnostic tool. This study was designed to determine the diagnostic usefulness of retinopathy on ophthalmoscopy in severe malaria syndromes: Cerebral malaria (CM) and non-cerebral severe malaria (non-CM), i.e. malaria with respiratory distress (RD) and malaria with severe anaemia (SA), in Ghanaian children. Secondly, to determine any association between retinopathy and the occurrence of convulsions in patients with CM. Methods and subjects: A cross-sectional study of consecutive patients on admission with severe malaria who were assessed for retinal signs, at the Department of Child Health, Korle-Bu Teaching Hospital, Accra, from July to August 2002 was done. All children had dilated-fundus examination by direct and indirect ophthalmoscopy. Results: Fifty-eight children aged between six months and nine years were recruited. Twenty six(45%) had CM, 22 with convulsion; 26(45%) had SA and six(10%) had RD. Any retinopathy was seen in: CM 19(73%), SA 14(54%), RD 3(50.0%), CM with convulsion 15(68%) and CM without convulsion 4(100%). Comparison between CM versus non-CM groups showed a significant risk relationship between retinal whitening and CM(OR = 11.0, CI = 2.2- 56.1, p = 0.001). There was no significant association with papilloedema(OR = 0.9, CI = 0.3 - 3.0, p = 0.9), macular whitening(OR = 1.6, CI = 0.5 - 4.8, p = 0.4), macular haemorrhage( OR = 0.28, CI = 0.03 - 2.7 p = 0.2), retinal haemorrhage(OR = 1.9, CI = 0.6 - 5.6, p = 0.3), vessel abnormality (OR = 1.9, CI = 0.6 - 6.1, p = 0.3) and cotton wool spots (OR not calculated, p = 0.08). Tortuous and engorged retinal veins, not previously described as a feature of CM, was the most common vascular abnormality(15/58 = 26%) and was detected even in the absence of papilloedema. Conclusion: Retinal whitening, a sign suggestive of retinal ischaemia, was significantly more common in CM than in non-CM syndromes. However, the high prevalence of any retinopathy in the latter suggests that the brain and the retina may be suffering from ischaemia in both CM and non-CM.
A study of central corneal thickness in glaucoma and nonglaucoma patients in a West African population.
(Cornea, 2012) Ntim-Amponsah, C.T.; Seidu, A.Y.; Essuman, V.A.; Fordjour, D.; Tagoe, N.N.; Coker, A.; Adam-Zakariah, L.I.
PURPOSE: To compare central corneal thickness (CCT) in high-tension glaucomatous eyes and nonglaucomatous eyes with normal intraocular pressure (IOP) and to determine if there is any correlation between CCT and severity of glaucoma, as indicated by vertical cup-to-disc ratio. METHODS: A case-control study that involved 506 subjects at the Korle-Bu Teaching Hospital, Accra, Ghana, from August 2006 to July 2007. The cases were patients with (high tension and IOP more than 21 mm Hg) primary open-angle glaucoma, and the controls were patients with normal IOP (less than 21 mm Hg) and no evidence of glaucoma. The main outcome measures were CCT, as measured by ultrasonic pachymetry (model DGH 55 pachmate), and vertical cup-to-disc ratio. RESULTS: Five hundred six subjects were recruited: 253 cases (506 eyes) and 253 controls (505 eyes). The mean CCT of the right eye for the glaucoma cases was 524.28 μm [95% confidence interval (CI), 4.44; SD, 36.85] and for the controls was 530.00 μm (95% CI, 4.56; SD, 35.75). The mean CCT of the left eye for the glaucoma cases was 524.70 μm (95% CI, 4.48; SD, 36.20) and for the controls was 531.06 μm (95% CI, 4.40; SD, 35.52). The relation between CCT and cupping determined by Pearson correlation coefficient yielded values of -0.09 and 0.01 for the right and left eyes, respectively. CONCLUSION: There was no significant difference between mean CCT of cases and controls in the right eye (P = 0.08), but there was a weakly significant difference in the CCT of the left eye (P = 0.05). Also, there was no correlation between cup-to-disc ratio and CCT.
A survey of hereditary colour vision defect in Ghanaian students
(Ghana Medical Journal, 2001-06) Ntim-Amponsah, C.T.; Edirisuriya, R.D.H.
The colour vision of 2,524 Ghanaian students made up of 1296 female and 1228 males were assessed in a cross-sectional survey, Eighty-seven students had hereditary colour vision defects. Red-Green defect accounted for 83 out of 87 of the colour blindness detected made up of 74 /1228 (6.02%) of the male and 9/1296 (0.69%) of the female population. The prevalence of red-green colour blindness IS significantly higher in males than females. We think it will be helpful and worth screening male students for colour vision defects to create awareness among parents, students and teachers and guide career planning.
Visual loss in urban and rural chronic glaucoma patients in Ghana
(Tropical Doctor, 2002-05) Ntim-Amponsah, C.T.
The visual acuity of newly diagnosed glaucoma patients in a rural and an urban area were compared in a hospital-based cross-sectional study in Ghana. Age at presentation was strikingly higher in the rural group due to local factors which result in a difference-in-age structure of the rural and urban population. The crude relative frequency of bilateral blindness was significantly higher for rural than urban. However, with age adjusted relative frequencies for bilateral blindness there was no significant difference between rural and urban patients. There was significant difference between them for those aged 51–71 when blindness in one or both eyes were considered together. There was more consistent blindness in the rural community: the difference was attributed to local factors such as better access to eye care in the urban group. © 2002, SAGE Publications. All rights reserved.