Browsing by Author "Tagoe, N.N."
Now showing 1 - 10 of 10
Results Per Page
Sort Options
Item Case series of six patients diagnosed and managed for idiopathic intracranial hypertension at a tertiary institution eye centre(Ghana medical journal, 2019-03-01) Amissah-Arthur, K.N.; Tagoe, N.N.; Beyuo, V.M.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. However, six cases were seen within a 6-month period, prompting the need to study the clinical features of IIH in this population. Objective: We aim to evaluate the clinical features of patients presenting with IIH at KBTH. Methodology: This is a retrospective case series with contemporaneous collection of data of six patients who presented to the Eye Centre (KBTH) between October 2016 and March 2017 with clinical features suggestive of IIH. The patients were evaluated and diagnosed based on clinical judgement as well as using the modified Dandy criteria. Results: All six patients were female and all except one were obese. The age range was 8 to 40 years with median 22.5 years. Symptoms in the 8-year-old were preceded by oral doxycycline for acne treatment. One patient had a history of using oral contraceptive pills prescribed for irregular menses. Clinical features of blurred vision, headache, and papilloedema were relieved with oral acetazolamide. Conclusion: The upsurge of IIH may be due to the increased incidence of obesity in Ghana. Timely diagnosis and treatment is needed to avoid irreversible blindnessItem 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.Item 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.Item Incidence and risk factors of steroid-induced ocular hypertension following pterygium excision with conjunctival autograft(https://doi.org/10.46829/hsijournal.2023.6.4.1.448-456, 2023) Toseafa, R.D.K.; Braimah, I.Z.; Tagoe, N.N.; Abaidoo, B.; Adam, Y.S.; Dogbe, E.M.; Essuman, V.A.Background: Topical steroids are used to reduce post-operative inflammation after ocular surgery with the potential risk of ocular hypertension, glaucoma and blindness. There is a paucity of published data globally and locally on steroid-induced ocular hypertension (SiOH) post pterygium excision (PE) with conjunctival autograft (CAG). Objective: We aimed to determine the incidence and risk factors of SiOH post-PE with CAG in Korle-Bu Teaching Hospital, Accra, Ghana. Methods: In this prospective observational study, the demographic and clinical data of patients undergoing PE with CAG were collected and analyzed. Post-operative intraocular pressures (IOP) were measured on days 1, 7, 14, 28, and 42. The cumulative incidence of SiOH (proportion of the increase in IOP ≥ 10mm Hg at six weeks compared to baseline) and mean change in IOP from baseline were computed. Risk factors of SiOH were determined using a multiple logistic regression model. The Kaplan-Meier survival curve was used in estimating the median time to develop SiOH. Results: Overall, 101 patients participated in this study with a mean age of 46.8 ± 11.9 years. The majority (65.3%, n= 66/101) of participants were females. The mean pre-operative IOP in the study eyes was 15.3 ± 3.0 mm Hg. The overall mean post-operative IOP was 18.6 ± 2.8 mm Hg (p = 0.001). The overall incidence of SiOH six weeks post-PE with CAG was 32.7% (95% confidence interval (CI) = 23.7 - 42.7%). Male sex was the only independent factor associated with the development of SiOH [odds ratio (OR) = 3.3; 95% CI = 1.1 - 9.7; p = 0.032]. The median time to develop SiOH was 42 days (95% CI = 37.1 - 46.9 days, p = 0.022). Conclusion: The study showed that SiOH post-PE is a common complication with an overall six-weeks post-excision incidence of 32.7%. Males are more likely to develop SiOH after PE with CAG. Patients undergoing PE with CAG should be closely monitored postoperatively to prevent complications associated with prolonged raised IOP.Item Morbidity and Complications of Diabetes Mellitus in Children and Adolescents in Ghana: Protocol for a Longitudinal Study(2021) Essuman, V.A.; Tagoe, N.N.; Akpalu, J.; Essuman, A.; Sackey, A.H.; Hayfron-Benjamin, C.F.; Asare, G.; Abaidoo, B.; A.G.B. Amoah; Ndanu, T.; Ofori-Adjei, I.D.B.; N.A. Barnes; Appiah-Thompson, B.L.; Amoaku, W.M.Background: Diabetes is associated with premature morbidity and mortality from its many complications. There are limited data on the chronic complications of diabetes in children and adolescents in sub-Saharan Africa. Objective: The study aims to determine the (1) burden and related factors of chronic systemic complications of diabetes, including diabetic and nondiabetic ocular conditions in children and adolescents, and (2) quality of life (QoL) of participants compared to healthy controls. This manuscript describes the study methodology. Methods: Demographic information, medical history, anthropometric measurements, and laboratory characteristics were collected, and the participants were screened for microvascular and macrovascular complications as well as nondiabetic ocular disease. QoL questionnaires were administered to participants, their caregivers, and controls. Participants were followed up annually up to 3 years to determine the natural history of and trends in these conditions. SPSS Version 25.0 will be used for data analysis. Continuous and categorical data will be presented as mean (SD) and as percentages (%), respectively. t tests and analysis of variance will be used to compare means, and chi-square tests will be used to compare categorical data. Correlation, regression, and logistic regression analyses will be employed to establish linear associations and causal associations as appropriate. Relative risk and odds ratios will be used to estimate risk. QoL outcomes in Ghanaian children and adolescents with diabetes mellitus compared with caregivers and healthy controls will be assessed using the Pediatric Quality of Life inventory. Significance will be set at α=.05. Results: Institutional approval from the Ethical and Protocol Review Committee of the University of Ghana Medical School was received on August 22, 2014 (Protocol Identification Number: MS-Et/M.12-P4.5/2013-2014). Funding for the project was received from the University of Ghana Research Fund (#UGRF/9/LMG-013/2015-2016) in March 2016. Patient recruitment, clinical examination, and data collection commenced in August 2016 and was completed in September 2019. A total of 58 children and adolescents with diabetes mellitus have been recruited. Blood samples were stored at –80 °C for analysis, which was completed at the end of July 2020. Data analysis is ongoing and will be completed by the end of December 2020. Investigators plan to submit the results for publication by the end of February 2021. Conclusions: The prevalence, natural history, trends in diabetic complications and nondiabetic ocular disease, and QoL will be provided. Our data may inform policies and interventions to improve care given to children and adolescents with diabetes.Item Morbidity and Complications of Diabetes Mellitus in Children andAdolescents in Ghana:Protocol for a Longitudinal Study(JMIR Research Protocols, 2021) Essuman, V.A.; Tagoe, N.N.; Akpalu, J. et.alBackground: Diabetes is associated with premature morbidity and mortality from its many complications. There are limiteddata on the chronic complications of diabetes in children and adolescents in sub-Saharan Africa.Objective: The study aims to determine the (1) burden and related factors of chronic systemic complications of diabetes,including diabetic and nondiabetic ocular conditions in children and adolescents, and (2) quality of life (QoL) of participantscompared to healthy controls. This manuscript describes the study methodology.Methods: Demographic information, medical history, anthropometric measurements, and laboratory characteristics werecollected, and the participants were screened for microvascular and macrovascular complications as well as nondiabetic oculardisease. QoL questionnaires were administered to participants, their caregivers, and controls. Participants were followed upannually up to 3 years to determine the natural history of and trends in these conditions. SPSS Version 25.0 will be used for dataanalysis. Continuous and categorical data will be presented as mean (SD) and as percentages (%), respectively. t tests and analysisof variance will be used to compare means, and chi-square tests will be used to compare categorical data. Correlation, regression,and logistic regression analyses will be employed to establish linear associations and causal associations as appropriate. Relative risk and odds ratios will be used to estimate risk. QoL outcomes in Ghanaian children and adolescents with diabetes mellituscompared with caregivers and healthy controls will be assessed using the Pediatric Quality of Life inventory. Significance willbe set at α=.05.Results: Institutional approval from the Ethical and Protocol Review Committee of the University of Ghana Medical Schoolwas received on August 22, 2014 (Protocol Identification Number: MS-Et/M.12-P4.5/2013-2014). Funding for the project wasreceived from the University of Ghana Research Fund (#UGRF/9/LMG-013/2015-2016) in March 2016. Patient recruitment,clinical examination, and data collection commenced in August 2016 and was completed in September 2019. A total of 58 childrenand adolescents with diabetes mellitus have been recruited. Blood samples were stored at –80 °C for analysis, which was completedat the end of July 2020. Data analysis is ongoing and will be completed by the end of December 2020. Investigators plan to submitthe results for publication by the end of February 2021.Conclusions: The prevalence, natural history, trends in diabetic complications and nondiabetic ocular disease, and QoL willbe provided. Our data may inform policies and interventions to improve care given to children and adolescents with diabetes.Item Neuro-ophthalmic and clinical characteristics of brain tumours in a tertiary hospital in Ghana(Ghana Medical Journal, 2015-09) Tagoe, N.N.; Essuman, V.A.; Fordjuor, G.; Akpalu, J.; Bankah, P.; Ndanu, T.Background Anecdotally, increasing number of patients are seen at Korle Bu Teaching Hospital (KBTH) with brain tumour. Neuro-ophthalmic symptoms and signs may help in timely diagnosis and intervention. Go to: Objective To evaluate the neuro-ophthalmic and clinical characteristics of brain tumour in patients presenting at a tertiary hospital in Ghana. Go to: Study design A prospective case series involving 36 consecutive patients newly diagnosed with brain tumour from November 2010 to October 2011, at the Ophthalmology, Neurosurgery and Endocrine units of KBTH, Ghana. All patients had clinical diagnosis of brain tumour with confirmation by computerized tomography (CT) or magnetic resonance imaging (MRI). Thirteen patients had histological confirmation of diagnosis. Go to: Outcome measures Presenting Visual acuity, Colour vision, Visual fields and Cranial nerve deficits. Go to: Results Data of 36 patients were analyzed. Ages ranged from 3 to 69years, mean (SD) 42.56(±16.6 years). Twenty-six (72%) were females. Tumours included pituitary adenoma (20,55.5%), meningioma(10,27.8%), choroid plexus tumour(1,2.8%), medulloblastoma(1,2.8%), craniopharyngioma(1,2.8%), haemangioblastoma(1,2.8%), thalamic tumour(1,2.8%) and haemangioma(1,2.8%). Histologically confirmed tumours included pituitary adenoma (9, 69.2%), meningioma (3, 23.1%), craniopharyngioma (1, 7.7%). One patient had both a pituitary adenoma and meningioma. Blurred vision (30, 83.3%), headache (28, 77.8%) and photophobia (13, 36.1%) were predominant symptoms. Commonest neuro-ophthalmic signs were impaired colour vision (62 eyes, 88.6%), optic atrophy (26, 74.3%), unilateral or bitemporal hemianopia (15, 41.5%) and relative afferent pupillary defect (12, 34.3%). Seven (19.4%) patients were visually impaired and nine (25%) blind. Thirty-three of 72(45.8%) eyes had monocular blindness. Go to: Conclusions Common neuro-ophthalmic characteristics were blurred vision, headache, impaired colour vision, optic atrophy, and relative afferent pupillary defect (RAPD). Significant numbers of patients were blind or visually impaired at presentation.Item Re: Neuro-ophthalmic and clinical characteristics of brain tumours in a tertiary hospital in Ghana(Ghana Medical Journal, 2016-03) Andrews, N.B.; Tagoe, N.N.The tumour frequencies quoted in the article are markedly different from prior reports published from Ghana. The prior published reports put Astrocytoma at 42%; meningioma 19% and pituitary adenoma at 11%.1 This poses a severe limitation on the article's results and conclusions that pituitary adenoma and meningioma are the commonest brain tumours as less than 50% of the pituitary adenomas and only 30% of the meningiomas were confirmed histologically. The article states that only 13 out of a total of 36 brain tumours that presented at the tertiary centre that has a dedicated neurosurgical department (and a training program for neurosurgical residents) were operated on during a 12 month period. It is stated that only 13 of the patients could afford surgery.Item 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.Item Visual Outcome of Patients with Pituitary Adenomas Following Surgery and Its Contributory Factors at a Tertiary Hospital in Ghana(Ethiopian journal of health sciences, 2019-01) Tagoe, N.N.; Essuman, V.A.; Bankah, P.; Dakurah, T.; Hewlett, V.K.; Akpalu, J.; Ndanu, T.A.Background Craniotomy and transphenoidal microsurgery are surgical options for treatment of pituitary adenoma at Korle Bu Teaching Hospital(KBTH). Despite major advances and reported success rates of transphenoidal resection globally, paucity of local data regarding visual outcome of either procedure exists. We evaluated the visual outcome of patient with pituitary adenoma following surgery in a tertiary hospital in Ghana. Methods This is a prospective study of 18 of 45 consecutive new patients with pituitary adenoma seen from November 2010 to July 2013 at Korle-Bu Teaching Hospital(KBTH), Accra, Ghana. Sixteen (88.9%) of the 18 had surgery by transphenoidal route and 2(11.1%) by craniotomy. All patients had macroadenoma (tumour size >1cm) and histological confirmation of diagnosis. Pre-operative and post-operative visual acuity and its relationship to tumour size and duration of symptoms before diagnosis were evaluated. Results Data on 18 patients aged 33–60 years, mean (SD) 45.9±8.5, was analysed. Eleven (61.1%) were females. Visual blur, 15(83.3%), and headache,13(72.2%), were predominant presenting complaints. Common neuro-ophthalmic signs included unilateral or bilateral optic atrophy, 17(94.4%), Relative Afferent Pupillary Defect (RAPD) in 8(44.4%) and impaired colour vision in 32 of 36(88.9%) eyes. Preoperatively, 8(22.2%) and 13(36.1%) of 36 eyes were visually impaired or blind respectively. Postoperatively, 6(16.7%) eyes were visually impaired and 17(47.2%) eyes blind. Blindness was associated with late presentation (p<0.005) and larger tumour width (p<0.036). Conclusions More than a third of eyes of patients with pituitary adenoma were blind before and after surgery. Blindness was associated with late presentation and larger tumours. Transphenoidal surgery may be beneficial following early diagnosis to avoid irreversible blindness/visual impairment.