Ophthalmic congenital anomalies: spectrum and systemic associations in a Nigerian tertiary hospital

Authors

  • Dr. A.I Ayede

Abstract

Background: To document the pattern of ophthalmic congenital anomalies and their associated systemic anomalies in Nigeria’s foremost university teaching hospital.

Methods: Retrospective cross-sectional study conducted at the University College Hospital, Ibadan from January 2009 to December 2013. Clinic and ward registers of various departments and units in the hospital were reviewed to identify children with any structural abnormality, present at birth, which involved the eye and/or its adnexae.

Results: Two hundred and forty eight children with 259 ophthalmic congenital anomalies were studied. The median age was 1.2 years with an interquartile range of 4.6 years. The male to female ratio was 1.27:1. Congenital cataract was found in 109 (44%) patients; 40 (15.4%) children had congenital glaucoma, and whole globe anomalies were observed in 18 (6.9%) children. Eighteen (7.9%) children had a family history of congenital anomalies. Associated systemic congenital anomalies were seen in 32 (12.9%) patients with the most common being cardiovascular anomalies in 13 (5.2%) patients. Children who had congenital cataracts were more likely to have multiple associated systemic anomalies (p<0.005). All the children who had associated cardiovascular anomalies had congenital cataracts (p= 0.001).

Conclusion: The commonest ophthalmic congenital anomaly presenting for tertiary care in Ibadan is congenital cataract. Cardiovascular anomalies are the commonest systemic association of ophthalmic congenital anomalies. There is an urgent need for the establishment of a registry for congenital anomalies with effective screening and active surveillance within the Nigerian health system.

Keywords: Ophthalmic, congenital, anomalies, surveillance

Résumé
Contexte: Pour documenter le profil des anomalies congénitales ophtalmiques et leurs anomalies systémiques associées dans l’hôpital universitaire le plus important du Nigéria.

Méthodes: Une étude rétrospective transversale menée au Collège Hospitalier Universitaire, Ibadan de janvier 2009 à décembre 2013. Les registres des cliniques et des salles de différents départements et unités de l’hôpital ont été examinés afin d’identifier les enfants présentant avec anomalies structurelles quelconques, présentes à la naissance, qui impliquaient l’œil et / ou ses annexes.

Résultats: Deux cent quarante-huit enfants avec 259 anomalies congénitales ophtalmiques ont été étudiés. L’âge médian était de 1,2 an avec un rang interquartile de 4,6 ans. Le rapport homme-femme était de 1,27: 1. La cataracte congénitale a été retrouvée chez 109 patients (44%); 40 (15,4%) enfants avaient un glaucome congénital et des anomalies globales ont été observées chez 18 (6,9%) enfants. Dix-huit (7,9%) enfants avaient des antécédents familiaux d’anomalies congénitales. Des anomalies congénitales systémiques associées ont été observées chez 32 (12,9%) patients avec les plus courantes étant des anomalies cardiovasculaires chez 13 patients (5,2%). Les enfants atteints de cataracte congénitale étaient plus susceptibles d’avoir de multiples anomalies systémiques associées (p <0,005). Tous les enfants qui avaient des anomalies cardiovasculaires associées avaient des cataractes congénitales (p = 0,001).

Conclusion: L’anomalie congénitale ophtalmique la plus fréquente pour les soins tertiaires à Ibadan est la cataracte congénitale. Les anomalies cardiovasculaires sont les plus fréquentes associations systémiques d’anomalies congénitales ophtalmiques. Il est urgent de créer un registre des anomalies congénitales avec un dépistage efficace et une surveillance active dans le système de santé Nigérian.

Mots-clés:
Ophtalmique, congénitale, anomalies, surveillance

Correspondence: Dr. A.I Ayede, Department of Paediatrics, College of Medicine, University of Ibadan, Ibadan, Nigeria. E-mail: idayede@yahoo.co.uk

References

Fredrick DR. Pre and postnatal growth of the eye, adnexa, visual system and emmetropization. In: Taylor D, Hoyt CS, (eds). Paediatric Ophthalmology and Strabismus. London: Elsevier Saunders; 2005: 26-31.

Guercio JR and Martyn LJ. Congenital malformations of the eye and orbit. Otolaryngol Clin North Am. 2007;40(1):113-140, vii.

Biswas J, Chakrabarti A and Das D. Rare association of familial aniridia, microcornea with myopia and aphakia. Middle East Afr J Ophthalmol. 2014;21(3):268-270.

Fries PD and Katowitz JA. Congenital craniofacial anomalies of ophthalmic importance. Surv Ophthalmol. 1990;35(2):87-119.

Okeigbemen V and Dawodu OA. Congenital anophthalmos in Benin city. Nig J Ophthalmol. 2014;22:47-49.

Skalicky SE, White AJ, Grigg JR, et al. Microphthalmia, anophthalmia, and coloboma and associated ocular and systemic features: understanding the spectrum. JAMA Ophthalmol. 2013;131(12):1517-1524.

Gilbert C and Awan H. Blindness in children. BMJ. 2003;327(7418):760-761.

Gogate P, Gilbert C and Zin A. Severe visual impairment and blindness in infants: causes and opportunities for control. Middle East Afr J Ophthalmol. 2011;18(2):109-114.

Rahi JS, Gilbert CE, Foster A and Minassian D. Measuring the burden of childhood blindness. Br J Ophthalmol. 1999;83(4):387-388.

Gogate P and Gilbert C. Blindness in children: a worldwide perspective. Community Eye Health. 2007;20(62):32-33.

Levin AV. Congenital eye anomalies. Paediatr Clin North Am. 2003;50(1):55-76.

Osaguona VB and Okeigbemen VW. Congenital Ophthalmic Anomalies in Benin City, Nigeria. Ann Biomed Sci. 2014;13:102-108.

Rahi JS and Dezateux C, British Congenital Cataract Interest G. Measuring and interpreting the incidence of congenital ocular anomalies: lessons from a national study of congenital cataract in the UK. Invest Ophthalmol Vis Sci. 2001;42(7):1444-1448.

Bhattacharjee H, Das K, Borah RR, et al. Causes of childhood blindness in the northeastern states of India. Indian J Ophthalmol. 2008;56(6):495-499.

Courtright P, Hutchinson AK and Lewallen S. Visual impairment in children in middle- and lower-income countries. Arch Dis Child. 2011;96(12):1129-1134.

Hornby SJ, Gilbert CE, Rahi JK, et al. Regional variation in blindness in children due to microphthalmos, anophthalmos and coloboma. Ophthalmic Epidemiol. 2000;7(2):127-138.

Rahi JS, Sripathi S, Gilbert CE and Foster A. Childhood blindness in India: causes in 1318 blind school students in nine states. Eye. 1995;9 ( Pt 5):545-550.

Titiyal JS, Pal N, Murthy GV, et al. Causes and temporal trends of blindness and severe visual impairment in children in schools for the blind in North India. Br J Ophthalmol. 2003; 87(8): 941-945.

Awoyesuku EA, Pedro-Egbe CN and Sibeudu OA. Congenital upper lid eversion and severe chemosis in a new born. Niger J Clin Pract. 2014;17(2):248-250.

Osahon AI, Dawodu OA and Ideh VC. Congenital anomalies of the eye and adnexae in Edo State, Nigeria. Niger Postgrad Med J. 2006;13(3):261-265.

Balogun BG, Adekoya BJ, Balogun MM and Ehikhamen OA. Orbito-oculoplastic diseases in Lagos: a 4-year prospective study. Niger Postgrad Med J. 2014;21(3):236-239.

Lawan A. Congenital eye and adnexial anomalies in Kano, a five year review. Niger J Med. 2008;17(1):37-39.

Chuka-Okosa CM, Magulike NO and Onyekonwu GC. Congenital eye anomalies in Enugu, South-Eastern Nigeria. West Afr J Med. 2005;24(2):112-114.

Bodunde OT and Ajibode HA. Congenital eye diseases at Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Niger J Med. 2006;15(3):291-294.

Ilechie AA, Essuman VA and Enyionam S. Prevalence of congenital eye anomalies in a paediatric clinic in Ghana. East Mediterr Health J. 2014;19 Suppl 3:S76-80.

Adekoya BJ, Balogun MM, Balogun BG and Ngwu RA. Spectrum of congenital defects of the eye and its adnexia in the paediatric age group; experience at a tertiary facility in Nigeria. Int Ophthalmol. 2015;35(3):311-317.

Eballe AO, Ellong A, Koki G, et al. Eye malformations in Cameroonian children: a clinical survey. Clin Ophthalmol. 2012;6:1607-1611.

Ezegwui IR, Aghaji AE, Uche NJ and Onwasigwe EN. Challenges in the management of paediatric cataract in a developing country. Int J Ophthalmol. 2011;4(1):66-68.

Mwende J, Bronsard A, Mosha M, et al. Delay in presentation to hospital for surgery for congenital and developmental cataract in Tanzania. Br J Ophthalmol. 2005;89(11):1478-1482.

You C, Wu X, Zhang Y, et al. Visual impairment and delay in presentation for surgery in chinese paediatric patients with cataract. Ophthalmology. 2011;118(1):17-23.

Forrester MB and Merz RD. Descriptive epidemiology of anophthalmia and microphthalmia, Hawaii, 1986-2001. Birth Defects Res A Clin Mol Teratol. 2006;76(3):187-192.

Stoll C, Alembik Y, Dott B and Roth MP. Epidemiology of congenital eye malformations in 131,760 consecutive births. Ophthalmic Paediatr Genet. 1992;13(3):179-186.

Zhu J, Wang Y, Zhou G, et al. [A descriptive epidemiological investigation of anophthalmos and microphthalmos in China during 1988 - 1992]. [Zhonghua Yan Ke Za Zhi] Chinese Journal of Ophthalmology. 2000;36(2):141-144.

Onwasigwe EN. A survey of congenital ophthalmic anomalies in Nigerian children. Orient J Med. 2002;14:18–20.

Bermejo E and Martinez-Frias ML. Congenital eye malformations: clinical-epidemiological analysis 1of 1,124,654 consecutive births in Spain. Am J Med Genet. 1998;75(5):497-504.

Ravikumara M and Bhat BV. Congenital ocular malformations at birth. Indian Paediatr. 1996;33(6):503-506.

Adewumi OM, Olayinka OA, Olusola BA, et al. Epidemiological evaluation of rubella virus infection among pregnant women in Ibadan, Nigeria. J Immunoassay Immunochem. 2015; 36(6): 613-621.

Downloads

Published

2020-09-02

Issue

Section

Original Articles