[Juvenile glaucoma in Cameroon].
OBJECTIVE
To determine the prevalence and the visual morbidity of juvenile glaucoma in an urban black population.


METHODS
A retrospective analysis of 1343 files of glaucomatous patients was carried out from January 1991 to December 2001 at the Douala General Hospital in Cameroon (Central Africa). Ninety four of them had juvenile glaucoma. Of the patients, 54 (57.4%) were males and 40 (42.6%) were females. Each subject underwent the following investigations: visual acuity, visual field testing, slit lamp examination, applanation tonometry, gonioscopy, and optic disc examination and photographies after mydriasis.


RESULTS
The prevalence of juvenile glaucoma in our population was 0.4%. The mean patients age at diagnosis was 26 +/- 6.8 years (range, 10 to 35 years). Among them, 88.3% had a positive family history of glaucoma. The mean intraocular pressure at diagnosis was 28.2 +/- 9.3 mmHg (range: 14 to 56 mmHg). It was lower than 21 mmHg in 5.3% of the cases. The mean recorded cup/disc ratio at diagnosis was 0.7 +/- 0.3. It was equal to 1.0 in 25.6% of the cases. Gonioscopy showed that the angles were open, with no abnormal pigmentation, iris processes, or embryonic tissue. The prevalence of monocular and bilateral blindness was 3.2% and 33% respectively at the first examination. The affected eye was blind in 50% (6/12) of patients with unilateral juvenile glaucoma. The mean IOP of the treated 166 eyes with topical medications decreased from 28 +/- 8.7 mmHg (range: 15 to 56 mmHg) to 19.1 +/- 8 mmHg (range: 8 to 48 mmHg) after a follow-up period average 1.6 +/- 2.3 years (range: one month to 11 years). Trabeculectomy was required in 10 eyes. Follow-up period of surgery ranged from 1 to 8 years (mean 3.8 +/- 3.3 years). The mean IOP decreased from 30.8 +/- 14 mmHg (range: 17 to 54 mmHg) preoperatively to 15.7 +/- 4.6 mmHg (from 10 to 25 mmHg) postoperatively.


CONCLUSIONS
This study confirms the high prevalence of juvenile glaucoma among black Cameroonian population. The screening, the treatment as well as the genetic studies of this glaucoma bump into strong economic contingencies in our regions. In the cases where topical medications were ineffective in controlling IOP, surgery was needed to obtain long-term pressure control.
Ellong
A
A
Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Cameroun. ellongaugustin@yahoo.fr
Ebana Mvogo
C
C
Nyouma Moune
E
E
Bella-Hiag
A
A
D000293:Adolescent; D000328:Adult; D044383:Black People / Q000706:statistics & numerical data*; D002163:Cameroon / Q000453:epidemiology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000453:epidemiology* / Q000235:genetics / Q000601:surgery; D006801:Humans; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies