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      Age de début de la presbytie chez le sujet noir camerounais Translated title: Age of onset of presbyopia in the black cameroonian subject

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          Abstract

          Introduction

          La prescription d'une addition dans notre pratique n'est pas rare chez les patients de moins de 40 ans. Nous avons recherché le besoin d'une addition après étude objective de la réfraction et partant déterminer l'âge moyen de début de la presbytie.

          Méthodes

          Nous avons mené une étude transversale et descriptive à l'Hôpital Central de Yaoundé durant trois mois chez les patients âgés de 35 à 45 ans. Ils ont tous bénéficié d'une étude objective de la réfraction sous cycloplégie. La correction de la vision de loin était faite sous cycloplégie, alors que l'addition en vison de près était évaluée deux jours plus tard lorsque la cycloplégie n'était plus effective. La prescription probable d'une addition à la correction de loin devait être réalisée 2 jours après la cycloplégie. L'analyse statistique a été faite avec le logiciel IBM SPSS 20.0.

          Résultats

          Nous avons examiné 55 patients soit 110 yeux. L'âge moyen des patients était de 41,87±2,5 ans, avec un sex-ratio de 0,28 en faveur des femmes. L'astigmatisme hypermétropique était l'amétropie la plus fréquente avec 58,2% de cas suivi de l'hypermétropie avec 24,6%. Nous n'avons retrouvé aucun sujet myope. L'âge moyen de début de la presbytie dans cette tranche d'âge était de 43,2±1,7 ans. Après correction objective en vision de loin, aucun patient n'avait besoin d'une addition avant 40 ans. Par ailleurs, 4 patients sur 10 avec une amétropie hypermétropique n'ont pas besoin d'addition avant 45 ans. La prescription d'une addition était liée de façon significative à l'âge.

          Conclusion

          L'âge moyen de début de la presbytie est de 43,2±1,7 ans. Avant 45 ans, toute prescription d'une addition doit être précédée d'une étude objective de la réfraction.

          Translated abstract

          Introduction

          Addition in patients of less than 40 years is not uncommon in our practice. We investigated the need for addition after objective refraction and thus determine the average age of onset of the presbyopia.

          Methods

          We conducted a cross-sectional descriptive study of patients aged 35-45 years at the Central Hospital of Yaoundé over a period of three months. All patients underwent cycloplegic refraction. Distance visual acuity was corrected after instillation of cycloplegic eye drops while near addition was assessed two days later when the cycloplegia was no longer effective. Possible additional distance correction was done 2 days after cycloplegia. Statistical analysis was done using IBM SPSS 20.0 software.

          Results

          We examined 55 patients, 110 eyes. The average age of patients was 41.87±2.5 years, the sex-ratio was 0.28. There was a female predominance. Hypermetropic astigmatism was the most common ametropia (58.2% of cases) followed by hyperopia (24.6%).No patient was myopic. the average age of presbyopia onset in this age group was 43.2±1.7 years. After objective correction of distance visual acuity, no patient needed for addition before the age of 40. Moreover, 4 out of 10 patients with hypermetropic ametropia did not need addition before the age of 40. Addition was significantly associated with age.

          Conclusion

          The average age of presbyopia onset is 43.2±1.7 years. Before the age of 45, addition must be preceded by objective refraction.

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          Most cited references15

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          Global vision impairment due to uncorrected presbyopia.

          To evaluate the personal and community burdens of uncorrected presbyopia. We used multiple population-based surveys to estimate the global presbyopia prevalence, the spectacle coverage rate for presbyopia, and the community perception of vision impairment caused by uncorrected presbyopia. For planning purposes, the data were extrapolated for the future using population projections extracted from the International Data Base of the US Census Bureau. It is estimated that there were 1.04 billion people globally with presbyopia in 2005, 517 million of whom had no spectacles or inadequate spectacles. Of these, 410 million were prevented from performing near tasks in the way they required. Vision impairment from uncorrected presbyopia predominantly exists (94%) in the developing world. Uncorrected presbyopia causes widespread, avoidable vision impairment throughout the world. Alleviation of this problem requires a substantial increase in the number of personnel trained to deliver appropriate eye care together with the establishment of sustainable, affordable spectacle delivery systems in developing countries. In addition, given that people with presbyopia are at higher risk for permanently sight-threatening conditions such as glaucoma and diabetic eye disease, primary eye care should include refraction services as well as detection and appropriate referral for these and other such conditions.
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            Comparison of cyclopentolate versus tropicamide cycloplegia: A systematic review and meta-analysis

            Purpose The aim of the present meta-analysis is to compare the efficacy of cyclopentolate and tropicamide in controlling accommodation during refraction. Methods A comprehensive literature search was performed in PubMed, Scopus, Science direct and Ovid databases by the key words: “tropicamide”; “cyclopentolate”; “cycloplegia” and “cycloplegic” from inception to April 2016. Methodological quality of the literature was evaluated according to the Oxford Center for Evidence Based Medicine and modified Newcastle-Ottawa scale. Statistical analyses were performed using Comprehensive Meta-Analysis (version 2; Biostat Inc., USA). Results The present meta-analysis included six studies (three randomized controlled trials and three case–control studies). Pooled standardized difference in the mean changes in the refractive error was 0.175 D [lower and upper limits: −0.089; 0.438] more plus in the cyclopentolate group compared to the tropicamide group; however, this difference was not statistically significant (p = 0.194; Cochrane Q value = 171.72 (p < 0.05); I 2 = 95.34%). Egger's regression intercept was −5.33 (p = 0.170). Considering type of refractive errors; refractive assessment procedure and age group; although cycloplegic effect of cyclopentolate was stronger than tropicamide; however, this effect was only statistically significant in children; hyperopic patients and with retinoscopy. Conclusion We suggest that tropicamide may be considered as a viable substitute for cyclopentolate due to its rapid onset of action. Although these results should be used cautiously in infants and in patients with high hyperopia or strabismus when using tropicamide as the sole cycloplegic agent especially in situations that the findings are variable or there is no consistency between the examination results and clinical manifestations of the visual problems.
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              Population-based study of presbyopia in rural Tanzania.

              To determine the prevalence of presbyopia in a rural African population. Cross-sectional prevalence study. One thousand seven hundred nine persons age 40 years and older who resided in 3 villages and randomly selected neighborhoods of Kongwa town, Tanzania. Eligible persons were refracted and given best distance correction. Near vision was tested and corrected to the nearest 0.5 diopter. Presbyopia was defined as at least 1 line of improvement on a near visual acuity chart with an addition of a plus lens. A total of 61.7% of eligible participants were presbyopic. A higher prevalence of presbyopia was associated with increased age, female gender, higher educational level, and residence in town (odds ratio = 3.09; 95% confidence interval: 2.46-3.90). The odds of developing presbyopia increased 16% per year of age from age 40 to 50, but the increase was nonsignificant at 1% per year after age 50. More severe presbyopia was associated with female gender and less with education. This study provides the first population-based data on prevalence of presbyopia in a large, random sample of older Africans and suggests a high rate of presbyopia. Presbyopia plateaus after age 50, and it is more common in females. In addition, the 3-fold increased odds in town versus village dwellers was unexpected and suggests that research of other factors, including environmental factors, is warranted.
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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                09 April 2019
                2019
                : 32
                : 162
                Affiliations
                [1 ]Département d'Ophtalmologie-ORL, Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
                [2 ]Hôpital Gynéco-Obstétrique et Pédiatrique de Douala (HGOPED), Douala, Cameroun
                [3 ]Hôpital Central de Yaoundé (HCY), Yaoundé, Cameroun
                [4 ]Faculté de Médecine et des Sciences Pharmaceutiques de l'Université de Douala, Douala, Cameroun
                [5 ]Hôpital Général de Douala (HGD), Douala, Cameroun
                Author notes
                [& ]Corresponding author: Stève Robert Ebana Mvogo, Département d'Ophtalmologie-ORL, Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
                Article
                PAMJ-32-162
                10.11604/pamj.2019.32.162.15808
                6607316
                31303931
                2fe540ec-d5c0-4954-b0a3-c92f3e3b7339
                © Stève Robert Ebana Mvogo et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 April 2018
                : 14 March 2019
                Categories
                Research

                Medicine
                age,presbytie,cycloplégie,cameroun,presbyopia,cycloplegia,cameroon
                Medicine
                age, presbytie, cycloplégie, cameroun, presbyopia, cycloplegia, cameroon

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