Etiologies des Affections des Voies Visuelles au CHU de Brazzaville

PW Atipo Tsiba, AO Eballe, VA Dohvoma, s Ebana Mvogo, IA Diomandé, G Noa, A Nomo, C Nomo, Y Tapsoba

Abstract


Introduction: Les maladies des voies visuelles peuvent être l’expression d’une atteinte de leurs structures propres ou d’une affection des structures cérébrales de voisinage. Elles sont congénitales (malformation) ou acquises (inflammatoire, toxique, tumorale, vasculaire, traumatique, dégénérative). Objectif: Décrire les principales pathologies des voies visuelles au CHU de Brazzaville. Matériels et méthodes: Étude transversale réalisée dans le service d’Ophtalmologie du CHU de Brazzaville sur une période de 5 ans (2011 – 2014). Elle a été faite sur la base de dossiers de patients suivis pour une atteinte d’au moins une voie visuelle (nerf optique, chiasma optique, bandelettes optiques, radiations optiques, cortex visuel). Avaient été exclus de cette enquête les dossiers des patients qui souffraient de glaucome et de papillopathie. Le champ visuel (octopus), le test d’Ishihara, le scanner et/ou l’IRM, la ponction lombaire et les sérologies (Lyme, VIH, TPHA-VDRL) avaient été réalisés chaque fois que cela avait été nécessaire. Résultats : 52 dossiers ont été retenus. Les pathologies étaient représentées par: névrite optique rétrobulbaire (40,38%), séquelles d’accident vasculaire cérébral (36,54%) avec HTA comme facteur de risque dans 100% des cas, adénome hypophysaire (9,61%), séquelles de traumatisme crânien (5,77%), névrite optique toxique due à l’éthambutol (5,77%), gliome du nerf optique (1,93%).
Conclusion: Les pathologies des voies visuelles au CHU de Brazzaville sont essentiellement inflammatoires et vasculaires. Un meilleur suivi de l’HTA peut réduire leur fréquence.

ABSTRACT
Introduction: Diseases of the visual pathways may be an expression of their own structures or of brain neighborhood structures. They can be congenital (malformations) or acquired (inflammatory, toxic, tumor, vascular, traumatic, and degenerative). Objective: To describe the main pathologies of the visual pathways at the University Teaching Hospital of Brazzaville (UHB). Materials and Methods: Cross-sectional study conducted in the Ophthalmology department of the UHB over a period of 5 years (2011 - 2014). It was made on the basis of records of patients followed for pathology of at least a visual pathway (optic nerve, optic chiasm, optic radiations, optical radiations, visual cortex). Were excluded from this survey records of patients suffering from glaucoma and papillopathy. The visual field (Octopus), the Ishihara test, CT scan and / or MRI, lumbar puncture and serologies (Lyme, HIV, TPHA-VDRL) were made whenever was necessary. Results: 52 records were found. The pathologies were represented by: retrobulbar optic neuritis (40.38%), sequellae of stroke (36.54%) with high blood pressure as a risk factor in 100% of cases, pituitary adenoma (9.61%), sequellae of head trauma (5.77%), optical neuritis toxic due to ethambutol (5.77%), and glioma of the optic nerve (1.93%).
Conclusion: The pathologies of the visual pathways at the UHB are essentially inflammatory and vascular. Better monitoring of high blood pressure can reduce their incidence.


Keywords


Voies visuelles, Névrite optique, Accident vasculaire cérébral, HTA

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