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Abstract

Introduction. Les auteurs ont examiné les prématurés au Complexe Pédiatrique de Bangui, dans le but d’évaluer les facteurs de risque de survenue de la rétinopathie du prématuré et les modalités de dépistage de cette maladie en Centrafrique. Patients et méthodes. Il s’agit d’une étude transversale prospective analytique de Janvier 2012 à Décembre 2014 à la Clinique Pédiatrique de Bangui. Tous les prématurés nés avant 32 semaines de gestation ou ayant un poids de naissance inférieur à 1500 grammes ont bénéficié d’un examen du fond d’œil à 5 semaines de vie. Le matériel utilisé était composé d’un ophtalmoscope binoculaire indirect Neitz, assorti d’une source d’alimentation électrique portative Zeiss/Opton, de deux lentilles d’examen 20 et 28 dioptries, d’un mydriatique (tropicamide®) et d’un anesthésique de contact. Les lésions observées ont été réparties selon la classification de Calgary. Résultats. 88 prématurés dont 39 garçons (44,3%) et 49 filles (55,7%) ont été étudiés. Leur âge gestationnel moyen était de 29,2 ±2,8 semaines et le poids de naissance moyen de 1205 ± 255 grammes. L’examen a été satisfaisant dans tous les cas. Le diagnostic de rétinopathie a été posé chez 29 (32,95%) prématurés, dont 12 garçons (41,4%) et 17 filles (58,6%), avec une atteinte bilatérale chez tous. 28 enfants sur 31 (90.3%) avaient des lésions minimes ou modérées et toutes ont régressé spontanément sans laisser de séquelle. Dix décès ont été enregistrés durant le suivi. Conclusion. L’ophtalmoscope binoculaire indirect est l’outil de choix pour le dépistage de la rétinopathie des prématurés et le tropicamide peut être utilisé sans effets indésirables pour obtenir une mydriase adéquate. Le poids de naissance et l’âge gestationnel sont deux facteurs de risque à considérer. Le risque semble être le même que l’enfant soit sous oxygène ou non.
ABSTRACT
Introduction. To determine the risk factors for the occurrence of retinopathy of prematurity and the modalities of detection of this disease in the Central African Republic. Patients and methods: This was a prospective, cross sectional analytic study from January 2012 to December 2014 at the Bangui Pediatric hospital. Premature babies born before 32 weeks of gestation and those who had a born weight less than 1500 grams had fundus examination performed at 5 weeks of age. The equipment consisted of a Zeitz indirect binocular ophthalmoscope with a Zeiss/Topcon portable power source power, two 20 and 28 diopters examination ocular lenses, a mydriatic eye drop (tropicamide) and topic anesthetic. Retinal lesions were grouped according to the Calgary classification. Results: 88 premature babies, among whom 39 boys (44.3%) and 49 girls (55,7%) were studied with a average gestational age of 29.2 ± 2.8 weeks and an average birth weight of 1205 ± 255 grams. Examination was satisfactory for all babies. The diagnosis of retinopathy of prematurity was made in 29 babies (32.95%) among whom 12 were boys (41.4%) and 17 were girls (58.6%). Retinal lesions were always bilateral. 28 babies over 31 (90.3%) had mild lesions (grade 1 or 2) and all these lesions spontaneously regressed, leaving no sequel. Ten babies died during the follow up period. Conclusion. Indirect binocular ophthalmoscopy is the tool of choice for screening of the retinopathy of prematurity and tropicamide can be used without undesirable side effects to obtain adequate mydriasis. Both birth weight and gestational age are two risk factors to consider. Premature babies with and without oxygen therapy seem to have a similar level.

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Yaya, G., Koki, G., Malendoma, J., Gossy, V., Gody, C., & Bobossi-Serengbe, G. (2017). La Rétinopathie du Prématuré en Centrafrique : Résultats de l’Examen du Fond d’Œil chez 88 Nouveau-Nés au Complexe Pédiatrique de Bangui. HEALTH SCIENCES AND DISEASE, 18(1). https://doi.org/10.5281/hsd.v18i1.758
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