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Abstract
RÉSUMÉ
But : Déterminer la prévalence et les caractéristiques épidémiologiques et cliniques de la dégénérescence maculaire liée à l’âge dans une population noire urbaine en milieu hospitalier. Matériel et méthodes : Il s’agit d’une étude rétrospective menée à l’Hôpital Général de Douala au Cameroun de Janvier 1990 à Décembre 2007. Elle portait sur l’analyse des dossiers de tous les patients âgés d’au moins 40 ans ayant consulté dans le service d’ophtalmologie. Chaque patient a bénéficié d’un examen ophtalmologique comprenant outre la mesure de l’acuité visuelle, une exploration du champ visuel, un examen du fond d’œil complété par une angiographie à la fluorescéine en cas de suspicion de dégénérescence maculaire liée à l’âge. Résultats : L’âge moyen des sujets était de 53,0±10,8 ans (de 40 ans à 99 ans). La prévalence de la dégénérescence maculaire liée à l’âge, toutes formes confondues, était de 4,8% et celle des drusen miliaires de 4,1%. La moyenne d’âge des sujets atteints de DMLA était de 62,2±10,6 ans. La fréquence des DMLA augmentait avec l’âge et la tranche d’âge la plus atteinte était celle des plus de 70 ans. Les femmes étaient plus atteintes que les hommes (sex ratio M/F=0,71), p=0,007. La prévalence de la malvoyance et de la cécité était respectivement de 24,3% et 5,3%. La forme atrophique était la plus fréquente 74,6%. Dans 66,7% des formes exsudatives, une complication hémorragique était mise en évidence. Conclusion : La DMLA est une réalité en milieu camerounais. Sa fréquence augmente avec l’âge. Les femmes sont plus atteintes que les hommes. La forme sèche est la plus répandue. Les complications hémorragiques, rares, sont l’apanage de la forme exsudative. Cependant, une étude prospective permettra de mieux cerner les facteurs de risque dans notre milieu, gage de la prévention de la DMLA.
ABSTRACT
Aim: To determine the prevalence and the clinical and epidemiologic features of age related macular degeneration (ARMD) in an urban black population. Material and Methods: This is a retrospective study carried out at the Douala General Hospital in Cameroon from January 1990 to December 2007. We analyzed the files of all patients aged at least 40 years old who consulted in the ophthalmology unit. Each patient underwent an eye examination consisting of measurement of visual acuity, visual field examination, fundoscopy and fluorescein angiography in cases of suspected ARMD. Results: The mean age of our subjects was 53.0 ± 10.8 years (40 years to 99 years). The prevalence of all forms of ARMD was 4.8% and that of miliary drusen was 4.1%. The average age of the patients with ARMD was 62.2 ± 10.6 years. The frequency of ARMD increased with age and the more than 70 years old was the most affected age group. Women were more affected than men (sex ratio M / F = 0.71), p = 0.007. The prevalence of visual impairment and blindness were 24.3% and 5.3% respectively. The atrophic form was the most common form (74.6% of cases). Hemorrhagic complications occurred in 66.7% of exudative forms. Conclusion: ARMD does exist in the Cameroonian community. Its frequency increases with age. Women are more affected. The dry form is the most common form. Hemorrhagic complications are rare, and are observed with the wet form. However, a prospective study will identify risk factors which could help in the prevention of ARMD
Article Details
References
- Coscas G. Dégénérescences Maculaires acquises Liées à l’Age et néovaisseaux sous-rétiniens. Rapport de la Société française d'ophtalmologie. Paris: Masson 1991.
- Soubrane G, Coscas G - Dégénérescence Maculaire Liée à l’Age. Encycl med chir (Elsevier, Paris) ophtalmol 21-249-A-20, 1998, 29p.
- Klein R, Klein BE, Linton KL. Prevalence of age-related maculopathy. The Beaver Dam Eye Study. Ophthalmology, 1992;99:933.
- Klein R, Chou C-F, Klein BE, Zhang X, Meuer SM, Saaddine JB. Prevalence of Age-Related Macular Degeneration in the US Population Arch Ophthalmol. 2011;129 (1):75-80.
- Klein R, Rowland ML, Harris MI. Racial/ethnic differences in age-related maculopathy: third national health and nutrition examination survey. Ophthalmology, 1995;102:371-81.
- Augood CA, Vingerling JR, De Jong PT, Chakravarthy U, Seland J, Soubrane G, and al. Prevalence of age-related maculopathy in older Europeans: the European Eye Study (EUREYE) Arch Ophthalmol 2006;124:529-535
- Vingerling JR, Diclemans I, Hofman A, Grobee DE, Hijmering M, Kramer C et al. The prevalence of age –related maculopathy in the Rotterdam Study. Ophthalmology 1995;102:205-210.
- Kawasaki R, Yasuda M, Song SJ, Chen SJ, Jonas JB, Wang JJ, Mitchell P, Wong TY. The prevalence of age-related macular degeneration in Asians: a systematic review and meta-analysis. Ophthalmology. 2010;117(5):921-7.
- Schachat AP, Hyman L, Leske MC, Connell AM, Wu SY. Features of age-related macular degeneration in a black population. The Barbados Eye Study Group. Arch Ophthalmol. 1995 Jun;113(6):728-35.
- El Matri L, Bouraoui R, Chebil A, Kort F, Limaiem R, Bouladi M, Mghaieth F. Prévalence et facteurs de risque de la dégénérescence maculaire liée à l’âge (dmla) dans une population hospitalière tunisienne. Bull. Soc. belge Ophtalmol. 2012, 319, 35-41.
- Friedman DS, O'Colmain BJ, Muñoz B, Tomany SC, McCarty C, De Jong PT, Nemesure B, Mitchell P, Kempen J. Eye Diseases Prevalence Research Group. Prevalence of age-related macular degeneration in the United States. Arch Ophthalmol. 2004;122(4):564-72.
- Mitchell P, Smith W, Attebo K, Wang JJ. Prevalence of age-related maculopathy in Australia. The Blue Mountains Eye Study. Ophthalmology 1995; 102:1450-60.
- Klein R, Klein BE, Cruickshanks KJ. The prevalence of age-related maculopathy by geographic region and ethnicity. Prog Retin Eye Res. 1999;18(3):371-89.
- Friedman DS, Katz J, Bressler NM, and al. Racial differences in the prevalence of age-related macular degeneration: the Baltimore Eye Survey. Ophthalmology, 1999;106:1049-55.
- Leveziel N, Delcourt C, Zerbib J et al. Epidemiology of age related macular degeneration. J Fr Ophtalmol. 2009;32:440-51.
- Klein R, Klein BE, Tomany SC, Meuer SM, Huang GH. Ten-year incidence and progression of age-related maculopathy: The Beaver Dam Eye Study. Ophthalmology. 2002;109(10):1767-79.
- Coscas G, Soubrane G, Chaine G, Quentel G, Delcourt C, Allaert FA. Etude épidémiologique transversale PROFIL DMLA France, 2004. Disponible sur http://www.bausch.fr/Ophtalmologie.
- Age-Related Eye Disease Study Research Group. Risk factors associated with age-related macular degeneration. A case-control study in the Age-Related Eye Disease Study: AREDS report no. 3. Ophthalmology, 2000;107: 2224-32.
- Klein R, Klein BE, Jensen SC, Meuer SM. The five-year incidence and progression of age-related maculopathy: the Beaver Dam Eye Study Ophthalmology 1997;104:7-21
- Evans JR – Risk factors of age-related macular degeneration. Prog Retin Eye Res 2001, 20: 227-253.
- Jampol LM, Tielsch J. Race, macular degeneration and the macular photocoagulation study. Arch Ophthalmol 1992, 110:1699-1700
- Miyazaki M, Nakamura H, Kubo M et al. Risk factors for age-related maculopathy in a Japanese population: the Hisayama Study. Br J Ophthalmol 2003; 87:469-472.
- Munoz B, Klein R et al. Prevalence of age-related macular degeneration in a population-based sample of Hispanic people in Arizona: Proyecto VER. Arch Ophthalmol 2005,123: 1575-1580.
- Leske MC, Wu SY, Hyman L, Hennis A, Nemesure B, Schachat AP; Barbados Eye Studies Group.Four-year incidence of macular changes in the Barbados Eye Studies. Ophthalmology. 2004;111(4):706-11.
References
Coscas G. Dégénérescences Maculaires acquises Liées à l’Age et néovaisseaux sous-rétiniens. Rapport de la Société française d'ophtalmologie. Paris: Masson 1991.
Soubrane G, Coscas G - Dégénérescence Maculaire Liée à l’Age. Encycl med chir (Elsevier, Paris) ophtalmol 21-249-A-20, 1998, 29p.
Klein R, Klein BE, Linton KL. Prevalence of age-related maculopathy. The Beaver Dam Eye Study. Ophthalmology, 1992;99:933.
Klein R, Chou C-F, Klein BE, Zhang X, Meuer SM, Saaddine JB. Prevalence of Age-Related Macular Degeneration in the US Population Arch Ophthalmol. 2011;129 (1):75-80.
Klein R, Rowland ML, Harris MI. Racial/ethnic differences in age-related maculopathy: third national health and nutrition examination survey. Ophthalmology, 1995;102:371-81.
Augood CA, Vingerling JR, De Jong PT, Chakravarthy U, Seland J, Soubrane G, and al. Prevalence of age-related maculopathy in older Europeans: the European Eye Study (EUREYE) Arch Ophthalmol 2006;124:529-535
Vingerling JR, Diclemans I, Hofman A, Grobee DE, Hijmering M, Kramer C et al. The prevalence of age –related maculopathy in the Rotterdam Study. Ophthalmology 1995;102:205-210.
Kawasaki R, Yasuda M, Song SJ, Chen SJ, Jonas JB, Wang JJ, Mitchell P, Wong TY. The prevalence of age-related macular degeneration in Asians: a systematic review and meta-analysis. Ophthalmology. 2010;117(5):921-7.
Schachat AP, Hyman L, Leske MC, Connell AM, Wu SY. Features of age-related macular degeneration in a black population. The Barbados Eye Study Group. Arch Ophthalmol. 1995 Jun;113(6):728-35.
El Matri L, Bouraoui R, Chebil A, Kort F, Limaiem R, Bouladi M, Mghaieth F. Prévalence et facteurs de risque de la dégénérescence maculaire liée à l’âge (dmla) dans une population hospitalière tunisienne. Bull. Soc. belge Ophtalmol. 2012, 319, 35-41.
Friedman DS, O'Colmain BJ, Muñoz B, Tomany SC, McCarty C, De Jong PT, Nemesure B, Mitchell P, Kempen J. Eye Diseases Prevalence Research Group. Prevalence of age-related macular degeneration in the United States. Arch Ophthalmol. 2004;122(4):564-72.
Mitchell P, Smith W, Attebo K, Wang JJ. Prevalence of age-related maculopathy in Australia. The Blue Mountains Eye Study. Ophthalmology 1995; 102:1450-60.
Klein R, Klein BE, Cruickshanks KJ. The prevalence of age-related maculopathy by geographic region and ethnicity. Prog Retin Eye Res. 1999;18(3):371-89.
Friedman DS, Katz J, Bressler NM, and al. Racial differences in the prevalence of age-related macular degeneration: the Baltimore Eye Survey. Ophthalmology, 1999;106:1049-55.
Leveziel N, Delcourt C, Zerbib J et al. Epidemiology of age related macular degeneration. J Fr Ophtalmol. 2009;32:440-51.
Klein R, Klein BE, Tomany SC, Meuer SM, Huang GH. Ten-year incidence and progression of age-related maculopathy: The Beaver Dam Eye Study. Ophthalmology. 2002;109(10):1767-79.
Coscas G, Soubrane G, Chaine G, Quentel G, Delcourt C, Allaert FA. Etude épidémiologique transversale PROFIL DMLA France, 2004. Disponible sur http://www.bausch.fr/Ophtalmologie.
Age-Related Eye Disease Study Research Group. Risk factors associated with age-related macular degeneration. A case-control study in the Age-Related Eye Disease Study: AREDS report no. 3. Ophthalmology, 2000;107: 2224-32.
Klein R, Klein BE, Jensen SC, Meuer SM. The five-year incidence and progression of age-related maculopathy: the Beaver Dam Eye Study Ophthalmology 1997;104:7-21
Evans JR – Risk factors of age-related macular degeneration. Prog Retin Eye Res 2001, 20: 227-253.
Jampol LM, Tielsch J. Race, macular degeneration and the macular photocoagulation study. Arch Ophthalmol 1992, 110:1699-1700
Miyazaki M, Nakamura H, Kubo M et al. Risk factors for age-related maculopathy in a Japanese population: the Hisayama Study. Br J Ophthalmol 2003; 87:469-472.
Munoz B, Klein R et al. Prevalence of age-related macular degeneration in a population-based sample of Hispanic people in Arizona: Proyecto VER. Arch Ophthalmol 2005,123: 1575-1580.
Leske MC, Wu SY, Hyman L, Hennis A, Nemesure B, Schachat AP; Barbados Eye Studies Group.Four-year incidence of macular changes in the Barbados Eye Studies. Ophthalmology. 2004;111(4):706-11.