We present the case of a middle-aged female Nigerian diagnosed to have right eye peripapillary polypoidal choroidal vasculopathy (PCV). At presentation, her right eye Snellen visual acuity was 6/24+ (unaided) and 6/12 (aided) and the left eye was 6/9 (unaided) and 6/6 (aided). Fundus fluorescein angiography showed a hyperfluorescent peripapillary subretinal lesion associated with subretinal fluid demonstrated on spectral-domain optical coherence tomography. The PCV lesion was successfully treated using a combination of 3 monthly doses of intravitreal ranibizumab initially, followed by one session of focal thermal retinal laser photocoagulation. Her clinical state has remained stable after 5 years of follow-up, requiring no further treatment. This case demonstrates the effectiveness of combination therapy and can be a strategy for treating this PCV type. Successful treatment using this approach will reduce the burden of intravitreal anti-vascular endothelial growth factor, e.g., ranibizumab injections.

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PURPOSE: Age-related macular degeneration (AMD) is a leading cause of visual impairment worldwide, and its prevalence may also be on the increase in Nigeria. The purpose of this study is to ascertain the burden and pattern of presentation of AMD in a developing country. METHODS: We conducted a multicenter, prospective study from January to December 2018. Biodata and history of systemic disease were obtained from consecutive patients presenting at four collaborating retina clinics and diagnosed with a retina disease after dilated fundus examination and ocular investigations such as fundus photography, fluorescein angiography, and optical coherence tomography. All eyes diagnosed to have wet and dry AMD were used for the study analysis. RESULTS: Out of 8614 patients, 156 eyes of 78 patients were diagnosed with AMD. The hospital-based prevalence for AMD was 0.91%. The mean age at presentation was 67.9 ± 9.2 years, ranging from 44 to 95 years. A majority (75.6%) of patients were between 60 and 79 years, 53.8% were females. Thirty-two eyes (20.5%) had wet AMD, while 124 eyes (79.5%) had dry AMD. Sixty-one eyes (39.1%) had moderate visual impairment (<6/18-6/60); 58 eyes (37.2%) had normal vision (6/18 and better); while 27 eyes (17.3%) were blind, and ten eyes (6.4%) had severe visual impairment. CONCLUSION: AMD contributes to the burden of visual impairment and blindness in the elderly Nigerian. In Nigeria, AMD occurs more in females and most common between the ages of 60 and 79. Dry AMD is four times more common than wet AMD. About 24% of eyes have severe visual impairment or blindness, while about a third each have a moderate visual impairment and normal vision. Increasing awareness of AMD among the at-risk population will be beneficial in achieving early diagnosis and treatment.

Aim: To determine the degree of visual loss associated with retinitis pigmentosa (RP) in Nigerians at first ophthalmic clinic presentation Methodology: Multicenter, prospective, cross-sectional study in four collaborating retina clinics within Nigeria between January and December 2018. The primary outcome measure was the World Health Organization’s visual status classification at presentation. Clinical examination, including a Snellen’s visual acuity, refraction, anterior segment examination using a slit lamp biomicroscope, and dilated fundus examination using a +90D or +78D, was done in all consecutive RP patients. We analyzed the data using SPSS (version 22), P < 0.05. Results: Of 8614 patients seen within the study period, fiftyfour eyes of 27 patients diagnosed to have RP with a mean age of 44.1years ± 17.6 years (ranging between 5–73 years) constituted the study population. Eighteen (66.7%) were males and 9 (33.3%) females. The hospital-based prevalence of RP was 0.31%. Ten patients (37.0%) presented with myopia. RP was bilateral in all cases and non-syndromic. Bilateral low vision and blindness were noted in 44.4% and 22.2% of patients respectively. Conclusion: About a quarter of patients with RP presenting to the retina clinics would have some degree of visual morbidity. Educating eye care providers and patients about the disease would improve understanding, encourage early clinic visits, manage visual morbidity and enhance rehabilitation when necessary. Keywords: Retinitis Pigmentosa; Nigeria; Low Vision; Blindness.

Objective: To investigate the prevalence and presentation of polypoidal choroidal vasculopathy (PCV) in Nigerians. Methods: A cross-sectional, multicenter, hospital-based, descriptive study. Data were collected prospectively between January and December 2018, from consecutive patients diagnosed to have a retina disease at the general outpatient and retinal clinics of four eye departments in Nigeria. All participants had visual acuity, refraction, intraocular pressure, anterior segment examination, and dilated fundus examination. Some patients had fundus fluorescein angiography, optical coherence tomography (OCT), and OCT angiography (OCTA). Systemic comorbidity was determined by medical history and systemic evaluation. Diagnosis of PCV was based on clinical findings, and in some patients using OCT. Results: A total of 8,614 patients were seen and 15 patients (18 eyes) were diagnosed to have PCV giving a yearly hospital-based prevalence of 0.17%. The mean age at presentation was 63.27 ± 11.5 years (range 44–84 years). There were nine females (60%). The male: female ratio was 1.5:1. Twelve (66.7%) of the 18 eyes were blind, 16.7% had severe visual impairment while 11.1% had mild visual impairment. Seven eyes (38.9%) had vitreous hemorrhage. Of the 12 blind eyes, 50% had vitreous hemorrhage (P = 0.463). Nine patients (60%) had systemic hypertensive as comorbidity (P = 0.016). Conclusion: PCV is a cause of vision loss among Nigerians. Majority of the eyes were blind and 50% of blind eyes had vitreous hemorrhage. Since Indocyanine Green Angiography is the most appropriate imaging technology and is mostly unavailable in Nigeria, efforts should be made to address this need and improve the diagnostic accuracy.