Toyin Akanbi - Academia.edu (original) (raw)

Papers by Toyin Akanbi

British Journal of Medicine and Medical Research, 2017

Aims: To conduct a situational analysis of human resources for eye health (HReH) and assess its p... more Aims: To conduct a situational analysis of human resources for eye health (HReH) and assess its progress towards vision 2020 goals in Ogun state of Nigeria. Study Design: A descriptive cross-sectional study. Place and Duration of Study: 21 eye care facilities in Ogun state between November and December 2014. Methodology: Data was collected with an adapted questionnaire developed by WHO and IAPB. The questionnaire was filled by telephone interview to key officials of registration boards for ophthalmologists, optometrists and ophthalmic nurses and public and private institutions employing these professionals in the state. Sources of population data was from census, state website and estimated rate of annual population. Each of these targets graded to show if vision 2020 target was met in 2014. Results: There were 21 eye care facilities in Ogun state. 7 (33%) are government owned, 2 (9.5%) Original Research Article Bogunjoko et al.; BJMMR, 19(10): 1-9, 2017; Article no.BJMMR.31702 2 are non-governmental organization (NGO)/mission owned and 12 (57.2%) are private for profit. There were 77 eye care workers in active service made up of 27 ophthalmologists, 31 ophthalmic nurses and 19 optometrists in 2014. Most eye care workers in Ogun state work in government establishments (66%), 26% in private for profit and 7.8% in NGO/mission. Vision 2020 targets had only been achieved for ophthalmologists in 2014. The Ogun state ratio for ophthalmologist was 5.4 per million populations, 3.8 for optometrists and 6.3 for ophthalmic nurses. The percentage of each of the eye care workers average 25% in the capital city and 75% outside capital. Practitioner per million population specific for capital and outside capital is worse outside capital city. Conclusion: The HReH was above the vision 2020 target for ophthalmologists. The ophthalmic nurses are above average and optometrists very low. There is need for a targeted investment for these two categories of practitioners and the need to address maldistribution of eye care workers.

Journal of Eye & Cataract Surgery, 2017

International Medical Case Reports Journal

Purpose: To report the natural history of a large bubble of perfluorocarbon liquid (PFCL) in a pa... more Purpose: To report the natural history of a large bubble of perfluorocarbon liquid (PFCL) in a parafoveal subretinal position which was monitored using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). The bubble of PFCL was removed when it migrated to the subfoveal position; outcome after removal is also reported. Observation: A 62-year-old male, after repair of a giant retinal tear (GRT) detachment, regained Snellen acuity of 6/18 from preoperative vision of CF at 1 meter. A large bubble of subretinal PFCL was in the superior parafoveal area. For 18 months, the PFCL bubble was monitored using OCT and OCTA until it migrated into the subfoveal position after 22 months, coinciding with a decrease in vision to 6/36. Surgical removal of subfoveal PFCL was performed. This involved detachment of the foveomacular, epiretinal membrane (ERM) peel (complicated by iatrogenic macular hole (MH) formation), intravitreal injection of PFCL to displace subretinal PFCL to the periphery, creation of an inverted internal limiting membrane (ILM) flap to repair the MH and air exchange. Postoperative vision remained 6/ 36. His postoperative OCT showed significant loss of subfoveal outer retina. On OCTA, the superficial and deep vascular plexi and choriocapillaris appeared to be intact after the removal of the subfoveal PFCL. Conclusion and Importance: This report suggests that a large superior parafoveal bubble of PFCL may take as much as 18 months to migrate to the subfoveal position. Before this time, vision does not appear to be affected, though macular edema is present. Therefore, removal of the PFCL can be delayed until a convenient time for surgeon and patient. A large bubble of parafoveal PFCL ought to be removed before migrating to a subfoveal position and vision loss, since its removal will reduce the risk of outer retina loss.

American Journal of Ophthalmology Case Reports

Taiwan Journal of Ophthalmology

International Journal Of Community Medicine And Public Health

Background: The objectives of the study were to review the training and assess the impact of midd... more Background: The objectives of the study were to review the training and assess the impact of middle level eye care personnel (community ophthalmic technician) with skills to complement the services of the ophthalmologist for efficient eye care system and fulfilling vision 2020 goals.Methods: The collaboration between 2010 and 2015 was reviewed with an institutional questionnaire for both Eye Foundation Centre and College of Health Technology in Ijebu, Nigeria: structure of 2 year training Programme and one year internship, community ophthalmic technicians (COT) as assistants to ophthalmologists, hierarchy/career options and challenges and ensuring clinical quality and their strength in the Eye Foundation Eye Health System were appraised.Results: From 2010 to 2015, a total of 72 COTs have graduated, 41(57%) of them employed by the Eye Foundation Hospital Group. Apart from this, 28 did their internship in 2015, 19 (68%) out of this at Eye Foundation establishments in southwestern and ...

Clinical Ophthalmology

Purpose: To determine the burden of retinal diseases and the degree of visual impairment associat... more Purpose: To determine the burden of retinal diseases and the degree of visual impairment associated with each disease, amongst Nigerians. Patients and Methods: This was a hospital-based multicenter, prospective, cross-sectional, non-comparative study conducted from January to December 2018. Data was obtained from consecutive patients with a retinal diagnosis presenting at the general ophthalmic and specialty retina clinics in four hospitals (three public, and one private teaching eye department) in Nigeria. Biodata, visual acuity and refraction, intraocular pressure, findings on dilated retinal examination, diagnosis and systemic diseases were noted. Degree of monocular and bilateral visual loss associated with each diagnosed retinal disease was summarized and p value was calculated using chi-square test. P < 0.05 was considered significant. Results: Eight hundred seventy-six of 8614 patients had a retinal diagnosis; establishing a hospital-based retinal disease prevalence of 9.8%. Male:female ratio was 1.1:1. The mean age of study patients was 49.97 (standard deviation 17.64 years). Mean symptom duration was 21.63 months (standard deviation 41.94). The mean intraocular pressure was 13.87 mmHg. Forty-three different retinal diseases were diagnosed. The most common was retinal complications of diabetes, i.e., diabetic retinopathy (DR) alone, diabetic macular edema (DME) alone and a combination of DR and DME, which accounted for 13.7%, 5.6% and 9.3%, respectively (contributed 28.6% of the entire diagnosis). This was followed by retinal detachment (RD), in 219 eyes (15.4%), dry age-related macular degeneration (AMD) in 124 eyes (8.7%). Nearly half of the eyes were blind or severely visually impaired. Blindness occurred in 34.1% of eyes; severe visual impairment in 8.2% of eyes and 29.7% had normal vision. There were 469 patients who had systemic diseases. The common systemic diseases were hypertension in 169 patients (19.3% of the total number of patients), hypertension and diabetes in 156 patients (18%), and diabetes alone in 98 patients (11.1%). Sickle cell disease was present in 1.5%. Conclusion: There is need to invest in infrastructure, local training and development of systems for early detection and treatment of several retinal diseases in sub-Saharan Africa; DR and DME having the largest burden. Collaborative physician care and management of hypertension and diabetes could significantly reduce the burden of DR and DME.

Journal of Advances in Medicine and Medical Research

Aims: To describe the sociodemographic details and indications for the use of anti endothelial gr... more Aims: To describe the sociodemographic details and indications for the use of anti endothelial growth factor (anti-VEGF) injections at the Eye Foundation Centres in Nigeria. Study Design: Retrospective, observational analysis Place and Duration of Study: Nigeria between January 2011 and December 2014. Methods: Records of all anti-VEGF injections given were assessed. All consecutiv taken in proportion seen in the 4 centres. Age, sex, occupation, diagnoses and types of injection were recorded in the data sheet prepared for the study. Results: This study included 1072 eyes of 540 patients. Mean age was 60.37(12.74) standa deviation years. The age range is from 10 were seen. Patients that presented were mostly currently employed 40.8%,

Ophthalmology Research: An International Journal

Primary Health Centres in Nigeria and particularly Ogun state have suffered serious neglect over ... more Primary Health Centres in Nigeria and particularly Ogun state have suffered serious neglect over the years. A private / public partnership together with private health /education partnership have strengthened government health systems, developing a sustainable model for delivery of eye services to the most indigent. Over the last four years, in Ogun state, screening for cataract alone has increased in fourfold and the number of cataracts surgeries performed, threefold. However, ongoing subsidising of surgeries may be needed until local health insurance schemes or other ways of financing eye care become reliable. Tackling health beliefs about eye care remain one of the main barriers to uptake of services.

International Journal Of Community Medicine And Public Health

Background: To review cases of posterior segment eye diseases (PSEDs) seen at the Eye Foundation ... more Background: To review cases of posterior segment eye diseases (PSEDs) seen at the Eye Foundation Centre Ijebu, Nigeria in a 5 year period for planning purposes.Methods: Data was collected from patients’ case notes from January 2006 to December 2011. A systematic sampling of 468 patients from 1173 case notes of patient with (PSEDs) was done. Information retrieved was: age, sex, state of residence and diagnosis. All patients were examined by the glaucoma and the vitroretinal specialist as the case may be. They had visual acuity, refraction, slit lamp examination (including intraocular pressure (IOP) with Goldman applanation tonometer), and dilated fundoscopy with (bilateral indirect ophthalmoscopy) BIO, slit lamp using 20 D, 78 D and 90 D respectively. The glaucoma patients in addition had central visual field (CVF), Central cornea thickness (CCT), fundus photograph and in some cases optical coherence tomography (OCT) done in addition to the above.Results: The mean age was 59.98 years...

British Journal of Medicine and Medical Research, 2017

Aims: To conduct a situational analysis of human resources for eye health (HReH) and assess its p... more Aims: To conduct a situational analysis of human resources for eye health (HReH) and assess its progress towards vision 2020 goals in Ogun state of Nigeria. Study Design: A descriptive cross-sectional study. Place and Duration of Study: 21 eye care facilities in Ogun state between November and December 2014. Methodology: Data was collected with an adapted questionnaire developed by WHO and IAPB. The questionnaire was filled by telephone interview to key officials of registration boards for ophthalmologists, optometrists and ophthalmic nurses and public and private institutions employing these professionals in the state. Sources of population data was from census, state website and estimated rate of annual population. Each of these targets graded to show if vision 2020 target was met in 2014. Results: There were 21 eye care facilities in Ogun state. 7 (33%) are government owned, 2 (9.5%) Original Research Article Bogunjoko et al.; BJMMR, 19(10): 1-9, 2017; Article no.BJMMR.31702 2 are non-governmental organization (NGO)/mission owned and 12 (57.2%) are private for profit. There were 77 eye care workers in active service made up of 27 ophthalmologists, 31 ophthalmic nurses and 19 optometrists in 2014. Most eye care workers in Ogun state work in government establishments (66%), 26% in private for profit and 7.8% in NGO/mission. Vision 2020 targets had only been achieved for ophthalmologists in 2014. The Ogun state ratio for ophthalmologist was 5.4 per million populations, 3.8 for optometrists and 6.3 for ophthalmic nurses. The percentage of each of the eye care workers average 25% in the capital city and 75% outside capital. Practitioner per million population specific for capital and outside capital is worse outside capital city. Conclusion: The HReH was above the vision 2020 target for ophthalmologists. The ophthalmic nurses are above average and optometrists very low. There is need for a targeted investment for these two categories of practitioners and the need to address maldistribution of eye care workers.

Journal of Eye & Cataract Surgery, 2017

International Medical Case Reports Journal

Purpose: To report the natural history of a large bubble of perfluorocarbon liquid (PFCL) in a pa... more Purpose: To report the natural history of a large bubble of perfluorocarbon liquid (PFCL) in a parafoveal subretinal position which was monitored using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). The bubble of PFCL was removed when it migrated to the subfoveal position; outcome after removal is also reported. Observation: A 62-year-old male, after repair of a giant retinal tear (GRT) detachment, regained Snellen acuity of 6/18 from preoperative vision of CF at 1 meter. A large bubble of subretinal PFCL was in the superior parafoveal area. For 18 months, the PFCL bubble was monitored using OCT and OCTA until it migrated into the subfoveal position after 22 months, coinciding with a decrease in vision to 6/36. Surgical removal of subfoveal PFCL was performed. This involved detachment of the foveomacular, epiretinal membrane (ERM) peel (complicated by iatrogenic macular hole (MH) formation), intravitreal injection of PFCL to displace subretinal PFCL to the periphery, creation of an inverted internal limiting membrane (ILM) flap to repair the MH and air exchange. Postoperative vision remained 6/ 36. His postoperative OCT showed significant loss of subfoveal outer retina. On OCTA, the superficial and deep vascular plexi and choriocapillaris appeared to be intact after the removal of the subfoveal PFCL. Conclusion and Importance: This report suggests that a large superior parafoveal bubble of PFCL may take as much as 18 months to migrate to the subfoveal position. Before this time, vision does not appear to be affected, though macular edema is present. Therefore, removal of the PFCL can be delayed until a convenient time for surgeon and patient. A large bubble of parafoveal PFCL ought to be removed before migrating to a subfoveal position and vision loss, since its removal will reduce the risk of outer retina loss.

American Journal of Ophthalmology Case Reports

Taiwan Journal of Ophthalmology

International Journal Of Community Medicine And Public Health

Background: The objectives of the study were to review the training and assess the impact of midd... more Background: The objectives of the study were to review the training and assess the impact of middle level eye care personnel (community ophthalmic technician) with skills to complement the services of the ophthalmologist for efficient eye care system and fulfilling vision 2020 goals.Methods: The collaboration between 2010 and 2015 was reviewed with an institutional questionnaire for both Eye Foundation Centre and College of Health Technology in Ijebu, Nigeria: structure of 2 year training Programme and one year internship, community ophthalmic technicians (COT) as assistants to ophthalmologists, hierarchy/career options and challenges and ensuring clinical quality and their strength in the Eye Foundation Eye Health System were appraised.Results: From 2010 to 2015, a total of 72 COTs have graduated, 41(57%) of them employed by the Eye Foundation Hospital Group. Apart from this, 28 did their internship in 2015, 19 (68%) out of this at Eye Foundation establishments in southwestern and ...

Clinical Ophthalmology

Purpose: To determine the burden of retinal diseases and the degree of visual impairment associat... more Purpose: To determine the burden of retinal diseases and the degree of visual impairment associated with each disease, amongst Nigerians. Patients and Methods: This was a hospital-based multicenter, prospective, cross-sectional, non-comparative study conducted from January to December 2018. Data was obtained from consecutive patients with a retinal diagnosis presenting at the general ophthalmic and specialty retina clinics in four hospitals (three public, and one private teaching eye department) in Nigeria. Biodata, visual acuity and refraction, intraocular pressure, findings on dilated retinal examination, diagnosis and systemic diseases were noted. Degree of monocular and bilateral visual loss associated with each diagnosed retinal disease was summarized and p value was calculated using chi-square test. P < 0.05 was considered significant. Results: Eight hundred seventy-six of 8614 patients had a retinal diagnosis; establishing a hospital-based retinal disease prevalence of 9.8%. Male:female ratio was 1.1:1. The mean age of study patients was 49.97 (standard deviation 17.64 years). Mean symptom duration was 21.63 months (standard deviation 41.94). The mean intraocular pressure was 13.87 mmHg. Forty-three different retinal diseases were diagnosed. The most common was retinal complications of diabetes, i.e., diabetic retinopathy (DR) alone, diabetic macular edema (DME) alone and a combination of DR and DME, which accounted for 13.7%, 5.6% and 9.3%, respectively (contributed 28.6% of the entire diagnosis). This was followed by retinal detachment (RD), in 219 eyes (15.4%), dry age-related macular degeneration (AMD) in 124 eyes (8.7%). Nearly half of the eyes were blind or severely visually impaired. Blindness occurred in 34.1% of eyes; severe visual impairment in 8.2% of eyes and 29.7% had normal vision. There were 469 patients who had systemic diseases. The common systemic diseases were hypertension in 169 patients (19.3% of the total number of patients), hypertension and diabetes in 156 patients (18%), and diabetes alone in 98 patients (11.1%). Sickle cell disease was present in 1.5%. Conclusion: There is need to invest in infrastructure, local training and development of systems for early detection and treatment of several retinal diseases in sub-Saharan Africa; DR and DME having the largest burden. Collaborative physician care and management of hypertension and diabetes could significantly reduce the burden of DR and DME.

Journal of Advances in Medicine and Medical Research

Aims: To describe the sociodemographic details and indications for the use of anti endothelial gr... more Aims: To describe the sociodemographic details and indications for the use of anti endothelial growth factor (anti-VEGF) injections at the Eye Foundation Centres in Nigeria. Study Design: Retrospective, observational analysis Place and Duration of Study: Nigeria between January 2011 and December 2014. Methods: Records of all anti-VEGF injections given were assessed. All consecutiv taken in proportion seen in the 4 centres. Age, sex, occupation, diagnoses and types of injection were recorded in the data sheet prepared for the study. Results: This study included 1072 eyes of 540 patients. Mean age was 60.37(12.74) standa deviation years. The age range is from 10 were seen. Patients that presented were mostly currently employed 40.8%,

Ophthalmology Research: An International Journal

Primary Health Centres in Nigeria and particularly Ogun state have suffered serious neglect over ... more Primary Health Centres in Nigeria and particularly Ogun state have suffered serious neglect over the years. A private / public partnership together with private health /education partnership have strengthened government health systems, developing a sustainable model for delivery of eye services to the most indigent. Over the last four years, in Ogun state, screening for cataract alone has increased in fourfold and the number of cataracts surgeries performed, threefold. However, ongoing subsidising of surgeries may be needed until local health insurance schemes or other ways of financing eye care become reliable. Tackling health beliefs about eye care remain one of the main barriers to uptake of services.

International Journal Of Community Medicine And Public Health

Background: To review cases of posterior segment eye diseases (PSEDs) seen at the Eye Foundation ... more Background: To review cases of posterior segment eye diseases (PSEDs) seen at the Eye Foundation Centre Ijebu, Nigeria in a 5 year period for planning purposes.Methods: Data was collected from patients’ case notes from January 2006 to December 2011. A systematic sampling of 468 patients from 1173 case notes of patient with (PSEDs) was done. Information retrieved was: age, sex, state of residence and diagnosis. All patients were examined by the glaucoma and the vitroretinal specialist as the case may be. They had visual acuity, refraction, slit lamp examination (including intraocular pressure (IOP) with Goldman applanation tonometer), and dilated fundoscopy with (bilateral indirect ophthalmoscopy) BIO, slit lamp using 20 D, 78 D and 90 D respectively. The glaucoma patients in addition had central visual field (CVF), Central cornea thickness (CCT), fundus photograph and in some cases optical coherence tomography (OCT) done in addition to the above.Results: The mean age was 59.98 years...