The Burden and Spectrum of Vitreo-Retinal Diseases Among Ophthalmic Outpatients in a Resource-Deficient Tertiary Eye Care Setting in South-Eastern Nigeria

PURPOSE: This study was designed to determine the rate and pattern of vitreo-retinal diseases at a tertiary eye care center in South-eastern Nigeria. MATERIALS AND METHODS: The outpatient register at the Eye Clinic of the University of Nigeria Teaching Hospital, Enugu, was retrospectively examined to identify all new patients registered between January 2004 and December 2008. A chart review of subjects with vitreo-retinal disease was conducted to record relevant demographic and clinical data including the needs for vitreo-retinal care. Descriptive and analytical statistics were performed. A P-value <0.001 (one degree of freedom) was considered statistically significant. RESULTS: Of the 8,239 new patients reported during the period, 326 subjects (males- 59.3%; females- 40.7%; sex ratio = 1.1:1) aged 49.3 ± 16.8 years (range 3-82 years) had vitreo-retinal disease. The rate of vitreo-retinal disease was 3.9%. The rate was higher in subjects above 40 years old (P < 0.001), but did not differ between sexes (P = 0.469). Diabetic retinopathy (24.9%), hypertensive retinopathy (13.3%), and age-related macular degeneration (10.7%) were the leading vitreo-retinal diseases. Blindness from vitreo-retinal disease was bilateral in 6.1% of subjects and unilateral in 17.5% of subjects. The common co-morbidities were ocular conditions such as refractive error (19.8%), cataract (14.2%), and glaucoma (10.4%); and systemic conditions such as diabetes mellitus (14.6%) and hypertension (13.2%). CONCLUSIONS: The rate of vitreo-retinal diseases among new ophthalmic outpatients at UNTH, Enugu, is 3.9%. Retinal vascular disorders and age-related maculopathy are the leading retinal diseases. At UNTH, resource needs for vitreo-retinal care are urgent including retinal photography/angiography, laser photocoagulation, intra-vitreal pharmacotherapy, and vitreo-retinal surgery.