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This study quantifies the performance of an international cohort of cornea specialists in image-based differentiation of bacterial and fungal keratitis, identifying significant regional variation and establishing a reference standard for comparison against machine learning models.

Ephrem Kibru Melese, Menen Ayalew Shibeshi, Sadik Taju Sherief Department of Ophthalmology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Sadik Taju Sherief, Department of Ophthalmology, School of Medicine, College of Health Sciences, Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia, Email goge4000@yahoo.comPurpose: A community-based study was conducted to determine the prevalence and sociodemographic factors of pseudoexfoliation syndrome among adults in Southern Ethiopia.Patients and Methods: A community-based cross-sectional study was conducted among subjects aged 40 years or older. Subjects underwent standardized examination, including portable slit-lamp biomicroscopy before and after pupillary dilatation, and intraocular pressure measurement using Tono-Pen. Pseudoexfoliation was diagnosed on slit-lamp examination by the presence of white dandruff-like material on the pupillary margin and/or on the anterior lens capsule of one or both eyes.Results: Among 760 participants, the prevalence of pseudoexfoliation was 12.0% (95% confidence interval: 9.7– 14.3%). The mean age of pseudoexfoliation cases was 63.9 years (SD 9.96, age range 40– 90 years). The prevalence increased with increasing age, with 26.9% of those 60 or older affected. Slightly higher proportion of males (12.4%) were found to have pseudoexfoliation in either of the eyes than females (11.6%) which was not statistically significant (p = 0.738). Mean IOP in subjects with pseudoexfoliation was found to be 20.65 ± 5.15 mmHg, while it was 15.0 ± 2.3 mmHg for those without pseudoexfoliation. The difference between the two populations was found to be statistically significant (P < 0.05).Conclusion: The prevalence of pseudoexfoliation in eyes of people in Southern Ethiopia appears greater than that reported in other places of Africa and Asia. Pseudoexfoliation occurs at a relatively younger age in our population. Increasing age is associated with the presence of pseudoexfoliation, and pseudoexfoliation in turn is associated with higher intraocular pressure.Keywords: pseudoexfoliation, intraocular pressure, glaucoma, rural community

Background: Clinical studies in the hospital settings using patients having ocular morbidities have shown a high prevalence of pseudoexfoliation (PXF) in Ethiopia. With this information in mind community based study was conducted to determine prevalence and socio demographic factors of pseudoexfoliation syndrome among adults in Southern Ethiopia.Methods: A community based Crosse sectional study was conducted among subjects aged 40 years or older. Subjects underwent standardized examination, including portable slit lamp biomicroscopy before and after pupillary dilatation, and IOP measurement using Tono-Pen. Pseudoexfoliation was diagnosed on slit lamp exam by the presence of white dandruff-like material on the pupillary margin and/or on the anterior lens capsule of one or both eyes. Results: Among 760 participants, the prevalence of Pseudoexfoliation(PXF) was 12.0% (95% confidence interval, 9.7%-14.3%). The mean age was 63.9 years (SD 9.96, age range 40-90 years). The prevalence increased with increasing age, with 26.9% of those 60 or older affected. Slightly higher proportion of males (12.4%) were found to have Pseudoexfoliation in either of the eyes than females (11.6%) which was not statistically significant (p=0.738). Mean IOP in subjects with PXF was found to be 20.65 + 5.15 mmHg, while it was 15.0 + 2.3mmHg for those without PXF. The difference between the two populations was found to be statistically significant (PConclusions: The prevalence of PXF in eyes of people in Southern Ethiopia appears greater than that reported in other places of Africa and Asia. PXF occurs at a relatively younger age in our population. Increasing age is associated with the presence of PXF, and PXF in turn is associated with high IOP.

Clinical studies in the hospital settings using patients having ocular morbidities have shown a high prevalence of pseudoexfoliation (PXF) in Ethiopia. With this information in mind community based study was conducted to determine age and sex-specific prevalence of pseudoexfoliation syndrome (PXF) and its relationship with some ophthalmological variables.Objective To determine the prevalence and clinical features of pseudoexfoliation among adults in kebena woreda of Gurage zone, SNNPR, Ethiopia.Design Random cross-sectional samples of adult population aged 40 years or older in the community of the district.Methods A total of 760 subjects aged 40 years or older underwent standardized examination, including portable slit lamp biomicroscopy before and after pupillary dilatation, and IOP measurement using Tono-Pen. PXF was diagnosed on slit lamp exam by the presence of white dandruff-like material on the pupillary margin and/or on the anterior lens capsule of one or both eyes.Results Among 760 participants, the prevalence of PXF was 12.0% (95% confidence interval, 9.7%-14.3%). The mean age was 63.9 years (SD 9.96, age range 40-90 years). Fifty six percent were found to have bilateral PXF. The prevalence increased with increasing age, with 26.9% of those 60 or older affected. Slightly higher proportion of males (12.4%) were found to have pseudoexfoliation in either of the eyes than females (11.6%) which was not statistically significant (p=0.738). Mean IOP in subjects with PXF was found to be 20.65 + 5.15 mmHg, while it was 15.0 + 2.3mmHg for those without PXF. The difference between the two populations was found to be statistically significant (P

PURPOSE To describe the indications, visual acuity outcomes, and graft survival after penetrating keratoplasty (PKP) in Addis Ababa, Ethiopia. METHODS The medical records of patients who underwent PKP at Menelik II Hospital between September 2000 and September 2013 were retrospectively reviewed. The prespecified outcomes were graft survival, visual acuity, and complication rates. RESULTS A total of 321 patients underwent PKP during the study period and were included in the analysis. Indications for surgery were trachoma or leukoma in 141 (44%), keratoconus in 45 (14%), corneal dystrophy in 46 (14%), pseudophakic or aphakic bullous keratopathy in 28 (9%), trauma in 27 (8%), previous graft failure in 18 (6%), active ulcer, burn, or perforation in 9 (3%), and others in 7 (2%). The graft survival rate was 80% overall at 2 years but varied considerably depending on the indication for surgery. Uncorrected visual acuity improved from baseline mean logarithm of the minimum angle of resolution 2.09 (SD 0.67) to mean logarithm of the minimum angle of resolution of 1.53 (SD 1.03) at 2 years. A number of factors affected the visual acuity outcomes. Patients were not routinely refracted, and only 18% (N = 60) of patients had access to corrective spectacles or contact lenses postoperatively. Complication rates were high with infectious keratitis being the most common. CONCLUSIONS PKP is becoming a viable treatment for corneal opacity in developing countries. However, the high burden of disease and lack of corrective lenses remain significant obstacles to overcome.

Background: Pterygium is principally prevalent in tropical Africa. Though Ethiopia is located in the tropics, the prevalence of pterygium has not been well studied previously. Aim: To determine the prevalence of pterygium among people older than 20 years and its association with age, sex, smoking and exposure to ultraviolet light (UVL) in Meskan District of Gurage zone, Southern Ethiopia. Methods: This cross-sectional study was conducted from March 15 to May 15, 2006. Two peasant associations (PA) were randomly selected from the total of 42 in the district. Based on the sampling fraction, every third household in the selected peasant associations was included in the study. All individuals above 20 years of age in the selected households were interviewed and examined for the presence of pterygium. Measurements of pterygium were made with ruler. Visual acuity was taken for those individuals with pterygium and checked with pinhole if found to be less than 6/18. Results: A total of 922 individuals, 400 (43.4%) males and 522 (56.6%) females, were involved in the study. The mean age was 38.2 ranging from 21-95 years. Pterygium was found in 81 (8.8%, 95% CI: 7.0,10.6) of the study subjects. For those individuals whose age was above 40 years, the prevalence was found to be 17.4% indicating an increased risk with age (p

Purpose The purpose of this study is to describe the clinical characteristics, microscopic findings, and treatment response to albendazole of microsporidial keratoconjunctivitis among immunocompromised individuals with HIV/AIDS. Methods This is a retrospective case series. Diagnosis of microsporidial keratoconjunctivitis was confirmed by subspecialist examination and conjunctival swabs examined by light microscopy. HIV infection was documented, and absolute CD4+ T cell count was determined. Patients were treated with albendazole and followed for clinical response. Results Light microscopy from the conjunctival swabs demonstrated myriad small, round to oval microsporidial organisms that stained positively with modified acid-fast methods. Two of the patients initially not taking highly active antiretroviral therapy (HAART) and presenting with an absolute CD4+ T cell count less than 100 cells/μL had a more severe form of keratoconjunctivitis than the third patient (receiving HAART, with a CD4+ T cell count of 259 cells/μL). All patients were started or continued on HAART. Two of the patients responded to oral albendazole, with resolution of symptoms and signs. The third patient did not initially respond, perhaps because of an immune recovery inflammatory syndrome, but subsequently had temporary improvement with albendazole. Conclusions Microsporidial keratoconjunctivitis is a rare ocular complication of HIV/AIDS. Light microscopic evaluation of conjunctival swabs may be a useful minimally invasive first step toward diagnosis of microsporidial keratoconjunctivis in settings where electron microscopy is not available. Based on the limited available information, albendazole often is effective for this condition, and is widely available in developing countries at low cost.