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Exfoliation syndrome in sub-Saharan Africa

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Abstract

The goal of this review is to estimate the burden of exfoliation syndrome (XFS) and exfoliation glaucoma (XFG) in sub-Saharan Africa and to identify the gaps in knowledge of disease prevalence in this region. PubMed, Medline, African Journals Online and Google engine search were carried out using the following terms “pseudoexfoliation” or “exfoliation syndrome Africa”, “pseudoexfoliation” or “exfoliation syndrome” + “glaucoma Africa,” “glaucoma prevalence Africa,” “pattern of glaucoma presentation Africa,” “pseudoexfoliation” or “exfoliation syndrome” + “cataract Africa,” “ophthalmic conditions Africa.” Studies were included if they described the proportion or prevalence/incidence of XFG and XFS in sub-Saharan Africa or if they investigated lysyl oxidase-like 1 (LOXL1) variants in XFS among Africans. 22 papers were identified and classified as clinic-based studies (n = 16) and population-based (n = 4) studies. Two other studies were considered important, and therefore, included in the review. Clinic-based studies demonstrate that XFS is a common cause of glaucoma, as is true in many other parts of the world. Furthermore, XFS often co-exists with cataract and climatic droplet keratopathy. Its prevalence ranged from 5.1 to 7.7 % in patients >40 years in population-based studies, a value that is considerably higher than that reported in African Americans. XFS was strongly associated with increasing age in the prevalence studies. The burden of XFS in sub-Saharan Africa is high. More investigation is needed to determine why clinic-based studies report virtually no XFS in some countries (Ghana and Tanzania), while nearby countries report greater proportions (Nigeria and Ethiopia).

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Acknowledgments

Competing Interest

The authors have no conflict of interest regarding the present study.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, University College Hospital, Ibadan, Nigeria

    Olusola O. Olawoye

  2. Department of Ophthalmology College of Medicine, University of Ibadan, Ibadan, Nigeria

    Olusola O. Olawoye

  3. Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA

    Louis R. Pasquale

  4. Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Louis R. Pasquale

  5. Einhorn Clinical Research Center, The New York Eye and Ear Infirmary at Mount Sinai School of Medicine, New York, NY, USA

    Robert Ritch

Authors
  1. Olusola O. Olawoye
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  2. Louis R. Pasquale
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  3. Robert Ritch
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Corresponding author

Correspondence to Olusola O. Olawoye.

Additional information

Pasquale is supported by a Harvard Medical School Distinguished Scholar Award and by the Arthur Ashley Williams Foundation.

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Olawoye, O.O., Pasquale, L.R. & Ritch, R. Exfoliation syndrome in sub-Saharan Africa. Int Ophthalmol 34, 1165–1173 (2014). https://doi.org/10.1007/s10792-014-9953-5

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  • DOI: https://doi.org/10.1007/s10792-014-9953-5

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