MyMedR

Displaying all 9 publications

Abstract:

Sort:

Kearns-Sayre syndrome: An unusual ophthalmic presentation

Ahmad SS, Ghani SA

Oman J Ophthalmol, 2012 May;5(2):115-7.
PMID: 22993469

Kearns-Sayre syndrome (KSS) belongs to the group of neuromuscular disorders known as mitochondrial encephalomyopathies. It has characteristic syndromal features, which include: chronic progressive external ophthalmoplegia, bilateral atypical pigmentary retinopathy, and cardiac conduction abnormalities. So far, only a single case has been reported where a patient with KSS had a normal retina. Herein, we report this extremely rare variant of KSS, which not only presented later than the normal age of presentation, but also had minimal pigmentary retinopathy.
Fulltext Android mobile applications in eye care

Karthikeyan SK, Thangarajan R, Theruvedhi N, Srinivasan K

Oman J Ophthalmol, 2019 6 15;12(2):73-77.
PMID: 31198290 DOI: 10.4103/ojo.OJO_226_2018

Google Play Store was used to search for eye care-related applications the android simulator using various general terms related to eye care to review and categorize various interactive eye care-related applications in android platform from the details available in the application website. Data collected from application description and application developer's webpage include target audience, category of apps, estimated number of downloads, average user rating, involvement of eye care professionals in developing the application, and cost of the app. All these data were collected only from the details provided in the application website considering on online user perspective and the developers were not contacted to collect any other details. In total, 475 applications were identified and grouped into 13 categories depending on the type of service the application provide. Out of which, only 107 (22.53%) applications had mentioned about the eye care professional involvement in their design or development of the application. The applications were also stratified according to the target audience, and many had no user rating with very few downloads. The lack of evidence-based principles and standardization of application development should be taken into consideration to avoid its negative impact on the community, especially in eye care.
Fulltext A rare case of solitary unifocal Langerhans cell histiocytosis with orbital extension: Diagnostic dilemma

Addenan M, May CM, Hooi TK, Ismail F, Kamalden TA

Oman J Ophthalmol, 2018 12 7;11(3):284-287.
PMID: 30505126 DOI: 10.4103/ojo.OJO_149_2017

Langerhans cell histiocytosis (LCH) is rarely encountered in ophthalmology practice. It is a spectrum of disorder characterized by accumulation of histiocytes in various tissues. Diagnosis is challenging as it may simulate periorbital hematoma, rhabdomyosarcoma, and neuroblastoma. We report a case of unifocal LCH with orbital extension. Diagnosis was obtained from incisional biopsy, and histopathological examination showed numerous histiocytes with eosinophilic infiltrations. The presence of Langerhans cells was confirmed by the presence of protein S-100, CD1a, and/or Langerin (CD207). Treatment depends on the degree of organ involvement. She responded well to cytotoxic drugs and steroids. This emphasized that prompt tissue diagnosis is crucial for early management.
Fulltext Vitreous loss-causes, associations, and outcomes: Eight-year analysis in Melaka Hospital

Thevi T, Abas AL

Oman J Ophthalmol, 2018 6 23;11(2):113-118.
PMID: 29930443 DOI: 10.4103/ojo.OJO_220_2016

BACKGROUND: Cataract surgery is associated with a variety of complications, one of which is vitreous loss. Doctors and policymakers should be aware about the precipitating factors, associations, and expected outcomes of vitreous loss. This study was, therefore, undertaken to set guidelines to improve the visual outcomes of patients.

MATERIALS AND METHODS: A retrospective 8-year analysis was conducted from 2007 to 2014 using the national eye database. Demographic features, ocular comorbidities, grade of surgeon, type of surgery, and the associations with the occurrence of vitreous loss, and the final visual outcomes of these patients were studied.

RESULTS: Out of 12,992 eyes, only 3.2% had vitreous loss, mostly aged <40 years. Pseudoexfoliation was the only ocular comorbidity causing vitreous loss. Medical Officers and Gazetting Specialists got more vitreous loss compared to specialists. Intracapsular cataract extraction, phaco convert to extracapsular cataract extraction (ECCE), ECCE, and phaco all had a significant vitreous loss. Vitreous loss was the most significant intraoperative complication causing poor vision and resulted in impaired or poor visual outcome.

CONCLUSION: Vitreous loss occurred in almost all types of cataract surgeries, especially by junior surgeons, among those aged <40 years and significantly caused poor visual outcome compared to other complications. Pseudoexfoliation had higher occurrence of vitreous loss. Vitreous loss patients had impaired/poor visual outcome due to preexisting comorbidity and astigmatism. Patients at risk and junior surgeons should be closely monitored to improve outcomes. Further studies need to be done to see why and when the vitreous loss occurred.
Fulltext Intraoperative and postoperative complications of cataract surgery in eyes with pseudoexfoliation - An 8-year analysis

Thevi T, Abas AL

Oman J Ophthalmol, 2019 10 11;12(3):160-165.
PMID: 31902990 DOI: 10.4103/ojo.OJO_238_2018

INTRODUCTION: Pseudoexfoliation (PXM) is a fibrillar material deposited in the anterior chamber of the eye and can cause disintegration of zonules and make pupillary dilatation difficult. This can make surgery difficult and result in intraoperative and postoperative complications. The aim of this study was to learn about whether the presence of pseudoexfoliation caused significant complications during cataract surgery.
MATERIALS AND METHODS: We did a secondary data analysis of 12,992 eyes from 2007 to 2014 using the National Eye Database of Melaka Hospital Malaysia on intraoperative and postoperative cataract surgery complications of patients with PXM.
RESULTS: Patients with PXM were 2.68 times more likely to get intraoperative complications (P < 0.001). They had a higher incidence of lens subluxation, zonular dehiscence, and vitreous loss (P < 0.001). Although posterior capsule rupture (PCR) was the most common intraoperative complication during cataract surgery (4.8%), the presence of pseudoexfoliation was not associated with PCR (P > 0.05). We did not observe any association between patients with pseudoexfoliation and any of the postoperative complications such as corneal decompensation, raised intraocular pressure, and intraocular lens decentration (P > 0.05). Pseudoexfoliation did not cause corneal decompensation (P > 0.05) although corneal decompensation was the highest postoperative complication of cataract surgeries (0.18%).
CONCLUSIONS: Patients with PXM had a higher rate of intraoperative complications which were mainly vitreous loss and zonular dehiscence and also lens subluxation/dislocation. We observed poorer visual outcomes in those with PXM following cataract surgery. Patients with pseudoexfoliation should be identified and precautions taken to minimize these complications to get better visual outcomes.
Fulltext Prevalence of visual impairment in school-going children among the rural and urban setups in the Udupi district of Karnataka, India: A cross-sectional study

Prabhu AV, Ve RS, Talukdar J, Chandrasekaran V

Oman J Ophthalmol, 2019 10 11;12(3):145-149.
PMID: 31902987 DOI: 10.4103/ojo.OJO_190_2018

AIM: The aim of this study is to estimate the prevalence of visual impairment among school-going children in Udupi district, Karnataka.
MATERIALS AND METHODS: A cross-sectional study across eleven schools from both urban and rural parts of Udupi taluk was conducted to report the magnitude of visual impairment among the schoolchildren. Complex survey design was used in allocating the sample size through stratification and clustering. Totally 1784 schoolchildren between the age groups of 5 and 15 years participated in the study. Presenting visual acuity and objective refraction was measured using computerized logMAR acuity charts and Plusoptix A09 photorefractor, respectively. Manifest ocular deviation or squint was also recorded.
RESULTS: The mean age of the students was found to be 10.62 ± 2.72 years. The prevalence of visual impairment, i.e., visual acuity worse than or equal to 20/40 in the better eye was found to be 4.32% (95% confidence interval: 3.38%, 5.26%). The prevalence rate was significantly higher among students from urban area (5.6%) compared to those from rural area (3.6%) (P = 0.011).
CONCLUSION: Visual impairment was found to be 4.32% in the school-going population of Udupi district. Effective and user-friendly devices aided the visual deficit screening including refractive error and squint.
Cladosporium spp. endogenous endophthalmitis simulating the classic "headlight-in-the-fog" appearance of active toxoplasmosis

Abd Hamid A, Suan ALL, Hashim H, Kamarudin Z, Muhammed J

Oman J Ophthalmol, 2022;15(3):379-381.
PMID: 36760965 DOI: 10.4103/ojo.ojo_459_20

Endogenous fungal endophthalmitis caused by an unusual fungus poses both diagnostic and therapeutic challenges. We report a case of endogenous endophthalmitis caused by a rare mold, namely Cladosporium spp., which presented with a foveal abscess. A 52-year-old male patient who was diagnosed with rectal carcinoma presented with pain, redness, and a loss of vision in the right eye. He had been experiencing the symptoms for 1 week. The patient had undergone gastrointestinal surgery 2 weeks before experiencing the eye complaint. His best-corrected visual acuity was hand movements. Fundus examination revealed a foveal abscess of around a half-disc diameter in size that simulated retinochoroiditis with vitritis. Optical coherence tomography of the macula revealed a hyperreflective lesion in the fovea, which breached the full thickness of the fovea and extended into the preretinal space. Ocular toxoplasmosis was considered. On that basis, oral trimethoprim/sulfamethoxazole was given for 1 week, although the patient's condition worsened. A vitreous tap and an intravitreal combination of vancomycin, ceftazidime, and amphotericin B were administered twice but did not improve the patient's condition. Pars plana vitrectomy was performed and the vitreous biopsy results revealed the presence of Cladosporium spp. Intravitreal voriconazole was given three times and the foveal abscess resolved into a scar. Endophthalmitis caused by Cladosporium spp. is uncommon and published case reports are extremely limited. The present case may provide insight into the variable presentation of fungal endophthalmitis and, therefore, assist with the early diagnosis and appropriate management of the condition.
Sphingomonas paucimobilis endophthalmitis postpenetration ocular trauma: A rare case report

Alias NAQ, Bari MA, Jabbari AJ, Salam A

Oman J Ophthalmol, 2023;16(3):555-557.
PMID: 38059095 DOI: 10.4103/ojo.ojo_298_22

Endophthalmitis is an uncommon purulent inflammation of the intraocular fluids secondary to endogenous or exogenous causes. It is known that posttraumatic endophthalmitis had a notably poor visual outcome, and it poses therapeutic challenges. Therefore, early organism detection would be beneficial in therapeutic management and are able to reduce long-term complications. This case report describes a patient with a rare positive culture-proven Sphingomonas paucimobilis endophthalmitis due to penetrating ocular trauma by a metal brush over the right eye. A 36-year-old man presented with progressively worsening right eye redness and blurring of vision with pain for 3 days following ocular penetration by a metal brush during grinding. On initial presentation, his visual acuity was 6/12 over the right eye and 6/6 over the left eye. His visual acuity deteriorated to hand movement 5 days later with worsening of ocular infection over the right eye despite topical and oral antibiotics. B-scan revealed dense vitreous infiltration. A vitreous tap was done, and a combination of intravitreal vancomycin and ceftazidime was administered. Vitreous culture isolated Gram negative S. paucimobilis. The patient was planned for early vitrectomy; however, the patient opted for conservative treatment. Therefore, the patient received intravitreal vancomycin and intravitreal ceftazidime injections every 48-72 h. Published articles on S. paucimobilis endophthalmitis postocular penetration are extremely limited. This case report may provide a better understanding of the presentation and is able to aid with early diagnosis and treatment initiation for future reference.
Fulltext A simplification of intricate multifocal electroretinogram understanding: A mini-review

Chen AH, Rafiuddin MSM, Ahmad A, Rosli SA

Oman J Ophthalmol, 2024;17(1):11-18.
PMID: 38524335 DOI: 10.4103/ojo.ojo_48_23

Variation of multifocal electroretinogram (mfERG) data presentation in existing scientific publications is a challenge for eye care practitioners to apply the scientific information for evidence-based practice in patient management. This review offers an overview of the mfERG data presentation types. Eight types of data presentation in the form of a table, scatter plot, line graph, bar graph/box plot, single waveform/a group of waveforms, trace array topography, three-dimensional topography, and two-dimensional topography are identified. The table format is used to provide the exact values. Line graphs, scatter, and box plots offer information about the relationship of mfERG values. Waveforms are helpful for comparison between groups or conditions. Topographies outline the retinal, especially the specific localized retinal abnormalities. An infographic of fundamental mfERG electrical response with definitions and clinical indications is provided to bridge the gap between researchers and clinicians to facilitate efficient clinical application.