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  1. Ng YS, Gan YK, Tupang L
    Turk J Ophthalmol, 2021 Feb 25;51(1):62-65.
    PMID: 33631919 DOI: 10.4274/tjo.galenos.2020.00225
    An 88-year-old woman was brought to the hospital immediately after her neighbours noticed that she was bleeding from her right eye. On examination, her right eye was phthisic with maggot infestation of her right orbit. Over a hundred live maggots were extracted using forceps. Computed tomography scan revealed the infestation was confined to the right orbit. The patient underwent exenteration of the right orbit under general anaesthesia. The species was identified by an entomologist as Chrysomya bezziana, which has aggressive larvae that eat living tissue. This case report demonstrates that orbital myiasis caused by C. bezziana poses a very real risk of intracranial invasion as they feed on living tissues. Adjacent tissue destruction can be very rapid and definitive treatment involves urgent removal of its larvae via surgical debridement. To our knowledge, we are reporting the first case of orbital myiasis from a patient in Malaysia. Therefore, our case report may be helpful in the management of similar case of orbital myiasis.
  2. Ab Kahar MEPI, Muhammed J, Hitam WHW, Husin A
    Turk J Ophthalmol, 2020 12 29;50(6):371-376.
    PMID: 33389938 DOI: 10.4274/tjo.galenos.2020.83873
    Bartonella henselae is a recognized cause of neuroretinitis in cat scratch disease. Meanwhile, polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes (POEMS) syndrome with Castleman disease (evidence of lymph node hyperplasia), is a chronic debilitating condition that predisposes to various superimposed infections. B. henselae neuroretinitis implicated in POEMS syndrome has not been reported previously. A 34-year-old asymptomatic man was referred for an eye assessment. Examination showed visual acuity of 6/18 in the right eye and 6/24 in the left eye. On fundus examination, both eyes exhibited typical features of neuroretinitis (optic disc swelling and incomplete macular star). There was otherwise no vitritis or chorioretinitis. Serology for B. henselae revealed high immunoglobulin M (IgM) titer (1:96) indicative of acute disease, and positive immunoglobulin G (IgG) (1:156). He was treated with oral azithromycin for 6 weeks and a short course of oral prednisolone. Subsequently, the visual acuity in both eyes improved with resolution of macular star. However, both optic discs remained swollen.
  3. Chitamparam S, Lim TH, Tai E, Ibrahim M
    Turk J Ophthalmol, 2020 12 29;50(6):332-338.
    PMID: 33389932 DOI: 10.4274/tjo.galenos.2020.57609
    Objectives: To identify the clinical profile, etiology, and outcome of culture-positive mycotic keratitis in a tertiary referral centre in the Northeastern part of Malaysia.

    Materials and Methods: A retrospective review of all patients with culture-positive mycotic keratitis in Hospital Universiti Sains Malaysia over a 3-year period, from January 2015 to December 2017.

    Results: This study included 27 eyes of 27 patients treated for mycotic keratitis based on a positive fungal culture. The most common predisposing factor was ocular trauma, in 22 patients (81.5%). Eleven patients (40.7%) had a presenting visual acuity worse than 6/60, due to central ulcer involvement. Approximately half of these (6 patients) experienced visual improvement post-treatment. Fusarium spp. was the most common fungus isolated (37%), followed by non-sporulating fungi and Curvularia spp. Three patients (7.4%) had corneal microperforations, which healed after gluing and bandage contact lens application. One patient (3.7%) required tectonic penetrating keratoplasty and 1 patient (3.7%) underwent evisceration. The final visual acuity was 6/18 or better in approximately half (14 patients) of our cohort and worse than 3/60 in approximately 20% (5 patients).

    Conclusion: Mycotic keratitis occurred mainly in males and secondary to ocular trauma. The most common organism isolated was Fusarium spp. Although treatment may improve vision, the visual outcome is guarded.

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