Displaying publications 221 - 240 of 255 in total

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  1. Peyman M, Tajunisah I, Loo A, Chuah KC, Subrayan V
    J Diabetes Complications, 2012 May-Jun;26(3):210-3.
    PMID: 22520399 DOI: 10.1016/j.jdiacomp.2012.03.019
    To correlate Heidelberg Retina Tomograph (HRT) derived macular edema (DME) index with severity of diabetic retinopathy and systemic factors. A total of 300 diabetic patients were recruited for the study for each of them a value for the macular edema index was obtained using the HRT II. Patients' age, gender, duration and type of diabetes mellitus, latest HbA1c result and presence or absence of co-morbid factors (hypertension, ischemic heart disease, nephropathy) were recorded together with the stage of diabetic retinopathy. These were correlated with DME. Out of 300 patients, HRT defined macula edema was seen in 68 patients (22.6%). There is a wider and higher range (95% percentile) of macula edema index in the severe non proliferative diabetic retinopathy (NPDR) group. Independent samples t test showed significant difference between the severe NPDR group and no DR group (p<0.001), mild NPDR group (p<0.05) and moderate NPDR group (p<0.05). A higher macula edema index was also found to have a low degree of correlation with more advanced stages of retinopathy (r=0.310; p<0.001). Also nephropathy showed a strong and significant correlation with DME. Hypertension had moderately significant correlation with DME. This study found no correlation between ischemic heart disease and DME. HRT derived scanning laser edema index is a reliable objective tool to evaluate diabetic retinopathy and systemic risk factors.
    Matched MeSH terms: Visual Acuity/physiology
  2. Saud Al-Abbas AH, Ling JL, Muhammed J, Hussein A
    BMJ Case Rep, 2019 Jun 22;12(6).
    PMID: 31229985 DOI: 10.1136/bcr-2019-229660
    Kodamaea ohmeri keratitis is an opportunistic pathogen seen in patients who have undergone invasive procedures and immunocompromised state. It has been identified in septicemia patients, resulting in mortality. To the best of our knowledge, we identified the first case of K. ohmeri keratitis following an injury with vegetative material. A 57-year-old woman with underlying, poorly controlled diabetes mellitus was gardening when a tree leaf accidentally poked her in the eye. Two weeks later, the patient presented with right eye pain, redness and progressive blurring of vision due to a traumatised right cornea. Slit-lamp examination showed a small inferior paracentral corneal stromal infiltrate with overlying epithelial defect. A corneal scraping sample yielded K. ohmeri from Analytical Profile Index (API) 20C yeast identification system. She was treated with intensive topical amphotericin B and fluconazole. After 6 weeks of treatment, the keratitis resolved with faint scar tissue, and her visual acuity improved.
    Matched MeSH terms: Visual Acuity/drug effects
  3. Eldem B, Lai TYY, Ngah NF, Vote B, Yu HG, Fabre A, et al.
    Graefes Arch Clin Exp Ophthalmol, 2018 May;256(5):963-973.
    PMID: 29502232 DOI: 10.1007/s00417-017-3890-8
    PURPOSE: To describe intravitreal ranibizumab treatment frequency, clinical monitoring, and visual outcomes (including mean central retinal thickness [CRT] and visual acuity [VA] changes from baseline) in neovascular age-related macular degeneration (nAMD) in real-world settings across three ranibizumab reimbursement scenarios in the Middle East, North Africa, and the Asia-Pacific region.

    METHODS: Non-interventional multicenter historical cohort study of intravitreal ranibizumab use for nAMD in routine clinical practice between April 2010 and April 2013. Eligible patients were diagnosed with nAMD, received at least one intravitreal ranibizumab injection during the study period, and had been observed for a minimum of 1 year (up to 3 years). Reimbursement scenarios were defined as self-paid, partially-reimbursed, and fully-reimbursed.

    RESULTS: More than three-fourths (n = 2521) of the analysis population was partially-reimbursed for ranibizumab, while 16.4% (n = 532) was fully-reimbursed, and 5.8% was self-paid (n = 188). The average annual ranibizumab injection frequency was 4.1 injections in the partially-reimbursed, 4.7 in the fully-reimbursed and 2.6 in the self-paid populations. The average clinical monitoring frequency was estimated to be 6.7 visits/year, with similar frequencies observed across reimbursement categories. On average, patients experienced VA reduction of -0.7 letters and a decrease in CRT of -44.4 μm. The greatest mean CRT change was observed in the self-paid group, with -92.6 μm.

    CONCLUSIONS: UNCOVER included a large, heterogeneous ranibizumab-treated nAMD population in real-world settings. Patients in all reimbursement scenarios attained vision stability on average, indicating control of disease activity.

    Matched MeSH terms: Visual Acuity/physiology*
  4. Vinuthinee-Naidu MN, Zunaina E, Azreen-Redzal A, Nyi-Nyi N
    BMC Ophthalmol, 2017 Jun 14;17(1):91.
    PMID: 28615022 DOI: 10.1186/s12886-017-0486-3
    BACKGROUND: Uric acid is a final breakdown product of purine catabolism in humans. It's a potent antioxidant and can also act as a pro-oxidant that induces oxidative stress on the vascular endothelial cells, thus mediating progression of diabetic related diseases. Various epidemiological and experimental evidence suggest that uric acid has a role in the etiology of type 2 diabetes mellitus. We conducted a cross-sectional study to evaluate the correlation of retinal nerve fibre layer (RNFL) and macular thickness with serum uric acid in type 2 diabetic patients.

    METHODS: A cross-sectional study was conducted in the Eye Clinic, Hospital Universiti Sains Malaysia, Kelantan between the period of August 2013 till July 2015 involving type 2 diabetes mellitus patients with no diabetic retinopathy and with non-proliferative diabetic retinopathy (NPDR). An evaluation for RNFL and macular thickness was measured using Spectralis Heidelberg optical coherence tomography. Six ml of venous blood was taken for the measurement of serum uric acid and glycosylated haemoglobin (HbA1C).

    RESULTS: A total of 180 diabetic patients were recruited (90 patients with no diabetic retinopathy and 90 patients with NPDR) into the study. The mean level of serum uric acid for both the groups was within normal range and there was no significance difference between the two groups. Based on gender, both male and female gender showed significantly higher level of mean serum uric acid in no diabetic retinopathy group (p = 0.004 respectively). The mean serum uric acid was significantly higher in patient with HbA1C 
    Matched MeSH terms: Visual Acuity*
  5. Khaw KW, Lam HH, Khang TF, Wan Ab Kadir AJ, Subrayan V
    BMC Ophthalmol, 2014;14:16.
    PMID: 24533465 DOI: 10.1186/1471-2415-14-16
    To report the rate of cystoid macular oedema (CMO) as detected by spectral-domain optical coherence tomography (SD-OCT) after intraoperative complication during phacoemulsification. The secondary objectives include comparing mean macular thickness and best-corrected visual acuity (BCVA) between those who developed postoperative CMO against those who did not.
    Matched MeSH terms: Visual Acuity
  6. Lee WW, Tajunisah I, Sharmilla K, Peyman M, Subrayan V
    Invest Ophthalmol Vis Sci, 2013 Nov;54(12):7785-92.
    PMID: 24135757 DOI: 10.1167/iovs.13-12534
    We determined structural retinal nerve fiber layer (RNFL) changes in schizophrenia patients and established if the structural changes were related to the duration of the illness using spectral-domain optical coherence tomography (SD-OCT).
    Matched MeSH terms: Visual Acuity
  7. Bastion ML
    BMJ Case Rep, 2012;2012.
    PMID: 22878988 DOI: 10.1136/bcr-2012-006303
    To describe the usage of 100% perfluoropropane and subsequent laser retinopexy for the repair of posterior pole retinal detachment in a previously vitrectomised patient with diabetic tractional detachment.
    Matched MeSH terms: Visual Acuity
  8. Bastion ML, Mustapha M, Ho I
    BMJ Case Rep, 2012;2012.
    PMID: 23093508 DOI: 10.1136/bcr-2012-007260
    To report a unique case of crystallisation in the anterior chamber and subretinal space in a Malay lady following inadvertent subretinal injection of ranibizumab prior to vitrectomy for proliferative diabetic retinopathy.
    Matched MeSH terms: Visual Acuity
  9. Kursiah MR, Sharif FM, Balaravi P
    Med J Malaysia, 2008 Dec;63(5):391-4.
    PMID: 19803298 MyJurnal
    This study was a retrospective study on corneal ulcer of one year period in Hospital Ipoh. A total of 28 cases were studied. Among the risk factors identified were foreign body on cornea, trauma, contact lens, vernal keratoconjunctivitis and surgical complication. The nature of this disease which was severe and slow healing caused prolonged hospital admission. Identification of causative microorganism by corneal scraping help in the treatment and management of this condition.
    Matched MeSH terms: Visual Acuity
  10. Hashim SE, Tan HK, Wan-Hazabbah WH, Ibrahim M
    Ann Acad Med Singap, 2008 Nov;37(11):940-6.
    PMID: 19082201
    INTRODUCTION: Refractive error remains one of the primary causes of visual impairment in children worldwide, and the prevalence of refractive error varies widely. The objective of this study was to determine the prevalence of refractive error and study the possible associated factors inducing refractive error among primary school children of Malay ethnicity in the suburban area of Kota Bharu, Kelantan, Malaysia.

    MATERIALS AND METHODS: A school-based cross-sectional study was performed from January to July 2006 by random selection on Standard 1 to Standard 6 students of 10 primary schools in the Kota Bharu district. Visual acuity assessment was measured using logMAR ETDRS chart. Positive predictive value of uncorrected visual acuity equal or worse than 20/40, was used as a cut-off point for further evaluation by automated refraction and retinoscopic refraction.

    RESULTS: A total of 840 students were enumerated but only 705 were examined. The prevalence of uncorrected visual impairment was seen in 54 (7.7%) children. The main cause of the uncorrected visual impairment was refractive error which contributed to 90.7% of the total, and with 7.0% prevalence for the studied population. Myopia is the most common type of refractive error among children aged 6 to 12 years with prevalence of 5.4%, followed by hyperopia at 1.0% and astigmatism at 0.6%. A significant positive correlation was noted between myopia development with increasing age (P <0.005), more hours spent on reading books (P <0.005) and background history of siblings with glasses (P <0.005) and whose parents are of higher educational level (P <0.005). Malays in suburban Kelantan (5.4%) have the lowest prevalence of myopia compared with Malays in the metropolitan cities of Kuala Lumpur (9.2%) and Singapore (22.1%).

    CONCLUSION: The ethnicity-specific prevalence rate of myopia was the lowest among Malays in Kota Bharu, followed by Kuala Lumpur, and is the highest among Singaporean Malays. Better socio-economic factors could have contributed to higher myopia rates in the cities, since the genetic background of these ethnic Malays are similar.

    Matched MeSH terms: Visual Acuity
  11. Gilbert CE, Ellwein LB, Refractive Error Study in Children Study Group
    Invest Ophthalmol Vis Sci, 2008 Mar;49(3):877-81.
    PMID: 18326706 DOI: 10.1167/iovs.07-0973
    Data on the prevalence and causes of functional low vision (FLV) in adults and children are lacking but are important for planning low-vision services. This study was conducted to determine the prevalence and causes of FLV among children recruited in eight population-based prevalence surveys of visual impairment and refractive error from six countries (India [2 locations]; China [2 locations]; Malaysia, Chile, Nepal, and South Africa).
    Matched MeSH terms: Visual Acuity
  12. Reddy SC, Tajunisah I
    Ann Ophthalmol (Skokie), 2008;40(1):39-44.
    PMID: 18556981
    Fifty-six contact lens-related corneal ulcers (central in 32; hypopyon in 24 and stromal abscess in 6) were studied. Culture was positive in 78.9%. Corneal ulcers healed with intense antibiotic therapy in nearly all patients. Increased awareness of lens care/disinfection and frequent replacement of storage cases and solution, and early detection of pathogens and intensive appropriate antibiotic therapy are key points in management.
    Matched MeSH terms: Visual Acuity
  13. Ali NA, Reddy SC
    Eye Contact Lens, 2007 Nov;33(6 Pt 1):338-40.
    PMID: 17993833
    PURPOSE: To report an unusual case of bilateral simultaneous hypopyon corneal ulcer in a contact lens wearer caused by polymicrobial infection with rare organisms.
    METHODS: A case report of a 21-year-old soft contact lens wearer, who visited the emergency department with a 3-day history of pain, redness, decreased vision, photophobia, and tearing in both eyes. Examination showed a central corneal ulcer with hypopyon in both eyes. The cultures from corneal scrapings of both eyes, the contact lenses, and the contact lens solution showed heavy growth of Pseudomonas aeruginosa, Alkaligenes species, and Flavobacterium meningosepticum.
    RESULTS: The corneal ulcers healed completely with aggressive antibiotic treatment for 4 weeks. The best-corrected visual acuity after 6 months of follow-up was 20/400 in the right eye and 20/60 in the left eye.
    CONCLUSIONS: The possibility of infectious keratitis should be kept in mind for an acute red eye in contact lens wearers, and appropriate initial management is essential for a successful outcome. It is believed that this is the first report of Flavobacterium meningosepticum as a causative organism in contact lens-related keratitis.
    Matched MeSH terms: Visual Acuity
  14. Jaais F
    Med J Malaysia, 2004 Aug;59(3):378-83.
    PMID: 15727384
    This study reviewed the trabeculectomies (TEs) carried out in University Malaya Medical Center between 1994 to 1998. One hundred and nine of 132 eyes operated were in the primary glaucoma group of which 63 (47.7%) were of the open angle type and 46 (34.8%) were of the angle closure type. Twenty-three eyes belong to the secondary glaucoma group. Sixty-five eyes had plain or non-augmented trabeculectomy (TE) while 20 were augmented with mitomycin C (MMC) and 11 with 5 flourouracil (5FU). In 31 eyes the plain TEs were combined with extracapsular cataract extraction (ECCE) and 4 with phacoemusification. One case had combined ECCE and augmented trabeculectomy with mitomycin-C. The patients were followed up at 1 month, 6 months, 1 year and 2 years. Ninety-four of 132 (71.2%) eyes had successful surgery with intraocular pressure (IOP) of less than 21 mmHg (tonometric success) at the end of 2 years. Four of these patients needed topical medication for the IOP control. More failures were seen in patients with cystic blebs than those with diffuse blebs. Complications include hypotony, shallow anterior chamber, cataracts and hyphaema. The majority of cases (53%) had no complications.
    Matched MeSH terms: Visual Acuity
  15. Lai YK, Fan RF
    J Cataract Refract Surg, 1996;22 Suppl 1:830-4.
    PMID: 9279680
    PURPOSE: To compare the efficacy of heparin-surface-modified (HSM), poly(methyl methacrylate) (PMMA) posterior chamber intraocular lenses (IOLs) with that of unmodified PMMA IOLs in reducing postoperative complications caused by inflammatory reactions after extracapsular cataract extraction in an Asian population.

    SETTING: Departments of Ophthalmology, University of Malaya, Kuala Lumpur, Malaysia, and Tan Tock Seng Hospital, Singapore.

    METHODS: In a randomized, double-blind study performed at two centers, 51 patients received an HSM PMMA lens and 48, an unmodified PMMA IOL. Cell and pigment deposits were evaluated by slitlamp at 1 to 6 days, 2 to 3 weeks, and 3 to 6 months postoperatively.

    RESULTS: Significantly more eyes with unmodified IOLs had inflammatory cell deposits than those with HSM IOLs at 3 to 6 months (P < .001) and 12 to 14 months (P = .018) postoperatively. The HSM group also had significantly fewer cell deposits per patient at these two follow-ups. Significantly more eyes in the non-HSM group had pigment deposits 3 to 6 months after surgery (P = .049). One year postoperatively, about 85% of patients in both groups had a best corrected visual acuity of 0.5 or better.

    CONCLUSION: Heparin surface modification significantly reduced the inflammatory response to PMMA IOLs in an Asian population for at least 12 to 14 months.

    Matched MeSH terms: Visual Acuity
  16. Ibrahim M, Yap JY
    BMJ Case Rep, 2018 Apr 25;2018.
    PMID: 29695396 DOI: 10.1136/bcr-2018-224552
    We describe the first clinical case of Burkholderia cepacia keratitis registered in Southeast Asia. A man in his mid-70s with underlying poorly controlled diabetes mellitus came with complaints of painful red left eye for 4 days. This was accompanied with photophobia and blurring of vision after being injured by a wooden particle while cutting grass. Slit-lamp examination showed a paracentral anterior corneal stromal infiltrates with overlying epithelial defect. Culture of the corneal smear isolated B. cepacia that was sensitive to ceftazidime, meropenem and bactrim (trimethorprim and sulfomethoxazole). Topical ceftazidime was given intensively to the patient and the infection resolved after 6 weeks of treatment.
    Matched MeSH terms: Visual Acuity
  17. Omar R, Wan Abdul WMH, Knight VF
    BMC Public Health, 2019 Jun 13;19(Suppl 4):543.
    PMID: 31196018 DOI: 10.1186/s12889-019-6865-3
    BACKGROUND: School children are considered a high-risk group for visual impairment because uncorrected refractive errors and problems such as amblyopia can seriously affect their learning abilities and their physical and mental development. There are many studies reporting the prevalence of refractive errors among school children of different ethnic groups in Malaysia, however, studies concerning the prevalence of refractive errors among indigenous or Orang Asli children are very limited. Therefore, the objective of this study was to determine the prevalence and causes of visual impairment among Orang Asli children.

    METHODS: One hundred ten Orang Asli children aged 7 to 12 years old in Negeri Sembilan, Malaysia were selected. 51% of these children were boys while the remainders were girls. They underwent visual acuity test, cover test, Hirschberg's test, ocular external assessment and ophthalmoscopy. Children who failed the vision screening were then referred for further eye examination.

    RESULTS: Of these 110 Orang Asli children, 46 failed the vision screening and subsequently 45 of them were confirmed to have visual problems (40.9% of the total subjects). The main cause of visual impairment in this study was refractive error (34.5% of the total subjects) where the main refractive error found was hyperopia (28.2%) followed by amblyopia (2.7%), strabismus (1.8%) and ocular abnormalities (1.8%).

    CONCLUSION: Hence, vision screening and a comprehensive eye examination is very important and needs to be done on all Orang Asli children so that any visual problems can be detect at an early stage to avoid the development of learning difficulties among these already disadvantaged children.

    Matched MeSH terms: Visual Acuity
  18. Patrick S, Hui-Tze C, Wan-Hazabbah WH, Zunaina E, Azhany Y, Liza-Sharmini AT
    J Taibah Univ Med Sci, 2018 Oct;13(5):483-487.
    PMID: 31435366 DOI: 10.1016/j.jtumed.2018.03.005
    Management of inflammation after surgery for recalcitrant anterior uveitis is challenging. Herein, we report successful treatment using intracameral injection of recombinant tissue plasminogen activator (rtPA) in two patients with recalcitrant anterior uveitis, due to infective uveitis and Vogt-Koyanagi-Harada disease, respectively. A 40-year-old woman presented with bilateral redness and vision reduction that had persisted 2 weeks. She also had bilateral anterior uveitis, vasculitis, retinitis, and optic disc swelling. Serology was positive for Bartonella henselae and Toxoplasma gondii. She was treated using long-term systemic corticosteroids and appropriate antibiotics. Our second case; a healthy 30-year-old man with bilateral eye redness and reduced vision without pain, and associated with headache and tinnitus for 1 weeks. He showed bilateral granulomatous inflammation with vitritis, choroiditis, retinitis, and hyperemic optic disc. The patient was diagnosed with Vogt-Koyanagi-Harada disease and treated with systemic corticosteroids. Both patients developed secondary cataracts and glaucoma that necessitated surgical intervention. Persistent chronic inflammation led to the formation of a thick fibrin membrane anterior to the intraocular lens (IOL) after phacoemulsification surgery with IOL implantation. This membrane was removed surgically, and intracameral injection of rtPA (25 μg) was carried out. The persistent inflammation had resolved and visual acuity had significantly improved within 1 week of intracameral rtPA injection. There were no reported ocular or systemic side effects. Intracameral rtPA is beneficial in patients with recalcitrant anterior uveitis who have undergone intraocular surgery. In most cases, surgical intervention improves the patients' vision. Intracameral rtPA should be considered in cases of persistent inflammation of varying etiology.
    Matched MeSH terms: Visual Acuity
  19. Loh UL, Tai PY, Hussein A, A Qamarruddin F
    Cureus, 2018 Dec 17;10(12):e3743.
    PMID: 30800553 DOI: 10.7759/cureus.3743
    Orbital apex syndrome (OAS) is a localized orbital cellulitis at the orbital apex that can cause vision loss from optic neuropathy and ophthalmoplegia involving multiple cranial nerves. Herein, we report a rare and rapidly progressive case of OAS secondary to fungal pansinusitis caused by Scedosporiumapiospermum in an immunocompromised patient following the extraction of abscessed teeth. A 48-year-old man with diabetes mellitus who had failed to adhere to his treatment presented with complaints of a right-sided headache and toothache for two weeks, with nausea and vomiting for two days prior to presentation. The patient was treated for septic shock secondary to the dental abscesses. Non-contrast brain computed tomography (CT) showed no significant intracranial abnormalities other than pansinusitis. Four days later, dental extraction was performed. The patient reported progressive painless blurring of the vision in his right eye following the dental extractions and was referred to the ophthalmology department. Subsequent examinations revealed decreased optic nerve function and ophthalmoplegia in his right eye and dental caries in the upper molars, with a mucopurulent discharge from the right sphenoid region. The clinical diagnosis was OAS. Pus near the orbital apex was drained surgically. Methicillin-resistant Staphylococcus aureus was isolated from the pus and a nasal swab. Tissue culture from the septal wall yielded S.apiospermum. The patient's condition deteriorated, despite intensive antibiotic and antifungal treatment and repeated surgical debridement. The disease progressed rapidly to his left eye. Sixty-seven days after the inital presentation, his visual acuity (VA) of both eyes was classified as no perception of light (NPL). The patient discharged himself from the hospital (at own risk discharge) and subsequently failed to attend a scheduled appointment in the ophthalmology clinic. If immunocompromised patients present with OAS, fungal infections should be ruled out. Prompt and aggressive treatment using a multidisciplinary approach is mandatory in cases of potentially life-threatening and vision-threatening fungal infections.
    Matched MeSH terms: Visual Acuity
  20. Maharajah KR, Tet CM, Yaacob A, Tajudin LS, Foster PJ
    Clin Exp Ophthalmol, 2008 Apr;36(3):222-31.
    PMID: 18412590 DOI: 10.1111/j.1442-9071.2008.01719.x
    To evaluate the functional impairment of glaucoma patients, using a modified Bahasa Malaysia version of VF-14 questionnaire, and to correlate the score with the severity of the disease.
    Matched MeSH terms: Visual Acuity
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