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Fulltext Effect of 532 nm argon laser pan retinal photocoagulation on corneal thickness and corneal endothelial cell parameters among proliferative diabetic retinopathy patients

Ghani SI, Zunaina E

J Diabetes Metab Disord, 2021 Jun;20(1):561-569.
PMID: 34222077 DOI: 10.1007/s40200-021-00780-9

Background: Laser photocoagulation has been the mainstay treatment for diabetic retinopathy (DR). However, the applied laser light must pass through multiple ocular structures such as the cornea to reach the retina, potentially causing thermal injury to non-target tissues. The purpose of this study was to examine the effects of 532 nm Argon laser pan-retinal photocoagulation (PRP) on corneal thickness and corneal endothelial cell parameters by comparing central corneal thickness (CCT), endothelial cell density (ECD), and endothelial cell area coefficient of variation (CoV) before and after PRP for proliferative diabetic retinopathy (PDR). The effect of laser PRP on these corneal parameters may help in adapting treatment protocols to reduce corneal damage and thereby improve patient outcome.
Methods: This was a prospective cohort study involving newly diagnosed PDR patients. All patients underwent specular microscopy examination (CCT, ECD and endothelial cell area CoV) both pre-PRP and at 1-week and 6-weeks after the final PRP session (post-PRP). A Carl Zeiss Visulas Argon laser (532 nm) was used to perform PRP.
Results: A total of 33 newly diagnosed PDR patients were included in this study. There were no significant differences in mean CCT, ECD, and endothelial cell area CoV at 1-week and 6-weeks following PRP compared to pre-treatment baseline (p > 0.05). Further, there were no significant correlations between laser energy delivered and CCT, ECD and endothelial cell area CoV at either post-PRP examination time.
Conclusion: Argon laser (523 nm) energy delivered within recommended ranges for PRP had no adverse effects on corneal structure.
Fulltext Extensive Forehead Swelling Including the Periorbital Area in a Child: A Rare Manifestation of Acute Lymphoblastic Leukemia

Hanapi MS, Ghani SI, Sonny Teo KS, Wan-Embong WZ, Ariffin N, Wan Hitam WH

Cureus, 2018 Nov 03;10(11):e3539.
PMID: 30648072 DOI: 10.7759/cureus.3539

Acute lymphoblastic leukemia (ALL) manifestations in a child are varied. We report a unique and rare presentation of acute lymphoblastic leukemia in a child who presented with frontal swelling involving bilateral upper lids. A previously healthy one-year-old girl presented with progressively increasing frontal swelling of seven months duration. An examination revealed erythematous, firm, nontender forehead swelling that extended up to the medial part of bilateral upper eye lids. The extraocular muscle movement was normal. The anterior segment and fundus examination were also normal in both eyes. Other systemic examination revealed multiple leukemic cutis on the scalp. The cervical lymph nodes were also palpable with hepatosplenomegaly. A full blood picture (FBP) showed the presence of leucoerythroblastic blood film with 62% blast cells. Flow cytometry and bone marrow aspiration confirmed the diagnosis. Computed tomographic (CT) scan images revealed multiple well-defined hyperdense lesions at the subcutaneous skull with the largest lesion at the anterior glabella. Upon diagnosis, the patient was started on chemotherapy and the swelling resolved after one month post treatment. Extensive forehead swelling is a rare manifestation of acute lymphoblastic leukemia. A high index of suspicion aided with diagnostic investigations could help the doctors arrive at a correct diagnosis and treatment.

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