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Fulltext A rare case of idiopathic intracranial hypertension in prepubertal age

Nurul Najieha Amir, Nor Fadhilah Mohamad, Mimiwati Zahari, Choo May May

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):331-333.

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A 2-year-old girl who was under genetic follow up for developmental delay and dysmorphism was accidentally found to have bilateral optic disc swelling during screening examination. She showed response to optokinetic drum examination and the anterior segment examination was unremarkable. Optic disc swellings were seen in both eyes. Lumbar puncture shows high opening pressure of 50 cm H2O with unremarkable CSF analysis. MRI of brain was done and showed features in keeping with mild cerebral atrophy, with no evidence of hydrocephalus or space oc- cupying lesion. She was diagnosed with idiopathic intracranial hypertension and oral acetazolamide 125mg bd was commenced. However, papilloedema persist despite medical therapy. Ventriculoperitonel shunt was inserted to re- duce the csf pressure. This case report highlights the importance of considering idiopathic intracranial hypertension as a cause of optic disc swelling in pre-pubertal children because delay in diagnosis and treatment may permanently affect visual function especially in children.

Corneal Hysteresis Is Reduced in Obstructive Sleep Apnea Syndrome

Nadarajah S, Samsudin A, Ramli N, Tan CT, Mimiwati Z

Optom Vis Sci, 2017 10;94(10):981-985.

PMID: 28858045 DOI: 10.1097/OPX.0000000000001117

SIGNIFICANCE: To our knowledge, this is the first time a study looking at the association between corneal hysteresis (CH) and obstructive sleep apnea syndrome (OSAS) severity has been reported. We provide evidence that CH is lower in OSAS and speculate on the possible causes.

PURPOSE: The present study aims to look at the association between CH and severity of OSAS, and whether CH could be another link between OSAS and the development of glaucoma.

METHODS: This was a cross-sectional, observational study at the University Malaya Medical Centre, Kuala Lumpur. Patients undergoing polysomnography for assessment of OSAS were recruited. We measured central corneal thickness (CCT) using optical biometry, and CH using ocular response analysis. Intraocular pressure (IOP) and Humphrey visual field (HVF) indices were also measured. The Apnea Hypopnea Index (AHI) divided patients into normal, mild, moderate, and severe OSAS categories. The normal and mild categories (47.9%) were then collectively called group 1, and the moderate and severe categories (52.1%) were called group 2. T tests, Pearson correlation tests, and general linear model analysis were performed, with P .05). CH correlated negatively with AHI (r = -0.229, P = .013) and positively with lowest oxygen saturation (r = 0.213, P = .022).

CONCLUSIONS: CH is lower in moderate/severe OSAS than in normal/mild cases. This may be another link between OSAS and the development of glaucoma; further studies are indicated to determine the significance of this connection.

Fulltext Matrix metalloproteinases and tissue inhibitors of metalloproteinases in the aqueous humour of patients with primary angle closure glaucoma - a quantitative study

Nga AD, Yap SL, Samsudin A, Abdul-Rahman PS, Hashim OH, Mimiwati Z

BMC Ophthalmol, 2014;14:33.

PMID: 24655889 DOI: 10.1186/1471-2415-14-33

Altered levels of specific matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in the aqueous humour of primary open-angle glaucoma (POAG) eyes have been described. In this study, levels of specific MMPs and TIMPs in the aqueous humour of primary angle-closure glaucoma (PACG) eyes were measured and compared with those of POAG as well as non-glaucoma control eyes.

Severity of visual impairment and depression among elderly Malaysians

Noran NH, Izzuna MG, Bulgiba AM, Mimiwati Z, Ayu SM

Asia Pac J Public Health, 2009 Jan;21(1):43-50.

PMID: 19124335 DOI: 10.1177/1010539508327353

OBJECTIVE: This study aimed at evaluating the relationship between severity of visual impairment and depression among elderly Malaysians attending an eye clinic.
METHODS: This was a cross-sectional study. The study population included patients, aged>or=60 years who attended the Eye Clinic in University Malaya Medical Centre. Exposure measurement was based on ophthalmologic examinations by an ophthalmologist. Data on outcome were measured using the Geriatric Depression Scale.
RESULTS: After adjusting for important confounders, severity of visual impairment either having low vision or blind were independent risk factors of depression. The odds of developing depression among elderly with low vision were 2 times more than those with normal vision, and elderly who were blind had almost 5 times the odds to be depressed compared with those having normal vision.
CONCLUSION: Findings from this study suggest a positive relationship between the severity of visual impairment and depression among elderly Malaysians.
Study site: Eye Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Device, Questionnaire & Scale: Geriatric Depression Scale (GDS-15)

Fulltext Ocular perfusion pressure and ophthalmic artery flow in patients with normal tension glaucoma

Samsudin A, Isaacs N, Tai ML, Ramli N, Mimiwati Z, Choo MM

BMC Ophthalmol, 2016;16:39.

PMID: 27079202 DOI: 10.1186/s12886-016-0215-3

Vascular insufficiency has been reported to be a cause of normal tension glaucoma (NTG). The aim of this study was to compare ocular perfusion pressure (OPP) and ophthalmic artery flow (OAF) between patients with NTG and those without glaucoma.

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