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  1. Mohd Ali, B., Nguan, D.K.C., Bashirah, I., Chan, K.M.
    MyJurnal
    Changes in tear protein concentrations may reflect ocular surface health. This study analyzes changes in tear protein concentrations of young Malays with dry eye (DE) and determines its association with the clinical findings. Methods: Subjects were screened using McMonnies questionnaire (MDEQ) and flourescein tear break up time (TBUT). Total tear protein concentration (TTPC) was determined using Bradford's technique and specific tear protein (sIgA, lysozyme, lactoferrin and human serum albumin (HSA)) concentrations were determined using SDS-PAGE. Parametric and nonparametric tests were used to compare means between groups. Spearman correlation was used to determine the association between variables measured. Results: A total of 42 subjects (21 DE and 21 NDE) were included. Mean MDEQ score for DE was 16.00±1.48 and NDE was 8.47±3.47. Mean TBUT for DE was 3.47±0.47s and NDE was 4.98±0.43s. Mean TTPC for DE and NDE was 9.84±2.40mg/ml and 8.96±1.84mg/ml respectively. Mean sIgA, lysozyme, lactoferrin and HSA for DE was 0.54±0.10mg/ml, 1.68±0.17mg/ml, 1.47±0.25mg/ml, 0.06±0.03mg/ml and for NDE was 0.57±0.09mg/ml, 2.04±0.19mg/ml, 1.75±0.23mg/ml, 0.06±0.03mg/ml accordingly. Significant differences were noted in MDEQ score (p=0.01), TBUT (p=0.01), lactoferrin (p=0.01) and lysozyme (p=0.01) but not in TTPC (p=0.19), HSA (p=0.74) and sIgA (p=0.24) between groups. Significant correlations were noted between TBUT with lactoferrin (r=0.02, p=0.02) and lysozyme (r=0.63, p=0.01) and between MDEQ score with lactoferrin (r=-0.34, p=0.02) and lysozyme (r=-0.64, p=0.01). Conclusions: There are changes in specific tear protein in dry eye patients, which correlate well with clinical results. Tear protein analysis may play an important role in the diagnosis of the dry eye.
  2. Mohd-Ali B, Chen LY
    Cont Lens Anterior Eye, 2021 02;44(1):72-75.
    PMID: 32624364 DOI: 10.1016/j.clae.2020.06.007
    PURPOSE: To analyse and compare the alterations in corneal endothelium morphology induced by different materials and durations of wearing soft contact lenses (CL) among young adults living in Kuala Lumpur.

    METHODS: Healthy soft CL wearers were invited to participate in this study. Visual acuity (VA) was measured using the Snellen chart, and subjective refraction was performed using cross-cylinder technique. Standard ocular assessments were conducted using a slit lamp biomicroscope and morphology of corneal endothelial cells (endothelial cell density, ECD, coefficient variation, COV, hexagonality, HEX and central corneal thickness, CCT) were evaluated using a non-contact specular microscope. Statistical analysis was conducted using ANOVA and data from the right eye only is included.

    RESULTS: A total of 72 subjects (32 SiHy and 40 HCL wearers) and 24 non-CL wearers (control) participated in this study. The gender distribution for study subjects was 13 males and 59 females, with a mean age 22.15 ± 1.84 years old. The mean refraction was -1.86 ± 1.25DS. The duration of wearing CL ranged from 1 to 9 years. Subjects were later divided into 2 groups following duration of CL wear: Group 1 (<5 years) and Group 2 (≥5 years) for analysis purposes. Statistical analysis showed significant alterations in ECD, COV and HEX of CL wearers (p 

  3. Mohd-Ali B, Tan XL
    PMID: 31861174 DOI: 10.3390/ijerph16245161
    BACKGROUND: Contact lenses (CLs) are more popular than spectacles for vision correction amongst the youth. Knowledge about the risks of wearing CLs is critical especially for those with poor access to public health education. This study investigates the patterns of use and level of knowledge about CL wear amongst teenagers living in rural areas in Selangor, Malaysia using a set of validated questionnaires.

    METHODS: A total of 8500 self-administered questionnaires were distributed in eight selected secondary schools. The results were analysed using descriptive statistics.

    RESULTS: A total of 2474 (29%) completed questionnaires were collected. The mean age of the respondents was 14.8 ± 1.5 years, and approximately 7.2% were CL wearers. The majority of the wearers were females (76.0%) and wore soft CLs (92.2%). Cosmetic purposes (58.1%) and comfort (24.6%) were the main reasons for wearing CLs. Many of the respondents purchased their lenses from optical shops (50.1%) and beauty accessory shops (15.6%), and approximately 10% did not disinfect their lenses properly. Regarding knowledge about CL care, approximately 56% of the respondents responded correctly.

    CONCLUSION: Half of the respondents do not have sufficient knowledge about the risks of wearing CLs. Thus, aggressive public health education aimed at teenagers is needed to prevent improper CL usage.

  4. Mohd-Ali B, Azmi N
    Clin Optom (Auckl), 2021;13:155-160.
    PMID: 34295203 DOI: 10.2147/OPTO.S277786
    PURPOSE: To investigate the wearing pattern and awareness about contact lens care among secondary school students in Kuala Lumpur.

    PATIENTS AND METHODS: This is a cross-sectional study using self-administered validated questionnaires. A total of 2500 questionnaires were distributed to secondary school students (aged 13 to 18 years) from 5 selected schools in Kuala Lumpur. Descriptive statistics were used to analyze the results.

    RESULTS: A total of 987 completed questionnaires were returned and analyzed. The response rate was 39.5%. Mean age of respondents was 15.5±2.5 years with 54.6% females. Around 9.9% of the respondents were contact lens wearers with female majority (78.6%) and the main reasons for wearing contact lenses were cosmesis (42.8%) and comfort (32.7%). Majority (92.2%) were soft contact lens wearers and daily wear (monthly disposable) is the preferred modality. Nevertheless, 42.4% purchased their lenses from unlicensed vendors and 18.4% rinsed their lenses using tap water. Regarding contact lens care, more than 50% of the respondents were not aware about the correct way of handling contact lenses.

    CONCLUSION: Soft contact lens wear is popular among the secondary school students in Kuala Lumpur but the level of practice and knowledge about CL care are unsatisfactory. Thus, health communication strategies and aggressive public ocular health education that can influence behavior changes in teenagers are needed to overcome these issues.

  5. Mohd-Ali B, Leong SF, Abdul-Mutalib H, Mohidin N
    Clin Ter, 2011;162(4):327-30.
    PMID: 21912820
    OBJECTIVE: Asians are known to have different tear characteristics compared to Caucasians that may affect contact lens wear. There are scanty research studies that have evaluated tears during continuous wear contact lens in Asia. The present study aims to evaluate changes in tears in subjects wearing continuous wear rigid gas permeable contact lens (CWRGP) for 6 months.
    MATERIALS AND METHODS: Thirty five neophyte subjects (21 females, 14 females) were recruited for this study. Subjects were fitted with CWRGP lenses with Dk of 163 on both eyes. Tear was evaluated using Phenol red thread test (PRT), tear break up time (TBUT) test and tear meniscus height (TMH) measurement. Non parametric and parametric analyses were used to compare the parameters.
    RESULTS: Values at baseline (BL) and six months (6M) were as follow: PRT, BL=19.10 ± 3.86 mm, 6M= 21.02 ± 4.27 mm, TBUT, BL= 8.58 ± 4.90 sec, 6M=8.08 ± 5.32 sec, TMH, BL= 0.38 ± 0.12 mm, 6M= 0.34 ± 0.07 mm. Statistical analysis showed significant difference in tear volume for PRT only at 6 months (p=0.007).
    CONCLUSION: Our analysis showed minimal change in the tear characteristics after six months of CWRGP lens wear, which indicated low impact of CWRGP contact lens on tears characteristics of Asian eyes. However, careful monitoring is required to prevent development of adverse events during contact lens wear.
  6. Ishak B, Mohd-Ali B, Mohidin N
    Clin Exp Optom, 2011 Sep;94(5):458-63.
    PMID: 21793918 DOI: 10.1111/j.1444-0938.2011.00621.x
    BACKGROUND: The monitoring and assessment of the upper tarsal conjunctiva can be enhanced by the use of a grading scale. The aim of this study was to categorise the appearance of normal tarsal conjunctiva among young adults in Malaysia using the Institute for Eye Research grading scale and to investigate inter- and intra-observer agreement.
    METHODS: The appearance of the upper tarsal conjunctiva of 416 non-contact lens wearing subjects aged between 19 to 24 years was assessed by two separate observers for roughness and redness in three separate zones using the Institute for Eye Research grading scale. The average grade for each zone and overall grade for roughness and redness were calculated. Inter- and intra-observer agreements were analysed.
    RESULTS: Subjects were categorised for ethnicity and the roughness and redness were calculated. No significant differences were found between Malay and Chinese eyes (p > 0.05). The average grades for the upper tarsal conjunctiva redness and roughness were 0.90 ± 0.25 and 0.86 ± 0.43, respectively. Significantly higher roughness scores were found in zone 1 compared to the other two zones (p = 0.03). Significant association was also found between tarsal conjunctiva redness and roughness (Spearman ρ= 0.45, p < 0.001). Correlation between redness and roughness with age (p = 0.48, p = 0.65) and gender (p = 0.30, p = 0.79) were not significant. Only 2.2 per cent of subjects had scores higher than 2.0 for roughness or redness. Inter- and intra-observer analysis showed good agreement between two observers during the study.
    CONCLUSION: The roughness and redness of normal tarsal conjunctiva among young adults in Malaysia were found to be less than two units. Results of this study might be beneficial in clinical trials using contact lenses where changes in the tarsal conjunctiva are commonly used as an outcome measure.
    Study site: Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  7. Ahmad A, Mohd-Ali B, Ishak B
    Clin Optom (Auckl), 2018;10:109-113.
    PMID: 30319302 DOI: 10.2147/OPTO.S172272
    Purpose: Soft contact lens wear is most frequently associated with morphologic changes in corneal endothelial cells, but the data are scarce in Asians. This study aimed to evaluate changes in corneal endothelial cell morphology after 6 months of wearing soft hydrogel contact lenses (SH) in young myopic adults living in Kuala Lumpur.

    Patients and methods: Forty-eight subjects were included in the study, 24 were fitted with SH contact lenses (A) and the rest were prescribed with glasses (B). Refraction was conducted subjectively and standard contact lens fitting protocol was followed. Corneal endothelial cell morphology (endothelial cell density, ECD; coefficient of variation, COV; cells' hexagonality, HEX; and central corneal thickness, CCT) was evaluated using specular microscope. Data were collected at baseline and after 6 months of lens wear.

    Results: Mean age of all subjects was 21.23±1.30 years. All results are shown at baseline and 6 months, respectively. Mean refraction for A was -2.16±0.97 diopter sphere (DS) and -2.05±1.03 DS (P=0.49); for B was -2.72±1.51 DS and -2.73±1.51 DS (P=0.58). Mean ECD (cell/mm2) for A: 3104.19±237.30 and 3107.23±237.51 (P=0.07); for B: 3011.56±227.95 and 2983.83±244.55 (P=0.33). COV (%) for A: 46.52±8.63 and 48.53±10.65 (P=0.06); for B: 46.93±9.31 and 46.14±10.65 (P=0.88). HEX (%) for A: 46.21±10.12 and 45.15±10.01 (P=0.08); for B: 46.21±10.12 and 45.15±10.01 (P=0.12). CCT (µm) for A: 520.33±0.04 and 525.70±0.05 (P=0.41); for B: 532.00±0.04 µm and 530.00±0.05 µm (P=0.40).

    Conclusion: This study found no significant change in corneal endothelial cell morphology after 6 months of wearing SH contact lenses. This is probably due to better oxygen permeability of the contact lens material, good compliance, and short wearing period.
  8. Mohd-Ali B, Liew LY, Tai HJ, Wong YY
    Med J Malaysia, 2011 Mar;66(1):53-5.
    PMID: 23765144 MyJurnal
    OBJECTIVE: To evaluate tears of newly diagnosed keratoconus patients attending the Optometry clinic in Malaysia and to compare this with tears of normal myopic subjects.
    METHODS: The ocular surface of newly diagnosed keratoconus patients were evaluated using tear break up time (TBUT) test, non invasive tear break up time test (NIBUT) and Schirmer test. Twenty keratoconus patients (40 eyes) and 40 normal subjects (80 eyes) participated in this study.
    RESULTS: Significantly lower TBUT and NIBUT values were found in keratoconus patients than normal control subjects (p<0.05). Mean TBUT and NIBUT for keratoconus patients were 3.99±1.69s and 7.03±3.48s and for normal subjects were 7.24±4.39s and 13.67±10.81s respectively. However, no significant difference was detected in Schirmer test values. Mean values of Schirmer tests I and II for keratoconus patients were 20.52±10.66mm and 10.71±10.43mm and for normals were 23.83±11.34mm and 13.27±8.28mm accordingly.
    CONCLUSION: It was concluded from this study that keratoconus patients have poor tear stability which need to be considered appropriately during management of the patients.
    Study site: Optometry clinic, Pusat Perubatan Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  9. Mohd-Ali B, Mohammed Z, Norlaila M, Mohd-Fadzil N, Rohani CC, Mohidin N
    Clin Exp Optom, 2006 May;89(3):150-4.
    PMID: 16637969 DOI: 10.1111/j.1444-0938.2006.00033.x
    Down syndrome is a common chromosomal anomaly. Few reported studies make reference to the ocular status in Asian children with Down syndrome. The purpose of this study was to determine the visual and binocular status of a sample of Down syndrome children in Malaysia.
  10. Ahmadi Hosseini SM, Mohidin N, Abolbashari F, Mohd-Ali B, Santhirathelagan CT
    Int Ophthalmol, 2013 Apr;33(2):139-45.
    PMID: 23138667 DOI: 10.1007/s10792-012-9654-x
    To evaluate corneal thickness and volume in subclinical and clinical keratoconus in Asian population with the aim of discriminating between normal and ectatic cornea. Eyes were placed into one of the following three groups: normal, subclinical, and mild-moderate keratoconus. Pentacam Scheimpflug imaging (Oculus Inc., Wetzlar, Germany) was performed for each participant to record thinnest corneal thickness, central corneal thickness, corneal volume (CV), peripheral corneal thickness (PCT) and percentage thickness increase (PTI) at 2, 4, 6, and 8 mm. The data were exported to SPSS for statistical analysis. Subjects comprised 52 normal, 15 subclinical keratoconus, and 32 mild-moderate clinical keratoconus eyes. Our results indicated that corneal thickness (CT) distribution, PTI, and CV in normal eyes were significantly different compared with subclinical and clinical keratoconus (P < .05). Overall, subclinical group exhibited lower CT distribution and volume, and higher PTI in comparison with normal eyes. However, they showed higher CT distribution and volume, and lower PTI compared with keratoconus group. In addition, there was a smaller change in PCT and PTI from the thinnest point of the cornea to the periphery. The results of the present study indicate that CT parameters and CV were significantly different in normal versus subclinical group and in normal versus keratoconus group. These findings could help clinicians to better discriminate between normal and ectatic cornea.
  11. Abolbashari F, Mohidin N, Ahmadi Hosseini SM, Mohd Ali B, Retnasabapathy S
    Cont Lens Anterior Eye, 2013 Aug;36(4):191-5.
    PMID: 23375190 DOI: 10.1016/j.clae.2013.01.005
    To assess changes in anterior segment parameters of keratoconus eyes at different stages of the disease in a sample of the Asian population.
  12. Mustapha I, Mohd Ali B, Rasid MF, Sali A, Mohamad H
    Sensors (Basel), 2015;15(8):19783-818.
    PMID: 26287191 DOI: 10.3390/s150819783
    It is well-known that clustering partitions network into logical groups of nodes in order to achieve energy efficiency and to enhance dynamic channel access in cognitive radio through cooperative sensing. While the topic of energy efficiency has been well investigated in conventional wireless sensor networks, the latter has not been extensively explored. In this paper, we propose a reinforcement learning-based spectrum-aware clustering algorithm that allows a member node to learn the energy and cooperative sensing costs for neighboring clusters to achieve an optimal solution. Each member node selects an optimal cluster that satisfies pairwise constraints, minimizes network energy consumption and enhances channel sensing performance through an exploration technique. We first model the network energy consumption and then determine the optimal number of clusters for the network. The problem of selecting an optimal cluster is formulated as a Markov Decision Process (MDP) in the algorithm and the obtained simulation results show convergence, learning and adaptability of the algorithm to dynamic environment towards achieving an optimal solution. Performance comparisons of our algorithm with the Groupwise Spectrum Aware (GWSA)-based algorithm in terms of Sum of Square Error (SSE), complexity, network energy consumption and probability of detection indicate improved performance from the proposed approach. The results further reveal that an energy savings of 9% and a significant Primary User (PU) detection improvement can be achieved with the proposed approach.
  13. Low YC, Mohd-Ali B, Shahimin MM, Mohidin N, Abdul-Hamid H, Mokri SS
    Clin Optom (Auckl), 2024;16:35-44.
    PMID: 38351972 DOI: 10.2147/OPTO.S448815
    PURPOSE: To investigate changes in peripheral eye length (PEL) in myopic children undergoing orthokeratology (Ortho-K) treatment for 12 months using MRI. The results were compared to single vision spectacle wearers (SVS).

    PATIENTS AND METHODS: A total of 70 children with myopia (aged 8-9 years old) were recruited. A total of 45 children were fitted with Ortho-K, and 25 were fitted with SVS. The PEL and axial length (AL) were measured by using MRI 3-Tesla, whereas central and peripheral refraction (PR) measurements were conducted at ±30 degrees horizontally with nasal (N) and temporal (T) intervals of 10°, 20°, and 30° and with an open field autorefractometer (WAM-5500 Grand Seiko). All the measurements were conducted at the baseline and 12 months.

    RESULTS: The MRI analysis indicates that at 12 months, the SVS group showed more elongation of the PEL and AL at all eccentricities than the Ortho-K group did (p < 0.05). The Ortho-K group only showed significant PEL elongation beyond 20 degrees at N20, N30, T20, and T30 (p < 0.05); however, a significant reduction in the AL was detected in the center AL, N10, and T10 (p < 0.05). All eccentricities in the relative PR of the Ortho-K group were significantly more myopic than at the baseline (p < 0.05), whereas in the SVS group, all eccentricities in the relative PR were shown to be significantly more hyperopic than at the baseline (p < 0.05). The PEL and PR showed negative correlations at 12 months in the Ortho-K group.

    CONCLUSION: MRI analysis can be utilized to describe changes in PEL in myopic children. It appears that as myopia progressed in Ortho-K lens wearers, the PEL increased by a greater amount than the AL did; thus, the retina was reshaped to become increasingly oblate and to display peripheral myopic defocus.

  14. Syed Mohd Dardin SF, Mohd-Ali B, Mohamad Shahimin M, Mohd Saman MN, Mohidin N
    Clin Optom (Auckl), 2024;16:107-114.
    PMID: 38596476 DOI: 10.2147/OPTO.S431608
    INTRODUCTION: Corneal characteristics are unique to each eye and can vary among different levels of refractive errors. However, minimal data are available in the literature on corneal characteristics in myopic Malay school children including the difference between the low myopic group and the moderate myopic group. Therefore, this study aims to determine the corneal characteristics of myopic Malay school children and their associations with axial length.

    METHODS: A total of eighty-four data samples were extracted from forty-two myopic Malay school children. Measurements of the central corneal thickness (CCT), corneal curvature, corneal diameter, and axial length were measured using Lenstar LS900, a non-contact optical biometer. Data were later stratified by the spherical equivalent refraction (SER) into a low myopic group and a moderate myopic group, and paired t-test were employed to determine the differences in the corneal characteristics between these two groups. Univariate and multivariate linear regressions were performed to identify factors that are significantly associated with axial length.

    RESULTS: There was no significant difference in the CCT, corneal curvature and corneal diameter between the low myopic group and the moderate myopic group (t82=0.015, P=0.99), (t82=-0.802, P=0.43) and (t82=-0.575, P=0.57), respectively. Pearson univariate correlation analysis found that axial length significantly correlated with corneal curvature (r=-0.765, P<0.001) and corneal diameter (r=0.614, P<0.001) but no significant correlation found with CCT (r=0.046, P=0.68). Multiple regression analysis showed that axial length was significantly associated with a flatter corneal curvature (P<0.001), older age (P<0.001) and larger corneal diameter (P=0.02).

    CONCLUSION: This study reported the corneal characteristics in myopic Malay school children and its associations with axial length. Results of this study can serve as a reference value for the myopic Malay schoolchild population.

  15. Mukhtar IS, Ezinne NE, Mohamad Shahimin M, Mohd-Ali B, Oghre E, Zeried FM, et al.
    Pediatr Rep, 2024 Jul 15;16(3):566-578.
    PMID: 39051235 DOI: 10.3390/pediatric16030048
    Background: Dyslexia, a neurodevelopmental disorder affecting reading skills, poses significant challenges to children's academic performance and quality of life. Despite its rising prevalence and adverse effects, understanding of its relationship with vision anomalies remains limited, particularly in low-resource settings like Nigeria. This study aims to assess the prevalence of binocular vision anomalies (BVAs) among children with and without dyslexia in Kano, Nigeria. Methods: This is a hospital-based, cross-sectional, matched-paired, controlled study conducted at the Aminu Kano Teaching Hospital (AKTH) Eye Clinic in Northern Nigeria. The study included school children who visited the AKTH Eye Clinic from January 2018 to December 2022. Visual acuity tests, external eye examinations and accommodative, binocular vision and oculomotor skills tests were conducted. Descriptive statistics, independent t-tests, Mann-Whitney U tests and Fisher's exact tests were conducted, with a significance level set at p < 0.05. Results: Forty-four children aged 12 ± 2 years participated. Children with dyslexia reported higher rates of visual symptoms than those without dyslexia, Blurring vision, visual distortion and eye strain were the most prevalent (p < 0.05) BV symptoms. Accommodative insufficiency), was the most common visual abnormality, and was significantly higher in children with dyslexia than those without dyslexia (45.5% vs. 18.2%). However, other visual anomalies showed no significant difference between groups. There was a high prevalence of binocular vision anomalies in both groups. Binocular test findings showed dyslexic children had significantly lower distance positive fusional vergence recovery values (p = 0.005). All cases of convergence insufficiency alone were found in the non-dyslexic group. Conclusions: The study found that children with dyslexia residing in Northern Nigeria demonstrated higher rates of visual symptoms, more accommodative insufficiency and lower distance positive fusional vergence recovery values compared to their non-dyslexic counterparts.
  16. Cheah PS, Mohidin N, Mohd Ali B, Maung M, Latif AA
    Malays J Med Sci, 2008 Jul;15(3):49-54.
    PMID: 22570589
    This study illustrates and quantifies the changes on corneal tissue between the paraffin-embedded and resin-embedded blocks and thus, selects a better target in investigational ophthalmology and optometry via light microscopy. Corneas of two cynomolgus monkeys (Macaca fascicularis) were used in this study. The formalin-fixed cornea was prepared in paraffin block via the conventional tissue processing protocol (4-day protocol) and stained with haematoxylin and eosin. The glutaraldehyde-fixed cornea was prepared in resin block via the rapid and modified tissue processing procedure (1.2-day protocol) and stained with toluidine blue. The paraffin-embedded sample exhibits various undesired tissue damage and artifact such as thinner epithelium (due to the substantial volumic extraction from the tissue), thicker stroma layer (due to the separation of lamellae and the presence of voids) and the distorted endothelium. In contrast, the resin-embedded corneal tissue has demonstrated satisfactory corneal ultrastructural preservation. The rapid and modified tissue processing method for preparing the resin-embedded is particularly beneficial to accelerate the microscopic evaluation in ophthalmology and optometry.
  17. Amil-Bangsa NH, Mohd-Ali B, Ishak B, Abdul-Aziz CNN, Ngah NF, Hashim H, et al.
    Optom Vis Sci, 2019 12;96(12):934-939.
    PMID: 31834153 DOI: 10.1097/OPX.0000000000001456
    SIGNIFICANCE: Total protein concentration (TPC) and tumor necrosis factor α (TNF-α) concentration in tears are correlated with severity of retinopathy. However, minimal data are available in the literature for investigating tear TPC and TNF-α concentrations in Asian individuals with different severity of nonproliferative diabetic retinopathy (NPDR).

    PURPOSE: This study evaluated differences of TPC and TNF-α concentrations in tears at different severity of NPDR among participants with diabetes in comparison with normal participants.

    METHODS: A total of 75 participants were categorized based on Early Treatment for Diabetic Retinopathy Study scale, with 15 participants representing each group, namely, normal, diabetes without retinopathy, mild NPDR, moderate NPDR, and severe NPDR. All participants were screened using McMonnies questionnaire. Refraction was conducted subjectively. Visual acuity was measured using a LogMAR chart. Twenty-five microliters of basal tears was collected using glass capillary tubes. Total protein concentration and TNF-α concentrations were determined using Bradford assay and enzyme-linked immunosorbent assay, respectively.

    RESULTS: Mean ± SD age of participants (n = 75) was 57.88 ± 4.71 years, and participants scored equally in McMonnies questionnaire (P = .90). Mean visual acuity was significantly different in severe NPDR (P = .003). Mean tear TPC was significantly lower, and mean tear TNF-α concentration was significantly higher in moderate and severe NPDR (P < .001). Mean ± SD tear TPC and TNF-α concentrations for normal were 7.10 ± 1.53 and 1.39 ± 0.24 pg/mL; for diabetes without retinopathy, 6.37 ± 1.65 and 1.53 ± 0.27 pg/mL; for mild NPDR, 6.32 ± 2.05 and 1.60 ± 0.21 pg/mL; for moderate NPDR, 3.88 ± 1.38 and 1.99 ± 0.05 pg/mL; and for severe NPDR, 3.64 ± 1.26 and 2.21 ± 0.04 pg/mL, respectively. Tear TPC and TNF-α concentrations were significantly correlated (r = -0.50, P < .0001). Visual acuity was significantly correlated with tear TPC (r = -0.236, P = .04) and TNF-α concentrations (r = 0.432, P < .0001).

    CONCLUSIONS: This cross-sectional study identified differences in tear TPC and TNF-α concentrations with increasing severity of NPDR.

  18. Mohd-Ali B, Low YC, Mohamad Shahimin M, Arif N, Abdul-Hamid H, Wan Abdul-Halim WH, et al.
    Cont Lens Anterior Eye, 2023 Feb;46(1):101774.
    PMID: 36319519 DOI: 10.1016/j.clae.2022.101774
    PURPOSE: There are limited reports available on the impact of wearing Orthokeratology (ortho-K) lenses on the quality of life of Asian children. This study evaluated and compared vision-related quality of life (VRQoL) between myopic children wearing ortho-K lenses and single-vision spectacles (SVSs), living in Kuala Lumpur, using Paediatric Refractive Error Profile (PREP) questionnaires.

    METHODS: This is a cross sectional study. Myopic children who had been wearing ortho-K and SVSs for 12 months were recruited, and the questionnaires were distributed online. The PREP scores were obtained using a summary scoring method. The Shapiro-Wilk test was used to determine data normality. Unpaired t-test was performed for normally distributed data, and the Mann-Whitney test for non-normally distributed data. P 

  19. Norazman FNN, Mohd-Ali B, Syed Mohd Dardin SF, Mohamad Shahimin M, Mohamad Fadzil N, Mohd Saman MN, et al.
    Clin Optom (Auckl), 2024;16:45-52.
    PMID: 38405333 DOI: 10.2147/OPTO.S432496
    Myopia control lenses have been shown to modify visual function; however, it is arguable if these changes are short-term or long-term. We investigated the changes in accommodative behaviour and binocular vision functions of Malay myopic children who participated in a myopia control trial utilising spectacle lenses (n = 40). This article presents baseline accommodation and binocular vision measurements. The mean (± SD) age, spherical equivalent measured by cycloplegic autorefraction, and axial length (AL) for the right eyes were 10.00 ± 1.47 years, -3.02 ± 1.20 D, and 24.42 ± 0.93 mm, respectively. All participants had good distance and near visual acuities with high-contrast charts (100%), which were significantly better than low-contrast charts (10%) (p < 0.001). The mean (± SD) accommodative lag at baseline was 1.14 ± 0.35 D, while monocular and binocular accommodative amplitudes were 15.35 ± 2.07 D and 16.82 ± 2.27 D, respectively. Malay schoolchildren in this study were more esophoric at near compared to distance, with an accommodative-convergence over accommodation (AC/A) ratio of 5.64 ± 0.66 ∆/D. A higher degree of myopia was found to be associated with a longer AL (r = -0.49, p < 0.05) and higher esophoria at near (r = -0.46, p < 0.05). These baseline measures are consistent with data from other studies showing that myopic children have a high accommodative lag, an elevated AC/A ratio, a longer AL, and are more esophoric at near. The measures reported herein will serve as a basis for examining changes that occur within 12 months of wearing myopia control spectacle lenses.
  20. Mohd-Ali B, Chen LY, Shahimin MM, Arif N, Abdul Hamid H, Wan Abdul Halim WH, et al.
    PMID: 37641786 DOI: 10.51329/mehdiophthal1447
    BACKGROUND: Magnetic resonance imaging (MRI) has been used to investigate eye shapes; however, reports involving children are scarce. This study aimed to determine ocular dimensions, and their correlations with refractive error, using three-dimensional MRI in emmetropic versus myopic children.

    METHODS: Healthy school children aged < 10 years were invited to take part in this cross-sectional study. Refraction and best-corrected distance visual acuity (BCDVA) were determined using cycloplegic refraction and a logarithm of the minimum angle of resolution (logMAR) chart, respectively. All children underwent MRI using a 3-Tesla whole-body scanner. Quantitative eyeball measurements included the longitudinal axial length (LAL), horizontal width (HW), and vertical height (VH) along the cardinal axes. Correlation analysis was used to determine the association between the level of refractive error and the eyeball dimensions.

    RESULTS: A total of 70 eyes from 70 children (35 male, 35 female) with a mean (standard deviation [SD]) age of 8.38 (0.49) years were included and analyzed. Mean (SD) refraction (spherical equivalent, SEQ) and BCDVA were -2.55 (1.45) D and -0.01 (0.06) logMAR, respectively. Ocular dimensions were greater in myopes than in emmetropes (all P < 0.05), with no significant differences according to sex. Mean (SD) ocular dimensions were LAL 24.07 (0.91) mm, HW 23.41 (0.82) mm, and VH 23.70 (0.88) mm for myopes, and LAL 22.69 (0.55) mm, HW 22.65 (0.63) mm, and VH 22.94 (0.69) mm for emmetropes. Significant correlations were noted between SEQ and ocular dimensions, with a greater change in LAL (0.46 mm/D, P < 0.001) than in VH (0.27 mm/D, P < 0.001) and HW (0.22 mm/D, P = 0.001).

    CONCLUSIONS: Myopic eyeballs are larger than those with emmetropia. The eyeball elongates as myopia increases, with the greatest change in LAL, the least in HW, and an intermediate change in VH. These changes manifest in both sexes at a young age and low level of myopia. These data may serve as a reference for monitoring the development of refractive error in young Malaysian children of Chinese origin.

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