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Fulltext Churg-Strauss syndrome presenting with conjunctival and eyelid masses: a case report

Ameli F, Phang KS, Masir N

Med J Malaysia, 2011 Dec;66(5):517-9.
PMID: 22390118 MyJurnal

Churg-Strauss syndrome, a small and medium vessel vasculitis, was first described by Churg and Strauss in 1951. It is characterised by the presence of asthma, prominent tissue and blood eosinophilia, systemic vasculitis, and pulmonary and systemic necrotising allergic granulomas. Involvement of the skin, heart and gastrointestinal tract is well documented, but ocular presentation is unusual. We describe a 40-year-old lady who presented with recurrent upper eyelid swelling due to conjunctival lesions. Although she has chronic asthma, Churg-Strauss syndrome was never suspected. The diagnosis of Churg-Strauss syndrome was only made following histological examination of the conjunctival lesions.

Matched MeSH terms: Conjunctiva/pathology*
Fulltext Corneo-pterygium total area measurements utilising image analysis method

Mohd Radzi H, Khairidzan MK, Mohd Zulfaezal CA, Azrin EA

J Optom, 2019 05 13;12(4):272-277.
PMID: 31097348 DOI: 10.1016/j.optom.2019.04.001

PURPOSE: To describe an objective method to accurately quantify corneo-pterygium total area (CPTA) by utilising image analysis method and to evaluate its association with corneal astigmatism (CA).
METHODS: 120 primary pterygium participants were selected from patients who visited an ophthalmology clinic. We adopted image analysis software in calculating the size of invading pterygium to the cornea. The marking of the calculated area was done manually, and the total area size was measured in pixel. The computed area is defined as the area from the apex of pterygium to the limbal-corneal border. Then, from the pixel, it was transformed into a percentage (%), which represents the CPTA relative to the entire corneal surface area. Intra- and inter-observer reliability testing were performed by repeating the tracing process twice with a different sequence of images at least one (1) month apart. Intraclass correlation (ICC) and scatter plot were used to describe the reliability of measurement.
RESULTS: The overall mean (N=120) of CPTA was 45.26±13.51% (CI: 42.38-48.36). Reliability for region of interest (ROI) demarcation of CPTA were excellent with intra and inter-agreement of 0.995 (95% CI, 0.994-0.998; P<0.001) and 0.994 (95% CI, 0.992-0.997; P<0.001) respectively. The new method was positively associated with corneal astigmatism (P<0.01). This method was able to predict 37% of the variance in CA compared to 21% using standard method.
CONCLUSIONS: Image analysis method is useful, reliable and practical in the clinical setting to objectively quantify actual pterygium size, shapes and its effects on the anterior corneal curvature.

Matched MeSH terms: Conjunctiva/pathology
Fulltext Grading of tarsal conjunctiva of young adults in Malaysia

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

Matched MeSH terms: Conjunctiva/pathology*
Prediction of Changes in Visual Acuity and Contrast Sensitivity Function by Tissue Redness after Pterygium Surgery

Hilmi MR, Che Azemin MZ, Mohd Kamal K, Mohd Tamrin MI, Abdul Gaffur N, Tengku Sembok TM

Curr Eye Res, 2017 Jun;42(6):852-856.
PMID: 28118054 DOI: 10.1080/02713683.2016.1250277

PURPOSE: The goal of this study was to predict visual acuity (VA) and contrast sensitivity function (CSF) with tissue redness grading after pterygium surgery.

MATERIALS AND METHODS: A total of 67 primary pterygium participants were selected from patients who visited an ophthalmology clinic. We developed a semi-automated computer program to measure the pterygium fibrovascular redness from digital pterygium images. The final outcome of this software is a continuous scale grading of 1 (minimum redness) to 3 (maximum redness). The region of interest (ROI) was selected manually using the software. Reliability was determined by repeat grading of all 67 images, and its association with CSF and VA was examined.

RESULTS: The mean and standard deviation of redness of the pterygium fibrovascular images was 1.88 ± 0.55. Intra-grader and inter-grader reliability estimates were high with intraclass correlation ranging from 0.97 to 0.98. The new grading was positively associated with CSF (p < 0.01) and VA (p < 0.01). The redness grading was able to predict 25% and 23% of the variance in the CSF and the VA, respectively.

CONCLUSIONS: The new grading of pterygium fibrovascular redness can be reliably measured from digital images and showed a good correlation with CSF and VA. The redness grading can be used in addition to the existing pterygium grading.

Matched MeSH terms: Conjunctiva/pathology*
Fulltext Conjunctival necrosis following a subconjunctival injection of triamcinolone acetonide in a child

Chong YJ, Wong CK, Shatriah I

Middle East Afr J Ophthalmol, 2015 Jan-Mar;22(1):125-8.
PMID: 25624689 DOI: 10.4103/0974-9233.148364

Conjunctival necrosis is a rare complication following periocular/intraocular triamcinolone acetonide injection and has been reported extensively in adults. We describe a child who developed conjunctival necrosis following subconjunctival injection of triamcinolone acetonide for severe chronic anterior uveitis. Prompt diagnosis and management of this uncommon condition is vital.

Matched MeSH terms: Conjunctiva/pathology*