METHODS: This is a case-control, hospital-based study conducted at Hospital Universiti Sains Malaysia between January and November 2022. Thirty-eight children with T1DM were recruited as cases, and 38 healthy children were recruited as controls. The cases and controls then underwent ophthalmic examination, IOP measurement, and CCT measurement using optical coherence tomography (OCT) of the right eye. The IOP measurements were adjusted for CCT for further analysis.
RESULTS: The means of CCT and IOP values were significantly higher in the T1DM group than in the control group (all p = 0.02). The mean CCT was 542.18 ± 20.40 μm in the T1DM group, and 529.52 ± 26.17 μm in the control group. The mean IOP was 14.68 ± 1.98 mmHg in the T1DM group, and 13.52 ± 1.66 mmHg in the control group. The mean HbA1c was 10.68% ± 2.49% in the T1DM group. Age and duration of DM were found to have a significant association with CCT in children with T1DM. The duration of DM was also found to be significantly associated with the IOP. Sex and HbA1c levels were found to have no significant relationship with either CCT or IOP.
CONCLUSIONS: Children with T1DM have significantly higher CCT and IOP than the average child. The duration of DM is a significant factor that impacts both CCT and IOP. In addition, age is another factor that affects CCT in children with T1DM.
Methods: Multicenter prospective cross-sectional study conducted in three tertiary hospitals in 2018 to 2019. Children less than seven years old with previous ROP diagnosis were recruited and divided into threshold, high-risk and low-risk pre-threshold subgroups. Patients with systemic comorbidities that affected vision or daily activities were excluded. A parent/guardian completed the Children's Visual Function Questionnaire (CVFQ) for the assessment of child's general health, general vision, competence, personality, family impact and treatment difficulty.
Results: Eight were categorized with threshold ROP, 16 with high-risk pre-threshold ROP, and 26 with low-risk pre-threshold ROP. 50 age-matched controls were also included. Mean visual acuity in logMAR was 0.46 in the threshold, 0.08 in high risk pre-threshold and 0.01 in low-risk pre-threshold subgroups. Threshold ROP was associated with myopia and strabismus, and associated with poor visual acuity compared to pre-threshold ROP. Mean total CVFQ score was significantly lower in the ROP group (p<0.001) compared to the control group. Mean score and all mean subscale scores were significantly lower in the threshold subgroup compared to high-risk and low-risk pre-threshold subgroups, with lowest subscale scores on general vision and general health. There was significant association between gestational age, visual acuity of the better eye and family income and VRQoL (p<0.05).
Conclusion: ROP was associated with lower VRQoL in children born prematurely in Malaysia. The threshold ROP group is the most affected. General vision and health domains are their main difficulties encountered. Gestational age, visual acuity of the better eye and family income affects the VRQoL.
MATERIALS AND METHODS: A retrospective review of patients who underwent horizontal strabismus surgery between 2013 and 2017 in Hospital Universiti Sains Malaysia was conducted. Surgery was considered successful if the post-operative deviation was within 10 prism diopters at 6 months' postoperative period. Factors influencing the outcome of surgery at 6 months were identified. Chi-square and Fisher's exact tests were used in data analysis.
RESULTS: Ninety-eight patients were included. Both genders were equally affected. Exotropia (58.2%) was the most common type. About 65.3% of patients had alternating strabismus, while 51% had an angle of deviation of more than 45 prism diopters. Amblyopia was documented in 14.3% of patients. Those operated on below 10 years of age comprised 64.3%. Ninety-four patients completed follow-ups at 6 months after the surgery. The success rate was 81.6%. Approximately 92% of the patients had best-corrected visual acuities of 6/12 and better at 6 months' postoperative period. There was no significant association between age of onset, gender, presence of amblyopia, type of deviation, amount of deviation, and postoperative best-corrected visual acuity with surgical outcome at 6 months' postoperative period (P > 0.05).
CONCLUSION: The success rate was good. Postoperative best-corrected visual acuity was promising. Age of onset, gender, presence of amblyopia, type of deviation, amount of deviation, and postoperative best-corrected visual acuity did not influence the outcome of horizontal strabismus surgery in our review.
METHODS: This study included children who had LAIE (with angle of 40 prism dioptres or greater), aged 5 and 17 years who had attended the Ophthalmology Clinic, Hospital Universiti Sains Malaysia from March to September 2016. The children and their parents or guardians were interviewed face-to-face using a validated semi-structured interview guide. Interviews were tape-recorded and transcribed verbatim. Content analysis was performed using the NVivo 12 software.
RESULTS: A total of 30 children and 30 parents were interviewed. The most common problems identified by the children were social interactions (73.3%, 22 children), visual functions (60.0%, 18 children), emotions (60.0%, 18 children), physical issues (40.0%, 12 children) and difficulties regarding treatment options (26.7%, eight children). The parents reported that their children were more affected in terms of visual functions (100.0%, 30 parents), social interactions (56.7%, 17 parents), emotions (43.3%, 13 parents), physical issues (20.0%, six parents), and difficulties regarding treatment options (16.7%, five parents).
CONCLUSION: The major problems that the children with LAIE identified were social interactions, while the parents observed that problems with visual functions was the most common issue encountered by their children. This suggests that the children affected have different perspectives from their parents and require support.
Purpose: The purpose of this study was to evaluate mean macular and RNFL thickness in pregnant women with GDM in a teaching institution in Malaysia. We also analyzed the association of age, HbA1c level, duration of GDM, type of treatment, family history, previous history of GDM and spherical equivalent with the macular and RNFL thickness.
Patients and Methods: This was a prospective and cross-sectional study involving 78 pregnant women with GDM, 72 healthy pregnant and 70 healthy non-pregnant women. The study was conducted in Hospital Universiti Sains Malaysia from 2016 to 2018. Macular and RNFL thickness were measured during the third trimester using spectral-domain optical coherence tomography. Age, HbA1c level, duration of GDM, type of treatment, family history, previous history of GDM and spherical equivalent were analysed.
Results: The mean macular thickness was 236.08 (16.44) µm, 237.26 (22.42) µm and 240.66 (20.95) µm for GDM, healthy pregnant, and healthy non-pregnant women. The mean RNFL thickness was 97.27 (9.14) µm, 99.83 (12.44) µm and 97.97 (10.07) µm for GDM, healthy pregnant, and healthy non-pregnant women. There was no significant difference in the mean macular and RNFL thickness in pregnant women with GDM when compared to the control groups (p>0.05). Age, HbA1c, duration of diabetes, treatment received, history of GDM and spherical equivalent did not show significant association with mean macular and retinal thickness (p>0.05).
Conclusion: Pregnant women with GDM have similar thickness of the macular and RNFL with the healthy pregnant and healthy non-pregnant women. Age, HbA1c, duration of diabetes, treatment received, history of GDM and spherical equivalent showed no significant association with mean macular and retinal thickness in pregnant women with GDM.
METHODS: This was a cross-sectional study involving 166 children aged 6 to 12 years old in Malaysia. Ocular examination, biometry, retinal photography, blood pressure and body mass index measurement were performed. Participants were divided into two groups; obese and non-obese. Retinal vascular parameters were measured using validated software.
RESULTS: Mean age was 9.58 years. Approximately 51.2% were obese. Obese children had significantly narrower retinal arteriolar caliber (F(1,159) = 6.862, p = 0.010), lower arteriovenous ratio (F(1,159) = 17.412, p < 0.001), higher venular fractal dimension (F(1,159) = 4.313, p = 0.039) and higher venular curvature tortuosity (F(1,158) = 5.166, p = 0.024) than non-obese children, after adjustment for age, gender, blood pressure and axial length.
CONCLUSIONS: Obese children have abnormal retinal vascular geometry. These findings suggest that childhood obesity is characterized by early microvascular abnormalities that precede development of overt disease. Further research is warranted to determine if these parameters represent viable biomarkers for risk stratification in obesity.
METHODS: This was a cross-sectional, hospital-based study involving 86 Malay girls aged 6 to 12 years old in Hospital Universiti Sains Malaysia from 2015-2016. Ocular examination, refraction, biometry, retinal photography, and anthropometric measurements were performed. The central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE) and overall fractal dimension (Df) were measured using validated computer-based methods (Singapore I vessel analyzer, SIVA version 3.0, Singapore). The associations of ocular biometry and CRAE, CRVE and Df were analyzed using multivariable analysis.
RESULTS: The mean CRAE, CRVE and Df in Malay girls were 171.40 (14.40) um, 248.02 (16.95) um and 1.42 (0.05) respectively. Each 1 mm increase in axial length was associated with a reduction of 4.25 um in the CRAE (p = 0.03) and a reduction of 0.02 in the Df (p = 0.02), after adjustment for age, blood pressure and body mass index. No association was observed between axial length and CRVE. Anterior chamber depth and corneal curvature had no association with CRAE, CRVE or Df.
CONCLUSION: Axial length affects retinal vessel measurements. Narrower retinal arterioles and reduced retinal fractal dimension were observed in Malay girls with longer axial lengths.
PURPOSE: To report the clinical profile of 34 ocular TB cases observed during 6 years period in Hospital Universiti Sains Malaysia (HUSM).
METHOD: A retrospective review of medical records from 34 patients diagnosed with ocular TB in HUSM from January 2011 until December 2016.
RESULTS: The mean age was 43 ± 14.6 years old. Both male and female affected in about 1:1 ratio. The majority of subjects were local Malays (91.2%). Risk factors included previous contact with pulmonary TB patients (38.2%), and patients with underlying diabetes mellitus (26.5%). Most patients showed normal chest radiography (79.4%). However they had positive Mantoux test (94.1%) and raised erythrocyte sedimentation rate (ESR) value (58.8%). Uveitis was the most common ocular manifestation of ocular TB (70.6%) while the rare ocular manifestations included optic perineuritis and optic neuritis, orbital apex syndrome, orbital cellulitis, sclerokeratitis, corneal ulcer and conjunctival abscess. All patients responded well to anti-TB treatment, but visual outcome was variable.
CONCLUSIONS: This review shows the diverse entity of ocular TB spectrum in an endemic area. Good clinical response to anti-tuberculous therapy supported the presumed diagnosis of ocular TB in majority of the cases.