METHODS: Reading acuity, critical print size, reading speed and maximum reading speed were measured in groups of 40 children (8 to 12 years old), 40 teenagers (13 to 19 years old), 40 young adults (20 to 39 years old), and 40 adults (40 years old and above) using the Buari-Chen Malay Reading Chart [contextual sentences (CS) set and random words (RW) set] in a cross-sectional study design.
RESULTS: Reading acuity was significantly improved by 0.04 logMAR for both CS set and RW set from children to teenagers, then gradually worsened from young adults to adults (CS set: 0.06 logMAR; RW set: 0.08 logMAR). Critical print size for children showed a significant improvement in teenagers (CS set: 0.14 logMAR; RW set: 0.07 logMAR), then deteriorated from young adults to adults by 0.09 logMAR only for CS set. Reading speed significantly increased from children to teenagers, [CS set: 46.20 words per minute (wpm); RW set: 42.06 wpm], then stabilized from teenagers to young adults, and significantly reduced from young adults to adults (CS set: 28.58 wpm; RW set: 24.44 wpm). Increment and decrement in maximum reading speed measurement were revealed from children to teenagers (CS set: 39.38 wpm; RW set: 43.38 wpm) and from young adults to adults (CS set: 22.26 wpm; RW set: 26.31 wpm) respectively.
CONCLUSION: The reference of age-related findings in term of acuity and speed of reading should be incorporated in clinical practice to enhance reading assessment among healthy eyes population.
METHODS: A total of 230 older adults (age ≥60y) participated in this study. Habitual distance and near VA were measured using the Early Treatment Diabetic Retinopathy Study Chart and Lighthouse Near Visual Acuity Chart, respectively. Global cognitive function was assessed using the Mini-Mental State Examination (M-MSE) and the Malay language version of the Montreal Cognitive Assessment (M-MoCA). Digit Symbol (DS) subtest was used to measure information processing.
RESULTS: No significant association was observed between vision and M-MSE and M-MoCA scores. However, poor distance and near VA were found to be significantly associated with low DS scores [distance VA: β=-0.01, R 2=0.1, P=0.02; odds ratio (OR)=2.84, 95% confidence interval (CI), 1.10-7.33, P=0.03; near VA: β=-0.05, R 2=0.08, P=0.00; OR=3.32, 95%CI, 1.28-8.59, P=0.01].
CONCLUSION: Poor vision is associated with a decline in information processing in older adults and substantiates the importance of preserving good vision in maintaining cognitive function.
METHODS: We retrospectively evaluated the surgical outcome of the BGI with Supramid© 3/0 ripcord stent in patients with NVG. No tube ligation or venting slits were performed. Supramid was removed after 3mo if the target intraocular pressure (IOP) was not achieved. Surgical success was defined as IOP≤21 mm Hg with (qualified success) or without IOP-lowering medications (complete success).
RESULTS: Twenty-six eyes from 24 patients were included in the study. The median duration of follow-up was 4 [interquartile range (IQR)=1-5]y, ranging from 0.5 to 5y. IOP decreased by a mean of 24.2 mm Hg (59.7%); from a mean of 40.5±12.6 mm Hg at baseline to 16.3±11.9 mm Hg, P≤0.001. The number of glaucoma medications reduced from a median of 5 (IQR=5-6) to 1 (IQR=0-2, P≤0.001) at the final follow-up. Overall success rates were 88.0% at 1y, 34.8% at 3y, 66.7% at 4y, and 50% at 5y. Hypertensive phase (HP) in the first 3mo occurred in 15/26 eyes (57.7%) with a mean IOP of 31.1 mm Hg.
CONCLUSION: BGI with Supramid© ripcord stent gives close to 90% of the overall survival rate at the final follow-up without significant early hypotony. However, early HP is still a challenge.
METHODS: This was a prospective cross-sectional study. All subjects underwent a full ophthalmic examination, refraction, visual field analysis and A-scan biometry. Myopic patients were classified as low myopia (LM) [spherical equivalent (SE) from greater than -0.5 D, up to -3.0 D], moderate myopia (MM; SE greater than -3.0 D, up to -6.0 D) and high myopia (HM; SE greater than -6.0 D). The control group consisted of emmetropic (EM) patients (SE from +0.5 D to -0.5 D). A Zeiss Cirrus HD-OCT machine was used to measure the peripapillary RNFL thickness of both eyes of each subject. The mean peripapillary RNFL thickness between groups was compared using both analysis of variance and analysis of covariance.
RESULTS: A total of 403 eyes of 403 subjects were included in this study. The mean age was 31.48±10.23y. There were 180 (44.7%) eyes with EM, 124 (30.8%) with LM, 73 (18.1%) with MM and 26 (6.5%) with HM. All groups of myopia severity had a thinner average RNFL than the EM group, but after controlling for gender, age, and axial eye length, only the HM group differed significantly from the EM group (P=0.017). Likewise, the superior, inferior and nasal RNFL was thinner in all myopia groups compared to controls, but after controlling for confounders, only the inferior quadrant RNFL was significantly thinner in the HM group, when compared to the EM group (P=0.017).
CONCLUSION: The average and inferior quadrant RNFL is thinner in highly myopic eyes compared to emmetropic eyes. Refractive status must be taken into consideration when interpreting the OCT of myopic patients, as RNFL thickness varies with the degree of myopia.
METHODS: ARPE-19 cells were cultured in Dulbecco's Modified Eagle Medium-F-12 supplemented with 10% foetal bovine serum and 1% penicillin-streptomycin in a humidified 5% CO2 incubator maintained at 37°C. Cells were treated with 247 µmol/L lutein, 49 µmol/L zeaxanthin and 1% (v/v) of either coconut oil, corn oil, peanut oil, olive oil, sunflower oil, soybean oil, castor oil, or linseed oil for 48h. Lutein and zeaxanthin concentration in the cells were quantified by high performance liquid chromatography.
RESULTS: Among the oils tested, the highest lutein and zeaxanthin uptake was observed with coconut oil while the lowest was observed with linseed oil.
CONCLUSION: ARPE-19 uptake of lutein and zeaxanthin are found to be dependent on the type of oils.
METHODS: A total of 64 university students were recruited in this study. The validated Malay version of Pittsburgh Sleep Quality Index questionnaire (PSQI-M) was used to measure the participants' sleep quality over the past month. Participants were categorized as good sleepers (n=32) and poor sleepers (n=32) based on the PSQI-M scores. Heterophoria and fusional vergences were measured at distance and near. Mann-Whitney U test was used to compare heterophoria, negative fusional vergence (NFV), and positive fusional vergence (PFV) at distance and near between good and poor sleepers. Spearman correlation analysis was used to study the relationship between PSQI-M score and PFV at distance.
RESULTS: Both distance and near heterophorias were not significantly different between good and poor sleepers (P>0.05). There was a difference in distance PFV (P<0.05) between good and poor sleepers, but not in distance NFV, near NFV, and near PFV (P>0.05). Distance PFV was negatively correlated with PSQI-M score (rs=-0.33, P<0.05).
CONCLUSION: University students with poor sleep quality demonstrates a reduced ability to maintain fusion with increasing convergence demand at distance. Sleep quality assessment during binocular vision examination in university students is recommended.
METHODS: Serum IGF-1 levels were measured in 25 pregnant diabetic patients and 25 pregnant non-diabetic patients who were matched for age, ethnicity, parity and period of gestation. Fundus examination was performed in both groups at 28, 32 and 36 weeks of gestation.
RESULTS: The serum IGF-I level was significantly elevated in pregnant diabetics compared to pregnant non-diabetics (366±199μg/L vs 184±89μg/L, (P=0.0001) at 24 weeks, 535±251μg/L vs 356±89μg/L, (P=0.007) at 32 weeks and 404±166μg/L vs 264±113μg/L, (P=0.003) at 36 weeks of gestation). The pregnant diabetics with established diabetes had significantly higher IGF-1 level than gestational diabetes at 28, 32 and 36 weeks of gestation. The serum IGF-I level in pregnant diabetics with retinopathy was significantly higher than that in those without retinopathy at all periods of gestation.
CONCLUSION: Increased serum IGF-1 in pregnancy may increase the risks for retinopathy.
METHODS: All diabetic patients were screened in Retinal Disease Awareness Programme (RDAP) and those who had significant DR changes were referred to the hospital for further management. Descriptive analyses were done to determine the prevalence of DR and sociodemographic characteristics among patients with diabetic. Univariate and multivariable analysis using Logistic regression were performed to find association and predictor factors in this screening.
RESULTS: A total of 3305 patients aged 40y and above were screened for DR. Of the patients screened, 9% patients were found to have DR and other visual complication such as maculopathy (0.9%), cataract (4.8%) and glaucoma (0.4%). The mean age of patients without retinopathy was 57.82±8.470y and the mean age of patients with DR was 63.93±9.857y. About 61.5% of the patients screened were aged below 60y and 38.5% were aged 60y and above. Majority of the patients screened were women 58.5% and Malay in the age group of 50-59y, while 27% were aged 60-69y. Significant association were found between age, sex, race, visual loss and DR.
CONCLUSION: Although the prevalence of DR among patients is not alarming, effective interventions need to be implemented soon to avert a large burden of visual loss from DR.
METHODS: This study was conducted among patients diagnosed with AMD in Kuala Lumpur. The generation of the instrument included four phases which included item and domains development, content, face validity and exploratory factor analysis. Content validity and modified Kappa was used for validation of knowledge domain. Exploratory factor analysis was used for validation of both attitude and practice domains. Face validity was conducted in 12 patients, content validity was ascertained in 120 patients and test-retest reliability was determined in 39 patients with AMD.
RESULTS: Content validity index (CVI) and modified kappa showed excellent values for most items in the knowledge domain with CVI for item (I-CVI) values between 0.78-1.0 and Kappa values of >0.74. The Kaiser-Meyer-Olkin (KMO) sampling adequacy showed acceptable scores of 0.70 and 0.75 for both attitude and practice domains respectively and Bartlett's Test of sphericity were significant (χ2 =0.00, P<0.001). Factor analysis resulted in five factors with thirty items for attitude domain and four factors with twenty items for practice domain. The Cronbach's alpha showed acceptable values for all items in knowledge, attitude and practice domain with values >0.70 and good test-retest reliability. The final version of the questionnaire consisted of 93 items from four sections consisting of demographic details, knowledge, attitude and practice.
CONCLUSION: The findings of this validation and reliability study show that the developed questionnaire has a satisfactory psychometric property for measuring KAP of patients diagnosed with AMD undergoing intravitreal injection treatment.
METHODS: This cross-sectional observational study includes 127 eyes of 127 subjects. Patients were divided into PPG (51 eyes), PG (46 eyes), and normal controls (30 eyes) based on clinical optic disc assessment and Humphrey visual field changes. The Heidelberg Spectralis OCT machine using Glaucoma Module Premium Edition software was used to measure the retinal nerve fiber layer (RNFL) and Bruch's membrane opening-minimum rim width (BMO-MRW) to assess the optic nerve head and ganglion cell layer (GCL) thickness in the macula.
RESULTS: RNFL, MRW, and GCL thickness were all significantly thinner in PG compared to PPG and the normal group. The BMO-MRW parameters showed better specificity (>70%) at 90% specificity compared to both RNFL and GCL parameters to discriminate normal, PPG, and PG patients. All BMO-MRW parameters showed higher area under curves (AUC) compared to RNFL and GCL parameters with the highest AUC observed in the superotemporal sector of the BMO-MRW (AUC=0.819 and and 0.897 between normal and PPG and PG groups respectively).
CONCLUSION: While the BMO-MRW best discriminates PPG and PG against normal eyes, GCL parameters poorly differentiate the three groups.