Displaying publications 1 - 20 of 30 in total

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  1. Mohammad AA, Yasuhiro Y, Seng LB, Rajagopal N, Yoko K
    Asian J Neurosurg, 2019 5 31;14(2):415-421.
    PMID: 31143255 DOI: 10.4103/ajns.AJNS_155_18
    Introduction: Surgical outcome and ischemic complications of Internal carotid Posterior Communicating (IC PC) and anterior choroidal aneurysms have been questionable due to frequent occlusion of the anterior choroid artery and also due to low incidence of true anterior choroid artery aneurysms. The present series describes the postoperative outcome after clipping of such aneurysms at a single centre.

    Methods: A retrospective analysis of 73 cases with IC PC and Anterior choroidal aneurysms performed at a Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Aichi, Japan from 2014 to 2018 have been studied and emphasis is made on the demography and ischemic complications.

    Results: A total of 73 patients with IC PC and anterior choroidal aneurysms were studied, out of which 57 patient had a true IC PC aneurysm, 14 patients had aneurysms involving the anterior choroidal artery and only 2 patients had aneurysms which involved both the IC PC and the anterior choroidal arteries. None of the patients had a permanent Anterior Choroidal Artery syndrome, whereas only 2 out of the 73 patients had postoperative complications in the form of transient hemiparesis.

    Conclusion: Ischemic complications following surgical clipping of IC PC and anterior choroidal aneurysms can be minimised by meticulous micro dissection to identify the anterior choroidal artery thus preserving the patency of the same.

    Matched MeSH terms: Choroid
  2. Bastion, M.L.C., Amelah, M.A.Q., Wong, H.S.
    MyJurnal
    This study aimed to review the risk factors and clinical outcomes of patients undergoing pars planar vitrectomy (PPV) for breakthrough bleeding (BTB) from age related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV). We performed a retrospective review of medical records of 346 patients operated by the vitreoretinal unit at Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia from January 2008 - June 2011. We found eight eyes of 8 patients with AMD/IPCV-related BTB who underwent PPV. Mean age of patients was 64.4 years (range 41-80 years) with 5 males. Five were Chinese. Duration of symptoms ranged from days to months. Four patients were on anti-coagulants. Two had history of prior photodynamic therapy. There were five cases of PCV, of which three were macular in location. All three cases of AMD were macular. Intraoperative intravitreal ranibizumab injection was given in three cases and two had combined vitrectomy and cataract extraction. All cases reported improvement in visual acuity with four cases achieving 6/60 or better post operatively including two cases of extramacular PCV achieving 6/9 vision. Mean follow-up was 60 weeks. Postoperative complications included retinal tear and detachment in one case, reattached on reoperation. Six patients had a history of hypertension including one individual with stroke. Our small series indicates a predominance of Chinese individuals with BTB. Usage of anticoagulants and hypertension may be a predisposing factor. Better visual prognosis occurs with extramacular lesions which tend to be of PCV type.
    Matched MeSH terms: Choroid
  3. Kamalden TA, Lingam G, Sundar G
    Ocul Oncol Pathol, 2014 Oct;1(1):13-8.
    PMID: 27175357 DOI: 10.1159/000363454
    Choroidal osteoma is a benign ossifying tumor of the choroid, consisting of mature bone tissue. It has been described to enlarge and evolve at varying rates over time. Here, we report and quantify the progression of a unilateral choroidal osteoma in a 7-year-old boy by fundus photography, and document tumor remodeling by spectral domain optical coherence tomography images.
    Matched MeSH terms: Choroid
  4. Koay CL, Quo MJ, Subrayan V
    Int Ophthalmol, 2017 Jun;37(3):655-671.
    PMID: 27558260 DOI: 10.1007/s10792-016-0306-4
    The purpose of this study was to investigate the reproducibility of choroidal thickness measurements in normal subjects on 3 spectral domain optical coherence tomography instruments, namely: Zeiss Cirrus HD-OCT (Carl Zeiss Meditec Inc., Dublin, CA), Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany), and Optovue RTVue (Optovue Inc., Fremont, CA). This cross-sectional non-interventional study was performed in a single institution. Images were obtained in 47 eyes of 47 healthy volunteers which age ranged between 23 and 72 without ocular pathology. All subjects were imaged on the fovea using Cirrus HD 1-line raster, Spectralis enhanced depth imaging, and RTVue retina-cross. The choroid was measured subfoveally and at intervals of 500 µm from the fovea nasally and temporally up to 2500 µm. Paired t test, modified Bland-Altman plot, and Pearson's correlation were used to compare the results. There is no significant difference between the systems for any measurement within 2500 µm either side of the fovea for most points. Inter-observer correlation was strong for RTVue, and moderate in both Cirrus and Spectralis.
    Matched MeSH terms: Choroid/cytology*
  5. Wong JG, Lai XJ, Sarafian RY, Wong HS, Smith JB
    Retin Cases Brief Rep, 2016;10(3):221-4.
    PMID: 26509999 DOI: 10.1097/ICB.0000000000000233
    PURPOSE: Choroidal nevus is the most common ocular fundus tumor in adults. Previous studies have widely discussed the features of choroidal neovascularization secondary to nevus and its treatment options. Polypoidal choroidal vasculopathy (PCV) is an exudative chorioretinopathy that is often underdiagnosed. Clinical features, natural history, and treatment response of PCV are distinct from occult choroidal neovascularization. Polypoidal choroidal vasculopathy secondary to choroidal nevus has not been previously documented. We report a patient with a history of stable choroidal nevus who developed a polypoidal lesion at the edge of the nevus lesion.

    METHODS: A white woman who presented with a choroidal nevus and clinical features of PCV was examined using fundoscopy, optical coherence tomography, fluorescein angiography, and indocyanine green angiography.

    RESULTS: A polypoidal lesion with an associated branching vascular network adjacent to the nevus was demonstrated by optical coherence tomography, fluorescein angiography, and indocyanine green angiography. The patient was asymptomatic and was managed conservatively.

    CONCLUSION: Our case showed that PCV developing in association with a stable choroidal nevus. Pathogenic mechanisms of this condition may include chronic degenerative or inflammatory changes at the level of the retinal pigment epithelium resulting in vascular changes. Unlike treatment of occult choroidal neovascularization secondary to nevus, optimal management of PCV secondary to nevus may vary. Indocyanine green angiography is the gold standard for the diagnosis of PCV and is a useful investigation in atypical choroidal neovascularization.

    Matched MeSH terms: Choroid Neoplasms/complications*; Choroid Neoplasms/pathology
  6. Wong JG, Lai XJ, Sarafian RY, Wong HS, Smith JB
    Int Med Case Rep J, 2017;10:51-54.
    PMID: 28243154 DOI: 10.2147/IMCRJ.S107648
    We report a case of a Caucasian female who developed active polypoidal choroidal vasculopathy (PCV) at the edge of a stable choroidal nevus and was successfully treated with verteporfin photodynamic therapy. No active polyp was detectable on indocyanine green angiography 2 years after treatment, and good vision was maintained. Indocyanine green angiography is a useful investigation to diagnose PCV and may be underutilized. Unlike treatment of choroidal neovascularization secondary to choroidal nevus, management of PCV secondary to nevus may not require intravitreal anti-vascular endothelial growth factor therapy. Photodynamic monotherapy may be an effective treatment of secondary PCV.
    Matched MeSH terms: Choroid; Choroidal Neovascularization
  7. Muhaizan WMW, Zurin AAR, Siti Aishah MA
    Med J Malaysia, 2003 Dec;58(5):763-5.
    PMID: 15190665
    Choroid plexus carcinoma is a rare intracranial neoplasm, affecting mainly very young children. The commonest site is within the lateral ventricles and the prognosis is very poor. We report a seven month old baby boy who presented with raised intracranial pressure and seizures. Brain CT scan showed large intraventricular mass with calcification and hydrocephalus. Total macroscopic resection of the tumour was performed and diagnosis of choroid plexus carcinoma was made. However, the patient died 11 days after the tumour excision. The histopathology of this rare childhood neoplasm is discussed.
    Matched MeSH terms: Choroid Plexus Neoplasms/surgery*
  8. Ng CWK, Tai PY, Oli Mohamed S
    Ocul Immunol Inflamm, 2018;26(5):666-670.
    PMID: 27929712 DOI: 10.1080/09273948.2016.1254804
    Matched MeSH terms: Choroid Diseases/diagnosis; Choroid Diseases/etiology*
  9. Nazrina Hassan, Yong Meng Hsien, Wan Haslina Wan Abdul Halim, Norshamsiah Md Din
    MyJurnal
    Introduction: High altitude retinopathy (HAR) is part of high altitude illness (HAI) which includes acute mountain sickness, high altitude cerebral oedema and pulmonary oedema. We present a case of bilateral HAR with right eye central scotoma during Mount Everest expedition. Case description: A 37-year-old lady presented with decreased right eye (OD) vision and central scotoma during ascending to the top of Mount Everest at 5100m. She developed respiratory symptoms with shortness of breath at the same time and warranted her a rapid descend on day eight of her excursion. Ocular examination revealed visual acuity of 6/36 OD and 6/6 left eye (OS). Both pupils were normal without relative afferent pupillary defect. Anterior segment and intraocular pressure were unremarkable. Fundus examination revealed bilateral multiple retinal haemorrhages along vascular arcades, with macula involvement in the right eye only. Otherwise there was no sign of optic disc swelling, vascular sheathing or choroidal involvement. Optical coherence tomography (OCT) of the macula showed hyperreflectivity changes on the right fovea at the level of superficial nerve fiber layer. Diagnosis of bilateral HAR was made and treated conservatively. She was also diag-nosed with HAI with acute pulmonary oedema and pneumonia by the treating physician. The retinal haemorrhages started to resolve after two weeks with full recovery of vision in ten weeks. Conclusion: With increasing popularity of mountaineering, ophthalmologists should be prepared to recognise HAR as part of HAI. Visual impairment depends on the location and extent of the lesions. HAR is self-limiting with good prognosis but can be associated with poten-tially fatal conditions of HAI e.g. pulmonary oedema in our case.
    Matched MeSH terms: Choroid
  10. Hashim H, Lim KS, Choong YY, Nor NM
    Retina, 2005 Jan;25(1):87-9.
    PMID: 15655449
    Matched MeSH terms: Choroid/injuries*
  11. Hor, S.M., Mushawiahti, M.
    MyJurnal
    A 42-year-old Chinese man, known case of renal cell carcinoma with lung metastasis, was referred to Universiti
    Kebangsaan Malaysia Medical Centre for left eye blurring of vision for one month duration, which was worse upon
    waking up in the morning and cleared up after 1-2 hours. On examination, visual acuities were 6/6 in both eyes. No
    relative afferent pupillary defect. Left fundus showed inferonasal retinal detachment without macular involvement.
    No retina break, no retinitis and no choroidal lesion seen. Right eye examination was normal. Optical coherence
    tomography (OCT) of left eye showed subretinal fluid temporal and inferior to optic disc. Fundus fluorescein
    angiography (FFA) left eye showed hypofluoresence in early phase but hyperfluorescence with pin point leakage in
    late phase over inferonasal quadrant. Indocyanine green (ICG) showed early hypofluoresence with late pin point
    hyperfluoresence in the same quadrant. A clinical diagnosis of exudative retinal detachment due to choroidal
    metastasis secondary to renal cell carcinoma was made. The patient was planned for cyber-knife radiotherapy of his
    left eye but unfortunately we lost the follow up. High index of suspicion and relevant investigation are needed for
    patients with visual complaints and history of renal cell carcinoma to diagnose choroidal metastasis.
    Matched MeSH terms: Choroid
  12. Sharudin SN, Saaid R, Samsudin A, Mohamad NF
    Optom Vis Sci, 2020 02;97(2):81-85.
    PMID: 32011579 DOI: 10.1097/OPX.0000000000001480
    SIGNIFICANCE: To our knowledge, this is the first time a study looking at the association between subfoveal choroidal thickness (SFCT) and the parameters affecting the severity of pre-eclampsia has been reported. We provide evidence that SFCT is thicker in pre-eclamptic (PE) patients and speculate on the possible causes.

    PURPOSE: The purposes of this study were to compare SFCT in PE, normal pregnant, and nonpregnant women using spectral domain optical coherence tomography and to correlate SFCT with severity of pre-eclampsia.

    METHODS: A cross-sectional, observational study was performed. A total of 150 participants were divided into three groups: group 1 (50 PE women), group 2 (50 normal pregnant women), and group 3 (50 nonpregnant healthy women). Subfoveal choroidal thickness was measured using spectral domain optical coherence tomography. Other parameters including mean arterial blood pressure (MABP), central corneal thickness, macular thickness, IOP, ocular perfusion pressure (OPP), and urine protein-to-creatinine ratio were also measured. ANOVA and Pearson correlation analysis were used to look at differences between the groups. P < .05 was considered as statistically significant.

    RESULTS: The MABP was higher in group 1 than in groups 2 and 3 (103.0 ± 12.9 vs. 83.2 ± 9.8 vs. 89.5 ± 7.2 mmHg, respectively; all P < .001). The SFCT of the PE group was higher than in groups 2 and 3 (370.7 ± 23.8 vs. 344.5 ± 30.8 vs. 315.8 ± 49.9 μm, respectively; all P < .001). There were no statistically significant differences in central corneal thickness, macular thickness, or IOP between the PE and healthy pregnant groups (all P > .05). The OPP was greater in PE patients (52.8 ± 8.5 vs. 41.9 ± 6.9 vs. 43.4 ± 5.2 mmHg, respectively; both P < .001). The SFCT was positively correlated with MABP (r = 0.464, P < .001), OPP (r = 0.495, P < .001), and urine protein-to-creatinine ratio (r = 0.635, P < .001) in the PE group.

    CONCLUSIONS: Subfoveal choroidal thickness is higher in pre-eclampsia and is proportional to established markers of severity of the condition. This parameter might serve as a novel predictive marker for the severity of pre-eclampsia.

    Matched MeSH terms: Choroid/pathology*
  13. Jumaat BH, Dahalan A, Mohamad M
    Am J Ophthalmol, 2003 Feb;135(2):254-6.
    PMID: 12566045
    PURPOSE: To report a case of choroidal osteoma presenting with massive subretinal hemorrhage not associated with choroidal neovascularisation (CNV).

    DESIGN: Case report.

    METHODS: An 18-year-old man presented with sudden loss of vision in the right eye following competitive swimming. He was found to have a massive subretinal hemorrhage involving the macula.

    RESULTS: Following resolution of the hemorrhage, the patient was found to have an underlying choroidal osteoma. There was no evidence of choroidal neovascularisation clinically and angiographically. He regained his normal vision.

    CONCLUSIONS: Choroidal osteoma presenting with massive subretinal hemorrhage not associated with underlying choroidal neovascularization need not result in poor visual outcome.

    Matched MeSH terms: Choroid Neoplasms/complications*; Choroid Neoplasms/diagnosis
  14. Reddy SC, Menon BS
    Acta Ophthalmol Scand, 1998 Dec;76(6):700-3.
    PMID: 9881556
    PURPOSE: To determine the prevalence of ocular manifestations in childhood acute leukaemia at the time of presentation.

    METHODS: Eighty-two children with acute leukaemia were examined for ocular lesions within two days of diagnosis before starting chemotherapy. The detailed ocular examination of both eyes was carried out by the ophthalmologist irrespective of the presence or absence of eye symptoms in all cases.

    RESULTS: Only 3 out of 82 children presented with eye symptoms (3.6%). However, ocular changes were found in 14 children (17%); ten with lymphoblastic and four with myeloid leukaemia. The ocular lesions observed were proptosis, intraretinal haemorrhages, white centered haemorrhages, cotton wool spots, macular haemorrhage, subhyaloid haemorrhage, vitreous haemorrhage, papilloedema, cortical blindness, sixth nerve palsy, and exudative retinal detachment with choroidal infiltration.

    CONCLUSION: In view of the high prevalence of asymptomatic ocular lesions in childhood acute leukaemia, routine ophthalmic examination should be included as a part of evaluation at the time of diagnosis.

    Matched MeSH terms: Choroid Diseases/diagnosis; Choroid Diseases/etiology*
  15. Clayton BA, Middleton D, Bergfeld J, Haining J, Arkinstall R, Wang L, et al.
    Emerg Infect Dis, 2012 Dec;18(12):1983-93.
    PMID: 23171621 DOI: 10.3201/eid1812.120875
    Human infections with Nipah virus in Malaysia and Bangladesh are associated with markedly different patterns of transmission and pathogenicity. To compare the 2 strains, we conducted an in vivo study in which 2 groups of ferrets were oronasally exposed to either the Malaysia or Bangladesh strain of Nipah virus. Viral shedding and tissue tropism were compared between the 2 groups. Over the course of infection, significantly higher levels of viral RNA were recovered from oral secretions of ferrets infected with the Bangladesh strain. Higher levels of oral shedding of the Bangladesh strain of Nipah virus might be a key factor in onward transmission in outbreaks among humans.
    Matched MeSH terms: Choroid Plexus/metabolism; Choroid Plexus/pathology
  16. Pei, Fang Neoh, Tai, Evelyn L.M., Liza-Sharmini A.T.
    MyJurnal
    A 65-year-old lady complained of occasional flashes of light over her left eye for 2 months. She was referred for ocular assessment after she underwent refractive assessment at the optometrist. On examination, best corrected visual acuity in both eyes was 6/9. Both eyes anterior segments were normal, with normal intraocular pressure. The pupils were equal with no relative afferent pupillary defect. Left eye fundus examination was normal. On the contrary, the "normal" right eye fundus examination revealed a huge, well-circumscribed hypo-pigmented elevated choroidal mass. B scan ultrasonography of the right eye showed a mushroom-shaped intraocular mass. Magnetic resonance imaging showed an intraocular lesion. Comprehensive systemic examination and investigations to rule out distant primary malignancy were unremarkable. A provisional diagnosis of right eye primary choroidal melanoma was made. Despite good vision in the affected eye, she underwent right eye enucleation in view of the large intraocular mass. The diagnosis was confirmed by histopathological examination.
    Matched MeSH terms: Choroid Neoplasms
  17. Bhatti MS, Tang TB, Laude A
    PLoS One, 2017;12(7):e0181512.
    PMID: 28742142 DOI: 10.1371/journal.pone.0181512
    The water-drinking test (WDT) is a provocative test used in glaucoma research to assess the effects of elevated intraocular pressure (IOP). Defective autoregulation due to changes in perfusion pressure may play a role in the pathophysiology of several ocular diseases. This study aims to examine the effects of WDT on ocular blood flow (in the form of pulse waveform parameters obtained using laser speckle flowgraphy) to gain insight into the physiology of ocular blood flow and its autoregulation in healthy individuals. Changes in pulse waveform parameters of mean blur rate (MBR) in the entire optic nerve head (ONH), the vasculature of the ONH, the tissue area of the ONH, and the avascular tissue area located outside of the ONH were monitored over time. Significant increases in the falling rate of MBR over the entire ONH and its tissue area and decreases in blowout time (BOT) of the tissue area were observed only at 10 minutes after water intake. Significant increases in the skew of the waveform and the falling rate were observed in the vasculature of the ONH at 40 and 50 minutes after water intake, respectively. In the avascular region of the choroid, the average MBR increased significantly up to 30 minutes after water intake. Furthermore, the rising rate in this region increased significantly at 20 and 40 minutes, and the falling rate and acceleration-time index were both significantly increased at 40 minutes after water intake. Our results indicate the presence of effective autoregulation of blood flow at the ONH after WDT. However, in the choroidal region, outside of the ONH, effective autoregulation was not observed until 30 minutes after water intake in healthy study participants. These pulse waveform parameters could potentially be used in the diagnosis and/or monitoring of patients with glaucoma.
    Matched MeSH terms: Choroid/blood supply
  18. Yeap KC, Sivagurunathan PD, Raman P, Khalid KHM
    GMS Ophthalmol Cases, 2019;9:Doc25.
    PMID: 31355123 DOI: 10.3205/oc000114
    Purpose: To report a rare case of non-tuberculous mycobacterial (NTM) choroiditis masquerading as choroidal tumour, where the initial diagnosis was masked by keratitis. Casedescription: A 57-year-old heroin chaser with a pre-existing left eye blindness due to past blunt trauma presented with diffuse bacterial keratitis on the same side. Systemic examination revealed multiple non-tender cervical lymphadenopathies. B-scan ultrasonography showed a hyperechoic choroidal mass with surrounding exudative retinal detachment, resembling a choroidal tumour. However, computed tomography (CT) and magnetic resonance imaging (MRI) scan findings were suggestive of inflammatory choroidal changes. Inflammatory markers were significantly raised and infective screening was positive for HIV and Hepatitis C. Tuberculosis workup was normal. In view of intractable pain, evisceration was done and his vitreous humour was sent for polymerase chain reaction (PCR). It was reported to be positive for Mycobacterium Fortuitum. Conclusion: NTM ocular infections are rare, challenging to diagnose, and potentially sight threatening. Early recognition and prompt treatment is life and vision saving.
    Matched MeSH terms: Choroid Neoplasms
  19. Shariff S, Teo KSS, Hitam WHW
    Rom J Ophthalmol, 2021 6 29;65(2):196-200.
    PMID: 34179588 DOI: 10.22336/rjo.2021.39
    Objective: To report a case of choroidal mass secondary to mucinous cystadenocarcinoma of ovary in a young woman. Method: A case report. Result: A 21-year-old woman presented with insidious painless, progressive, central scotoma of the right eye for 5 weeks. She was disease free for 9 years after she underwent right salpingo-oophorectomy for her mucinous cystadenocarcinoma of right ovary. She completed 6 cycles of chemotherapy regimen. On presentation, her visual acuity was counting finger in the right eye and 6/ 6 in the left eye. Both anterior segments were unremarkable. Fundus examination of the right eye showed multiple choroidal masses with the largest in the temporal to fovea. Generally, she was well. Her tumor markers were raised. Urgent Computed Tomography (CT) Scan of thorax, abdomen and pelvis showed multiple distance metastases. She was referred to the gynecology team. She was scheduled for chemotherapy. However, she defaulted the treatment. 3 months after that, her general condition deteriorated. She developed bilateral internal jugular vein thrombosis and massive right pleural effusion. She passed away due to that complication. Conclusion: Choroidal metastasis from primary ovary carcinoma is very rare. Ocular symptoms can be the first presenting features to a life-threatening condition.
    Matched MeSH terms: Choroid
  20. Farhana, I., Nor Azita, A.T., Hamisah, I.
    Medicine & Health, 2018;13(2):158-163.
    MyJurnal
    Ocular tuberculosis is an ocular infection caused by Mycobacterium tuberculosis (TB). About 5-10% of ocular inflammation cases are caused by ocular TB. Spectrum of ocular TB is diverse, affecting any part of the adnexa, different layers and structures of the globe, orbital contents, optic nerve to the orbital apex posteriorly. It can be associated with or without systemic manifestation. Posterior uveitis is the most common presentation of ocular tuberculosis. Subretinal haemorrhage secondary to choroidal neovascularization (CNV) is a rare complication in ocular tuberculosis. We report a rare case of secondary choroidal neovascularization in a 9-year-old boy with bilateral eye choroidal tuberculoma with underlying miliary tuberculosis. He was treated with intravitreal ranibizumab and intravitreal recombinant-tissue plasminogen activator (r-TPA) injection. The CNV resolved, however, vision was poor due to atrophic fovea.

    Matched MeSH terms: Choroid; Choroidal Neovascularization
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