Displaying publications 1 - 20 of 33 in total

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  1. Fulltext Optic neuritis and retinal vasculitis as primary manifestations of systemic lupus erythematosus
    Barkeh HJ, Muhaya M
    Med J Malaysia, 2002 Dec;57(4):490-2.
    PMID: 12733176
    Systemic lupus erythematosus (SLE) is a common multisystem disorder. However, retinal vasculitis as a primary manifestation of SLE is uncommon, accounting for only 4% of causes of retinal vasculitis. The postulated mechanism appeared to be vaso-occlusion of the retinal arterioles by thrombosis, with resultant ischaemia. Optic neuropathy in SLE is also rare, with a prevalence of 1%. This is a case report of a young lady who presented to us with retinal vasculitis as her initial presentation of SLE. Interestingly, the pathologic mechanism appeared to be inflammatory and not vaso-occlusive.
    Matched MeSH terms: Optic Neuritis/diagnosis*; Optic Neuritis/etiology*; Optic Neuritis/therapy
  2. Fulltext Bilateral optic neuritis in pregnancy
    Suraiya MS, Norazlina B, Carmen C, Muhaya M
    Med J Malaysia, 2003 Dec;58(5):771-3.
    PMID: 15190668
    A 25-year old primigravida at 11-weeks period of amenorrhoea presented with bilateral optic neuritis following Varicella Zoster viral (VZV) infection. She was serologically positive for systemic lupus erythematosus but negative for virus. The exact pathogenesis of the patient's severe optic neuritis, adduction and neurological deficit was unknown. The initiation of high dose steroids for optic neuritis was a big clinical dilemma in a pregnant patient with viral infection. The patient was treated with high dose steroids after three days of commencement of antiviral treatment. At 6 months after presentation, her visual acuity in the right eye was 6/36 with perception to light in the left.
    Matched MeSH terms: Optic Neuritis/virology*
  3. Pansinusitis causing bilateral optic neuritis in a 9-year-old child
    Bashkaran K, Shatriah I, Zunaina E, Bakiah S, Sakinah Z
    Orbit, 2009;28(6):377-9.
    PMID: 19929663 DOI: 10.3109/01676830903104678
    Sinusitis is a rare cause of optic neuritis in children. This case illustrates bilateral optic neuritis in a 9-year-old child caused by pansinusitis. It demands an accurate diagnosis with a prompt management. A proper treatment of sinusitis is essential to prevent this complication.
    Matched MeSH terms: Optic Neuritis/diagnosis; Optic Neuritis/drug therapy; Optic Neuritis/etiology*
  4. Fulltext Mistaken diagnosis of optic neuritis and the possible role of phosphodiasterase-5 inhibitors (Sildenafil/Viagra)
    Cullen JF, Chung HW
    Med J Malaysia, 2010 Dec;65(4):315-6.
    PMID: 21901956
    The diagnosis of optic neuritis and particularly retrobulbar optic neuritis when atypical and not responsive to corticosteroid treatment may need to be revised. This is now especially so in male patients who should be questioned regarding their taking a phosphodiasterase-5 inhibitor in particular Viagra. The case history of such a patient is presented who sustained posterior ischaemic optic neuropathy mistaken for retrobulbar neuritis resulting in bilateral severe visual loss.
    Matched MeSH terms: Optic Neuritis/chemically induced; Optic Neuritis/diagnosis*
  5. Fulltext Isolated optic neuritis secondary to presumed tuberculosis in an immunocompetent child
    Norazizah MA, Wan Hazabbah WH, Rohaizan Y, Shatriah I
    Med J Malaysia, 2012 Feb;67(1):102-4.
    PMID: 22582557 MyJurnal
    Isolated optic neuritis as a presenting sign of tuberculosis in children is uncommon. We report a case of an immunocompetent child who displayed features of bilateral optic neuritis secondary to presumed tuberculosis. It is essential to highlight this alarming presentation in a child, as the presence of tuberculosis has re-emerged as a serious public health problem especially in developing countries.
    Matched MeSH terms: Optic Neuritis/etiology*
  6. Fulltext Clinical profile and aetiology of optic neuritis in Hospital Universiti Sains Malaysia--5 years review
    Ismail S, Wan Hazabbah WH, Muhd-Nor NI, Daud J, Embong Z
    Med J Malaysia, 2012 Apr;67(2):159-64.
    PMID: 22822635
    Although few studies concerning optic neuritis (ON) in Asian countries have been reported, there is no report about ON in Malaysia particularly within the Malay population. We aimed to determine the clinical manifestation, visual outcome and aetiology of ON in Malays, and discussed the literature of ON studies in other Asian populations. This was a retrospective study involving 31 consecutive patients (41 eyes) with ON treated at Hospital Universiti Sains Malaysia commencing from July 2005 till January 2010 with a period of follow-up ranging from 18-60 months. The clinical features, laboratory results, possible aetiology, and visual acuity after one year were analysed. Females were the predominant group. The age of the patients ranged between 3-55 years and peaked between 21-30 years old. 67.7% of the patients had unilateral involvement. Pain on ocular movement was observed in 31.7% of the affected eyes. 73.3% of 41 involved eyes showed visual acuity equal 6/60 or worse on presentation. Paracentral scotoma was the most common visual field defect noted. Optic disc papillitis proved more widespread compared to the retrobulbar type of ON. The aetiology was idiopathic in more than 50%, while the risk of multiple sclerosis was extremely low (3.2%) in our series. 66.0% demonstrating visual acuity improved to 6/12 or better at one year after the attack. 16.1% showed evidence of recurrence during follow-up. In conclusion, the clinical profile and aetiology of ON in Malay patients are comparable to other ON studies reported by other Asian countries.
    Matched MeSH terms: Optic Neuritis/etiology*; Optic Neuritis/epidemiology
  7. Clinical profile of Malay children with optic neuritis
    Shatriah I, Adlina AR, Alshaarawi S, Wan-Hitam WH
    Pediatr Neurol, 2012 May;46(5):293-7.
    PMID: 22520350 DOI: 10.1016/j.pediatrneurol.2012.02.020
    Limited data are available on optic neuritis in Asian children. Clinical profiles tend to vary with different races. We aimed to determine the clinical manifestations, visual outcomes, and etiologies of optic neuritis in Malaysian children, and discuss the literature of optic neuritis in Asian children. A retrospective study involving 14 children with optic neuritis was performed at Hospital Universiti Sains Malaysia between July 2005 and January 2010 (follow-up, 18-60 months). Clinical features, laboratory results, possible etiologies, and visual acuity after 1 year were studied. Females were predominant (mean age at presentation, 11.1 years). All patients manifested bilateral involvement. Swollen optic discs were observed in 92.9% of eyes; 60.7% of patients demonstrated a visual acuity of 6/60 (or 20/200) or worse on presentation, whereas 14.3% remained at 6/60 (or 20/200) or worse, 1 year after their attack. Cecocentral scotoma comprised the most common visual field defect. Infection contributed to 50.0% of cases; 14.3% progressed to multiple sclerosis during follow-up, with no evidence of recurrent optic neuritis. The clinical profiles and etiologies of optic neuritis in Malay children differ slightly compared with other optic neuritis studies of Asian children. The frequency of progression to multiple sclerosis is relatively lower.
    Matched MeSH terms: Optic Neuritis/etiology; Optic Neuritis/epidemiology*; Optic Neuritis/physiopathology*
  8. Fulltext Bilateral atypical optic neuritis associated with tuberculosis in an immunocompromised patient
    Jaafar J, Hitam WH, Noor RA
    Asian Pac J Trop Biomed, 2012 Jul;2(7):586-8.
    PMID: 23569976 DOI: 10.1016/S2221-1691(12)60102-6
    A 27 year-old lady, presented with sudden loss of vision in the right eye for a week. It was followed by poor vision in the left eye after 3 days. It involved the whole entire visual field and was associated with pain on eye movement. She was diagnosed to have miliary tuberculosis and retroviral disease 4 months ago. She was started on anti-TB since then but defaulted highly active anti-retroviral therapy (HAART). On examination, her visual acuity was no perception of light in the right eye and 6/120 (pinhole 3/60) in the left eye. Anterior segment in both eyes was unremarkable. Funduscopy showed bilateral optic disc swelling with presence of multiple foci of choroiditis in the peripheral retina. The vitreous and retinal vessels were normal. Chest radiography was normal. CT scan of orbit and brain revealed bilateral enhancement of the optic nerve sheath that suggest the diagnosis of bilateral atypical optic neuritis. This patient was managed with infectious disease team. She was started on HAART and anti-TB treatment was continued. She completed anti-TB treatment after 9 months without any serious side effects. During follow up the visual acuity in both eyes was not improved. However, funduscopy showed resolving of disc swelling and choroiditis following treatment.
    Matched MeSH terms: Optic Neuritis/drug therapy; Optic Neuritis/etiology*; Optic Neuritis/pathology*
  9. Fulltext Optic neuritis in a child with biotinidase deficiency: case report and literature review
    Hayati AA, Wan-Hitam WH, Cheong MT, Yunus R, Shatriah I
    Clin Ophthalmol, 2012;6:389-95.
    PMID: 22457589 DOI: 10.2147/OPTH.S29048
    Optic atrophy has often been reported in children with biotinidase deficiency. The visual prognosis is usually poor. This report is of a 6-year-old boy with an early onset of biotinidase deficiency who presented with acute profound visual loss in both eyes. Fundoscopy revealed swollen discs in both eyes, and the imaging was consistent with bilateral optic neuritis. He was treated with systemic corticosteroid, and commenced on oral biotin. The final visual outcome was promising.
    Matched MeSH terms: Optic Neuritis
  10. Fulltext Encephalitis followed by optic neuritis: a case report and review of literature
    Hasan S, B Basri H, P Hin L, Stanslas J
    Pak J Med Sci, 2013 May;29(3):859-62.
    PMID: 24353644
    Encephalitis has been included in the causes of optic neuritis, but post encephalitic optic neuritis has been rarely reported. Majority of the cases of optic neuritis are either idiopathic or associated with multiple sclerosis, especially in western countries. This is very important in the Asian population where the incidence and prevalence of multiple sclerosis is not as high as in the Western countries. Although post infectious optic neuritis is more common in children, it can also be found in adults and is usually seen one to three weeks after a symptomatic infective prodrome. Here, we present a case of a 48 year-old-male who developed optic neuritis following viral encephalitis. His first presentation was with severe headache of two weeks duration. Viral encephalitis was diagnosed and treated. The patient presented again three weeks later with right eye pain and other features typical of optic neuritis. Corticosteroid therapy facilitated prompt recovery. Optic neuritis is an uncommon manifestation of encephalitis. It is important that both doctors and patients remain aware of post infectious cause of optic neuritis, which would enable a timely diagnosis and treatment of this reversible cause of vision loss.
    Matched MeSH terms: Optic Neuritis
  11. Fulltext Posterior intraorbital metallic foreign body: a case discussion
    Vinodh VP, Sellamuthu P, Harun RH, Zenian MS
    Med J Malaysia, 2014 Apr;69(2):89-91.
    PMID: 25241819 MyJurnal
    Intraorbital foreign body (IOFB) has been a rare phenomenon in the cases of gunshot wounds and always represents a dilemma in medical management. In Sabah, this scenario is becoming common as there is still certain population in the interiors who owns self made guns for hunting. They either present with self inflicted gunshot injuries or after being mistakenly shot while hunting. There are very few articles on this topic especially when it is located posteriorly in the orbit and occurs without visual impairment. This case reports the challenges faced in the management of the patient with a posteriorly located metallic IOFB. The appropriate management of the patient is discussed based on several international literatures. Author describes a 37 years old male farmer, who was referred from a nearby district hospital after he sustained gunshot injuries to his face and scalp. Urgent computed tomography (CT) scan showed that bullet pellets were at the left orbital floor, the left mandible and the left frontal bone. All bullet pellets were located extracranially only without intracranial involvement. Patient clinically does not have any neurologic deficit and without any visual impairment, thus he refused any surgical intervention. As there is no proper guideline in managing such cases, decision was made based on evidences from international literatures. It was concluded that metallic IOFB located in the posterior orbit may be conservatively managed with observation and regular follow-ups as they are well-tolerated and does not cause much impact on visual deterioration unless inflammation, infection, optic neuropathy or functional deficit occurs. This avoids unnecessary surgery and prevents risk of iatrogenic injury to the eye.
    Matched MeSH terms: Optic Neuritis
  12. Fulltext Clinical presentation, severity and progression of primary angle closure in malay and chinese patients
    Liza-Sharmini AT, Ng GF, Nor-Sharina Y, Khairil Anuar MI, Nik Azlan Z, Azhany Y
    Med J Malaysia, 2014 Dec;69(6):245-51.
    PMID: 25934953 MyJurnal
    OBJECTIVE: To compare the clinical presentation, severity and progression of primary angle closure between Chinese and Malays residing in Malaysia.

    METHODS: A comparative retrospective record review study was conducted involving one hundred (200 eyes) Malay and fifty eight (116 eyes) Chinese patients. They were selected from medical records of Hospital Universiti Sains Malaysia, Kelantan and Hospital Pulau Pinang, Penang, Malaysia. The selected patients were re-diagnosed based on the International Society of Geographical and Epidemiological classification. The clinical data on presentation including the presence of systemic diseases were documented. Progression of the disease was based on available reliable visual fields and optic disc changes of patients who have been on follow-up for at least five years.

    RESULTS: Malay patients presented at older age (61.4 years SD 8.4) compared to Chinese (60.6 years SD 8.3). There was significant higher baseline Intraocular Pressure (IOP) among Malays (34.7 SD 18.5mmHg) compared to Chinese (30.3 SD 16.7mmHg) (p=0.032). The Chinese patients presented with significantly better visual acuity (p<0.001) and less advanced cup to disc changes (p=0.001) compared to Malays. Malay patients progressed faster than the Chinese. Majority progressed within 1 year of diagnosis. Malays without laser peripheral iridotomy (LPI) have a 4 fold (95% CI 1.4, 10.9) risk of progression. Higher baseline IOP, more advanced visual field defect and absence of LPI was identified as significant predictors associated with progression.

    CONCLUSION: The Malays presented with more advanced angle closure glaucoma as compared to the Chinese in Malaysia. Aggressive disease progression was observed in Malays with the onset of optic neuropathy. Effective public awareness and aggressive management is important to prevent blindness in the Malaysian population.
    Matched MeSH terms: Optic Neuritis
  13. A unilateral optic perineuritis in a teenager - A case report
    Ameilia A, Shatriah I, Wan-Hitam WH, Yunus R
    Brain Dev, 2015 Jun;37(6):635-7.
    PMID: 25457086 DOI: 10.1016/j.braindev.2014.09.011
    Optic perineuritis is an uncommon inflammatory disorder that involves optic nerve sheath. Numerous case reports have been published on optic perineuritis in adults, the majority of whom had bilateral presentation. There are limited data on optic perineuritis occurring in pediatric patients. We report a teenager who presented with a unilateral sign that mimicked the presentation of optic neuritis. The orbit and brain magnetic resonance imaging confirmed features of unilateral optic perineuritis. She was treated with a high dose of corticosteroids for 2weeks, and her final visual outcome was satisfactory. No signs of relapse were noted during follow-up visits.
    Matched MeSH terms: Optic Neuritis/diagnosis; Optic Neuritis/pathology*; Optic Neuritis/physiopathology
  14. Multiphasic disseminated encephalomyelitis followed by optic neuritis in a child with gluten sensitivity
    Ching BH, Mohamed AR, Khoo TB, Ismail HI
    Mult Scler, 2015 Aug;21(9):1209-11.
    PMID: 26199345 DOI: 10.1177/1352458515593404
    Multiphasic disseminated encephalomyelitis (MDEM) followed by optic neuritis (ON) has been described as a new entity in recent years. Gluten encephalopathy has also been recognized as a neurological manifestation of celiac disease. Accurate diagnosis of both is important due to the therapeutic implications. We report a girl presenting with recurrent encephalopathic polyfocal demyelinating episodes followed by optic neuritis, and a clinical history suggestive of gluten sensitivity. She had persistently high ESR, neutrophilia, and tested positive for anti-MOG (myelin oligodendrocyte glycoprotein) antibody. She responded well to methylprednisolone in each relapse, and achieved remission for a year after azathioprine was added.
    Matched MeSH terms: Optic Neuritis/complications*
  15. Fulltext Bilateral idiopathic optic perineuritis in a young Malay woman: A case report
    Ayesha Mohd Zain, Umi Kalthum Md Noh, Mushawiahti Mustapha, Norshamsiah Md. Din, Bastion, Mae Lynn Catherine
    Neurology Asia, 2015;20(4):407-409.
    MyJurnal
    A 28-year-old Malay woman presented with severe loss of vision in both eyes associated with periocular pain on eye movement. She was completely blind at presentation and examination showed optic discs
    swelling. Optic nerve imaging showed ‘doughnut sign’, characteristic of optic perineuritis. Steroid was
    given over six months. Visual function improved gradually and was maintained at one year follow-up.
    This case highlights the importance of differentiation between optic neuritis and optic perineuritis as
    visual recovery depends on prolonged management with corticosteroid in optic perineuritis.
    Matched MeSH terms: Optic Neuritis
  16. Fulltext Bilateral optic neuritis in a boy - More than the eyes
    Loh MA, Alex Khoo PC, Chong MF
    Med J Malaysia, 2016 04;71(2):79-80.
    PMID: 27326949
    Neuromyelitis optica (NMO) is a rare disorder in children with variable presentation. We report a 7-year-old boy who presented with bilateral retrobulbar optic neuritis and responded very well to treatment. He was also positive for aquaporin 4 (AQP4) antibodies, which is part of an emerging endophenotype within autoimmune neurological disorders in childhood.
    Matched MeSH terms: Optic Neuritis/diagnosis*; Optic Neuritis/immunology
  17. Ocular tuberculosis in Hospital Universiti Sains Malaysia - A case series
    Shahidatul-Adha M, Zunaina E, Liza-Sharmini AT, Wan-Hazabbah WH, Shatriah I, Mohtar I, et al.
    Ann Med Surg (Lond), 2017 Dec;24:25-30.
    PMID: 29062482 DOI: 10.1016/j.amsu.2017.10.003
    INTRODUCTION: Ocular tuberculosis (TB) encompasses a broad spectrum of clinical manifestations affecting different structures of the eye. It is caused by Mycobacterium tuberculosis, a great ancient organism that induces various types of diseases and unfavorable outcomes if unrecognized and not well treated.

    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.

    Matched MeSH terms: Optic Neuritis
  18. Fulltext The natural history of optic neuritis in Asian patients: an observational cohort study
    Seah, B.H.A., Tow, S.L.C., Ong, K.C.B. Ong, Yang, C.C., Tsai, C.P., Lee, K.H., et al.
    Neurology Asia, 2017;22(4):341-348.
    MyJurnal
    Optic neuritis, which may be a precursor to multiple sclerosis (MS), is an uncommon disease in
    Asian patients. The Asian Collaborative Longitudinal Optic Neuritis Epidemiology (ACLONE) is
    an observational cohort study that assessed the risk of recurrent optic neuritis and/or progression
    of further neurologic events, either MS or neuromyelitis optica (NMO) in Asian patients with firstever
    optic neuritis. Secondary aims were to study the presenting characteristics and visual outcome,
    and to identify risk factors for development of either MS or NMO. A total of 112 patients (25 men
    and 87 women) aged from 12 to 61 years were recruited from Singapore, Taiwan, South Korea and
    Malaysia. Of these, 94 (84%) had unilateral optic neuritis, with the right eye involved in 45 patients
    and the left eye in 49 patients and the remaining 18 (16%) had bilateral optic neuritis. Follow up
    data was available for 104 patients, and patients were followed for a median duration of 25.9 months.
    Of these patients, 6 patients were adjudicated to have reached the primary endpoint (composite of
    MS/NMO and optic neuritis): 3 patients with recurrent optic neuritis also subsequently experienced
    neurologic symptoms, and 3 patients without recurrent eye involvement had neurologic symptoms.
    Only one patient was considered to have prototypical MS, the other 5 were diagnosed with NMO,
    all with subsequent antibody confirmation. Optic neuritis in Asian patients has significantly different
    presenting characteristics from the classic description. However, in the majority of the patients it is
    usually a benign disease, with good visual outcome and no further events.
    Matched MeSH terms: Optic Neuritis
  19. Fulltext Chemotherapy related optic neuritis
    Nur, A.S., Jemaima, C.H., Fuad Ismail, Safinaz, M.K.
    International Medical Journal Malaysia, 2017;16(2):133-136.
    MyJurnal
    In children, most cases of optic neuritis are immune-related. Less frequently, it may also be due to
    demyelinating disorders. Other secondary causes such as infection of adjacent structures or infiltration are
    even rarer. The occurrence of optic neuritis in children on chemotherapy also has not being extensively
    reported. We report a case of bilateral optic neuritis in a young girl with subacute visual loss after receiving
    systemic chemotherapy for embryonal ovarian carcinoma.
    Matched MeSH terms: Optic Neuritis
  20. Fulltext Retinitis punctata albescens presenting with tunnel vision: diagnostic dilemmas
    Norhayaty S., Nurul Dalila M.S., Tai, Evelyn L.M., Liza Sharmini A.T., Zunaina E., Azhany Y.
    Journal of Biomedical and Clinical Sciences, 2017;2(1):20-22.
    MyJurnal
    Tunnel vision is a classic sign among patients with advanced glaucoma. However, other conditions such as retinitis pigmentosa, optic neuritis and rod-cone dystrophy may be characterized by similar visual field defects. A 52-year-old lady with a family history of glaucoma presented with bilateral gradual loss of peripheral vision for two years. She claimed to have poor night vision about 20 years prior to this presentation. Her visual acuity was 6/7.5 in both eyes. The anterior chamber depth was moderate bilaterally, with Schaffer grading on gonioscopy of grade I to II. The intraocular pressure was 14 mmHg in both eyes. The optic discs appeared normal. Fundus examination showed scattered hypopigmented changes sparing the fovea. Humphrey visual field test revealed bilateral constricted visual fields. She was diagnosed with retinitis punctata albescens (RPA) based on her symptom of poor night vision, supported by the diffuse hypopigmented changes in her fundi. The management of this condition involves careful counselling regarding the genetic nature of the disease and its progressive course. We discuss this case to illustrate the importance of a thorough history taking and careful fundus examination in the workup of patients presenting with tunnel vision.
    Matched MeSH terms: Optic Neuritis
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