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Unusual presentation of severe dengue: Dengue maculopathy

Chuah KH, Ng CW, Zabri K, Wong CL

Med J Malaysia, 2017 02;72(1):73-74.
PMID: 28255149 MyJurnal

Dengue infection is epidemic but ocular complications of dengue are less reported. We report a case of dengueinfected patient with disturbing ocular symptoms. He was admitted for severe dengue. Subsequently, he presented with symptoms of bilateral central scotoma with metamorphosia. Fundus examination revealed cotton wool spots and flame-shaped haemorrhages at the macula, with dull foveal light reflex. He was diagnosed with bilateral dengue maculopathy. The patient was managed conservatively with surveillance. One week later, his eye symptoms improved and were resolved six months later. Early recognition and close monitoring remains the key to successful management and interventions are rarely needed.

Matched MeSH terms: Retinal Diseases
Fulltext Tuberous sclerosis complex: a review with a study of eight cases

Malik AS, Hussin ZA, Shriwas SR, Kasim ZM

Med J Malaysia, 1994 Dec;49(4):375-84.
PMID: 7674974

This paper reviews the subject of tuberous sclerosis complex and presents data in eight cases of this condition, admitted to Hospital Universiti Sains Malaysia over a period of 8.5 years. The average age at presentation was 53 months. Seizures were the most common presenting feature. Male to female ratio was 3:1. Family history was present in four patients. All of the patients had one or more skin lesions. Six of them had retinal in six patients. Two patients had renal angiomyolipomas. A high index of hamartomas. Cardiac tumours were found in two patients. Multiple subependymal hamartomas were detected in six patients. Two patients had renal angiomyolipomas. A high index of suspicion and a detailed physical examination is required to diagnose this rare disorder.

Matched MeSH terms: Retinal Diseases/complications*
Fulltext Tuberculous retinal vasculitis

Hoh HB, Kong VY, Jaais F

Med J Malaysia, 1998 Sep;53(3):288-9.
PMID: 10968169

A patient who was referred to the eye department for routine ocular assessment prior to commencement of antituberculous therapy was found to have periphlebitis in both eyes despite being visually asymptomatic. Fluorescein angiography confirms the presence of vasculitis without any retinal oedema or areas of non-perfusion, which may sometimes accompany the condition. Within 2 months of systemic treatment, the ocular signs regressed without any permanent effect on vision. This case highlights a rare ocular complication associated with systemic tuberculosis which fortunately did not result in loss of vision due to prompt treatment.

Matched MeSH terms: Retinal Diseases/microbiology*; Retinal Diseases/pathology
Transvitreal migration of a Toxocara larva resulting in a second chorioretinal granuloma

Sivaratnam D, Subrayan V, Ali NA

Jpn. J. Ophthalmol., 2008 Sep-Oct;52(5):416-417.
PMID: 18991049 DOI: 10.1007/s10384-008-0569-z
Matched MeSH terms: Retinal Diseases/diagnosis; Retinal Diseases/parasitology*; Retinal Diseases/therapy
Fulltext Tay-Sach disease with "cherry-red spot"--first reported case in Malaysia

Chan LY, Balasubramaniam S, Sunder R, Jamalia R, Karunakar TV, Alagaratnam J

Med J Malaysia, 2011 Dec;66(5):497-8.
PMID: 22390110

We present a rare case of Tay-Sachs disease with retinal 'cherry-red spots' in a 19-month-old Malay child. Molecular genetic studies confirmed the diagnosis. The case highlights that 'cherry-red spot' is a useful clinical clue in Tay-Sachs disease and several other lysosomal storage disorders. It serves as an ideal illustration of the eye as a window to inborn error of metabolism.

Matched MeSH terms: Retinal Diseases/genetics; Retinal Diseases/pathology*
Taurine protects against NMDA-induced retinal damage by reducing retinal oxidative stress

Jafri AJA, Agarwal R, Iezhitsa I, Agarwal P, Ismail NM

Amino Acids, 2019 Apr;51(4):641-646.
PMID: 30656415 DOI: 10.1007/s00726-019-02696-4

This study aimed to evaluate effect of TAU on NMDA-induced changes in retinal redox status, retinal cell apoptosis and retinal morphology in Sprague-Dawley rats. Taurine was injected intravitreally as pre-, co- or post-treatment with NMDA and 7 days post-treatment retinae were processed for estimation of oxidative stress, retinal morphology using H&E staining and retinal cell apoptosis using TUNEL staining. Treatment with TAU, particularly pre-treatment, significantly increased retinal glutathione, superoxide dismutase and catalase levels compared to NMDA-treated rats; whereas, the levels of malondialdehyde reduced significantly. Reduction in retinal oxidative stress in TAU pre-treated group was associated with significantly greater fractional thickness of ganglion cell layer within inner retina and retinal cell density in inner retina. TUNEL staining showed significantly reduced apoptotic cell count in TAU pre-treated group compared to NMDA group. It could be concluded that TAU protects against NMDA-induced retinal injury in rats by reducing retinal oxidative stress.

Matched MeSH terms: Retinal Diseases/chemically induced; Retinal Diseases/drug therapy*; Retinal Diseases/metabolism; Retinal Diseases/pathology
Sustained Connexin43 Mimetic Peptide Release From Loaded Nanoparticles Reduces Retinal and Choroidal Photodamage

Mat Nor N, Guo CX, Rupenthal ID, Chen YS, Green CR, Acosta ML

Invest Ophthalmol Vis Sci, 2018 07 02;59(8):3682-3693.
PMID: 30029255 DOI: 10.1167/iovs.17-22829

Purpose: To evaluate the long-term effect on inflammation and inflammasome activation of intravitreally delivered connexin43 mimetic peptide (Cx43MP) in saline or incorporated within nanoparticles (NPs) for the treatment of the light-damaged rat eye.
Methods: Light-induced damage to the retina was created by exposure of adult albino Sprague-Dawley rats to intense light for 24 hours. A single dose of Cx43MP, Cx43MP-NPs, or saline was injected intravitreally at 2 hours after onset of light damage. Fluorescein isothiocyanate (FITC)-labelled Cx43MP-NPs were intravitreally injected to confirm delivery into the retina. Electroretinogram (ERG) recordings were performed at 24 hours, 1 week, and 2 weeks post cessation of light damage. The retinal and choroidal layers were analyzed in vivo using optical coherence tomography (OCT) and immunohistochemistry was performed on harvested tissues using glial fibrillary acidic protein (GFAP), leukocyte common antigen (CD45), and Cx43 antibodies.
Results: FITC was visualized 30 minutes after injection in the ganglion cell layer and in the choroid. Cx43MP and Cx43MP-NP treatments improved a-wave and b-wave function of the ERG compared with saline-injected eyes at 1 week and 2 weeks post treatment, and prevented photoreceptor loss by 2 weeks post treatment. Inflammation was also reduced and this was in parallel with downregulation of Cx43 expression.
Conclusions: The slow release of Cx43MP incorporated into NPs is more effective at treating retinal injury than a single dose of native Cx43MP in solution by reducing inflammation and maintaining both retinal structure and function. This NP preparation has clinical relevance as it reduces possible ocular complications associated with repeated intravitreal injections.

Matched MeSH terms: Retinal Diseases/drug therapy*; Retinal Diseases/metabolism; Retinal Diseases/pathology
Successful Resolution of Preretinal Haemorrhage with Intravitreal Ranibizumab

Noorlaila B, Zunaina E, Raja-Azmi MN

Case Rep Ophthalmol Med, 2016;2016:4164198.
PMID: 27800200

We would like to report two cases of preretinal haemorrhage from two different aetiology courses of bleeding being treated with intravitreal ranibizumab and its outcome. Our first case was a 39-year-old man with a diagnosis of severe aplastic anaemia that presented with bilateral premacular haemorrhages in both eyes. His right eye vision was 6/45 and it was counting finger in the left eye. He was treated with intravitreal ranibizumab once to the right eye and twice to the left eye. Right eye showed complete resolution of premacular haemorrhage and minimal residual premacular haemorrhage in the left eye at 3 months after initial presentation. Our second case was a 32-year-old healthy teacher that presented with preretinal haemorrhage at superotemporal region extending to macular area in left eye secondary to valsalva retinopathy. Her left vision was counting finger. She was treated with single intravitreal ranibizumab to the left eye. There was significant reduction of premacular haemorrhage and her left eye vision improved to 6/6 at 10 weeks after injection. Both cases had favourable outcome with intravitreal ranibizumab and can be considered as nonsurgical treatment option in treating premacular haemorrhage.

Matched MeSH terms: Retinal Diseases
Fulltext Spontaneous closure of large base idiopathic full thickness macular hole

Nurul Ain, S., Norshamsiah, M.D., Safinaz, M.K., Bastion, M.L.C.

Medicine & Health, 2018;13(1):232-236.
MyJurnal

Spontaneous closure of idiopathic full thickness macular hole is a rare case as it occurs in only 3.5% while awaiting vitrectomy surgery. There are few pathologies associated with it such as vitreomacular traction (VMT) and posterior vitreous detachment. We report a case in a 74-year-old man who presented with right eye painless, progressive blurring of vision with idiopathic stage 4 full thickness macular hole which was confirmed on optical coherence tomography. It closed spontaneously after sometimes while waiting for surgery. It is important to monitor closely for the possibility of spontaneous closure based on the optical coherence tomography findings.

Matched MeSH terms: Retinal Diseases
Fulltext Risk factors for diabetic retinopathy in diabetic screened using fundus photography at a primary health care setting in East Malaysia

Mallika PS, Lee PY, Cheah WL, Wong JS, Syed Alwi SAR, Nor Hayati H, et al.

Malays Fam Physician, 2011;6(2):60-65.
MyJurnal

Introduction: This study reports on the prevalence of diabetic retinopathy (DR) and risk factors among diabetic patients, who underwent fundus photography screening in a primary care setting of Borneo Islands, East Malaysia. We aimed to explore the preliminary data to help in the planning of more effective preventive strategies of DR at the primary health care setting.
Materials and Methods: A cross-sectional study on 738 known diabetic patients aged 19-82 years was conducted in 2004. Eye examination consists of visual acuity testing followed by fundus photography for DR assessment. The fundus pictures were reviewed by a family physician and an ophthalmologist. Fundus photographs were graded as having no DR, NPDR, PDR and maculopathy. The data of other parameters was retrieved from patient’s record. Bi-variate and multivariate analysis was used to elucidate the factors associated with DR.
Results: Any DR was detected in 23.7% (95% CI=21 to 27%) of the patients and 3.2% had proliferative DR. The risk factors associated with any DR was duration of DM (OR =2.5, CI=1.6 to 3.9 for duration of five to 10 years when compared to <5 years) and lower BMI (OR=1.8, CI=1.1 to 3.0). Moderate visual loss was associated with DR (OR=2.1, CI=1.2 to 3.7).
Conclusions: This study confirms associations of DR with diabetic duration, body mass index and visual loss. Our data provide preliminary findings to help to improve the screening and preventive strategies of DR at the primary health care setting.
Keywords: Diabetic retinopathy, epidemiology, screening, primary health care, Malaysia
Study site: Klinik Kesihatan Jalan Masjid, Kuching, Sarawak, Malaysia

Matched MeSH terms: Retinal Diseases
Fulltext Retrospective review of the adjunctive use of pre- operative ranibizumab “lucentistm” in the surgical management of diabetic retinopathy in a tertiary referral hospital in Malaysia

Bastion, M.L.C., Siti Aishah, S., Aida Zairani, M.Z., Barkeh, H.J.

Medicine & Health, 2010;5(2):93-102.
MyJurnal

A retrospective case series review was conducted to determine the pre-operative role and safety of pre-operative adjunctive anti-vascular endothelial growth factor (anti- VEGF) agent ranibizumab “LUCENTISTM” in patients with diabetic retinopathy requiring vitrectomy. The study involved twenty consecutive eyes of sixteen patients (age range: 46-72 years; mean 57.5 years) which received intravitreal injection of 0.5 - 1 mg of ranibizumab 3 to 8 days (mean 4.4 days) prior to vitrectomy for diabetic retinopathy. There were no local or systemic post-injection complications. Indications for vitrectomy were retinal detachment (RD) [n=11; 3 combined tractional (TRD) - rhegmatogenous RD (RRD), 8 TRD], TRD with vitreous haemorrhage (VH) (n=3) ,VH (n=8) and vitreomacular traction syndrome (n=1). Inclusion criteria include all consecutive eyes of diabetic patients requiring vitrectomy receiving a first pre-operative injection of anti- VEGF. Pre-operative visual acuity (VA) ranged from 6/36 to light perception. All eyes had minimal to moderate intraoperative bleeding. Post-operative VH in eyes without tamponade or gas tamponade was nil (n=1), mild (n=13) or moderate (n=1). Silicone filled eyes had nil (n=1), moderate (n=3) or severe haemorrhages (n=1). Post-operative VA was unchanged (n=2) (10%), improved (n = 14) (70%) or worsened (n=4). VA was 2/60 or better (n=15) to no light perception (n=1). Two eyes achieved 6/12 or better vision (10%). Ten eyes (50%) had 6/36 or better vision. In conclusion, pre-operative intravitreal ranibizumab is safe and useful in diabetic vitrectomy and appears to help with perioperative bleeding leading to improvement in vision.

Matched MeSH terms: Retinal Diseases
Retinopathy in a patient with acute Epstein-Barr virus infection: follow-up analysis using spectral domain optical coherence tomography

Weller JM, Bergua A, Mardin CY

Retin Cases Brief Rep, 2015;9(1):72-7.
PMID: 25383851 DOI: 10.1097/ICB.0000000000000087

To describe the clinical findings, diagnostics, and differential diagnosis in a patient with retinopathy in acute systemic Epstein-Barr virus (EBV) infection.

Matched MeSH terms: Retinal Diseases/virology*
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: Retinal Diseases
Retinal vascular fractal and blood pressure in a multiethnic population

Sng CC, Wong WL, Cheung CY, Lee J, Tai ES, Wong TY

J Hypertens, 2013 Oct;31(10):2036-42.
PMID: 23787404 DOI: 10.1097/HJH.0b013e328362c201

OBJECTIVE(S): To examine the effect of blood pressure (BP) on retinal vascular fractal dimension (Df), a measure of microvascular network complexity and density in a multiethnic cohort.
METHODS: A population-based study of 3876 Chinese, Malay and Indian participants in Singapore. Retinal Df was measured using a computer-based program from digital retinal photographs. Associations between retinal Df and mean arterial BP (MABP) in the whole cohort and in each racial group were analysed using linear regression analysis. Logistic regression was used to examine the association between retinal Df and hypertension status.
RESULTS: The mean retinal Df of the study population was 1.45 (standard deviation 0.03). After adjustment for age, sex, race, diabetes, BMI, cholesterol and creatinine levels, persons with smaller Df had higher MABP (mean difference MABP was 6.18 mmHg comparing lowest to highest Df quartiles, P<0.001). This was similar in Chinese, Malay and Indian persons [mean difference 6.40 (P<0.001), 4.72 (P=0.011) and 6.62 (P<0.001)mmHg, respectively]. Persons with smaller retinal Df were more likely to have uncontrolled treated or untreated hypertension [odds ratio 1.79 (P=0.003) and 2.60 (P=0.003), respectively, comparing lowest to highest Df quartiles] than those with no hypertension; this relationship was not seen comparing persons with controlled treated hypertension with no hypertension (odds ratio 1.01, P=0.972).
CONCLUSION: Hypertension was associated with a sparser retinal vascular network, which was similar across different racial/ethnic groups and most apparent in those with uncontrolled or untreated hypertension. These data suggest that microvascular remodelling can be quantified by measuring retinal vasculature.

Matched MeSH terms: Retinal Diseases/ethnology*; Retinal Diseases/pathology*
Retinal nerve fiber layer structure abnormalities in schizophrenia and its relationship to disease state: evidence from optical coherence tomography

Lee WW, Tajunisah I, Sharmilla K, Peyman M, Subrayan V

Invest Ophthalmol Vis Sci, 2013 Nov;54(12):7785-92.
PMID: 24135757 DOI: 10.1167/iovs.13-12534

We determined structural retinal nerve fiber layer (RNFL) changes in schizophrenia patients and established if the structural changes were related to the duration of the illness using spectral-domain optical coherence tomography (SD-OCT).

Matched MeSH terms: Retinal Diseases/complications; Retinal Diseases/diagnosis*; Retinal Diseases/physiopathology
Fulltext Retinal laser photocoagulation

Lock JH, Fong KC

Med J Malaysia, 2010 Mar;65(1):88-94; quiz 95.
PMID: 21265262 MyJurnal

Since its discovery in the 1940s, retinal photocoagulation has evolved immensely. Although the first photocoagulators utilised incandescent light, it was the invention of laser that instigated the widespread use of photocoagulation for treatment of retinal diseases. Laser permits choice of electromagnetic wavelength in addition to temporal delivery methods such as continuous and micropulse modes. These variables are crucial for accurate targeting of retinal tissue and prevention of detrimental side effects such as central blind spots. Laser photocoagulation is the mainstay of treatment for proliferative diabetic retinopathy amongst many other retinal conditions. Considering the escalating prevalence of diabetes mellitus, it is important for physicians to grasp the basic principles and be aware of new developments in retinal laser therapy.

Matched MeSH terms: Retinal Diseases/surgery*
Retinal image analysis for disease screening through local tetra patterns

Porwal P, Pachade S, Kokare M, Giancardo L, Mériaudeau F

Comput Biol Med, 2018 11 01;102:200-210.
PMID: 30308336 DOI: 10.1016/j.compbiomed.2018.09.028

Age-related Macular Degeneration (AMD) and Diabetic Retinopathy (DR) are the most prevalent diseases responsible for visual impairment in the world. This work investigates discrimination potential in the texture of color fundus images to distinguish between diseased and healthy cases by avoiding the prior lesion segmentation step. It presents a retinal background characterization approach and explores the potential of Local Tetra Patterns (LTrP) for texture classification of AMD, DR and Normal images. Five different experiments distinguishing between DR - normal, AMD - normal, DR - AMD, pathological - normal and AMD - DR - normal cases were conducted and validated using the proposed approach, and promising results were obtained. For all five experiments, different classifiers namely, AdaBoost, c4.5, logistic regression, naive Bayes, neural network, random forest and support vector machine were tested. We experimented with three public datasets, ARIA, STARE and E-Optha. Further, the performance of LTrP is compared with other texture descriptors, such as local phase quantization, local binary pattern and local derivative pattern. In all cases, the proposed method obtained the area under the receiver operating characteristic curve and f-score values higher than 0.78 and 0.746 respectively. It was found that both performance measures achieve over 0.995 for DR and AMD detection using a random forest classifier. The obtained results suggest that the proposed technique can discriminate retinal disease using texture information and has potential to be an important component for an automated screening solution for retinal images.

Matched MeSH terms: Retinal Diseases
Protective effect of magnesium acetyltaurate against NMDA-induced retinal damage involves restoration of minerals and trace elements homeostasis

Jafri AJA, Arfuzir NNN, Lambuk L, Iezhitsa I, Agarwal R, Agarwal P, et al.

J Trace Elem Med Biol, 2017 Jan;39:147-154.
PMID: 27908408 DOI: 10.1016/j.jtemb.2016.09.005

Glutamate-mediated excitotoxicity involving N-methyl-d-aspartate (NMDA) receptors has been recognized as a final common outcome in pathological conditions involving death of retinal ganglion cells (RGCs). Overstimulation of NMDA receptors results in influx of calcium (Ca) and sodium (Na) ions and efflux of potassium (K). NMDA receptors are blocked by magnesium (Mg). Such changes due to NMDA overstimulation are also associated with not only the altered levels of minerals but also that of trace elements and redox status. Both the decreased and elevated levels of trace elements such as iron (Fe), zinc (Zn), copper (Cu) affect NMDA receptor excitability and redox status. Manganese (Mn), and selenium (Se) are also part of antioxidant defense mechanisms in retina. Additionally endogenous substances such as taurine also affect NMDA receptor activity and retinal redox status. Therefore, the aim of this study was to evaluate the effect of Mg acetyltaurate (MgAT) on the retinal mineral and trace element concentration, oxidative stress, retinal morphology and retinal cell apoptosis in rats after-NMDA exposure. One group of Sprague Dawley rats received intravitreal injection of vehicle while 4 other groups similarly received NMDA (160nmolL(-1)). Among the NMDA injected groups, 3 groups also received MgAT (320nmolL(-1)) as pre-treatment, co-treatment or post-treatment. Seven days after intravitreal injection, rats were sacrificed, eyes were enucleated and retinae were isolated for estimation of mineral (Ca, Na, K, Mg) and trace element (Mn, Cu, Fe, Se, Zn) concentration using Inductively Coupled Plasma (DRC ICP-MS) techniques (NexION 300D), retinal oxidative stress using Elisa, retinal morphology using H&E staining and retinal cell apoptosis using terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL). Intravitreal NMDA injection resulted in increased concentration of Ca (4.6 times, p<0.0001), Mg (1.5 times, p<0.01), Na (3 times, p<0.0001) and K (2.3 times, p<0.0001) compared to vehicle injected group. This was accompanied with significant increase of Ca/Mg and Na/K ratios, 3 and 1.27 times respectively, compared to control group. The trace elements such as Cu, Fe and Zn also showed a significant increase amounting to 3.3 (p<0.001), 2.3 (p<0.0001) and 3 (p<0.0001) times respectively compared to control group. Se was increased by 60% (p<0.005). Pre-treatment with MgAT abolished effect of NMDA on minerals and trace elements more effectively than co- and post-treatment. Similar observations were made for retinal oxidative stress, retinal morphology and retinal cell apoptosis. In conclusion, current study demonstrated the protective effect of MgAT against NMDA-induced oxidative stress and retinal cell apoptosis. This effect of MgAT was associated with restoration of retinal concentrations of minerals and trace elements. Further studies are warranted to explore the precise molecular targets of MgAT. Nevertheless, MgAT seems a potential candidate in the management of diseases involving NMDA-induced excitotoxicity.

Matched MeSH terms: Retinal Diseases/chemically induced; Retinal Diseases/metabolism*; Retinal Diseases/pathology
Fulltext Prevalence of microvascular complications in newly diagnosed type 2 diabetes mellitus in primary healthcare clinics

Wong WL, Valliappan VN, Leong MC, Aminudin SNA, Chew SCJ, Cheong AT

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):237-243.
MyJurnal

Introduction: Delayed diagnosis of type 2 diabetes mellitus (T2D) increases the risk of presenting late with microvas- cular complications due to untreated long-standing hyperglycaemia. This study aimed to determine the prevalence of microvascular complications in newly diagnosed T2D patients in primary healthcare clinics.
Methods: This was a cross-sectional study carried out in three government primary healthcare clinics in the state of Selangor, Malaysia. Malaysian aged 18 years and above with newly diagnosed T2D (<6 months of diagnosis) were invited to participate in the study. Data collected included the sociodemographic characteristic and the clinical profile (weight, height, waist circumference, blood pressure, lipid, glycaemic, urine albumin, microalbuminuria and renal profile). The assessment of nephropathy, peripheral neuropathy and retinopathy were performed using standard protocol. Multivariate logistic regression analysis was used to identify the significant factors that contribute to the presence of microvascular complications.
Results: A total of 162 newly diagnosed patients were recruited. The majority was women (64%). The mean age was 51 (SD 11) years. About one-third of the patients (27.7%) had developed at least one microvascular complication. Nephropathy was the commonest microvascular complication (19.2%), followed by peripheral neuropathy (8.6%) and retinopathy (6.5%). Poor glycaemic control was found to be a significant factor contributing to the presence of microvascular complications (OR 5.8, 95%CI:1.466, 23.288).
Conclusion: There is a high prevalence of microvascular complications among the newly diagnosed T2D. There is a need to develop appropriate strategies to increase the awareness and early detection of T2D.
Study site: three Klinik Kesihatan, Selangor, Malaysia

Matched MeSH terms: Retinal Diseases
Fulltext Prevalence of eye diseases and visual impairment among the rural population - a case study of Temerloh Hospital

Thevi T, Maslina B, Reddy SC

Malays Fam Physician, 2012;7(1):6-10.
PMID: 25606238

Objective: To determine the prevalence of eye diseases and visual impairment among new patients at the eye clinic of Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang.
Method: In this cross-sectional prospective study, 1081 new patients were examined over a period of six months. Age, gender, ethnicity, visual acuity and diagnosis were noted from the medical records.
Results: Out of 1081 examined, 607 (56.1%) were males, 783 (72.4%) were Malays. The mean age of patients was 45.2 years (ranging from one month to 91 years). Cataract (248, 22.9%) was the most common eye disease, followed by retinal diseases (124, 11.5%) and ocular trauma (106, 9.8%). Majority of the patients (48) suffering from ocular trauma had foreign body cornea. In 85 premature infants screened for retinopathy, 19 showed different stages of retinopathy of prematurity. Visual impairment was noted in 89 (8.2%) patients, severe visual impairment in 12 (1.1%) and blindness in 35 (3.2%); vision could not be determined in 85 premature infants (7.9%). Cataract was singled out as the cause of severe visual impairment in 11 out of 12 patients.
Conclusion: Health education at primary health centres and availability of eye specialists in all the district hospitals will facilitate the rehabilitation of visually impaired and blind persons by providing early treatment for eye problems (specifically prescription for spectacles, medical treatment and cataract surgery with intraocular lens implantation).
Keywords: Visual impairment, cataract, diabetic retinopathy, glaucoma, refractive errors, ocular trauma, conjunctivitis
Study site: Eye clinic, Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang, Malaysia

Matched MeSH terms: Retinal Diseases

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