Displaying publications 1 - 20 of 21 in total

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  1. Agarwal R
    Medical Health Reviews, 2009;2009(1):75-93.
    MyJurnal
    Glaucoma, recognized as optic neuropathy is the second largest cause of blindness worldwide. The disease is characterized by progressive loss of retinal ganglion cells and visual field defects. The pathophysiological factors involved in the onset and progression of glaucoma are not fully understood. However, it is now well accepted that elevated intraocular pressure is not the only causative factor. The pathophysiology of glaucoma involves multiple factors that interact in a highly complex manner to favor development of glaucomatous optic neuropathy. As the knowledge of molecular mechanisms involved is expanding, more and more therapeutic targets are being recognized for the development of safe and effective pharmacotherapy of glaucoma. Although at present the intraocular pressure lowering drugs are still the first line of treatment, the prospect of introducing neuroprotective therapies that can directly protect and perhaps stimulate regeneration of dying and dead retinal ganglion cells, shows considerable promise. This review presents recent developments in the pathophysiology and pharmacotherapy of glaucoma.
    Matched MeSH terms: Tetrahymenina
  2. Ahmad SS
    Taiwan J Ophthalmol, 2018 7 25;8(2):74-81.
    PMID: 30038885 DOI: 10.4103/tjo.tjo_106_17
    Glaucoma suspects are controversial clinical dilemmas. These individuals harbor certain risk factors or demonstrate some clinical features suggestive of an increased probability to develop glaucomatous optic atrophy in the future. These characteristics range from high intraocular pressure; optic disc, visual field, or retinal nerve fiber layer abnormalities; or abnormal angles to a positive family history of glaucoma and other risk factors. Individuals having these characteristics should be assessed diligently before a diagnosis of glaucoma is made. Glaucoma is a chronic, lifelong condition, having a negative impact on the quality of life, with an increased risk of medication-related side-effects, adverse economic impacts, and the need for lifestyle changes in the patient. Overdiagnosis and unnecessary treatment of such individuals is bereft of any advantage. This review aims to provide a practical blueprint for the proper diagnosis and management of such glaucoma suspects.
    Matched MeSH terms: Tetrahymenina
  3. Ahmad SS
    Saudi J Ophthalmol, 2017 Jan-Mar;31(1):38-41.
    PMID: 28337061 DOI: 10.1016/j.sjopt.2016.08.001
    Glaucoma is a multi-factorial neurodegenerative disorder. The common denominator in all types of glaucomas is retinal ganglion cell death through apoptosis. However, this cellular demise in glaucoma is detected late by structural or functional analyses. There can be a 10-year delay prior to the appearance of visual field defects and pre-perimetric glaucoma is an issue still being addressed. However, a new cutting-edge technology called detection of apoptosing retinal cells (DARC) is being developed. This technique is capable of non-invasive, real-time visualization of apoptotic changes at the cellular level. It can detect glaucomatous cell damage at a very early stage, at the moment apoptosis starts, and thus management can be initiated even prior to development of visual field changes. In future, this technique will also be able to provide conclusive evidence of the effectiveness of treatment protocol and the need for any modifications which may be required. This article aims to provide a concise review of DARC technology.
    Matched MeSH terms: Tetrahymenina
  4. Ahmad SS
    Taiwan J Ophthalmol, 2016 Oct-Dec;6(4):182-186.
    PMID: 29018738 DOI: 10.1016/j.tjo.2016.05.009
    An understanding of the pathogenesis of glaucoma is one of the foundations in glaucoma management. A number of theories have been presented to explain glaucomatous neural degeneration. The vascular theory attempts to explain the causation of glaucoma on the basis of vasogenic factors and altered he-modynamics in the body; however, this theory remains controversial. There are proponents for and against the role played by vascular factors in the development of glaucomatous optic nerve degeneration. This review aims to analyze the various studies performed to provide evidence for and against the vascular theory of glaucoma. It also affirms the need to undertake further studies regarding the path-ogenesis of glaucoma and integrate them into our management strategies. The literature search for this systemic analysis was performed using search engines, such as PubMed, The Virtual Library of the Ministry of Health Malaysia, Google Scholar, and ClinicalKey.
    Matched MeSH terms: Tetrahymenina
  5. Azhany Y, Norhayati A, Siti Raihan I, Liza Sharmini AT
    Malays Fam Physician, 2014;9(2):48-52.
    PMID: 25883765 MyJurnal
    To determine the clinical presentations, management and outcome of lens-induced glaucoma (LIG) in Hospital Universiti Sains Malaysia.
    Matched MeSH terms: Tetrahymenina
  6. Azmi NA, Ahem A, Mustapha M, Bastion MC
    BMJ Case Rep, 2016 Sep 28;2016.
    PMID: 27681348 DOI: 10.1136/bcr-2016-215987
    We report a case of enucleation for painful blind eye secondary to recurrent bleeding from choroidal neovascularisation in an eye that was irradiated following presumed metastatic breast carcinoma to the choroid. A 58-year-old woman with a history of treated breast malignancy presented with haemophthalmus and intractable glaucoma in the right eye. One year previously she had presented with right vitreous haemorrhage with subretinal mass that had been irradiated given her history of breast carcinoma. Following irradiation, vitrectomy was performed to clear the blood. Intraoperative and postoperative angiography findings suggested a diagnosis of breakthrough bleeding secondary to polypoidal choroidal vasculopathy. At this presentation, however, the intraocular bleeding was recurrent resulting in elevated intraocular pressure and pain. Despite repeat surgery and medical therapy, the eye had to be enucleated. Histopathology showed choroidal neovascularisation.
    Matched MeSH terms: Tetrahymenina
  7. Che Hamzah J, Daka Q, Azuara-Blanco A
    Eye (Lond), 2020 01;34(1):155-160.
    PMID: 31772381 DOI: 10.1038/s41433-019-0669-7
    Glaucoma services are overwhelmed and struggling to accommodate current demand. Reducing the need for hospital based services would improve our ability to see those most at risk of vision loss, which could both reduce demand and improve patient outcomes. Digital technologies that provide opportunities for home monitoring of glaucoma progression have potential to contribute to solve these challenges and, potentially, improve glaucoma care. This article will review the literatures of well-established technologies that support home monitoring for glaucoma, specifically home tonometry (with rebound tonometry) and perimetry with Moorfields Motion Displacement Test and Melbourne Rapid Field.
    Matched MeSH terms: Tetrahymenina
  8. Chua PY, Day AC, Lai KL, Hall N, Tan LL, Khan K, et al.
    Br J Ophthalmol, 2018 Apr;102(4):539-543.
    PMID: 28794074 DOI: 10.1136/bjophthalmol-2017-310725
    PURPOSE: To estimate the incidence, and describe the clinical features and short-term clinical outcomes of acute angle closure (AAC).

    METHODS: Patients with newly diagnosed AAC were identified prospectively over a 12-month period (November 2011 to October 2012) by active surveillance through the Scottish Ophthalmic Surveillance Unit reporting system. Data were collected at case identification and at 6 months follow-up.

    RESULTS: There were 114 cases (108 patients) reported, giving an annual incidence of 2.2 cases (95% CI 1.8 to 2.6) or 2 patients (95% CI 1.7 to 2.4) per 1 00 000 in the whole population in Scotland. Precipitating factors were identified in 40% of cases. Almost one in five cases was associated with topical dilating drops. Best-corrected visual acuity (BCVA) at presentation ranged from 6/6 to perception of light. The mean presenting intraocular pressure (IOP) was 52 mm Hg (SD 11). Almost 30% cases had a delayed presentation of 3 or more days. At 6 months follow-up, 75% had BCVA of 6/12 or better and 30% were found to have glaucoma at follow-up. Delayed presentation (≥3 days) was associated with higher rate of glaucoma at follow-up (22.6% vs 60.8%, p<0.001), worse VA (0.34 vs 0.74 LogMAR, p<0.0001) and need for more topical medication (0.52 vs 1.2, p=0.003) to control IOP.

    CONCLUSION: The incidence of AAC in Scotland is relatively low compared with the Far East countries, but in line with previous European data. Almost one in five cases were associated with pupil dilation for retinal examination.

    Matched MeSH terms: Tetrahymenina
  9. Kamal, M., Amini, F., Ramasamy, TS
    JUMMEC, 2016;19(1):23-32.
    MyJurnal
    Glaucoma is a common eye disease that can cause irreversible damage if left undiagnosed and untreated. It is one of the most common neurodegenerative diseases causing blindness. Pre-clinical studies have been carried out on animal models of glaucoma for stem cell therapy. We carried out a systematic review to determine whether stem cell therapy had the potential to treat glaucoma. Nine studies were selected based on the predetermined inclusion and exclusion criteria. Of these nine studies, eight focused on neuroprotection conferred by stem cells, and the remaining one on neuroregeneration. Results from these studies showed that there was a potential in stem cell based therapy in treating glaucoma, especially regarding neuroprotection via neurotrophic factors. The studies revealed that a brain-derived neurotrophic factor expressed by stem cells promoted the survival of retinal ganglion cells in murine glaucoma models. The transplanted cells survived without any side effects. While these studies proved that stem cells provided neuroprotection in glaucoma, improvement of vision could not be determined. Clinical studies would be required to determine whether the protection of RGC correlated with improvement in visual function. Furthermore, these murine studies could not be translated into clinical therapy due to the heterogeneity of the experimental methods and the
    use of different cell lines. In conclusion, the use of stem cells in the clinical therapy of glaucoma will be an important step in the future as it will transform present-day treatment with the hope of restoring sight to patients with glaucoma.
    Matched MeSH terms: Tetrahymenina
  10. Lam CS, Umi Kalthum MN, Norshamsiah MD, Bastion M
    Malays Fam Physician, 2018;13(3):32-37.
    PMID: 30800232
    Steroid-induced glaucoma is the most serious complication of the injudicious use of steroids, particularly among children affected by allergic conjunctivitis. This condition is steroid-dependent, and children are commonly being prescribed topical anti-inflammatories, including topical steroids, by general practitioners. Furthermore, topical steroids are also available over the counter, and this availability contributes to overuse without proper monitoring by an ophthalmologist. We present a series of five cases illustrating the devastating effect of unmonitored, long-term use of steroids among children for vernal keratoconjunctivitis. The medications were prescribed initially by general ophthalmologists and were continually bought over the counter by parents. At the presentation to our center, these patients were already compromised visually, exhibiting glaucomatous optic disc changes and high intraocular pressure. The series highlights the optic nerve damage resulting in irreversible visual compromises among children on long-term, topical steroids and the importance of regular monitoring with a low threshold for ophthalmologist referral.
    Matched MeSH terms: Tetrahymenina
  11. Lam, C.S., Umi Kalthum, M.N., Norshamsiah, M.D., Bastion, M.L.C.
    Malaysian Family Physician, 2018;13(3):32-37.
    MyJurnal
    Steroid-induced glaucoma is the most serious complication of the injudicious use of steroids,
    particularly among children affected by allergic conjunctivitis. This condition is steroid-dependent,
    and children are commonly being prescribed topical anti-inflammatories, including topical steroids,
    by general practitioners. Furthermore, topical steroids are also available over the counter, and this
    availability contributes to overuse without proper monitoring by an ophthalmologist. We present
    a series of five cases illustrating the devastating effect of unmonitored, long-term use of steroids
    among children for vernal keratoconjunctivitis. The medications were prescribed initially by general
    ophthalmologists and were continually bought over the counter by parents. At the presentation to
    our center, these patients were already compromised visually, exhibiting glaucomatous optic disc
    changes and high intraocular pressure. The series highlights the optic nerve damage resulting in
    irreversible visual compromises among children on long-term, topical steroids and the importance
    of regular monitoring with a low threshold for ophthalmologist referral.
    Matched MeSH terms: Tetrahymenina
  12. Maheshwari S, Kanhangad V, Pachori RB, Bhandary SV, Acharya UR
    Comput Biol Med, 2019 Feb;105:72-80.
    PMID: 30590290 DOI: 10.1016/j.compbiomed.2018.11.028
    BACKGROUND AND OBJECTIVE: Glaucoma is a ocular disorder which causes irreversible damage to the retinal nerve fibers. The diagnosis of glaucoma is important as it may help to slow down the progression. The available clinical methods and imaging techniques are manual and require skilled supervision. For the purpose of mass screening, an automated system is needed for glaucoma diagnosis which is fast, accurate, and helps in reducing the burden on experts.

    METHODS: In this work, we present a bit-plane slicing (BPS) and local binary pattern (LBP) based novel approach for glaucoma diagnosis. Firstly, our approach separates the red (R), green (G), and blue (B) channels from the input color fundus image and splits the channels into bit planes. Secondly, we extract LBP based statistical features from each of the bit planes of the individual channels. Thirdly, these features from the individual channels are fed separately to three different support vector machines (SVMs) for classification. Finally, the decisions from the individual SVMs are fused at the decision level to classify the input fundus image into normal or glaucoma class.

    RESULTS: Our experimental results suggest that the proposed approach is effective in discriminating normal and glaucoma cases with an accuracy of 99.30% using 10-fold cross validation.

    CONCLUSIONS: The developed system is ready to be tested on large and diverse databases and can assist the ophthalmologists in their daily screening to confirm their diagnosis, thereby increasing accuracy of diagnosis.

    Matched MeSH terms: Tetrahymenina
  13. Marina, M.B., Mohd Tahir, J., Mawaddah, A., Asma, A., Mohd Razif, M.Y., Jemaima, C.H.
    Medicine & Health, 2018;13(2):36-47.
    MyJurnal
    Obstructive Sleep Apnoea (OSA) affects 2-5% of the middle-aged population and is a potentially life-threatening condition. Previous studies on OSA and glaucoma have reported mixed findings. This was a cross-sectional comparative study with a study duration of one year to compare the incidence of high intraocular pressure among OSA subjects and non-OSA subjects. This study took place in a tertiary hospital where a total of 50 subjects with OSA and 50 non-OSA subjects were recruited. The average age was 37 years (19,65) in a multiethnic study population (76% (Malay), 18% (Chinese) and 6% (Indian)). All patients underwent a full night computer-assisted polysomnogram (SOMNOCheck Effort Weinmann, Hamburg, Germany), Epworth Sleepiness Scale (ESS), Mullers manouevre (MM) to assess the level of obstruction and tonometry. The incidence of high Intra Ocular Pressure (IOP) among OSA subject was 52% with a significant difference between non-OSA and OSA subjects. Correlation between ESS and IOP were significant (p
    Matched MeSH terms: Tetrahymenina
  14. Ngah NF, Muhamad NA, Asnir ZZ, Abdul Aziz RA, Mhad Kassim Z, Sahar SA, et al.
    Int J Ophthalmol, 2020;13(11):1808-1813.
    PMID: 33215014 DOI: 10.18240/ijo.2020.11.19
    AIM: To determine the prevalence of diabetic retinopathy (DR) among diabetic patients at the primary health clinics in Selangor, Malaysia.

    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.

    Matched MeSH terms: Tetrahymenina
  15. Nurul Hanim Nasaruddin, Nurul Hanim Nasaruddin, Ahmad NazlimYusoff, Sharanjeet, Kaur
    MyJurnal
    The purpose of this study was to characterize, differentiate and correlate visual field and brain activation in visual cortex
    for normal, glaucoma suspect (GS) and primary open angle glaucoma (POAG) participants using Standard Automated
    Perimetry (SAP) and functional Magnetic Resonance Imaging (fMRI) respectively. The fMRI scans and SAP test were both
    carried out in Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM). Two types of black-and-white checkerboard
    pattern were displayed to the participants during the fMRI scans. The fMRI data were analyzed using WFU pickatlas
    toolbox targeting visual cortex area. The results showed that there was no significant difference in number of activated
    voxel between the three groups in visual cortex (BA 17, 18 and 19) while viewing all the given stimuli (p > 0.05). The
    pattern standard deviation (PSD) of SAP for visual field also revealed no significant differences (p > 0.05) in all groups of
    participants. However, negative correlation between PSD and fMRI activation was observed. The PSD values increased with
    a decrease in fMRI activation. With reference to visual field analysis, the results suggest that glaucomatous neuropathy of
    POAG patients has led to a gradual decrease in visual cortex activation and a gradual increase in PSD.
    Matched MeSH terms: Tetrahymenina
  16. Ramli R, Idris MYI, Hasikin K, A Karim NK, Abdul Wahab AW, Ahmedy I, et al.
    J Healthc Eng, 2017;2017:1489524.
    PMID: 29204257 DOI: 10.1155/2017/1489524
    Retinal image registration is important to assist diagnosis and monitor retinal diseases, such as diabetic retinopathy and glaucoma. However, registering retinal images for various registration applications requires the detection and distribution of feature points on the low-quality region that consists of vessels of varying contrast and sizes. A recent feature detector known as Saddle detects feature points on vessels that are poorly distributed and densely positioned on strong contrast vessels. Therefore, we propose a multiresolution difference of Gaussian pyramid with Saddle detector (D-Saddle) to detect feature points on the low-quality region that consists of vessels with varying contrast and sizes. D-Saddle is tested on Fundus Image Registration (FIRE) Dataset that consists of 134 retinal image pairs. Experimental results show that D-Saddle successfully registered 43% of retinal image pairs with average registration accuracy of 2.329 pixels while a lower success rate is observed in other four state-of-the-art retinal image registration methods GDB-ICP (28%), Harris-PIIFD (4%), H-M (16%), and Saddle (16%). Furthermore, the registration accuracy of D-Saddle has the weakest correlation (Spearman) with the intensity uniformity metric among all methods. Finally, the paired t-test shows that D-Saddle significantly improved the overall registration accuracy of the original Saddle.
    Matched MeSH terms: Tetrahymenina
  17. Rokiah Omar, Knight, Victor Feizal, Zainora Mohammed
    MyJurnal
    When medical and surgical intervention cannot alleviate all of the impairments resulting from diseases of the eye, visual rehabilitation can help reduce the disability and increase the quality of life. Data from 169 patients seen at the UKM Low Vision Clinic (UKM LVC) over the past 2 years were examined and analysed. The age ranged from 6 to 87 years of age. The main cause of ocular pathological categories was conduction (63.9%), media (24.9%) and congenital (11.2%) related problems. The main causes of low vision at UKM LVC were congenital cataract, retinitis pigmentosa, glaucoma, cataract and diabetic retinopathy. 84% of these patients received low vision devices to improve their near or/and distance vision. The most common optical devices dispensed at UKM LVC were near high addition spectacle, hand magnifiers and stand magnifiers. Medical, vision care and rehabilitation professionals working together can offer a comprehensive treatment plan for the visually impaired, offering these patients the very best services to increase their quality of life.
    Matched MeSH terms: Tetrahymenina
  18. Shoeb Ahmad S, Abdul Ghani S, Hemalata Rajagopal T
    J Curr Glaucoma Pract, 2013 May-Aug;7(2):49-53.
    PMID: 26997782 DOI: 10.5005/jp-journals-10008-1137
    Glaucoma is now regarded as a neurodegenerative disorder. A number of theories including the mechanical and vascular models have been used to explain the pathogenesis of glaucoma. However, there is now increasing evidence of biochemical molecules which may play a part in it's causation. These biochemical mechanisms include the role of excitatory aminoacids, caspases, protein kinases, oxygen free radicals, nitric oxide, TNF-alpha, neurotrophins and metalloproteins. This paper reviews these new developments which form the biochemical basis of glaucomatous neural degeneration. How to cite this article: Ahmad SS, Ghani SA, Rajagopal TH. Current Concepts in the Biochemical Mechanisms of Glaucomatous Neurodegeneration. J Current Glau Prac 2013;7(2):49-53.
    Matched MeSH terms: Tetrahymenina
  19. Tan, Kok-Leong, Fhun, Lai-Chan, Ahmad Tajudin Liza Sharmini, Maizan Yaakub, Chong, Mei-Fong
    MyJurnal
    Glaucoma is a chronic disease that could affect the quality of life and is a potential stressor for patients. Visual field assessment is important in monitoring disease progression among glaucoma patients. Stress could influence the performance of patients in visual field test that may affect the reliability of the test. Our objective in this study was to determine the association between stress score using Depression, Anxiety and Stress Scale (DASS) questionnaire and reliability indices of Humphrey visual field analysis (HFA). A total of 155 primary and secondary glaucoma patients were recruited in the study. Face to face interview using stress component of DASS questionnaire was conducted after automated HFA test. Reliability indices; i.e. fixation loss, false positive, and false negative error, were used to determine the accuracy of HFA result. Only 12 patients (7.7%) were found to have elevated stress score. No significant correlation was found between DASS stress score and the reliability indices of HFA. There was 0.2 folds (95% confidence interval (CI) [-2.35, -0.06], p = 0.039) reduction of fixation loss for every number of HFA done. For every one year increase in age, there was 0.2 folds (95% CI [-0.38, -0.07], p = 0.006) reduction in false positive error in HFA.
    Minimal stress may not affect the reliability of HFA assessment. Minimising stress among glaucoma patients is important not only for assessment of visual field but also for improvement of quality of life.
    Matched MeSH terms: Tetrahymenina
  20. Tang SP, Lim SC, Arkachaisri T
    J Clin Med, 2021 Feb 03;10(4).
    PMID: 33546120 DOI: 10.3390/jcm10040559
    Childhood onset systemic lupus erythematosus is a rare disease that is more common amongst Southeast Asian children compared to the West. It is typified by a peripubertal onset and a female preponderance, which increases with advancing age. Organs commonly involved at diagnosis include haematological, renal, and mucocutaneous. Fever, malar rash, and cutaneous vasculitis are common. Lupus nephritis is typically proliferative especially Class IV and contributes to both disease activity and damage. Antinuclear antibody and anti-dsDNA positivity are both prevalent in this region. Disease activity is higher than Western cohorts at onset but responds to therapy reducing to low disease activity by six months. However, organ damage occurs early and continues to accumulate over the time, a consequence of both active disease (neurological and renal systems) and steroid-related complications especially in the eye (cataract and glaucoma) and musculoskeletal systems (avascular necrosis). Infections remain the leading cause of death and mortality in this region is highly variable contributed by the heterogeneity in social economic status, healthcare access, and availability of paediatric rheumatology expertise in the region.
    Matched MeSH terms: Tetrahymenina
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