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Fulltext Vitreous loss-causes, associations, and outcomes: Eight-year analysis in Melaka Hospital

Thevi T, Abas AL

Oman J Ophthalmol, 2018 6 23;11(2):113-118.
PMID: 29930443 DOI: 10.4103/ojo.OJO_220_2016

BACKGROUND: Cataract surgery is associated with a variety of complications, one of which is vitreous loss. Doctors and policymakers should be aware about the precipitating factors, associations, and expected outcomes of vitreous loss. This study was, therefore, undertaken to set guidelines to improve the visual outcomes of patients.

MATERIALS AND METHODS: A retrospective 8-year analysis was conducted from 2007 to 2014 using the national eye database. Demographic features, ocular comorbidities, grade of surgeon, type of surgery, and the associations with the occurrence of vitreous loss, and the final visual outcomes of these patients were studied.

RESULTS: Out of 12,992 eyes, only 3.2% had vitreous loss, mostly aged <40 years. Pseudoexfoliation was the only ocular comorbidity causing vitreous loss. Medical Officers and Gazetting Specialists got more vitreous loss compared to specialists. Intracapsular cataract extraction, phaco convert to extracapsular cataract extraction (ECCE), ECCE, and phaco all had a significant vitreous loss. Vitreous loss was the most significant intraoperative complication causing poor vision and resulted in impaired or poor visual outcome.

CONCLUSION: Vitreous loss occurred in almost all types of cataract surgeries, especially by junior surgeons, among those aged <40 years and significantly caused poor visual outcome compared to other complications. Pseudoexfoliation had higher occurrence of vitreous loss. Vitreous loss patients had impaired/poor visual outcome due to preexisting comorbidity and astigmatism. Patients at risk and junior surgeons should be closely monitored to improve outcomes. Further studies need to be done to see why and when the vitreous loss occurred.

Matched MeSH terms: Eye
Fulltext Role of intravitreal/intracameral antibiotics to prevent traumatic endophthalmitis - Meta-analysis

Thevi T, Abas AL

Indian J Ophthalmol, 2017 Oct;65(10):920-925.
PMID: 29044054 DOI: 10.4103/ijo.IJO_512_17

Traumatic endophthalmitis is a devastating condition that can occur following an open globe injury and result in loss of vision. The use of prophylactic antibiotics is empirical as most surgeons fear complications associated with the same. No systematic review has been performed in English on the role of intravitreal/intracameral antibiotics in preventing traumatic endophthalmitis. We searched for randomized controlled trials and controlled clinical trials comparing intracameral/intravitreal antibiotics with placebos on PubMed, Google Scholar, Science Direct, and Cochrane Library using keywords open globe/trauma/penetrating/perforating injuries endophthalmitis. The last search was on 5 May 2017. We included patients of all ages with open globe injuries who received intracameral/intravitreal antibiotics, regardless of the dose. Quality of the trials was assessed using Cochrane collaboration tools to assess the risk of bias. The main outcome measures were endophthalmitis and visual acuity. We included three trials. Overall, intravitreal/intracameral antibiotics were noted to significantly reduce the occurrence of endophthalmitis in open globe injuries (relative risk [RR] 0.19, 95% confidence interval [CI] 0.06-0.57). The use of intravitreal/intracameral antibiotics did not have an effect in improving visual acuity (RR 1.17, 95% CI 0.61-2.23). Two trials (Narang 2003; Soheilan 2001) were observed to have no significant effect on visual acuity while another trial (Soheilan 2007) did not list visual acuity as part of its objectives. Intracameral/intravitreal antibiotics reduce the risk of endophthalmitis in open globe injuries; although, there was no improvement in the visual acuity. We, therefore, recommend the use of intravitreal/intracameral injections in open globe injuries to prevent this devastating complication.

Matched MeSH terms: Eye Injuries, Penetrating/complications*; Eye Injuries, Penetrating/drug therapy; Eye Infections, Bacterial/etiology; Eye Infections, Bacterial/prevention & control*
Fulltext The effect of induced visual stress on three dimensional perception

Abd-Manan F

Malays J Med Sci, 2000 Jul;7(2):18-26.
PMID: 22977386 MyJurnal

Previous studies have shown that stress on the vergence and accommodation systems, either artificially induced or naturally occurring, results in small misalignment of the visual axes, reduces binocular visual acuity and produces symptoms of ocular discomfort. This study examines the effect of artificially induced visual stress using ophthalmic prisms on three dimensional perception on 30 optometry students ages ranging from 19 to 29 years old. 6D base-in prisms, equally divided between the eyes (3D base-in each) was used to induce stress on the visual system producing misalignment of visual axes known as fixation disparity. The fixation disparity is quantified using near vision Mallett Unit and an enlarged scaled diagram. Stereoscopic perception was measured with the TNO test, with and without the presence of stress and the results was compared. Wilcoxon's matched pair ranked tests show statistically significant difference in the stereo thresholds of both conditions, p = 0.01 for advancing stereopsis and p = 0.01 for receding stereopsis, respectively. The study concludes that visual stress induced by prisms, produce misalignment of the visual axes and thus reduces three dimensional performance.

Matched MeSH terms: Eye
A Concise Review on Mesenchymal Stem Cells for Tissue Engineering with a Perspective on Ocular Surface Regeneration

Salih M, Shaharuddin B, Abdelrazeg S

Curr Stem Cell Res Ther, 2020;15(3):211-218.
PMID: 31995019 DOI: 10.2174/1574888X15666200129145251

Organ and tissue transplantation are limited by the scarcity of donated organs or tissue sources. The success of transplantation is limited by the risk of disease transmission and immunological- related rejection. There is a need for new strategies and innovative solutions to make transplantation readily available, safer and with less complications to increase the success rates. Accelerating progress in stem cell biology and biomaterials development have pushed tissue and organ engineering to a higher level. Among stem cells repertoire, Mesenchymal Stem Cells (MSC) are gaining interest and recognized as a cell population of choice. There is accumulating evidence that MSC growth factors, its soluble and insoluble proteins are involved in several key signaling pathways to promote tissue development, cellular differentiation and regeneration. MSC as multipotent non-hematopoietic cells with paracrine factors is advantageous for regenerative therapies. In this review, we discussed and summarized the important features of MSC including its immunomodulatory properties, mechanism of homing in the direction of tissue injury, licensing of MSC and the role of MSC soluble factors in cell-free therapy. Special consideration is highlighted on the rapidly growing research interest on the roles of MSC in ocular surface regeneration.

Matched MeSH terms: Eye/anatomy & histology*
Fulltext Contact lens related Elizabethkingia meningoseptica keratitis-a first Southeast ASEAN case report & literature review

Ang, Wen-Jeat, Embong Zunaina, Raja Omar Raja Norliza, Abdul Jalil Fadzillah

Journal of Biomedical and Clinical Sciences, 2017;2(1):1-4.
MyJurnal

We describe the first clinical case of contact lens related corneal ulcer caused by Elizabethkingia meningosepticaregistered in Southeast Asia. A 20-year-old female student who wasa regular soft contact lens wearer, presented with pain, photophobia and blurring of vision of the right eye for 3 days. On slit lamp examination, there was a small paracentral anterior stromal infiltrate with an overlying epithelial defect. Microbiological cultures from corneal scrapings, contact lens and its casing were positive for E.meningoseptica. Due to high likelihood of contact lens contamination causing keratitis, topical fortified gentamicin0.9% and ceftazidime 5% were administered empirically. Topical vancomycin 5% was later added tailoring to the culture and sensitivity of the organism. After 8 weeks of treatment, the keratitis subsided and corneal epithelial defect completely healed with residual corneal opacity. Even though uncommon, contact lens related E.meningosepticakeratitis can occur in healthy immunocompetent individuals with no ocular comorbidities.

Matched MeSH terms: Eye
Multiple retentive means for prosthetic restoration of a large facial defect - a case report

Abdulhadi LM

Chin J Dent Res, 2010;13(1):61-6.
PMID: 20936194

A 70-year-old man who suffered from extensive extra and intraoral defects was rehabilitated with a prosthesis using multiple retaining means. The treatment was performed in two parts: externally involving the construction of an episthesis supported only by the remaining intact boundaries of the defect and retained by mini-dental implants and spectacle frame with a modified ear hook; and intraorally by an acrylic resin obturator to restore the function of the hemi-sectioned hard and soft palate. The episthesis was securely retained with minimal movement and/or dislodgment of the prosthesis during function. Multiple retentive techniques may be used to fix heavy external prostheses as an alternative to conventional implants or biological adhesives.

Matched MeSH terms: Eye Neoplasms/rehabilitation; Eye, Artificial
Fulltext Intra-cranial metastatic lacrimal gland tumour

Wahab NA, Ramasamy U, George J, Madhavan M, Arif AR, Abdullah J

Med J Malaysia, 2006 Dec;61(5):641-3.
PMID: 17623971 MyJurnal

We report a case of an adult who presented with progressive swelling in the right eye with suggestive of intracranial lesion on imaging. Histopathological revealed a lacrimal gland malignant mixed tumour.

Matched MeSH terms: Eye Neoplasms/diagnosis; Eye Neoplasms/pathology; Eye Neoplasms/surgery*
Combination of vascularized outer-table calvarial bone graft based on the superficial temporal vessels and allomatrix for the repair of an orbito-frontal blow-out fracture in a child

Ali F, Halim AS, Najihah SZ, Ibrahim M, Abdullah J

J Craniomaxillofac Surg, 2005 Oct;33(5):326-30.
PMID: 16125400

A vascularized outer-table calvarial bone graft was used for repairing a Posnick type 2 traumatic orbito-frontal bone defect supported by the use of a calcium-based putty (Allomatrix) in a 7-year-old girl. Gaps between the donor and recipient sites were filled with Allomatrix containing demineralized bone matrix particles. Four years later there was a good cosmetic result using an artificial left eye.

Matched MeSH terms: Eye, Artificial
Fulltext Rice millers' syndrome: a preliminary report

Lim HH, Domala Z, Joginder S, Lee SH, Lim CS, Abu Bakar CM

Br J Ind Med, 1984 Nov;41(4):445-9.
PMID: 6498108 DOI: 10.1136/oem.41.4.445

A study was carried out to determine the health effects of rice husk dust in Malaysian rice millers. The study population consisted of 122 male Malay workers from three rice mills, with 42 controls of similar age, sex, ethnic group, and agricultural work background. Interviews using standardised questionnaires, physical examination, total and differential white cell counts, chest radiographs, and lung function tests were performed on each of the millers and the controls. Environmental dust monitoring was also carried out in the three rice mills. Clinical, haematological, and radiological findings suggest that a distinct clinical syndrome seems to be associated with exposure to rice husk dust. The manifestations of this "rice millers' syndrome" include acute and chronic irritant effects affecting the eyes, skin, and upper respiratory tract; allergic responses such as nasal catarrh, tightness of chest, asthma, and eosinophilia; and radiological opacities in the chest, probably representing early silicosis or extrinsic allergic alveolitis.

Matched MeSH terms: Eye Diseases/etiology
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: Eye
Fulltext Traumatic globe displacement into anterior cranial fossa

Patricia Ann John, Sylves Patrick, Mohtar Ibrahim, Adil Hussein

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):325-327.
MyJurnal

A 64-year-old Malay gentleman alleged occupational injury when a malfunctioned metal hydraulic door hit on his face while unloading sand from his tipper-truck. Post-trauma, he complained of right eye (RE) pain and total loss of vision. On examination, noted RE visual acuity was unable to be assessed and left eye (LE) was 6/24 with pinhole 6/9. No eyeball could be seen in the right socket with superior orbital rim step deformity and left periorbital haema- toma. Computed tomography scan of the brain and orbit confirmed displaced right eye globe into the right anterior cranial fossa with right and left multiple orbital wall fractures. He then underwent successful right eye globe reposi- tioning. Traumatic orbital roof fracture is a rare condition. Repositioning of the eye globe was done to salvage the eye globe for a cosmetic reason and to avoid localised inflammatory reaction at the anterior cranial fossa.

Matched MeSH terms: Eye
Fulltext Angiogenic potential of extracellular matrix of human amniotic membrane

Hashim SNM, Yusof MFH, Zahari W, Noordin KBAA, Kannan TP, Hamid SSA, et al.

Tissue Eng Regen Med, 2016 Jun;13(3):211-217.
PMID: 30603401 DOI: 10.1007/s13770-016-9057-6

Combination between tissue engineering and other fields has brought an innovation in the area of regenerative medicine which ultimate aims are to repair, improve, and produce a good tissue construct. The availability of many types of scaffold, both synthetically and naturally have developed into many outstanding end products that have achieved the general objective in tissue engineering. Interestingly, most of this scaffold emulates extracellular matrix (ECM) characteristics. Therefore, ECM component sparks an interest to be explored and manipulated. The ECM featured in human amniotic membrane (HAM) provides a suitable niche for the cells to adhere, grow, proliferate, migrate and differentiate, and could possibly contribute to the production of angiogenic micro-environment indirectly. Previously, HAM scaffold has been widely used to accelerate wound healing, treat bone related and ocular diseases, and involved in cardiovascular repair. Also, it has been used in the angiogenicity study, but with a different technical approach. In addition, both side of HAM could be used in cellularised and decellularised conditions depending on the objectives of a particular research. Therefore, it is of paramount importance to investigate the behavior of ECM components especially on the stromal side of HAM and further explore the angiogenic potential exhibited by this scaffold.

Matched MeSH terms: Eye
Fulltext Increment of Access Points in Integrated System of Wavelength Division Multiplexed Passive Optical Network Radio over Fiber

Amiri IS, Alavi SE, Soltanian MR, Fisal N, Supa'at AS, Ahmad H

Sci Rep, 2015;5:11897.
PMID: 26153536 DOI: 10.1038/srep11897

This paper describes a novel technique to increase the numbers of access points (APs) in a wavelength division multiplexed-passive optical network (WDM-PON) integrated in a 100 GHz radio-over-fiber (RoF). Eight multi-carriers separated by 25 GHz intervals were generated in the range of 193.025 to 193.200 THz using a microring resonator (MRR) system incorporating an add-drop filter system. All optically generated multi-carriers were utilized in an integrated system of WDM-PON-RoF for transmission of four 43.6 Gb/sec orthogonal frequency division multiplexing (OFDM) signals. Results showed that an acceptable BER variation for different path lengths up to 25 km was achievable for all four access points and thus the transmission of four OFDM channels is feasible for a 25 km standard single mode fiber (SSMF) path length.

Matched MeSH terms: Eye
Fulltext Radical resection for naso-lacrimal duct tumour

Vickers PG, Shue CL, Ahmad H

Med J Malaysia, 1999 Jun;54(2):277-9.
PMID: 10972044

Naso-lacrimal duct tumours are uncommon and present with epiphora and swelling. Since the naso-lacrimal duct is embedded in bone for the majority of its anatomical length, the late presentation of proptosis is due to orbital extension of the tumour. Radical surgical treatment is necessary to establish clear margins and facilitate reconstruction.

Matched MeSH terms: Eye Neoplasms/surgery*
Fulltext A benign presentation of primary ductal adenocarcinoma of lacrimal gland: A rare malignancy

Lau LL, Lung CK, Ahmad SS

Indian J Ophthalmol, 2015 Nov;63(11):856-8.
PMID: 26669339 DOI: 10.4103/0301-4738.171969

A 34-year-old patient with a swelling over the upper eyelid for nearly 1 year was seen in our clinic. The history, examination and investigations were suggestive of a benign lacrimal gland tumor. The tumor and lacrimal gland were resected. Subsequent histopathological examination revealed the tumor was a primary ductal adenocarcinoma of the lacrimal gland. This is a very rare tumor with less than half a dozen cases reported so far. This case report is being presented to highlight an unusual presentation of this rare malignancy.

Matched MeSH terms: Eye Neoplasms
Fulltext Bilateral Panuveitis in a Case of Ocular Sarcoidosis

Payman, A.K., Tajunisah, I., Ahmad, F.

International Medical Journal Malaysia, 2008;7(1):0-0.
MyJurnal

Glaucoma is a major cause of permanent visual loss in patients with sarcoid uveitis.In this case glaucoma occurred early in the course of the disease and IOP started to rise up after one month from the initial presentation. Uveitic glaucoma can be extremely difficult to treat; pilocarpine is not normally used in eyes with active inflammation. Patients with uveitis respond poorly to laser trabeculoplasty, and filtering procedures usually fail. Success of modified goniotomy, trabeculectomy and Molteno valve implantation were reported. More drastic therapy, such as cyclodestructive procedures, may be required in the most severe cases. In this case the challenge in preserving the vision. by keeping the balance between the need to control the inflammation and the necessity to avoid the treatment related complications.

Matched MeSH terms: Eye
Fulltext Distribution of Refractive Errors among Healthy Infants and Young Children between the Age of 6 to 36 Months in Kuala Lumpur, Malaysia-A Pilot Study

Yahya AN, Sharanjeet-Kaur S, Akhir SM

Int J Environ Res Public Health, 2019 11 27;16(23).
PMID: 31783494 DOI: 10.3390/ijerph16234730

Uncorrected refractive error, especially myopia, in young children can cause permanent visual impairment in later life. However, data on the normative development of refractive error in this age group is limited, especially in Malaysia. The aim of this study was to determine the distribution of refractive error in a sample of infants and young children between the ages of 6 to 36 months in a prospective, cross-sectional study. Cycloplegic retinoscopy was conducted on both eyes of 151 children of mean age 18.09 ± 7.95 months. Mean spherical equivalent refractive error for the right and left eyes was +0.85 ± 0.97D and +0.86 ± 0.98D, respectively. The highest prevalence of refractive error was astigmatism (26%), followed by hyperopia (12.7%), myopia (1.3%) and anisometropia (0.7%). There was a reduction of hyperopic refractive error with increasing age. Myopia was seen to emerge at age 24 months. In conclusion, the prevalence of astigmatism and hyperopia in infants and young children was high, but that of myopia and anisometropia was low. There was a significant reduction in hyperopic refractive error towards emmetropia with increasing age. It is recommended that vision screening be conducted early to correct significant refractive error that may cause disruption to clear vision.

Matched MeSH terms: Eye
Fulltext Bacterial and fungal keratitis in Upper Egypt: in vitro screening of enzymes, toxins and antifungal activity

Gharamah AA, Moharram AM, Ismail MA, Al-Hussaini AK

Indian J Ophthalmol, 2014 Feb;62(2):196-203.
PMID: 24008795 DOI: 10.4103/0301-4738.116463

This work was conducted to study the ability of bacterial and fungal isolates from keratitis cases in Upper Egypt to produce enzymes, toxins, and to test the isolated fungal species sensitivity to some therapeutic agents.

Matched MeSH terms: Eye Infections, Bacterial/drug therapy; Eye Infections, Bacterial/microbiology; Eye Infections, Bacterial/epidemiology*; Eye Infections, Fungal/drug therapy; Eye Infections, Fungal/microbiology; Eye Infections, Fungal/epidemiology*
White-eyed blowout fracture: Diagnostic pitfalls and review of literature

Yew CC, Shaari R, Rahman SA, Alam MK

Injury, 2015 Sep;46(9):1856-9.
PMID: 25986667 DOI: 10.1016/j.injury.2015.04.025

White-eyed blowout fracture was first termed by Jordan et al. in individuals sustaining a blow to the periocular area and presenting with ocular symptoms, although with minimal soft tissue signs of trauma. It is often found in pure orbital floor blowout fractures among paediatric patients, and it could manifest as a linear or hinge-like trapdoor deformity. Unlike the more common open orbital blowout fractures with distinct diagnostic clinical signs, white-eyed blowout fractures are rarer and their diagnoses can be easily missed, subsequently costing an optimal time window for surgical intervention. This is critical as better outcomes are found with earlier release of entrapments. This report describes a case of a white-eyed blowout fracture in a 10-year-old child faced with its diagnostic challenges. The current literature review discusses the types of fracture pattern, signs and symptoms, mechanism of action, as well as timing of surgery. In view of the common complication of persistent diplopia, clinical pitfalls in achieving this diagnosis are emphasized to prevent any delay of treatment. Current literature evidences are weighted towards urgent surgical intervention, as positive outcomes are found to correlate with earlier release of entrapments.

Matched MeSH terms: Eye
Fulltext A comparative assessment of prosthetic outcome on enucleation and evisceration in three different etiological eye defects: A case series

Jamayet NB, Kirangi JK, Husein A, Alam MK

Eur J Dent, 2017 4 25;11(1):130-134.
PMID: 28435380 DOI: 10.4103/1305-7456.202636

Enucleation and evisceration are the most common surgical procedures that are performed to manage tumor, trauma, and infection. Given the consequences of surgical intervention, the conditions of the remaining eye socket may affect future prosthetic rehabilitation. A custom-made ocular prosthesis can be used to help restore the esthetics and functional defects and to improve the quality of life of patients with such conditions. An assessment must be performed on the prosthetic outcome before rehabilitation. The etiology of defect, type of surgery, condition of the remaining socket, and patient's age should all be considered. This report discusses three different etiological eye defects that have undergone enucleation and evisceration and describes the factors that have a significant role in the esthetic and functional outcome of the prosthesis. This report should serve as a helpful aid for maxillofacial prosthodontists to understand the primary objective of rehabilitating each eye defect and to meet patient expectations.

Matched MeSH terms: Eye, Artificial

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