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Displaying publications 21 - 26 of 26 in total

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Fulltext Objective Assessment of Retinal Artery Macroaneurysm With Optical Coherence Tomography Angiography

Mohd Lokman M, Catherine Bastion ML, Che Hamzah J

Cureus, 2022 Dec;14(12):e32328.
PMID: 36628049 DOI: 10.7759/cureus.32328

Retinal artery macroaneurysm (RAM) is an acquired retinal arteriole dilatation with vision-threatening complications. Diagnosis of this condition can be made clinically, supported by multi-modal imaging modalities, commonly optical coherence tomography (OCT) and dye-based angiography studies which show the lesion itself and the complications to the adjacent retina. We report a case of an 83-year-old patient with renal impairment who had the diagnosis and monitoring of RAM done using optical coherence tomography angiography (OCT-A) as an alternative to conventional fluorescein angiography. This case highlighted the use of OCT-A using Cirrus 5000 with AngioPlex (Zeiss, Jena, Germany) as a useful diagnostic and monitoring tool for RAM with its features that enables objective quantification of the disease activity via vessel and perfusion density pre- and post-laser treatment.
Fulltext Bilateral Open Globe Injury Secondary to the King of Fruits: Durian Fall

Lee J, Che Hamzah J, Mohd Khialdin S, Naffi AA

Cureus, 2023 May;15(5):e39153.
PMID: 37332448 DOI: 10.7759/cureus.39153

We report a case of bilateral open globe injury that resulted from a durian fruit falling on a 62-year-old woman's unprotected face during durian picking in her orchard. On presentation, the bilateral vision was light perception. The right eye sustained a curvilinear corneal laceration with expelled intraocular content. Meanwhile, the left eye sustained a corneoscleral laceration with expelled uvea and retina. Additionally, the right upper lid margin was lacerated. Emergency wound exploration, primary toilet, and suturing were performed on bilateral eyes. Preoperatively, she received intramuscular anti-tetanus toxoid and intravenous ciprofloxacin. Intravitreal ceftazidime and vancomycin were given intraoperatively as endophthalmitis prophylaxis. Postoperatively, the vision remained as light perception. There were no signs of endophthalmitis in both eyes. Although traumatic globe injury due to durian is uncommon, individuals should wear protective gear while in a durian orchard to avoid such unprecedented accidents. Prompt yet scrupulous action should be taken to save the globe and further possible complications.
Fulltext Neovascular Glaucoma Complicating Central Retinal Artery Occlusion Despite Cilioretinal Artery Sparing

Zakaria NA, Cheng TC, Nasaruddin RA, Che Hamzah J

Cureus, 2023 Aug;15(8):e43303.
PMID: 37700979 DOI: 10.7759/cureus.43303

This case report aims to describe a case of unilateral central retinal artery occlusion (CRAO) with cilioretinal artery sparing, which was complicated by neovascular glaucoma (NVG). A 75-year-old Indian woman with underlying normal tension glaucoma presented with the sudden onset of painless generalized blurring of the right eye's vision for a week. Her right eye vision was hand motion with the presence of a right relative afferent pupillary defect. Fundus examination revealed retinal whitening over the macula sparing the papillomacular bundle with generalized retinal arteriolar attenuation, which was suggestive of right CRAO with cilioretinal artery sparing. Systemic examination revealed high blood pressure (175/75 mmHg) without ocular bruit or audible murmur on auscultation. Optical coherence tomography of the macula showed inner retinal thickening over the temporal macula. Ultrasound carotid Doppler and computed tomography angiography of the carotid showed more than 75% stenosis over the right distal internal carotid artery. Unfortunately, she developed rubeosis iridis over her right eye two weeks after her presentation, which required pan-retinal photocoagulation. She subsequently progressed to NVG, requiring maximum anti-glaucoma medications to stabilize intraocular pressure. In conclusion, CRAO is a sight-threatening medical emergency. Thorough investigations are required to determine the underlying cause so that early intervention can be done to reduce the risk of a similar attack in the fellow eye and the risk of a cerebrovascular event or cardiac ischemia, which could be life-threatening. The presence of a cilioretinal artery does not prevent ocular neovascularization in CRAO. Hence, patients should also be closely monitored after the initial diagnosis to prevent devastating complications such as NVG.
Fulltext Home monitoring for glaucoma

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.
Selective laser trabeculoplasty vs. topical medications for step-up treatment in primary open angle glaucoma: comparing clinical effectiveness, quality of life and cost-effectiveness

Yong MH, Che Hamzah J

Med J Malaysia, 2020 07;75(4):342-348.
PMID: 32723992

INTRODUCTION: The aim of this study was to investigate the clinical effectiveness, health related quality of life (HRQoL) and cost effectiveness of selective laser trabeculoplasty (SLT) compared to topical anti-glaucoma medications in step-up treatment of patients with primary open angle glaucoma (POAG).
METHODS: Seventeen POAG patients with suboptimal IOP control despite pre-existing topical medications were subjected to adjunct SLT (50 applications 180 degrees) or second line medical therapy. Current medications were continued, and patients were followed up for 6 months for degree of intraocular pressure (IOP) lowering. HRQoL was assessed using Glaucoma Quality of Life 36-item (GlauQoL-36), Assessment of Quality of Life-7D (AQoL-7D) and Vision related Quality of Life (VisQoL). Costs involved were calculated and compared to the effect (IOP reduction) achieved in each arm.
RESULTS: Ten patients were in the SLT group and 7 in the topical medication (MED) group. Mean baseline intraocular pressure (IOP) was 18.90±3.48mmHg in SLT group and 15.57±2.23mmHg in MED group. Mean reduction of IOP was 4.30±1.64mmHg in SLT group and 2.71±2.56 mmHg in MED group at 6 months which was not statistically significant (p=0.14) between two groups. All the HRQoL questionnaires did not show significant changes in the groups or between groups when compared baseline with 6-month post treatment (p-values ranging from 0.247 to 0.987). For every 1mmHg reduction in IOP, cost involved in MED group (RM53.61) was 165% of the cost involved in SLT group (RM32.56).
DISCUSSION AND CONCLUSION: This study has shown that SLT was as effective clinically and tolerable as topical anti glaucoma medications and was possibly more cost effective in the step-up treatment of patients with POAG at 6 months follow- up.
Fulltext Various ways of continuous intraocular pressure monitoring in glaucoma patients: a narrative review

Ramakrishnan, G., Che Hamzah, J., Sharanjeet-Kaur S.

Medicine & Health, 2019;14(2):17-29.
MyJurnal

Glaucoma is a group of neurodegenerative disease linked with imbalance in the aqueous humor flow due to resistance in the aqueous drainage system. This increases the intraocular pressure (IOP), which causes damage to the optic nerve head and leads to irreversible blindness. As IOP is the only treatable risk factor for glaucoma, its 24 hours biorhythm need to be understood before managing it. Monitoring IOP is a critically important part in the management of glaucoma. Various approach and technology have been initiated and on-going for a frequent, round-the-clock IOP measurement to determine the IOP peaks and fluctuations. We review the current innovative approach and its importance as well as discussing the shortcomings of each method to obtain the 24 hour IOP profile.