MyMedR

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).

Central corneal thickness measurements with different imaging devices and ultrasound pachymetry

Tai LY, Khaw KW, Ng CM, Subrayan V

Cornea, 2013 Jun;32(6):766-71.

PMID: 23095499 DOI: 10.1097/ICO.0b013e318269938d

The aim of this study was to compare 4 methods of central corneal thickness (CCT) measurements in terms of their agreement, repeatability, and measurement time.

The trend of retinopathy of prematurity in Malaysia from 1992 to 2001 based on a nationwide blind schools study

Chang KM, Patel DK, Tajunisah I, Subrayan V

Asia Pac J Public Health, 2015 Mar;27(2):217-24.

PMID: 22887807 DOI: 10.1177/1010539512455047

Retinopathy of prematurity (ROP) is one of the most important causes of childhood blindness worldwide. The trend of ROP in Malaysia was unclear because there was no national registry before 2002. The purpose of this study is to analyze ROP students of different ages in the schools for the blind in Malaysia in order to evaluate the trend of ROP from 1992 to 2001. Data were obtained from a previous survey of 24 blind schools. It was found that 78 students or 17.4% were blind/severely visual impaired as a result of ROP. There was a significant surge in the number of ROP students who were born in 1994 when the use of synthetic surfactants was first introduced in Malaysia; otherwise there was no increasing trend in the number of students with ROP. However, the percentage of ROP in total was increasing, which indicates that ROP is becoming a more important cause of childhood blindness in this country.

An age-adjusted seroprevalence study of Toxoplasma antibody in a Malaysian ophthalmology unit

Singh S, Khang TF, Andiappan H, Nissapatorn V, Subrayan V

Trans R Soc Trop Med Hyg, 2012 May;106(5):322-6.

PMID: 22480791 DOI: 10.1016/j.trstmh.2012.01.009

Toxoplasma gondii is a public health risk in developing countries, especially those located in the tropics. Widespread infection may inflict a substantial burden on state resources, as patients can develop severe neurological defects and ocular diseases that result in lifelong loss of economic independence. We tested sera for IgG antibody from 493 eye patients in Malaysia. Overall age-adjusted seroprevalence was estimated to be 25% (95% CI: [21%, 29%]). We found approximately equal age-adjusted seroprevalence in Chinese (31%; 95% CI: [25%, 38%]) and Malays (29%; 95% CI: [21%, 36%]), followed by Indians (19%; 95% CI: [13%, 25%]). A logistic regression of the odds for T. gondii seroprevalence against age, gender, ethnicity and the occurrence of six types of ocular diseases showed that only age and ethnicity were significant predictors. The odds for T. gondii seroprevalence were 2.7 (95% CI for OR: [1.9, 4.0]) times higher for a patient twice as old as the other, with ethnicity held constant. In Malays, we estimated the odds for T. gondii seroprevalence to be 2.9 (95% CI for OR: [1.8, 4.5]) times higher compared to non-Malays, with age held constant. Previous studies of T. gondii seroprevalence in Malaysia did not explicitly adjust for age, rendering comparisons difficult. Our study highlights the need to adopt a more rigorous epidemiological approach in monitoring T. gondii seroprevalence in Malaysia.

An unusual presentation of gestational thrombocytopenia

Lim CC, Patel DK, Bakhtiari A, Subrayan V

Platelets, 2013;24(6):498-9.

PMID: 22994680 DOI: 10.3109/09537104.2012.724484

Thrombocytopenia is classically defined as a platelet count of less than 150 000/µl. Counts from 100 000 to 150 000/µl are considered mildly depressed, 50 000 to 100 000/µl moderately depressed, and less than 50 000/µl severely depressed. Thrombocytopenia occurs in about 10% of pregnant women. Gestational thrombocytopenia (GT) is a diagnosis of exclusion and considered the most prevalent cause of thrombocytopenia in pregnancy. GT accounts for almost 75% of cases of thrombocytopenia in pregnancy. The cause of GT is unclear, although existing studies denote the possibility of accelerated platelet consumption and the increased plasma volume during pregnancy. The presence of antiplatelet antibodies is not specific to GT. The degree of thrombocytopenia in GT is usually mild to moderate, usually remaining greater than 70 000/µl. Patients are asymptomatic with no evidence of bleeding and rarely preconception history of thrombocytopenia. The platelet count returns to normal within 2-12 weeks post partum. We wish to report a unique case of GT presenting as blurred vision due to retinal hemorrhages.

Bilateral asymmetrical mucoceles of the paranasal sinuses with unilateral orbital complications

Chong AW, Prepageran N, Rahmat O, Subrayan V, Jalaludin MA

Ear Nose Throat J, 2011 Feb;90(2):E13.

PMID: 21328215

We report the rare occurrence of bilateral asymmetrical mucoceles of the paranasal sinuses that resulted in a unilateral orbital complication. The patient was a 47-year-old woman who presented with complaints of diplopia, blurred vision, and protrusion of her right eye that had progressed over a period of several months following an upper respiratory tract infection. Computed tomography detected the presence of two large, asymmetrical mucoceles. The lesion on the right involved the frontal and ethmoid sinuses, and the one on the left involved the ethmoid sinus. The mucoceles were locally expansile and had eroded the surrounding bony structures on the right. The expansile nature of the right-sided mass had displaced the right orbit, which was the cause of the vision deterioration. Transnasal endoscopic surgery was performed to excise and marsupialize the mucoceles. This modality was preferred over conventional open surgery because it affords good visualization, it is safe, and it is a less morbid procedure. The patient's recovery was uneventful, and she was discharged home on the third postoperative day. On continuing follow-up, her vision had improved, her intraocular pressure had returned to normal, and her orbits were in their normal position. Based on our literature search, no case of bilateral frontal and ethmoid sinus mucoceles has been previously reported.

Fulltext Agreement analysis of LENSTAR with other techniques of biometry

Jasvinder S, Khang TF, Sarinder KK, Loo VP, Subrayan V

Eye (Lond), 2011 Jun;25(6):717-24.

PMID: 21394115 DOI: 10.1038/eye.2011.28

To assess the agreement of the optical low-coherence reflectometry (OLCR) device LENSTAR LS900 with partial coherence interferometry (PCI) device IOLMaster and applanation and immersion ultrasound biometry.

Endogenous Cushing syndrome from an ectopic adrenocorticotropic hormone production as a rare cause of ocular hypertension

Khaw KW, Jalaludin MY, Suhaimi H, Harun F, Subrayan V

J AAPOS, 2010 Aug;14(4):356-7.

PMID: 20637667 DOI: 10.1016/j.jaapos.2010.04.009

Ocular hypertension caused by endogenous Cushing syndrome from an ectopic adrenocorticotropic hormone-producing tumor is rare. We report an 11-year-old boy who presented with intraocular pressures (IOPs) of 50 mm Hg in both eyes. Surgical resection of the tumor was performed with subsequent normalization of serum cortisol and IOP levels.

Fulltext Iris mammillations in two female siblings with congenital adrenal hyperplasia

Peyman M, Ong MJ, Iqbal T, Subrayan V

BMJ Case Rep, 2010;2010.

PMID: 22802477 DOI: 10.1136/bcr.08.2010.3266

Iris mammillations are dark brown, smooth, mound- or dome-shaped protuberances that are typically found on the anterior iris surface and are presumed to be congenital in origin. This congenital anomaly is usually unilateral and can be hereditary or sporadic. Lisch nodules in neurofibromatosis, tapioca melanoma of the iris, inflammatory iris granulomata and Cogan-Reese syndrome should be considered in the differential diagnosis. In this case report, the authors present a case of a bilateral iris mammillations in two siblings with congenital adrenal hyperplasia (CAH). To our knowledge, this is the first case where bilateral iris mammilations have been found to be associated with a systemic condition. Iris mammillations can be considered as one of the clinical signs in CAH in view of the pathogenesis discussed. Detailed ocular examination in CAH may reveal an increased incidence.

Comparison of B-scan sonographic measurements of optic cup with fundus photographic measurements

Ali NA, Subrayan V, Reddy SC, Othman F

J Clin Ultrasound, 2009 Jun;37(5):285-9.

PMID: 19280658 DOI: 10.1002/jcu.20570

To compare the measurements of the optic cup diameter with B-scan sonography with fundus photography in patients with clear ocular media and to propose a solution for the clinical problem of determining the cup-disc ratio in eyes with opaque ocular media.

Colloid cyst of third ventricle mimicking normal tension glaucoma

Patel DK, Ali NA, Iqbal T, Subrayan V

Ann Ophthalmol (Skokie), 2008;40(3-4):177-9.

PMID: 19230359

Colloid cysts are rare intracranial tumors most commonly found in the third ventricle. We present a case of colloid cyst of the third ventricle that manifested as bilateral advance optic disc cupping, superior hemifield defects in the visual fields and normal intraocular pressure.

Silent sinus syndrome due to a maxillary mucocele

Tan TY, Shashinder S, Subrayan V, Krishnan G

Auris Nasus Larynx, 2008 Jun;35(2):285-7.

PMID: 18024042

Silent sinus syndrome is a rare clinical condition in which patients present with spontaneous enophthalmos and hypoglobus secondary to collapse of orbital floor due to chronic subclinical maxillary sinusitis. It is postulated that obstruction of the osteomeatal complex lead to negative antrum pressure which causes the maxillary sinus atelectasis.

Role of Angiography in Systemic Lupus Erythematosus-Induced Choroiditis

Lee KR, Peng LY, Iqbal TB, Subrayan V

Ocul Immunol Inflamm, 2018;26(8):1146-1149.

PMID: 28362518 DOI: 10.1080/09273948.2017.1298821

PURPOSE: To report a case of systemic lupus erythematosus-induced choroidal vasculitis.

METHODS: A 34-year-old woman with a long-standing history of systemic lupus erythematosus had a sudden painless loss of vision in the right eye over 12 hours. Ocular examination revealed a visual acuity of counting fingers of 1 foot on the right eye and 20/20 on the left. There was a relative afferent pupillary defect on the right side with a pink, distinct optic disk margin.

RESULTS: Optical coherence tomography of the macula and fundus fluorescein angiogram for the eyes were normal. The MRI brain and orbit with the cerebral MRA did not show signs of optic neuritis or occipital vasculitic changes. However, the indocyanine green angiography revealed patches of ill-defined areas of choroidal hypofluorescence in the early- to mid-phase in the macula region.

CONCLUSION: ICGA becomes the crucial tool in unmasking the presence of choroidal vasculitis.

Scanning laser edema index: a reliable tool to correlate with diabetic retinopathy and systemic risk factors?

Peyman M, Tajunisah I, Loo A, Chuah KC, Subrayan V

J Diabetes Complications, 2012 May-Jun;26(3):210-3.

PMID: 22520399 DOI: 10.1016/j.jdiacomp.2012.03.019

To correlate Heidelberg Retina Tomograph (HRT) derived macular edema (DME) index with severity of diabetic retinopathy and systemic factors. A total of 300 diabetic patients were recruited for the study for each of them a value for the macular edema index was obtained using the HRT II. Patients' age, gender, duration and type of diabetes mellitus, latest HbA1c result and presence or absence of co-morbid factors (hypertension, ischemic heart disease, nephropathy) were recorded together with the stage of diabetic retinopathy. These were correlated with DME. Out of 300 patients, HRT defined macula edema was seen in 68 patients (22.6%). There is a wider and higher range (95% percentile) of macula edema index in the severe non proliferative diabetic retinopathy (NPDR) group. Independent samples t test showed significant difference between the severe NPDR group and no DR group (p<0.001), mild NPDR group (p<0.05) and moderate NPDR group (p<0.05). A higher macula edema index was also found to have a low degree of correlation with more advanced stages of retinopathy (r=0.310; p<0.001). Also nephropathy showed a strong and significant correlation with DME. Hypertension had moderately significant correlation with DME. This study found no correlation between ischemic heart disease and DME. HRT derived scanning laser edema index is a reliable objective tool to evaluate diabetic retinopathy and systemic risk factors.

Fulltext Extramedullary plasmacytoma of the eyelid: a case report and review of literature

Lim CC, Soong TK, Chuah KC, Subrayan V

Clin Exp Optom, 2013 May;96(3):349-51.

PMID: 22970978 DOI: 10.1111/j.1444-0938.2012.00797.x

Primary extramedullary plasmacytomas of the eyelid are rare with only five other cases reported in the literature. A 43-year-old Chinese man presented with painless swelling of the left lower eyelid that developed over the past two years. An incisional biopsy and histopathological analysis of the lesion revealed a primary extramedullary plasmacytoma of the eyelid. The tumour was completely excised. There has been no tumour recurrence over the last five years. This tumour should be among those considered when encountering an atypical adnexal lesion. A systemic examination, relevant clinical investigations, as well as life-long monitoring are essential for these patients due to the strong association of extramedullary plasmacytoma with multiple myeloma. When a lesion can be completely resected, surgery provides similar results to radiotherapy.

Intravitreal bevacizumab: a viable treatment for bilateral central retinal vein occlusion with serous macular detachment secondary to Waldenström macroglobulinaemia

Ratanam M, Ngim YS, Khalidin N, Subrayan V

Br J Haematol, 2015 Aug;170(3):431-4.

PMID: 25640801 DOI: 10.1111/bjh.13307

Ocular trauma injuries: a 1-year surveillance study in the University of Malaya Medical Centre, Malaysia. 2008

Soong TK, Koh A, Subrayan V, Loo AV

Graefes Arch Clin Exp Ophthalmol, 2011 Dec;249(12):1755-60.

PMID: 20607549 DOI: 10.1007/s00417-010-1444-4

PURPOSE: To describe the epidemiology of ocular injuries presenting to the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia.

DESIGN: Prospective analysis of all ocular trauma injuries presenting to the Department of Ophthalmology in UMMC from 1 January 2008 to 31 December 2008.

PARTICIPANTS: A total of 603 eyes of 546 patients were recruited for the study.

METHODS: All patients presenting to the department with ocular trauma injuries were assessed by an ophthalmologist. Data on the type and source of injury, demographic profile of the patients, and clinical presentation were documented using a uniform and validated datasheet.

RESULTS: Among eye injury cases, 481 patients (88.1%) were male, with a male-to-female ratio of 7.4:1. Of the patients, 412 (75.5%) were Malaysian while the remaining 134 (24.5%) were of non-Malaysian nationality. The average age was 31.5 years (range 1-81 years). A total of 238 injured eyes (43.6%) were work-related. The common sources of eye trauma include the use of high-powered tools (30.8%), motor vehicle accident (23.1%), and domestic accidents (17.7%). Only six patients (2.5%) reported to having used eye protective device (EPD) at time of their work-related injuries.

CONCLUSIONS: A major cause of preventable ocular injuries in Malaysia was work-related trauma. Ocular injuries can be reduced by the use of eye protection devices and the implementation of appropriate preventive strategies to address each risk factor. Effective training is an integral part of occupational safety and health, which should be made mandatory at the workplace. In addition, there should be a continual assessment of safety and health issues at the workplace. A long-term database of all ocular injuries in Malaysia is recommended, to aid research on a larger scale and the development of new preventive strategies for ocular injuries.

The Effect of Irradiated Riboflavin in Human Tenon's Fibroblast - A Study on Cellular Viability

See WYN, Ismail F, Sheikh Abdul Kadir SH, Subrayan V

Curr Eye Res, 2021 Dec 29.

PMID: 34963422 DOI: 10.1080/02713683.2021.2011326

PURPOSE/ AIM: The main purpose of this work is to study the cellular viability effect of irradiated riboflavin in cultured human tenon fibroblasts.

MATERIALS AND METHODS: The tenon tissue was harvested from a patient undergoing strabismus surgery. The human tenon fibroblast cell culture and isolation were performed according to the standard laboratory cell culturing protocol. The cells were divided into three groups: control, treatment with irradiated and non-irradiated riboflavin. There were five different concentrations (0.00156%, 0.003125%, 0.00625%, 0.0125%, 0.025%) in each group of riboflavin. The fibroblasts were treated with riboflavin and the cellular viability was assessed at 24-hour and 48-hour post treatment with MTT 3-(4,5-dimethylthiazolyl-2)-2,5-diphenyl tetrazolium bromide colorimetric assay. The absorbance values were analysed using Magellan microplate reader data analysis. A triplicate of readings was taken. The data were presented as mean ± standard deviation of the triplicates. Statistical analysis was performed with Statistical Package for Social Sciences (SPSS) analysis version 23.

RESULTS: Irradiated riboflavin caused a concentration-dependent cell death in human tenon fibroblast cell culture (p

Fulltext Association between Ocular Pseudoexfoliation and Sensorineural Hearing Loss

Singham NV, Zahari M, Peyman M, Prepageran N, Subrayan V

J Ophthalmol, 2014;2014:825936.

PMID: 24864196 DOI: 10.1155/2014/825936

Background. Our study aimed to investigate an association between ocular pseudoexfoliation (PXF) and sensorineural hearing loss (SNHL) and to compare them with age and sex matched controls without pseudoexfoliation. Method. This was a case-control study of 123 patients which included 68 cases with PXF (at least one eye) and 55 controls without pseudoexfoliation. Pure-tone audiometry (PTA) was done for these patients at sound frequencies taken as important for speech comprehension, that is, 250 Hertz (Hz), 500 Hz, 1000 Hz, and 2000 Hz. Results. There were 41 patients with pseudoexfoliation syndrome (PXE) and 27 with pseudoexfoliative glaucoma (PXEG). The majority of patients with hearing loss (60%; n = 51) were PXF patients and the remaining 40% (n = 34) were controls. Below average hearing thresholds were significantly higher in the pseudoexfoliation group compared to the control group (P = 0.01; odds ratio (OR), 3.00; 95% confidence interval (CI), 1.25-7.19). However, there was no significant difference in the mean hearing threshold levels between the three groups (PXE, PXEG, and controls) in either ear (ANOVA, right ear: P = 0.46 and left ear P = 0.36). Conclusion. Our study found an association between PXF and SNHL, confirming that PXF can involve organs in the body other than the eye.

Fulltext Association of potential salivary biomarkers with diabetic retinopathy and its severity in type-2 diabetes mellitus: a proteomic analysis by mass spectrometry

Chee CS, Chang KM, Loke MF, Angela Loo VP, Subrayan V

PeerJ, 2016;4:e2022.

PMID: 27280065 DOI: 10.7717/peerj.2022

AIM/HYPOTHESIS: The aim of our study was to characterize the human salivary proteome and determine the changes in protein expression in two different stages of diabetic retinopathy with type-2 diabetes mellitus: (1) with non-proliferative diabetic retinopathy (NPDR) and (2) with proliferative diabetic retinopathy (PDR). Type-2 diabetes mellitus without diabetic retinopathy (XDR) was designated as control.
METHOD: In this study, 45 saliva samples were collected (15 samples from XDR control group, 15 samples from NPDR disease group and 15 samples from PDR disease group). Salivary proteins were extracted, reduced, alkylated, trypsin digested and labeled with an isobaric tag for relative and absolute quantitation (iTRAQ) before being analyzed by an Orbitrap fusion tribrid mass spectrometer. Protein annotation, fold change calculation and statistical analysis were interrogated by Proteome Discoverer. Biological pathway analysis was performed by Ingenuity Pathway Analysis. Data are available via ProteomeXchange with identifiers PXD003723-PX003725.
RESULTS: A total of 315 proteins were identified from the salivary proteome and 119 proteins were found to be differentially expressed. The differentially expressed proteins from the NPDR disease group and the PDR disease group were assigned to respective canonical pathways indicating increased Liver X receptor/Retinoid X receptor (LXR/RXR) activation, Farnesoid X receptor/Retinoid X receptor (FXR/RXR) activation, acute phase response signaling, sucrose degradation V and regulation of actin-based motility by Rho in the PDR disease group compared to the NPDR disease group.
CONCLUSIONS/INTERPRETATION: Progression from non-proliferative to proliferative retinopathy in type-2 diabetic patients is a complex multi-mechanism and systemic process. Furthermore, saliva was shown to be a feasible alternative sample source for diabetic retinopathy biomarkers.

Displaying publications 21 - 40 of 56 in total