METHODS: Case series of three patients with syphilitic uveitis who were managed in Hospital USM.
RESULTS: Three patients were diagnosed to have uveitis secondary to Syphilis. All three patients were not known to have syphilis prior to presentation but have positive history of sexual promiscuity. All patients presented with progressive blurring of vision for average of one-month duration. Two of them have association with fever, ocular pain and floaters. Visual acuity at presentation ranges from 6/12 to hand movement. Mild anterior uveitis (non-granulomatous), vitritis and papillitis were presence in all the patients. First patient has multifocal chorioretinitis with exudative retinal detachment. The second patient presented with exudative retinal detachment while the third patient has chorioretinitis only. All the patients were treated with intramuscular benzyl-penicillin 2.4 MU weekly for 4 weeks and two of them received oral doxycycline 200mg twice daily for 3 months. The uveitis responded well to the treatment and two of them showed dramatic visual improvement from 6/120 to 6/21 and 6/12 to 6/6. The one with worse outcome was confirmed to have positive retroviral.
CONCLUSION: Ocular syphilis presented here as non-granulomatous inflammation associated with exudative retinal detachment. Final visual outcome is generally good despite slow improvement after treatment.
METHODS: A cross-sectional study on sports vision screening was used to evaluate the visual skills of 214 elementary students (107 athletes, 107 non-athletes), aged between 13 and 16y. The visual screening assessed visual parameters such as ocular motor alignment, accommodation, and vergence functions.
RESULTS: Mean visual parameters were compared between age-group matched athletes (mean age 14.82±0.98y) and non-athletes (mean age 15.00±1.04y). The refractive errors of all participants were corrected to maximal attainable best corrected visual acuity of logMAR 0.0. Accommodation function assessment evaluated amplitude of accommodation and accommodation facility. Vergence functions measured the near point of convergence, vergence facility, and distance fusional vergence at break and recovery point. Ocular motor alignment was not statistically significant between both groups. Athletes had a statistically significant amplitude of accommodation for both the right eye (t=2.30, P=0.02) and the left eye (t=1.99, P=0.05). Conversely, non-athletes had better accommodation facility (t=-2.54, P=0.01) and near point of convergence (t=4.39, P<0.001) when compared to athletes. Vergence facility was found to be better among athletes (t=2.47, P=0.01). Nevertheless, non-athletes were significantly better for both distance negative and positive fusional vergence.
CONCLUSION: Although the findings are still inconclusive as to whether athletes had superior visual skills as compared to non-athletes, it remains important to identify and elucidate the key visual skills needed by athletes in order for them to achieve higher performance in their sports.
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.
METHODS: On two different occasions, a panel of 14 retinal specialists from Malaysia, together with an external expert, responded to a questionnaire on management of DME. A consensus was sought by voting after compiling, analyzing and discussion on first-phase replies on the round table discussion. A recommendation was deemed to have attained consensus when 12 out of the 14 panellists (85%) agreed with it.
RESULTS: The terms target response, adequate response, nonresponse, and inadequate response were developed when the DME patients' treatment responses were first characterized. The panelists reached agreement on a number of DME treatment-related issues, including the need to classify patients prior to treatment, first-line treatment options, the right time to switch between treatment modalities, and side effects associated with steroids. From this agreement, recommendations were derived and a treatment algorithm was created.
CONCLUSION: A detail and comprehensive treatment algorithm by Malaysia Retina Group for the Malaysian population provides guidance for treatment allocation of patients with DME.
METHODS: A total of 230 older adults (age ≥60y) participated in this study. Habitual distance and near VA were measured using the Early Treatment Diabetic Retinopathy Study Chart and Lighthouse Near Visual Acuity Chart, respectively. Global cognitive function was assessed using the Mini-Mental State Examination (M-MSE) and the Malay language version of the Montreal Cognitive Assessment (M-MoCA). Digit Symbol (DS) subtest was used to measure information processing.
RESULTS: No significant association was observed between vision and M-MSE and M-MoCA scores. However, poor distance and near VA were found to be significantly associated with low DS scores [distance VA: β=-0.01, R 2=0.1, P=0.02; odds ratio (OR)=2.84, 95% confidence interval (CI), 1.10-7.33, P=0.03; near VA: β=-0.05, R 2=0.08, P=0.00; OR=3.32, 95%CI, 1.28-8.59, P=0.01].
CONCLUSION: Poor vision is associated with a decline in information processing in older adults and substantiates the importance of preserving good vision in maintaining cognitive function.
METHODS: Retrospective cohort. Data was collected from charts of all PACD patients treated from April 2013 to December 2015. Analysis was done on 137 patient charts with complete biometric data. Patient demographics, PACD type, refractive status (spherical equivalent), ACD and AL were studied.
RESULTS: The median age of 137 subjects [53 with primary angle-closure suspects (PACS), 27 with primary angle-closure (PAC) and 57 with primary angle-closure glaucoma (PACG)] was 68y (range 21-88y). The majority was Chinese (n=68; 49.6%) and most of them were women (n=75; 54.7%). The distribution of myopia (n=51; 37.2%) and hyperopia (n=49; 35.8%) was similar. The ACD was shallower in myopes compared to hyperopes (P=0.02) and emmetropia (P=0.049) but the AL was not significantly different between groups. There were no patients blind from PACG.
CONCLUSION: Both myopia and hyperopia can occur in PACD. Despite a shallower ACD in angle closure myopes, the AL was not different between groups.
METHODS: Sprague Dawley rats, 180-250 g in weight were divided into four groups. Groups 1, 2, 3 and 4 were intravitreally administered with vehicle and NMDA at the doses 80, 160 and 320 nmol respectively. Seven days after injection, rats were euthanized, and their eyes were taken for optic nerve toluidine blue and retinal hematoxylin and eosin stainings. The TUNEL assay was done for detecting apoptotic cells.
RESULTS: All groups treated with NMDA showed significantly reduced ganglion cell layer (GCL) thickness within inner retina, as compared to control group. Group NMDA 160 nmol showed a significantly greater GCL thickness than the group NMDA 320 nmol. Administration of NMDA also resulted in a dose-dependent decrease in the number of nuclei both per 100 µm GCL length and per 100 µm2 of GCL. Intravitreal NMDA injection caused dose-dependent damage to the optic nerve. The degeneration of nerve fibres with increased clearing of cytoplasm was observed more prominently as the NMDA dose increased. In accordance with the results of retinal morphometry analysis and optic nerve grading, TUNEL staining demonstrated NMDA-induced excitotoxic retinal injury in a dose-dependent manner.
CONCLUSION: Our results demonstrate dose-dependent effects of NMDA on retinal and optic nerve morphology in rats that may be attributed to differences in the severity of excitotoxicity and oxidative stress. Our results also suggest that care should be taken while making dose selections experimentally so that the choice might best uphold study objectives.