METHODS: Thirty nine eyes of 39 new keratoconus patients were selected and randomly fitted with two types of RGP contact lenses. Group 1 had 21 eyes with regular rigid gas-permeable (RRGP) contact lens and rest 18 eyes were in group 2 with specially designed rigid gas-permeable (SRGP) contact lens. Corneal cell morphology was evaluated using a slit scanning confocal microscope at no-lens wear and after 1y of contact lens wearing.
RESULTS: After 1y of contact lens wearing in group 1, the mean anterior and posterior stromal keratocyte density were significantly less (P=0.006 and P=0.001, respectively) compared to no-lens wear. The mean cell area of anterior and posterior stromal keratocyte were also significantly different (P=0.005 and P=0.001) from no-lens wear. The anterior and posterior stromal haze increased by 18.74% and 23.81%, respectively after 1y of contact lens wearing. Whereas in group 2, statistically significant changes were observed only in cell density & area of anterior stroma (P=0.001 and P=0.001, respectively) after 1y. While, level of anterior and posterior stromal haze increased by 16.67% and 11.11% after 1y of contact lens wearing. Polymegathism and pleomorphism also increased after 1y of contact lens wearing in both the contact lens groups.
CONCLUSION: Confocal microscopy observation shows the significant alterations in corneal cell morphology of keratoconic corneas wearing contact lenses especially in group 1. The type of contact lens must be carefully selected to minimize changes in corneal cell morphology.
METHODS: This is an open-labeled, randomized, prospective crossover study on fourty primary open angle glaucoma patients. Two weeks of washout period were followed by randomization to either once daily (OD, group A) or twice daily dosing (BD, group B) of LTFC for 4wk. After another 2-week washout period, the patients' treatment dose was crossed-over for another 4wk. IOP reduction alongside ocular and systemic side effects were evaluated.
RESULTS: Mean baseline IOP was 18.57±2.93 and 17.8±3.01 mm Hg before OD and BD dose respectively, (P=0.27). Mean IOP after BD dose was statistically lower (12.49±1.59 mm Hg) compared to OD (13.48±1.81 mm Hg, P=0.017). Although IOP reduction after BD dose was more (5.32±3.24 mm Hg, 29.89%) than after OD dosing (5.04 mm Hg, 27.14%), it did not reach statistical significance (P=0.68). Patients switched from OD to BD (group A) showed mean IOP reduction by 0.69 mm Hg [95% confidence interval (CI): -0.09 to 1.48 mm Hg, P=0.078]; but patients switched from BD to OD (group B) had significantly higher mean IOP by 1.25 mm Hg (95%CI: -2.04 to -0.46 mm Hg, P=0.006). BD dose had more ocular side effects albeit mild.
CONCLUSION: Mean IOP after LTFC dosed twice daily is statistically lower, with additional mild side effects.
METHODS: ARPE-19 cells were cultured in Dulbecco's Modified Eagle Medium-F-12 supplemented with 10% foetal bovine serum and 1% penicillin-streptomycin in a humidified 5% CO2 incubator maintained at 37°C. Cells were treated with 247 µmol/L lutein, 49 µmol/L zeaxanthin and 1% (v/v) of either coconut oil, corn oil, peanut oil, olive oil, sunflower oil, soybean oil, castor oil, or linseed oil for 48h. Lutein and zeaxanthin concentration in the cells were quantified by high performance liquid chromatography.
RESULTS: Among the oils tested, the highest lutein and zeaxanthin uptake was observed with coconut oil while the lowest was observed with linseed oil.
CONCLUSION: ARPE-19 uptake of lutein and zeaxanthin are found to be dependent on the type of oils.
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: 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: We retrospectively evaluated the surgical outcome of the BGI with Supramid© 3/0 ripcord stent in patients with NVG. No tube ligation or venting slits were performed. Supramid was removed after 3mo if the target intraocular pressure (IOP) was not achieved. Surgical success was defined as IOP≤21 mm Hg with (qualified success) or without IOP-lowering medications (complete success).
RESULTS: Twenty-six eyes from 24 patients were included in the study. The median duration of follow-up was 4 [interquartile range (IQR)=1-5]y, ranging from 0.5 to 5y. IOP decreased by a mean of 24.2 mm Hg (59.7%); from a mean of 40.5±12.6 mm Hg at baseline to 16.3±11.9 mm Hg, P≤0.001. The number of glaucoma medications reduced from a median of 5 (IQR=5-6) to 1 (IQR=0-2, P≤0.001) at the final follow-up. Overall success rates were 88.0% at 1y, 34.8% at 3y, 66.7% at 4y, and 50% at 5y. Hypertensive phase (HP) in the first 3mo occurred in 15/26 eyes (57.7%) with a mean IOP of 31.1 mm Hg.
CONCLUSION: BGI with Supramid© ripcord stent gives close to 90% of the overall survival rate at the final follow-up without significant early hypotony. However, early HP is still a challenge.
METHODS: A total of 64 university students were recruited in this study. The validated Malay version of Pittsburgh Sleep Quality Index questionnaire (PSQI-M) was used to measure the participants' sleep quality over the past month. Participants were categorized as good sleepers (n=32) and poor sleepers (n=32) based on the PSQI-M scores. Heterophoria and fusional vergences were measured at distance and near. Mann-Whitney U test was used to compare heterophoria, negative fusional vergence (NFV), and positive fusional vergence (PFV) at distance and near between good and poor sleepers. Spearman correlation analysis was used to study the relationship between PSQI-M score and PFV at distance.
RESULTS: Both distance and near heterophorias were not significantly different between good and poor sleepers (P>0.05). There was a difference in distance PFV (P<0.05) between good and poor sleepers, but not in distance NFV, near NFV, and near PFV (P>0.05). Distance PFV was negatively correlated with PSQI-M score (rs=-0.33, P<0.05).
CONCLUSION: University students with poor sleep quality demonstrates a reduced ability to maintain fusion with increasing convergence demand at distance. Sleep quality assessment during binocular vision examination in university students is recommended.