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Fulltext Orbital rhabdomyosarcoma: a case series

Chen, C.Y., Nor Hidayah, A.B., Adil, H.

Malaysian Journal of Medicine and Health Sciences, 2013;9(2):69-72.
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In this paper, we report three cases of orbital rhabdomyosarcoma in different age groups with different histopathologic types. Case 1 is a 10-year old Malay boy who presented with painless proptosis of the left eye. Magnetic resonance imaging (MRI) showed soft tissue mass arising from the lateral rectus muscle. Tissue biopsy revealed rhabdomyosarcoma of embryonal type. Case 2 is a 32-year old Malay man who presented with a progressive left eye proptosis associated with pain and redness. Computed Tomography (CT) scan showed a retrobulbar mass extending medially in the left orbit. Meanwhile, biopsy showed rhabdomyosarcoma of pleomorphic type. Case 3 is a 67-year old Malay woman who presented with proptosis and fungating growth of left orbital region, epistaxis and nasal blockage. CT scan revealed an ill-defined mass filling up the left orbital cavity. Biopsy showed rhabdomyosarcoma of alveolar type. Rhabdomyosarcoma is the most common in childhood but it should be considered as a differential diagnosis of orbital tumours irrespective of age.
Recent Advancements in Fuzzy C-means Based Techniques for Brain MRI Segmentation

Latif G, Alghazo J, Sibai FN, Iskandar DNFA, Khan AH

Curr Med Imaging, 2021;17(8):917-930.
PMID: 33397241 DOI: 10.2174/1573405616666210104111218

BACKGROUND: Variations of image segmentation techniques, particularly those used for Brain MRI segmentation, vary in complexity from basic standard Fuzzy C-means (FCM) to more complex and enhanced FCM techniques.
OBJECTIVE: In this paper, a comprehensive review is presented on all thirteen variations of FCM segmentation techniques. In the review process, the concentration is on the use of FCM segmentation techniques for brain tumors. Brain tumor segmentation is a vital step in the process of automatically diagnosing brain tumors. Unlike segmentation of other types of images, brain tumor segmentation is a very challenging task due to the variations in brain anatomy. The low contrast of brain images further complicates this process. Early diagnosis of brain tumors is indeed beneficial to patients, doctors, and medical providers.
RESULTS: FCM segmentation works on images obtained from magnetic resonance imaging (MRI) scanners, requiring minor modifications to hospital operations to early diagnose tumors as most, if not all, hospitals rely on MRI machines for brain imaging.
CONCLUSION: In this paper, we critically review and summarize FCM based techniques for brain MRI segmentation.
Fulltext Candida glabrata endophthalmitis following penetrating keratoplasty in a patient with negative donor rim culture

Muzaliha MN, Adil H, Ibrahim M, Shatriah I

BMC Ophthalmol, 2010;10:18.
PMID: 20537193 DOI: 10.1186/1471-2415-10-18

Candida glabrata endophthalmitis following keratoplasty is rare and almost always associated with positive donor rim culture.
Orbital rhabdomyosarcoma in an HIV positive child

Khairy-Shamel ST, Shatriah I, Adil H, Zunaina E, Bakiah S, Rohaizan Y, et al.

Orbit, 2008;27(5):388-90.
PMID: 18836940 DOI: 10.1080/01676830802336629

We reported a case of orbital rhabdomyosarcoma with an intracranial extension in an HIV-infected child. It was an uncommon sarcoma in a retroviral-positive patient that resulted in a diagnostic and therapeutic dilemma. The child is currently asymptomatic following surgery, chemotherapy, and reinstitution of highly active retroviral therapy (HAART).
Fulltext Successful treatment of syphilitic uveitis in HIV-positive patients

Nurfahzura MJ, Hanizasurana H, Zunaina E, Adil H

Clin Ophthalmol, 2013;7:1651-4.
PMID: 23986629 DOI: 10.2147/OPTH.S46876

We report successful treatment of syphilitic uveitis in a case series of three Human immunodeficiency virus (HIV)-positive patients at Malaysia's Selayang Hospital eye clinic. All three patients with syphilitic uveitis were male, aged from 23 to 35 years old, with a history of high-risk behaviors. Of the patients, two presented with blurring of vision and only one patient presented with floaters in the affected eye. Ocular examination revealed intermediate uveitis (case 1 and case 3) and panuveitis (case 2). Each patient showed a high Venereal Disease Research Laboratory (VDRL) titer at presentation and they were also newly diagnosed as HIV positive with variable CD4 counts. All three patients responded well to a neurosyphilis regimen of intravenous penicillin G. At 3 months posttreatment, there was reduction in VDRL titer with improvement of vision in the affected eye. Diagnosis of syphilis needs to be ruled out in all cases of uveitis. All syphilitic uveitis cases should have HIV screening and vice versa, as syphilis is one of the most common infectious diseases associated with HIV-positive patients. Early detection and treatment are important for a good visual outcome.

Study site: opthamolagy clinic, Hospital Selayang
Fulltext Neuroretinitis in ocular bartonellosis: a case series

Raihan AR, Zunaina E, Wan-Hazabbah WH, Adil H, Lakana-Kumar T

Clin Ophthalmol, 2014;8:1459-66.
PMID: 25120352 DOI: 10.2147/OPTH.S63667

We report a case series of neuroretinitis in ocular bartonellosis and describe the serologic verification for Bartonella henselae. This is a retrospective interventional case series of four patients who presented in the ophthalmology clinic of Hospital Universiti Sains Malaysia from June 2012 to March 2013. All four patients had a history of contact with cats and had fever prior to ocular symptoms. Each patient presented with neuroretinitis characterized by optic disc swelling with macular star. Serology analysis showed strongly positive for B. henselae in all of the patients. All patients were treated with oral azithromycin (except case 4, who was treated with oral doxycycline), and two patients (case 1 and case 3) had poor vision at initial presentation that warranted the use of oral prednisolone. All patients showed a good visual outcome except case 3. Vision-threatening ocular manifestation of cat scratch disease can be improved with systemic antibiotics and steroids.
Study site: Ophthalmology clinic, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
Fulltext A Rare Ocular Manifestation of Idiopathic Hypertrophic Cranial Pachymeningitis

Lee JEH, Subramaniam S, Cheah CF, Chan KH, Adil H

Cureus, 2021 Dec;13(12):e20633.
PMID: 35106199 DOI: 10.7759/cureus.20633

Idiopathic hypertrophic cranial pachymeningitis (IHCP) is a rare form of thickening of the dura mater. There are limited reports on the ocular manifestation of IHCP and its treatment. Up to our knowledge, there is no report on bilateral superior ophthalmic veins (SOV) dilatation with IHCP and there are only a few reports on anterior scleritis with IHCP. We report a 62-year-old gentleman with underlying hypertension and chronic headache who presented with fever, headache, and unresolving both eyes redness as manifestations of bilateral anterior scleritis, anterior uveitis, secondary glaucoma, and multiple cranial nerve palsies. Magnetic resonance imaging of the brain showed global thickening and enhancement of the pachymeninges with bilateral SOV dilatations. The diagnosis of IHCP was made after ruling out infective and autoimmune causes. The patient was treated with oral prednisolone, oral azathioprine, topical timolol maleate, topical dexamethasone, and topical moxifloxacin. The patient was successfully treated and was stable throughout two years review. In conclusion, unresolved red eyes with headaches can be an early presentation of IHCP. Pathophysiology and treatment of the ocular manifestations and IHCP were discussed.
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.
Fulltext Open globe injury in Hospital Universiti Sains Malaysia - A 10-year review

Madhusudhan AP, Evelyn-Tai LM, Zamri N, Adil H, Wan-Hazabbah WH

Int J Ophthalmol, 2014;7(3):486-90.
PMID: 24967196 DOI: 10.3980/j.issn.2222-3959.2014.03.18

To identify the aetiology of open globe injuries at Hospital Universiti Sains Malaysia over a period of 10y and the prognostic factors for visual outcome.
Fulltext Comparison of peripapillary retinal nerve fiber layer thickness between myopia severity groups and controls

Tai ELM, Ling JL, Gan EH, Adil H, Wan-Hazabbah WH

Int J Ophthalmol, 2018;11(2):274-278.
PMID: 29487819 DOI: 10.18240/ijo.2018.02.16

AIM: To compare the peripapillary retinal nerve fiber layer (RNFL) thickness measuredviaoptical coherence tomography (OCT) between different groups of myopia severity and controls.
METHODS: This was a prospective cross-sectional study. All subjects underwent a full ophthalmic examination, refraction, visual field analysis and A-scan biometry. Myopic patients were classified as low myopia (LM) [spherical equivalent (SE) from greater than -0.5 D, up to -3.0 D], moderate myopia (MM; SE greater than -3.0 D, up to -6.0 D) and high myopia (HM; SE greater than -6.0 D). The control group consisted of emmetropic (EM) patients (SE from +0.5 D to -0.5 D). A Zeiss Cirrus HD-OCT machine was used to measure the peripapillary RNFL thickness of both eyes of each subject. The mean peripapillary RNFL thickness between groups was compared using both analysis of variance and analysis of covariance.
RESULTS: A total of 403 eyes of 403 subjects were included in this study. The mean age was 31.48±10.23y. There were 180 (44.7%) eyes with EM, 124 (30.8%) with LM, 73 (18.1%) with MM and 26 (6.5%) with HM. All groups of myopia severity had a thinner average RNFL than the EM group, but after controlling for gender, age, and axial eye length, only the HM group differed significantly from the EM group (P=0.017). Likewise, the superior, inferior and nasal RNFL was thinner in all myopia groups compared to controls, but after controlling for confounders, only the inferior quadrant RNFL was significantly thinner in the HM group, when compared to the EM group (P=0.017).
CONCLUSION: The average and inferior quadrant RNFL is thinner in highly myopic eyes compared to emmetropic eyes. Refractive status must be taken into consideration when interpreting the OCT of myopic patients, as RNFL thickness varies with the degree of myopia.