This was a 28-year-old mentally-challenged girl with underlying congenital Rubella syndrome. She was bilaterally aphakic after congenital cataract surgery. She then developed bilateral aphakic glaucoma and had to undergo multiple glaucoma filtering surgeries. The most recent procedure she had undergone for her left eye was a second Ahmed valve implantation with an overlying sclera patch. Postoperatively, intraocular pressure was well controlled. However, nine months later, slit lamp examination revealed the tube was adherent to the overlying cornea with surrounding deep and superficial cornea vascularization. Siedel test was negative and intraocular pressure was normal. Subsequently the tube was removed but the plate was left in situ.
Central retinal vein occlusion (CRVO) is uncommon among young patients. Among the young adults, CRVO tends to be more benign with good visual prognosis. Macular oedema secondary to retinal vein occlusion is a relatively common complication that is currently being treated with intravitreal anti vascular endothelial growth factor with good outcomes. Other complications include lamellar hole, vitreous hemorrhage and neovascular glaucoma. We report a case of central retinal vein occlusion in a young female who presented to us with the complaint of blurring of vision in the left eye for four months. Fundus examination showed hyperemic optic disc, dilated tortuous vein, extensive retinal hemorrhages with macular oedema and an inferior shallow exudative retinal detachment. One month later, intravitreal ranibizumab injection for her macular oedema, a full thickness macular hole developed with reduction of macular oedema. Four months later, the hole spontaneously closed but her macular oedema persisted. The possibility of rare complications like exudative retinal detachment and full thickness macular hole must be kept in mind to ensure early detection and effective management is provided to preserve vision.
Kajian ini bertujuan untuk mengkaji hubung kait antara diameter kornea dan diameter kanta di kalangan kanak-kanak. Kajian ini melibatkan sejumlah empat puluh kanak-kanak (40 mata) yang kurang daripada 4 tahun yang menjalani pemeriksaan, prosedur atau pembedahan di Hospital Kuala Lumpur dari Januari 2010 sehingga September 2011. Pemeriksaan dijalankan dengan menggunakan bius am di dewan bedah. Diameter kornea diukur dengan ‘Holladay-Godwin cornea gauge’ sementara diameter kanta diukur dengan menggunakan mesin ultrasound yang mempunyai resolusi tinggi ‘ultrasound biomicroscope (UBM)’. Purata umur populasi kajian adalah 24.7 + 12.1 bulan. Purata diameter kornea melintang adalah 11.62 + 0.50 mm, lebih besar berbanding dengan purata diameter kornea menegak yang berukuran 11.20 + 0.58 mm. Purata diameter kanta adalah 7.94 + 0.47 mm. Diameter kornea didapati mempunyai korelasi positif yang sederhana dengan diameter kanta (r=0.479, p=0.002). Terdapat hubung kait yang kukuh di antara diameter kanta dengan umur pesakit (r=0.718, p
Conventional argon laser causes transient thickening of retinal nerve fibre layer (RNFL). The effect of pattern scanning laser (PASCAL) has not been well described. We compared the immediate changes in peripapillary RNFL thickness post-panretinal photocoagulation between conventional argon lasers and PASCAL in patients with diabetic retinopathy changes. A total of 32 subjects were recruited. There were 16 patients in the argon group and 16 patients in PASCAL group. Diabetic patients were recruited from Ophthalmology Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Complete eye examinations and fundus photographs were performed at baseline prior to laser treatment, and post-laser treatment at two and four months. RNFL thickness was measured using time domain optical coherence tomography. Both groups were comparable with respect to clinical characteristics and demographics. There was no significant difference in average RNFL thickness between the two groups prior to treatment (p= 0.323). RNFL post-laser treatment for patients receiving conventional argon laser remained unchanged with no significant differences in all quadrants at any time-point (two and four months). However, for the PASCAL group, significant thickening occurred at four months for average RNFL and the inferior quadrant (p <0.05). The other quadrants similarly demonstrated increasing thickness at four months but this did not reach statistical significance. Transient RNFL thickening occurs in both conventional and PASCAL laser patients. The PASCAL laser induces a greater increase in RNFL thickness than the argon laser group. Important events, such as laser eye treatments and even type of laser used, are worthy of consideration when evaluating RNFL.
Keywords: diabetic retinopathy, optical coherence, photocoagulation, retinal ganglion cells, tomography
Study site: Ophthalmology Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Selulitis orbital merupakan jangkitan tisu di sekitar mata di dalam ruangan orbit yang
termasuk saraf mata. Ia boleh menyebabkan komplikasi yang membawa kematian
sekiranya merebak melalui saraf mata dan ke otak. Penyebab utama jangkitan
adalah termasuk perebakan jangkitan sinusitis dari ruangan paranasal atau melalui
selulitis preseptal. Kes ini menggambarkan jangkitan di luar kebiasaan mengenai
jangkitan orbital selulitis yang berlaku akibat luka torehan pada konjunktiva mata
yang disebabkan oleh kemalangan. Rawatan antibiotik sistemik yang agresif
mengurangkan risiko komplikasi penglihatan. Kesemua luka pada atau sekelililng
mata haruslah dirawat dengan sebaiknya bagi mengelakkan berlakunya komplikasi
yang membahayakan.