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Fulltext Fatal Orbital Cellulitis With Intracranial Abscess: A Case Report

Teoh RJJ, Lai YP, Alias R

Cureus, 2023 Jul;15(7):e42435.
PMID: 37637668 DOI: 10.7759/cureus.42435

Orbital cellulitis is a sight- and life-threatening condition. Prompt diagnosis and immediate intervention are required. We report a case of fatal odontogenic orbital cellulitis complicated with intracranial abscesses in a 55-year-old gentleman. The patient presented with painful swelling of the left eye associated with reduced eye movement, blurry vision, and a headache. There was generalized periodontitis. Initial imaging was suggestive of left eye orbital cellulitis with intracranial abscess, and intensive systemic antibiotic therapy was initiated. After six weeks of antibiotic therapy, there was an improvement in ocular signs and symptoms. However, the patient developed signs of meningism with a persistent fever. Serial brain imaging demonstrated worsening intracranial abscesses. The patient died eight weeks after the initial onset of presentation. This case emphasized that brain abscesses could be a fatal complication of odontogenic orbital cellulitis. A high index of suspicion is important in diagnosing orbital cellulitis and its complications. Early consideration of surgical intervention is necessary in cases not responding to antibiotic therapy.
Acquired proptosis and progressive abducens nerve palsy due to overpacked coiling material: rare sequelae of endovascular treatment for carotid cavernous fistula

Teoh RJJ, Ain Masnon N, Bahari NA, Ch'ng LS

BMJ Case Rep, 2023 Oct 10;16(10).
PMID: 37816571 DOI: 10.1136/bcr-2023-255406
Fulltext A 2-year longitudinal evaluation of the iStent inject® system for open-angle glaucoma in East Asian eyes

Teoh RJJ, Yogesvaran R, Cheng FFY, Muji R

Oman J Ophthalmol, 2025;18(1):28-32.
PMID: 40124440 DOI: 10.4103/ojo.ojo_223_23

BACKGROUND: The aim of the study was to assess the midterm efficacy and safety of the iStent glaucoma device in patients with open-angle glaucoma (OAG).
MATERIALS AND METHODS: We conducted a retrospective case series of all patients implanted with iStent inject® in OAG. Primary outcomes included intraocular pressure (IOP) and the reduction of antiglaucoma medications. Safety outcomes comprised adverse complications, additional surgeries, and postoperative best-corrected visual acuity (BCVA).
RESULTS: Eight eyes from eight patients were included in this series. The mean age was 56.3 ± 17.5 years. Six eyes had primary OAG and two eyes had secondary OAG. The majority of eyes (75%) had mild-to-moderate glaucoma. Five eyes underwent combined surgery, whereas the remaining three eyes underwent a standalone procedure. The mean baseline IOP was 22.9 ± 8.2 mmHg, and the mean IOP at 2 years after the procedure was 13.6 ± 2.8 mmHg. There was a 44.5% (10.2 ± 2.5 mmHg; P = 0.002) IOP reduction over 2 years. There was also a reduction in medication burden from a baseline mean of 3.4 ± 0.7 to 2.0 ± 1.2 (P = 0.17). There was no documented intraoperative adverse complication, whereas one patient required trabeculectomy post iStent for IOP control.
CONCLUSION: iStent inject implantation safely reduced IOP and medication burden up to 24 months postoperative.
Falls, frailty, and metabolic syndrome in urban dwellers aged 55 years and over in the Malaysian elders longitudinal research (MELoR) study - a cross-sectional Study

Teoh RJJ, Mat S, Khor HM, Kamaruzzaman SB, Tan MP

Postgrad Med, 2021 Apr;133(3):351-356.
PMID: 33143493 DOI: 10.1080/00325481.2020.1842026

OBJECTIVES: While metabolic syndrome, falls, and frailty are common health issues among older adults which are likely to be related, the potential interplay between these three conditions has not previously been investigated. We investigated the relationship between metabolic syndrome with falls, and the role of frailty markers in this potential relationship, among community-dwelling older adults.
METHODS: Data from the first wave Malaysian Elders Longitudinal Research (MELoR) study comprising urban dwellers aged 55 years and above were utilized. Twelve-month fall histories were established during home-based, computer-assisted interviews which physical performance, anthropometric and laboratory measures were obtained during a hospital-based health check. Gait speed, exhaustion, weakness, and weight loss were employed as frailty markers.
RESULTS: Data were available for 1415 participants, mean age of 68.56 ± 7.26 years, 57.2% women. Falls and metabolic syndrome were present in 22.8% and 44.2%, respectively. After adjusting for age, sex, and multiple comorbidities, metabolic syndrome was significantly associated with falls in the sample population [odds ratio (OR): 1.33, 95% confidence interval (CI): 1.03; 1.72]. This relationship was attenuated by the presence of slow gait speed, but not exhaustion, weakness, or weight loss.
CONCLUSION: Metabolic syndrome was independently associated with falls among older adults, and this relationship was accounted for by the presence of slow gait speed. Future studies should determine the value of screening for frailty and falls with gait speed in older adults with metabolic syndrome as a potential fall prevention measure.