Displaying publications 1 - 20 of 33 in total

  1. Mensa-Vilaro A, Tarng Cham W, Ping Tang S, Chin Lim S, González-Roca E, Ruiz-Ortiz E, et al.
    Arthritis Rheumatol, 2016 Apr;68(4):1039-44.
    PMID: 26606664 DOI: 10.1002/art.39519
    Blau syndrome is characterized by noncaseating granulomatous arthritis, dermatitis, and uveitis, and results from gain-of-function NOD2 mutations. This study was undertaken to identify the genetic cause of the disease in a family with 3 members with Blau syndrome.
    Matched MeSH terms: Uveitis
  2. Choo MM, Jaais F
    Med J Malaysia, 2002 Jun;57(2):225-8.
    PMID: 24326658
    "Cauliflower Ears" describes the appearance of swelling of the auricular cartilage resulting in gross distortion of the auricle. The underlying pathology is inflammation of the auricular cartilage. We report a case of a patient who presented to the ophthalmology clinic with an ocular inflammation, whose subsequent diagnosis of replapsing polychondritis was clinched with the finding of "Cauliflower Ears". This case emphasizes the importance of an appropriate general examination of ophthalmic patients for early diagnosis and prompt institution of medical treatment, which may prevent life-threatening complications to the patient.
    Study site: Eye clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Uveitis, Anterior*
  3. Agrawal R, Testi I, Mahajan S, Yuen YS, Agarwal A, Rousselot A, et al.
    Ocul Immunol Inflamm, 2020 Apr 06.
    PMID: 32250731 DOI: 10.1080/09273948.2020.1716025
    An international, expert led consensus initiative was set up by the Collaborative Ocular Tuberculosis Study (COTS) group to develop systematic, evidence, and experience-based recommendations for the treatment of ocular TB using a modified Delphi technique process. In the first round of Delphi, the group identified clinical scenarios pertinent to ocular TB based on five clinical phenotypes (anterior uveitis, intermediate uveitis, choroiditis, retinal vasculitis, and panuveitis). Using an interactive online questionnaires, guided by background knowledge from published literature, 486 consensus statements for initiating ATT were generated and deliberated amongst 81 global uveitis experts. The median score of five was considered reaching consensus for initiating ATT. The median score of four was tabled for deliberation through Delphi round 2 in a face-to-face meeting. This report describes the methodology adopted and followed through the consensus process, which help elucidate the guidelines for initiating ATT in patients with choroidal TB.
    Matched MeSH terms: Uveitis; Panuveitis; Uveitis, Intermediate
  4. 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
    Matched MeSH terms: Uveitis*
  5. Deva JP
    Med J Malaysia, 1977 Mar;31(3):241-3.
    PMID: 904520
    Matched MeSH terms: Uveitis/complications*
  6. Payman, A.K., Tajunisah, I., Ahmad, F.
    Glaucoma is a major cause of permanent visual loss in patients with sarcoid uveitis.In this case glaucoma occurred early in the course of the disease and IOP started to rise up after one month from the initial presentation. Uveitic glaucoma can be extremely difficult to treat; pilocarpine is not normally used in eyes with active inflammation. Patients with uveitis respond poorly to laser trabeculoplasty, and filtering procedures usually fail. Success of modified goniotomy, trabeculectomy and Molteno valve implantation were reported. More drastic therapy, such as cyclodestructive procedures, may be required in the most severe cases. In this case the challenge in preserving the vision. by keeping the balance between the need to control the inflammation and the necessity to avoid the treatment related complications.
    Matched MeSH terms: Uveitis
  7. Ee CL, Sockalingam S, Kamalden TA
    Postgrad Med J, 2018 Jul;94(1113):417.
    PMID: 29907697 DOI: 10.1136/postgradmedj-2018-135560
    Matched MeSH terms: Uveitis/diagnosis; Uveitis/drug therapy; Uveitis/etiology*
  8. Thirupathy A, Tajunisah I
    Ocul Immunol Inflamm, 2011 Jun;19(3):156-7.
    PMID: 21595530 DOI: 10.3109/09273948.2011.555593
    To report a rare case of intermediate uveitis following rubella infection in pregnancy.
    Matched MeSH terms: Uveitis, Intermediate/complications; Uveitis, Intermediate/pathology; Uveitis, Intermediate/virology*
  9. Zurainee MN, Khairul Anuar A, Fong MY, Hoh HB, Choon J, Rahmah N
    JUMMEC, 2000;5:98-102.
    During the period 1996-1998, 134 patients suspected of having ocular toxoplasmosis were seen in the Ophthalmology Clinic of the University Hospital, Kuala Lumpur. Clinical presentations in these patients ranged from poor vision to severe retinal detachment. Of these patients, 72% were confirmed positive for Toxoplasma gondii infection by serological methods. Chorioretinjtis and vitritis were found to be the most apparent symptoms, both having 100%correlation with serological positivity, This was followed by uveitis, floaters, and retinal detachment with correlation at 78%, 75%and 75%, respectively. However, there was no correlation between level of serotitre and ocular presentations. KEYWORDS: Toxoplasmosis, serology, chorioretinitis, uveitis
    Matched MeSH terms: Uveitis
  10. Shankar Ganesh, K.
    Jurnal Veterinar Malaysia, 2017;29(2):25-26.
    The livestock industry has been relying merely on chemically synthesized antibiotic for eye infections as sprays and ointment. A natural remedy from Curcuma spp. has been tested for efficacy in curing keratoconjunctivitis and uveitis. A severe case of uveitis has been cured within 7 days, with impaired vision restored. These results are observations of a preliminary study conducted in a goat with uveitis.
    Matched MeSH terms: Uveitis
  11. Siak J, Jansen A, Waduthantri S, Teoh CS, Jap A, Chee SP
    Ocul Immunol Inflamm, 2017;25(sup1):S81-S93.
    PMID: 27419535 DOI: 10.1080/09273948.2016.1188968
    PURPOSE: To describe the pattern of uveitis among Chinese, Malays, and Indians at a tertiary referral institution in Singapore.

    METHODS: Charts between January 1997 and December 2010 were retrospectively reviewed. Charts between January 2014 and December 2014 were prospectively reviewed.

    RESULTS: A total of 1249 and 148 charts were retrospectively and prospectively reviewed, respectively. The top causes of anterior uveitis (AU) were HLA-B27, idiopathic, and CMV AU. The top known causes of intermediate uveitis were tuberculosis, primary intraocular lymphoma, and sarcoidosis. The top causes of posterior uveitis were CMV retinitis, toxoplasmosis, and dengue maculopathy. The top causes of panuveitis were VKH, idiopathic panuveitis, tuberculosis, and Behçet disease. HLA-B27 and CMV AU were more frequent among Chinese (21% vs 9% (non-Chinese); p<0.001; 10% vs 5% (non-Chinese); p<0.001, respectively). Tuberculous uveitis was more frequent among Malays and Indians (12% (non-Chinese) vs 5% (Chinese), p<0.001).

    CONCLUSIONS: Different uveitis patterns were encountered among patients of different races.

    Matched MeSH terms: Uveitis/classification; Uveitis/ethnology*; Uveitis/etiology
  12. Agrawal R, Agarwal A, Jabs DA, Kee A, Testi I, Mahajan S, et al.
    Ocul Immunol Inflamm, 2019 Dec 10.
    PMID: 31821096 DOI: 10.1080/09273948.2019.1653933
    Purpose: To standardize a nomenclature system for defining clinical phenotypes, and outcome measures for reporting clinical and research data in patients with ocular tuberculosis (OTB).Methods: Uveitis experts initially administered and further deliberated the survey in an open meeting to determine and propose the preferred nomenclature for terms related to the OTB, terms describing the clinical phenotypes and treatment and reporting outcomes.Results: The group of experts reached a consensus on terming uveitis attributable to tuberculosis (TB) as tubercular uveitis. The working group introduced a SUN-compatible nomenclature that also defines disease "remission" and "cure", both of which are relevant for reporting treatment outcomes.Conclusion: A consensus nomenclature system has been adopted by a large group of international uveitis experts for OTB. The working group recommends the use of standardized nomenclature to prevent ambiguity in communication and to achieve the goal of spreading awareness of this blinding uveitis entity.
    Matched MeSH terms: Uveitis
  13. Ghanimi Zamli AK, Irma Ngah NS, Chew-Ean T, Muhammed J, Wan Hitam WH, Hussein A, et al.
    Cureus, 2019 Feb 05;11(2):e4015.
    PMID: 31007973 DOI: 10.7759/cureus.4015
    Introduction Ocular syphilis is a sight-threatening condition. It can occur at any stage of syphilis infection, which present either with acute inflammation during the primary, secondary, and early latent stages or with chronic inflammation during tertiary infection, affecting virtually every ocular structure. This study was to report on the clinical presentation of ocular syphilis that presented to eye clinic Hospital Universiti Sains Malaysia. Methodology This was a retrospective study where medical records of ocular syphilis patients who attended eye clinic in Hospital Universiti Sains Malaysia from January 2013 to June 2017 were reviewed. Results A total of 10 patients (13 eyes) with ocular syphilis were identified out of 106 cases that presented with ocular inflammation. The mean age of presentation was 69.8 ± 6.4 years and seven of them (70%) were female. All patients were Malay and human immunodeficiency virus (HIV) was negative. The ocular manifestations included panuveitis (four eyes, 30.8%), anterior uveitis (two eyes, 15.4%), posterior uveitis (seven eyes, 53.8%) and optic neuritis (two eyes, 15.4%). Seven (53.8%) eyes presented with visual acuity of worse than 6/60, five (38.5%) eyes had visual acuity between 6/15 to 6/60, and one (7.7%) eye had visual acuity of 6/12 or better. Nine patients received an intravenous benzylpenicillin regime and one patient received an intramuscular penicillin injection. Out of 13 eyes affected, 11 (84.6%) eyes had improved visual acuity of at least one Snellen line after treatment. Visual acuity of 6/12 or better increased to four (30.8%) eyes. Conclusions Posterior uveitis was the commonest presentation of ocular syphilis in HIV-negative patients. Early detection and treatment of ocular syphilis can result in resolution of inflammation and improvement of vision.
    Matched MeSH terms: Uveitis, Anterior; Uveitis, Posterior
  14. Yap JF, Wai YZ, Ng QX, Lim LT
    J Med Case Rep, 2019 May 06;13(1):131.
    PMID: 31056080 DOI: 10.1186/s13256-019-2064-1
    BACKGROUND: This is a case report of an iatrogenic intralenticular broken steroid (Ozurdex™) implant in a patient with uveitis. There are only a few case reports on broken Ozurdex™ implants in the vitreous cavity, with none of them involving the crystalline lens. A few authors have described the accidental injection of an Ozurdex™ implant into the crystalline lens, but all of the implants remained in one piece in the lens and none of them were broken. We report an unusual case of an Ozurdex™ implant which was injected inadvertently into the crystalline lens, resulting in a broken Ozurdex™ implant with an entry and exit wound through the posterior capsule of the lens.

    CASE PRESENTATION: An ophthalmic trainee performed an Ozurdex™ intravitreal injection into a 48-year-old Asian man's right eye under aseptic conditions. This patient was then followed up for further management. On day 7 post-procedure, a slit lamp examination revealed that the Ozurdex™ implant was injected into the intralenticular structure of his right eye and had fractured into two pieces. The posterior capsule of the right lens was breached, with one half of the Ozurdex™ implant stuck at the entry and the other stuck at the exit wound of the posterior capsule. This patient underwent right eye cataract extraction and repositioning of the fractured implant; he made an uneventful recovery.

    CONCLUSIONS: Ophthalmologists should be aware of the potential risk of injecting an Ozurdex™ implant into an anatomical structure other than the vitreous cavity. Adequate training and careful administration of the Ozurdex™ implant are necessary to avoid such a complication, which fortunately is rare.

    Matched MeSH terms: Uveitis/drug therapy*
  15. Nimsuphan B, Prasroedsang S, Kengradomkij C, Thayananuphat A, Kromkhun P
    Trop Biomed, 2020 Sep 01;37(3):551-559.
    PMID: 33612770 DOI: 10.47665/tb.37.3.551
    Uveitis associated with Ehrlichia canis or Anaplasma platys infections were reported in dogs. However, only two E. canis-infected dogs with hypergammaglobulinemia showed acute blindness were reported. There were limited data of the species of Ehrlichia or Anaplasma and the alteration of serum protein fractions in infected dogs. Thus, the species of causative pathogen were investigated and compared the serum protein fractions between infected dogs associated with anterior uveitis and panuveitis in clinical situations. All 103 studied dogs were brought into the ophthalmology clinic which each dog showed signs of unilateral or bilateral uveitis related to ehrlichial infection. Dogs were divided into anterior uveitis and panuveitis groups. The species of Ehrlichia or Anaplasma were identified using nested-PCR based on the 16S rRNA gene and DNA sequencing from blood samples. The serum protein fractions were analyzed using electrophoresis. Fifty-eight dogs (56.31%) were positive of which E. canis and A. platys were detected in 51 and 7 dogs, respectively. The total serum protein and globulin levels were higher in the infected dogs associated with panuveitis than anterior uveitis while the albumin levels were significantly lower in the panuveitis group. The A/G ratios significantly decreased in both groups. Gamma globulin was detected at high levels in both groups while beta globulin significantly increased in the panuveitis group. Hypergammaglobulinemia was detected in 76.92 and 90.90% of infected dogs associated with anterior uveitis and panuveitis, respectively. Most of the infected dogs associated with panuveitis showed significantly levels of hyperproteinemia, hyperbetaglobulinemia and hypergammaglobulinemia compared with anterior uveitis group. E. canis was found as the major pathogen in infected dogs associated with uveitis in this study.
    Matched MeSH terms: Uveitis; Uveitis, Anterior; Panuveitis
  16. Greuter T, Bertoldo F, Rechner R, Straumann A, Biedermann L, Zeitz J, et al.
    J Pediatr Gastroenterol Nutr, 2017 08;65(2):200-206.
    PMID: 27801751 DOI: 10.1097/MPG.0000000000001455
    BACKGROUND: There is a paucity of data on extraintestinal manifestations (EIM) and their treatment in pediatric patients with inflammatory bowel disease (IBD).

    METHODS: Since 2008, the Pediatric Swiss IBD Cohort Study has collected data on the pediatric IBD population in Switzerland. Data on 329 patients were analyzed retrospectively.

    RESULTS: A total of 55 patients (16.7%) experienced 1-4 EIM (39 Crohn disease, 12 ulcerative colitis, and 4 IBD-unclassified patients). At IBD onset, presence of EIM was more frequent than in the adult population (8.5% vs 5.0%, P = 0.014). EIM were more frequent in Crohn disease when compared to ulcerative colitis/IBD-unclassified (22.5% vs 10.3%, P = 0.003). The most prevalent EIM were peripheral arthritis (26/329, 7.9%) and aphthous stomatitis (24/329, 7.3%). Approximately 27.6% of all EIM appeared before IBD diagnosis. Median time between IBD diagnosis and occurrence of first EIM was 1 month (-37.5-149.0). Thirty-one of the 55 patients (56.4%) were treated with 1 or more anti-tumor necrosis factor (TNF) agents. IBD patients with EIM were more likely to be treated with anti-TNF compared to those without (56.4% vs 35.0%, P = 0.003). Response rates to anti-TNF depended on underlying EIM and were best for peripheral arthritis (61.5%) and uveitis (66.7%).

    CONCLUSIONS: In a cohort of pediatric patients with IBD, EIM were frequently encountered. In up to 30%, EIM appeared before IBD diagnosis. Knowledge of these findings may translate into an increased awareness of underlying IBD, thereby decreasing diagnostic delay. Anti-TNF for the treatment of certain EIM is effective, although a substantial proportion of new EIM may present despite ongoing anti-TNF therapy.

    Matched MeSH terms: Uveitis/diagnosis; Uveitis/drug therapy; Uveitis/etiology*; Uveitis/epidemiology
  17. Singh S, Khang TF, Andiappan H, Nissapatorn V, Subrayan V
    Trans R Soc Trop Med Hyg, 2012 May;106(5):322-6.
    PMID: 22480791 DOI: 10.1016/j.trstmh.2012.01.009
    Toxoplasma gondii is a public health risk in developing countries, especially those located in the tropics. Widespread infection may inflict a substantial burden on state resources, as patients can develop severe neurological defects and ocular diseases that result in lifelong loss of economic independence. We tested sera for IgG antibody from 493 eye patients in Malaysia. Overall age-adjusted seroprevalence was estimated to be 25% (95% CI: [21%, 29%]). We found approximately equal age-adjusted seroprevalence in Chinese (31%; 95% CI: [25%, 38%]) and Malays (29%; 95% CI: [21%, 36%]), followed by Indians (19%; 95% CI: [13%, 25%]). A logistic regression of the odds for T. gondii seroprevalence against age, gender, ethnicity and the occurrence of six types of ocular diseases showed that only age and ethnicity were significant predictors. The odds for T. gondii seroprevalence were 2.7 (95% CI for OR: [1.9, 4.0]) times higher for a patient twice as old as the other, with ethnicity held constant. In Malays, we estimated the odds for T. gondii seroprevalence to be 2.9 (95% CI for OR: [1.8, 4.5]) times higher compared to non-Malays, with age held constant. Previous studies of T. gondii seroprevalence in Malaysia did not explicitly adjust for age, rendering comparisons difficult. Our study highlights the need to adopt a more rigorous epidemiological approach in monitoring T. gondii seroprevalence in Malaysia.
    Matched MeSH terms: Uveitis, Posterior/diagnosis*; Uveitis, Posterior/ethnology; Uveitis, Posterior/immunology
  18. Shahrudin NA, Mohd Zahidin AZ, Md Noh UK, Wan Abdul Halim WH, Md Din N
    GMS Ophthalmol Cases, 2017;7:Doc31.
    PMID: 29326863 DOI: 10.3205/oc000082
    Objective: To highlight the clinical presentation of CMV endotheliitis and the challenge in diagnosing this condition in recurrent failed penetrating keratoplasty (PK). Methods: Case series Results: There are 3 cases of recurrent failure in PK secondary to CMV endotheliitis presented. Case 1 and 2 were pseudophakic patients, while in case 3, the patient had a previous history of recurrent anterior uveitis. Case 1 and 3 had four and one previous failed PK respectively, while case 2 had endothelial keratoplasty twice before the diagnosis of CMV endotheliitis was made, following positive culture of aqueous humour. The visual acuity ranged from 1/60 to hand movement. All patients had pigmented KP, and two of them had typical coin-shaped KP. Oral valganciclovir was instituted for all patients consisting of 900 mg bidaily for two weeks, followed by 900 mg once daily for six months. Additionally, topical ganciclovir eyedrop 0.5% was given every four hours with topical dexaminim four times a day. Repeated anterior chamber (AC) tap after six months of treatment was negative for CMV in case 3 while cases 1 and 2 are still on treatment. CMV endotheliitis is an increasingly important cause of failed corneal transplant. We recommend anterior chamber tap in suspicious cases of repeatedly failed corneal transplant, regardless of the presence of coin-shaped KP or not. Minimum treatment with oral valganciclovir is important to eradicate the problem, before proceeding with another corneal transplant. Conclusion: It is important to make an accurate early diagnosis by good clinical judgement in preventing loss of corneal endothelial cells. High index of suspicion for CMV endotheliitis as a cause of graft failure must be made especially when the patient presents with coin-shaped KP. Therefore unnecessary treatment resulting from misdiagnosis in these patients can be prevented. Early recognition and treatment of this condition is important to prevent permanent endothelial cell loss and corneal decompensation.
    Matched MeSH terms: Uveitis, Anterior
  19. Leong KF, Sato R, Oh GGK, Surana U, Pramono ZAD
    Indian J Dermatol, 2019 9 24;64(5):400-403.
    PMID: 31543536 DOI: 10.4103/ijd.IJD_44_18
    Blau syndrome (BS) is a very rare autosomal dominant juvenile inflammatory disorder caused by mutation in nucleotide-binding oligomerization domain containing 2 (NOD2). Usually, dermatitis is the first symptom that appears in the 1st year of life. About 220 BS cases with confirmed NOD2 mutation have been reported. However, the rarity and lack of awareness of the disease, especially in the regions where genetic tests are very limited, often result in late diagnosis and misdiagnosis. Here, we report a de novo BS case from Malaysia, which may be the first report from southeast Asia. PCR and DNA sequencing of peripheral blood mononuclear cells were performed to screen the entire coding region of NOD2 gene. A heterozygous c.1000C>T transition in exon 4, p. R334W, of the NOD2 gene was identified in the patient. This report further reaffirms the ubiquitousness of the disease and recurrency of p. R334W mutation.
    Matched MeSH terms: Uveitis
  20. Farhana, I., Nor Azita, A.T., Hamisah, I.
    Medicine & Health, 2018;13(2):158-163.
    Ocular tuberculosis is an ocular infection caused by Mycobacterium tuberculosis (TB). About 5-10% of ocular inflammation cases are caused by ocular TB. Spectrum of ocular TB is diverse, affecting any part of the adnexa, different layers and structures of the globe, orbital contents, optic nerve to the orbital apex posteriorly. It can be associated with or without systemic manifestation. Posterior uveitis is the most common presentation of ocular tuberculosis. Subretinal haemorrhage secondary to choroidal neovascularization (CNV) is a rare complication in ocular tuberculosis. We report a rare case of secondary choroidal neovascularization in a 9-year-old boy with bilateral eye choroidal tuberculoma with underlying miliary tuberculosis. He was treated with intravitreal ranibizumab and intravitreal recombinant-tissue plasminogen activator (r-TPA) injection. The CNV resolved, however, vision was poor due to atrophic fovea.

    Matched MeSH terms: Uveitis, Posterior
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