Malaysian Journal of Ophthalmology最新文献

{"title":"Intermittently blotchy","authors":"M. Bastion, Mun Wai Lee","doi":"10.35119/myjo.v4i2.304","DOIUrl":"https://doi.org/10.35119/myjo.v4i2.304","url":null,"abstract":"","PeriodicalId":405983,"journal":{"name":"Malaysian Journal of Ophthalmology","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125845811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence, clinical profile, and visual outcome of optic neuritis in Hospital Kuala Lumpur: a Malaysian perspective","authors":"Eeling Goh, Nurul Ain Masnon, L. Thavaratnam, Shanthi Viswanathan Shantakumar, Tajunisah Begam Bt Mohd Iqbal","doi":"10.35119/myjo.v4i2.242","DOIUrl":"https://doi.org/10.35119/myjo.v4i2.242","url":null,"abstract":"Purpose: To study the clinical presentation, visual outcome, and predictors for both recurrence and poor visual recovery among optic neuritis (ON) patients in the Malaysian population.Study design: Retrospective cohort study with longitudinal follow-up.Methods: A total of 113 patients from the neuro-ophthalmology clinic fulfilling optic neuritis inclusion criteria within 4 weeks of onset were included. The study was conducted from May 2015 to June 2018. Demographic data, clinical findings, ophthalmological investigation, serological investigation, and imaging results were documented and tabulated. Patients were followed up to 1 year to assess the visual outcome and evidence of retinal nerve fibre layer (RNFL) thinning. Significant associative factors for recurrence and poor visual outcomes were identified using multivariate analysis.Results: The age of the patients ranged from 13 to 71 years of age. The commonest age of presentation was 15–49 (67.3%) years of age. ON was predominant among Malays (65.5%), followed by Chinese (21.2%), and Indians (13.3%). The commonest form of ON was neuromyelitis optica spectrum disorder (NMOSD), which affected all ethnicities. Significant predictors for recurrence of ON were presentation within the 15–49 age group (p = 0.013) and presence of RNFL thinning following 1 year of treatment (p = 0.001). Indians had significantly lower odds of recurrence, 0.063 (p = 0.015). Significant variables associated with poor visual outcome > 6/18 were poor presenting vision > 6/18 (p < 0.001) and evidence of RNFL thinning following 1 year of treatment (p = 0.003). Females had better visual prognosis (p = 0.005) than males.Conclusion: NMOSD was the commonest form of ON in our study population. The presenting age group of 15–49 along with the presence of RNFL thinning within 1 year of treatment were significantly associated with recurrence. Additionally, evidence of RNFL thinning and poor presenting vision > 6/18 were associated with a poor visual outcome. This group of patients will require regular monitoring and early access to treatment.","PeriodicalId":405983,"journal":{"name":"Malaysian Journal of Ophthalmology","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122914856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of primary vasoproliferative tumor of the retina using laser photocoagulation and intravitreal ranibizumab","authors":"Muhammad Syafiq Ahmad Musthafa, Wan Norliza Wan Muda, N. Ramli","doi":"10.35119/myjo.v4i2.260","DOIUrl":"https://doi.org/10.35119/myjo.v4i2.260","url":null,"abstract":"Background: Vasoproliferative tumours (VPT) of the retina are benign, uncommon tumours that occur mostly in patients with no other ocular pathology. Several treatment modalities are used to treat these tumours including cryotherapy, laser photocoagulation, anti-VEGF injection, and observation.Case presentation: We present a case of a 40-year-old female with retinal VPT. The patient received a combination of selective laser photocoagulation of the tumour and serial intravitreal injections of ranibizumab that resulted in regression of the VPT and good visual outcome.Conclusion: Laser photocoagulation treatment should be considered for treating primary retinal VPT as it is the most available treatment modality. Combination therapy laser photocoagulation treatment with anti-VEGF provides long-term tumour regression, which is effective for the macular oedema associated with this condition.","PeriodicalId":405983,"journal":{"name":"Malaysian Journal of Ophthalmology","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129533193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autologous blood injection: alternative treatment for bleb leak","authors":"Nur Hafeela Mohamad Rusli, Safinaz Mohd Khialdin, J. Che-Hamzah","doi":"10.35119/myjo.v4i2.265","DOIUrl":"https://doi.org/10.35119/myjo.v4i2.265","url":null,"abstract":"Background: To report a case of post-glaucoma drainage device (GDD) surgery with multiple small conjunctival defects treated with autologous blood injection.Case presentation: A 28-year-old female with a history of juvenile open-angle glaucoma who had undergone multiple glaucoma surgeries with antimetabolite injections for uncontrolled intraocular pressure (IOP) of the left eye since 2006 underwent Baerveldt glaucoma implantation in 2017. One year postoperatively, she experienced persistent hypotony, which could not be resolved with a scleral bandage contact lens. Ocular examination revealed visual acuity of 6/9 and IOP of 8 mmHg. Multiple leakage points were identified with fluorescein at the junction between the plate and the tube. Subconjunctival injection of 1 ml autologous blood was administered near the conjunctival defects. Five months postoperatively, the leakage was sealed with IOP of 12 mmHg.Conclusion: Autologous blood injection can be used as an alternative procedure for treating leaking blebs after a GDD surgery.","PeriodicalId":405983,"journal":{"name":"Malaysian Journal of Ophthalmology","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130428883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fungal corneal ulcers: our 5-year experience in Bintulu","authors":"Loshni Murugia, P. Palaniappan, K. Teow, M. Choo","doi":"10.35119/myjo.v4i2.275","DOIUrl":"https://doi.org/10.35119/myjo.v4i2.275","url":null,"abstract":"Purpose: The aim of this study is to investigate the epidemiological and aetiological pattern of fungal corneal ulcers treated in Hospital Bintulu, Sarawak.Study design: Cross-sectional study.Methods: This study is based on the data collected from clinical records of patients with culture-positive fungal corneal ulcer who presented to Hospital Bintulu from 2016 to 2020. Data was analysed using descriptive statistical methods.Results: A total of 13 patients had fungal corneal ulcer. Males (84.6%) were more commonly affected compared to females (15.4%). The age of the patients ranged from 19 to 67 years. The commonest age group involved was 21–40 years, constituting more than half of the patients (53.8%). The mean age of the patients was 38 years old. Fusarium sp. was isolated in eight of them (61.5%), all of which had a history of palm oil dust insertion into the eye prior to presentation. Other fungal pathogens found include Phellinus noxius sp. in two cases (15.4%) as well as Ascomyces sp., Nectriaceae sp., and Colletotrichum trunchatum sp. in one case each (7.6%). Hypopyon was seen in eight cases (61.5%), where six cases were caused by Fusarium sp. while Ascomyces sp. and Nectriaceae sp. contributed one case each. Mixed fungal and bacterial infection was seen in two cases (15.4%).Conclusion: This study showed that Fusarium sp. is the commonest pathogen causing fungal corneal ulcer and affects predominantly young male plantation workers. The establishment of a proper framework to educate as well as strict enforcement of occupational safety may reduce the incidence of this disease in the population.","PeriodicalId":405983,"journal":{"name":"Malaysian Journal of Ophthalmology","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124830615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a patient educational video on visual field test reliability","authors":"Hsin Yi Lee, N. Ramli, Nurul Akma Saharuddin, Hanim Syed Yaziz Siti Faeza, P. Ong","doi":"10.35119/myjo.v4i2.249","DOIUrl":"https://doi.org/10.35119/myjo.v4i2.249","url":null,"abstract":"Purpose: Standard automated perimetry (SAP) is the gold standard for detecting and monitoring visual field (VF) defects in glaucoma, but frequent re-testing due to unreliable results increase the burden on this frequently used service. This study aims to assess the reliability of the Humphrey visual field (HVF) test in glaucoma-suspect patients with no previous SAP experience and to determine the effect of a VF test educational video on reliability.Study design: The study was conducted as a full cycle audit.Methods: The audit cycle was carried out in four phases: pre-intervention audit, intervention, monitoring, and post-intervention audit. The pre-intervention audit was carried out from January 2020 to May 2020 and the post-intervention audit was carried out from September 2020 to December 2020. The intervention was in the form of a VF test educational video. A post-video assessment pertaining to the contents of the video was given to patients in the intervention group to complete after they watched the video. The results were then tabulated and analysed.Results: The pre-intervention audit showed that only 66.7% of glaucoma-suspect patients with no previous SAP experience had reliable HVF tests. Post-intervention, HVF reliability improved to 87.5% of patients. Based on the reliability parameters, the main reason for the HVF test being classified as unreliable in both the pre- and post-intervention was fixation loss greater than 20% in 36 (90%) and 11 (73.3%) patients, respectively. There were 76.9% of patients with unreliable fields who had < 4 correct answers on the post-video assessment; all patients who had > 4 correct answers had reliable HVF results.Conclusion: HVF reliability performance in glaucoma-suspect patients improved with the introduction of a pre-test educational video. It is a simple and inexpensive method which may reduce the need for repeat HVF tests for those with unreliable tests.","PeriodicalId":405983,"journal":{"name":"Malaysian Journal of Ophthalmology","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132986040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The perfect visual field test: does it exist?","authors":"N. Ramli","doi":"10.35119/myjo.v4i2.298","DOIUrl":"https://doi.org/10.35119/myjo.v4i2.298","url":null,"abstract":"The role of standard automated perimetry in glaucoma monitoring is irrefutable. White on white standard automated perimetry has been used in clinical practice since 1970 with the Octopus Perimeter. 1 Subsequently, Andres Heigl and his colleagues were instrumental in the development of what is arguably the most used perimetry test and analysis method in current clinical practice and research, the Humphrey Field Analyser. 2 It has undergone many improvements since its inception. Measures were developed to improve the accuracy, make the tests easier to perform, enhance efficiency, and establish a robust system to enhance the reliability. In this current issue of Malaysian Journal of Ophthalmology, we have two articles which have highlighted the issue of enhancing the reliability of Humphrey visual field (HVF) results. In the first article, Mahayana et al. investigated the reliability parameters after three repeated HVF tests in the same patient spread over several days. They concluded that it required three perimetry examinations for the learning effect to diminish. Interestingly, while factors such as duration of test, fixation loss, and false-positive rates improved with each subsequent test, there was no sta-tistically significant change in global indices. This indicates the robustness of the algorithm for glaucoma detection irrespective of the learning effect. In other words, the defects in pathological field loss are not possible to learn. The second article investigated the effect of instructional videos on patients doing HVF for the first time. This is an important article which highlights how the artefact of learning effect can be minimised in perimetry through the use of demon-stration videos. It is especially pertinent in patients undergoing perimetry for the first time. The findings of improved reliability parameters after watching the instructional videos were particularly evident in patients from lower educational levels. Performing a HVF test is tedious at best for a patient.","PeriodicalId":405983,"journal":{"name":"Malaysian Journal of Ophthalmology","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128723649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric endophthalmitis: a 10-year retrospective study at Hospital Kuala Lumpur for incidence, risk factors, and outcomes","authors":"Tanusha Dorairaja, Azida Juana Wan Ab Kadir, Jamalia Rahmat","doi":"10.35119/myjo.v4i2.236","DOIUrl":"https://doi.org/10.35119/myjo.v4i2.236","url":null,"abstract":"Purpose: Paediatric infectious endophthalmitis is a serious sightthreatening disease for children. The purpose of this study was to investigate the incidence, aetiology, microbiological spectrum, management, and visual outcomes of infectious endophthalmitis in children referred to the Department of Ophthalmology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.Study design: Retrospective study.Methods: The medical records of all patients under 18 years of age with histories of endophthalmitis treated at Hospital Kuala Lumpur from January 2009 to December 2018 were reviewed. The clinical characteristics, aetiology, microbiological spectrum, management, as well as the visual outcomes were analysed.Results: A total of 23 children were identified, with a mean age of 3.15 (ranging from 20 days to 8 years of age). Previous ocular surgery (47.8%) and ocular trauma (30.4%) were the most common causes of endophthalmitis. Overall, eight (38.1%) cases with positive cultures were identified. The most commonly identified organism was Staphylococcus sp. comprising 50% of the isolates. Moreover, five isolates (62.5%) were gram-positive organisms and three isolates (37.5%) were gram-negative organisms. The final visual outcome was 20/200 or better in one eye (4.3 %), hand movement in two eyes (8.7%), light perception in five eyes (21.7%), and no light perception in 13 eyes (56.5%). The visual outcome was not available for two patients (8.7%).Conclusions: Previous ocular surgery and penetrating ocular trauma are the most frequent causes of paediatric endophthalmitis in our centre. Staphylococcus sp. was the most commonly identified organism in paediatric endophthalmitis. In this study, despite aggressive management with intravitreal antibiotics and vitrectomy, the visual prognosis was found to be generally poor.","PeriodicalId":405983,"journal":{"name":"Malaysian Journal of Ophthalmology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131673880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ab-externo XEN gel stent implantation in primary open-angle glaucoma: 6-month follow-up","authors":"Mohd Hasif Mustafa, Norshamsiah Md. Din, Seng Fai Tang","doi":"10.35119/myjo.v4i2.252","DOIUrl":"https://doi.org/10.35119/myjo.v4i2.252","url":null,"abstract":"Purpose: XEN gel stent (XGS) is one of the minimally invasive glaucoma surgery (MIGS) procedures offering substantial intraocular pressure (IOP)-lowering. We evaluated the efficacy and safety of XGS implantation via an ab externo approach in patients with primary open-angle glaucoma (POAG). We present 13 cases of successful XEN implantation via an ab externo approach in these patients.Study design: Retrospective case series.Methods: This was a retrospective case series involving patients diagnosed with POAG at a tertiary referral centre who underwent XGS implantation between February 2019 and June 2020 for uncontrolled IOP despite maximum topical medications. All patients underwent XGS implantation via an ab externo approach placed at the superotemporal quadrant. The main outcome measure was IOP reduction and number of antiglaucoma medications after XGS implantation, postoperative procedures, and surgical complications.Results: Thirteen eyes of 13 patients were included in the analysis. At the 6-month follow-up, mean IOP reduction was 2.73 ± 3.66 mmHg and mean IOP was 13.8 ± 1.99 mmHg on an average of 1.6 antiglaucoma medications. Complications included transient hypotony and transient IOP spikes requiring needling. Two patients required stent removal due to recurrent conjunctival erosion and stent migration into the anterior chamber.Conclusion: XGS implantation is able to achieve good IOP control with reduced need for antiglaucoma medications after a minimum follow-up of 6 months. Longer follow-up is needed to assess its long-term outcome.","PeriodicalId":405983,"journal":{"name":"Malaysian Journal of Ophthalmology","volume":"113 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114567275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral exudative retinal detachment as the first manifestation of lung carcinoma","authors":"Thamarai Munirathinam, Pei Fang Neoh","doi":"10.35119/myjo.v4i2.240","DOIUrl":"https://doi.org/10.35119/myjo.v4i2.240","url":null,"abstract":"Background: Exudative retinal detachment without ocular metastasis is extremely rare.Case presentation: We report a case of sudden onset of painless vision loss in the left eye with relative afferent pupillary defect. Fundus features suggested exudative retinal detachment. Abnormal cutaneous findings and lung findings led to the suspicion of malignancy. Computed tomography of the brain and orbit showed no ocular metastasis; however, imaging of thorax, abdomen and pelvis revealed lung malignancy with distant metastasis. Immunohistochemistry profile of the skin biopsy was suggestive of metastatic adenocarcinoma.Conclusion: A high index of suspicion, thorough physical examination and prompt intervention can be lifesaving.","PeriodicalId":405983,"journal":{"name":"Malaysian Journal of Ophthalmology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127222077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}