Unilateral branch retinal artery occlusion due to internal carotid artery occlusive disease in a young adult: a rare case report

Branch retinal artery occlusion occurs when an artery in the branch retina is blocked, most commonly due to emboli. The sensitive neural tissue of the retina is highly dependent on adequate blood flow and hypoperfusion of retinal tissue can cause visual field loss. We report a case of a 23-year-old librarian presented to us with the complaint of sudden onset painless inferior visual field loss in the right eye for three days. She had no other co-morbidities, was a non-smoker and denied any history of head and neck trauma. Clinical examination revealed vision in the right eye was 6/6 and no Marcus Gunn Pupil with Humphrey Visual Field showed hemifield respecting the vertical meridian at inferior part. IOP was 13 mmHg. Fundoscopy revealed a retinal whitening on the superior part with minimal cotton wool spots and Hollen haurst plaque at end of vessels. Left eye examination was unremarkable, with 6/6 vision. Systemic examination revealed a BP of 121/88 mmHg, no cardiac murmurs and absent carotid bruit. Blood and imaging studies were performed to determine the underlying cause of Branch Retinal Artery Occlusion. These include screening for diabetes, dyslipidemia, valvular or cardiac wall abnormalities, vasculitis, coagulopathies and carotid artery stenosis. The blood investigation results revealed that the patient was dyslipidemic. The Carotid Doppler demonstrated proximal right internal carotid artery thrombosis causing significant Internal Carotid stenosis. An urgent vascular, cardiology & haematology referral was done. Endarterectomy was not required and she was treated conservatively with aspirin and statins

Demystifying the controversies and outcome : toric intraocular lens implantation in cataract patients with corneal astigmatism post pterygium surgery

Purpose To evaluate the accuracy of toric intraocular lens (IOL) implantation in cataract patients with corneal astigmatism post pterygium surgery. Methods In this prospective case series, six patients who had corneal astigmatism post pterygium surgery were implanted with Zeiss toric IOL (AT-TORBI 709). Preoperative corneal regularity and symmetry pattern was measured with placido disc topography (Zeiss Atlas 900) examination. Three-month postoperative corneal astigmatism was measured with Zeiss IOLMaster 700 and compared with the manifest astigmatic refractive outcome in patients implanted with toric IOLs. The postoperative refractive astigmatism prediction error was calculated by vector analysis derived from Barrett toric calculator to predict the required toric IOL cylinder power. Results The spherical equivalent recorded for the postoperative refraction is +0.50 ± 1.00D with logMAR of 0.0 to 0.05. The mean for preoperative corneal astigmatism and postoperative refractive astigmatism are 1.45 ± 0.87D and 0.38 ± 0.19D respectively (P 0.001). The mean absolute error in predicted residual astigmatism is 0.37 ± 0.16D and with-the-rule centroid error of 0.26 ± 0.34D @ 26. The postoperative refractive astigmatism resulted with 33.0% achieved less than -0.25D, 67.0% obtained less than -0.50D and 100.0% of eyes were within -0.25D to -0.75D. Conclusion Toric IOL provides low post operative astigmatism correction and better predictive error in patients with post pterygium excisio

Repeatability and reproducibility of pterygium grading based on clinical translucence appearance

Background: The goal of this study was to evaluate the repeatability and reproducibility of pterygium grading based on clinical translucence appearances and its reliability in clinical setting. Methods: A total of 93 primary pterygium eyes from 93 participants who vi sited a tertiary ophthalmic clinic were recruited in this study. Two ( ophthalmologists and two ( optometrists evaluated and graded the 93 primary pterygium images in randomized fashion. Graders were instructed to utilise the clinical translucence appe arance of pterygium to grade them into type I, II and III. Repeatability testing was done by a single expert by comparing grading of each image on two separate sessions, with one month interval between sessions. Reproducibility was tested by comparing the grading obtained by both experts and optometrists. Results: Paired and independent T test results showed no significance difference between graders for both experts and optometrists’ group (all P 0.05). Intra grader and inter grader reliability estimate s were high with intraclass correlation ranging from 0.97 to 0.98 for both groups. Conclusions: Pterygium clinical grading based on its translucence appearance is reliable and repeatable in clinical setting, easily to be graded, interpreted, and recommend ed for clinicians with different levels of experience

Ocular Permeation of Topical Tazocin and Its Effectiveness in the Treatment of Pseudomonas aeruginosa Induced Keratitis in Rabbits

Purpose: Pseudomonas aeruginosa is the most common causative organism for contact lens-associated corneal ulcer and is commonly treated with fluoroquinolones. With the emergence of resistant strains, it is important to investigate alternative therapies. Despite well-established efficacy of tazocin against systemic Pseudomonas infections, its topical use for the treatment of Pseudomonas keratitis has not been described, hence this study was aimed to find the ocular permeation of Tazocin and its efficacy in treating keratitis in rabbit eyes. Methods: We investigated the ocular permeation of topical tazocin after single drop application in normal rabbit eyes by estimating piperacillin and tazobactam concentrations in cornea, aqueous, and vitreous using a validated LC-MS/MS method. Furthermore, we determined the efficacy of repeated dose administration of tazocin against experimentally induced P. aeruginosa keratitis in rabbits in comparison to moxifloxacin. To determine the efficacy, clinical examination, histopathological examination, and estimation of bacterial load and inflammatory cytokines in cornea were done. Results: Significant corneal concentration of piperacillin and tazobactam was detected in normal rabbit corneas after single dose treatment with tazocin. In rabbits with Pseudomonas-induced keratitis, topical tazocin caused significant clinical and histopathological improvement. This improvement was associated with reduction in corneal bacterial load and inflammatory cytokines. Compared to moxifloxacin 0.5%, tazocin treated group showed greater clinical response which was associated with higher interleukin (IL)-1β, lower tumor necrosis factor (TNF)-α, a comparable level of IL-8, greater reduction in corneal bacterial load, and lesser inflammatory cell infiltration. Conclusion: Tazocin showed good ocular penetration and was effective in treatment of Pseudomonas induced keratitis in rabbits

Abstracts of the International Halal Science Conference 2023

This book presents the extended abstracts of the selected contributions to the International Halal Science Conference, held on 22-23 August 2023 by the International Institute for Halal Research and Training (INHART), IIUM, Malaysia in collaboration with Halalan Thayyiban Research Centre, University Islam Sultan Sharif (UNISSA), Brunei Darussalam. With the increasing global interest in halal products and services, this conference is timely. Conference Title:  International Halal Science ConferenceConference Acronym: IHASC23Conference Theme: Halal Industry Sustainability Through ScienceConference Date: 22-23 August 2023Conference Venue: International Islamic University (IIUM), MalaysiaConference Organizer: International Institute for Halal Research and Training (INHART), International Islamic University (IIUM), Malaysi