A common variant near TGFBR3 is associated with primary open angle glaucoma

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.Primary open angle glaucoma (POAG), a major cause of blindness worldwide, is a complex disease with a significant genetic contribution.We performed Exome Array (Illumina) analysis on 3504 POAG cases and 9746 controls with replication of the most significant findings in 9173 POAG cases and 26 780 controls across 18 collections of Asian, African and European descent. Apart from confirming strong evidence of association at CDKN2B-AS1 (rs2157719 [G], odds ratio [OR] = 0.71, P = 2.81 × 10−33), we observed one SNP showing significant association to POAG (CDC7–TGFBR3 rs1192415, ORG-allele = 1.13, Pmeta = 1.60 × 10−8). This particular SNP has previously been shown to be strongly associated with optic disc area and vertical cup-to-disc ratio, which are regarded as glaucoma-related quantitative traits. Our study now extends this by directly implicating it in POAG disease pathogenesis

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Abstract Primary open angle glaucoma (POAG), a major cause of blindness worldwide, is a complex disease with a significant genetic contribution. We performed Exome Array ), we observed one SNP showing significant association to POAG (CDC7-TGFBR3 rs1192415, OR G-allele = 1.13, P meta = 1.60 × 10 −8 ). This particular SNP has previously been shown to be strongly associated with optic disc area and vertical cup-to-disc ratio, which are regarded as glaucoma-related quantitative traits. Our study now extends this by directly implicating it in POAG disease pathogenesis

AN ELDERLY LADY WITH BLURRING OF VISION

A 64-year-old Malay lady presented to outpatient clinic withcomplaint of progressive painless blurring of vision in botheyes for two years duration. The eye condition currently isnot improving with new glasses. There was presence ofmetamorphopsia (distorted image), but no history of floaters.She is a known case of hypertension and hyperlipidaemiawith good compliance to treatment. Her blood pressure (BP)was 140/80 mmHg at presentation and her random bloodsugar (RBS) was 7.0 mmol/l.On examination, her visual acuity was 6/60 in the right eyeand 6/45 in the left eye. The conjunctiva and cornea werenormal with presence of red reflex in both eyes. Funduscopyexamination for both eyes showed similar finding

Antiphospholipid syndrome in lupus retinopathy

Ng Hong-Kee,1,2 Chong Mei-Fong,2 Yaakub Azhany,1 Embong Zunaina1 1Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia; 2Department of Ophthalmology, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia Abstract: Systemic lupus erythematosus (SLE) is a chronic, multisystem, autoimmune disease that can affect any part of the human body including the eyes. Common blinding ocular manifestations include central retinal artery occlusion (CRAO), central retinal vein occlusion (CRVO), severe vaso-occlusive retinopathy, and optic nerve involvement. Antiphospholipid syndrome (APS) in lupus is usually associated with large vessel occlusions and needs prompt treatment with anticoagulant. We are reporting two cases of APS in SLE patients that presented with CRVO (case 1) and vaso-occlusive lupus retinopathy (case 2). Both cases were positive for antiphospholipid antibody (APA) and were treated with immunosuppression, anticoagulant, and laser treatment. Thus, screening for APA is vital in SLE patients with lupus retinopathy, as prompt treatment with anticoagulants is important to prevent further vascular thrombosis, which worsens the visual prognosis. Keywords: systemic lupus erythematosus, antiphospholipid antibody, central retinal vein occlusion, vaso-occlusive retinopath

Sequelae of neglected senile cataract

Cataract is the most common cause of blindness in the world. An attack of phacolytic and phacomorphic glaucoma as a result of neglected cataract constitutes a medical emergency that must be addressed immediately. Ocular emergencies such as these is challenging for the surgeon with guarded or poor prognosis. We describe the presentation, management and prognosis of three cases of phacomorphic and phacolytic glaucoma. All three patients underwent aggressive management of intraocular pressure. Despite successful cataract operation with implantation of intraocular lens, there was only mild improvement of the vision. Optic nerve and pupil functions were permanently affected following the insult. Phacomorphic and phacolytic glaucoma present a very challenging problem to the surgeon with poor visual outcome. Public health education and awareness are important and health workers should encourage patients with cataract to seek early treatment for better prognosis

Cyanoacrylate tissue glue for wound repair in early posttrabeculectomy conjunctival bleb leak: a case series

Abdul-Rahim Haslinda, Yaakub Azhany, Rasid Noor-Khairul, Embong Zunaina, Ahmad-Tajudin Liza-Sharmini Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia Abstract: We demonstrated a noninvasive management of early bleb leak following trabeculectomy using cyanoacrylate tissue glue (CATG). Three patients who underwent augmented trabeculectomy with mitomycin C with early bleb leak between January 2009 and June 2010 were reviewed. Case 1 and Case 2 exhibited bleb leak on postoperative Day 1 and Case 3 showed leak on follow-up at postoperative Day 7. Case 1 was successfully sealed with CATG at postoperative Day 3, after failed pressure padding and bandage contact lens. Case 2 was successfully sealed with CATG at postoperative Day 3, after failed pressure padding and conjunctiva flap resuturing. In Case 3, the leaking conjunctival flap was managed with combined techniques of resuturing and applying CATG at postoperative Day 9, after failed pressure padding. During leakage, the intraocular pressure was low (6–8 mmHg) in all three cases, with shallow anterior chamber depth and absence of other complications such as choroidal detachment, hypotony maculopathy, or endophthalmitis. Foreign body sensation was the main complaint following the procedure. No clinical allergy reaction was documented. CATG may serve as a potential adjunctive and effective method in the management of posttrabeculectomy early bleb leak. Keywords: cyanoacrylate tissue glue, bleb leak, trabeculectomy, mitomycin

The Effect of Anchovy Sauce on Severity and Progression of Glaucoma

Introduction: Anchovy sauce is a known appetizer in many Asian’s cuisines. Based on the bio-physical content of anchovy sauce, there is a possibility of the frequent consumption can affect severity and progression of glaucoma. The aim of this study was to determine the association of anchovy sauce intake in severity and progression of glaucoma. <div>Methods: A cross-sectional study was conducted involving 91 primary glaucoma patients who were compliance and achieved target intraocular pressure, non-smoker and without a family history of glaucoma. Direct face-to-face interview on the dietary recall of anchovy sauce consumption was conducted between May 2013 and December 2013. The complete ocular examination was performed including intraocular pressure measurement. Hoddap-Parrish-Anderson criterion was used to assess the severity of glaucoma based on the latest reliable and reproducible of two consecutive Humphrey visual fields 24-2. The association between anchovy sauce and glaucoma severity was determined using Fisher’s exact test. Multiple logistic regression analysis was performed to determine the association of anchovy sauce intake with glaucoma progression. </div><div>Results: A total of 46 male and 45 female with primary glaucoma were recruited with a mean age of 66.4 (SD10.1) years old. 56 patients consumed anchovy sauce with 19% occasionally, 44.6% weekly, 16.1% daily and 5.4% in every meal. There was no significant association of anchovy sauce intake with severity and progression of primary glaucoma after a mean of 6.4 years of follow-up.</div><div>Conclusion: Anchovy sauce has potential protective effect against progression and severity of glaucoma. However, it was not reflected in this study due to small sample size and poor quantification of the amount of anchovy sauce as a condiment to the main dish. </div