Evaluation Of PCR Method To Detect Fungal Aetiology In Microbial Keratitis.

Microbial keratitis is a serious ocular infection. It is often difficult to establish a microbial keratitis that is due to fungal infection. Inadequate therapy and delayed diagnosis of fungal keratitis leads to generally poor visual outcomes. Ulser komea merupakan jangkitan mata yang merbahaya. Jangkitan ulser kornea yang disebabkan oleh kulat selalunya sukar untuk ditentukan. Kelewatan mengenalpasti jangkitan ulser komea yang disebabkan oleh kulat dan juga dengan rawatan yang tidak mencukupi, mengakibatkan penglihatan meenjadi rosak

Agreement of macular oedema features between FFA And HRT II and evaluation of visual function, macular oedema index and quality of life post laser photocoagulation in diabetic macular oedema

Objectives: To evaluate the agreement of macular edema features between FFA and HRT, and also to evaluate the visual function, macular edema index and quality of life between pre and post laser photocoagulation in diabetic macular edema. Methodology: Sixty-seven patients were subjected to HRT, FFA (served as the gold standard) and laser photocoagulation. The visual function, macular edema index and quality of life measurements were done at baseline and three months post laser photocoagulation. Results: Topographic edema map of HRT has better sensitivity and specificity compare with other modules. There is a good agreement between topographic edema map and macular edema index (MEI) thickness map. There were improvement in visual function, macular edema index, and quality of life at 3 months post laser photocogulation. Conclusion: Topographic edema map of HRT has better sensitivity compared with other modules. Good agreement exists between topographic edema map and MEI thickness map. The visual function, macular edema index and quality of life were improved post laser photocoagulation

Ocular Tuberculosis with Multiple Cerebral Abscesses

A 23-year-old Malay man presented with headache for one-month duration. It was associated with painless blurring of vision of the right eye. He had loss of appetite and reduced weight but no night sweats or hemoptysis. His visual acuity on the right eye was 6/45 and improved to 6/15 with pinhole. Right fundus examination revealed a choroidal tuberculoma located at one disc diameter away from optic disc superiorly with mild vitritis. Systemic examinations revealed no significant finding. Mantoux test reading was 22 mm with erythrocyte sedimentation rate that was 14 mm/h. Other blood investigations were negative with normal chest radiography. The computerized tomography scan of the brain revealed multiple cerebral abscesses. A clinical diagnosis of right ocular tuberculosis with multiple cerebral abscesses was made. He was treated with antituberculosis chemotherapy for one year which divided into intensive phase for three months and maintenance phase for nine months. Cerebral abscesses resolved after three months of antituberculosis drugs and at one-year follow-up, and the choroidal tuberculoma resolved completely with scar formation and significant macular striae

Corneal laceration caused by river crab

A 5-year-old boy presented with right eye pain associated with tearing and photophobia of 1-day duration. He gave a history of playing with a river crab when suddenly the crab clamped his fingers. He attempted to fling the crab off, but the crab flew and hit his right eye. Ocular examination revealed a right eye corneal ulcer with clumps of fibrin located beneath the corneal ulcer and 1.6 mm level of hypopyon. At presentation, the Seidel test was negative, with a deep anterior chamber. Culture from the corneal scrapping specimen grew Citrobacter diversus and Proteus vulgaris, and the boy was treated with topical gentamicin and ceftazidime eyedrops. Fibrin clumps beneath the corneal ulcer subsequently dislodged, and revealed a full-thickness corneal laceration wound with a positive Seidel test and shallow anterior chamber. The patient underwent emergency corneal toileting and suturing. Postoperatively, he was treated with oral ciprofloxacin 250 mg 12-hourly for 1 week, topical gentamicin, ceftazidime, and dexamethasone eyedrops for 4 weeks. Right eye vision improved to 6/9 and 6/6 with pinhole at the 2-week follow-up following corneal suture removal

Assessment of the Optic Nerve Head Parameters Using Heidelberg Retinal Tomography III in Preterm Children

Background: Variations in optic nerve head morphology and abnormal retinal vascular pattern have been described in preterm children using digital image analysis of fundus photograph, optical coherence tomograph and serial funduscopy. We aimed to compare the optic nerve head parameters in preterm and term Malay children using Heidelberg Retinal Tomograph III. Design: A cross sectional study. Methodology/Principal Findings: Thirty-two preterm Malay children who were born at up to 32 weeks postconception, and 32 term Malay children aged 8–16 years old were recruited into this cross sectional study, which was conducted in the Hospital Universiti Sains Malaysia, Malaysia from January to December 2011. Their optic nerves were scanned and analyzed using a Heidelberg Retinal Tomography (HRT) III (Heidelberg Engineering, Germany). Preterm children showed an increased rim volume (SD) (0.56 (0.26) vs 0.44 (0.18) mm3, respectively), smaller cup shape (SD) (0.18 (0.07) vs 0.25 (0.06) mm, respectively), increased height variation contour (SD) (0.44 (0.14) vs 0.35 (0.08) mm, respectively), and increased cup depth (SD) (0.24 (0.11) vs 0.17 (0.05) mm3, respectively) when compared to their normal peers (p,0.05). There were no significant differences in the mean disc area, cup area, cup to disc ratio or rim area between the preterm and term children (p.0.05) in our study. Conclusions/Significance: Preterm children exhibit different characteristics of optic nerve head parameters with HRT III analysis. Increased cup depth in preterm children suggests a need for close observation and monitoring. It may raise suspicion of pediatric glaucoma when proper documentation of intraocular pressure and clinical funduscopy are unsuccessful in uncooperative children

Orbital apex cyst: a rare cause of compressive optic neuropathy post-functional endoscopic sinus surgery

There are various causes that can lead to compressive optic neuropathy. We present here orbital apex cyst as an unusual cause of compressive optic neuropathy in a 49-year-old male. He presented with 2 weeks painless loss of vision in the left eye with left-sided headache. He had had left functional endoscopic sinus surgery for left nasal polyps 4 years earlier. Magnetic resonance imaging of brain and orbit revealed a left discrete orbital nodule, possibly orbital cyst or mucocele, which was compressing on the left optic nerve. Left eye vision improved markedly from hand movement to 6/36 pinhole 6/18 after initiation of intravenous dexamethasone. A subsequent endoscopic endonasal left optic nerve decompression found the orbital nodule lesion to be an orbital cyst. Marsupialization was performed instead of excision, as the cyst ruptured intraoperatively. Postoperative vision improved to 6/7.5 with normal optic nerve function postoperatively. Possible cause of orbital apex cyst is discussed

Preliminary study to compare the prediction error of post operative refraction in pediatric cataract surgery between 2 different intraocular lens power calculation formula

Introduction: The treatment of paediatric cataracts has progressed tremendously in the past 15 to 20 years. There is a growing trend towards intraocular lens implantation in infants and younger children whose eyes are still undergoing rapid growth and refractive changes. Objective: This study is intended to assess the predictability of desired refractive outcomes at 3 month postoperative period in paediatric patients undergoing cataract surgery with primary placement of an intraocular lens. Methodology: This randomized interventional study of 31 eyes (24 patients) that successfully underwent cataract surgery and intraocular lens implantations. All patients were 12 years old and below. Intraocular lens power calculations were made using either SRK II or Modified Formula For Paediatric IOL Calculation. The postoperative refractive outcome was taken as the spherical equivalent of the refraction at 3 month postoperative follow-up. The prediction error was taken as the absolute difference between the predicted and the actual refraction. The data were analysed to compare the mean prediction error between SRK II and Modified Formula and evaluate the predictability. Results: The mean prediction error in the SRK II group was 1.03 D (SD, 0.69 D) while in Modified Formula 1.14 D (SD, 1.19 D). The SRK II group showed lower prediction error of 0.11 D compared to Modified Formula group, but this was not statistically significant (p > 0.05). There were 3 eyes (18.75%) in SRK II group achieved accurate predictability where the refraction postoperatively was within ± 0.5 D from predicted refraction compared to 7 eyes (46.67%) in the Modified Formula group. However the difference of the predictability between the two formulas was also not statistically significant (p = 0.097). Conclusion: The prediction error and the accuracy of predictability of postoperative refraction in paediatric cataract surgery are comparable between SRK II and Modified Formula. The existence of the Modified Formula provides an alternative to the ophthalmologist for intraocular lens calculation in paediatric patients

Classification of fundus images for diabetic retinopathy using artificial neural network

People with diabetes may suffer from an eye disease called Diabetic Retinopathy (DR). This is caused by damage to the blood vessels of the light-sensitive tissue at the back of the eye (i.e retina). Fundus images obtained from fundus camera are often imperfect; normally are in low contrast and blurry. Hence, causing difficulty in accurately classifying diabetic retinopathy disease. This study focuses on classification of fundus image that contains with or without signs of DR and utilizes artificial neural network (NN) namely Multi-layered Perceptron (MLP) trained by Levenberg-Marquardt (LM) and Bayesian Regularization (BR) to classify the data. Nineteen features have been extracted from fundus image and used as neural network inputs for the classification. For analysis, evaluation were made using different number of hidden nodes. It is learned that MLP trained with BR provides a better classification performance with 72.11% (training) and 67.47% (testing) as compared to the use of LM. Such a finding indicates the possibility of utilizing BR for other artificial neural network model

Choroidal neovascularization secondary to Best’s vitelliform macular dystrophy in two siblings of a Malay family

Best’s vitelliform macular dystrophy complicated with choroidal neovascularization is rare in children. We report three children from a Malay family of five siblings with Best’s vitelliform macular dystrophy, in which two of them subsequently developed choroidal neovascularization. The possible pathogenesis of this rare condition is described and highlighted in this report

Severe panuveitis in neuro-Behçet’s disease in Malaysia: a case series

Behçet’s disease (BD) is a multisystemic disease that is very rare in Malaysia. About 5% of patients develop central nervous system involvement, termed neuro-Behçet’s. Neuro- Behçet’s is one of the most serious causes of long-term morbidity and mortality. We report two cases of neuro-Behçet’s associated with uveitis (ocular BD) highlighting the clinical presentation, diagnostic measurement, and therapeutic management of these cases