Ophthalmic features of craniosynostosis: A Malaysian experience.

BACKGROUND: This study aims to collect local Malaysian data regarding the ophthalmic features and complications in craniosynostosis patients who attended the Combined Craniofacial Clinic (CFC) in University Malaya Medical Centre (UMMC). METHODS: Retrospective study of medical notes of craniosynostosis patients who attended the CFC in UMMC from 2014 to December 2020. RESULTS: Out of 37 patients, 29 had syndromic craniosynostosis, and 8 had non-syndromic craniosynostosis. Visual impairment was present in 32.1% of patients. Causes for visual impairment were as follows - amblyopia (25.0%), exposure keratopathy (3.6%), and optic atrophy (3.6%). Hypermetropia and myopia were each seen in 20.6% of patients. Astigmatism was seen in 47.1% of patients, and 29.1% had anisometropia. Proptosis was present in 78.6% and lagophthalmos in 53.3% of patients. Strabismus in primary position occurred in 51.7% of patients. Thirty-one percent of the patients had exposure keratopathy. Optic disc atrophy was seen in 13.7% of patients, and 8.3% had optic disc swelling. Optic disc swelling was resolved in all patients who underwent craniofacial surgery. CONCLUSION: Our experience in Malaysia was consistent with previously reported data on ophthalmic features of craniosynostosis patients. Additionally, we found that non-syndromic craniosynostosis patients are also at risk of ocular complications just as much as syndromic patients. Appropriate treatment of amblyogenic risk factors, ocular complications, and timely detection of papilledema, and prompt surgical intervention are crucial in preserving long-term visual function in these patients.

Visual outcomes after Phacoemulsification with Intraocular Implantation surgeries among patients with and without Diabetes Mellitus

@#Introduction: The aim of this study was to compare the visual outcomes of phacoemulsification with intraocular lens implantation (IOL) surgery in patients with and without diabetes mellitus (DM) in Malaysia over a 12-year period and to identify factors that may contribute to poor visual outcome. Materials and Methods: Data was retrieved from the webbased Malaysian Cataract Surgery Registry (CSR). Perioperative data for cataract surgery performed from 2007- 2018 were analysed. Inclusion criteria were age ≥40 years, phacoemulsification and IOL and senile cataract. Combined surgeries, surgeries performed by trainees and ocular comorbidities were excluded. Post-operative Best-Corrected Visual Acuity (BCVA) were compared. Factors affecting poor visual outcomes among those with DM were analysed using multivariate logistic regression to produce adjusted odds ratio (OR) for variables of interest. Results: Total number of cases between 2007-2018 was 442,858, of whom 179,210 qualified for our analysis. DM group consisted of 72,087 cases (40.2%). There were 94.5% cases in DM group and 95.0% from non-DM group who achieved BCVA ≥6/12 (p<0.001). Among patients with DM, advanced age (70-79 years old, OR: 2.54, 95% Confidence Interva, 95%CI: 1.91, 3.40; 80-89 years old, OR: 5.50, 95%CI: 4.02, 7.51), ≥90 years, OR: 9.77, 95%CI: 4.18, 22.81), poor preoperative presenting visual acuity [<6/18–6/60] (OR: 2.40, 95%CI: 1.84, 3.14) and <6/60-3/60 (OR: 3.00, 95%CI: 2.24, 4.02), <3/60 (OR 3.63, 95%CI: 2.77, 4.74)], presence of intraoperative complication (OR 2.24, 95%CI: 1.86, 2.71) and presence of postoperative complication (OR 5.21, 95%CI: 2.97, 9.16) were significant factors for poor visual outcome. Conclusions: Visual outcomes following phacoemulsification with IOL implantation surgery among cases with DM were poorer compared to cases without DM. Risk factors for poor visual outcomes among cases with DM were identified.

Treatment of macular oedema secondary to idiopathic retinitis, vasculitis, aneurysms, and neuroretinitis with intravitreal triamcinolone / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To report the treatment of macular oedema secondary to idiopathic retinitis, vasculitis, aneurysrns,and neuroretinitis (IRVAN) with intravitreal triamcinolone.METHODS: Case report.RESULTS: A patient diagnosed with IRVAN with visual loss secondary to macular oedema. The macular oedema and her visual acuity was improved dramatically with the administration of intravitreal triamcinolone.CONCLUSION: Previous reports recommend treatment of IRVAN with panretinal photocoagulation, vitrectomy,systemic and periocular steroids. Our case shows that intravitreal triamcinolone appears to be a safe and effective treatment for macular oedema and vasculitis secondary to IRVAN.

Alterations of tear function tests in 50 patients with unilateral pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To determine tear function tests values,Schirmer Ⅰ test(S Ⅰt),tear film break-up time(TBUT)in patients with pterygium.METHODS:A total of 100 eyes(50 with primary pterygium and 50 without pterygium)of 50 patients who fulfilled the inclusion criteria were evaluated for S Ⅰt and TBUT.RESULTS:The mean S Ⅰ t value in eyes with pterygium was 19.6±11.6(range 1-40)mm and in control eyes without pterygium was 17.2±10.6(range 1-35)mm.S Ⅰ tresults were abnormal in 20 eyes(40%)with pterygium and in 21 eyes(42%)without pterygium(control);the difference was not statistically significant(P= 0.75).The difference between the groups was not statistically significant(f= 1.453,P=0.15).The TBUT in eyes with pterygium was 7.4±5.1(range 2-20)seconds and in control eyes without pterygium was 13.4±6.1(range 2-25)seconds.The difference between the groups was statistically significant(f = 8.029,P＜0.01).The TBUT was abnormal in 39 eyes(78%)with pterygium and in 16 control eyes(32%);the difference was statistically significant(P＜0.01).CONCLUSION:There was no significant difference in S Ⅰ t in eyes with pterygium compared to eyes without pterygium.There is reduction of TBUT in eyes with pterygium.