RESUMO
· AIM: To evaluate the optic disc parameters in the three main ethnic groups of Malaysia (Malay, Chinese and Indian). Possible relationships between optic disc parameters and gender, intraocular pressure and axial length of eye were also studied. · METHODS: The study included 244 eyes of 122 subjects (61 cases with open angle glaucoma and 61 non- glaucomatous individuals) with clear ocular media. Magnification corrected measurements of optic disc diameters and area were done using Zeiss FF450 Plus fundus camera. Differences between the three ethnic groups were tested by using ANOVA. The association between factors such as gender, intraocular pressure and axial length of the eye, and the optic disc size was tested through Pearson's bivariate correlation analysis. · RESULTS: The overall mean vertical optic disc diameter as (1.96 ± 0.20) mm, horizontal optic disc diameter was (1.84±0.20)mm and optic disc area was (2.84±0.56)mm2. Indians had larger optic disc area compared to Malay and Chinese. However, the difference was not statistically significant. · CONCLUSION: Optic disc size is larger in Malaysian population than Caucasians, Among the three ethnic groups, Indians have the largest optic disc size without any statistical difference.
RESUMO
AIM: To report the usefulness of a new parameter (maximum cross sectional area) in the measurements of B-scan ultrasonography to evaluate the progress of choroidal metastatic tumour size during the follow-up of patient.METHODS: Case report-the B-scan ultrasonographic measurements of height, base and maximum cross sectional area during the follow-up of the patient are presented.RESULTS: A 62-year-old Chinese lady, known case of non-small cell lung carcinoma, presented with painless blurring of vision in the right eye. She was diagnosed to have bilateral choroidal metastasis (advanced in the right eye and early in the left eye) with good vision in both eyes. The tumour size in the right eye reduced significantly after the first chemotherapy; but increased again 6 weeks after the end of last cycle of chemotherapy. She was given radiotherapy and another course of chemotherapy. The tumour size in the right eye did not respond much later on. However, the tumour size in the left eye was static through out the follow up period of 2years. The patient maintained best corrected visual acuity in both eyes (6/9 in right eye and 6/6 in left eye). The progress of tumour size in right eye was evaluated with serial B-scan ultrasonographic measurements.CONCLUSION: The ultrasonographic measurements were reproducible all through the follow up period and coincided well with clinical appearance of the tumour in right eye. We suggest the use of B-scan ultrasonography in the follow up of patients with elevated choroidal masses for quantitative assessment of progression/regression in their size during the treatment period.
RESUMO
·AIM: To report a rare case of antiphospholipid syndrome presenting as papilledema and sixth nerve palsy in right eye due to superior sagittal sinus thrombosis, and regression of papilledema following anticoagulation and acetazolamide therapy.·METHODS: A 44-year-old Chinese gentleman presented with headache, diplopia and mild blurring of vision. Clinical examination revealed the presence of sixth nerve palsy in right eye and papilledema. There was enlargement of blind spot in the visual fields and red green deficiency in both eyes.Computed tomography and magnetic resonance imaging showed superior sagittal sinus thrombosis. Hematological investigation confirmed the presence of antiphospholipid syndrome as the underlying cause.·RESULTS: The condition was treated successfully in three months with the adjunctive use of anticoagulation and acetazolamide. Reversal of papilledema changes in the optic disc to normal indicates the anatomical recovery, while reduction of enlargement of blind spot to normal size,recovery of red green deficieny to normal colour vision in both eyes and visual improvement after regression of papilledema in right eye indicate functional recovery in this patient.·CONCLUSION: Antiphospholipid syndrome should be considered in the differential diagnosis of papilledema, and oral acetazolamide is an important adjunct therapy to anticoagulation in cases of refractory papilledema to protect the optic nerve from potential damage which results in blindness.
