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1.  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.
doi:10.2147/OPTH.S55623
PMCID: PMC3958546  PMID: 24648718
Best’s vitelliform macula dystrophy; choroidal neovascularization; children; Malay
2.  Assessment of the Optic Nerve Head Parameters Using Heidelberg Retinal Tomography III in Preterm Children 
PLoS ONE  2014;9(2):e88056.
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.
doi:10.1371/journal.pone.0088056
PMCID: PMC3923764  PMID: 24551076
3.  Rapid anterior capsular contraction after phacoemulsification surgery in a patient with retinitis pigmentosa 
A decrease in the anterior capsule opening after cataract surgery has been observed in eyes with weakened lens zonules. It commonly occurs in diabetes mellitus, uveitis, pseudoexfoliation syndrome, high myopia, and elderly patients. Herein, we report the case of a middle-aged man with advanced retinitis pigmentosa who developed a rapid contraction of the anterior capsule after an uneventful phacoemulsification surgery that resulted in severe visual loss during the early postoperative period.
doi:10.2147/OPTH.S42122
PMCID: PMC3652515  PMID: 23674886
contraction of anterior capsule; early postoperative period; phacoemulsification surgery; retinitis pigmentosa
4.  Bilateral spontaneous rupture of anterior lens capsules in a middle-aged woman 
Hypermature cataracts are commonly seen in developing countries. Spontaneous rupture of the anterior capsule, resulting in dislocation of the lens nucleus into the anterior chamber, presents rarely in hypermature cataracts. We describe a middle-aged woman who presented with spontaneous anterior dislocation of the nucleus in both eyes. The presence of calcification spots in the posterior capsule at the pupillary edge strongly suggested that our patient had hypermature cataracts. It is important to highlight this uncommon cause of nucleus dislocation in a patient with no previous history of ocular trauma.
doi:10.2147/OPTH.S37276
PMCID: PMC3514058  PMID: 23225999
dislocation of the nucleus; anterior chamber; hypermature cataract
5.  Visual acuity and visual skills in Malaysian children with learning disabilities 
Background:
There is limited data in the literature concerning the visual status and skills in children with learning disabilities, particularly within the Asian population. This study is aimed to determine visual acuity and visual skills in children with learning disabilities in primary schools within the suburban Kota Bharu district in Malaysia.
Methods:
We examined 1010 children with learning disabilities aged between 8–12 years from 40 primary schools in the Kota Bharu district, Malaysia from January 2009 to March 2010. These children were identified based on their performance in a screening test known as the Early Intervention Class for Reading and Writing Screening Test conducted by the Ministry of Education, Malaysia. Complete ocular examinations and visual skills assessment included near point of convergence, amplitude of accommodation, accommodative facility, convergence break and recovery, divergence break and recovery, and developmental eye movement tests for all subjects.
Results:
A total of 4.8% of students had visual acuity worse than 6/12 (20/40), 14.0% had convergence insufficiency, 28.3% displayed poor accommodative amplitude, and 26.0% showed signs of accommodative infacility. A total of 12.1% of the students had poor convergence break, 45.7% displayed poor convergence recovery, 37.4% showed poor divergence break, and 66.3% were noted to have poor divergence recovery. The mean horizontal developmental eye movement was significantly prolonged.
Conclusion:
Although their visual acuity was satisfactory, nearly 30% of the children displayed accommodation problems including convergence insufficiency, poor accommodation, and accommodative infacility. Convergence and divergence recovery are the most affected visual skills in children with learning disabilities in Malaysia.
doi:10.2147/OPTH.S33270
PMCID: PMC3460699  PMID: 23055674
Learning disabilities; Malaysian children; visual acuity; visual skills
6.  Rhino-orbito-cerebral Mucormycosis in an Immunocompetent Patient: Case Report and Review of Literature 
Rhino-orbito-cerebral mucormycosis is a fungal infection that can be fatal especially in immunocompromised patients. It is extremely rare in immunocompetent individuals. We describe here an immunocompetent patient who survived rhino-orbito-cerebral mucormycosis due to Saksenaea vasiformis, and provide a literature review of this rare entity.
doi:10.4103/0974-9233.95269
PMCID: PMC3353681  PMID: 22623872
Immunocompetent; Saksenaea vasiformis; Rhino-Orbito-Cerebral Mucormycosis
7.  Optic neuritis in a child with biotinidase deficiency: case report and literature review 
Optic atrophy has often been reported in children with biotinidase deficiency. The visual prognosis is usually poor. This report is of a 6-year-old boy with an early onset of biotinidase deficiency who presented with acute profound visual loss in both eyes. Fundoscopy revealed swollen discs in both eyes, and the imaging was consistent with bilateral optic neuritis. He was treated with systemic corticosteroid, and commenced on oral biotin. The final visual outcome was promising.
doi:10.2147/OPTH.S29048
PMCID: PMC3307667  PMID: 22457589
optic neuritis; children; biotinidase deficiency
8.  Correction: Central Corneal Thickness and Intraocular Pressure in Malay Children 
PLoS ONE  2011;6(12):10.1371/annotation/627b0a20-6623-4d46-970a-2f1f2ad0d002.
doi:10.1371/annotation/627b0a20-6623-4d46-970a-2f1f2ad0d002
PMCID: PMC3248572
9.  Central Corneal Thickness and Intraocular Pressure in Malay Children 
PLoS ONE  2011;6(10):e25208.
Background
To determine the mean values for central corneal thickness (CCT) and intraocular pressure (IOP) and the relationship between these values, in healthy Malay children to serve as reference values in diagnosis and treatment.
Design
A cross-sectional study.
Methodology/Principal Findings
One hundred and eight eyes (54 subjects) of Malay children without diagnosis of ocular abnormality or disease meeting our inclusion and exclusion criteria were selected. The CCT and IOP were measured by specular microscopy and non-contact air-puff tonometry respectively, for analysis and comparison with the values obtained in previous studies. Mean CCT and IOP was found to be 530.87±30.79 µm and 15.65±3.05 mm Hg respectively. CCT was found not to vary with age. A positive relationship was found between CCT and IOP; specifically, with every 100-µm increase in CCT, IOP increased by 3.5 mm Hg.
Conclusions/Significance
CCT and IOP are strongly related in healthy Malay children aged 8 to 16. The mean CCT of Malay children is lower than that of majority children of other ethnic groups, supporting the existence of CCT variation among different populations and that ethnicity should be a key consideration when applying CCT data to the general pediatric population.
doi:10.1371/journal.pone.0025208
PMCID: PMC3187772  PMID: 21998644
10.  Single intravitreal ranibizumab for myopic choroidal neovascularization 
We report a case of myopic choroidal neovascularization that showed improvement after a single injection of ranibizumab. A 45-year-old Chinese man with high myopia presented with sudden onset painless central scotoma of his right eye of 2 weeks’ duration. There was no history of trauma. His right eye vision on presentation was 6/30 which showed no improvement with pinhole. The right fundus showed myopic maculopathy at the posterior pole with subretinal hemorrhage at the inferotemporal fovea. The optic disc was tilted with inferotemporal peripapillary atrophy. There was a myopic maculopathy appearance in the macula of the left eye. Fundus fluorescein angiography revealed choroidal neovascularization at the fovea of the right eye. A diagnosis of right eye choroidal neovascularization secondary to myopic maculopathy was made. A single intravitreal injection of ranibizumab 0.05 mL was given. Ten weeks following intravitreal injection, vision had improved to 6/7.5, and repeated fundus fluorescein angiography showed absence of choroidal neovascularization. Follow-up at 6 months showed visual acuity had normalized to 6/6 with glasses, which was maintained up to 12 months following treatment. The right fundus showed no further subretinal hemorrhage with no new lesions.
doi:10.2147/OPTH.S21057
PMCID: PMC3155273  PMID: 21847340
myopia; choroidal neovascularization; antivascular endothelial growth factor
11.  Candida glabrata endophthalmitis following penetrating keratoplasty in a patient with negative donor rim culture 
BMC Ophthalmology  2010;10:18.
Background
Candida glabrata endophthalmitis following keratoplasty is rare and almost always associated with positive donor rim culture.
Case presentation
A 63-year-old patient, diagnosed Fuch's endothelial dystrophy in both eyes underwent a penetrating keratoplasty in his right eye. He had multiple underlying medical problems, which included diabetes mellitus, hypertension, hypoadrenalism on oral dexamethasone and fatty liver secondary to hypertrigliseridemia. He developed multiple suture abscesses, corneal haziness, retrocorneal white plaques and a level of hypopyon two weeks after an uneventful penetrating keratoplasty in his right eye. Cultures of the donor button and the transport media culture were negative. Candida glabrata was isolated successfully from the aqueous and vitreous taps. He was treated with a combination of topical, intracameral, intravitreal and intravenous Amphotericin B. His final visual acuity remained poor due to the haziness of the corneal button.
Conclusion
Candida glabrata endophthalmitis following penetrating keratoplasty can occur in negative donor rim and transport media cultures. The growth of the organism is facilitated by the patient's immunocompromised status. Awareness by the ophthalmologists and appropriate choice of antibiotics are mandatory in this challenging condition.
doi:10.1186/1471-2415-10-18
PMCID: PMC2891680  PMID: 20537193

Results 1-11 (11)