1.Cultivated oral mucosal epithelial transplantation (COMET) andpenetrating keratoplasty in long-standing severe ocular surface injury
Ing Hong Lim ; Rohanah Alias ; Thiageswari Umapathy ; Amir Samsudin
The Medical Journal of Malaysia 2019;74(5):433-435
Ocular chemical injury is a true ophthalmic emergency
requiring immediate medical intervention. Damages can be
devastating and potentially resulting in blindness, corneal
perforation and phthisis bulbi. We describe here a
successful treatment outcome in a patient who sustained
Roper-Hall Grade 4 injury to both eyes. Patient received
medical therapy followed by serial ocular surgeries with
eventual visual recovery in one eye from counting finger to
6/15 after a decade. In conclusion, after maximum medical
therapy, a carefully planned serial surgeries of cultivated
oral mucosal epithelial transplantation (COMET) and PK has
proven beneficial for this patient with advanced limbal stem
cell deficiency (LSCD).
2.A rare case of methicillin resistant Staphylococcus aureus (MRSA) cerebral abscess secondary to conjunctivitis
Gan Yuen Keat ; Annuar Zaki Azmi ; Shuaibah Abdul Ghani ; Amir Samsudin
The Medical Journal of Malaysia 2017;72(3):197-198
This case report discusses the rare association of cerebral
abscess related to conjunctivitis in an otherwise healthy
child. A 6 year old boy presented with conjunctivitis was
treated with topical antibiotics and resolved after a week.
Conjunctival swab cultures grew MRSA. A month later he
developed status epileptics and CT scans revealed a large
cerebral abscess. He was treated with intravenous
antibiotics which covered for MRSA, along with an incision
and drainage for the cerebral abscess. Pus cultures grew
MRSA. The patient recovered well with no disturbance in
visual acuity or visual field. On post-operative follow ups, he
had no other neurological deficit apart from a slight limp.
3.Prevalence of Dyslipidaemia in Type 2 Diabetes Mellitus Patients and Its Association to Diabetic Retinopathy in a Malaysian Tertiary Hospital
Intan Nureslyna Samsudin ; Rafidah Md Saleh ; Subashini C.Thambiah ; Aiffa Syafira Mohamad Amir Hamzah ; Wan Noor Fatini Wan Khalik ; Elizabeth George
Malaysian Journal of Medicine and Health Sciences 2014;10(2):47-51
Background: Diabetic retinopathy (DR) is a microvascular complication of diabetes, which is a cause of
visual impairment and blindness. Its development and progression have been linked to dyslipidaemia,
although the link remains inconclusive. Aim: This study aimed to determine the prevalence of
dyslipidaemia among type 2 diabetic patients with DR in a tertiary setting and to determine the association
between dyslipidaemia and DR severity. Materials and methods: This was a cross sectional study using
retrospective data of type 2 diabetic patients attending the opthalmology clinic of a tertiary centre from
January 2007 to June 2014. Results of their fasting lipid profile and clinical data were retrieved from
the hospital information system. Results: A total of 178 patient’s data were collected. 120 (n=67.4%)
patients had non-proliferative diabetic retinopathy (NDPR) with moderate NPDR being the most
prevalent. Dyslipidaemia was noted in 151 (84.8%) of the patients. Patients had a combination of more
than one abnormality in the lipid profile with increased LDL-cholesterol being the main abnormality.
Dyslipidaemia was however, not significantly associated with DR severity. Conclusion: Dyslipidaemia
was highly prevalent in DR patients. The dyslipidaemia was however not associated with severity of DR.
Diabetic retinopathy
4.Retinoblastoma in an Older Child: A Case Report
Ong Wu ZHUAN ; Jamalia RAHMAT ; Sunder RAMASAMY ; Amir SAMSUDIN
Malaysian Journal of Medicine and Health Sciences 2018;14(2):93-96
Retinoblastoma is a rare intraocular malignant tumour more commonly seen in children below five years of age. We presented a rare case of retinoblastoma in an older child. A nine-year-old girl noticed that she had loss of vision OS following a fall at home. Her vision was 6/6 OD and only light perception OS. Examination of the left eye revealed an extensive exudative retinal detachment. Her right eye examination was unremarkable. CT scan showed a left eye intraocular mass with calcification. EUA revealed a mixed endophytic and exophytic mass with extensive exudative retinal detachment. Family members consented to left eye enucleation and histopathological report confirmed the diagnosis of retinoblastoma. Post enucleation, patient is doing well with a prosthetic eye. In conclusion, any unexplained visual loss in children regardless of age warrants a full ophthalmological examination as the possibility of retinoblastoma cannot be ruled out.
5.Choroidal thickness in Malaysian eyes with full-thickness macular holes
Tan Y CHEW ; Vengadasalam R SELVA ; Samsudin AMIR ; Khaliddin NURLIZA
International Eye Science 2018;18(3):401-405
·AIM: To compare choroidal thickness at the macula in eyes with unilateral idiopathic full - thickness macular holes (FTMH) with that of unaffected fellow eyes, and eyes of normal control patients. ·METHODS: Cross-sectional study. Thirty patients with unilateral idiopathic FTMH and thirty age, sex, and race-matched controls were recruited. Axial lengths were measured using laser interferometry. Enhanced depth imaging optical coherence tomography images were obtained using Heidelberg spectral - domain optical coherence tomography. Choroidal thickness was measured at the fovea, and at 1 mm and 2 mm nasally, temporally, superiorly and inferiorly from the center of the fovea. Statistical analysis was performed using independent and paired t-tests, chi-square tests, and Pearson correlation tests (P<0.05). ·RESULTS:The mean subfoveal choroidal thickness was 201.0±44.0 μ m in the FTMH group,225.3± 51.4 μ m in the fellow eye group and 262.3±70.3 μ m in the control group. The choroid was thinner in FTMH eyes at all locations when compared to control eyes(P<0.05). The fellow eye group also had thinner choroids than the control group at all locations except at 1 mm and 2 mm nasal to the fovea (P<0.05). Choroidal thickness in the FTMH group was lower than in the fellow eye group, but the differences were not statistically significant (P > 0.05). Choroidal thickness was generally highest subfoveally and lowest nasally. Subfoveal choroidal thickness was negatively correlated with age (r = -0.278, P = 0.032), and axial length (r=-0.328,P=0.011). ·CONCLUSION:Choroidal thickness is lower in both eyes of patients with unilateral FTMH compared to healthy control eyes.
6.Preschool Children Feeding Patterns And Early Childhood Oral Health Impact In Tanah Merah, Kelantan, Malaysia
Nizamuddin Pardan ; Ruhaya Hasan ; Norsamsu Arni Samsudin ; Wan Muhamad Amir W Ahmad
Malaysian Journal of Medicine and Health Sciences 2023;19(No.4):178-185
Introduction: Poor feeding patterns increase risk of Early Childhood Caries (ECC), which can cause negative impacts
on oral health-related quality of life (OHQoL) of preschool children and parents. This study aims to assess feeding
patterns of preschool children and OHQoL of the children and their parents in Tanah Merah. Methods: A cross-sectional study was conducted involving 134 preschool children aged 5-6 years old from eight private preschools, chosen by multi-staged stratified cluster sampling. Parents answered adopted self-administered questionnaire on feeding
patterns and oral health-related impacts. Mann-Whitney U test and Kruskal-Wallis test were used to compare the
median between groups of feeding patterns. Results: A total of 122 parents responded. Majority of the children had
history of bottle-feeding (97.5%) and being given solid food during infancy (61.2%). Many children were still using
bottle to drink (38.5%). Majority were still given formula milk at least three times daily (51.1%) and were feed with
bottle to put to sleep (97.9%). The Child Impact Section (CIS), Family Impact Section (FIS) and Overall ECOHIS mean
scores were 2.39 (SD=3.41), 0.71 (SD=1.45) and 3.10 (SD=4.41), respectively. Most common impact reported in CIS
was ‘oral pain’ (26.2%) whereas in FIS, ‘parents felt guilty’ (7.4%). None of feeding patterns were found significantly
different in terms of ECOHIS score median (p-value>0.05). Children OHQoL reporting by proxy should be treated as complementary. Conclusion: Many preschool children were involved in prolonged, frequent and nocturnal
bottle-feeding. No significant difference in median ECOHIS scores found according to feeding patterns.
7.Effectiveness of simple interventions to remind eye doctors to educate glaucoma patients about the dangers of driving
Adeline Low ; Sujaya Singh ; Ee Ling Ang ; Azida Juana Kadir ; Amir Samsudin
Malaysian Family Physician 2021;16(2):45-49
Purpose: A clinical audit to establish whether eye doctors achieve the benchmark in reminding glaucoma patients about the dangers of driving. After introducing two simple interventions, a follow-up audit was performed.
Methodology: Initially, we interviewed 85 patients with established glaucoma who underwent Humphrey visual field (HVF) testing and also reviewed their medical notes. We looked for documentation of their driving status, specifically whether those with bilateral visual field (VF) defects recalled being given advice about the dangers of driving and whether this was documented in the notes. After this initial audit, doctors were educated on the availability of guidelines on visual requirements for driving, and reminder adhesive labels were put on the front of medical notes of driving glaucoma patients. A follow-up audit was then performed on 95 different patients.
Results: In the initial audit, none of the patients had their driving status recorded. Only 36% of drivers with bilateral VF defects recalled being advised of the dangers of driving, with no documentation of whether the advice was given to them. Following the interventions, documentation of driving status became 86%. All drivers with bilateral VF defects recalled being advised regarding the dangers of driving, with documentation of the advice being given recorded in 73% of the medical notes.
Conclusion: Eye doctors are inadequately identifying, advising, and documenting the dangers of driving in the medical notes of glaucoma patients with bilateral VF defects. This can be improved with simple interventions, such as the education of doctors and creating reminder labels, for the benefit of our glaucoma patients.