Optic perineuritis(OPN)refers to a spectrum of conditions involving pathologic inflammation of the optic nerve sheath. The classic triad of OPN consists of unilateral optic neuropathy associated with pain and/or disc oedema, but the condition often mimics other optic neuropathies, resulting in delayed diagnosis and suboptimal treatment. We performed a database search of Medline and Ovid in January 2016 for articles published in any language with the keywords ‘optic perineuritis'. Sixty articles were found, published from 1956 to 2015. Two reviewers(Tai ELM and Tevaraj JMP)performed an independent screening of abstracts. Articles of interest were subsequently examined. In this review, we highlight the salient features of OPN, with particular emphasis on the clinical differences between OPN and optic neuritis. Although the majority of cases of OPN are idiopathic, investigations are required to rule out specific infectious and inflammatory causes of secondary OPN. MRI is an invaluable component of the workup, as radiographic demonstration of peri-neural inflammation is diagnostic of OPN. Corticosteroid therapy results in dramatic and rapid reversal of the signs and symptoms, but prolonged therapy with slow tapering of oral corticosteroids may be necessary to reduce the risk of relapses.

Purpose: There are limited data from Asian countries regarding retinal thickness in children with type 1 diabetes mellitus (T1DM). This study aimed to compare the macular and retinal nerve fiber layer (RNFL) parameters between diabetic children without retinopathy and non-diabetic healthy children. We also evaluated the factors associated with RNFL thickness in children with T1DM. Methods: A comparative cross-sectional study was conducted among children with T1DM and healthy children aged 7 to 17 years old in Hospital Universiti Sains Malaysia from 2017 to 2019. Children with retinal disease or glaucoma were excluded. Macular and RNFL thicknesses were measured using spectral-domain optical coherence tomography. Demographic information, duration of diabetes, blood pressure, body mass index, visual acuity, and retinal examination findings were documented. Glycosylated hemoglobin levels, renal function, and blood lipid levels were also collected. Results: Forty-one children with T1DM and 80 age- and sex-matched children were enrolled. Both sexes were affected. Mean duration of diabetes mellitus was 3.66 years. The mean glycated hemoglobin levels in the T1DM group was 9.99%. The mean macular and RNFL thicknesses in children with T1DM were 277.56 (15.82) µm and 98.85 (12.05) µm, respectively. Children with T1DM had a significantly thinner average macula, superior outer macula, nasal outer macula, mean RNFL, and inferior RNFL thickness compared to controls (p < 0.05). There was a significant association between nephropathy and the mean RNFL thickness. Conclusions Children with T1DM had significantly decreased mean macular and RNFL thicknesses. Nephropathy is associated with an increased RNFL thickness.

Purpose: There are limited data from Asian countries regarding retinal thickness in children with type 1 diabetes mellitus (T1DM). This study aimed to compare the macular and retinal nerve fiber layer (RNFL) parameters between diabetic children without retinopathy and non-diabetic healthy children. We also evaluated the factors associated with RNFL thickness in children with T1DM. Methods: A comparative cross-sectional study was conducted among children with T1DM and healthy children aged 7 to 17 years old in Hospital Universiti Sains Malaysia from 2017 to 2019. Children with retinal disease or glaucoma were excluded. Macular and RNFL thicknesses were measured using spectral-domain optical coherence tomography. Demographic information, duration of diabetes, blood pressure, body mass index, visual acuity, and retinal examination findings were documented. Glycosylated hemoglobin levels, renal function, and blood lipid levels were also collected. Results: Forty-one children with T1DM and 80 age- and sex-matched children were enrolled. Both sexes were affected. Mean duration of diabetes mellitus was 3.66 years. The mean glycated hemoglobin levels in the T1DM group was 9.99%. The mean macular and RNFL thicknesses in children with T1DM were 277.56 (15.82) µm and 98.85 (12.05) µm, respectively. Children with T1DM had a significantly thinner average macula, superior outer macula, nasal outer macula, mean RNFL, and inferior RNFL thickness compared to controls (p < 0.05). There was a significant association between nephropathy and the mean RNFL thickness. Conclusions Children with T1DM had significantly decreased mean macular and RNFL thicknesses. Nephropathy is associated with an increased RNFL thickness.

Purpose: Macular edema, serous retinal detachment, and retinal pigment epithelial detachment have been reported in patients with nephrotic syndrome. However, there is limited data about macular thickness in children with nephrotic syndrome. The aim of this study was to compare the mean macular thickness in children with nephrotic syndrome and in a control group and to correlate it with visual acuity and level of proteinuria. Methods: The comparative cross-sectional study included 66 children aged 6 to 17 years with nephrotic syndrome and healthy control seen in two tertiary centers in Malaysia. We recorded demographic data, as well as visual acuity, level of proteinuria, and the mean macular thicknesses in both groups. The mean macular thickness was measured using Stratus optical coherence tomography according to nine areas of the Early Treatment Diabetic Retinopathy Study map. Results: The mean foveal thickness was 238.15 ± 22.98 µm for children with nephrotic syndrome and 237.01 ± 22.60 µm for the control group. There was no significant difference in the mean macular thickness between the groups (p = 0.843). A significant correlation with visual acuity was observed in the superior outer macula (r = –0.41, p = 0.019), the nasal outer macula (r = –0.41, p = 0.019), and the inferior outer macula (r = –0.40, p = 0.021). There was no significant correlation between the mean macular thickness and level of proteinuria (p = 0.338), although those with higher levels of proteinuria demonstrated a trend towards increased macular thickness. Conclusions The mean macular thickness in children with nephrotic syndrome was similar to that of healthy children. A significant correlation between the mean thickness of the outer macular layer and the presenting visual acuity was observed. There was no correlation between the mean macular thickness and the level of proteinuria.

·This study aims to describe the treatment efficacy of supratarsal injection of triamcinolone acetonide and dexamethasone sodium phosphate for paediatric vernal keratoconjuctivitis(VKC) over a 5-year-period in Hospital Universiti Sains Malaysia. Totally 10 patients were treated with this combination injection had clinical improvement by 1mo post injection. The main complication was increased intraocular pressure (4 patients). Four patients had recurrences within 6mo. We concluded that the clinical responsetosupratarsalcombination corticosteroids in VKC is fairly similar to that reported in the literature using a single corticosteroid agent. However, the risk of increased intraocular pressure is higher.

AIM: To compare the optic nerve function and visual evoked potential(VEP)between optic neuritis patients and normal individuals.

METHODS: A cross-sectional study was conducted at the Eye Clinic of Hospital Universiti Sains Malaysia(HUSM)between September 2011 and February 2013. We recruited twenty optic neuritis patients with a single episode of idiopathic optic neuritis occurring between 3mo and 2y prior to examination, and twenty control subjects. Ocular examination included visual acuity, colour vision, contrast sensitivity, visual field and pattern VEP. Independent t-test was conducted to compare the differences in the means of optic nerve function and VEP parameters between the optic neuritis group and control group. In parameters that were not normally distributed, Mann-Whitney test was used to compare the medians between the two groups.

RESULTS: In the optic neuritis group, the mean age was 30.8y. The mean duration between the episode of optic neuritis and the time of evaluation was 6.6mo. The visual acuity was poorer in the group with optic neuritis, with the mean LogMAR score(0.52)being significantly higher in this group than in controls(P=0.001). Colour vision was likewise decreased, with a mean score of 63.0% in the optic neuritis group(P=0.001). Contrast sensitivity was reduced in all four spatial frequencies; 3CPD(P=0.029), 6CPD(P=0.026), 12CPD(P=0.002)and 18CPD(P=0.006)in patients with optic neuritis. There was also a statistically significant loss of visual field in this group(P≤0.001). Although subjects with optic neuritis had a slightly prolonged VEP P100 latency compared to normal subjects, this difference in VEP latency was not significant using checkerboard pattern 1 or 2. Higher VEP amplitude was observed in optic neuritis subjects, but the difference between groups was not statistically significant.

CONCLUSION: There were significant reductions in optic nerve functions(i.e. visual acuity, colour vision, contrast sensitivity and visual field)at a mean of 6mo after an acute attack of optic neuritis. However, no significant differences in VEP amplitude and latency were noted between patients with optic neuritis and the control group. VEP may not be the ideal test to diagnose a previous attack of optic neuritis, as VEP parameters tend to normalize after a variable interval.

ABSTRACT Kimura disease (KD) is a rare chronic inflammatory disorder of unknown aetiology that primarily affects the head and neck region with lymph node involvement. Young to middle-aged adult Asian males are predominantly affected. The most common presentation is painless subcutaneous swelling in the head and neck region, while proptosis or orbital involvement is very rarely reported. KD shares some features with other inflammatory and neoplastic disorders, including lymphoma; thus, investigations to confirm the diagnosis should not be delayed. Systemic corticosteroids are commonly used to treat KD and show an excellent response; however, the optimal treatment is still uncertain, and KD has a high recurrence rate. We describe the case of a patient with KD who presented with proptosis and post-auricular swelling, which responded well to oral prednisolone treatment.
Kimura Disease ; Exophthalmos