1.Patterns of Polypoidal Choroidal Vasculopathy among a Multiracial Population in a Malaysian Hospital
Nazima SA ; Hanisah AH ; Rona AN ; Wong HS ; Amin A ; Bastion MLC ; Mushawiahti M ; Hazlita MI
Medicine and Health 2016;11(2):245-256
Polypoidal choroidal vasculopathy (PCV) is a retinal disorder characterized
by aneurismal polypoidal lesions in choroidal vasculature. PCV appears to
preferentially affect pigmented individuals and is considerably high among Asians.
Most reports on patterns of PCV around Asia are based on a homogenous race
(e.g. Chinese, Japanese) and very few descriptions from a multiracial population
like those seen in Malaysia. The present study aimed to describe the demographic
features, clinical and investigative characteristics of PCV in a multiracial group at
Universiti Kebangsaaan Malaysia Medical Centre (UKMMC). Ninety one eyes of 86
PCV patients, comprising of Chinese (65.1%), Malays (31.4%), Indians (2.3%) and
Eurasian (1.2%) were retrospectively reviewed. All underwent complete ophthalmic
examination and investigations. Mean patient age was 70.4 years with a male
preponderance (59.3%), and mostly unilateral presentation (94.1%). The logMAR
mean presenting visual acuity was 0.78 ± 0.64. Polypoidal vascular lesions were
located generally within the macula area (86.8%), manifesting mainly as submacular
hemorrhage (59.3%). Interestingly a number of eyes (43.9%) had associated drusen.
Optical coherence tomography largely demonstrated exudative changes (75.9%)
and almost all patients (97.7%) had loss of external limiting membrane (ELM) and
IS/OS interface. On indocyanine green angiography, majority of eyes had multiple
polyps (82.4%) with ‘cluster’ (58.2%) being the commonest configuration. In
conclusion, although the patterns of PCV in UKMMC were mainly similar to other
Asian patients, a number of our patients had associated drusen. This indicates
that PCV in our population could be a variant of neovascular age related macular
degeneration and not solely idiopathic in nature.
Retinaldehyde
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Choroid
2.An Orbital Solitary Fibrous Tumor: Report of Two Cases with Different Presentation
Hanisah AH ; Othmaliza O ; Rona Asnida N ; Sunder R ; Hazlita MI
Journal of Surgical Academia 2016;6(2):18-21
Solitary fibrous tumour (SFT) is a rare spindle-cell neoplasm that can occur in the orbit. We report two cases of
orbital SFT in a 35-year-old female and a 28-year-old male with different presentations. First patient presented with
slowly progressive left lateral upper lid mass which is firm in consistency and non tender. Patient had non axial
proptosis as the mass compressed the globe inferonasally. There was also funduscopy evidence of choroidal folds
superotemporally. There is slight impairment of vision on the left eye comparing to right eye. Meanwhile, the second
patient presented with a painless diffuse swelling of left upper eyelid. It was soft in consistency, non fluctuate and no
opening or pus discharge noted. There is mild mechanical ptosis, however there was no proptosis and no evidence of
compression into the globe nor visual impairment.Computed tomography (CT) imaging revealed a well
circumscribed and contrast enhanced soft tissue mass intraorbital extraconal mass in both cases. However in the first
case, the tumour was at the level of lacrimal gland with compression of the globe, while in second case, it was
superior and posterior to the left lacrimal gland with no globe compression. Both patients underwent complete
resection of their tumors. The histological findings showed alternating hypercellular and hypocellular areas
composed of bland spindle cells with a fibrous stroma. The strong immunoreactivity for CD34 supported the
diagnosis of orbital SFT. There was no recurrence at the 2nd and 3rd year follow-up visits for both patients. SFT
should be considered as one of the differential diagnosis of an orbital tumor. The combination of CT scan, histologic
findings and immunohistochemical staining provide accurate diagnosis. En bloc excision of the tumour is the
mainstay of treatment.
Neoplasms