Purpose: To evaluate corneal cell morphology in patients with keratoconus using an in vivo slit scanning confocal microscope. Methods: A cross-sectional study was conducted to evaluate the corneal cell morphology of 47 keratoconus patients and 32 healthy eyes without any ocular disease. New keratoconus patients with different disease severities and without any other ocular co-morbidity were recruited from the ophthalmology department of a public hospital in Malaysia from June 2013 to May 2014. Corneal cell morphology was evaluated using an in vivo slit-scanning confocal microscope. Qualitative and quantitative data were analysed using a grading scale and the Nidek Advanced Visual Information System software, respectively. Results: The corneal cell morphology of patients with keratoconus was significantly different from that of healthy eyes except in endothelial cell density (P = 0.072). In the keratoconus group, increased level of stromal haze, alterations such as the elongation of keratocyte nuclei and clustering of cells at the anterior stroma, and dark bands in the posterior stroma were observed with increased severity of the disease. The mean anterior and posterior stromal keratocyte densities and cell areas among the different stages of keratoconus were significantly different (P < 0.001 and P = 0.044, respectively). However, the changes observed in the endothelium were not significantly different (P > 0.05) among the three stages of keratoconus. Conclusion: Confocal microscopy observation showed significant changes in corneal cell morphology in keratoconic cornea from normal healthy cornea. Analysis also showed significant changes in different severities of keratoconus. Understanding the corneal cell morphology changes in keratoconus may help in the long-term monitoring and management of keratoconus.

The aim of the present study was to evaluate visual functions and retinal morphology of Polypoidal Choroidal Vasculopathy (PCV) patients seen in an AMD referral centre of Malaysia and to further explore association between visual functions and optical coherence tomography (OCT) parameters in PCV eyes. In this single centre, cross sectional study, best corrected distance visual acuity (DVA), near vision acuity (NVA), reading speed (RS), and contrast sensitivity (CS) were measured in naïve PCV eyes. Selective parameters such as integrity of external limiting membrane (ELM), inner segment and outer segment junction (IS-OS), retinal pigment epithelium and Bruch’s membrane (RPE-BM) complex, average retinal thickness (ART) and volume (ARV), central retinal thickness (CT), centre maximum (CTmax) and centre minimum (CTmin) thickness were assessed using spectral-domain OCT. Forty-three new PCV eyes of 42 patients were evaluated. Mean (±SD) DVA, NVA, CS, RS were 0.83 ± 0.35 logMAR, 0.77 ± 0.3 logMAR, 0.69 ±.26 log CS and 59.56 ±14 words per minutes respectively. ART and CT showed good correlation with DVA (r=0.571& 0.546) and CS (r= 0.576 & 0.586). ARV and CTmax showed good correlation with CS (r=0.516 &, 0.513). The mean DVA, NVA and CS between three ELM and IS-OS status were significantly different (p=.002 & .000; p=.012 & .029; p=.005 & .001). In conclusion, present study reports visual functions and OCT characteristics of PCV patients in an AMD referral centre of Malaysia. Many of the quantitative and qualitative OCT parameters showed good association with the visual functions in eyes with PCV.
polypoidal choroidal vasculopathy ; visual functions ; ocular coherence tomography

PURPOSE: The purpose of the study was to differentiate ischemic central retinal vein occlusion (CRVO) from nonischemic CRVO during the early acute phase using plasma homocysteine as a biochemical marker. METHODS: Fasting plasma homocysteine, serum vitamin B12, and folate levels were measured in 108 consecutive unilateral elderly adult (age >50 years) ischemic CRVO patients in the absence of local and systemic disease and compared with a total of 144 age and sex matched nonischemic CRVO patients and 120 age and sex matched healthy control subjects. RESULTS: Homocysteine level was significantly increased in the patients with ischemic CRVO in comparison with nonischemic CRVO patients (p = 0.009) and also in comparison with control subjects (p < 0.001). Analysis also showed that hyperhomocysteinemia was associated with increased incidence of ischemic CRVO (odds ratio, 18) than that for nonischemic CRVO (odds ratio, 4.5). Serum vitamin B12 and folate levels were significantly lower (p < 0.001) in CRVO patients compared to the control but were not significantly different between nonischemic and ischemic CRVO patients (p > 0.1). CONCLUSIONS: Hyperhomocysteinemia can be regarded as useful in differentiating nonischemic and ischemic CRVO during the early acute phase in absence of local and systemic disease in the elderly adult (age >50 years) population.
Acute Disease ; Aged ; Biomarkers/*blood ; Case-Control Studies ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Hyperhomocysteinemia/blood/*complications/diagnosis ; Male ; Middle Aged ; Prospective Studies ; Retinal Vein Occlusion/complications/*diagnosis ; Time Factors

Introduction: Amblyopia is a condition with reduced best corrected visual acuity in absence of any ocular pathology. Different treatment approaches of amblyopia have been researched for decades. Recent studies on binocular dichoptic therapy using different software and video game based training showed drastic improvement in visual functions in amblyopic adults. Aim of this review is to assess the effect of vision therapy with dichoptic training in adults with anisometropic amblyopes. Method: Review was conducted in articles published within last 25 years from databases like PubMed, research gate, google scholar. Results: Dichoptic therapy has promising results in treatment of adults with anisometropic amblyopia. However, several limitations of these said researches were observed. Conclusion: Further studies particularly RCTs with strict methodology and treatment protocol, larger sample size and longer follow ups are recommended before clinicians could impart dichoptic therapy as a management option of adults with amblyopia into their evidence based practice.

OBJECTIVETo screen, isolate and optimize anti-white spot syndrome virus (WSSV) drug derived from various terrestrial plants and to evaluate the efficacy of the same in host-pathogen interaction model.

METHODSThirty plants were subjected to Soxhlet extraction using water, ethanol, methanol and hexane as solvents. The 120 plant isolates thus obtained were screened for their in vivo anti-WSSV property in Litopenaeus vannamei. The best anti-WSSV plant isolate, TP22C was isolated and further analyzed. The drug was optimized at various concentrations. Viral and immune genes were analysed using reverse transcriptase PCR to confirm the potency of the drug.

RESULTSSeven plant isolates exhibited significant survivability in host. The drug TP22C thus formulated showed 86% survivability in host. The surviving shrimps were nested PCR negative at the end of the 15 d experimentation. The lowest concentration of TP22C required intramuscularly for virucidal property was 10 mg/mL. The oral dosage of 750 mg/kg body weight/day survived at the rate of 86%. Neither VP28 nor ie 1 was expressed in the test samples at 42nd hour and 84th hour post viral infection.

CONCLUSIONSThe drug TP22C derived from Momordica charantia is a potent anti-white spot syndrome virus drug.

OBJECTIVETo screen, isolate and optimize anti-white spot syndrome virus (WSSV) drug derived from various marine floral ecosystems and to evaluate the efficacy of the same in host-pathogen interaction model.

METHODSThirty species of marine plants were subjected to Soxhlet extraction using water, ethanol, methanol and hexane as solvents. The 120 plant isolates thus obtained were screened for their in vivo anti-WSSV property in Litopenaeus vannamei. By means of chemical processes, the purified anti-WSSV plant isolate, MP07X was derived. The drug was optimized at various concentrations. Viral and immune genes were analysed using reverse transcriptase PCR to confirm the potency of the drug.

RESULTSNine plant isolates exhibited significant survivability in host. The drug MP07X thus formulated showing 85% survivability in host. The surviving shrimps were nested PCR negative at the end of the 15 d experimentation. The lowest concentration of MP07X required intramuscularly for virucidal property was 10 mg/mL. The oral dosage of 1 000 mg/kg body weight/day survived at the rate of 85%. Neither VP28 nor ie 1 was expressed in the test samples at 42nd hour and 84th hour post viral infection.

CONCLUSIONSThe drug MP07X derived from Rhizophora mucronata is a potent anti-WSSV drug.

OBJECTIVE: To describe the clinical presentation and course of seven ectopic thyroid patients.

METHODS:
Design: Retrospective Chart Review
Setting: Tertiary Government Teaching Hospital
Patient: Seven patients

RESULTS: Five patients were female and two were male (ratio of 5:2). Three belonged to the 20 to 30 year-old age group, whereas two were below 10 years of age. All seven were biochemically hypothyroid and ectopic thyroid was found to be the only functioning thyroid tissue. Three patients were managed medically with levothyroxine, while ectopic thyroid was excised in four. Ectopic thyroid tissue was autotransplanted in two cases following excision.

CONCLUSION: The ages of presentation in the present series correspond with the increased physiological demand of thyroid hormone. Thyroid substitution therapy is a must in the presence of clinical and/or biochemical hypothyroidism. Surgical excision should be avoided as far as possible especially if the ectopic tissue is the only functioning thyroid in the body. Surgery is required in selected cases presenting with obstructive symptoms or hemorrhage which are unresponsive to substitution therapy. Auto transplantation of the ectopic thyroid may not provide significant benefit to the patient and more research is warranted in this aspect.

Human ; Male ; Female ; Adult ; Young Adult ; Thyroid Gland ; Lingual Thyroid ; General Surgery