1.Adult Coats' disease: a case report
Nor-Sharina YUSOF ; Zunaina EMBONG ; Mokhtar IBRAHIM
International Eye Science 2010;10(6):1041-1043
·AIM: To present a case of Coats' disease in adult and to illustrate the retinal findings.·METHODS: A case report.·RESULTS: A 63 years old Malay man, a known case of diabetes mellitus, presented with one year history of painless and progressive reduced vision in the right eye. Right eye visual acuity was counting finger 2 feet while left eye best corrected visual acuity was 6/12. Right fundus showed presence of extensive subretinal exudates at the temporal part of the posterior pole involving the macular area and nasal to the optic disc. It was associated with multiple areas of abnormal blood vessels temporal to the macula with attenuated vessels. Fundus fluorescein angiography(FFA) showed presence of telangiectatic vessels at the area of subretinal exudates and leakage of fluorescein from the telangiectatic vessels. The left eye was normal. Based on clinical and FFA findings, he was diagnosed to have adult Coats' disease. The right eye was treated with argon laser photocoagulation. Six months post laser, his visual acuity remained at 6/120 and there was minimal regression of the disease seen in the retina. ·CONCLUSION: The clinical and angiographic findings are important in diagnosing retinal telangiectasia. Treatment by laser photocoagulation in area of leakages may be beneficial in preventing visual loss.
2.Clinical Presentation, Severity and Progression of Primary Angle Closure in Malays
Ahmad Tajudin Liza-Sharmini ; Yusof Nor Sharina ; Dolaboladi Ali Jaafari ; Zaid Nik Azlan ; Yaakub Azhany ; Embong Zunaina
The Medical Journal of Malaysia 2014;69(1):21-26
Introduction: There is limited knowledge on primary angle
closure (PAC) in Malays. Understanding the clinical
presentation and progression of PAC in Malays is important
for prevention of blindness in Southeast Asia.
Material and methods: A retrospective record review study
was conducted on Malay patients seen in the eye clinic of
two tertiary hospitals in Kelantan, Malaysia. Based on the
available data, Malay patients re-diagnosed as primary angle
closure suspect (PACS), primary angle closure (PAC), and
primary angle closure glaucoma (PACG) based on the
International Society Geographical Epidemiological
classification. Clinical data was collected from initial
presentation including the presence of acute primary angle
closure until at least 5 years follow up. Progression was
defined based on gonioscopic changes, vertical cup to disc
ratio (VCDR), intraocular pressure (IOP) and Humphrey
visual field (HVF) analysis. Progression and severity of
PACG was defined based Hodapp-Parrish-Anderson
classification on reliable HVF central 24-2 or 30-2 analysis.
Results: A total of 100 patients (200 eyes) with at least 5
years follow up were included. 94 eyes (47%) presented with
APAC. During initial presentation, 135 eyes (67.5%) were
diagnosed with glaucomatous changes with 91 eyes already
blind. After 5 years of follow up, 155 eyes (77.5%)
progressed. There was 4 times risk of progression in eyes
with PAC (p=0.071) and 16 times risk of progression in PACG
(p=0.001). Absence of laser peripheral iridotomy was
associated with 10 times the risk of progression.
Conclusion: Angle closure is common in Malays. Majority
presented with optic neuropathy at the initial presentation
and progressed further. Preventive measures including
promoting public awareness among Malay population is
important to prevent blindness.