1.High Myopia Following Unilateral Cryocoagulation for Threshold Retinopathy of Prematurity
Nazri Omar ; Lo Yee Lin ; Rafidah Md Saleh
Malaysian Journal of Medicine and Health Sciences 2016;12(2):56-59
Despite the proven benefit of cryotherapy in the management of
threshold retinopathy of prematurity (ROP), it was shown
leading to ocular adverse effects. A male infant was born at 28
week of gestation with a birth weight of 1200 g. Serial
examinations revealed worsening ROP in both eyes until he
reached a high risk pre-threshold ROP in his right eye and
threshold ROP in his left eye. Cryotherapy was performed for
the threshold ROP in the left eye while the right eye was
subjected to further observation. Subsequently, ROP in both
eyes regressed without cicatrisation. The patient was followedup
over 8 years and refractions showed that the treated eye
developed steadily increasing myopia while the untreated eye
remained emmetropic. This case demonstrated the detrimental
effect of cryotherapy to the treated eye leading to the progressive
myopia as the child grew.
Retinopathy of Prematurity
;
Cryotherapy
2.Open Globe Injury in Hospital Serdang - An 8-year Retrospective Review
Nazri Omar ; Maimunah Abdul Muna’aim ; Rafidah Md. Saleh
Malaysian Journal of Medicine and Health Sciences 2017;13(2):17-28
Introduction: Open globe injury may lead to devastating visual outcome. Urgent management and subsequent
follow-up is important to maximise recovery. More data on open globe injury in Malaysia is needed to identify risk
groups and prognostic factors. This study was carried out to investigate open globe injury, the socio-epidemic profile,
clinical characteristics and outcome of the open globe injury in the Hospital Serdang, Malaysia. Methods: All
patients managed for open globe injury to Hospital Serdang from January 2006 to December 2013 were included in
this retrospective case review. Student’s T-test was used to determine difference between means and chi-square for
categorical data. P value of less than 0.05 was regarded as statistically significant. Results: There were 155 patients
managed for open globe injury with three of them had bilateral involvement. As such, there were 158 cases eligible
for analysis in this study. The average age was 32.2 ± 16.5 years (mean ± standard deviation, SD). Male was at higher
risk for open globe injury. Predictors for poor visual outcome were foreign nationality (p=0.047), lid laceration
(0.008), type of injury (p=0.001), site of injury (p=0.008), RAPD (p<0.001), uveal prolapse (p<0.001), hyphaema
(p=0.008), lens damage (p=0.010), vitreous loss (0.014), retinal detachment (p=0.011), intraocular foreign body
(IOFB) (0.014) and poor presenting uncorrected visual acuity (UCVA) (p<0.001). Conclusions: Occupational injury
was a main cause of open globe injury in Hospital Serdang. Although in general the visual outcome is good, effort
should be put to prevent work-related injury.
3.Dry Eye Among Patients at the Eye Clinic of A Secondary Referral Hospital
Maimunah Abdul Muna’aim, Tey Yin Yee ; Alya Az-Zahra Mohamad Zafarullah ; Rafidah Md Saleh ; Azri Omar
Malaysian Journal of Medicine and Health Sciences 2016;12(2):30-37
Introduction: Dry eye is a common but under-diagnosed
problem in the general population. Lack of standardised
diagnostic protocol causes prevalence of dry eye varied widely
in different populations. Nevertheless, effective management
rests largely on the accurate diagnosis and identification of the
contributing risk factors. Methods: In a cross sectional study,
socio-demographic, lifestyle and medical history data were
collected from 157 respondents. A validated six-item
questionnaire was used to determine the dry eye symptoms. Dry
eye was determined by using Schirmer’s test. Fluorescein
staining test and tear break up time (TBUT) test were performed
to characterise the dry eye. Results: Using the Schirmer’s test,
33.8% of respondents had dry eyes. The likelihood of dry eye
increased among Malay females in the seventh decade. The
most frequently reported symptom was sensation of dryness of
the eye. Although only 22.6% of dry eye cases were
symptomatic, up to 47.2% of them may developed surface
changes detectable by fluorescein dye test. Ethnicity (p=0.019)
and diabetes mellitus (p=0.049) were significantly associated
with dry eye. Conclusion: Dry eye could be subclinical but
clinical tests in potential risk groups can lead to better detection
of this condition and allow prescription of appropriate treatment
for affected patients.
Keywords: Dry eye symptoms; Dry eye syndrome
Eye
4.An 8-year Retrospective Review of Microbial Keratitis in A Secondary Referral Centre in Malaysia.
Nazri Omar ; Maimunah Abdul Muna’aim ; Rafidah Md. Saleh ; Muhammad Mohd. Isa
Malaysian Journal of Medicine and Health Sciences 2017;13(2):47-57
Introduction: Microbial keratitis (MK) is an important cause for corneal blindness and understanding its risk factors
enable us to improve management and minimise its complications. Methods: In this retrospective case review,
medical records of all patients treated for MK from 2006 to 2013 was analysed to know the socio-demography,
preceding risk factors, clinical characteristics, causative organisms and final visual outcome. Results: A total of 174
patients (180 eyes) were included in this study. Identifiable ocular risk factors included contact lens (CL) usage (85,
47.2%), ocular trauma (50, 27.8%), ocular surface disease (21, 11.6%), steroid use (6, 3.3%) and immuno-compromy
(19, 10.5%). Association factors for presenting uncorrected visual acuity (UCVA) were age group (p=0.013), size
(p<0.001), location (p<0.001) and hypopyon (p<0.001). The predictors for final best spectacle-corrected visual
acuity (BSCVA) were age group (p<0.001), nationality (p=0.020), occupation (p<0.001), CL use (p<0.001), ocular
surface disease (p=0.048), size (p<0.001) and location (p<0.044), hospitalisation duration (p=0.002) and presenting
UCVA (p<0.001). Conclusions: Contact lens was the most frequent predisposing risk factor for microbial keratitis,
followed by ocular trauma. Understanding the association factors for presenting vision and predictors for final vision
may help in the patients’ management and improve eventual outcome of microbial keratitis.
5.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
6.Arrow Ocular Injury
Rafidah Saleh ; Wahid Abdullah Salem Wajih
Malaysian Journal of Medicine and Health Sciences 2020;16(No.4):397-399
Pediatric ocular trauma; though the number is small, can lead to a devastating lifetime impact due to its risk of amblyopia (if it occurs before the age of seven) and also loss of vision. We are reporting a case of a young 12-year-old-boy
who was struck unintentionally by an arrow to the eye by another friend during sports activity. The arrow pierced
the right eyebrow just below the orbital roof then perforated the globe from the superior orbit pointing downwards
piercing the floor of the orbit fracturing the maxillary roof. Emergency scleral repair was done; however, there was no
useful vision left. Arrow injury to the eye is a rare occurrence but leads to severe consequences given its high velocity
and projectile in nature. The incidence is low and highly avoidable if precautionary measures are taken.
7.Pseudomonas Keratitis Predominance in Government Hospitals in Johor, Malaysia
Vidhubala Balasegar ; Rafidah Md Saleh ; Leslie Thian Lung Than ; Azmiza Syawani Jasni ; Rosni Ibrahim
Malaysian Journal of Medicine and Health Sciences 2024;20(No.2):4-10
Introduction: Keratitis is an eye-threatening condition, which requires immediate treatment, due to the rapid progression when the infection caused by Pseudomonas aeruginosa. This study aimed to describe the socio-demographic factors and risk factors related to Pseudomonas keratitis in selected six government hospitals in Johor, Malaysia. Methods: An 18 months cross-sectional study was conducted among bacterial keratitis patients from six government hospitals offering ophthalmology services in Johor, Malaysia. The cases were confirmed through a positive culture of Pseudomonas aeruginosa. All data on socio-demographic factors, risk factors, and symptoms were recorded using a data collection form and analysed using the Statistical Package for Social Sciences (SPSS) software version 26. Results: Fifty-five patients were diagnosed with Pseudomonas keratitis in this study. The majority of patients were males (65.5%) with a mean age of 41.22 years old. The majority of patients were of Malay ethnicity (60.0%). More than a quarter of cases are involved in office-oriented jobs (n=14, 25.5%). The major risk factors in this study were contact-lens usage (n=25, 45.5%), trauma (n=20, 36.4%), ophthalmic steroid usage (n=16, 29.1%), ocular surface disease (n=12, 21.8%) and previous eye surgery (n=4, 7.3%). This study found underlying medical illness (p=0.036) and ocular surface disease (p=0.051) are significantly associated with Pseudomonas keratitis. Conclusion: The present study is the first study in Malaysia focusing on Pseudomonas keratitis. This study provides additional information on the epidemiology data of keratitis in Malaysia. Future studies shall be extended to all government hospitals in Malaysia to obtain better insight on the disease burden of keratitis especially on Pseudomonas keratitis.