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Philippine Journal of Ophthalmology

2002 (v1, n1) to Present ISSN: 1671-8925

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I am not just a number

Pearl M. Tamesis-Villalon

Philippine Journal of Ophthalmology.2018;43(1):1-.

In this day and age of research and constantly improving methods of research conduct and protocols, policies are determined, to a large part, by the results of these researches, most of which are numbers. So in addressing the growing need to prevent blindness from Retinopathy of Prematurity (ROP), experts worldwide, in at least 2 major landmark studies and 4 World ROP Congresses, agreed on the definitions of high-risk criteria, with emphasis on timely referral. These were all meant to guide the pediatricians in referring premature babies for ROP screening. These efforts were meant to drive home a very important point: the occurrence of visually-debilitating stages of ROP are preventable. The incidence of blindness from ROP is quite small, but nonetheless, catastrophic to the patient. To speak of those numbers is not my purpose today. My purposes are to put a face and a voice to those who are “the tiny number … the small incidence” crying out from the outer edges of bar graphs, and to remind everyone that that tiny number of blind and nearly blind children are people with lives to live, and futures to look forward to, just like the rest of us. Certainly, opening that golden window of opportunity is the most important thing that one can do for the premature baby at risk of developing ROP. One is not born with ROP. No one wants to have it. No parent will want his child to have it. And if one does have it, one must be protected from the deleterious consequences of ROP. This will happen only if everyone concerned will just do what they have to do. Screening of a high-risk baby by an ophthalmologist cannot be done without a referral from the attending pediatrician. The tireless efforts of neonatologists and pediatricians in keeping the premature babies alive and managing all their life-threatening conditions are truly laudable. However, we must insist that sight is just as important. We must insist that high-risk babies be referred to an ophthalmologist for ROP screening. The importance of a wholistic approach in the management of a premature baby cannot be overemphasized. Quality of life should be a primary consideration when it comes to any situation where something has been compromised. To drive home a point, please do this: Imagine your child blind. Then think of everything that a blind child will miss in his life. Think of all the difficulties that the blind child will encounter in his entire life. Think of all the difficulties and the heartaches for the parents of the blind child. Then think of how this blind person will be when the doting parents who took care of him will one day no longer be around. A parent of an ROP blind child once said “To a parent there are no statistics. My child is always 100%.” And finally, think about these wise words from Nelson Mandela: History will judge us by the difference we make in the everyday lives of children.
Retinopathy of Prematurity ; Blindness

Retinopathy of Prematurity ; Blindness

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A review article on neuroretinitis

Franz Marie Cruz ; Cheryl A. Arcinue

Philippine Journal of Ophthalmology.2018;43(1):3-9.

Neuroretinitis is an inflammatory optic neuropathy with a classic fundoscopic appearance of optic disc swelling and hard exudates on the macula in a star formation. It can be a manifestation of systemic, infectious or autoimmune disease. In nearly half of cases, the etiology is idiopathic. This review aims to summarize the clinical presentation, fundoscopic mimics, etiologies, investigation, and treatment of neuroretinitis. Cat-scratch disease, the most common cause of infectious neuroretinitis, and recurrent idiopathic neuroretinitis, which can cause ocular morbidity, are discussed in detail.
Retinitis ; Cat-Scratch Disease

Retinitis ; Cat-Scratch Disease

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Maternal and infantile risk factor profile of preterm infants screened for retinopathy of prematurity in a tertiary hospital

Maynard Sam O. Lazo ; Kristine D. Corpus-Velasquez

Philippine Journal of Ophthalmology.2018;43(1):10-14.

Objective: To identify maternal and infantile risk factors for retinopathy of prematurity (ROP) among preterm infants screened in St. Luke’s Medical Center, Quezon City (SLMC-QC) from 2014-2017. Methods: This was a retrospective study that included the ROP databank of the Eye Institute and the Research and Biotechnology Group of St. Luke’s Medical Center, Quezon City from 2014 to 2017. This study included medical records of all premature infants screened for ROP and excluded those who had incomplete data or other ocular pathologies other than ROP. Risk factors were analyzed using univariate analysis. Odds ratio (OR) and 95% confidence interval (CI) were also calculated with significant P value set at <0.05. Results: Among the 455 infants screened for ROP, 118 (25.9%) had any stage of ROP while 23 (5.0%) had treatment-warranted ROP (TW-ROP). Univariate regression analysis showed that the top 5 infantile risk factors associated with any stage of ROP and TW-ROP were low birth weight (97.5% and 100%, respectively), prematurity (87.3% and 100%, respectively), history of blood transfusion (21.2% and 13%, respectively), sepsis (21.2% and 17.4%, respectively), and oxygen supplementation (16.1% and 8.7%, respectively). After multivariate analyses, the most important adjusted risk factors associated with any stage of ROP include low birth weight (OR 52, CI 16.20166.96, P =0.001), prematurity (OR 25.73, CI 14.10-46.95, P =0.001), and history of blood transfusion (OR 8.79, CI 4.08-18.96, P =0.0001). Conclusion The most significant infantile risk factors associated with any ROP include low birth weight, prematurity, and history of blood transfusion. There were no significant probable maternal risk factors. Timely ROP screening is recommended especially among infants with any of these risk factors in their profile.
Retinopathy of Prematurity ; Risk Factors ; Blood Transfusion ; Infant, Low Birth Weight

Retinopathy of Prematurity ; Risk Factors ; Blood Transfusion ; Infant, Low Birth Weight

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Local validation of WINROP, an online screening tool for retinopathy of prematurity

Grace Celine D. Bautista ; Ricardo H. Ventura

Philippine Journal of Ophthalmology.2018;43(1):15-18.

Objective: To validate WINROP, a web-based screening tool for retinopathy of prematurity (ROP), in the detection of any-stage ROP or treatment-requiring ROP among Filipino preterm infants screened for ROP from January 2013 to April 2017. Methods: Charts of preterm infants who were screened for ROP at a tertiary hospital from January 2013 to April 2017 were reviewed. Birth date, gestational age, birth weight, and weekly postnatal weight measurements were collected and entered into WINROP. The number of infants that were tagged by WINROP with alarm signals for any-stage ROP or treatment-requiring ROP were noted and compared with actual ROP screening findings. The sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) of the WINROP application in predicting any-stage ROP and treatment-requiring ROP were computed. Results: Charts of 138 preterm infants were included in the study. Sixty-four (64) had a chart diagnosis of anystage ROP and 13 had treatment-requiring ROP. WINROP tagged 77 and 10 preterm infants with any-stage ROP and treatment-requiring ROP, respectively. The sensitivity and specificity rates of WINROP for detecting any-stage ROP were 63.5% (95% CI: 51.5% - 74.2%) and 78.1% (95% CI: 65.7% - 87.1%), respectively. While the sensitivity and specificity rates at identifying treatment-requiring ROP were 76.9% (95% CI: 45.9% - 93.8%) and 46.4% (95% CI: 37.5% - 55.5%), respectively. Conclusion WINROP is fairly sensitive and specific in predicting any-stage ROP but has fair sensitivity and poor specificity in predicting treatment-requiring ROP. WINROP may aid in ROP prediction, but regular screening of preterm infants at risk for ROP based on current criteria remains to be the standard of care.
Retinopathy of Prematurity

Retinopathy of Prematurity

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Comparison of the clinical profile of patients with glaucoma between private and government clinics in the Philippines.

Edgar Felipe U LEUENBERGER ; James Paul S GOMEZ ; Robert Edward T ANG ; Maria Imelda YAP-VELOSO ; Joseph Anthony J TUMBOCON ; Jose Maria D MARTINEZ ; John Mark S DE LEON ; Nilo Vincent FLORCRUZ ; Rainier Victor A COVAR ; Irene R FELARCA ; Denise Polly CHAO-PO ; Shalam SIAO-MARIANO ; Marie Joan Therese D BALGOS ; Noel D ATIENZA

Philippine Journal of Ophthalmology.2019;44(2):45-53.

OBJECTIVE: To describe the demographic and clinical characteristics of patients with glaucoma managed at private and government institutions in the Philippines between 2009 and 2014.

METHODS: A research team from two private and two government institutions in the Philippines reviewed the case records of 1246 patients seen who met the following criteria: intraocular pressure of >21 mmHg, optic nerve and nerve fiber layer abnormalities, and visual field defects. For bilateral cases, we selected the eye with worse glaucoma parameters.

RESULTS: There were 600 and 646 patients in the private and government groups (mean age at presentation, 60.51 and 55.88 years), respectively, with the majority being Filipino (91%). Patients with visual acuity (VA) of 20/20 to 20/40 were more frequently observed in private centers (58.7% vs. 41.3%), while a VA worse than counting fingers was more frequently observed in government centers (66.1% vs. 33.9%). Within-group analysis showed that primary angle-closure glaucoma was the most frequent glaucoma subtype in both private (27.3%) and government institutions (37.8%). In between-group analysis showed the following to be more common in private than government centers: primary open-angle glaucoma (61.3% vs. 38.7%), normal-tension glaucoma (63.9% vs. 36.1%), ocular hypertension (92.3% vs. 7.7%), and glaucoma suspects (80.4% vs. 19.6%) while government institutions registered a larger number of primary angle-closure glaucoma (59.8% vs. 40.2%) and secondary glaucoma (70.3% vs. 29.7%) cases. Medical treatment using a single drug and multiple drugs was employed for 245 (23%) and 825 (77%) patients, respectively. Within-group analysis showed that laser iridotomy and trabeculectomy were the most commonly performed laser and surgical procedures in both institution types.

CONCLUSION: There is a contrasting profile of glaucoma between clinical institutions in the Philippines with openangle glaucoma being more predominant in private centers while closed-angle glaucoma and secondary glaucoma being more frequent in government centers. Our findings may provide important preliminary information that can aid future health studies or training programs.


Human ; Glaucoma ; Patients

Human ; Glaucoma ; Patients

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Risk factors for conjunctival tube erosion in eyes implanted with Ahmed glaucoma valve in a private eye institution in the Philippines.

Jovell Ian M. PEREGRINO ; Edgar U. LEUENBERGER ; Ma. Imelda Y. VELOSO

Philippine Journal of Ophthalmology.2018;43(2):51-59.

Objective: To identify the risk factors for conjunctival tube erosion (CTE) in eyes implanted with Ahmed® glaucoma valve (AGV) device Method: This is a retrospective study conducted at a private eye institution. Medical records of patients who underwent AGV implantation surgery from January 2004 to December 2013 were reviewed. Eyes with at least 24 months of follow-up and complete records were included. Several variables from the pre-, intra-, and postoperative periods were collected. The primary outcome was development of CTE after AGV surgery. Univariable logistic regression and multivariable analysis were employed. Results: Forty-six (46) eyes of 45 patients were included in the study. The mean follow-up was 50.2 months (range: 24-140 months). Eight (8) eyes developed CTE (17.4%). Univariable logistic regression analysis identified female gender (P =0.064), presence of diabetes (P =0.083), prior intraocular surgeries (P =0.09), and postoperative use of antiglaucoma medications (P =0.086) to be marginally significant risk factors for CTE. On multivariable analysis, only female gender (OR=15.4, P =0.033) and diabetes (OR=14.1, P =0.031) were found to be significantly associated with CTE. Conclusion Risk factors for CTE following AGV implantation include female gender and presence of diabetes.
Human ; Glaucoma

Human ; Glaucoma

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Improving Philippine ophthalmic research

Sibayan Dr.Santiago

Philippine Journal of Ophthalmology.2006;31(1):6-7.


HEALTH SERVICES RESEARCH ; BIOMEDICAL RESEARCH ; INTERNSHIP AND RESIDENCY ; RESEARCH ; OPTHALMOLOGY ;

HEALTH SERVICES RESEARCH ; BIOMEDICAL RESEARCH ; INTERNSHIP AND RESIDENCY ; RESEARCH ; OPTHALMOLOGY ;

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Long-term intraocular-pressure outcome following an attack of acute primary angle closure

Na Koay Aun ; Eu Lim Andrew Keat ; Hussain Rusnah ; Abdul Rahman Ropilah

Philippine Journal of Ophthalmology.2006;31(1):29-34.


Human ; INTRAOCULAR PRESSURE ; GLAUCOMA, ANGLE-CLOSURE ;

Human ; INTRAOCULAR PRESSURE ; GLAUCOMA, ANGLE-CLOSURE ;

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Effect of sibutramine on intraocular pressure

Satici Ahmet ; Yilmaz Nevin ; Guzey Mustafa ; Kilic Adil

Philippine Journal of Ophthalmology.2006;31(1):35-37.

OBJECTIVE: This study evaluated the effects of sibutramine on intraocular pressure (IOP) and body-mass index (BMI). METHODS: Thirty obese females (body-mass index>30 kg/m2) treated with sibustramine (10 mg/day) plus plus diet restriction for 3 months were included in the study. IOP, BMI, and blood biochemical parameters were measured at the beginning and end of the treatment. Results were evaluated statistically by paired t-test, analysis of variance, and least-significant difference test. RESULTS: A statistically significant decrease was observed in the mean body-mas index (p<0.001) ans serum triglyceride (p<0.001), while a statistically significant increase was observed in IOP (p=0.54). CONCLUSION: While sibustramine provided an effective means for weight loss, it caused a slight increase in IOP, although this was not statistically significant. Nevertheless, it is prudent to monitor IOP in selected obese patients treated with sibustramine.
Human ; Female ; Adult ; OBESITY ; INTRAOCULAR PRESSURE

Human ; Female ; Adult ; OBESITY ; INTRAOCULAR PRESSURE

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Chopstick splinter: A rare cause of bilateral frozen orbits

Bin Lieh O. ; Ong Lee C. ; Tet Min C. ; Raja Selva V. ; Liza-Sharmini AT ; Balaravi P. ; Singh Gurdeep M.

Philippine Journal of Ophthalmology.2006;31(1):42-43.

OBJECTIVE: To report an unusual case of frozen orbit caused by an unsuspected intraorbital foreign body. METHOD: This is a case report. RESULTS: A 31-year old Chinese man presented with a 6-month history of painless progressive right caruncular growth with mucoid discharge. He also had bilateral progressive reduction in ocular movements. His best-corrected vision was 6/9 bilaterally. A conjunctival granuloma arising from the right caruncle and extending to the cornea and associate with ophthalmoplegia was also present. Orbital computed tomography showed a dense rod-like structure traversing the nasal area, extending from the superomedial wall of the right orbit to the apex of the left orbit with surrounding inflammatory reaction but sparing the optic nerve. The intraorbital foreign body, a 6 cm chopstick splinter, was successfully removed via right lateral rhinotomy. CONCLUSION: Intraorbital foreign bodies are not uncommonly seen and, generally, the diagnosis is straightforward. Nevertheless, diagnosis, could be missed if it is not suspected.
Human ; Male ; Adult ; WOUNDS AND INJURIES ; EYE FOREIGN BODIES ; EYE DISEASES ;

Human ; Male ; Adult ; WOUNDS AND INJURIES ; EYE FOREIGN BODIES ; EYE DISEASES ;

Country

Philippines

Publisher

Philippine Academy of Ophthalmology

ElectronicLinks

https://paojournal.com

Editor-in-chief

Franz Marie O. Cruz, MD

E-mail

secretariat@pao.org.ph

Abbreviation

PJO

Vernacular Journal Title

ISSN

0031-7659

EISSN

3028-1202

Year Approved

2009

Current Indexing Status

Currently Indexed

Start Year

1969

Description

The PHILIPPINE JOURNAL OF OPHTHALMOLOGY (PJO), the official journal of the Philippine Academy of Ophthalmology. It aims to provide a venue for exchange of ideas and information among ophthalmologists and other physicians. It publishes peer-reviewed reports of original clinical and laboratory investigations, epidemiological studies done in the Philippines and other countries, major reviews of specific topics, evaluation of diagnostic and surgical techniques, treatment methods, latest updates and controversial issues in ophthalmology. Initially published quarterly, the very first issue was dated January – March 1969 and entered as third-class mail at the Manila Post Office on February 13, 1969.

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