Publications by authors named "Lik Thai Lim"

50 Publications

A rare case of unilateral Cogan's anterior internuclear ophthalmoplegia, upgaze palsy and ataxia caused by dorsal tegmentum lesion at pontomesencephalic junction.

BMC Ophthalmol 2021 Feb 25;21(1):105. Epub 2021 Feb 25.

Universiti Malaysia Sarawak (UNIMAS), Kota Samarahan, Sarawak, Malaysia.

Background: Cogan's anterior internuclear ophthalmoplegia (INO) is characterized by INO with inability to converge and commonly thought to be due to rostral midbrain lesion. A lesion outside midbrain that causes unilateral Cogan's anterior INO combined with upgaze palsy and ataxia are rarely described.

Case Presentation: A 67-year old male presented with left Cogan's anterior internuclear ophthalmoplegia (INO), left appendicular ataxia and bilateral upgaze palsy. A Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA) brain showed a left dorsal tegmental infarct at the level of pontomesencephalic junction.

Conclusions: This case highlights the clinical importance of Cogan's anterior INO in combination with upgaze palsy and ataxia, and report possible site of lesion in patients with such constellation. Clinicians should consider looking for cerebellar signs in cases of Cogan's anterior INO, apart from just considering localizing the lesion at the midbrain.
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http://dx.doi.org/10.1186/s12886-021-01868-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908666PMC
February 2021

Human coronaviruses: ophthalmic manifestations.

BMJ Open Ophthalmol 2020 2;5(1):e000630. Epub 2020 Nov 2.

Ophthalmology Department, Universiti Malaysia Sarawak (UNIMAS), Kota Samarahan, Sarawak, Malaysia.

The 2019 novel coronavirus which causes severe acute respiratory syndrome (SARS) known as SARS-CoV-2 still remains as a global pandemic since its discovery and continues to spread across the world, given how highly contagious the virus is. We reviewed various articles that explore eye involvement in COVID-19 and other human coronaviruses, its human manifestations in comparison to animal studies and potential mechanism of viral entry into the eye surface. Evidence of animal studies depicted various complications of coronaviruses infection into the eyes, in both anterior and posterior segments of the eye. Conjunctival inflammation remains uncommon in association with COVID-19, with other ophthalmic findings. The risk of transmission via the ocular surface remains likely low, though it is inarguably present based on preliminary finding of viral load in ocular samples and expression of ACE2 on the ocular surface. Testing the tears sample for diagnosing SARS-CoV-2 was unreliable due to limitations of the testing kits and conflicting evidence of the viral titre in the ocular samples. Further larger, more precise and specific studies are required to allow us to better understand the pattern of virulence underlying the associations of SARS-CoV-2 in the eye despite its rare occurrence. This review article aims to enhance better awareness among clinicians regarding ocular manifestations associated with COVID-19 and necessary precautions should be implemented to minimise the risk of person-to-person especially in the nosocomial setting.
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http://dx.doi.org/10.1136/bmjophth-2020-000630DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7607601PMC
November 2020

Comparison of Icare Rebound Tonometer and Perkins Applanation Tonometer in Community Eye Screening.

Asia Pac J Ophthalmol (Phila) 2019 May-Jun;8(3):229-232. Epub 2019 Jun 5.

Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Malaysia.

Purpose: To compare the measurement of intraocular pressure (IOP) of Icare rebound tonometer and Perkins applanation tonometer (PAT) during community eye screening and to assess the agreement between these 2 instruments.

Design: A cross-sectional, non-interventional study.

Methods: The IOP measurements by handheld Icare rebound tonometer (Finland) were first performed by a primary care physician. Then the IOP was measured using Perkins Mk3 applanation tonometer (Haag-Streit, UK) by an ophthalmologist who was masked to previous readings from the Icare rebound tonometer. The mean IOP measured by each tonometer was compared. Pearson correlation coefficient was used to explore the correlation between the IOP measurements of the 2 instruments. The level of agreement between them was assessed using the Bland and Altman method.

Results: A total of 420 left eyes were examined. The mean age of subjects was 38.6 ± 18.2 years. Approximately 67% of subjects were female. The mean IOP was 16.3 ± 4.0 mm Hg using Icare and 13.4 ± 2.3 mm Hg using PAT. Pearson correlation coefficient showed a moderate positive correlation between the 2 methods ( = +0.524, < 0.001). Linear regression analysis revealed a slope of 0.28 with R² of 0.255. The mean difference between the 2 methods was 2.90 ± 3.5 mm Hg and the sample -test revealed a statistically significant mean difference from 0 ( < 0.001). The 95% limits of agreement between the 2 methods were between -9.73 and 3.93 mm Hg.

Conclusions: The handheld Icare rebound tonometer is a reasonably acceptable screening tool in community practices. However, Icare overestimated IOP with a mean of 2.90 mm Hg higher than the PAT. Thus, using Goldmann applanation tonometer as a confirmatory measurement tool of IOP is suggested.
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http://dx.doi.org/10.22608/APO.2018433DOI Listing
June 2019

Iatrogenic intralenticular broken steroid implant: a case report.

J Med Case Rep 2019 May 6;13(1):131. Epub 2019 May 6.

Universiti Malaysia Sarawak (UNIMAS), Kota Samarahan, Sarawak, Malaysia.

Background: This is a case report of an iatrogenic intralenticular broken steroid (Ozurdex™) implant in a patient with uveitis. There are only a few case reports on broken Ozurdex™ implants in the vitreous cavity, with none of them involving the crystalline lens. A few authors have described the accidental injection of an Ozurdex™ implant into the crystalline lens, but all of the implants remained in one piece in the lens and none of them were broken. We report an unusual case of an Ozurdex™ implant which was injected inadvertently into the crystalline lens, resulting in a broken Ozurdex™ implant with an entry and exit wound through the posterior capsule of the lens.

Case Presentation: An ophthalmic trainee performed an Ozurdex™ intravitreal injection into a 48-year-old Asian man's right eye under aseptic conditions. This patient was then followed up for further management. On day 7 post-procedure, a slit lamp examination revealed that the Ozurdex™ implant was injected into the intralenticular structure of his right eye and had fractured into two pieces. The posterior capsule of the right lens was breached, with one half of the Ozurdex™ implant stuck at the entry and the other stuck at the exit wound of the posterior capsule. This patient underwent right eye cataract extraction and repositioning of the fractured implant; he made an uneventful recovery.

Conclusions: Ophthalmologists should be aware of the potential risk of injecting an Ozurdex™ implant into an anatomical structure other than the vitreous cavity. Adequate training and careful administration of the Ozurdex™ implant are necessary to avoid such a complication, which fortunately is rare.
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http://dx.doi.org/10.1186/s13256-019-2064-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6501317PMC
May 2019

Systematic Review of the Effect of Reflective Materials Around a Phototherapy Unit on Bilirubin Reduction Among Neonates With Physiologic Jaundice in Developing Countries.

J Obstet Gynecol Neonatal Nurs 2018 11 30;47(6):795-802. Epub 2018 Aug 30.

Objective: To identify the efficacy and safety of the use of various cost-effective reflective materials around phototherapy units to reduce the duration of phototherapy and hasten the reduction of bilirubin among neonates with physiologic jaundice.

Data Sources: A systematic review of randomized controlled trials identified from searches in the Cumulative Index to Nursing and Allied Health Literature, ScienceDirect, Embase, and the Cochrane Library with the use of keywords, MeSH terms, operators, and the review of reference lists of retrieved articles.

Study Selection: From a total of 186 studies initially screened, five were eventually included in this analysis.

Data Extraction: Two authors independently reviewed each study with a standard template. Review parameters included the quality of each study based on the Physiotherapy Evidence Database scale and the Consolidated Standards of Reporting Trials guidelines.

Data Synthesis: All studies were generalizable and were rated as high quality on the Physiotherapy Evidence Database scale; one study scored 8 points, and the other four scored 6 points each. The reflective materials used in these studies included the following: white 100% cotton cloths (one study), white plastic covers (two studies), underpads (one study), and silver fabric cloth (one study). Pooled analysis of three studies indicated that reflective materials significantly reduced the duration of phototherapy with a large effect size of 0.82 (p = .04). Pooled analysis of another three studies indicated that the mean decrease of the total serum bilirubin 4 hours after the initiation of phototherapy was significantly greater when reflective materials were added (mean difference of 11.39 μmol/L, 95% confidence interval [2.26, 20.52 μmol/L], p = .01).

Conclusion: The addition of reflective materials to phototherapy units may be therapeutic for neonates with physiologic jaundice.
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http://dx.doi.org/10.1016/j.jogn.2018.07.008DOI Listing
November 2018

A Review on the Extraction of Quantitative Retinal Microvascular Image Feature.

Comput Math Methods Med 2018 2;2018:4019538. Epub 2018 Jul 2.

Department of Electrical and Electronics Engineering, University Malaysia Sarawak (UNIMAS), 94300 Kota Samarahan, Kuching, Malaysia.

Digital image processing is one of the most widely used computer vision technologies in biomedical engineering. In the present modern ophthalmological practice, biomarkers analysis through digital fundus image processing analysis greatly contributes to vision science. This further facilitates developments in medical imaging, enabling this robust technology to attain extensive scopes in biomedical engineering platform. Various diagnostic techniques are used to analyze retinal microvasculature image to enable geometric features measurements such as vessel tortuosity, branching angles, branching coefficient, vessel diameter, and fractal dimension. These extracted markers or characterized fundus digital image features provide insights and relates quantitative retinal vascular topography abnormalities to various pathologies such as diabetic retinopathy, macular degeneration, hypertensive retinopathy, transient ischemic attack, neovascular glaucoma, and cardiovascular diseases. Apart from that, this noninvasive research tool is automated, allowing it to be used in large-scale screening programs, and all are described in this present review paper. This paper will also review recent research on the image processing-based extraction techniques of the quantitative retinal microvascular feature. It mainly focuses on features associated with the early symptom of transient ischemic attack or sharp stroke.
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http://dx.doi.org/10.1155/2018/4019538DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6051289PMC
December 2018

The incidence of acute angle closure in Scotland: a prospective surveillance study.

Br J Ophthalmol 2018 Apr 9;102(4):539-543. Epub 2017 Aug 9.

Centre for Vision and Vascular Science, Queen's University, Belfast, Northern Ireland, UK.

Purpose: To estimate the incidence, and describe the clinical features and short-term clinical outcomes of acute angle closure (AAC).

Methods: Patients with newly diagnosed AAC were identified prospectively over a 12-month period (November 2011 to October 2012) by active surveillance through the Scottish Ophthalmic Surveillance Unit reporting system. Data were collected at case identification and at 6 months follow-up.

Results: There were 114 cases (108 patients) reported, giving an annual incidence of 2.2 cases (95% CI 1.8 to 2.6) or 2 patients (95% CI 1.7 to 2.4) per 1 00 000 in the whole population in Scotland. Precipitating factors were identified in 40% of cases. Almost one in five cases was associated with topical dilating drops. Best-corrected visual acuity (BCVA) at presentation ranged from 6/6 to perception of light. The mean presenting intraocular pressure (IOP) was 52 mm Hg (SD 11). Almost 30% cases had a delayed presentation of 3 or more days. At 6 months follow-up, 75% had BCVA of 6/12 or better and 30% were found to have glaucoma at follow-up. Delayed presentation (≥3 days) was associated with higher rate of glaucoma at follow-up (22.6% vs 60.8%, p<0.001), worse VA (0.34 vs 0.74 LogMAR, p<0.0001) and need for more topical medication (0.52 vs 1.2, p=0.003) to control IOP.

Conclusion: The incidence of AAC in Scotland is relatively low compared with the Far East countries, but in line with previous European data. Almost one in five cases were associated with pupil dilation for retinal examination.
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http://dx.doi.org/10.1136/bjophthalmol-2017-310725DOI Listing
April 2018

An alternative to direct ophthalmoscopy.

Clin Teach 2016 08;13(4):316

Ophthalmology Department, Royal Berkshire Hospital, Reading, UK.

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http://dx.doi.org/10.1111/tct.12506DOI Listing
August 2016

MACULA RETINAL VASCULITIS AND CHOROIDITIS ASSOCIATED WITH GRANULOMATOSIS WITH POLYANGIITIS.

Retin Cases Brief Rep 2017 Spring;11(2):119-122

*Ophthalmology Department, Royal Berkshire Hospital, Reading, United Kingdom; †Loyola Stritch School of Medicine, Maywood, Illinois; ‡University of Utah, Salt Lake City, Utah; §Indiana University School of Medicine, Indianapolis, Indiana; ¶Ophthalmology Department, Universiti Malaysia Sarawak (UNIMAS), Kota Samarahan, Sarawak, Malaysia.

Purpose: To report a case series of two cases of granulomatosis with polyangiitis, previously known as Wegener granulomatosis, which developed macular necrosis, not previously associated with granulomatosis with polyangiitis, healed with fibrosis, despite aggressive immune-modulating therapy and good control of systemic disease.

Methods: Case series of two cases with observation of treatment progress.

Results: The results reported the progress of response to treatment in the two cases, which resulted in the final outcome of fibrosis in the macula region, despite being on aggressive immune-modulating therapy and good systemic control.

Conclusion: Granulomatosis with polyangiitis can be associated with macular necrosis leading to fibrosis, unresponsive to immune-modulating therapy.
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http://dx.doi.org/10.1097/ICB.0000000000000307DOI Listing
September 2017

High altitude subhyaloid hemorrhage.

Oman J Ophthalmol 2015 Sep-Dec;8(3):213-4

Department of Ophthalmology, Leighton Hospital, Crewe, Cheshire, England, UK.

Subhyaloid hemorrhages can occur as a result of exposure to high altitude. We hereby report a clinical picture of subhyaloid hemorrhage associated with high altitude. The case demonstrates optical coherence tomography findings that aid diagnosis of subhyaloid hemorrhage.
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http://dx.doi.org/10.4103/0974-620X.169885DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4738676PMC
February 2016

WIDESPREAD MACULAR NEUROSENSORY DETACHMENT AFTER OCRIPLASMIN INTRAVITREAL INJECTION.

Retin Cases Brief Rep 2016 ;10(4):354-6

King Edward VII Hospital, Windsor, SL4 3DP, United Kingdom.

Purpose: To present the case of a patient with vitreomacular traction who experienced immediate severe acute complications after ocriplasmin intravitreal injection.

Methods: Case report.

Results: A 61-year-old woman with vitreomacular traction underwent ocriplasmin treatment. Within 24 hours after injection, she noticed severe reduction in visual acuity. Spectral domain optical coherence tomography revealed release of vitreous traction, together with widespread subretinal fluid and decreased reflectivity in the outer retina. Ten weeks after treatment, visual acuity improved, although below pretreatment levels, with partial reduction in subretinal fluid.

Conclusion: Intravitreal ocriplasmin can produce acute visual acuity changes with widespread subretinal fluid and outer retinal ellipsoid zone hyporeflectivity on spectral domain optical coherence tomography. The overall acute and long-term safety profile of ocriplasmin remains unknown.
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http://dx.doi.org/10.1097/ICB.0000000000000260DOI Listing
March 2017

A review of drug-induced acute angle closure glaucoma for non-ophthalmologists.

Qatar Med J 2015 10;2015(1). Epub 2015 May 10.

Department of Ophthalmology, University Hospital Ayr, Ayr, Glasgow, United Kingdom.

Acute angle closure glaucoma is an ophthalmic emergency and can lead to blindness if left untreated. Several types of drugs have the potential to precipitate acute angle closure glaucoma. These include adrenergic, cholinergic and anticholinergic, antidepressants, anticoagulants and sulfa-based agents. This article provides a basic overview of the risk factors and pathophysiologic mechanisms involved in angle closure glaucoma and focuses on drug-induced angle closure glaucoma for the non-ophthalmologist. A PubMed search limited to the English language was conducted to find relevant literature for the purpose of this article. Most attacks occur in subjects unaware that they are at risk due to innately narrow iridocorneal angles. Clinicians should always review medications in patients presenting with symptoms of acute angle closure glaucoma. The aim of this article is to bring this ophthalmic condition to the attention of clinicians, particularly those outside the field of ophthalmology who commonly prescribe these medications or see these patients prior to referring to ophthalmologists.
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http://dx.doi.org/10.5339/qmj.2015.6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4614311PMC
November 2015

Simulated eye surgery: The future of ophthalmology training?

Med Teach 2016 16;38(3):320-1. Epub 2015 Oct 16.

b Ophthalmology Department, Royal Berkshire Hospital , London Road , Reading RG1 5AN , UK.

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http://dx.doi.org/10.3109/0142159X.2015.1066767DOI Listing
January 2017

Ocular fundus photography: An alternative to direct ophthalmoscopy for teaching?

Med Teach 2016 May 15;38(5):529-30. Epub 2015 Sep 15.

c Ophthalmology Department, Royal Berkshire Hospital , London Road , Reading RG1 5AN , UK.

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http://dx.doi.org/10.3109/0142159X.2015.1076159DOI Listing
May 2016

Advances in the management of diabetic macular oedema based on evidence from the Diabetic Retinopathy Clinical Research Network.

Singapore Med J 2015 May;56(5):237-47

Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, Scotland, United Kingdom.

The Diabetic Retinopathy Clinical Research Network (DRCR.net) performs studies on new treatments for diabetic retinopathy. This review aims to summarise recent findings from DRCR.net studies on the treatment of diabetic macular oedema. We performed a PubMed search of articles from the DRCR.net, which included all studies pertaining to the treatment of diabetic maculopathy. The main outcome measures were retinal thickening as assessed by central subfield thickness on optical coherence tomography and improvement of visual acuity on the Early Treatment Diabetic Retinopathy Study (ETDRS) chart. Findings from each study were divided into modalities of treatment, namely photocoagulation, bevacizumab, triamcinolone, ranibizumab and vitrectomy. While modified ETDRS focal/grid laser remains the standard of care, intravitreal corticosteroids or anti-vascular endothelial growth factor agents have also proven to be effective, although they come with associated side effects. The choice of treatment modality for diabetic macular oedema is a clinical judgement call, and depends on the patient's clinical history and assessment.
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http://dx.doi.org/10.11622/smedj.2015071DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4447924PMC
May 2015

The Effect of Socio-Economic Status on Severity of Periocular Basal Cell Carcinoma at Presentation.

Ophthalmic Plast Reconstr Surg 2015 Nov-Dec;31(6):456-8

*Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, United Kingdom; †Princess Alexandra Eye Pavilion, Edinburgh, United Kingdom; ‡Department of Mathematics and Statistics, University of Strathclyde, Glasgow, United Kingdom; §Monklands Hospital, Airdrie, North Lanarkshire, United Kingdom; and ‖Southern General Hospital, Glasgow, Lanarkshire, United Kingdom.

Purpose: To evaluate the influence of socio-economic factors on size of periocular basal cell carcinoma at presentation.

Methods: All periocular basal cell carcinoma cases receiving treatment from the oculoplastics team in South Glasgow Hospitals NHS Trust, Glasgow, between 1999 and 2009, were identified retrospectively. Information collected included demographic details of patients, side and site of lesions, type of lesions, and size of lesions. The size of lesion was defined as small for any dimension not exceeding 5 mm, medium for dimensions between 6 mm and 10 mm, and large for dimensions exceeding 11 mm. Home address was used to determine the Scottish Index of Multiple Deprivation rank. The demographics, size of lesion, and Scottish Index of Multiple Deprivation rank were investigated using the general linear regression modelling.

Results: Of the 67 cases, 24 were men and 43 were women. The mean age was 71.5 years. There were a total of 67 identified cases, of which 38 presented with small-size lesions, 24 with medium-size lesions, and 5 with large-size lesions. Scottish Index of Multiple Deprivation is related to the presenting incidence of basal cell carcinoma, with the lower ranks presenting more frequently.

Conclusions: Socio-economic deprivation is associated with larger and more frequent presentation of periocular basal cell carcinoma. This highlights the importance of raising awareness among populations of the more deprived areas of the significance of lumps and bumps within the periocular regions.
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http://dx.doi.org/10.1097/IOP.0000000000000386DOI Listing
June 2016

Does amniotic membrane absorb cytokines and growth factors from the local engrafted environment? A novel mechanism of therapeutic action.

Clin Exp Ophthalmol 2015 Aug 27;43(6):596-9. Epub 2015 Apr 27.

Eye Department, Tennent Institute of Ophthalmology, Glasgow, UK.

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http://dx.doi.org/10.1111/ceo.12507DOI Listing
August 2015

Common eye drops and their implications for pH measurements in the management of chemical eye injuries.

Int J Ophthalmol 2014 18;7(6):1067-8. Epub 2014 Dec 18.

Altnagelvin Area Hospital, Glenshane Rd, Londonderry, Derry, BT47 6SB, United Kingdom.

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http://dx.doi.org/10.3980/j.issn.2222-3959.2014.06.29DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4270978PMC
December 2014

The management of gas-filled eyes in the emergency department.

Case Rep Emerg Med 2014 26;2014:347868. Epub 2014 Nov 26.

Indiana University School of Medicine, Fort Wayne, IN 46202, USA.

Background. Intraocular gas bubbles are commonly used in retinal surgery. There are specific management guidelines that need to be followed to ensure surgical success, and there are also unique ophthalmic and systemic complications that can occur in such patients. Objective. To educate emergency department personnel about important issues in the management of patients who have a gas-filled eye following retinal surgery. Case Report. A patient with a gas-filled eye developed several complications including pain, severe vision loss, high-grade atrioventricular (AV) block, and pneumocephalus. Conclusion. Awareness of potential problems that may arise in patients with gas-filled eyes who present to the emergency department may help minimize morbidity for such patients.
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http://dx.doi.org/10.1155/2014/347868DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265529PMC
December 2014

Outcome of rhegmatogenous retinal detachment repair by scleral buckling: The experience of a tertiary referral center in Scotland.

Oman J Ophthalmol 2014 Sep;7(3):130-4

Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 0YN, UK.

Purpose: The primary aim of this study is to report the outcome of patients with rhegmatogenous retinal detachment (RRD) who underwent scleral buckling (SB) surgery.

Methods: This is a retrospective noncomparative case series study of all patients who underwent RRD repair by primary SB between March 2008 and February 2009. Patient demographics, visual outcome, complications, and failure rates were identified and recorded.

Results: A total of 65 patients underwent RRD repair by SB, with a mean age of 44.44 years. Results showed that the primary outcome (primary anatomical success following index surgery) was 90.77%, while the secondary outcome (anatomical success following repeat surgery) was 98.46%.

Conclusion: The study showed a high-success rate of SB in phakic eyes both in terms of postoperative best-corrected visual acuity and complication rates. We recommend the continued use of this technique in selected cases of RRD.
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http://dx.doi.org/10.4103/0974-620X.142595DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4220399PMC
September 2014

Impact of parental history of myopia on the development of myopia in mainland china school-aged children.

Ophthalmol Eye Dis 2014 24;6:31-5. Epub 2014 Jun 24.

Chinese Center for Disease Control and Prevention, Beijing, China.

Background: Myopia is a very common condition and a significant public health problem in China. The objective of the study was to explore the genetic influence on myopia in Mainland China school-aged children in Beijing.

Methods: In 2008, the data from 15,316 Chinese school students aged 6-18 years from 19 randomized schools in Beijing were analyzed to evaluate genetic influence on myopia in children. Heritability was calculated by mid-parent-offspring regression and parent-offspring regression.

Results: The estimate of heritability was 0.30 (95% CI, 0.27-0.33) for refractive value (RV). The adjusted mean refractive error was -2.33D (95% CI, -2.45 to -2.21) in children with two myopic parents compared with -1.13D (95% CI, -1.78 to -1.08) in children with no parental myopia. The adjusted odds ratio (OR) was 2.83 (95% CI, 2.47-3.24) in children with two myopic parents compared with no parental myopia.

Conclusion: The study found a strong association between parental history of myopia and genesis of myopia in the offspring even after adjusting for environmental factors.
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http://dx.doi.org/10.4137/OED.S16031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4076205PMC
July 2014

Macular optical coherence tomography findings following blunt ocular trauma.

Clin Ophthalmol 2014 19;8:989-92. Epub 2014 May 19.

Falkirk Community Hospital (Forth Valley NHS Trust), Falkirk, UK.

This case report describes the optical coherence tomography (OCT) results of Berlin's edema in a male subject following blunt ocular trauma from a soccer ball. A 27-year-old male presented with blurred vision in his left eye following blunt trauma. On admission, he underwent a complete eye examination and an OCT of the macula. Fundoscopy revealed commotio retinae, observed as an abnormal cream-colored discoloration of the fovea. The OCT showed outer photoreceptor segment disruption, retinal pigment epithelium inter-digitation, and intra-retinal edema of the outer nuclear layer. Following initial management, a repeat OCT after 3 months showed near complete resolution. OCT can be a useful adjunct for monitoring the progress of Berlin's edema secondary to blunt ocular trauma because Berlin's edema may present similarly clinically to other ocular trauma, but can affect different layers of the retina depending on the type of injury to the eye.
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http://dx.doi.org/10.2147/OPTH.S64082DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038424PMC
June 2014

New corneal findings in chromosome 10 deletion syndrome: report of two cases of corneal ectasia of varying severity.

Semin Ophthalmol 2015 Jan 30;30(1):58-61. Epub 2013 Sep 30.

Tennent Institute of Ophthalmology, Eye Department, Gartnavel General Hospital , Glasgow , UK .

Purpose: To describe corneal changes associated with chromosome 10 terminal deletion (chromosome 10, monosomy 10qter) syndrome.

Methods: Report of two cases of bilateral corneal ectasia with literature review.

Results: Corneal pathology has not previously been reported in the limited number of case reports on 10qter syndrome. However, Rodrigues et al.(1) have reported sclerocornea in 10q translocation.

Conclusions: Ophthalmic manifestations of 10qter syndrome include strabismus, lid, and facial anomalies. We present two cases of corneal ectasia of varying severity. Possible etiologies include the following: secondary to genetic factors, acquired corneal exposure during sleep, or possible intrinsic immunocompromise exacerbating ocular surface infections. Corneal ectasia with specific histological changes is a feature of various genetic disorders (e.g., Down's, Ehler's Danlos, and Marfan's syndromes). It is unknown whether genetics plays a role in the development of corneal changes in 10qter syndrome. Management of inflammation and visual rehabilitation in these patients poses a therapeutic challenge.
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http://dx.doi.org/10.3109/08820538.2013.821503DOI Listing
January 2015

Orbital inflammation secondary to a delayed hypersensitivity reaction to sub-Tenon's hyaluronidase.

Semin Ophthalmol 2014 Mar 19;29(2):57-8. Epub 2013 Jul 19.

Tennent Institute of Ophthalmology, Gartnaval General Hospital , Glasgow , UK.

We report a rare case of a delayed orbital inflammation with raised intraocular pressure as a result of hyluronidase allergy following sub-Tenon's anaesthesia. Here, we have shown evidence to prove the orbital inflammation to be an allergic response to hyluronidase with a skin patch test. This is the first case to our knowledge of a delayed hypersensitivity reaction to sub-Tenon's hyluronidase comprising of an initial exposure to hyluronidase in the fellow eye with no subsequent allergic response, but with a subsequent delayed reaction to hyluronidase during a second eye cataract surgery. This case demonstrates hyaluronidase allergy should be considered as a differential diagnosis among patients presenting with acute post-operative orbital inflammation, even if there is a history of previous exposure to hyaluronidase in the fellow eye with no subsequent allergic response.
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http://dx.doi.org/10.3109/08820538.2012.760616DOI Listing
March 2014

Secondary intracranial hypertension from testosterone therapy in a transgender patient.

Semin Ophthalmol 2014 May 12;29(3):156-8. Epub 2013 Jun 12.

The Tennent Institute of Ophthalmology, Gartnavel General Hospital , Glasgow , UK and.

We report an occurrence of intracranial hypertension secondary to testosterone therapy in a transgender patient. This is the first reported case to our knowledge demonstrating a direct association with raised levels of free testosterone and intracranial hypertension.
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http://dx.doi.org/10.3109/08820538.2013.788678DOI Listing
May 2014

Capillary haemangioma successfully treated with oral beta-blocker in Dar es Salaam, Tanzania: a case report.

Semin Ophthalmol 2013 Jan;28(1):32-3

Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK.

Capillary haemangiomas are the most common orbital and periocular tumors in children, typically presenting in infancy. Propranolol has recently been introduced as a novel pharmacologic treatment for infantile haemangiomas, after Leaute-Labreze and colleagues observed that two patients being treated for cardiac indications had rapid regression of their haemangiomas. We report a case of haemangioma, successfully treated with oral beta-blocker, in the context of a public eye clinic in Dar es Salaam, Tanzania. To the best of our knowledge, this is the first recorded instance of a capillary haemangioma being successfully treated with a systemic beta-blocker in Tanzania.
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http://dx.doi.org/10.3109/08820538.2012.730100DOI Listing
January 2013

Lymphomatoid papulosis of the eyelid.

Semin Ophthalmol 2013 Jan;28(1):1-3

Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK.

Lymphomatoid papulosis (LyP) is a chronic papulonecrotic or papulonodular skin disease, with histological features suggestive of malignant lymphoma. It was originally described by Macauley (1968) as a "self-healing paradoxical eruption, histologically malignant but clinically benign." Unless accompanied by systemic lymphoma, most patients have no constitutional symptoms, and physical findings are limited to the skin. The distribution of lesions is characteristically on the trunk or extremities, but the face, scalp, or oral mucosa may be involved. We report an unusual case of lymphomatoid papulosis of the eyelid. To the best of our knowledge, this is the first report of eyelid involvement by lymphomatous papulosis.
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http://dx.doi.org/10.3109/08820538.2012.680643DOI Listing
January 2013

Toll-like receptor 9 is correlated to disease activity in Chinese systemic lupus erythematosus population.

Chin Med J (Engl) 2012 Aug;125(16):2873-7

Department of Rheumatology, Peking University People's Hospital, Beijing 100044, China.

Background: Toll like receptor (TLR) 9 has been shown to play a crucial role in the pathogenesis of systemic lupus erythematosus (SLE) in animal models. Its pathogenic role in human SLE, however, was poorly elucidated. This study was performed to investigate the role of TLR9 involved in the aberrant signaling pathway and its correlation with disease activity in SLE.

Methods: mRNA level of TLR9 and interferon (IFN) regulatory factor 5 (IRF5) in peripheral blood mononuclear cells (PBMCs) were determined by real-time polymerase chain reaction (PCR). IFN-a expression was measured in the serum of the SLE patients by enzyme-linked immunosorbent assay (ELISA).

Results: TLR9 expression was significantly higher in SLE patients than that in health controls (P = 0.011). SLE patients with positive anti-dsDNA antibody had significantly higher expression of TLR9 than that with negative anti-dsDNA antibody (P = 0.001). TLR9 expression was positively correlated with fever (P = 0.017), alopecia (P = 0.046), safety of estrogens in lupus erythematosus national assessment SLE disease activity index (SELENA-SLEDAI) score (r(s) = 0.385, P = 0.003), and the level of IRF5 (r(s) = 0.35, P = 0.027) and IFN-a (r(s) = 0.627, P = 0.001) in SLE patients.

Conclusion: TLR9 is associated with SLE disease activity and might be involved in the IFN-a pathway of SLE.
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August 2012

Lacrimal-auricular-dental-digital (LADD) syndrome with diffuse ophthalmoplegia--a new finding.

Semin Ophthalmol 2012 May-Jul;27(3-4):59-60

Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK.

Lacrimal-auricular-dental-digital (LADD) syndrome comprises multiple anomalies. It can be inherited as autosomal dominant with variable expressivity or can be sporadic in nature. The clinical features of LADD syndrome include variably, lacrimal system hypoplasia, ear anomalies (with or without hearing impairment), salivary system hypoplasia, epiblepharon, dry eyes, corneal limbal stem cells deficiency, hypodontia, microdontia, xerostomia, and clinodactyly. We would like to report a unique case series of LADD syndrome patients presenting with diffuse ophthalmoplegia and facial muscle dysfunction, which may be a distinct subset of LADD syndrome or a new syndrome itself. We believe this to be the first such report. We suggest careful examination of ocular movements in all newly diagnosed LADD syndrome patients.
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http://dx.doi.org/10.3109/08820538.2012.680639DOI Listing
October 2012

Atypical conjunctival CD5 positive mucosa-associated lymphoid tissue (MALT) lymphoma.

Semin Ophthalmol 2012 May-Jul;27(3-4):46-7

Tennent Institute of Ophthalmology, Glasgow, United Kingdom.

A 61-year-old woman with intermittent ocular irritation redness and swelling of her eyes was followed up and investigated. The diagnosis was conjunctival CD5 positive mucosa-associated lymphoid tissue (MALT) lymphoma, which is an atypical and rare type of pathology of the eye, in which the clinical course/behavior is not fully understood. Our experience showed that this disease is indolent and responds well to radiotherapy. It can recur in the fellow eye, even after as many as eight years of successful treatment with no evidence of recurrences in the previously affected eye. Therefore, long-term periodic follow-up is mandatory to detect recurrences in such patients. Further studies are also required to elucidate a more conclusive clinical behavior of this disease so that a clearer therapeutic and management plan can be devised for future patients with this disease.
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http://dx.doi.org/10.3109/08820538.2012.667494DOI Listing
October 2012