ABSTRACT Follicular thyroid carcinoma (FTC) is a well-differentiated tumor which resembles the no... more ABSTRACT Follicular thyroid carcinoma (FTC) is a well-differentiated tumor which resembles the normal microscopic pattern of the thyroid. Although intracranial metastasis to the brain is frequent in adults, metastasis from FTC is very rare. Dural metastases mimicking meningioma have been documented in the literature now and then. However, cases arising from a FTC are again very rare. We report the case of a middle-aged lady who presented with progressive, painless left eye proptosis. She was noted to have a non-axial proptosis with dystopia, compressive optic neuropathy and exposure keratitis. She also had a painless swelling over the occipital region. She was initially misdiagnosed to have multiple foci of meningioma based on magnetic resonance imaging findings. Subsequent histopathological examination revealed presence of FTC. She was euthyroid but was found to have multiple small thyroid nodules by ultrasonography. Hence, the definite diagnosis of all dural masses must be histological wherever possible and thyroid carcinoma should be considered as a potential primary tumour in such presentations.
ABSTRACT Objective To determine the microbiological aetiology of acute dacryocystitis presented t... more ABSTRACT Objective To determine the microbiological aetiology of acute dacryocystitis presented to the Hospital University Sains Malaysia, Kubang Kerian, Kelantan in 5 years duration from 2005 until 2010.Methods This is a retrospective analysis of patients who were clinically diagnosed as acute dacryocystitis from 2005 until 2010 to determine the regional microbiological pattern. The age, gender, predisposing factors, intravenous antibiotics and their microbiological results of discharge from punctal expression were collected. The laboratory procedures were in accordance with the Clinical and Laboratory Standards Institute guidelines.ResultsThere were 23 patients admitted to the eye ward during study period. Females (n=17) outnumbered males (n=6). Majority of isolates were Gram-positive bacteria (n=10, 43.4%) followed by Gram-negative isolates (n=2, 12.9%). The most predominant isolates were Streptococcus pneumonia (S. pneumonia) (21.7%) followed by Staphylococcus epidermidis (S. epidermidis) (13.0%).ConclusionsS. pneumoniae was the commonest gram positive organism identified in our study. 47.8% patients showed resistant to initial empirical treatment.
Background: Candida glabrata endophthalmitis following keratoplasty is rare and almost always ass... more Background: Candida glabrata endophthalmitis following keratoplasty is rare and almost always associated with positive donor rim culture.
The aim of this study was to adapt MARMS with some modifications to detect beta mutation in our c... more The aim of this study was to adapt MARMS with some modifications to detect beta mutation in our cohort of thalassemia patients. We focused only on transfusion-dependent thalassemia Malay patients, the predominant ethnic group (95%) in the Kelantanese population. Eight mutations were identified in 46 out of 48 (95.83%) beta thalassemia alleles. Most of the patients (54.2%) were compound heterozygous with co-inheritance Cd 26 (G>A). The frequencies of spectrum beta chain mutation among these patients are presented in . Among the transfusion dependent beta thalassemia Malay patients studied, 26 patients were found to be compound heterozygous and the main alleles were Cd 26 (G>A). Compound heterozygous mutation of Cd 26 (G>A) and IVS 1-5 (G>C) were 12 (46.2%), Cd 26 (G>A) and Cd 41/42 (TTCT) were 9 (34.6%), Cd 26 (G>A) and IVS 1-1 (G>C) were 2 (7.7%) respectively. Meanwhile the minority were made of a single compound heterozygous of Cd 26 (G>A) and Cd 71/72, Cd 26 (>A) and Cd 17 (A>T), Cd 26 (G>A) and -28 (G>A) respectively. Twenty out of forty six patients were shown to have homozygous of IVS 1-5 (G>C) were 2 (10.0%), Cd 26 (G>A) were 15 (75.0%), Cd 19 (A>G) were 1 (5.0%), and IVS 1-1 (G>T) were 2 (10.0%). The beta chain mutations among the Kelantanese Malays followed closely the distribution of beta chain mutations among the Thais and the Malays of the Southern Thailand. The G-C transition at position 5 of the IVS 1-5 mutation was predominant among the Malay patients. In conclusion, this method has successfully identified the mutation spectrum in our cohort of transfusion-dependent beta thalassemia patients, and this method is equally effective in screening for mutation among thalassemia patients.
The aim of this study was to adapt MARMS with some modifications to detect beta mutation in our c... more The aim of this study was to adapt MARMS with some modifications to detect beta mutation in our cohort of thalassemia patients. We focused only on transfusion-dependent thalassemia Malay patients, the predominant ethnic group (95%) in the Kelantanese population. Eight mutations were identified in 46 out of 48 (95.83%) beta thalassemia alleles. Most of the patients (54.2%) were compound heterozygous with co-inheritance Cd 26 (G>A). The frequencies of spectrum beta chain mutation among these patients are presented in . Among the transfusion dependent beta thalassemia Malay patients studied, 26 patients were found to be compound heterozygous and the main alleles were Cd 26 (G>A). Compound heterozygous mutation of Cd 26 (G>A) and IVS 1-5 (G>C) were 12 (46.2%), Cd 26 (G>A) and Cd 41/42 (TTCT) were 9 (34.6%), Cd 26 (G>A) and IVS 1-1 (G>C) were 2 (7.7%) respectively. Meanwhile the minority were made of a single compound heterozygous of Cd 26 (G>A) and Cd 71/72, Cd 26 (>A) and Cd 17 (A>T), Cd 26 (G>A) and -28 (G>A) respectively. Twenty out of forty six patients were shown to have homozygous of IVS 1-5 (G>C) were 2 (10.0%), Cd 26 (G>A) were 15 (75.0%), Cd 19 (A>G) were 1 (5.0%), and IVS 1-1 (G>T) were 2 (10.0%). The beta chain mutations among the Kelantanese Malays followed closely the distribution of beta chain mutations among the Thais and the Malays of the Southern Thailand. The G-C transition at position 5 of the IVS 1-5 mutation was predominant among the Malay patients. In conclusion, this method has successfully identified the mutation spectrum in our cohort of transfusion-dependent beta thalassemia patients, and this method is equally effective in screening for mutation among thalassemia patients.
A21-year man presented with symptom of photophobia and tearing in the right eye for 2 months dura... more A21-year man presented with symptom of photophobia and tearing in the right eye for 2 months duration. lt was associated with painless gradual reduced vision. There was a history of hammering on a metal object prior to that. Ocular examination revealed signs of mild anterior uveitis due to a retained metallic intralenticular foreign body. Conjunctiva was white. Computed Tomography ( CT) scan of the orbit confirmed presence of a single intraocular foreign body. The condition is misleading and can be easily overlooked. A detailed history and clinical examination are mandatory in this misleading situation.
Objectives: To describe the clinical presentation of vaso-occlusive changes in hidden presumed oc... more Objectives: To describe the clinical presentation of vaso-occlusive changes in hidden presumed ocular tuberculosis (TB). Methods: Retrospective case review of 3 patients with a diagnosis of presumed ocular TB at Eye Clinic, Hospital Universiti Sains Malaysia. Results: All three patients presented with hazy fundus view in which 2 patients were presented with vitreous hemorrhage (case I & case 3) and one patient was presented with vitritis and vitreous condensation (case 2). Vaso-occlusive changes was noted by post vitrectomy (case l), based on fluorescein fundus angiography (case 2) and after resolving vitreous hemorrhage (case 3). A diagnosis of presumed ocular TB was made based on presence of vaso-occlusive changes (case 1, case 2 & case 3) and supported by positive Mantoux test (case 1 & case 3) and history of contact with pulmonary TB (case 3). Conclusions: Diagnosis of ocular TB requires a high index of suspicion. Early anti TB treatment for suspected ocular TB can give a better...
The Malaysian journal of medical sciences : MJMS, 2007
A 43 year-old man presented with pain on the right tooth for three days duration. Computed tomogr... more A 43 year-old man presented with pain on the right tooth for three days duration. Computed tomography showed left orbital cellulitis and right parapharyngeal abscess. There was also evidence suggestive of a dental abscess over right upper alveolar region. Magnetic resonance imaging revealed left superior ophthalmic vein thrombosis. Emergency drainage of the right parapharyngeal abscess was performed. Right maxillary molar extraction revealed periapical abscess. Left eye proptosis markedly reduced after initiating heparin.
To identify the aetiology of open globe injuries at Hospital Universiti Sains Malaysia over a per... more To identify the aetiology of open globe injuries at Hospital Universiti Sains Malaysia over a period of 10y and the prognostic factors for visual outcome. Retrospective review of medical records of open globe injury cases that presented from January 2000 to December 2009. Classification of open globe injury was based on the Birmingham Eye Trauma Terminology (BETT). Records were obtained with hospital permission via the in-house electronic patient management system, and the case notes of all patients with a diagnosis of open globe injury were scrutinised. Patients with prior ocular trauma, pre-existing ocular conditions affecting the visual acuity, contrast sensitivity, central vision or corneal thickness, as well as those with a history of previous intraocular or refractive surgery were excluded. Analysis of data was with SPSS version 20.0. Ordinal logistic regression analysis was used to examine the association between prognostic factors and visual outcome. This study involved 220 ...
ABSTRACT Terson's syndrome is a condition of vitreous haemorrhage occurring in associatio... more ABSTRACT Terson's syndrome is a condition of vitreous haemorrhage occurring in association with subarachnoid haemorrhage (SAH). This condition is uncommon during pregnancy. We report a fatal case of Terson's syndrome in a pregnant lady. She presented with an episode of seizure and complained of blurring of vision in the right eye after the seizure. Examination revealed subhyaloid haemorrhage in the right eye. The left fundus was normal. Subsequent investigations revealed a posterior communicating artery aneurysm. We would like to highlight that any case of non-traumatic vitreous haemorrhage with neurological symptoms and signs must be worked up as neuro-ophthalmic emergency.
The aim of this study was to adapt MARMS with some modifications to detect beta mutation in our c... more The aim of this study was to adapt MARMS with some modifications to detect beta mutation in our cohort of thalassemia patients. We focused only on transfusion-dependent thalassemia Malay patients, the predominant ethnic group (95%) in the Kelantanese population. Eight mutations were identified in 46 out of 48 (95.83%) beta thalassemia alleles. Most of the patients (54.2%) were compound heterozygous with co-inheritance Cd 26 (G>A). The frequencies of spectrum beta chain mutation among these patients are presented in Table 2. Among the transfusion dependent beta thalassemia Malay patients studied, 26 patients were found to be compound heterozygous and the main alleles were Cd 26 (G>A). Compound heterozygous mutation of Cd 26 (G>A) and IVS 1-5 (G>C) were 12 (46.2%), Cd 26 (G>A) and Cd 41/42 (TTCT) were 9 (34.6%), Cd 26 (G>A) and IVS 1-1…
A 60 year-old man presented with acute on set of left eye proptosis and ptosis. It was associated... more A 60 year-old man presented with acute on set of left eye proptosis and ptosis. It was associated with poor vision, eye pain and restriction of eye movement of the same eye after 5 hours post left upper molar tooth extraction. The visual acuity in the left eye was hand movement. There was severe ptosis and proptosis of the left eye. The conjunctiva was chemotic with quite anterior chamber. The pupil was mid dilated and sluggished to light. The ocular movement was restricted in all directions. Fundoscopy of the left eye revealed features of central retinal artery occlusion with hyperaemic disc and subretinal exudates at posterior pole. The right eye appeared normal. Urgent MRI brain and orbit revealed severe left paranasal sinusitis with anterior displacement of the left globe and presence orbital abscess. Patient was managed with Otorhinolaryngology and Neurosurgery teams. He underwent emergency transnasal drainage of abscess. Histopathological examination of unhealthy sinus mucosa ...
ABSTRACT Primary intraocular lymphoma (PIOL) is an uncommon subset of primary central nervous sys... more ABSTRACT Primary intraocular lymphoma (PIOL) is an uncommon subset of primary central nervous system lymphoma (PCNSL). We report a rapid progressive of this disease in a 73 years old lady who presented with one year history of left eye floaters, associated with deterioration of left vision. Examination revealed left eye vitritis and typical vitreous clumps. Left vitrectomy and vitreous biopsy was performed with result showed few singly dispersed atypical lymphoid cells. She was diagnosed to have Primary Intraocular lymphoma and was started on intravitreal methotrexate. Initially she responded well but later the tumour spread to liver, breast and brain within a year. She finally succumbed to the disease. High index of suspicion of PIOL is mandatory in all elderly patients presenting with panuveitis. Co-management with the Neurologist is vital in the continuous management of these patients in view of the high rate of mortality.
ABSTRACT Fifty-seven years old Malay lady, post menopausal with co-morbid of diabetes mellitus an... more ABSTRACT Fifty-seven years old Malay lady, post menopausal with co-morbid of diabetes mellitus and hypertension presented with three months history of bilateral painful red eyes associated with double vision. Examination revealed both eyes proptosis, corkscrew vessels with present of bruit, secondary narrow angle with raised intraocular pressure, 6th cranial nerve palsy, and bilateral venous stasis retinopathy. CT angiogram showed bilateral dilated superior ophthalmic veins with cerebral angiogram findings of bilateral indirect carotid cavernous fistula involving small meningeal vessels. Indirect or dural cavernous sinus Fistula can easily be missed or misdiagnosed. Trivial injury especially in the predisposing patient can initiate the occurrence.
We report a case series of neuroretinitis in ocular bartonellosis and describe the serologic veri... more We report a case series of neuroretinitis in ocular bartonellosis and describe the serologic verification for Bartonella henselae. This is a retrospective interventional case series of four patients who presented in the ophthalmology clinic
ABSTRACT Follicular thyroid carcinoma (FTC) is a well-differentiated tumor which resembles the no... more ABSTRACT Follicular thyroid carcinoma (FTC) is a well-differentiated tumor which resembles the normal microscopic pattern of the thyroid. Although intracranial metastasis to the brain is frequent in adults, metastasis from FTC is very rare. Dural metastases mimicking meningioma have been documented in the literature now and then. However, cases arising from a FTC are again very rare. We report the case of a middle-aged lady who presented with progressive, painless left eye proptosis. She was noted to have a non-axial proptosis with dystopia, compressive optic neuropathy and exposure keratitis. She also had a painless swelling over the occipital region. She was initially misdiagnosed to have multiple foci of meningioma based on magnetic resonance imaging findings. Subsequent histopathological examination revealed presence of FTC. She was euthyroid but was found to have multiple small thyroid nodules by ultrasonography. Hence, the definite diagnosis of all dural masses must be histological wherever possible and thyroid carcinoma should be considered as a potential primary tumour in such presentations.
ABSTRACT Objective To determine the microbiological aetiology of acute dacryocystitis presented t... more ABSTRACT Objective To determine the microbiological aetiology of acute dacryocystitis presented to the Hospital University Sains Malaysia, Kubang Kerian, Kelantan in 5 years duration from 2005 until 2010.Methods This is a retrospective analysis of patients who were clinically diagnosed as acute dacryocystitis from 2005 until 2010 to determine the regional microbiological pattern. The age, gender, predisposing factors, intravenous antibiotics and their microbiological results of discharge from punctal expression were collected. The laboratory procedures were in accordance with the Clinical and Laboratory Standards Institute guidelines.ResultsThere were 23 patients admitted to the eye ward during study period. Females (n=17) outnumbered males (n=6). Majority of isolates were Gram-positive bacteria (n=10, 43.4%) followed by Gram-negative isolates (n=2, 12.9%). The most predominant isolates were Streptococcus pneumonia (S. pneumonia) (21.7%) followed by Staphylococcus epidermidis (S. epidermidis) (13.0%).ConclusionsS. pneumoniae was the commonest gram positive organism identified in our study. 47.8% patients showed resistant to initial empirical treatment.
Background: Candida glabrata endophthalmitis following keratoplasty is rare and almost always ass... more Background: Candida glabrata endophthalmitis following keratoplasty is rare and almost always associated with positive donor rim culture.
The aim of this study was to adapt MARMS with some modifications to detect beta mutation in our c... more The aim of this study was to adapt MARMS with some modifications to detect beta mutation in our cohort of thalassemia patients. We focused only on transfusion-dependent thalassemia Malay patients, the predominant ethnic group (95%) in the Kelantanese population. Eight mutations were identified in 46 out of 48 (95.83%) beta thalassemia alleles. Most of the patients (54.2%) were compound heterozygous with co-inheritance Cd 26 (G>A). The frequencies of spectrum beta chain mutation among these patients are presented in . Among the transfusion dependent beta thalassemia Malay patients studied, 26 patients were found to be compound heterozygous and the main alleles were Cd 26 (G>A). Compound heterozygous mutation of Cd 26 (G>A) and IVS 1-5 (G>C) were 12 (46.2%), Cd 26 (G>A) and Cd 41/42 (TTCT) were 9 (34.6%), Cd 26 (G>A) and IVS 1-1 (G>C) were 2 (7.7%) respectively. Meanwhile the minority were made of a single compound heterozygous of Cd 26 (G>A) and Cd 71/72, Cd 26 (>A) and Cd 17 (A>T), Cd 26 (G>A) and -28 (G>A) respectively. Twenty out of forty six patients were shown to have homozygous of IVS 1-5 (G>C) were 2 (10.0%), Cd 26 (G>A) were 15 (75.0%), Cd 19 (A>G) were 1 (5.0%), and IVS 1-1 (G>T) were 2 (10.0%). The beta chain mutations among the Kelantanese Malays followed closely the distribution of beta chain mutations among the Thais and the Malays of the Southern Thailand. The G-C transition at position 5 of the IVS 1-5 mutation was predominant among the Malay patients. In conclusion, this method has successfully identified the mutation spectrum in our cohort of transfusion-dependent beta thalassemia patients, and this method is equally effective in screening for mutation among thalassemia patients.
The aim of this study was to adapt MARMS with some modifications to detect beta mutation in our c... more The aim of this study was to adapt MARMS with some modifications to detect beta mutation in our cohort of thalassemia patients. We focused only on transfusion-dependent thalassemia Malay patients, the predominant ethnic group (95%) in the Kelantanese population. Eight mutations were identified in 46 out of 48 (95.83%) beta thalassemia alleles. Most of the patients (54.2%) were compound heterozygous with co-inheritance Cd 26 (G>A). The frequencies of spectrum beta chain mutation among these patients are presented in . Among the transfusion dependent beta thalassemia Malay patients studied, 26 patients were found to be compound heterozygous and the main alleles were Cd 26 (G>A). Compound heterozygous mutation of Cd 26 (G>A) and IVS 1-5 (G>C) were 12 (46.2%), Cd 26 (G>A) and Cd 41/42 (TTCT) were 9 (34.6%), Cd 26 (G>A) and IVS 1-1 (G>C) were 2 (7.7%) respectively. Meanwhile the minority were made of a single compound heterozygous of Cd 26 (G>A) and Cd 71/72, Cd 26 (>A) and Cd 17 (A>T), Cd 26 (G>A) and -28 (G>A) respectively. Twenty out of forty six patients were shown to have homozygous of IVS 1-5 (G>C) were 2 (10.0%), Cd 26 (G>A) were 15 (75.0%), Cd 19 (A>G) were 1 (5.0%), and IVS 1-1 (G>T) were 2 (10.0%). The beta chain mutations among the Kelantanese Malays followed closely the distribution of beta chain mutations among the Thais and the Malays of the Southern Thailand. The G-C transition at position 5 of the IVS 1-5 mutation was predominant among the Malay patients. In conclusion, this method has successfully identified the mutation spectrum in our cohort of transfusion-dependent beta thalassemia patients, and this method is equally effective in screening for mutation among thalassemia patients.
A21-year man presented with symptom of photophobia and tearing in the right eye for 2 months dura... more A21-year man presented with symptom of photophobia and tearing in the right eye for 2 months duration. lt was associated with painless gradual reduced vision. There was a history of hammering on a metal object prior to that. Ocular examination revealed signs of mild anterior uveitis due to a retained metallic intralenticular foreign body. Conjunctiva was white. Computed Tomography ( CT) scan of the orbit confirmed presence of a single intraocular foreign body. The condition is misleading and can be easily overlooked. A detailed history and clinical examination are mandatory in this misleading situation.
Objectives: To describe the clinical presentation of vaso-occlusive changes in hidden presumed oc... more Objectives: To describe the clinical presentation of vaso-occlusive changes in hidden presumed ocular tuberculosis (TB). Methods: Retrospective case review of 3 patients with a diagnosis of presumed ocular TB at Eye Clinic, Hospital Universiti Sains Malaysia. Results: All three patients presented with hazy fundus view in which 2 patients were presented with vitreous hemorrhage (case I & case 3) and one patient was presented with vitritis and vitreous condensation (case 2). Vaso-occlusive changes was noted by post vitrectomy (case l), based on fluorescein fundus angiography (case 2) and after resolving vitreous hemorrhage (case 3). A diagnosis of presumed ocular TB was made based on presence of vaso-occlusive changes (case 1, case 2 & case 3) and supported by positive Mantoux test (case 1 & case 3) and history of contact with pulmonary TB (case 3). Conclusions: Diagnosis of ocular TB requires a high index of suspicion. Early anti TB treatment for suspected ocular TB can give a better...
The Malaysian journal of medical sciences : MJMS, 2007
A 43 year-old man presented with pain on the right tooth for three days duration. Computed tomogr... more A 43 year-old man presented with pain on the right tooth for three days duration. Computed tomography showed left orbital cellulitis and right parapharyngeal abscess. There was also evidence suggestive of a dental abscess over right upper alveolar region. Magnetic resonance imaging revealed left superior ophthalmic vein thrombosis. Emergency drainage of the right parapharyngeal abscess was performed. Right maxillary molar extraction revealed periapical abscess. Left eye proptosis markedly reduced after initiating heparin.
To identify the aetiology of open globe injuries at Hospital Universiti Sains Malaysia over a per... more To identify the aetiology of open globe injuries at Hospital Universiti Sains Malaysia over a period of 10y and the prognostic factors for visual outcome. Retrospective review of medical records of open globe injury cases that presented from January 2000 to December 2009. Classification of open globe injury was based on the Birmingham Eye Trauma Terminology (BETT). Records were obtained with hospital permission via the in-house electronic patient management system, and the case notes of all patients with a diagnosis of open globe injury were scrutinised. Patients with prior ocular trauma, pre-existing ocular conditions affecting the visual acuity, contrast sensitivity, central vision or corneal thickness, as well as those with a history of previous intraocular or refractive surgery were excluded. Analysis of data was with SPSS version 20.0. Ordinal logistic regression analysis was used to examine the association between prognostic factors and visual outcome. This study involved 220 ...
ABSTRACT Terson's syndrome is a condition of vitreous haemorrhage occurring in associatio... more ABSTRACT Terson's syndrome is a condition of vitreous haemorrhage occurring in association with subarachnoid haemorrhage (SAH). This condition is uncommon during pregnancy. We report a fatal case of Terson's syndrome in a pregnant lady. She presented with an episode of seizure and complained of blurring of vision in the right eye after the seizure. Examination revealed subhyaloid haemorrhage in the right eye. The left fundus was normal. Subsequent investigations revealed a posterior communicating artery aneurysm. We would like to highlight that any case of non-traumatic vitreous haemorrhage with neurological symptoms and signs must be worked up as neuro-ophthalmic emergency.
The aim of this study was to adapt MARMS with some modifications to detect beta mutation in our c... more The aim of this study was to adapt MARMS with some modifications to detect beta mutation in our cohort of thalassemia patients. We focused only on transfusion-dependent thalassemia Malay patients, the predominant ethnic group (95%) in the Kelantanese population. Eight mutations were identified in 46 out of 48 (95.83%) beta thalassemia alleles. Most of the patients (54.2%) were compound heterozygous with co-inheritance Cd 26 (G>A). The frequencies of spectrum beta chain mutation among these patients are presented in Table 2. Among the transfusion dependent beta thalassemia Malay patients studied, 26 patients were found to be compound heterozygous and the main alleles were Cd 26 (G>A). Compound heterozygous mutation of Cd 26 (G>A) and IVS 1-5 (G>C) were 12 (46.2%), Cd 26 (G>A) and Cd 41/42 (TTCT) were 9 (34.6%), Cd 26 (G>A) and IVS 1-1…
A 60 year-old man presented with acute on set of left eye proptosis and ptosis. It was associated... more A 60 year-old man presented with acute on set of left eye proptosis and ptosis. It was associated with poor vision, eye pain and restriction of eye movement of the same eye after 5 hours post left upper molar tooth extraction. The visual acuity in the left eye was hand movement. There was severe ptosis and proptosis of the left eye. The conjunctiva was chemotic with quite anterior chamber. The pupil was mid dilated and sluggished to light. The ocular movement was restricted in all directions. Fundoscopy of the left eye revealed features of central retinal artery occlusion with hyperaemic disc and subretinal exudates at posterior pole. The right eye appeared normal. Urgent MRI brain and orbit revealed severe left paranasal sinusitis with anterior displacement of the left globe and presence orbital abscess. Patient was managed with Otorhinolaryngology and Neurosurgery teams. He underwent emergency transnasal drainage of abscess. Histopathological examination of unhealthy sinus mucosa ...
ABSTRACT Primary intraocular lymphoma (PIOL) is an uncommon subset of primary central nervous sys... more ABSTRACT Primary intraocular lymphoma (PIOL) is an uncommon subset of primary central nervous system lymphoma (PCNSL). We report a rapid progressive of this disease in a 73 years old lady who presented with one year history of left eye floaters, associated with deterioration of left vision. Examination revealed left eye vitritis and typical vitreous clumps. Left vitrectomy and vitreous biopsy was performed with result showed few singly dispersed atypical lymphoid cells. She was diagnosed to have Primary Intraocular lymphoma and was started on intravitreal methotrexate. Initially she responded well but later the tumour spread to liver, breast and brain within a year. She finally succumbed to the disease. High index of suspicion of PIOL is mandatory in all elderly patients presenting with panuveitis. Co-management with the Neurologist is vital in the continuous management of these patients in view of the high rate of mortality.
ABSTRACT Fifty-seven years old Malay lady, post menopausal with co-morbid of diabetes mellitus an... more ABSTRACT Fifty-seven years old Malay lady, post menopausal with co-morbid of diabetes mellitus and hypertension presented with three months history of bilateral painful red eyes associated with double vision. Examination revealed both eyes proptosis, corkscrew vessels with present of bruit, secondary narrow angle with raised intraocular pressure, 6th cranial nerve palsy, and bilateral venous stasis retinopathy. CT angiogram showed bilateral dilated superior ophthalmic veins with cerebral angiogram findings of bilateral indirect carotid cavernous fistula involving small meningeal vessels. Indirect or dural cavernous sinus Fistula can easily be missed or misdiagnosed. Trivial injury especially in the predisposing patient can initiate the occurrence.
We report a case series of neuroretinitis in ocular bartonellosis and describe the serologic veri... more We report a case series of neuroretinitis in ocular bartonellosis and describe the serologic verification for Bartonella henselae. This is a retrospective interventional case series of four patients who presented in the ophthalmology clinic
Uploads
Papers by Adil Hussein