Biomedical subjects

Aliza Jap

Publications and source records attributed to Aliza Jap.

4 recordsLinked to original sources

PubMed2007

Corneal endotheliitis associated with evidence of cytomegalovirus infection.

OBJECTIVE: To describe the clinical presentation of cytomegalovirus (CMV) corneal endotheliitis in human immunodeficiency virus (HIV)-negative patients. DESIGN: Retrospective interventional case series. PARTICIPANTS: Twelve consecutive patients with corneal endotheliitis diagnosed between 2002 and 2005. METHODS: Aqueous of eyes with corneal endotheliitis was analyzed for viral DNA by polymerase chain reaction (PCR), and patient records were reviewed for demographic data, medical and ocular history, best-corrected Snellen visual acuity, intraocular pressure (IOP), anterior and posterior segment findings, laboratory workup, diagnosis, and treatment. MAIN OUTCOME MEASURE: Presence of CMV DNA. RESULTS: Corneal endotheliitis was seen in 12 eyes of 10 patients during the study period. There were 8 men and 2 women, and all were Chinese. Their mean age was 49 years (range, 25-61 years). The corneal involvement ranged from small areas of focal endotheliitis to diffuse bullous keratopathy. The keratic precipitates had a variable appearance. There was only mild anterior chamber inflammation with no posterior synechiae. Two thirds of eyes had diffuse iris atrophy. All the eyes had elevated IOP. Eleven of the 12 eyes were positive for CMV DNA. None of the patients were positive for HIV. All patients had received local or systemic immunosuppression, or both, before corneal endotheliitis developed. Ten eyes of 8 patients were treated with systemic antiviral therapy. After treatment, the endotheliitis resolved completely in 7 eyes, and 3 eyes had significant improvement in corneal translucency. The IOP was normal, with no medications in all but 1 eye. Repeat PCR analysis in all the treated eyes was negative for CMV DNA. CONCLUSIONS: Cytomegalovirus infection is an important cause of corneal endotheliitis in our patients, and appropriate antiviral therapy may prevent more ocular damage.

Adult↗

PubMed2006

Spectrum of Vogt-Koyanagi-Harada disease in Singapore.

PURPOSE: Review of all cases of Vogt-Koyanagi-Harada disease (VKH) handled in the Uveitis Clinic of the Singapore National Eye Centre, with the aim of determining the clinical spectrum of this disease in these patients and the outcomes of treatment. METHODS: The case notes were retrospectively analyzed for patient demographics, clinical signs, investigations, complications and treatment received. The treatment groups were classified according to the steroid regimen (dose and timing). The early-high (EH) group received > or =1 mg/kg per day of systemic prednisolone within 2 weeks of presenting with symptoms, the late-high (LH) group received the same dose between 2 and 4 weeks of presenting with symptoms, and the low-dose (LD) group received no or lower doses of oral corticosteroids, or received the same high dose, but only after more than 1 month of presenting with symptoms. RESULTS: A total of 178 eyes of 89 patients, mainly of Chinese ethnicity, were examined. The mean age of the patients at onset of the study was 41.80 +/- 14.65 (SE) years, and there were nearly equal numbers of male and female patients. The mean duration of the follow-up was 9.42 years (+/-9.87 years). There were 60 eyes in the EH group, 18 in the LH group, and 68 in the LD group. When the results on our patient group were compared to known data on a number of other ethnic groups, our patients were found to be similar to the Japanese with respect to gender distribution and prevalence, to the Hispanics for alopecia, and to the non-Hispanics of North America for tinnitus and vitiligo. The EH group were more likely to achieve complete resolution, with fewer complications, than the LD group, but one third of the former still developed chronic disease. CONCLUSION: Higher doses of systemic steroids may be required to ensure adequate immunosuppression in VKH patients.

Acute Disease↗

PubMed2006

Orbital metastatic tumour as initial manifestation of asymptomatic gastric adenocarcinoma.

INTRODUCTION: Metastatic orbital tumour from gastric cancer is rare. Patients with metastatic disease may present initially to the ophthalmologist with symptoms from metastases instead of from the primary cancer. CLINICAL PICTURE: We report a case, with clinicopathological correlation, of metastatic gastric adenocarcinoma presenting first in the orbit with diplopia. Computed tomography and magnetic resonance imaging of the orbit showed a well-defined enhancing right intraconal tumour. TREATMENT AND RESULTS: Excisional biopsy was performed and histopathology confirmed a metastatic adenocarcinoma. Focused gastrointestinal screening revealed an otherwise asymptomatic Stage IV gastric adenocarcinoma. Chemotherapy was initiated with good tumour response. CONCLUSION: Early biopsy of unusual orbital tumours is critical as orbital metastases may be the initial manifestation of an asymptomatic primary. Histopathological diagnosis can aid localisation of the primary tumour and allow prompt treatment to be instituted.

Biopsy↗

PubMed2005

Visual function in Vogt-Koyanagi-Harada patients.

BACKGROUND: Vogt-Koyanagi-Harada (VKH) disease presents with anterior segment inflammation, choroiditis and exudative retinal detachment. Following resolution of the inflammation, VKH patients have been noted to complain of visual disturbances despite good visual acuity. We therefore investigated the visual function deficits of convalescent VKH patients. METHODS: A cross-sectional observational nonrandomized controlled study of convalescent VKH patients from the Uveitis Service of the Singapore National Eye Centre, and normal subjects was performed. The best-corrected visual acuities (BCVA) and multifocal electroretinograms (mfERGs) of VKH patients with and without peripapillary atrophy (PPA) were compared with those of the normal eyes. The mfERG results were subdivided into those obtained from the peripapillary area and those from the rest of the macular. RESULTS: Eleven VKH eyes with large PPA to disc ratios (PPA/D ratio >2), 15 VKH eyes with PPA/D ratios<1 and 6 normal eyes were included in the study. Five eyes (54.5%) of VKH patients with PPA/D>2 had a BCVA of less than 20/40. All the other eyes had 20/20 vision. Nine of the 11 VKH eyes with PPA/D>2 also had large areas of chorioretinal atrophy. The mfERG responses of VKH eyes with PPA/D ratio >2 were markedly reduced in amplitude (p<0.001) and delayed in implicit time (p<0.001) throughout the entire macular area. VKH patients with PPA/D ratio<1 had significantly reduced mfERG amplitudes throughout the entire macular area, as well as delayed implicit times at the peripapillary region (p=0.026). Sub-division of VKH eyes with PPA/D<1 into eyes with no PPA and eyes with a small PPA, showed that both groups had a similar reduction in response amplitude over the entire macular region. However, the implicit time was significantly delayed in eyes with small PPA when compared to those without PPA (p<0.03). CONCLUSIONS: VKH patients with large PPA have clinically significant visual dysfunction. VKH patients without PPA also have subclinical retinal dysfunction. The mfERG may be a useful adjunct in the management of VKH by detecting early retinal damage.

Cross-Sectional Studies↗