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Anuchit Poonyathalang

Publications and source records attributed to Anuchit Poonyathalang.

12 recordsLinked to original sources
PubMed2006

The unique characteristics of Thai Leber hereditary optic neuropathy: analysis of 30 G11778A pedigrees.

Leber hereditary optic neuropathy (LHON) is characterized by acute or subacute bilateral visual loss, and affects mostly young males. The most common mitochondrial DNA mutation responsible for LHON worldwide is G11778A. Despite different genetic backgrounds, which are believed to influence the disease expression, most features of LHON are quite common in different populations. However, there seem to be a few ethnic-specific differences. Analyses of our 30 G11778A LHON pedigrees in Thailand showed some characteristics different from those of Caucasians and Japanese. In particular, our pedigrees showed a lower male to female ratio of affected persons (2.6:1) and much higher prevalence of G11778A blood heteroplasmy (37% of the pedigrees contained at least one heteroplasmic G11778A individual). Heteroplasmicity seemed to influence disease manifestation in our patients but did not appear to alter the onset of the disease. The estimated overall penetrance of our G11778A LHON population was 37% for males and 13% for females. When each of our large pedigrees were considered separately, disease penetration varied from 9 to 45% between the pedigrees, and also varied between different branches of the same large pedigree. Survival analysis showed that the secondary LHON mutations G3316A and C3497T had a synergistic deleterious effect with the G11778A mutation, accelerating the onset of the disease in our patients.

Adolescent↗
PubMed2006

Orbital apex syndrome from gnathostomiasis.

A 16-year-old Thai girl presented with acute unilateral visual loss, proptosis, and ophthalmoparesis. CT demonstrated thickening and enhancement of orbital tissues including the orbital apex. A history of consumption of raw fish, together with the findings of cutaneous migratory swelling and eosinophilia, made the diagnosis of gnathostomiasis likely. Her serum was positive for Gnathostoma spinigerum using an immunoblotting technique. Parasites removed from the skin lesions revealed the typical head bulbs with 4 circumferential rows of hooklets and fine cuticular spines on their surface. Treatment with an antihelminthic and systemic corticosteroids led to resolution of orbital inflammation but left a persistent optic neuropathy marked by nerve fiber bundle visual field loss with normal visual acuity. Gnathostomiasis should be suspected in patients with an orbital apex syndrome who live or travel in an endemic area, have eaten raw fish, and develop a migratory skin rash.

Adolescent↗
PubMed2006

Four recti enlargement at orbital apex and thyroid associated optic neuropathy.

OBJECTIVE: To determine the site of muscle enlargement in thyroid-associated ophthalmopathy and optic neuropathy in Ramathibodi Hospital. MATERIAL AND METHOD: Data and images of MRI and CT of patients with thyroid-associated ophthalmopathy were retrospectively reviewed Neuro-ophthalmologic data and correlation to the imaging findings were analyzed. RESULTS: Among 19 patients with thyroid-associated ophthalmopathy, 20 imaging studies were collected. There were 4 patients with bilateral disease and crowdedness of 4 recti muscle. All of them had thyroid associated optic neuropathy. One out of 19 patients underwent two different sessions study. During her first study, right optic nerve was involved with the crowding of right optic nerve but 7 months later her left optic nerve became involved with crowding of the left optic nerve and the right 4 recti appeared smaller CONCLUSION: Four recti muscle enlargement in thyroid-associated ophthalmopathy, like four-leaf clover in coronal section of imaging study, may be an important sign of thyroid associated optic neuropathy.

Adult↗
PubMed2006

Stereotactic radiation therapy for optic nerve sheath meningioma; an experience at Ramathibodi Hospital.

OBJECTIVE: To evaluate results of stereotactic radiotherapy for the treatment of optic nerve sheath meningioma (OM) at Ramathibodi Hospital. MATERIAL AND METHOD: Twelve patients with primary OM were treated with stereotactic radiation between 1998 and 2005. Five patients underwent surgery and had no light perception before radiation. All patients except one were treated with fractionated stereotactic radiotherapy (FSRT). Mean average dose of FSRT was 55. 7 Gy; 180 cGy/fraction. One patient was treated with 15-Gy stereotactic radiosurgery. RESULTS: With a median follow-up of 34 months, there was no visual improvement in the five patients who were completely blind before radiation. Visual acuity improved in four patients and remained stable in two patients. Four of six patients had improved visual field, and five of six decreased in proptosis. Follow-up images were available in six patients, showing minimal tumor regression in five and stable in one. No serious acute side effect was observed. Vision became worse in one patient, who developed vitreous hemorrhage two years after FSRT. CONCLUSION: Stereotactic radiotherapy is an effective treatment for primary OM. It provides tumor control and visual preservation with low risk of complications. However more patients and further follow-up are needed for long-term outcomes.

Adult↗
PubMed2005

Reconstruction of contracted eye socket with amniotic membrane graft.

PURPOSE: To investigate the use of amniotic membrane graft for socket reconstruction in cases in which forniceal shortening by scar or symblepharon formation has made it difficult to successfully wear an ocular prosthesis. METHODS: A retrospective analysis of 20 contracted eye sockets that underwent forniceal reconstruction with amniotic membrane graft from 1997 to 2001. RESULTS: There were 8 male and 12 female patients, with an age range between 2 and 66 years. Duration of forniceal shortening varied from 2 months to 48 years. The operation was performed in the lower fornix in 13 eyes, upper fornix in 1 eye, and both fornices in 6 eyes. The mean follow-up period was 13.6 months. Eighty percent of cases achieved successful prosthetic fitting after surgery. Four eyes had recurrent forniceal shortening after surgery in which a prosthesis could not be properly fitted. There were no serious complications, such as infection or graft rejection. CONCLUSIONS: The use of amniotic membrane grafts can be a useful option in forniceal reconstruction with a high success rate, a low rate of complications, and without discomfort of donor sites.

Adolescent↗
PubMed2005

Retrobulbar injection of triamcinolone in thyroid associated orbitopathy.

OBJECTIVE: To identify the result of retrobulbar triamcinolone injection in patients with thyroid associated orbitopathy MATERIAL AND METHOD: Prospective noncomparative pilot study in 27 eyes of 19 patients who had been diagnosed as thyroid associated orbitopathy during October 2000 through April 2002. The patients received retrobulbar 40 mg triamcinolone treatment for each orbit weekly, totaling 4 applications. RESULTS: Three months after treatment, most of the patients demonstrated no significant change in visual acuity and visual field. Improvement of proptosis was observed in 15 eyes (56%) and stable in 10 eyes (37%). Seven patients (41%) had improvement of extraocular muscle function as demonstrated by Hess test. These results remained stable in the majority of patients at the 6 months follow up period. No systemic side effects were observed The only significant local side-effect was intraocular pressure elevation which was found in 8 eyes and responded to antiglaucoma therapy. CONCLUSION: This preliminary study demonstrated the potential benefit of retrobulbar triamcinolone injection in cases of thyroid associated orbitopathy. Long-term study in these patients is required.

Adult↗
PubMed2005

POEMS syndrome with venous sinus thrombosis and visual failure: a case report.

POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein and skin changes) syndrome is a multisystem disorder associated with plasma cell dyscrasia. Other clinical signs include clubbing of the fingers, edema, papilledema etc. Although papilledema and increased intracranial pressure are common features, their causes or pathophysiology have been uncertain. The authors report here a 16-year-old Thai patient with these features who also suffered from venous sinus thrombosis and visual failure which have never been reported before. The former is considered to be one of the possible causes of the intracranial hypertension and visual failure. MRI of the brain and optic nerve revealed enhancement and swelling of the optic nerve sheaths and optic discs. MRV findings were compatible with chronic veno-occlusive disease. Bone marrow aspiration and biopsy demonstrated an increase of aggregates of intermediate and mature plasma cells. The CSF pressure was markedly elevated. His clinical condition continued to deteriorate and he expired 3 years and 5 months from the onset of his illness. Although, overproduction of vascular endothelial growth factor has been reported and is being considered to be the possible cause of vascular hyperpermeability, the chronic venous sinus thrombosis may play an important role in the pathogenesis of intracranial hypertension and visual failure.

Adolescent↗
PubMed2004

Aneurysmal third nerve palsy.

To study the clinical characteristics, treatment and outcome of patients with aneurysmal third nerve palsy. Eleven patients with isolated third nerve palsy from an intracranial aneurysm from 1998 to 2002 at Ramathibodi Hospital were reviewed retrospectively. The average age was 60 years. Ipsilateral headache and/or retroorbital pain occured in 80 percent of the patients. Ten patients had unilateral disease, whereas one patient had bilateral involvement. The most common site of aneurysm was at the origin of the posterior communicating artery. Endovascular treatment with coil embolization provided successful occlusion as well as neurosurgical clipping. Recovery of third nerve function was found in all patients but had variable degrees. Patients who received early treatment, especially within 10 days after onset of oculomotor dysfunction appeared to have the best chance of recovery. Aberrant regeneration developed in 5 cases. The commonest sign was lid retraction during adduction and downward gaze.

Adult↗