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Soon-Phaik Chee

Publications and source records attributed to Soon-Phaik Chee.

25 records · Page 2Linked to original sources
PubMed2004

Ocular manifestations of dengue fever.

PURPOSE: To evaluate ocular manifestations associated with dengue fever. DESIGN: Retrospective case series and literature review. METHODS: Clinical records of patients with dengue fever who subsequently had ocular symptoms and signs develop were reviewed. The clinical presentation and ocular complications were evaluated. RESULTS: Six patients, 5 females and 1 male, were seen with a sudden decrease in vision 6 to 7 days after the initial manifestations of dengue fever were identified. The diagnosis was confirmed by detection of dengue-specific IgM antibodies (IgM enzyme-linked immunoassay). The presenting best-corrected visual acuity ranged from 20/30 to counting fingers, and ocular involvement was bilateral but asymmetric in 5 cases and unilateral in 1 case. Fundus findings included small, intraretinal, whitish lesions, with localized retinal and retinal pigment epithelium (RPE) disturbance, small dot hemorrhages, and vascular sheathing around the macula and the papillomacular bundle. Fluorescein angiography showed arteriolar focal knobby hyperfluorescence at the macula with mild staining of the vascular walls and leakage at the level of the RPE. All 5 cases that had indocyanine green angiography done showed early diffuse choroidal hyperfluorescence with late silhouetting of the larger choroidal vessels. Five patients received steroid therapy: 1 topical, 2 periocular, and 2 oral. Over 2 to 4 months, RPE discoloration was observed over the affected areas. After the acute episode, 3 patients showed partial recovery of vision, and in the remaining patients, the visual acuity remained stable. CONCLUSIONS: Ocular complications associated with dengue fever are rare but may result in permanent visual impairment.

Adult↗
PubMed2004

Retinal detachment in atopic dermatitis can masquerade as acute panuveitis with rapidly progressive cataract.

PURPOSE: To report two cases of retinal detachment in young patients with atopic dermatitis masquerading as acute panuveitis. DESIGN: Retrospective observational clinical case reports. PATIENTS: Patients with atopic dermatitis presenting with acute panuveitis and subsequently diagnosed with retinal detachment at the Singapore National Eye Centre. METHODS: A review of the clinical case records. RESULTS: Two young patients aged 19 and 21 years with a history of atopic dermatitis presented with acute unilateral moderately severe panuveitis. Both developed rapidly progressing cataracts that made detailed visualization of the fundus difficult. Hypotony persisted in one eye despite partial response of uveitis to therapy. The other patient developed ocular hypertension when the vision in the affected eye suddenly deteriorated. Both eyes demonstrated partial response to steroid therapy. The diagnosis of shallow retinal detachment with anteriorly located incriminating retinal breaks was made after partial resolution of vitreous haze in one case and on repeated ultrasonography in the other case. CONCLUSION: A high index of suspicion is required when examining young patients with atopic dermatitis who present with acute panuveitis and a rapidly progressive cataract, which may mask the presence of a shallow retinal detachment.

Acute Disease↗
PubMed2003

Ocular manifestations and complications of pyogenic liver abscess.

In anecdotal reports, septic metastatic lesions from a pyogenic liver abscess can result in endogenous endophthalmitis, an infection of intraocular contents. Recent reports suggest that this devastating complication is increasing in frequency. The initial presentation may be nonspecific and easily misdiagnosed by the surgical team. When the infecting organism is virulent, it tends to be rapidly progressive and often leads to permanent visual deterioration or blindness despite medical intervention. We conducted a study to determine the incidence of endophthalmitis associated with pyogenic liver abscess, to identify its associations, and to determine the outcome of treatment. A retrospective review of 289 patients with a clinical diagnosis of pyogenic liver abscess admitted between January 1995 and March 2001 revealed 10 patients (3.5%) with the complication of endogenous endophthalmitis. Among them, seven had a previous history of diabetes mellitus. The offending organism was Klebsiella pneumoniae in all cases. There was no mortality in this series. Final visual outcomes of our patients were as follows: Five had no light perception (two had undergone evisceration), one had light perception only, and four were able to visualize hand motion only. There is a trend toward a worse outcome when ocular symptoms are not diagnosed and treated within 24 hours of onset. Of the five patients who lost their eyesight completely, three were initially misdiagnosed, and referral to the ophthalmologist was delayed. Surgeons must be alert to the complication of endogenous endophthalmitis. Ocular symptoms in patients treated for pyogenic liver abscess must be referred early for an ophthalmologic consult. Increased awareness and a high index of suspicion are required for salvage of visual function.

Adult↗
PubMed2002

Group B Streptococcus endogenous endophthalmitis : case reports and review of the literature.

PURPOSE: To report five cases of group B Streptococcus endogenous endophthalmitis (GBSEE) and to review the literature. DESIGN: Retrospective, noncomparative, interventional case series and literature review. PATIENTS: All patients with this condition treated at the Singapore National Eye Centre from 1994 through 2001. INTERVENTIONS: Core or complete vitrectomy and intravitreal and systemic antibiotics. METHODS: A review of the systemic and ocular characteristics and treatment. MAIN OUTCOME MEASURE: Visual outcome. RESULTS: Group B Streptococcus endogenous endophthalmitis developed in four patients after the onset of septic arthritis and in one patient with cervical epidural abscess after acupuncture, presenting as a diffuse endophthalmitis. Group B Streptococcus was isolated in the blood, vitreous, and joints. Despite the use of high-dose intravenous antibiotics within 72 hours of ocular presentation, intravitreal antibiotic injection, and vitrectomy (two eyes), all eyes lost light perception and became phthisical. A survey of the literature revealed that GBSEE is rare and that 17 cases have been reported since 1985. For purposes of analysis, four of these cases were excluded because of inadequate details and our five cases were included. Group B Streptococcus endogenous endophthalmitis was found to arise from hematogenous spread from cutaneous sites of infection (16.7%), pharyngitis (11.1%), and pneumonia (11.1%). Septic arthritis (38.9%) and endocarditis (33.3%) were concomitant sites of infection along with endophthalmitis. The septic arthritis typically involved multiple joints. Four patients (22.2%) had diabetes mellitus and three had other underlying predisposing illness. Although most patients received intravenous (83.3%) and intravitreal (55.6%) antibiotics and four eyes underwent therapeutic vitrectomy, useful vision was preserved in only four eyes. Two patients died of sepsis. CONCLUSIONS: Group B Streptococcus endogenous endophthalmitis is a devastating condition often associated with septic arthritis. The visual prognosis is poor, despite therapy.

Aged↗
PubMedDate not supplied

Orbital cysts lined with both stratified squamous and columnar epithelia: a late complication of silicone implants.

Two patients presented with orbital cysts 5 and 7 years after orbital blowout fracture repair with silicone plate implants. The orbital cysts caused significant exophthalmos and restriction in ocular motility. Surgical excision revealed thick-walled cysts that were displacing the globe and encapsulating the silicone implant. On histopathologic examination, the cysts were lined with both stratified squamous and ciliated columnar (respiratory) epithelia. We propose that squamous and respiratory epithelial cells may have been deposited during surgery from the conjunctival and sinus epithelia, respectively. This case series illustrates that although an uncommon complication, epithelium-lined inclusion cysts may develop several years after orbital fracture repair with a silicone implant. A transconjunctival surgical approach is a possible risk factor.

Adult↗