Original Article
Risk of dementia in the elderly with non-alcoholic fatty liver disease: A nested case-control study in the Republic of Korea
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease affecting about 25% of the general population.1,2 NAFLD has a broad disease...
Letter to the Editor
Treatment outcomes of micropulse cyclophototherapy in uveitic glaucoma
Dear Editor,
We present a case series, describing the utility of micropulse cyclophototherapy in the treatment of uveitic glaucoma.
Prevalence of glaucoma in patients suffering from...
Commentary
Transforming radiology to support population health
The recent launch of Healthier SG—a national initiative by Singapore’s Ministry of Health (MOH) focusing on preventive health—will have far-reaching effects on the delivery...
Commentary
Leveraging ChatGPT to aid patient education on coronary angiogram
Natural-language artificial intelligence (AI) is a promising technological advancement poised to revolutionise the delivery of healthcare.1 Traditionally, inclusion of technology in the augmentation of...
Editorial
Promise and pitfalls of ChatGPT for patient education on coronary angiogram
The past decade has seen extraordinary and rapid progress in the field of artificial intelligence (AI), which produces computer systems capable of performing tasks...
Commentary
Artificial intelligence innovation in healthcare: Relevance of reporting guidelines for clinical translation from bench to bedside
Artificial intelligence (AI) and digital innovation have revolutionised many sectors and industries, prominently including healthcare during the coronavirus disease 2019 (COVID-19) pandemic.1 For example,...
Editorial
The eye as a window to the brain
Over the last 20 years, it has become evident that the age-old expression, “the eye is the window into the soul”, might in fact...
Letter to the Editor
Clinical outcome of bacterial endogenous endophthalmitis in 15 patients
Dear Editor,
Endophthalmitis refers to the inflammation of the ocular cavities and their immediate adjacent structures without extension beyond the sclera, usually secondary to...
Letter to the Editor
Implementation of an AI model to triage paediatric brain magnetic resonance imaging orders
Dear Editor,
Artificial intelligence (AI) is viewed as the most important recent advancement in radiology with the potential to achieve Singapore’s objective of delivering value-based...
Letter to the Editor
Neuralgic amyotrophy in COVID-19 infection and after vaccination
Dear Editor,
Various neurological manifestations associated with coronavirus disease 2019 (COVID-19) have been described,1 conditions which left a significant proportion of patients with permanent disability....
Images in Medicine
A 52-year-old woman with beading of intracranial arteries
A 52-year-old woman of Indian ethnicity with a history of well-controlled hypertension, hyperlipidaemia and recurrent transient ischaemic attacks presented with altered mentation and slurred...
Others
Creutzfeldt-Jakob Disease Presenting with Visual Blurring, Diplopia and Visual Loss: Heidenhain’s Variant
The electroencephalographic pattern is distinctive in many but not in all patients with Creutzfeldt-Jakob disease (CJD). Often, it is one of diffuse and non-specific...
Original Article
Glaucoma Pattern Amongst the Elderly Chinese in Singapore
Glaucoma is a major cause of world blindness in developing and developed nations. The WHO Global data on blindness show that over half of...
Original Article
The Profile of Hospitalised Patients with Parkinson’s Disease
Prevalence studies in various parts of the world have shown that Parkinson’s disease (PD) is relatively common among the aged in all countries. Crude...
Others
Frontal Sinus Mucoceles Causing Proptosis—Two Case Reports
Frontal mucoceles are collections of inspissated mucus which occur when there is obstruction to the outflow of the frontal sinuses. The obstruction may be...
Others
The Alien Hand Sign–Case Report and Review of the Literature
The alien hand sign or “strange hand sign”, first coined by Brion and Jedynak in 1972, refers to a feeling that the hand is...
Others
A Case Series of Ocular Disease as the Primary Manifestation in Sarcoidosis
Sarcoidosis is an idiopathic, systemic, non-caseating, granulomatous disease with protean clinical manifestations. Although the first description of sarcoidosis was attributed to Hutchinson, its ocular...
Review Article
Trends in the Pattern of Blindness and Major Ocular Diseases in Singapore and Asia
Singapore’s population has grown rapidly since 1965, the year in which it gained independence. The total population enumerated at its first census in 1970...
Original Article
Electrophysiological Features in the Management of Meralgia Paraesthetica
Meralgia paraesthetica is a condition resulting from entrapment of the lateral femoral cutaneous nerve at the region of the anterior superior iliac spine, when...
Others
A Case of Accelerated Development of Proliferative Diabetic Retinopathy in a Woman with Type 2 Diabetes Mellitus after Pregnancy
Diabetic retinopathy is the leading cause of blindness in persons between the age of 24 and 64 years both in the US and the...
Others
Trilateral Retinoblastoma—A Case Report
Retinoblastoma is the third most common tumour in childhood. It is inherited genetically.
This article is available only as a PDF. Please click on “Download...
Original Article
A Retrospective Review of Patients with Clinically Definite Multiple Sclerosis
Genetic susceptibility and environmental factors influence the prevalence and clinical manifestations of multiple sclerosis (MS). Since MS is rare in Southeast Asia, descriptions of...
Others
Chronic Subdural Haematoma Presenting with Transient Ischaemic Attacks— A Case Report
Transient ischaemic attacks (TIA) are commonly seen in neurologic practice. They are most commonly associated with cerebrovascular insufficiency, either from a thrombotic or embolic...
Original Article
Excimer Laser Phototherapeutic Keratectomy for Recurrent Corneal Erosions
Recurrent cornea1 erosion (RCE) syndrome is a commonly encountered clinical condition which may be difficult to treat. Hansen first described it in 1872.
This article...
Original Article
Use of EMLA Cream or Alfentanil for Analgesia during Ophthalmic Nerve Blocks
Cataract surgery is performed mainly as day-case surgery, with the majority performed under regional anaesthesia. Retrobulbar block, combined with facial nerve block, provides good...
Others
Palatal Myoclonus—A Case Report
Palatal myoclonus is a rare movement disorder characterised by rhythmic recurring jerky movements of the soft palate, pharynx, larynx and rarely diaphragm, trunk and...
Original Article
Potentiation of Acetylcholine-induced Smooth Muscle Contraction in Rat Ileum by Lead
It is known that exposure of animals and humans to heavy metals such as lead can result in neurological dysfunction. Pharmacodynamic effects of lead...
Others
Extensor Pollicis Longus Paralysis Following Thoracoscopic Sympathectomy
A 24-year-old man was referred for hyperhidrosis of more than 15 years duration. It affected both hands, feet and axilla.
This article is available only...
Original Article
Retinopathy of Prematurity in Very Low Birth Weight Infants
Retinopathy of prematurity (ROP), which could lead to visual impairment and blindness, is a recognised serious morbidity amongst surviving premature infants. The inverse relationship...
Original Article
Role of Magnetic Resonance Imaging and Magnetic Resonance Angiography in Patients with Hemifacial Spasm
Hemifacial spasm (HFS), characterized by intermittent twitching of muscles supplied by one facial nerve is commonly due to compression of the facial nerve by...
Review Article
Diabetic Retinopathy
Diabetes mellitus affects some 9% of Singaporeans. Studies had shown that virtually all insulin dependent diabetes mellitus (Type 1) and 85% of non-insulin dependent...
Original Article
Cross-Sectional Study of Near-work and Myopia in Kindergarten Children in Singapore
Myopia is the commonest eye disease worldwide, and is especially prevalent in certain Asian countries such as Taiwan, Japan and Hong Kong. Physiologic myopia...
Original Article
The Reliability and Validity of the Alzheimer’s Disease Assessment Scale Cognitive Subscale (ADAS-Cog) among the Elderly Chinese in Hong Kong
The Alzheimer’s Disease Assessment Scale (ADAS) is a 21-item scale designed to assess the severity of cognitive and non-cognitive impairment in patients with Alzheimer’s...
Original Article
The Correction of Oriental Lower Lid Involutional Entropion Using the Combined Procedure
Involutional entropion is a frequent cause of ocular irritation in the local elderly patients. The inturning of the lid margin and the eyelashes result...
Others
The Current State of Multiple Sclerosis Genetic Research
It was Charcot (1868) who first made the formal pathological correlation between lesions in the central nervous system (CNS) and a disorder termed, ‘la...
Others
Myopia: Gene-environment Interaction
Myopia affects up to 70% of adults in Singapore, Taiwan, Hong Kong and Japan. The prevalence rates in these Asian countries are higher than...
Others
The Genetics of Human Epilepsies
Epilepsies are one of the most common neurological disorders, affecting about 3% of individuals at least once in a lifetime. It thus represents a...
Review Article
Sleep/Wake Cycle and Circadian Disturbances in Shift Work: Strategies for Their Management—A Review
Humans have primarily been active/awake during the day and inactive/asleep at night. The discovery of artificial light and introduction of electric power generator have...
Original Article
Incidence and risk factors of delirium in post-anaesthesia care unit
Post-anaesthesia care unit (PACU) delirium is defined as a disorder in thought processes that affect cognition in terms of memory, comprehension and attention.1 It...
Editorial
Delirium in patients following general anaesthesia
Delirium is a disturbance of consciousness characterised by an acute onset and fluctuating course of inattention, accompanied by either a change in cognition or...
Others
Listeria Meningoencephalitis: Two Cases and a Review of the Literature
The general experience of local physicians and available data suggest that listerial infections of the central nervous system (CNS) are uncommon among adults in...
Others
Panhypopituitarism due to Pituitary Cyst of Rathke’s Cleft Origin—Two Case Reports
Rathke’s cleft cysts are non-neoplastic cystic epithelial lesions of the sellar and suprasellar region which are thought to originate from the remnants of Rathke’s...
Review Article
Causes and Management of Descemet’s Membrane Detachment Associated with Cataract Surgery—Not Always a Benign Problem
It is well known that stripping of Descemet’s membrane (DM) occurs not infrequently during cataract surgery. In 1928, Samuels described frequent DM detachments of...
Others
Book Review
The above is a textbook of medicine written by Singapore doctors and published in Singapore. It is difficult not to be over-enthusiastic about it...
Review Article
Advances in Neurointensive Care
Neurointensive care has come into being in the past decade as a recognised subspecialty. Pioneering neurointensivists in the United States, such as Allan Ropper...
Review Article
The Eye in Neurology: Evaluation of Sudden Visual Loss and Diplopia—Diagnostic Pointers and Pitfalls
The first step in the evaluation of sudden visual loss is to determine if the visual loss is monocular or binocular. The first diagnostic...
Review Article
Neuroprotection in Acute Stroke
The neuronal cells of the central nervous system are especially susceptible to various forms of insult such as trauma and ischaemia. Once the ischaemic...
Review Article
Current and Emerging Treatments in Parkinson’s Disease
Parkinson’s disease (PD) affects 1% of adults above the age of 65 years. It is characterised histologically by the loss of neurons in the...
Original Article
Trinucleotide Repeat Analysis of Huntington’s Disease gene in Singapore
Huntington’s disease (HD) is an autosomal dominantly inherited disease, affecting 1 in 10,000 individuals of European origin. The incidence in the Asian population is...
Original Article
Aseptic Meningitis in Children—The Singapore Experience
Aseptic meningitis is a common diagnosis among infants admitted for fever without an obvious source. In cases where the aetiologic agent could be identified,...
Others
Update in the Management of Stroke
Stroke is the fourth leading cause of death and a leading cause of morbidity in Singapore. The number of hospital admissions for cerebrovascular disorders...
Others
6th Yahya Cohen Lecture: Visual Experience During Cataract Surgery
What a patient can see during his or her surgery can be a cause of anxiety for the patient. It may cause additional stress...
Others
Stroke Disease Management—A Framework for Comprehensive Stroke Care
Disease management (DM) is an approach to patient care that coordinates medical resources for patients across the entire healthcare delivery system. It requires a...
Original Article
Variance Analysis Applied to a Stroke Pathway: How This Can Improve Efficiency of Healthcare Delivery
Stroke is the fourth principal cause of death in Singapore, and the leading cause of long-term disability amongst developed countries. Due to the spiralling...
Others
Age-related Macular Degeneration: What’s New
Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in the developed western world, accounting for approximately 50% of all cases of...
Others
Visual Rehabilitation with New-Age Rigid Gas-Permeable Scleral Contact Lenses—A Case Series
Advanced primary corneal ectasia presents a difficult problem in terms of visual rehabilitation. Soft contact lenses do not address the astigmatic aberrations in these...
Original Article
Nursing Home Falls: A Local Perspective
Falls in the elderly has been a well-studied subject and now occupies an important place in geriatric medicine. While many studies have been done...
Others
Primary Meningococcal Arthritis and Endogenous Endophthalmitis: A Case Report
Primary meningococcal arthritis (PMA) and endogenous meningococcal endophthalmitis are both uncommon presentations of meningococcal infection that should be considered in the differential diagnosis of...
Review Article
Seeing How We Think About Words Using BOLD Contrast fMR Imaging
Functional brain imaging refers to a set of non-invasive imaging techniques that are used to infer linkages between brain structure and function. In this...
Review Article
Imaging of Acquired Immunodeficiency Syndrome (AIDS)
The pandemic of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a global healthcare problem and HIV infection is the most common cause of...
Others
Gyrate Atrophy of the Choroid: Two Cases
Gyrate atrophy of the choroid (GA) is a rare choroidal dystrophy. It is an autosomal recessive disorder that results in progressive deterioration in peripheral...
Review Article
Nipah Encephalitis Outbreak in Malaysia
From September 1998 to June 1999, there was an outbreak of viral encephalitis in several pig farming villages in Malaysia. The outbreak, which started...
Others
MELAS: A Case Report
A 6-year-old Chinese boy presented at the Oral and Maxillofacial Surgery clinic with gingival bleeding due to poor oral hygiene, odontogenic pain due to...
Others
Case Reports of Two Biopsy-proven Patients with Creutzfeldt-Jakob Disease in Singapore
Creutzfeldt-Jakob disease (CJD) is the commonest human transmissible subacute spongiform encephalopathy. It has a worldwide distribution with an estimated annual incidence of 0.5 to...
Others
Initial Experience of Macular Translocation in Singapore – One-year Results
Choroidal neovascularisation (CNV) is a devastating complication of macular degeneration and a major cause of irreversible vision loss in many developed countries. The most...
Review Article
Axoglial Interaction via the Notch Receptor in Oligodendrocyte Differentiation
Oligodendrocytes (OLs) derived from the common neural progenitor cells in the central nervous system (CNS) ensheathe the nude axon to form the myelin that...
Review Article
Ocular Surface Stem Cells and Disease: Current Concepts and Clinical Applications
The ocular surface is a complex biological continuum responsible for the maintenance of corneal clarity, elaboration of a stable tear film for clear vision,...
Letter to the Editor
Re: Evidence for an “epidemic” of myopia
In the Annals January 2004 theme issue on Myopia, Park and Congdon have disputed the reality of the increases in prevalence of myopia in...
Original Article
Contact Lens Microbial Keratitis and Prior Topical Steroid Use: A Disaster in the Making?
Topical steroid use in cornea ulcers is still a very contentious issue in ophthalmology. A recent review by Wilhelmus found that the use of...
Original Article
Integrated Hydroxyapatite Implant and Non-integrated Implants in Enucleated Asian Patients
Much has been published on the complications of integrated and non-integrated implants. Most studies on integrated implants pertain to experience with the hydroxyapatite implant,...
Others
A Case of Right Loin Pain: Septic Ovarian Vein Thrombosis Due to Campylobacter fetus Bacteraemia
Septic ovarian venous thrombosis is an uncommon entity. Classically, it occurs as a postpartum complication with reported frequency of 1 in 600 to 2000...
Original Article
Hemifacial Spasm in Singapore: Clinical Characteristics and Patients’ Perceptions
Hemifacial spasm (HFS) is a movement disorder characterised by intermittent involuntary contractions of the facial muscles. It begins with contractions of the orbicularis oculi,...
Original Article
Characteristics and Acute Rehabilitation of Guillain-Barré Syndrome in Singapore
The Guillain-Barré syndrome (GBS) is an acute, frequently severe evolution of a demyelinating inflammatory polyradiculopathy with an autoimmune pathogenesis. In developed countries, GBS is...
Others
Clinical Indications for Positron Emission Tomography (PET) Scanning
The purpose of these guidelines is to provide a broad framework for clinicians considering the use of positron emission tomography (PET) scanning for their...
Review Article
PET Tracers and Radiochemistry
Positron emission tomography (PET) has become a powerful scientific and clinical tool for probing biochemical processes in the human body. This is due, in...
Review Article
Physical Principles and Technology of Clinical PET Imaging
The past few years have seen the transition of positron emission tomography (PET) from the research domain into mainstream clinical applications for oncology. The...
Editorial
Positron Emission Tomography – A Vital Component of Molecular Imaging
Contemporary medical imaging is progressing towards quantification of tissue function in addition to merely providing anatomical information, as illustrated by the rising use of...
Others
Spinocerebellar Ataxia Type 2 with Focal Epilepsy – An Unusual Association
The spinocerebellar ataxias (SCAs) are a rare group of neurodegenerative disorders that are clinically and genetically heterogeneous. Almost all SCAs are due to trinucleotide...
Review Article
The Correction of Myopia Evaluation Trial: Lessons from the Study Design
“A properly planned and executed clinical trial is a powerful technique for assessing the effectiveness of an intervention”. While each new clinical trial involves...
Original Article
Myopia Progression Among Preschool Chinese Children in Hong Kong
Myopia occurs when the image of distant objects, focused by the cornea and lens, falls in front of the retina. It is the commonest...
Review Article
The Epidemiology of Myopia in Hong Kong
Myopia is a refractive condition in which the image of a distant object is formed anterior to the retina of the unaccommodated (relaxed) eye....
Original Article
Prevalence of Myopia in Taiwanese Schoolchildren: 1983 to 2000
Today in Taiwan, with increasing level of educational and living standard, the prevalence and severity of myopia appear to be on an upward trend....
Review Article
Evidence for an “Epidemic” of Myopia
A number of authors have recently proposed that myopia is increasing at an “epidemic” rate, particularly in East Asia, and especially among populations of...
Review Article
Using Natural STOP Growth Signals to Prevent Excessive Axial Elongation and the Development of Myopia
Myopia in humans results from an imbalance between the refractive power of the cornea and lens and the axial length of the eye, such...
Review Article
Ocular Shape and Myopia
Myopia develops from a mismatch of the eye’s anatomical axial length and its focal length, as determined by the combined optical powers of the...
Others
Is it Possible to Slow the Progression of Myopia?
The rates of myopia, including high myopia , have been reported to be rising to epidemic proportions in Asia and solutions to this huge...
Editorial
Issues and Challenges for Myopia Research
Myopia is an ocular disorder of major public health and socioeconomic significance in many East Asian urban cities. In Singapore, the prevalence of myopia...
Original Article
Accommodative Stimulus Response Curve of Emmetropes and Myopes
There is a strong association between myopia and near work, and it has been reported that the rapid rise in the prevalence of myopia...
Original Article
Electrophysiological Findings in Persons With Nyctalopia
Nyctalopia is a subjective sensation of poor vision under dark conditions. It may be clinically associated with retinal diseases affecting the rod photoreceptors or...
Commentary
Identification of a Common Genetic Risk Variant (LRRK2 Gly2385Arg) in Parkinson’s Disease
For diseases with complex inheritance, the age-old debate regarding the relative contribution of gene-environment interaction never fails to generate interest, discussion and hypothesis within...
Others
Neisseria meningitidis Keratitis in Adults: A Case Series
Neisseria meningitidis has been reported as a causative organism for conjunctivitis and endogenous endophthalmitis, more commonly in neonates and young children. A search of...
Others
Visual Recovery Following Emergent Orbital Decompression in Traumatic Retrobulbar Haemorrhage
Acute retrobulbar haemorrhage is a potentially sight threatening condition that can occur spontaneously or following retrobulbar injections and trauma to the orbit. Visual loss...
Review Article
Macular Carotenoids and Age-related Maculopathy
The macula lutea is an anatomic region of the posterior retina that measures approximately 5.5 mm in diameter, and is exquisitely specialised for sharp...
Review Article
Neural Progenitor and Stem Cells in the Adult Central Nervous System
Seminal studies in the 1960s, using -thymidine autoradiography, reported that neurogenesis occurs in discrete areas of the adult mammalian brain, in rodents. Studies in...
Others
Book Review
Ophthalmologists today depend heavily on various investigative modalities such as fluorescein angiography (FA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) for an...
Others
Recombinant Tissue Plasminogen Activator (r-TPA) in Fibrin Dissolution due to Postoperative Endophthalmitis
Cataract surgery is one of the most successful surgical procedures performed. However, postoperative endophthalmitis, defined as severe inflammation involving both the anterior and posterior...
Original Article
Orbital Metastatic Tumour as Initial Manifestation of Asymptomatic Gastric Adenocarcinoma
Metastatic orbital tumour from gastric cancer is rare. In a Japanese survey of metastatic orbital tumours seen over 95 years, gastric metastases accounted for...
Original Article
Eye Injuries in Singapore – Don’t Risk It. Do More. A Prospective Study
The issue of ophthalmic trauma is a major cause for concern. An estimated 55 million eye injuries occur each year worldwide, leaving 1.6 million...
Original Article
Retrospective Review of Eyes with Neovascular Age-related Macular Degeneration Treated with Photodynamic Therapy with Verteporfin and Intravitreal Triamcinolone
Among the variety of paradigms implicated in the pathogenesis of choroidal neovascularisation (CNV), an inflammatory component has been a recent focus of interest. The...
Original Article
Rates of Posterior Capsule Rupture During Cataract Surgery Among Different Races in Singapore
Posterior capsule rupture (PCR) is a potentially serious intraoperative complication of cataract surgery. The anecdotal experience of some surgeons suggests that differences in the...
Others
Surgically-induced Corneal Changes Following Macular Translocation with Punctate Retinotomies and Chorioscleral Infolding (Limited Macular Translocation)
Changes in corneal curvatures and astigmatism after retinal surgery are well documented. Although some of these changes are mild and transient, some have reported...
Review Article
Updates on the Surgical Management of Paediatric Cataract with Primary Intraocular Lens Implantation
Paediatric cataract has a low incidence compared with adult cataract. The estimated incidence is about 1 to 6/ 10,000 births.
This article is available only...
Original Article
Efficacy of Measuring Visual Performance of LASIK Patients under Photopic and Mesopic Conditions
LASIK is routinely carried out to correct the refractive errors of myopic patients. A high percentage of patients have good high-contrast visual acuity after...
Original Article
Role of Ultrasound Biomicroscopy (UBM) in the Detection and Localisation of Anterior Segment Foreign Bodies
The presence of an intraocular foreign body (IOFB) is a common complication of ocular trauma. For surgical planning, the localisation of IOFBs has to...
Original Article
Diabetic Retinopathy in Type II Diabetics Detected by Targeted Screening Versus Newly Diagnosed in General Practice
The epidemic of type II diabetes mellitus is now recognised worldwide. In India, it has been estimated that the population with type II diabetes...
Commentary
Ethical Issues in Ophthalmology and Vision Research
The importance of ethics in research was highlighted in the USA when a healthy volunteer subject, 24-year-old Ellen Roche, died in a Johns Hopkins...
Others
Can Long-term Corticosteroids Lead to Blindness? A Case Series of Central Serous Chorioretinopathy Induced by Corticosteroids
Central serous chorioretinopathy (CSCR) is an idiopathic disorder characterised by serous detachment of the macula, retinal pigment epithelial (RPE) detachment and areas of RPE...
Original Article
A Novel Locus for X-linked Retinitis Pigmentosa
Retinitis pigmentosa (RP) is characterised by initial night blindness followed by progressive loss of visual fields and eventually, loss of central vision. RP is...
Original Article
Utility and Validity of the Self-administered SF-36: Findings From an Older Population
The shift towards broader health perspectives and the emphasis on patient preferences have led to the development of many health questionnaires and their inclusion...
Others
The Role of Optical Coherence Tomography (OCT) in the Diagnosis and Management of Retinal Angiomatous Proliferation (RAP) in Patients with Age-related Macular Degeneration
Retinal angiomatous proliferation (RAP), initially described as deep retinal vascular anomalous complex in 1992 by Hartnett et al, has been recently defined as a...
Original Article
Axial Length: A Risk Factor for Cataractogenesis
There are several known risk factors for cataract formation, including older age, lower educational status, smoking, ultraviolet light exposure, trauma, dehydration, diabetes, uveitis and...
Original Article
Clinical Features of Autosomal Dominant Retinitis Pigmentosa Associated with a Rhodopsin Mutation
Retinitis pigmentosa (RP) is the most prevalent group of inherited retinopathies. This spectrum of diseases affects approximately 1 in 4800 individuals.
This article is available...
Original Article
A Novel Mutation of the VMD2 Gene in a Chinese Family with Best Vitelliform Macular Dystrophy
Best vitelliform macular dystrophy is an autosomal dominant disorder characterised by an egg yolk-like appearance of the macula. The vitelliform “egg yolk” lesions result...
Original Article
Characterisation of Human Tear Proteins Using High-resolution Mass Spectrometry
Over the last few years, with advances in mass spectrometry, there has been increasing interest in exploring the proteome of body fluids such as...
Original Article
Scanning Laser Polarimetry in Pulmonary Tuberculosis Patients on Chemotherapy
Pulmonary tuberculosis is a worldwide disease. In Hong Kong, there are about 7000 new cases of pulmonary tuberculosis each year and the prevalence remains...
Letter to the Editor
Time to Raise Awareness of Blindness as Another Smoking-related Condition
Singapore currently has a comprehensive range of tobacco control policies and programmes. It started implementing legislative measures against cigarette smoking in the early 1970s,...
Letter to the Editor
“Galaxy in My Eye”: An Artist’s View of Cataract Surgery from Behind the Crystalline Lens
Cataract surgery is the most commonly performed elective surgery in many countries. As a result of advances in surgical and anaesthetic techniques, most cataract...
Commentary
Methodologies for Interventional Myopia Studies
Past studies on intervention in myopia progression have given conflicting results. For example, in the past, studies on (PMMA) hard contact lenses took researchers...
Others
Ethambutol-associated Optic Neuropathy
Tuberculosis (TB) has been present since ancient times. Around 460 BC, Hippocrates identified phthisis, which is the Greek term for consumption (TB seemed to...
Others
Concurrent Intermediate Uveitis and an Enhancing Intracranial Lesion as the Initial Manifestation of Sarcoidosis
Sarcoidosis remains an enigmatic disease with protean manifestations. It is a multi-system disorder of unknown cause characterised by an accumulation of T-lymphocytes, mononuclear phagocytes...
Others
Retrobulbar Alcohol Injection for Orbital Pain Relief Under Difficult Circumstances: A Case Report
The management of pain in the orbital region, whether ocular or orbital in origin, is complex and lies at the margins of several subspecialty...
Others
Book Review
In Retinal Vascular Disorders, Dr Mohan and co-authors cover common and important retinal vascular disorders in a series of short chapters which are written...
Others
Vision 2020 and Prevention of Blindness: Is it Relevant or Achievable in the Modern Era?
This review article considers the universal definition of blindness, the causes of world/global blindness, and ongoing international efforts in blindness prevention. The prospects for...
Original Article
Enhancement of the Mechanical and Biological Properties of a Biomembrane for Tissue Engineering the Ocular Surface
The most recent treatment for severe ocular surface disease is the transplantation of cultivated corneal and conjunctival epithelial stem cells, which makes use of...
Others
Mycobacterium-related Ocular Inflammatory Disease: Diagnosis and Management
Tuberculosis (TB) is an ancient disease that has been detected in 3000-year-old Egyptian mummies. Robert Koch’s discovery of the tubercle bacillus as the aetiologic...
Others
Photodynamic Therapy for Choroidal Neovascularisation Secondary to Inflammatory Chorioretinal Disease
Photodynamic therapy using verteporfin (Visudyne, Novartis Ophthalmics) has been proven safe and effective for the treatment of predominantly classic, age-related macular degeneration (AMD)-related subfoveal...
Original Article
Variables Determining Perceived Global Health Ranks: Findings from a Population-based Study
In 1982, Mossey and Shapiro first demonstrated that global self-rating of health was a better predictor of 7-year survival than medical records or self-reports...
Original Article
Multivariate Analysis of Childhood Microbial Keratitis in South India
Corneal infection is the most common cause of profound ocular morbidity leading to blindness worldwide. Corneal infection in children is difficult to diagnose and...
Original Article
Can the Sequential Use of Conventional Silicone Oil and Heavy Oil be a Strategy for the Management of Proliferative Vitreoretinopathy?
Advances in vitreoretinal surgery have greatly increased the anatomical re-attachment rate in cases with proliferative vitreoretinopathy (PVR). The availability of perfluoro-carbon liquids, indirect viewing...
Original Article
Surgical Outcomes of 25-Gauge Transconjunctival Vitrectomy Combined With Cataract Surgery for Vitreoretinal Diseases
The recent development of 25-gauge instrumentation for vitreous surgery has promoted a great interest in the transconjuctival sutureless vitrectomy system. Similar to the trend...
Review Article
New Concepts in the Management of Optic Nerve Sheath Meningiomas
Optic nerve sheath meningiomas (ONSMs) account for one-third of primary optic nerve tumours, are the second most common optic nerve tumours after gliomas, and...
Review Article
Ophthalmic Regional Block
Patient comfort, safety and low complication rates are the essentials of local anaesthesia. The anaesthetic requirements for ophthalmic surgery are dictated by the nature...
Review Article
Hyperbaric Oxygen Therapy for Radiation-induced Optic Neuropathy
Radiation optic neuropathy (RON) is an infrequent but usually devastating consequence of radiation to the optic pathways. It is almost exclusively an iatrogenic phenomenon,...
Review Article
The Natural History of Occult Choroidal Neovascularisation Associated With Age-related Macular Degeneration. A Systematic Review
Choroidal neovascularisation (CNV) is a leading cause of blindness in the western world. It causes 90% of the visual loss in age-related macular degeneration...
Review Article
Retinal Prostheses for the Blind
Each year, thousands of people are afflicted with photoreceptor degenerative diseases that reduce vision to bare light perception or complete blindness. Retinitis pigmentosa (RP)...
Editorial
Age-related Macular Degeneration: An Emerging Challenge for Eye Care and Public Health Professionals in the Asia Pacific Region
Age-related macular degeneration (AMD) is a severe ocular disease characterised by progressive deterioration of the macula, the most sensitive central back portion of the...
Others
Intravitreal Triamcinolone Acetonide for the Treatment of Diffuse Diabetic Macular Oedema – A Case Report
Focal and grid laser photocoagulation are the primary surgical treatments for diabetic macular oedema. However, laser treatment of eyes with diffuse macular oedema has...
Original Article
Bruch’s Membrane Abnormalities in Dome-shaped and Mushroom-shaped Choroidal Melanomas
Uveal melanoma is the most common primary intraocular malignancy and is diagnosed chiefly in the fifth to seventh decades of life. The choroid is...
Original Article
Human Limbal Progenitor Cell Characteristics are Maintained in Tissue Culture
The surface of the eye is covered by 3 distinct forms of non-keratinising stratified squamous epithelium – transparent corneal epithelium overlying the corneal surface,...
Original Article
Angiographic Characteristics of Acute Central Serous Chorioretinopathy in an Asian Population
Acute central serous chorioretinopathy (CSCR) is a condition of unknown origin characterised by a serous detachment of the macula. It afflicts young healthy adults,...
Original Article
A Nationwide Survey on the Knowledge and Attitudes of Malaysian Optometry Students on Patients’ Visual Experiences During Cataract Surgery
Cataract is one of the most common causes of visual impairment in the elderly and its surgery is the most common major ophthalmic surgery,...
Editorial
Re-defining Neurological Syndromes: The Genotype Meets the Phenotype
Since time immemorial, generations of medical students and physicians have always been taught that a thorough and detailed history and examination is the foundation...
Editorial
Towards 2020 Vision in Singapore
With the increasing demands of contemporary life, higher levels of visual performance are expected. In modern societies such as Singapore, many more adults will...
Original Article
An Intelligent Tutoring System for Trauma Management (Trauma-Teach): A Preliminary Report
In Singapore, trauma1-7 is the leading cause of hospitalisation and the fifth leading cause of morbidity and mortality.8,9 Common causes of trauma include road...
Others
Fungal Pan-sinusitis with Severe Visual Loss in Uncontrolled Diabetes
Fungi are known opportunistic organisms, which potentially invade and infect a host with depressed immunity. Fungal pan-sinusitis complicated with orbital apex syndrome or cavernous...
Original Article
Prevalence of Refractive Error in Malay Primary School Children in Suburban Area of Kota Bharu, Kelantan, Malaysia
Refractive error remains one of the primary causes of visual impairment in children worldwide. Prevalence of visual impairment in children, is defined as uncorrected...
Others
The Teaching of Radiology
A record of Diagnostic Radiology would be incomplete without reference to Wilheim Roentgen, who discovered the rays that he could not comprehend; hence, X-rays....
Letter to the Editor
Opening Our Eyes to Guide Dogs for the Blind in Singapore
The concept of the modern guide dog first began in Germany after World War I in an effort to support veterans blinded in combat....
Others
Ultrasound Assisted Thrombolysis in Acute Ischaemic Stroke: Preliminary Experience in Singapore
Most patients with acute ischaemic stroke have arterial thrombi that occlude extra- or intracranial vessels. Intravenously administered tissue plasminogen activator (IV-TPA) induces thrombolysis and...
Original Article
Diabetic Retinopathy in Diabetics Referred to a Tertiary Centre from a Nationwide Screening Programme
Diabetic retinopathy (DR) is a leading cause of vision loss in Asia. Singapore has one of the highest prevalence rates of diabetes mellitus (DM)...
Review Article
Functional Neuroimaging of Sleep Deprived Healthy Volunteers and Persons with Sleep Disorders: A Brief Review
Most adults have experienced sleep deprivation at some stage of their lives, be it in the context of work, illness or play. Sleep deprivation...
Review Article
Treatment of Circadian Rhythm Sleep Disorders with Light
In humans, the daily pattern of consolidated sleep and wake is strongly influenced by the timing of exposure to light and darkness. In the...
Review Article
Basic Science Review on Circadian Rhythm Biology and Circadian Sleep Disorders
The sleep-wake cycle, with its characteristic intervals of activity alternating with restfulness that recur with a periodicity approximating the 24-hour day-night cycle, is the...
Images in Medicine
Delayed and Extra-pontine Myelinolysis after Osmotic Dysregulation
A 58-year-old Chinese man was admitted because of increasing lethargy and confusion over 4 days. He had been taking hydrochlorthiazide for hypertension and regularly...
Letter to the Editor
Limb-Shaking Transient Ischemic Attack with Distal Micro-Embolic Signals and Impaired Cerebrovascular Reactivity Using Transcranial Doppler
We present a patient with limb-shaking transient ischaemic attack (TIA) associated with extracranial carotid occlusion and suggest that the pathophysiological mechanism is hypoperfusion, as...
Letter to the Editor
Progressive Hemi-facial Atrophy and Keratoconus
Progressive hemifacial atrophy (Parry-Romberg syndrome, PHA) is characterised by slowly progressive atrophy, usually involving one side of the face, and may be associated with...
Commentary
Neuropsychiatry – An Emerging Field
Neuropsychiatry can be described as the interface between neurology and psychiatry – the intersecting field of enquiry for both the brain and the mind....
Others
Effects on the Contralateral Eye After Intravitreal Bevacizumab and Ranibizumab Injections: A Case Report
Vascular endothelial growth factor (VEGF) is recognised as an important mediator in the pathogenesis of age-related macular degeneration (AMD) and retinal neovascularisation. Anti-VEGF therapies...
Editorial
Alzheimer’s Disease – Towards More Patient-centred and Meaningful Clinical Outcomes
More than 100 years ago Alois Alzheimer first presented the clinical and pathological features of an unusual brain disease at his seminal lecture in...
Commentary
Sir Gordon Arthur Ransome (1910-1978) – His Teaching Style and His Legacy
Sir Gordon Arthur Ransome was born in Salop, England, in 1910.1 He came to Singapore in 1938, where he taught and practised medicine for...
Others
Corticospinal Tract Degeneration in Amyotrophic Lateral Sclerosis: A Diffusion Tensor Imaging and Fibre Tractography Study
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder characterised by spinal and cortical motor neuron degeneration. Although electro myography, muscle biopsy and motor...
Review Article
Biomarkers of Mild Cognitive Impairment and Alzheimer’s Disease
Alzheimer’s disease (AD) is the most prevalent form of age-related dementia in the modern society. Other than symptomatic treatment with acetylcholinesterase inhibitors at its...
Original Article
Validation of Transcranial Doppler with CT Angiography in Cerebral Ischaemia: A Preliminary Pilot Study in Singapore
Transcranial Doppler (TCD) is routinely performed to assess the blood flow in patients with cerebral ischaemia and provides important real-time information about cerebral haemodynamics....
Original Article
Superior Sagittal Sinus Thrombosis: Subtle Signs on Neuroimaging
Cerebral venous thrombosis (CVT) is an infrequent but potentially deadly disease. The mortality rate of CVT is 10% to 20%, and surviving patients may...
Review Article
Current Understanding of the Treatment and Outcome of Acute Primary Angle Closure Glaucoma: An Asian Perspective
Primary angle-closure glaucoma (PACG) is a major cause of irreversible blindness in Asia and many parts of the world. It is a particularly serious...
Original Article
Seeing the Wood for the Trees: Approaches to Teaching and Assessing Clinical Pharmacology and Therapeutics in a Problem-based Learning Course
Over the last 3 decades, the rate of knowledge accumulation in drug development has been enhanced by advances in molecular modelling, the molecular genetics...
Editorial
Embryonic Stem Cells and Parkinson’s Disease: Cell Transplantation to Cell Therapy
Although levodopa is currently a well-endorsed form of treatment for Parkinson’s Disease (PD), the search for a safe, long-term and dyskinesia-free treatment remains an...
Commentary
Bridging the Gap Between Primary and Specialist Care – An Integrative Model for Stroke
Cerebrovascular disease (CVD) is Singapore’s fourth leading cause of death, comprising 9% of all deaths, a crude death rate of 40.4/100,000, an age- and...
Letter to the Editor
Acute Concomitant Esotropia during Heroin Detoxification
Although acute concomitant esotropia following heroin detoxification or withdrawal has been described in a few case reports in Europe and Australia, it has not...
Letter to the Editor
Malignant Syndrome of Two Parkinson Patients due to Withdrawal of Drugs
Neuroleptic malignant syndrome (NMS) is characterised by the impairment of consciousness, high fever, rigidity and autonomic instability. Although originally described in patients taking neuroleptic...
Others
Intraocular Avastin (Bevacizumab) for Neovascularisation of the Iris and Neovascular Glaucoma
Neovascularisation of the iris is associated with many ischaemia retinal disorders and elevated levels of the vascular endothelial growth factor is found in patients...
Review Article
Evaluating the Optic Nerve and Retinal Nerve Fibre Layer: The Roles of Heidelberg Retina Tomography, Scanning Laser Polarimetry and Optical Coherence Tomography
Glaucoma is an optic neuropathy with characteristic optic nerve damage and visual field loss. With the introduction of the ophthalmoscope by Helmholtz in 1851,...
Original Article
Lack of Awareness amongst Community Patients with Diabetes and Diabetic Retinopathy: The Singapore Malay Eye Study
Diabetes is a major public health problem, and diabetic retinopathy is the leading cause of blindness in working-aged people.1 Previous studies have documented poor...
Others
Radiology: Does It Have a Sell-by Date?
Radiology is riding the crest of a wave. We have superb images, available immediately in all parts of the hospital. Fusion of functional and...
Original Article
Emergency Department Headache Admissions in an Acute Care Hospital: Why Do They Occur and What Can We Do About It?
Headache is a common presenting complaint in the Emergency Department (ED), accounting for 1% to 4% of all visits.1-3 A significant proportion of these...
Review Article
Hypoxic-ischaemic Brain Injury in Young Infants
In young infants, different types of hypoxic-ischaemic brain injury can occur.1-6 Brain injury can be localised or diffused.2-6 In localised brain injury, arterial or...
Letter to the Editor
Cysticercosis of the Levator Palpebrae Superioris
Cysticercosis cellulosae, the larval form of the pork
tapeworm Taenia solium, causes cysticercosis, in which
humans serve as the intermediate hosts in the parasite
life cycle. Cysticercosis...
Letter to the Editor
Multimodal Therapeutic Approach in Acute Ischaemic Stroke with Real-time Neurovascular Monitoring
Intravenously administered tissue plasminogen activator (IV-TPA) induces thrombolysis and remains the only FDA-approved therapy for acute ischaemic stroke (IS) within the therapeutic time-window according...
Original Article
Validity and Reliability of the Zarit Burden Interview in Assessing Caregiving Burden
Dementia is a growing public health issue in the Asia-Pacific region. The number of people with dementia in the Asia-Pacific region will increase from...
Letter to the Editor
Chewing-induced Facial Dystonia
Dystonia is a movement disorder characterised by sustained muscle contractions, repetitive twisting movements, and abnormal postures of the trunk, neck, face, or arms and...
Original Article
Intraretinal Segmentation on Fourier Domain Optical Coherence Tomography
Optical coherence tomography (OCT) has become an indispensable tool in the management of retinal and optic nerve diseases as well as in clinical trials....
Original Article
Timing of Arrival to a Tertiary Hospital after Acute Ischaemic Stroke – A Follow-up Survey 5 Years Later
Intravenous tPA is a proven treatment for acute ischaemic stroke. However as it has to be given in a narrow time window from symptom...
Editorial
Alzheimer’s disease–The Inexorable Epidemic
Alzheimer's disease (AD) is the most common form of dementia which refers collectively to syndromes of progressive deterioration of memory along with other cognitive...
Letter to the Editor
Unusual Cause for Unilateral Headache: A Quadrigeminal Cistern Arachnoid Cyst
Young adults are frequently presented with headaches due to various causes. Atypical facial pain, renamed as persistent idiopathic facial pain (PIFP) is a poorly...
Letter to the Editor
Intravitreal Bevacizumab for the Treatment of Myopic Choroidal Neovascularisation in an Asian Population
Myopic choroidal neovascularisation (mCNV) is one of the most common causes of permanent central visual loss in patients with high myopia, and its natural...
Others
Inadvertent Use of Bevacizumab to Treat Choroidal Neovascularisation During Pregnancy: A Case Report
The recognition that vascular endothelial growth factor (VEGF) plays an important role in the pathogenesis of neovascular age-related macular degeneration (NVAMD) has led to...
Editorial
Genome-wide Association Studies: Promises and Pitfalls
Genetic testing is an important means to confirm the diagnosis of an inheritable disease. For this to be feasible, genes that are associated with...
Letter to the Editor
Atypical Presentation of Central Retinal Artery Occlusion
Central retinal artery occlusion (CRAO) typically presents with a retinal “cherry red spot”. In CRAO, infarction of the retinal nerve fibre layer renders the...
Original Article
Computed Tomography Features in Enteric Fever
Enteric fever is a potentially fatal multi-systemic febrile disease caused by Salmonella. Salmonella are gram-negative, rod-shaped facultative intracellular anaerobic bacteria with more than 2500...
Editorial
Epilepsy: Looking Beyond Seizures
World Epilepsy Day falls on 26 March 2013. As we observe this important date in Singapore, it is perhaps instructive to take a step...
Editorial
Sleep, Public Health and Wellness: The Elephant in the Room
The rising cost of health care and the burden of chronic illness are perennial concerns. Remarkably, there exists a measure that around 30% of...
Letter to the Editor
Bilateral Polychromatic Crystalline Keratopathy as the Initial Manifestation of IgG-Lambda Multiple Myeloma
Dear Editor,
Multiple myeloma is a subgroup of plasma cell dyscrasias with neoplastic proliferation of plasma cells or their precursors. Crystalline keratopathy is a well-recognised...
Letter to the Editor
Re: An Alternative Diagnosis: Bartonella Neuroretinitis
I would like to thank the authors for the reply to our case report. The differential diagnosis of Bartonella neuroretinitis in this patient was...
Letter to the Editor
An Alternative Diagnosis: Bartonella Neuroretinitis
We refer to the letter ‘Lyme Neuroretinitis in Singapore: A Diagnostic Dilemma’ published in the April 2012 Vol. 41 No. 4 issue of the...
Letter to the Editor
Single-level Anterior Corpectomy with Fusion versus 2-level Anterior Cervical Decompression with Fusion: A Prospective Controlled Study with 2-year Follow-up Using Cages for Fusion
Anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) are performed for decompression of the spine when the primary compressive...
Letter to the Editor
27-Gauge Vitrectomy for Primary Rhegmatogenous Retinal Detachment: Is it Feasible?
Pars plana vitrectomy (PPV) using the 27-gauge transconjunctival approach is the last frontier of small gauge vitrectomy. Only 1 paper has been published so...
Editorial
A Decade of Progress in the Understanding, Prevention and Treatment of Age-related Macular Degeneration in Singapore
The year 2014 had marked the 10th anniversary of the nationwide Age-related Macular Degeneration (AMD) Awareness Week in Singapore.1 This public health campaign, organised...
Images in Medicine
A maxillary sinus mass
A 55-year-old Chinese woman presented to the ear, nose and throat clinic with a 6-month history of left-sided blood-stained mucus. It was dark brown...
Letter to the Editor
Chorea precipitated by phototherapy as initial presentation of systemic lupus erythematosus
Dear Editor,
Chorea is a well-recognised albeit rare neuropsychiatric manifestation of systemic lupus erythematosus (SLE). We describe here a case of a 67-year-old woman presenting...
Letter to the Editor
Attendance for ischaemic stroke before and during COVID-19 lockdown in Singapore
The coronavirus disease 2019 (COVID-19) outbreak has impacted healthcare systems worldwide. Globally, visits to the emergency department have fallen as much as 25% during...
Letter to the Editor
Rare homozygous PRKN exon 8 and 9 deletion in Malay familial early-onset Parkinson’s disease
Little is known about the genetics of Parkinson’s disease (PD) in Southeast Asian populations.1 We extended knowledge of the Southeast Asian monogenic PD landscape...
Original Article
Incidence and trends of ophthalmic cancer in Singapore: Data from Singapore Cancer Registry
Ophthalmic cancers are commonly encountered in clinical practice and are an important cause of morbidity and mortality. Globally, the incidence of ophthalmic cancers have...
Letter to the Editor
Seeing through the eyes of patients with age-related macular degeneration
Age-related macular degeneration (AMD) is a severe ocular disease characterised by progressive deterioration of the macula, the most sensitive central part of the retina....
Letter to the Editor
Neuro-Behçet’s disease presenting as isolated intracranial hypertension
Behçet’s disease (BD) is a chronic multisystem inflammatory disease with a classic triad of painful oral ulcers, genital ulcers and uveitis. Neurological manifestations, though...
Review Article
Teleophthalmology and its evolving role in a COVID-19 pandemic: A scoping review
The World Health Organization declared coronavirus disease 2019 (COVID-19) a Public Health Emergency of International Concern on 30 January 2020. To control the outbreak,...
Original Article
Cost of inpatient rehabilitation for children with moderate to severe traumatic brain injury
The cost of rehabilitation for children post-traumatic brain injury (TBI) is significant. The annual total healthcare cost of TBI had been estimated to range...
Original Article
Long-term outcomes of ischaemic stroke patients with diabetes in a multi-ethnic cohort in Singapore
Asia faces an epidemic of diabetes. The prevalence of diabetes in Asia is projected to grow from 114 million in 2007 to 180 million...
Editorial
Recurrent vascular events in ischaemic stroke patients with diabetes
Stroke is a major cause of death and disability globally, with 6.55 million deaths (95% uncertainty interval 6.00–7.02 million), 101 million prevalent cases...
Editorial
The Singapore Cerebral Palsy Registry: An important new resource for cerebral palsy research
Cerebral palsy (CP) is a common, lifelong disorder of movement and posture resulting from an insult or maldevelopment of the developing brain. The movement...