Li-anne Lim - Academia.edu (original) (raw)

Papers by Li-anne Lim

Journal of Clinical Oncology, Jun 1, 2023

Journal of Pharmacy and Pharmacology, 2022

Objectives Uveal melanoma (UM) is the most common primary intraocular tumour in adults. UM has a ... more Objectives Uveal melanoma (UM) is the most common primary intraocular tumour in adults. UM has a poor overall prognosis and ~50% of patients progress to metastatic disease that has a median survival of 5.2 months. There are currently no proven pharmacological treatments for primary or metastatic UM. Research efforts continue to seek new agents. Many natural compounds have shown promising anti-UM activity in in-vitro and/or in-vivo studies. This review summarises the current findings for natural compounds that may be potentially useful in treating UM. Key findings Literature suggests that natural compounds, such as pristimerin, picropodophyllin, oridonin, zeaxanthin, withaferin and FR-900359, may be promising candidate compounds to treat UM. Most of these compounds have demonstrated satisfactory efficacy in inhibiting in-vitro UM cell growth. Summary The evidence regarding the anti-UM effects of natural compounds is mainly limited to in-vitro studies; to date, only a small number of ...

Acta Ophthalmologica Scandinavica, 2009

Familial adenomatous polyposis (FAP) is a genetically transmitted disease affecting the colon. It... more Familial adenomatous polyposis (FAP) is a genetically transmitted disease affecting the colon. It is characterized by the presence of several (at least 100) adenomatous polyps, each able to develop into carcinomas, and by other extra-colonic signs such as skin and bone lesions. Within the framework of research studies to identify phenotyphic markers for early detection of subjects at risk within a family affected by FAP, attention has recently been paid to congenital hypertrophy of the retinal pigment ephitelium (CHRPE). With the aim of evaluating the relationship between FAP and CHRPE, 36 members of 7 FAP families were examined. We found that 43.75% of the subjects presenting CHRPE areas were also affected by FAP, whereas 58.33% of patients affected by FAP had CHRPE. Our findings indicated a lower incidence of CHRPE in FAP patients, compared to other studies reported so far. Moreover, in a control group of 160 healthy individuals we found a CHRPE prevalence of 5.5%.

License, which permits unrestricted use, distribution, and reproduction in any medium, provided t... more License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Sirtuin 1 (SIRT1) is a deacetylase that can regulate various biological processes via repression of transcription. Its activity has been linked to the differentiation of neural progenitor cells, although little is known about its function during retinal development. The study described herein was undertaken to evaluate the expression of SIRT1 and its innate inhibitor, DBC1, in retinal tissues and progenitor cells. We found both SIRT1 and DBC1 to be widely expressed in mouse and human retinas, with subtle differences in subcellular distribution of each protein. We further demonstrate that nuclear-localized SIRT1 is only seen in human-derived retinal progenitor cells and not in adult retinas, suggesting that this nuclear localization may be important in retinal development. Moreover, we observed cytoplasmic DBC1 in a subset of progenitor cells as well as...

American Journal of Ophthalmology, 2019

To compare clinical, optical coherence tomography (OCT), and fundus autofluorescence (FAF) charac... more To compare clinical, optical coherence tomography (OCT), and fundus autofluorescence (FAF) characteristics of peripapillary versus (vs.) macular variants of combined hamartoma of the retina and retinal pigment epithelium (combined hamartoma). Design: Retrospective observational, comparative case series Methods: Setting: Multicentre collaborative study Study Population: 50 eyes with a clinical diagnosis of combined hamartoma Observational Analysis: A comparative analysis of color fundus photographs (CFPs), OCT and FAF was performed for peripapillary and macular variants of combined hamartoma. Main Outcome Measures: Pigmentation and OCT features of macular and peripapillary combined hamartoma Results: The review of imaging from 50 eyes of 49 patients diagnosed with combined hamartoma identified 18 (36%) peripapillary lesions, 27 (54%) macular lesions and 5 (10%) peripheral lesions. A comparative analysis of peripapillary vs. macular combined hamartoma identified differences in the following features: lesion pigmentation on CFPs corresponding to hypoautofluorescent FAF (88% vs. 0%, p<0.001) and OCT features of full thickness involvement (88% vs. 3%, p<0.001), preretinal fibrosis (27% vs. 81%, p<0.001), maxi peaks (5% vs. 88%, p<0.001), intraretinal cystoid spaces (72% vs. 40%, p<0.038), outer plexiform layer involvement (5% vs. 96%, p<0.001), ellipsoid zone disruption (83% vs. 3%, p<0.001), RPE disruption (77% vs. 3%, p<0.001) and choroidal neovascularization (16% vs. 0%, p=0.028). Conclusions: This comparative analysis identified a higher frequency of pigmentation with hypoautofluorescence, full thickness retinal involvement, intraretinal cystoid spaces, ellipsoid zone disruption, RPE disruption and choroidal neovascularization in peripapillary combined hamartoma. These findings suggest that lesions occurring near or at the optic nerve are associated with a more severe degree of pigmentary changes and retinal disruption than those located in the macula.

Ophthalmology, 2001

Purpose: To investigate features and outcomes of circumscribed choroidal hemangioma by patient ag... more Purpose: To investigate features and outcomes of circumscribed choroidal hemangioma by patient age. Methods: Retrospective review of circumscribed choroidal hemangioma from 3/29/1967-6/4/2018 based on age at presentation (20 vs. >20-50 vs. >50 years). Results: There were 458 circumscribed choroidal hemangiomas diagnosed at mean age (13 vs. 41 vs. 64 years, p < 0.001). The youngest age group had worse presenting visual acuity (20/400 vs. 20/150 vs. 20/100, p < 0.001), larger tumor basal diameter (13.5 vs. 6.6 vs. 6.2, p < 0.001), greater tumor thickness (5.8 vs. 3.1 vs. 2.9, p < 0.001), closer distance to foveola (0.5 vs. 1.4 vs. 1.2, p = 0.03), and greater extent of subretinal fluid (4 quadrants, 26% vs. 8% vs. 2%, p < 0.001). The youngest patients were less likely to be treated with primary observation (39% vs. 39% vs. 56%) or photodynamic therapy (10% vs. 27% vs. 22%) and more likely to be treated with plaque radiotherapy (26% vs. 6% vs. 3%) or external beam radiotherapy (13% vs. 1% vs. 0%) (p < 0.001). The youngest patients required greater total number of treatments (mean 4 vs. 2 vs. 1, p < 0.001). At mean follow-up (44 vs. 68 vs. 60 months, p = 0.37), the youngest patients had worse visual acuity (20/400 vs. 20/200 vs. 20/100, p = 0.03), but no difference in visual acuity loss of 3 or more Snellen lines (27% vs. 13% vs. 16%, p = 0.55). Conclusion: Younger patients (20 years) with circumscribed choroidal hemangioma present with worse visual acuity and larger, more posterior tumors. Future studies are needed to improve early detection and treatment for this subgroup of patients.

BMC Ophthalmology, 2014

Background: The treatment of uveal melanoma has seen a shift towards eye conserving treatments. E... more Background: The treatment of uveal melanoma has seen a shift towards eye conserving treatments. Efforts have been made towards the identification of patients at high risk of metastatic disease with the use of prognostic fine needle biopsy, Monosomy 3 a risk factor for metastatic death thought to occur early in the development of uveal melanoma. Case presentation: We report a case in which an atypical optic nerve lesion was found to be a peripapillary primary uveal melanoma with distinct non-pigmented and pigmented halves on gross dissection and corresponding disomy 3 and monosomy 3 halves. The tumour demonstrated rapid growth with apparent transformation from disomy 3 to monosomy 3. Conclusions: These are clinical features that challenge the current concepts of the cytogenetic pathogenesis of uveal melanoma and demonstrate the potential problems and limitations of prognostic fine needle biopsy and molecular classifications.

Journal of Clinical Oncology

TPS9610 Background: Geographical differences in the management of primary UM, surveillance for re... more TPS9610 Background: Geographical differences in the management of primary UM, surveillance for recurrence, and care of metastatic disease have emerged based upon local expertise, treatment availability and insurance coverage. We have initiated accrual to OMNi (NCT04588662), an ambispective database developed to provide contemporary real-world data of UM, capturing its natural history and serving as a virtual biospecimen repository. The overall objectives of OMNi are to characterize regional/international UM management practice patterns and associated clinical outcomes in an effort to inform best practice recommendations. Methods: OMNi utilizes the Pulse Infoframe Healthie platform, a globally compliant platform which enables the structured collection of data mapped to Observational Medical Outcomes Partnership. The data fields created permit longitudinal capture of data including baseline patient and tumor characteristics, treatment of primary lesion and outcomes, surveillance patte...

Clinical Ophthalmology, 2013

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2008

To determine the surgical outcome of primary trabeculectomy with mitomycin C (MMC) and fornix-bas... more To determine the surgical outcome of primary trabeculectomy with mitomycin C (MMC) and fornix-based conjunctival flap technique in Thai patients. This retrospective review was conducted from the clinical records of all Thai glaucoma patients who underwent a primary trabeculectomy with MMC using a fornix-based conjunctival flap technique by or under supervision of one ophthalmologist (NK) between February 2004 and July 2006 at Siriraj Hospital, School of Medicine, Mahidol University, Bangkok, Thailand. There were 69 eyes from 60 patients. Postoperatively, mean intraocular pressure (IOP) was significantly decreased from 26.1 +/- 11.7 mmHg to 11.7 +/- 4.4 mmHg (p < 0.001) and mean number of anti-glaucoma medication was significantly reduced from 3.9 +/- 0.7 to 0.3 +/- 0.9 (p < 0.001) at last visit. Sixty-seven eyes (96.8%) were considered as success. Eight eyes (11.6%) in this group needed topical anti-glaucoma medications. Two eyes (2.9%) were considered as failure. Mean follow-...

which permits unrestricted noncommercial use, provided the original work is properly cited.

Objective: To determine the surgical outcome of primary trabeculectomy with mitomycin C (MMC) and... more Objective: To determine the surgical outcome of primary trabeculectomy with mitomycin C (MMC) and fornix-based conjunctival flap technique in Thai patients. Material and Method: This retrospective review was conducted from the clinical records of all Thai glaucoma patients who underwent a primary trabeculectomy with MMC using a fornix-based conjunctival flap technique by or under supervision of one ophthalmologist (NK) between February 2004 and July 2006 at Siriraj

Stroke

Background: The introduction of intra-arterial chemotherapy (IAC) for treatment of retinoblastoma... more Background: The introduction of intra-arterial chemotherapy (IAC) for treatment of retinoblastoma considerably changed the paradigm by which this disease is managed, with event-free survival rates being above 70%. Objective: Our aim is to analyze efficacy of IAC treatment using alternative approaches to OAC such as external carotid artery (ECA) approach or balloon-assisted drug delivery. Methods: This is a retrospective chart review for subjects receiving IAC for retinoblastoma. The primary approach was OAC. In cases where selective OAC was not feasible, alternative routes including catheterization of the ECA or use of a balloon-assisted drug infusion where used. Results: This study included 197 consecutive patients with 207 retinoblastomas who underwent 658 IAC procedures overall. The mean age at diagnosis was 24 months, and 54.5% of the study population was male. Success rate with IAC was 97% (639. Alternative approaches to OAC were in total 42 cases (6.4%) - external carotid arte...

Stroke

Background: Intra-arterial chemotherapy (IAC) for retinoblastoma (Rb) has dramatically altered th... more Background: Intra-arterial chemotherapy (IAC) for retinoblastoma (Rb) has dramatically altered the natural history of the disease. The spectacular outcomes associated with a high safety profile have pushed the envelope to offer treatment for patients < 10 kg of weight. Objective: We aim to share our findings and experience in a large series of IAC infusions performed in infants < 10 kg. Methods: A retrospective chart review was performed for patients diagnosed with retinoblastoma and managed with IAC as either primary or secondary treatment. Results: There were 207 Rb tumors of 207 eyes in 197 consecutive patients. Of these, patient weight was 10 kg in 69 (35.7%) and >10 kg in 133 (67.5%) patients. Of the 69 patients weighing < 10 kg, 5 patients had bilateral Rb. Thus, a total of 74 eyes of 69 patients weighing < 10 kg were compared to 133 eyes of 133 patients weighing > 10 kg. Comparison ( < 10 kg vs. >10 kg) revealed the total number of IAC cycles was 222 v...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2008

OBJECTIVE To determine the surgical outcome of primary trabeculectomy with mitomycin C (MMC) and ... more OBJECTIVE To determine the surgical outcome of primary trabeculectomy with mitomycin C (MMC) and fornix-based conjunctival flap technique in Thai patients. MATERIAL AND METHOD This retrospective review was conducted from the clinical records of all Thai glaucoma patients who underwent a primary trabeculectomy with MMC using a fornix-based conjunctival flap technique by or under supervision of one ophthalmologist (NK) between February 2004 and July 2006 at Siriraj Hospital, School of Medicine, Mahidol University, Bangkok, Thailand. RESULTS There were 69 eyes from 60 patients. Postoperatively, mean intraocular pressure (IOP) was significantly decreased from 26.1 +/- 11.7 mmHg to 11.7 +/- 4.4 mmHg (p < 0.001) and mean number of anti-glaucoma medication was significantly reduced from 3.9 +/- 0.7 to 0.3 +/- 0.9 (p < 0.001) at last visit. Sixty-seven eyes (96.8%) were considered as success. Eight eyes (11.6%) in this group needed topical anti-glaucoma medications. Two eyes (2.9%) we...

PURPOSE To evaluate spectral domain optical coherence tomography (SD-OCT) features of vitreoretin... more PURPOSE To evaluate spectral domain optical coherence tomography (SD-OCT) features of vitreoretinal lymphoma (VRL). METHODS Review of records and SD-OCT images of vitreoretinal lymphoma evaluated at Ocular Oncology Service, Wills Eye Hospital between July 1, 2000, and April 1, 2019. RESULTS There were 55 eyes of 32 patients included. At presentation, SD-OCT features included vitreous opacities (n = 36, 65%), preretinal deposits (n = 7, 13%), intraretinal deposits (n = 8, 15%), subretinal deposits (n = 20, 36%), retinal pigment epithelium abnormalities (n = 35, 64%), and subretinal pigment epithelium deposits (n = 35, 64%). Of 36 eyes with observed tumor progression, comparison (initial visit vs. time of progression) revealed more intraretinal deposits (17% vs. 50%, P = 0.005) at progression. Of 15 eyes with tumor recurrence, comparison (initial visit vs. time of recurrence) revealed more intraretinal deposits (7% vs. 47%, P = 0.04) at recurrence. At last visit, 39 eyes demonstrated ...

Indian Journal of Ophthalmology

Purpose: To quantify outcomes for neonatal retinoblastoma patients treated during the pre-chemoth... more Purpose: To quantify outcomes for neonatal retinoblastoma patients treated during the pre-chemotherapy (1980–1994) and chemotherapy (1995–2018) eras. Methods: Retrospective review of retinoblastoma patients diagnosed within the first 28 days of life between 1/1/1980 and 11/30/2018. Student's t-test, Chi-square, and Fisher's exact test were performed to compare treatments and outcomes by era. Results: There were 68 patients with neonatal retinoblastoma (12% unilateral and 88% bilateral). According to era (pre-chemotherapy vs. chemotherapy), the number of treated patients was 26 (38%) vs. 42 (62%). Primary treatment was external beam radiotherapy (50% vs. 1%,P < 0.001), plaque radiotherapy (17% vs. 0%,P < 0.001), focal treatment (transpupillary thermotherapy or cryotherapy) only (21% vs. 14%,P= 0.33), intravenous chemotherapy (0% vs. 81%,P < 0.001), enucleation (10% vs. 4%,P= 0.26), or exenteration (2% vs. 0%,P= 0.37). Outcomes included tumor control (79% vs. 94%,P= 0.02), globe salvage (75% vs. 91%,P= 0.02), final gross visual acuity for salvaged eyes 20/200 or better (66% vs. 89%,P < 0.01), and death (19% vs. 0%,P < 0.01). Conclusion: Chemotherapy advancements for neonatal retinoblastoma have improved tumor control, globe salvage, visual acuity, and patient survival.

Indian Journal of Ophthalmology

To assess features and outcomes of Coats disease over 5-decades. Methods: Retrospective review of... more To assess features and outcomes of Coats disease over 5-decades. Methods: Retrospective review of Coats disease patients at a single center. Features and outcomes were compared based on decade of presentation. Results: There were 351 patients with Coats disease. The presenting median age (6 years), male sex (84%), and unilaterality (100%) did not change per decade. Coats disease classification did not change per decade with Stage 1 (1%), Stage 2 (21%), Stage 3 (68%), Stage 4 (6%), and Stage 5 (1%). Clinical features that changed per decade (1970s vs. 1980s vs. 1990s vs. 2000s vs. 2010s) included 1980s features of more eyes with exudation in all 4 quadrants (22% vs. 58% vs. 44% vs. 33% vs. 27, P = 0.01) and total exudative retinal detachment (33% vs. 53% vs. 39% vs. 27% vs. 21%, P < 0.001). Imaging features that changed per decade included 2010s greater fluorescein angiographic extent of retinal non-perfusion in mean clock hours (4 vs. 4 vs. 3 vs. 5 vs. 6, P = 0.003), and 1980s greater mean height of retinal detachment ultrasonographically (5 vs. 12 vs. 5 vs. 5 vs. 4 mm, P < 0.001). Treatment features that changed per decade included 1980s greater primary enucleation (11% vs. 16% vs. 3% vs. 4% vs. 1%, P = 0.001), and 2010s greater use of laser photocoagulation (55% vs. 33% vs. 38% vs. 40% vs. 72%, P < 0.001), sub-Tenon corticosteroid (0% vs. 4% vs. 5% vs. 8% vs. 29%, P < 0.001), and intravitreal anti-VEGF) (0% vs. 4% vs. 2% vs. 13% vs. 18%, P = 0.003). Outcomes that changed per decade included 2010s findings of more complete resolution of subretinal fluid (64% vs. 59% vs. 38% vs. 58% vs. 72%, P = 0.01) and less need for primary/secondary enucleation (17% vs. 27% vs. 14% vs. 13% vs. 6%, P = 0.04). Conclusion: Eyes with Coats disease in the 1980s demonstrated more advanced findings, often requiring enucleation. Over the decades, greater use of laser photocoagulation and injections has led to improved disease resolution with greater globe salvage.

Journal of Clinical Oncology, Jun 1, 2023

Journal of Pharmacy and Pharmacology, 2022

Objectives Uveal melanoma (UM) is the most common primary intraocular tumour in adults. UM has a ... more Objectives Uveal melanoma (UM) is the most common primary intraocular tumour in adults. UM has a poor overall prognosis and ~50% of patients progress to metastatic disease that has a median survival of 5.2 months. There are currently no proven pharmacological treatments for primary or metastatic UM. Research efforts continue to seek new agents. Many natural compounds have shown promising anti-UM activity in in-vitro and/or in-vivo studies. This review summarises the current findings for natural compounds that may be potentially useful in treating UM. Key findings Literature suggests that natural compounds, such as pristimerin, picropodophyllin, oridonin, zeaxanthin, withaferin and FR-900359, may be promising candidate compounds to treat UM. Most of these compounds have demonstrated satisfactory efficacy in inhibiting in-vitro UM cell growth. Summary The evidence regarding the anti-UM effects of natural compounds is mainly limited to in-vitro studies; to date, only a small number of ...

Acta Ophthalmologica Scandinavica, 2009

Familial adenomatous polyposis (FAP) is a genetically transmitted disease affecting the colon. It... more Familial adenomatous polyposis (FAP) is a genetically transmitted disease affecting the colon. It is characterized by the presence of several (at least 100) adenomatous polyps, each able to develop into carcinomas, and by other extra-colonic signs such as skin and bone lesions. Within the framework of research studies to identify phenotyphic markers for early detection of subjects at risk within a family affected by FAP, attention has recently been paid to congenital hypertrophy of the retinal pigment ephitelium (CHRPE). With the aim of evaluating the relationship between FAP and CHRPE, 36 members of 7 FAP families were examined. We found that 43.75% of the subjects presenting CHRPE areas were also affected by FAP, whereas 58.33% of patients affected by FAP had CHRPE. Our findings indicated a lower incidence of CHRPE in FAP patients, compared to other studies reported so far. Moreover, in a control group of 160 healthy individuals we found a CHRPE prevalence of 5.5%.

License, which permits unrestricted use, distribution, and reproduction in any medium, provided t... more License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Sirtuin 1 (SIRT1) is a deacetylase that can regulate various biological processes via repression of transcription. Its activity has been linked to the differentiation of neural progenitor cells, although little is known about its function during retinal development. The study described herein was undertaken to evaluate the expression of SIRT1 and its innate inhibitor, DBC1, in retinal tissues and progenitor cells. We found both SIRT1 and DBC1 to be widely expressed in mouse and human retinas, with subtle differences in subcellular distribution of each protein. We further demonstrate that nuclear-localized SIRT1 is only seen in human-derived retinal progenitor cells and not in adult retinas, suggesting that this nuclear localization may be important in retinal development. Moreover, we observed cytoplasmic DBC1 in a subset of progenitor cells as well as...

American Journal of Ophthalmology, 2019

To compare clinical, optical coherence tomography (OCT), and fundus autofluorescence (FAF) charac... more To compare clinical, optical coherence tomography (OCT), and fundus autofluorescence (FAF) characteristics of peripapillary versus (vs.) macular variants of combined hamartoma of the retina and retinal pigment epithelium (combined hamartoma). Design: Retrospective observational, comparative case series Methods: Setting: Multicentre collaborative study Study Population: 50 eyes with a clinical diagnosis of combined hamartoma Observational Analysis: A comparative analysis of color fundus photographs (CFPs), OCT and FAF was performed for peripapillary and macular variants of combined hamartoma. Main Outcome Measures: Pigmentation and OCT features of macular and peripapillary combined hamartoma Results: The review of imaging from 50 eyes of 49 patients diagnosed with combined hamartoma identified 18 (36%) peripapillary lesions, 27 (54%) macular lesions and 5 (10%) peripheral lesions. A comparative analysis of peripapillary vs. macular combined hamartoma identified differences in the following features: lesion pigmentation on CFPs corresponding to hypoautofluorescent FAF (88% vs. 0%, p<0.001) and OCT features of full thickness involvement (88% vs. 3%, p<0.001), preretinal fibrosis (27% vs. 81%, p<0.001), maxi peaks (5% vs. 88%, p<0.001), intraretinal cystoid spaces (72% vs. 40%, p<0.038), outer plexiform layer involvement (5% vs. 96%, p<0.001), ellipsoid zone disruption (83% vs. 3%, p<0.001), RPE disruption (77% vs. 3%, p<0.001) and choroidal neovascularization (16% vs. 0%, p=0.028). Conclusions: This comparative analysis identified a higher frequency of pigmentation with hypoautofluorescence, full thickness retinal involvement, intraretinal cystoid spaces, ellipsoid zone disruption, RPE disruption and choroidal neovascularization in peripapillary combined hamartoma. These findings suggest that lesions occurring near or at the optic nerve are associated with a more severe degree of pigmentary changes and retinal disruption than those located in the macula.

Ophthalmology, 2001

Purpose: To investigate features and outcomes of circumscribed choroidal hemangioma by patient ag... more Purpose: To investigate features and outcomes of circumscribed choroidal hemangioma by patient age. Methods: Retrospective review of circumscribed choroidal hemangioma from 3/29/1967-6/4/2018 based on age at presentation (20 vs. >20-50 vs. >50 years). Results: There were 458 circumscribed choroidal hemangiomas diagnosed at mean age (13 vs. 41 vs. 64 years, p < 0.001). The youngest age group had worse presenting visual acuity (20/400 vs. 20/150 vs. 20/100, p < 0.001), larger tumor basal diameter (13.5 vs. 6.6 vs. 6.2, p < 0.001), greater tumor thickness (5.8 vs. 3.1 vs. 2.9, p < 0.001), closer distance to foveola (0.5 vs. 1.4 vs. 1.2, p = 0.03), and greater extent of subretinal fluid (4 quadrants, 26% vs. 8% vs. 2%, p < 0.001). The youngest patients were less likely to be treated with primary observation (39% vs. 39% vs. 56%) or photodynamic therapy (10% vs. 27% vs. 22%) and more likely to be treated with plaque radiotherapy (26% vs. 6% vs. 3%) or external beam radiotherapy (13% vs. 1% vs. 0%) (p < 0.001). The youngest patients required greater total number of treatments (mean 4 vs. 2 vs. 1, p < 0.001). At mean follow-up (44 vs. 68 vs. 60 months, p = 0.37), the youngest patients had worse visual acuity (20/400 vs. 20/200 vs. 20/100, p = 0.03), but no difference in visual acuity loss of 3 or more Snellen lines (27% vs. 13% vs. 16%, p = 0.55). Conclusion: Younger patients (20 years) with circumscribed choroidal hemangioma present with worse visual acuity and larger, more posterior tumors. Future studies are needed to improve early detection and treatment for this subgroup of patients.

BMC Ophthalmology, 2014

Background: The treatment of uveal melanoma has seen a shift towards eye conserving treatments. E... more Background: The treatment of uveal melanoma has seen a shift towards eye conserving treatments. Efforts have been made towards the identification of patients at high risk of metastatic disease with the use of prognostic fine needle biopsy, Monosomy 3 a risk factor for metastatic death thought to occur early in the development of uveal melanoma. Case presentation: We report a case in which an atypical optic nerve lesion was found to be a peripapillary primary uveal melanoma with distinct non-pigmented and pigmented halves on gross dissection and corresponding disomy 3 and monosomy 3 halves. The tumour demonstrated rapid growth with apparent transformation from disomy 3 to monosomy 3. Conclusions: These are clinical features that challenge the current concepts of the cytogenetic pathogenesis of uveal melanoma and demonstrate the potential problems and limitations of prognostic fine needle biopsy and molecular classifications.

Journal of Clinical Oncology

TPS9610 Background: Geographical differences in the management of primary UM, surveillance for re... more TPS9610 Background: Geographical differences in the management of primary UM, surveillance for recurrence, and care of metastatic disease have emerged based upon local expertise, treatment availability and insurance coverage. We have initiated accrual to OMNi (NCT04588662), an ambispective database developed to provide contemporary real-world data of UM, capturing its natural history and serving as a virtual biospecimen repository. The overall objectives of OMNi are to characterize regional/international UM management practice patterns and associated clinical outcomes in an effort to inform best practice recommendations. Methods: OMNi utilizes the Pulse Infoframe Healthie platform, a globally compliant platform which enables the structured collection of data mapped to Observational Medical Outcomes Partnership. The data fields created permit longitudinal capture of data including baseline patient and tumor characteristics, treatment of primary lesion and outcomes, surveillance patte...

Clinical Ophthalmology, 2013

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2008

To determine the surgical outcome of primary trabeculectomy with mitomycin C (MMC) and fornix-bas... more To determine the surgical outcome of primary trabeculectomy with mitomycin C (MMC) and fornix-based conjunctival flap technique in Thai patients. This retrospective review was conducted from the clinical records of all Thai glaucoma patients who underwent a primary trabeculectomy with MMC using a fornix-based conjunctival flap technique by or under supervision of one ophthalmologist (NK) between February 2004 and July 2006 at Siriraj Hospital, School of Medicine, Mahidol University, Bangkok, Thailand. There were 69 eyes from 60 patients. Postoperatively, mean intraocular pressure (IOP) was significantly decreased from 26.1 +/- 11.7 mmHg to 11.7 +/- 4.4 mmHg (p < 0.001) and mean number of anti-glaucoma medication was significantly reduced from 3.9 +/- 0.7 to 0.3 +/- 0.9 (p < 0.001) at last visit. Sixty-seven eyes (96.8%) were considered as success. Eight eyes (11.6%) in this group needed topical anti-glaucoma medications. Two eyes (2.9%) were considered as failure. Mean follow-...

which permits unrestricted noncommercial use, provided the original work is properly cited.

Objective: To determine the surgical outcome of primary trabeculectomy with mitomycin C (MMC) and... more Objective: To determine the surgical outcome of primary trabeculectomy with mitomycin C (MMC) and fornix-based conjunctival flap technique in Thai patients. Material and Method: This retrospective review was conducted from the clinical records of all Thai glaucoma patients who underwent a primary trabeculectomy with MMC using a fornix-based conjunctival flap technique by or under supervision of one ophthalmologist (NK) between February 2004 and July 2006 at Siriraj

Stroke

Background: The introduction of intra-arterial chemotherapy (IAC) for treatment of retinoblastoma... more Background: The introduction of intra-arterial chemotherapy (IAC) for treatment of retinoblastoma considerably changed the paradigm by which this disease is managed, with event-free survival rates being above 70%. Objective: Our aim is to analyze efficacy of IAC treatment using alternative approaches to OAC such as external carotid artery (ECA) approach or balloon-assisted drug delivery. Methods: This is a retrospective chart review for subjects receiving IAC for retinoblastoma. The primary approach was OAC. In cases where selective OAC was not feasible, alternative routes including catheterization of the ECA or use of a balloon-assisted drug infusion where used. Results: This study included 197 consecutive patients with 207 retinoblastomas who underwent 658 IAC procedures overall. The mean age at diagnosis was 24 months, and 54.5% of the study population was male. Success rate with IAC was 97% (639. Alternative approaches to OAC were in total 42 cases (6.4%) - external carotid arte...

Stroke

Background: Intra-arterial chemotherapy (IAC) for retinoblastoma (Rb) has dramatically altered th... more Background: Intra-arterial chemotherapy (IAC) for retinoblastoma (Rb) has dramatically altered the natural history of the disease. The spectacular outcomes associated with a high safety profile have pushed the envelope to offer treatment for patients < 10 kg of weight. Objective: We aim to share our findings and experience in a large series of IAC infusions performed in infants < 10 kg. Methods: A retrospective chart review was performed for patients diagnosed with retinoblastoma and managed with IAC as either primary or secondary treatment. Results: There were 207 Rb tumors of 207 eyes in 197 consecutive patients. Of these, patient weight was 10 kg in 69 (35.7%) and >10 kg in 133 (67.5%) patients. Of the 69 patients weighing < 10 kg, 5 patients had bilateral Rb. Thus, a total of 74 eyes of 69 patients weighing < 10 kg were compared to 133 eyes of 133 patients weighing > 10 kg. Comparison ( < 10 kg vs. >10 kg) revealed the total number of IAC cycles was 222 v...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2008

OBJECTIVE To determine the surgical outcome of primary trabeculectomy with mitomycin C (MMC) and ... more OBJECTIVE To determine the surgical outcome of primary trabeculectomy with mitomycin C (MMC) and fornix-based conjunctival flap technique in Thai patients. MATERIAL AND METHOD This retrospective review was conducted from the clinical records of all Thai glaucoma patients who underwent a primary trabeculectomy with MMC using a fornix-based conjunctival flap technique by or under supervision of one ophthalmologist (NK) between February 2004 and July 2006 at Siriraj Hospital, School of Medicine, Mahidol University, Bangkok, Thailand. RESULTS There were 69 eyes from 60 patients. Postoperatively, mean intraocular pressure (IOP) was significantly decreased from 26.1 +/- 11.7 mmHg to 11.7 +/- 4.4 mmHg (p < 0.001) and mean number of anti-glaucoma medication was significantly reduced from 3.9 +/- 0.7 to 0.3 +/- 0.9 (p < 0.001) at last visit. Sixty-seven eyes (96.8%) were considered as success. Eight eyes (11.6%) in this group needed topical anti-glaucoma medications. Two eyes (2.9%) we...

PURPOSE To evaluate spectral domain optical coherence tomography (SD-OCT) features of vitreoretin... more PURPOSE To evaluate spectral domain optical coherence tomography (SD-OCT) features of vitreoretinal lymphoma (VRL). METHODS Review of records and SD-OCT images of vitreoretinal lymphoma evaluated at Ocular Oncology Service, Wills Eye Hospital between July 1, 2000, and April 1, 2019. RESULTS There were 55 eyes of 32 patients included. At presentation, SD-OCT features included vitreous opacities (n = 36, 65%), preretinal deposits (n = 7, 13%), intraretinal deposits (n = 8, 15%), subretinal deposits (n = 20, 36%), retinal pigment epithelium abnormalities (n = 35, 64%), and subretinal pigment epithelium deposits (n = 35, 64%). Of 36 eyes with observed tumor progression, comparison (initial visit vs. time of progression) revealed more intraretinal deposits (17% vs. 50%, P = 0.005) at progression. Of 15 eyes with tumor recurrence, comparison (initial visit vs. time of recurrence) revealed more intraretinal deposits (7% vs. 47%, P = 0.04) at recurrence. At last visit, 39 eyes demonstrated ...

Indian Journal of Ophthalmology

Purpose: To quantify outcomes for neonatal retinoblastoma patients treated during the pre-chemoth... more Purpose: To quantify outcomes for neonatal retinoblastoma patients treated during the pre-chemotherapy (1980–1994) and chemotherapy (1995–2018) eras. Methods: Retrospective review of retinoblastoma patients diagnosed within the first 28 days of life between 1/1/1980 and 11/30/2018. Student's t-test, Chi-square, and Fisher's exact test were performed to compare treatments and outcomes by era. Results: There were 68 patients with neonatal retinoblastoma (12% unilateral and 88% bilateral). According to era (pre-chemotherapy vs. chemotherapy), the number of treated patients was 26 (38%) vs. 42 (62%). Primary treatment was external beam radiotherapy (50% vs. 1%,P < 0.001), plaque radiotherapy (17% vs. 0%,P < 0.001), focal treatment (transpupillary thermotherapy or cryotherapy) only (21% vs. 14%,P= 0.33), intravenous chemotherapy (0% vs. 81%,P < 0.001), enucleation (10% vs. 4%,P= 0.26), or exenteration (2% vs. 0%,P= 0.37). Outcomes included tumor control (79% vs. 94%,P= 0.02), globe salvage (75% vs. 91%,P= 0.02), final gross visual acuity for salvaged eyes 20/200 or better (66% vs. 89%,P < 0.01), and death (19% vs. 0%,P < 0.01). Conclusion: Chemotherapy advancements for neonatal retinoblastoma have improved tumor control, globe salvage, visual acuity, and patient survival.

Indian Journal of Ophthalmology

To assess features and outcomes of Coats disease over 5-decades. Methods: Retrospective review of... more To assess features and outcomes of Coats disease over 5-decades. Methods: Retrospective review of Coats disease patients at a single center. Features and outcomes were compared based on decade of presentation. Results: There were 351 patients with Coats disease. The presenting median age (6 years), male sex (84%), and unilaterality (100%) did not change per decade. Coats disease classification did not change per decade with Stage 1 (1%), Stage 2 (21%), Stage 3 (68%), Stage 4 (6%), and Stage 5 (1%). Clinical features that changed per decade (1970s vs. 1980s vs. 1990s vs. 2000s vs. 2010s) included 1980s features of more eyes with exudation in all 4 quadrants (22% vs. 58% vs. 44% vs. 33% vs. 27, P = 0.01) and total exudative retinal detachment (33% vs. 53% vs. 39% vs. 27% vs. 21%, P < 0.001). Imaging features that changed per decade included 2010s greater fluorescein angiographic extent of retinal non-perfusion in mean clock hours (4 vs. 4 vs. 3 vs. 5 vs. 6, P = 0.003), and 1980s greater mean height of retinal detachment ultrasonographically (5 vs. 12 vs. 5 vs. 5 vs. 4 mm, P < 0.001). Treatment features that changed per decade included 1980s greater primary enucleation (11% vs. 16% vs. 3% vs. 4% vs. 1%, P = 0.001), and 2010s greater use of laser photocoagulation (55% vs. 33% vs. 38% vs. 40% vs. 72%, P < 0.001), sub-Tenon corticosteroid (0% vs. 4% vs. 5% vs. 8% vs. 29%, P < 0.001), and intravitreal anti-VEGF) (0% vs. 4% vs. 2% vs. 13% vs. 18%, P = 0.003). Outcomes that changed per decade included 2010s findings of more complete resolution of subretinal fluid (64% vs. 59% vs. 38% vs. 58% vs. 72%, P = 0.01) and less need for primary/secondary enucleation (17% vs. 27% vs. 14% vs. 13% vs. 6%, P = 0.04). Conclusion: Eyes with Coats disease in the 1980s demonstrated more advanced findings, often requiring enucleation. Over the decades, greater use of laser photocoagulation and injections has led to improved disease resolution with greater globe salvage.