Macular Degeneration: Au Eong KG

Woo JH, Au Eong KG. · No affiliation provided · Singapore Med J. · Pubmed #19037547 links to  free full text

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Au Eong KG. · No affiliation provided · Ann Acad Med Singapore. · Pubmed #16625260 links to  free full text

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O'Connell E, Neelam K, Nolan J, Au Eong KG, Beatty S. · Department of Ophthalmology, Waterford Regional Hospital, Waterford, Republic of Ireland. · Ann Acad Med Singapore. · Pubmed #17160199 links to  free full text

Abstract: Lutein (L) and zeaxanthin (Z) are concentrated at the macula, where they are collectively known as macular pigment (MP), and where they are believed to play a major role in protecting retinal tissues against oxidative stress. Whilst the exact pathogenesis of age-related maculopathy (ARM) remains unknown, the disruption of cellular processes by oxidative stress may play an important role. Manipulation of dietary intake of L and Z has been shown to augment MP, thereby raising hopes that dietary supplementation with these carotenoids might prevent, delay, or modify the course of ARM. This article discusses the scientific rationale supporting the hypothesis that L and Z are protective against ARM, and presents the recent evidence germane to this theory.

Fujii GY, Au Eong KG, Humayun MS, de Juan E. · Retina Institute, Doheny Eye Institute, Keck School of Medicine, University of Southern California, DEI-3600, 1450 San Pablo Street, Los Angeles, CA 90033, USA. · Ophthalmol Clin North Am. · Pubmed #12515074 No free full text.

Abstract: Macular translocation is a promising treatment modality that offers patients a chance to improve their vision, potentially to a level that may allow reading and driving. Proper patient selection avoids surgery in eyes with permanently damaged central retina and identifies eyes with the greatest potential for good visual outcomes. Functionally, those patients with recent-onset subfoveal CNV without permanent foveal neurosensory retina damage have the greatest likelihood of good visual outcome. Use of fixation evaluation by means of the SLO appears to greatly optimize patient selection. Anatomically, the best candidates have small minimum desired translocations and healthy RPE-Bruch membrane-choriocapillaris complex beyond the borders of the lesion. The exact role of limited macular translocation for the management of subfoveal CNV in this era of photodynamic therapy remains to be evaluated, and a pilot multicenter, randomized, clinical trial is under way to compare the efficacy of limited macular translocation with photodynamic therapy in eyes with subfoveal CNV secondary to AMD.

Fujii GY, Humayun MS, Pieramici DJ, Schachat AP, Au Eong KG, de Juan E. · Wilmer Ophthalmological Institute, The Johns Hopkins University School of Medicine., Baltimore, Maryland, USA. · Am J Ophthalmol. · Pubmed #11162983 No free full text.

Abstract: PURPOSE: To report our initial experience of inferior limited macular translocation in patients with subfoveal choroidal neovascularization resulting from causes other than age-related macular degeneration. METHODS: We conducted a retrospective study of 23 eyes of 22 patients with choroidal neovascularization involving the foveal center secondary to pathologic myopia (11 eyes), ocular histoplasmosis syndrome (four eyes), angioid streaks (four eyes), idiopathic neovascularization (three eyes), and multifocal choroiditis (one eye), in which the fovea was moved inferiorly by means of limited macular translocation surgery. The mean preoperative best-corrected visual acuity was 20/150, and in five of 23 eyes (21.7%) the visual acuity was 20/80 or better. The major outcome measures were preoperative and postoperative visual acuity, postoperative foveal displacement, and complications related to the surgery. RESULTS: The mean postoperative follow-up was 10.82 months (range, 6 to 18 months). Postoperative best-corrected visual acuity improved by 2 or more Snellen lines of visual acuity in 11 of 23 eyes (47.82%), remained within 1 line in seven of 23 eyes (30.43%), and worsened 2 or more lines of vision in five of 23 eyes (21.74%). The mean postoperative best-corrected visual acuity was 20/100, and in 12 of the 23 eyes (52.17%) the visual acuity achieved was 20/80 or better. Retinal detachment was the most frequent complication and occurred in six eyes (26%). CONCLUSIONS: Our initial experience with limited macular translocation shows that this treatment modality offers the potential to improve visual function in some eyes with subfoveal choroidal neovascularization secondary to myopia, ocular histoplasmosis syndrome, angioid streaks, idiopathic neovascularization, and multifocal choroiditis. Although longer and more complete follow-up is needed, the results of this initial series warrant further studies to define the precise role of macular translocation in the management of these conditions.

Woo JH, Sanjay S, Au Eong KG. · Department of Ophthalmology and Visual Sciences, Alexandra Hospital, Singapore. · Acta Ophthalmol. · Pubmed #19016663 No free full text.

Abstract: CONTEXT: The Indian subcontinent is one of the most populous regions in the world. Given the projected rapid population growth and ageing of the population, age-related macular degeneration (AMD) is likely to emerge as a major public health threat in the near future. However, existing literature on AMD in the region is scarce. METHODS: This paper reviews the epidemiology and risk factors of AMD in the Indian subcontinent. RESULTS: Data on AMD in India show prevalences ranging from 1.8% to 4.7%. Blindness prevalence studies in Pakistan, Bangladesh and Nepal have also reported rates of 2.1% to 8.7% for all blindness attributable to AMD. Age-related macular degeneration is therefore a significant cause of visual morbidity in these countries. To date, no reliable epidemiological data on AMD or blindness have been published for Sri Lanka, Afghanistan, Maldives or Bhutan. CONCLUSIONS: The prevalence of AMD in the region is likely to follow a trend similar to that seen in the developed world in the coming years. Eye care policies should therefore make provisions for this chronic age-related eye disease. In addition, there is an urgent need for more data on the epidemiology of AMD in the Indian subcontinent.

Liang XL, Chen HY, Huang YS, Au Eong KG, Yu SS, Liu X, Yan H. · State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China. · Ann Acad Med Singapore. · Pubmed #17483861 links to  free full text

Abstract: INTRODUCTION: Macular oedema is the main cause of visual impairment following retinal vein occlusion. The purpose of this study was to evaluate the anatomical and functional outcome of pars plana vitrectomy and internal limited membrane (ILM) peeling for macular oedema secondary to retinal vein occlusion. CLINICAL PICTURE: This pilot study is a prospective nonrandomised series of 11 eyes of 11 patients with macular oedema secondary to retinal vein occlusion. The best-corrected visual acuity (BCVA), foveal thickness on optical coherence tomography, fundus fluorescein angiography (FFA) and multifocal electroretinography were evaluated. TREATMENT AND OUTCOME: All 11 patients underwent pars plana vitrectomy with ILM peeling. The mean postoperative follow-up was 13.5 months (range, 1.5 to 24). The mean thickness at the foveal centre decreased from 794 +/- 276 microm preoperatively to 373 +/- 150 microm, 302 +/- 119 microm, 249 +/- 203 microm and 185 +/- 66 microm at 1 week, 1 month, 3 months and the final visit postoperatively, respectively (all P <0.001, paired t- test, compared to preoperative thickness). Postoperative FFA demonstrated markedly reduced leakage in the macular region. At the final visit, BCVA improved 2 lines or more in 72.7% (8/11) of patients and was unchanged in 27.3% (3/11) patients. Complications included cataract in 7 patients and vitreous haemorrhage, recurrence of macular oedema and visual field defect in 1 case each. CONCLUSION: Pars plana vitrectomy and ILM peeling rapidly reduced the macular oedema caused by retinal vein occlusion, with improvement in BCVA.

Au Eong KG. · The Eye Institute, Alexandra Hospital, Singapore. · Ann Acad Med Singapore. · Pubmed #15531962 links to  free full text

Abstract: INTRODUCTION: This paper reports the 1-year results of the first 2 cases of macular translocation in Singapore. CLINICAL PICTURE: A 66-year-old female and a 45-year-old male Chinese presented with subfoveal choroidal neovascularisation (CNV) in their right eyes. The woman's condition was secondary to pathological myopia while the man's was idiopathic. Their preoperative best-corrected visual acuities were 6/15-2 and 6/30, respectively. TREATMENT: Both patients underwent macular translocation with punctate retinotomies and chorioscleral infolding (limited macular translocation) in their affected eye. OUTCOME: Both patients achieved effective macular translocation postoperatively. Their CNVs became extrafoveal and were ablated with conventional laser photocoagulation in the early postoperative period. They did not recur and their visual acuities improved to 6/9-1 and 6/12 at 1 year postoperatively, respectively. CONCLUSION: Macular translocation is a new treatment modality that offers patients with subfoveal CNV a chance of improving their vision, potentially to a level that may allow reading and driving.

Fujii GY, De Juan E, Zarbin MA, Humayun MS, Au Eong KG, Phillips S. · Wilmer Ophthalmological Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-9277, USA. · Retina. · Pubmed #11508889 No free full text.

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Fujii GY, de Juan E, Au Eong KG, Harlan JB. · The Wilmer Ophthalmological Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-9277, USA. · Am J Ophthalmol. · Pubmed #11438073 No free full text.

Abstract: PURPOSE: To describe a case of effective foveal displacement toward the optic disk (nasal limited macular translocation) in a patient with a large subfoveal choroidal neovascularization secondary to age-related macular degeneration. METHODS: Case report. RESULTS: A 77-year-old white man presented with decreased vision of 20/400 due to subfoveal predominantly occult CNV secondary to age-related macular degeneration in the left eye. The CNV, measuring 9 Macular Photocoagulation Study disk areas in size, was centered temporally relative to the fovea with a minimum desired translocation of 650 microm for nasal macular translocation. The patient underwent nasal LMT with punctate retinotomy and temporal chorioscleral infolding, followed by postoperative head-positioning on his right side. Effective LMT was achieved with a postoperative nasal foveal displacement of 1400 microm. The entire CNV was ablated with laser photocoagulation postoperatively. His vision improved to 20/40 6 months postoperatively. CONCLUSION: Nasal LMT is feasible and may be considered in patients with subfoveal CNV centered temporally relative to the fovea.

Au Eong KG, Fujii GY, Ng EW, Humayun MS, Pieramici DJ, de Juan E. · Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, Maryland 21287-9277, USA. · Am J Ophthalmol. · Pubmed #11336950 No free full text.

Abstract: PURPOSE: To report the occurrence of transient formed visual hallucinations following macular translocation. METHODS: Two case reports. RESULTS: Two white women aged 84 and 83 years with bilateral age-related macular degeneration and unilateral subfoveal choroidal neovascularization underwent macular translocation with punctate retinotomy (limited macular translocation) and chorioscleral infolding in the eye with neovascularization. They complained of formed visual hallucinations which began within 24 hours following macular translocation and ceased 7 and 3 days postoperatively, respectively. Their symptoms occurred in the presence of normal cognition, orientation and insight, were not associated with other psychiatric symptoms, and were characteristic of Charles Bonnet syndrome (CBS). CONCLUSION: The temporary deliberate retinal detachment and/or poor vision following macular translocation may be associated with postoperative CBS, and this report extends the spectrum of conditions associated with CBS.

Beatty S, Au Eong KG, McLeod D, Bishop PN. · Academic Department of Ophthalmology, Manchester Royal Eye Hospital, Manchester. · Br J Ophthalmol. · Pubmed #10502566 links to  free full text

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Lee SB, Au Eong KG, Yong VS. · Department of Ophthalmology, Tan Tock Seng Hospital, Singapore. · Singapore Med J. · Pubmed #10489495 No free full text.

Abstract: PURPOSE: To review the visual and surgical outcome of planned intracapsular cataract extraction (ICCE) and anterior chamber intraocular lens (AC IOL) implantation for subluxated crystalline lenses. METHODS: Eight eyes of 7 patients with subluxated lenses which underwent planned ICCE, AC IOL implantation and peripheral iridectomy by one surgeon between September 1995 and November 1996 were prospectively followed-up to ascertain their visual and surgical outcome. RESULTS: There were 4 male and 3 female patients. Their mean age was 64.4 years (range, 39-86 years). Seven lenses were removed by cryoextraction while one was removed with the aid of a vectis. The mean post-operative follow-up was 11.6 months, (range, 3-22 months). Excluding 1 eye with pre-existing ocular pathology, all eyes achieved a best corrected visual acuity (BCVA) of 6/12 or better post-operatively. One of these eyes, in a schizophrenia patient, developed subluxation of the AC IOL and retinal detachment 11 months after the cataract surgery due to repeated eye rubbing. The final BCVA became 6/120 after successful repositioning of the AC IOL and retinal re-attachment surgery. One eye achieved a BCVA of 6/36 due to age-related macular degeneration. CONCLUSION: Our results show that planned ICCE and AC IOL implantation is a useful and safe procedure in the management of subluxated lenses.

Wagle AM, Yeo TK, Au Eong KG. · No affiliation provided · Lancet. · Pubmed #17964347 No free full text.

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Tan CS, Sanjay S, Au Eong KG. · No affiliation provided · Am J Ophthalmol. · Pubmed #17659977 No free full text.

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Au Eong KG, Sanjay S, Lim SC. · No affiliation provided · Lancet. · Pubmed #17027721 No free full text.

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Sangtam T, Tan CS, Au Eong KG, Beatty S, Kwok AK. · No affiliation provided · Am J Ophthalmol. · Pubmed #16876540 No free full text.

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