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Dexter Y L Leung

Publications and source records attributed to Dexter Y L Leung.

At least 19 recordsLinked to original sources

Novel myocilin mutation in a Chinese family with juvenile-onset open-angle glaucoma.

OBJECTIVE: To search for the genetic cause of juvenile-onset open-angle glaucoma (JOAG) in a Chinese family. METHODS: In a 3-generation glaucoma family affected with JOAG or ocular hypertension, we screened myocilin (MYOC) and optineurin (OPTN) for mutations and investigated apolipoprotein E (APOE) polymorphisms in 6 family members, 2 of them patients with JOAG, 2 patients with ocular hypertension, and 2 patients who were asymptomatic. Normal controls included 200 unrelated Chinese subjects. The COS-7 cell line was transfected with expression vectors encoding wild-type or mutated MYOC complementary DNA. Cellular and secreted MYOC proteins were characterized by Western blotting. RESULTS: One missense MYOC mutation, 734G>A: Cys245Tyr, was identified. It occurred in all 4 family members afflicted with JOAG or ocular hypertension but not in asymptomatic family members. No OPTN variations were observed. APOE polymorphism frequencies were similar to those for controls. The Cys245Tyr MYOC mutation cosegregated with the disorder within the family. It was absent in the 200 control subjects. The Cys245Tyr mutant MYOC protein formed homomultimeric complexes that migrated at molecular weights larger than their wild-type counterparts. These mutant complexes remained sequestered intracellularly in COS-7 cells. CONCLUSIONS: The Cys245Tyr MYOC mutation was the genetic cause of JOAG in this Chinese family. This mutation may alter covalent bonds that formed between MYOC cysteines. Clinical Relevance Genetic tests of MYOC mutations may be beneficial to predict new cases of the disease in families with JOAG.

Adolescent↗

Microincision bimanual phacotrabeculectomy in eyes with coexisting glaucoma and cataract.

PURPOSE: To report the technique and surgical outcomes of microincision bimanual phacotrabeculectomy in eyes with glaucoma and coexisting cataract. SETTING: Glaucoma Service, Hong Kong Eye Hospital, Hong Kong SAR, China METHODS: Microincision bimanual phacoemulsification with a sleeveless phaco needle and irrigating chopper was performed in combination with trabeculectomy. Phacoemulsification was performed through 2 small clear corneal wounds, sparing the trabeculectomy site from trauma. The intraocular lens (IOL) was then implanted through the trabeculectomy site, so no corneal wound larger than 1.5 mm was required for IOL implantation. RESULTS: The first 10 consecutive eyes of 10 patients who had combined phacotrabeculectomy by a microincision bimanual technique had significantly reduced intraocular pressure. There was a 10.5% reduction in the mean corneal endothelial cell count. There were no other complications up to 6 months after surgery. CONCLUSION: Microincision bimanual phacotrabeculectomy appeared to be an effective and safe option in patients with glaucoma and coexisting cataract.

Aged↗

Pressure phosphene self-tonometry in a patient with Posner-Schlossman syndrome.

Studies have shown that pressure phosphene tonometry (PPT) may be applied to glaucoma patients. It has the potential for patients to self-monitor the intraocular pressure (IOP) at home. We describe the successful use of this approach in a patient with Posner-Schlossman syndrome. In the first part of the study, we investigated whether our patient could use PPT accurately and reliably. In the second part of the study, our patient performed daily home self-tonometry, and was educated to seek ophthalmic assessment if his self-measured IOP was >or=21 mmHg. The outcome measurements included IOP and the number of unscheduled attendances for ophthalmic assessment. The use of PPT reduced his number of unscheduled hospital visits from 0.82 to 0.47 visits per month. PPT can be applied with accuracy, reliability and safety in patients with Posner-Schlossman syndrome, with potential benefits in reducing unnecessary ophthalmic attendances by nearly 50%.

Adult↗

Comparison between central corneal thickness measurements by ultrasound pachymetry and optical coherence tomography.

PURPOSE: Measurement of central corneal thickness (CCT) plays an important role in both diagnostic and therapeutic assessment of ocular diseases. Although ultrasound pachymetry (U-PACH) is regarded as the golden standard for measurement of CCT, optical coherence tomography (OCT) may offer advantages as it can locate the central cornea with precision with no corneal touch. Nevertheless, the agreement of OCT with U-PACH has not yet been gauged by Bland-Altman analysis. This study compares CCT measurement by OCT with that by U-PACH. METHODS: Healthy subjects without ocular abnormality (except refractive errors less than or equal to -6.0 D), contact lens wear or ocular surgery were recruited. CCT was measured in one eye of normal subjects using OCT and U-PACH. Results were compared using correlation and Bland-Altman plots. RESULTS: Fifty subjects were recruited. Mean +/- SD CCT measured by OCT was 565 +/- 33 microm. This was highly correlated (Pearson's coefficient = 0.934) with the mean thickness measured by U-PACH (543 +/- 33 microm). The coefficients of variation were good and comparable at 7.9% for U-PACH and 3.5% for OCT. Compared with U-PACH, OCT consistently overestimated the CCT by a mean of 23 microm as shown on Bland-Altman plot. CONCLUSION: CCT measured by OCT and U-PACH is highly correlated. With appropriate adjustment factor, OCT agrees well with U-PACH and is a reliable alternative for CCT measurement.

Adult↗

Changes in the RNFL.

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Antihypertensive Agents↗

Intraocular pressure measurement in patients with previous LASIK surgery using pressure phosphene tonometer.

PURPOSE: To compare intraocular pressure (IOP) assessment in post-LASIK patients using non-contact tonometry, pressure phosphene tonometry and applanation tonometry. METHODS: Sixty-two consecutive LASIK patients were analysed preoperatively and postoperatively with non-contact, pressure phosphene and applanation tonometry. Comparisons among these values were assessed with paired sample Student t-test, Pearson's correlation test and Bland-Altman plotting. RESULTS: There was no significant difference for preoperative IOP measurement between non-contact, pressure phosphene and applanation tonometry. The mean +/-SD difference between the preoperative non-contact tonometry and postoperative pressure phosphene tonometry IOP measurements was 0.80 +/- 2.77 mmHg (P < 0.01). Postoperative applanation tonometry significantly underestimated IOP measurement by 5.45 +/- 2.96 mmHg (P < 0.001) and postoperative non-contact tonometry significantly underestimated IOP measurement by 9.96 +/- 2.25 mmHg (P < 0.001). CONCLUSION: Pressure phosphene tonometry may provide an alternative method for the assessment of IOP in post-LASIK patients.

Adult↗

Extent and predictors of microbial hand contamination in a tertiary care ophthalmic outpatient practice.

PURPOSE: To measure the extent of microbial hand contamination among ophthalmologists during routine clinic practice and examine its association with hand cleansing practices and beliefs, glove use, and patient load. METHODS: This was a single-masked analysis of resident and transient flora of ophthalmologists before and after patient examination and after handwashing by agar imprints of the dominant hand. Standardized questionnaires were used to collect information concerning subjects' hand cleansing practices and patient load. RESULTS: Of the 108 cultures, 107 (99.1%) were culture positive, yielding 15 separate organisms. Gram-negative bacilli were the most common transient flora, followed by Gram-positive cocci and fungi. Thirty-five (97.2%) ophthalmologists were culture positive for at least one resident and 8 (22.2%) ophthalmologists were culture positive for at least one transient organism, before patient contact. Regression models showed alcohol-based hand rub use, transient and resident floral load before patient contact, and patient load collectively accounted for 58.7% of the variance in resident floral load after patient contact. Use of alcohol-based hand rubs was associated with a mean resident floral reduction of 324.4 CFUs (95% confidence interval [CI] = 185.4 to 463.5; P < 0.01) and 31.6 CFUs (95% CI = 1.2 to 62.0; P < 0.05) after patient contact and handwashing, respectively. Handwashing with chlorhexidine was a significant predictor for transient floral load after handwashing (unstandardized beta = -17.2; 95% CI = -10.2 to -24.2; P < 0.01). CONCLUSIONS: The extent of contamination with pathogenic organisms after contact with eye outpatients, who have traditionally been perceived as relatively "clean," was of concern. Previously identified risk factors for hand contamination in inpatient settings, such as patient load, only explained a small proportion of variance in microbial load in the ophthalmic outpatient setting.

Bacteria↗