A 60-year-old Aboriginal man with underlying severe exfoliative dermatitis, treated with oral azathioprine and oral prednisolone, presented with left painful red eye for ten days. On initial presentation, left eye vision was poor at hand motion. There was corneal endotheliitis over the left eye with severe anterior chamber inflammation obscuring the fundus view. B-scan ultrasonography showed evidence of vitritis with a flat retina. An urgent aqueous tap for viral polymerase chain reaction (PCR) yielded positive cytomegalovirus (CMV) DNA results. As CMV infection commonly affects immunosuppressed individuals, his systemic immunosuppressants were withheld temporarily. He was successfully treated with combination intravenous ganciclovir, intravitreal ganciclovir 2mg/0.1ml, and topical ganciclovir 2%. His vision improved significantly from hand motion to 20/40. There was no reactivation of CMV infection post-treatment.

Ocular tuberculosis is a common cause of infective uveitis among our Malaysian population as the local incidence of tuberculosis (per 100,000 people) was reported at 92 in 2018, according to the World Bank collection of development indicators, compiled from officially recognized sources.1 Choroidal granuloma is one of the characteristic findings of ocular tuberculosis. We report a case of unilateral ocular tuberculosis with choroidal granuloma, which developed recurrent choroidal neovascularization (CNV) requiring multiple intravitreal ranibizumab injections.

A 14-year-old girl with bilateral chronic posterior scleritis was referred to us for poor control of ocular inflammation. There was an incidental finding of choroidal osteoma bilaterally whereby the choroidal mass in her right eye demonstrated a significant tumor growth in a short duration of two months. The right eye choroidal tumor was orangy in color with a well-defined margin, two-disc diameter in size, and located at the macula encroaching the fovea. Multimodal imaging assessments, including serial color fundus photo, enhanced depth imaging optical coherence tomography (EDI-OCT), and B scan ultrasonography monitoring, confirmed a continuous rapid growth of choroidal osteoma with episodes of scleritis flare-ups. Furthermore, intolerance toward second-line immunosuppressants and loss of follow-ups during the coronavirus disease 2019 (COVID-19) pandemic lockdown led to frequent relapses of her posterior scleritis. Therefore, a new treatment plan was designed, and close monitoring of choroidal osteoma growth and control of posterior scleritis were initiated. Subsequently, bilateral posterior scleritis remained quiescent, and her vision remained stable with stagnant growth of choroidal osteoma.

Introduction: Polypoidal choroidal vasculopathy (PCV) is a distinct clinical entity, characterized by focal hyperfluorescence in the early phase of indocyanine green angiography (ICGA), with or without its associated branching vascular network (BVN).Purpose: To report the angiographic characteristics of PCV on ICGA in presumed PCV patients.Study design: Descriptive cross-sectional study.Materials and methods: This study involved 36 suspected PCV patients who attended the Ophthalmology Clinic, Universiti Kebangsaan Malaysia Medical Centre from June 1, 2012 to May 31, 2013. All patients underwent complete ophthalmologic examination including colour fundus photography, ICGA, and fundus fluorescein angiography. ICGA images of confirmed PCV patients were analysed.Results: Twenty-five out of 36 eyes (69.4%) were diagnosed to have PCV based on ICGA. Mean age of confirmed PCV patients was 66.4 ± 8.42 years, with predominance of males (n = 17) and Chinese ethnicity (n = 19). Best-corrected visual acuity (BCVA) was between 6/6 and 6/18 in 64%. All 25 patients had unilateral disease. Average size of PCV lesions was 1461.4 ± 864.4 μm. The lesions were mostly concentrated in the extrafoveal region (n = 15, 60%). Lesion formation was cluster in 56% (n = 14), single in 32% (n = 8), string in 4% (n = 1), and combination in 8% (n = 2). The majority involved a single discrete area. Polyp pulsation was detected in six eyes, while seven eyes revealed nodular hyperfluorescence when viewed stereoscopically. BVN was evident in 56% (n = 14). Fifteen eyes demonstrated the hypofluorescent halo, while no hyperfluorescent ring was seen in this study population. Late geographical hyperfluorescence (LGH) was noted in seven eyes (28%). There was no significant association between the morphological characteristics of PCV, i.e., size of lesion, location, formation, discrete area involved, and LGH with BCVA.Conclusion: The demographic, clinical, and angiographic features observed in this study were in agreement with other previously published Asian studies. However, we found no association between the morphological characteristics of PCV with BCVA.