We aimed to study the prevalence of refractive conditions in Singapore teenagers. Grade 9 and 10 students (n = 946) aged 15–19 years from two secondary schools in Singapore were recruited. The refractive errors of the students’ eyes were measured using non‐cycloplegic autorefraction. Sociodemographic data and information on risk factors for myopia (such as reading and writing) were also obtained using an interviewer‐administered questionnaire. The prevalence of refractive conditions was found to be: myopia [spherical equivalent (SE) at least −0.50 D] – 73.9%, hyperopia (SE at least +0.50 D) – 1.5%, astigmatism (cylinder at least −0.50 D) – 58.7% and anisometropia (SE difference at least 1.00 D) – 11.2%. After adjusting for age and gender, currently doing more than 20.5 h of reading and writing a week was found to be positively associated with myopia [odds ratio 1.12 (95% CI 1.04–1.20, p = 0.003)], as was reading and writing at a close distance and a better educational stream. The prevalence of myopia (73.9%) in Singapore teenagers is high. Current reading and writing habits, reading at close distances and a better educational stream are possible risk factors for myopia.

Introduction: This study aimed to determine the clinical profile and outcome of anti-transcriptional intermediary factor 1 gamma autoantibody (anti-TIF1-γ Ab)-positive dermatomyositis patients and propose cancer screening programmes based on regional cancer trends. Method: Data on history, physical findings and investigations were collected using chart review on dermatomyositis patients seen at a tertiary hospital in Singapore from 1 January 2015 to 30 June 2021. Comparisons were made between anti-TIF1-γ Ab-positive and anti-TIF1-γ Ab-negative dermatomyositis. Results: Ninety-six dermatomyositis patients were analysed and 36 patients were positive for anti-TIF1-γ Ab. Anti-TIF1-γ Ab-positive patients had more frequent heliotrope rashes, shawl sign, periungual erythema, holster sign, Gottron’s papules, dysphagia and truncal weakness (P<0.05). They had less frequent interstitial lung disease, polyarthritis, cutaneous ulcers, palmar papules and mechanic’s hands (P<0.05). After 48 months of follow-up, a higher proportion of anti-TIF1-γ Ab-positive patients developed cancer compared with Ab-negative patients (63.9% versus 8.5%; odds ratio 19.1, 95% confidence interval 6.1–59.8; P<0.001). Nasopharyngeal carcinoma (NPC) and breast cancer were the most common malignancies, followed by bowel, lung and non-Hodgkin lymphoma. Most malignancies (78.3%) occurred within 13 months prior to, or 4 months after the onset of dermatomyositis. The mortality rate for anti-TIF1-γ Ab-positive patients was significantly higher than Ab-negative patients (36.1% vs 16.7%, P=0.031), and Kaplan-Meier survival estimates at 24 months were 66% and 89%, respectively (P=0.0153). Conclusion: These observational data support periodic screening of NPC and other malignancies in patients with anti-TIF1-γ Ab-positive dermatomyositis in Singapore. Keywords: Autoantibody, cancer, dermatomyositis, nasopharyngeal carcinoma, transcriptional intermediary factor 1 gamma

Reports of thrombosis post coronavirus disease 2019 (COVID-19) mRNA vaccination have sparked concerns about the safety of these immunizations. As of October 31, 2021, the Health Sciences Authority of Singapore reported 13 suspected cases of cerebral venous thrombosis (CVT) with the Pfizer-BioNTech/Comirnaty (BNT162b2) and Moderna/Spikevax (mRNA-1273) COVID-19 vaccines out of 9 953 673 total number of doses administered. 1 We previously reported on three patients who developed CVT post BNT162b2 vaccination, occurring 1-9 days after the second dose. 2 Compared to vaccine-induced thrombotic thrombocytopenia (VITT) associated with the use of adenovirus vector ChAdOx1 nCoV-19 and Ad26.COV2.S COVID-19 vaccines, these patients with CVT CORRESPONDENCE E141