Introduction Uveitis is one of the common causes of visual impairment in Malaysia. It remains a challenging entity to diagnose and manage due to variation in its clinical presentation. This study aims to observe the demographic and clinical pattern of cases from the participating ophthalmology units in Malaysia. Methods This study involved prospective and multicentered data collection for patients newly diagnosed with uveitis from 1st January 2018 to 31st December 2018. Variables collected and analyzed included age, gender, ethnicity, nationality, state of origin, laterality, granulomatous or non-granulomatous uveitis, and etiology of uveitis. Results A total of 1199 newly diagnosed uveitis patients were analyzed within the study period. There was a significant association between the anatomical location of uveitis with age at presentation. The percentage of patients with anterior uveitis was higher in the ‘40 to 60’ years and ‘above 60’ years age groups at 52.1% (n = 210) and 61.3% (n = 114) respectively. In contrast the percentage of patients with posterior and panuveitis was higher in the 1 to 20 and 20 to 40 years age groups at 51.4% (n = 54) and 48.7% (n = 246) respectively. Sixty three percent of the patients presented with unilateral uveitis (n = 760, p < 0.001) vs bilateral. Non-granulomatous uveitis comprised 84.5% of all patients (n = 1013, p < 0.001) compared to granulomatous uveitis. Non-infectious etiology contributed to 65.7% of all patients (n = 788, p < 0.001) with the majority being unclassifiable uveitis (n = 686, 57.2%,). Specific inflammatory entities contributed to only 8.5% (n = 102) of the non-infectious causes with Vogt-Koyanagi-Harada (VKH) syndrome being the most common (n = 25, 2.1%,). Infectious uveitis comprised 34.3% (n = 411) with tubercular (TB) uveitis (n = 105, 8.8%) and viral uveitis (n = 107, 8.9%) contributing the most followed by ocular Toxoplasmosis (n = 93,7.8%).] Conclusion This study has highlighted the demographic data and common causes of uveitis in Malaysia.

Differential diagnosis of vision loss in a space-occupying lesion can be exhaustive. Olfactory groove meningioma (OGM) is a rare, benign, slow-growing tumour originating from the anterior cranial base. OGM is one of the differential diagnoses of intracranial tumours. We report a case of an OGM compressing the optic nerve and frontal lobe causing bilateral vision loss for six months. Multidisciplinary management by ophthalmologists, neurosurgeons, radiologists, and pathologists led to the diagnosis and tumour resection of OGM in the patient. Possible mechanisms of vision loss, imaging features, and treatment are discussed in this report.

Title: Bilateral primary vitreoretinal lymphoma. Objective: To report a rare case of bilateral primary vitreoretinal lymphoma (PVRL). Method: Retrospective review of the patient's clinical assessment, vitreous biopsy, and response to treatment. A 64-year-old female presented with gradual painless blurring of vision, associated with floaters in both eyes for 5 months duration. Her best corrected visual acuity (BCVA) was counting finger 1 foot in the RE and 6/24 in the LE. Anterior segment examination was unremarkable. RE fundus showed severe vitritis with large vitreous clumps and hazy fundus view. Whereas LE fundus showed mild vitritis with minimal vitreous clumps inferiorly with no retinitis, vasculitis, retinal haemorrhage, or sub-retinal infiltrate. All blood investigations including infective screening and tumour markers were unremarkable. A vitreous biopsy was performed in the RE and vitreous cytology showed atypical lymphoid cells highly suspicious for malignancy. As the vitreous sample was scanty, a cell block reading could not be carried out for immunohistochemistry. Magnetic resonance imaging (MRI) of brain and orbits were normal. Patient was diagnosed with presumed bilateral PVRL and intravitreal injection of methotrexate was initiated. MRI brain surveillance was planned for every 6 months. Her BCVA improved to 6/12 in the RE and 6/9 in the LE after completed 15 courses of intravitreal methotrexate. Conclusion: PVRL is a rare disease in older patients with features of severe vitritis and absence of macular oedema that mimics chronic uveitis and poses diagnostic challenge. Intravitreal methotrexate is an effective and minimal-invasive treatment with good visual outcome if early recognition and prompt treatment. Conflicts of Interest:The author reports no conflicts of interest.

Introduction:Uveitis is one of the common causes of visual impairment in Malaysia and it remains a challenging entity to diagnose and manage. This study aims to observe the demographic and clinical pattern of uveitis cases that are referred to most ophthalmology units in Malaysia Methods:This was an observational, multicenter study with a total of 1199 newly diagnosed uveitis patients. Data collected and analyzed included age, gender, ethnicity, nationality, state of origin, laterality, granulomatous or non-granulomatous uveitis, and etiology of uveitis.Results:The results showed that majority of the patients across all age groups had anterior uveitis (n=560; 46.7%). The higher the age group, the higher the percentage of anterior uveitis patients (39.0% among 20-40 age group vs 61.3% among the >60 age group). Sixty three percent of the patients presented with unilateral uveitis (n= 760, p <0.001). Non granulomatous uveitis comprised 84.5% of all patients (n=1013, p< 0.001). Non-infectious etiology contributed to 65.7% of all patients (n=788, p<0.001) with idiopathic (57.2%, n=686) as the most common cause followed by Vogt-Koyanagi-Harada (VKH) syndrome (2.1%, n=25). Infectious uveitis comprised 34.3% (411 patients) in total with Tuberculous (TB) related uveitis (105 patients with 8.8%) and Viral related uveitis (107 patients with 8.9%) contributing the most followed by Ocular Toxoplasmosis (n=93,7.8%). The likelihood of posterior uveitis being more infectious was statistically significant (Odds ratio (OR) 12.54, 95% CI 8.81-18.13) (p-value <0.001)Conclusion:This study has highlighted the demographic data and common causes of uveitis in Malaysia