Hyperreflective dots (HRD) are activated retinal microglial cells induced by retinal inflammation in diabetic patients. This study was conducted to compare the HRD count of normal and diabetic subjects; to determine the correlation between hemoglobin A1c (HbA1c) levels and HRD count; to determine HbA1c cut-off levels for the appearance of HRD in diabetic patients. A cross-sectional study was conducted among normal and diabetic patients. Fundus photos, SD-OCT images and HbA1c levels were taken. A total of 25 normal subjects, 32 diabetics without retinopathy and 26 mild-to-moderate nonproliferative diabetic retinopathy (NPDR) diabetics were recruited. There was a statistically significant difference between the mean count of HRD among the normal group, the diabetic without retinopathy group and the mild-to-moderate NPRD group. The mean HRD count in the inner retina layer was significantly higher compared to the outer retina layer. There was a significant linear relationship between the HbA1c levels and HRD count. Using the receiver operating curve, the HbA1c level of 5.4% was chosen as the cut-off point for the appearance of HRD. The positive linear correlation between the HbA1c levels and the appearance of HRD may indicate that hyperglycemia could activate retina microglial cells in diabetic patients.

Postpartum depression (PPD) is one of the mental health complications that may arise following childbirth. This cross-sectional study explores the association between socioeconomic factors and PPD literacy with PPD incidence in 350 participants (mean age: 30.58±4.72 years) at one to six months postpartum, who attended the Kuala Lumpur Health Clinic from May to October 2020. PPD incidence and literacy were assessed using the validated Malay versions of the Edinburgh Postpartum Depression Scale (EPDS) and the Postpartum Depression Literacy Scale (PoDLiS), respectively. The participants’ socioeconomic characteristics were collected using a self-administered questionnaire. Chi-square tests were performed to determine the association between these factors and PPD incidence. Binary logistic regression models were used to determine the odds ratios (OR). The incidence of postpartum depressive symptoms was 14.29%. Those with low household income were twice likely to have PPD symptoms (OR:2.58, 95% CI:1.23–5.19; p = 0.01) than those with higher incomes. Unemployment (i.e., participants who were housewives/homemakers) was associated with higher PPD incidence (Χ2(2, 350) = 6.97, p = 0.03), but it was not a significant PPD predictor. In conclusion, PPD incidence in the sample of Kuala Lumpur postpartum mothers is significantly associated with low household income. Other socioeconomic characteristics, including PPD literacy, were not significant predictors of PPD incidence.

Many East Asians apply double eyelid tape to create the double eyelid effect temporarily as a means of increasing their beauty. This study evaluated the effects of four-week wear of double eyelid tape on anterior ocular health in young adult women with single eyelids. Twenty-nine participants who met the inclusion criteria were recruited. The participants’ anterior ocular health was examined including blinking characteristics (blink pattern and blink rate), ocular surface health (presence of corneal abrasion, corneal staining, conjunctival staining, corneal curvatures, meibomian gland dysfunction), tear break up time, intraocular pressure, and subjective comfort level. Participants were required to apply the double eyelid tape for at least eight hours a day and five days a week for four weeks. The parameters were re-measured at the end of each week. There was a significant increase in conjunctival staining, corneal staining, and meibomian gland dysfunction, with a significant reduction in tear break-up time and intraocular pressure. By week 3, all participants had incomplete blinks. There was no significant change in symptoms and subjective comfort level reported. Therefore, patients and eye care practitioners should be aware of the potential implications of double eyelid tape wear on ocular health, with no significant change in subjective comfort.

Visual-motor integration (VMI) is related to children’s academic performance and school readiness. VMI scores measured using the Beery-Bucktenicka Developmental Test of Visual-Motor Integration (Beery-VMI) can differ due to differences in cultural and socioeconomic backgrounds. This study compared the VMI scores of Malaysian preschoolers with the corresponding US norms and determined the association between their VMI scores and socioeconomic factors. A cross-sectional study was conducted among 435 preschoolers (mean age: 5.95±0.47 years; age range: 5.08–6.83 years) from randomly selected public and private preschools. VMI scores were measured using Beery-VMI in the preschools’ classrooms. Information on the socioeconomic characteristics of the preschoolers was obtained using a parent-report questionnaire. One sample t-test was used to compare their VMI scores with the corresponding US norms. Multivariate logistic regression models were used to explore the influence of socioeconomic factors on the preschoolers’ VMI scores. Overall, Malaysian preschoolers’ VMI performance was similar to the US standardized norms (p>0.05). Children from low-income families were twice likely to obtain lower than average VMI scores than those from higher-income families (OR = 2.47, 95%CI 1.05, 5.86). Children enrolled at public preschools were more likely to obtain a lower than average VMI score than those who enrolled at private preschools (OR = 2.60, 95%CI 1.12, 6.06). Children who started preschool at the age of six were more likely to obtain lower than average VMI scores than those who started at an earlier age (OR = 4.66, 95%CI 1.97, 11.04). Low maternal education level was also associated with lower than average VMI score (OR = 2.60, 95%CI 1.12, 6.06). Malaysian preschoolers’ Beery-VMI performance compared well to their US counterparts. Some socioeconomic factors were associated with reduced VMI scores. Those from disadvantaged socioeconomic backgrounds are more likely to have reduced VMI performance, potentially adversely affecting their school readiness, cognitive performance, and future academic achievements.

Uncorrected refractive error, especially myopia, in young children can cause permanent visual impairment in later life. However, data on the normative development of refractive error in this age group is limited, especially in Malaysia. The aim of this study was to determine the distribution of refractive error in a sample of infants and young children between the ages of 6 to 36 months in a prospective, cross-sectional study. Cycloplegic retinoscopy was conducted on both eyes of 151 children of mean age 18.09 ± 7.95 months. Mean spherical equivalent refractive error for the right and left eyes was +0.85 ± 0.97D and +0.86 ± 0.98D, respectively. The highest prevalence of refractive error was astigmatism (26%), followed by hyperopia (12.7%), myopia (1.3%) and anisometropia (0.7%). There was a reduction of hyperopic refractive error with increasing age. Myopia was seen to emerge at age 24 months. In conclusion, the prevalence of astigmatism and hyperopia in infants and young children was high, but that of myopia and anisometropia was low. There was a significant reduction in hyperopic refractive error towards emmetropia with increasing age. It is recommended that vision screening be conducted early to correct significant refractive error that may cause disruption to clear vision.