Sains Malaysiana 49(2)(2020): 383-388

http://dx.doi.org/10.17576/jsm-2020-4902-16

 

Effects of Different Types of Primary Pterygium on Changes in Oculovisual Function 

(Jenis Pterigium Primari dan Kesannya pada Perubahan Fungsi Okulovisual)

 

MOHD RADZI HILMI1, KHAIRIDZAN MOHD KAMAL2*, AZRIN ESMADY ARIFFIN4, NUR AIN NORAZMAR1, NUR NABILAH MARUZIKI1, NUR HIDAYAH MUSA1, MARDHIAH SYAZWANI NASIR1, MOHD ZULFAEZAL CHE AZEMIN1, MUHAMMAD HANAFI AZAMI3 & MUHAMMAD AFZAM SHAH ABDUL RAHIM1

 

1Department of Optometry and Vision Sciences, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia (IIUM), Kuantan, Pahang Darul Makmur, Malaysia

 

2Department of Ophthalmology, Kulliyyah of Medicine, International Islamic University Malaysia (IIUM), Kuantan, Pahang Darul Makmur, Malaysia

 

3Department of Mechanical Engineering, Kulliyyah of Engineering, International Islamic University Malaysia, Kuala Lumpur, Federal Territory, Malaysia

 

4Faculty of Optometry and Vision Science, Jalan Teknologi, Kota Damansara, 47810 SEGi University, Petaling Jaya, Selangor Darul Ehsan, Malaysia

 

Received: 21 March 2019/Accepted: 29 October 2019

 

ABSTRACT

Pterygium are known to cause reduction in oculovisual function. However, the effects are varying due to its various morphological factors, thus, the impact on patient are difficult to predict which indirectly not all pterygium need to be excised. To describe the effects of different types of pterygium on changes in oculovisual function. Ninety-three (93) primary pterygium eyes from 93 patients were recruited in this study. Diagnosis and classification of primary pterygium were done by a consultant ophthalmologist (KMK). Standard optometric examinations were performed in all participants. Best-corrected visual acuity (BCVA) and contrast sensitivity (CS) was subjectively measured using computerised M&S Technologies Smart System II, performed by a single operator on the same visit. Pterygium excision was done based on a standardised method performed by a single surgeon (KMK). At third month post-surgical, repeated measurements of BCVA and CS were performed. Difference between pre and post-surgical was taken as magnitude changes for each pterygium type. Paired T-test and ANOVA were employed to evaluate the difference between pre- and post-surgical and pterygium types for both BCVA and CS parameters. Overall mean (n = 93) of BCVA and CS were found significantly associated with advance pterygium (P < 0.001). Paired T-test and ANOVA results showed a significant difference in BCVA and CS values between pterygium groups in pre- and post-surgical sessions and between pterygium types (both P < 0.001). Reduction of oculovisual function in pterygium patient is expected in advance pterygium. Management of pterygium should be coherent with pterygium types.

 

Keywords: Best-corrected visual acuity (BCVA); contrast sensitivity; morphology; primary pterygium; pterygium excision

 

Abstrak

Untuk mengkaji jenis pterigium yang mampu mengubah fungsi okulovisual. Sebanyak 93 mata daripada 93 pesakit pterigium primer telah direkrut untuk kajian ini. Diagnosis dan pengelasan pterigium primer dilakukan oleh pakar perunding oftalmologi (KMK). Semua peserta kajian telah menjalani pemeriksaan optometri piawai. Ketajaman visual yang diperbetulkan terbaik (BCVA) dan sensitiviti kontras (CS) diukur pada sesi yang sama untuk setiap sesi oleh seorang operator (MRH) secara subjektif menggunakan perisian M&S Technologies Smart System II. Pembedahan pterigium dilakukan oleh seorang pakar bedah (KMK) menggunakan kaedah piawai. Setelah 3 bulan pos-pembedahan, pengukuran BCVA dan CS dilakukan semula. Perubahan untuk setiap jenis pterigium ditakrifkan sebagai perbezaan magnitud antara pra dan pos-pembedahan. Ujian T-berpasangan dan ANOVA digunakan untuk menganalisis perbezaan antara pra dan pos-pembedahan untuk BCVA dan CS. Min keseluruhan untuk BCVA dan CS (n = 93) berkolerasi secara signifikan dengan lanjutan pterigium (P < 0.001). Ujian T-berpasangan dan ANOVA menunjukkan perubahan signifikan pada nilai BCVS dan CS antara jenis pterigium ketika pra dan pos-pembedahan dan antara jenis pterigium (kedua-dua P < 0.001). Untuk pesakit pterigium, pengurangan fungsi okulovisual dijangkakan berlaku pada peringkat lanjutan pterigium. Pengurusan pterigium seharusnya mengambil kira jenis pterigium.

 

Kata kunci: Kelengkungan kornea; ketajaman visual yang diperbetulkan terbaik (BCVA); morfologi; pterigium; sensitiviti kontras

 

REFERENCES

Altan-Yaycioglu, R., Kucukerdonmez, C., Karalezli, A., Corak, F. & Akova, Y.A. 2013. Astigmatic changes following pterygium removal: Comparison of 5 different methods. Indian J. Ophthalmol. 61: 104-108.

Avisar, R., Loya, N., Yassur, Y.Weinberger, D. 2000. Pterygium-induced corneal astigmatism. Isr. Med. Assoc. J. 2(1): 14-15.

Azemin, M.Z.C., Hilmi, M.R. & Kamal, M.K. 2014. New Trends in Software Methodologies, Tools and Techniques. Amsterdam: IOS Press. 

Chandrakumar, M., Colpa, L., Reginald, Y.A., Goltz, H.C. & Wong, A.M.F. 2013. Measuring contrast sensitivity using the M&S smart system II versus the Pelli-Robson chart. Ophthalmology 120(10): 2160-2161.

Che Azemin, M.Z., Mohd Tamrin, M.I., Hilmi, M.R. & Mohd Kamal, K. 2016. Inter-grader reliability of a supervised pterygium redness grading system. Adv. Sci. Lett. 22(10): 2885-2888.

Che Azemin, M.Z., Mohd Tamrin, M.I., Hilmi, M.R. & Mohd Kamal, K. 2015. GLCM texture analysis on different color space for pterygium grading. ARPN J. Eng. Appl. Sci. 10: 6410-6413.

Che Azemin, M.Z., Hilmi, M.R., Mohd Tamrin, M.I. & Mohd Kamal, K. 2014. Fibrovascular redness grading using Gaussian process regression with radial basis function kernel. Biomedical Engineering and Sciences (IECBES), 2014 IEEE Conference. pp. 113-116.

Chui, J., Coroneo, M.T., Tat, L.T., Crouch, R., Wakefield, D. & DiGirolamo, N. 2011. Ophthalmic pterygium: A stem cell disorder with premalignant features. Am. J. Pathology 178(2): 817-827.

Džunic, B., Jovanović, P., Veselinović, D., Petrović, A., Stefanović, I. & Kovaćević, I. 2010. Analysis of pathohistological characteristics of pterygium. Bosn. J. of Basic Med. Sci. 10(4):  307-313.

Errais, K., Bouden, J., Mili-boussen, I., Anane, R., Beltaif, O. & Meddeb Ouertani, A. 2008. Effect of pterygium surgery on corneal topography. Eur. J. Ophthalmol. 18(2): 177-181.

Farhood, Q.K. & Kareem, A.A. 2012. Pterygium and induced astigmatism. Kufa. Med. Journal 15(1)1: 341-345.

George, D. & Mallery, M. 2010. SPSS for Windows Step by Step, A Simple Guide and References. 11th ed. Boston: Pearson.

Gumus, K., Topaktas, D., Göktaş A., Karakucuk, S., Oner, A. & Mirza, G.E. 2012. The change in ocular higher-order aberrations after pterygium excision with conjunctival autograft: A 1-year prospective clinical trial. Cornea 31(12): 1428-1431.

Gumus, K., Erkilic, K., Topaktas, D. & Colin, J. 2011. Effect of pterygia on refractive indices, corneal topography, and ocular aberrations. Cornea 30(1): 24-29.

Han, S.B., Jeon, H.S., Kim, M., Lee, S.J., Yang, H.K. & Hwang, J.M. 2016. Quantification of astigmatism induced by pterygium using automated image analysis. Cornea 35(3): 370-376.

Hilmi, M.R., Khairidzan, M.K., Zulfaezal, M.Z.C., Ithnin, M.H., Mustafa, M.M.S.M., Yusof@Alias, F. & Ahmad, N. 2018. Corneal curvature measurements utilizing a new swept-source optical coherence tomography tomey OA-2000® and comparison with IOL Master® 500 in pterygium patients. Sains Medika 9(1): doi:http://dx.doi.org/10.26532/sainsmed.v9i1.2918.       

Hilmi, M.R., Khairidzan, M.K., Azemin, M.Z.C., Azami, M.H. & Ariffin, A.E. 2018. Measurement of contrast sensitivity using the M&S Smart System II Compared with the Standard Pelli-Robson Chart in Patients with Primary Pterygium. Makara J. Health Res. 22(3): 167-171.

Hilmi, M.R., Khairidzan, M.K., Azemin, M.Z.C., Azami, M.H. & Ariffin, A.E. 2018. Utilization of anterior segment optical coherence tomography enhanced high resolution corneal in measuring pterygium thickness. Sains Medika 9(2): doi: http://dx.doi.org/10.30659/sainsmed.v9i2.2982.

Kampitak, K.J. 2003. The effect of pterygium on corneal astigmatism. Med. Assoc. Thai. 86(1): 16-23.

Kheirkhah, A., Safi, H., Nazari, R., Kaghazkanani, R., Hashemi, H. & Behrouz, M.J. 2012. Effects of pterygium surgery on front and back corneal astigmatism. Int. Ophthalmol. 32: 251-257.

Kurian, A., Reghunadhan, I. & Nair, K.G. 2015. Autologous blood versus fibrin glue for conjunctival autograft adherence in sutureless pterygium surgery: A randomised controlled trial. Br. J. Ophthalmol. 99(4): 464-470.

Lawan, A., Hassan, S., Ifeanyichukwu, E.P., Yahaya, H.B., Sani, R.Y., Habib, S.G., Abdul Salam Shuaib. & Okpo, E. 2018. The astigmatic effect of pterygium in a tertiary hospital in Kano, Nigeria. Ann. Afr. Med. 17(1): 7-10.

Lin, A. & Stern, G.A. 1998. Correlation between pterygium size and induced corneal astigmatism. Cornea 17: 28-30.

Liu, L., Wu, J., Geng, J., Yuan, Z. & Huang, D. 2013. Geographical prevalence and risk factors for pterygium: A systematic review and meta-analysis. BMJ Open 3: e003787. doi:10.1136/bmjopen-2013-003787.

Malik, A., Arya, S.K., Sood, S., Sarda, S.B. & Narang, S. 2014. Effect of pterygium on contrast sensitivity. Int. Ophthalmol. 34: 505-509.

Manzar, N. & Mahar, P.S. 2013. Pterygium recurrence related to its size and corneal involvement. J. Coll. Physicians Surg. Pak. 23(2): 120-123.

Marmamula, S., Khanna, R.C. & Rao, G.N. 2013. Population-based assessment of prevalence and risk factors for pterygium in the South Indian state of Andhra Pradesh: The Andhra Pradesh Eye Disease Study. Invest. Ophthalmol. Vis. Sci. 54(8): 5359-5366.

Maharjan, I.M., Shreshth, E., Gurung, B. & Karmacharya, S. 2014. Prevalence of and associated risk factors for pterygium in the high altitude communities of Upper Mustang, Nepal. Nepal J. Ophthalmol. 6(11): 65-70.

McClenaghan, N., Kimura, A. & Stark, L.R. 2007. An evaluation of the M&S technologies smart system II for visual acuity measurement in young visually-normal adults. Optom. Vis. Sci. 84: 218-223.

M&S Technologies Inc. M&S Smart System II Use and Operation Guide. Illinois, IMP-0706: 2011.

Mohammad-Salih, P.A.K. & Sharif, A.F.M.D. 2008. Analysis of pterygium size and induced corneal astigmatism. Cornea 27: 434-438.

Mohd Radzi, H., Mohd Zulfaezal, C.A., Khairidzan, M.K., Mohd Izzuddin, M.T., Norfazrina, A.G. & Tengku Mohd, T.S. 2017. Prediction of changes in visual acuity and contrast sensitivity function by tissue redness after pterygium surgery. Curr. Eye Res. 42: 852-856.

Nejima, R., Masuda, A., Minami, K., Mori, Y., Hasegawa, Y. & Miyata, K. 2015. Topographic changes after excision surgery of primary pterygia and the effect of pterygium size on topographic restoration. Eye Contact Lens 41(1): 58-63.

Ozgurhan, E.B., Kara, N., Cankaya, K.I., Sezgin Akcay, B.I., Kurt, T., Yilmaz, I. & Ahmet, D. 2015. Corneal wavefront aberrations after primary and recurrent pterygium surgery. Eye Contact Lens 41(6): 378-381. doi: 10.1097/ICL.0000000000000143.

Oh, J.Y. & Wee, W.R. 2010. The effect of pterygium surgery on contrast sensitivity and corneal topographic changes. Clin. Ophthalmol. 4: 315-319.

Pan, X., Zhang, D., Jia, Z., Chen, Z. & Su, Y. 2018. Comparison of hyperdry amniotic membrane transplantation and conjunctival autografting for primary pterygium. BMC Ophthalmol. 18(1): 119. doi: 10.1186/s12886-018-0784-4.

Pelli, D.G. & Bex, P. 2013. Measuring contrast sensitivity. Vision Res. 90: 10-14.

Reda, A.M., Shaaban, Y.M.M. & Saad El-Din, S.A. 2018. Histopathological parameters in pterygia and significant clinical correlations. J. Ophthalmic. Vis. Res. 13(2): 110-118.

Ribatti, D., Nico, B., Perra, M.T., Maxia, C., Piras, F., Murtas, D., Crivellato, E. & Sirigu, P. 2009. Correlation between NGF/TrkA and microvascular density in human pterygium. Int. J. Exp. Pathology 90(6): 615-620.

Sandra, S., Zeljka, J., Zeljka, V., Kristian, S. & Ivana, A. 2014. The influence of pterygium morphology on fibrin glue conjunctival autografting pterygium surgery. Int. Ophthalmol. 34(1): 75-79.

Tan, D.T., Chee, S.P., Dear, K.B. & Lim, A.S. 1997. Effect of pterygium morphology on pterygium recurrence in a controlled trial comparing conjunctival autografting with bare sclera excision. Arch. Ophthalmol. 115: 1235-1240.

Thurman, S.M., Davey, P.G., McCray, K.L., Paronian, V. & Seitz, A.R. 2016. Predicting individual contrast sensitivity functions from acuity and letter contrast sensitivity measurements. J. Vis. 16: 1-15.

Vives, P.P., Castanheira, A.M.C.M., Mora, G.J., Margarit, S.L., Encina, D.M. & Garcia, I.S. 2013. Topographic corneal changes in astigmatism due to pterygium’s limbal-conjunctival autograft surgery. J. Emmetropia. 4: 13-18.

Zare, M., Zarei-Ghanavati, S., Ansari-Astaneh, M.R., Baradaran-Rafiee, A. & Einolahi, B. 2010. Effects of pterygium on ocular aberrations. Cornea 29(11): 1232-1235.

 

*Corresponding author; email: khairidzan@gmail.com

 

 

 

 

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