Anggraini, Neni Tri
Department Of Ophthalmology, Faculty Of Medicine, Universitas Indonesia Cipto Mangunkusumo Hospital, Jakarta

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Successful systemic propranolol treatment for periocular capillary hemangioma in Indonesian infant girls: A case series Neni Anggraini; Mutmainah
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 14, No 1, (2023)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol14.Iss1.art15

Abstract

Capillary hemangioma (CH) is the most prevalent benign tumour in children. Most cases showed spontaneous involution without any intervention. However, approximately 10% of all CH patients require treatment. Most cases of periocular capillary hemangioma (PCH), especially orbital form, risk significant morbidity; therefore, aggressive treatment is needed. Studies showed a superior outcome of systemic propranolol for CH compared to standard therapy (corticosteroids). We present cases with different PCH types successfully treated with systemic propranolol. Five patients with different types of PCH were given systemic propranolol. One patient presented with a lesion at birth, while others were less than ten months of age. Oral propranolol was given at 0.5 mg/kg body weight (BW) as the initial dose for two weeks. The dose was gradually increased to 2.0 mg/kg BW within 1-18 months of treatment. All patients showed sufficient initial responses regarding mass reduction and colour change within 2-12 weeks. No complications or adverse effects were observed. The regimen of 2.0 mg/kg BW systemic propranolol treatment was considered safe and beneficial for PCH.
Transcranial Supraorbital Approach for Tumor Removal of Spheno-Orbital Meningioma with Favorable Clinical Outcomes Nina Asrini Noor; Neni Anggraini; Mutmainah Mutmainah; Renindra Ananda Aman
Majalah Oftalmologi Indonesia Vol 42 No 2 (2016): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/journal.v42i2.76

Abstract

Background: To describe and evaluate the surgery results regarding resectability and clinical outcomes oftranscranial supraorbital approach for tumor removal of spheno-orbital meningiomaCase Illustration: A 58-year-old woman presented with proptosis of the right eye since 9 years prior.At initial examination, visual acuity was 6/15 with significant nasal visual field defect. There wereprominent proptosis and inferior globe displacement of the right eye with no palpable mass. A frontoparietalbone deformity was also observed. CT scan examination revealed hyperostosis of sphenoid,frontal, and temporal bone with extensive intraorbital mass with contrast enhancement suggestive ofmeningioma. Incisional biopsy was the performed and confirmed the histopathological diagnosis ofmeningothelial meningioma (WHO grade 1). Transcranial supraorbital in conjunction with lateralorbitotomy was performed in this patient as the definitive treatment for tumor removal of sphenoorbitalmeningioma. Craniotomy and opening of orbital roof were carried out by neurosurgeon toexpose intraorbital region. Total tumor removal was than completed.Conclusion: Transcranial supraorbital approach is an effective surgery for spheno-orbital meningiomaremoval as it offers excellent exposure. A radical resection through transcranial approach can be achievedwith low morbidity, providing a significantly improved clinical outcome in long term period. In thiscase, the spheno-orbital meningioma was grossly resected totally with excellent visual outcome andacceptable cosmetic appearance.Keywords: spheno-orbital meningioma, transcranial approach, tumor resection
Devastating Lower Eyelid Squamous Cell Carcinoma in Patient with Xeroderma Pigmentosum Novia Rahayu; Neni Anggraini; Rossalyn Sandra Andrisa
Majalah Oftalmologi Indonesia Vol 42 No 3 (2016): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/journal.v42i3.91

Abstract

Background: Xeroderma pigmentosum (XP), an inherited condition of cellular sensitivity to ultraviolet (UV) radiation, mainly presents as cutaneous and ocular abnormalities, including neoplasia. This report aimed to demonstrate a devastating case of lower eyelid squamous cell carcinoma in XP patient.Case Illustration: Twenty four-year-old female with XP came with white plaque on both cornea. Excisional biopsy revealed a conjunctival intraepithelial neoplasia DD/ carcinoma in situ on right eye, and hyperplastic squamous epithelia on left eye. For nearly two years, she was lost to follow up, and revisited our clinic with a rapid growing, ulcerated, susceptible to bleed, red-yellowish mass, expanding to bulbar and tarsal conjunctiva, about 27 x 15 x 10 mm size, on her lower left eyelid, with restricted ocular movement. Incisional biopsy revealed a well-differentiated squamous cell carcinoma. In 6 weeks time, mass has grown to size 75 x 50 x 20 mm, and already infiltrated to superior eyelid and orbit.Conclusion: The nature of malignancy in XP patient is exceptionally progressive. Thorough education, close monitoring and early treatment is critical to prevent rapid deterioration and minimize possible impairment caused.  Keywords: xeroderma pigmentosum, squamous cell carcinoma, eyelid squamous cell carcinoma, squamous cell carcinoma treatment
Malignant Triton Tumor without Von Recklinghausen’s Neurofibromatosis in a 16 year-old Indonesian Girl: A Case Report Neni Anggraini; Nurjati Chairani Siregar
Majalah Oftalmologi Indonesia Vol 43 No 1 (2017): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/journal.v43i1.129

Abstract

Background: To diagnose malignant peripheral nerve sheath tumor with rhabdomyoblastic differentiation in malignant triton tumor which has a rare incidence. Case Illustration: We reported a case in a 16 year-old girl who presented with progressively painless proptosis of the left eye and decreased visual acuity. There was no evidence of Recklinghausen’s disease. She underwent surgery and radiotherapy. The histopatologic findings showed malignant peripheral nerve sheath tumor (MPNST). Four years later, she suffered recurrence proptosis and decreased visual acuity. Histomorphology supported by immunostaining with S-100 protein confirmed the diagnosis of malignant triton tumor. She underwent chemotherapy and enucleation. Conclusion: This case highlights the prudent use of immunohistochemistry that is essential in making an early detection and a correct diagnosis.
Case Series of Two Patients with Primary Malignant Melanoma of the Lacrimal Sac Tessa H Anindya; Neni Anggraini; Evelina Kodrat
Majalah Oftalmologi Indonesia Vol 42 No 2 (2016): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/journal.v42i2.194

Abstract

Background: To demonstrate two rare case of primary malignant melanoma of lacrimal sac. Case Illustration: Patients were both female, 38-year-old and 46-year-old, with lacrimal sac mass,bloody discharge and epiphora. The first patient was previously diagnosed with chronic dacryocystitisand treated with antibiotics and anti-inflammation for two months which resulted in worsen conditionand enlarged swelling. Computed tomography scan revealed solid mass at lacrimal sac 13 x 12 x 7.4millimeters in size with no bone destruction. Patient underwent total mass removal surgery, whichrevealed solid highly pigmented mass. The second patient also had enlarged mass within two months.Other complaints include obstructed left nose and epistaxis. Computed tomography scan revealed solidmass at left medial canthal region involving inferior orbit, nasolacrimal duct, left nose cavity, andmaxillary sinus. Incisional biopsy revealed a malignant melanoma. Patient underwent eye exenteration,maxilectomy, and radical neck dissection. Conclusion: Primary malignant melanoma of the lacrimal sac is a rare case and often mimics chronicdacryocystitis. It’s imporant to understand this disease entity to make accurate diagnosis and managementwith the help of imaging modality.
Efficacy and Safety Outcome Comparison of Endoresection and Proton Beam Therapy as Primary Treatment for Choroidal Melanoma Denisa Anggi Kurnia; Neni Anggraini
Majalah Oftalmologi Indonesia Vol 46 No 2 (2020): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/journal.v46i2.100095

Abstract

Objective: To evaluate and compare the efficacy and safety between endoresection and proton beam radiotherapy, as primary treatment in choroidal melanoma.Methods: Articles that were published from 2008 to 2018 were collected from multiple sources including Pubmed, Clinical Key, and Ophthalmology Advance. All study that comply with the inclusion and exclusion criteria were categorized based on level of evidence Oxford Center for Evidence-based Medicine Levels of Evidence. Primary outcome is secondary enucleation. Secondary outcomes are metastasis, recurrence, death, visual outcomes, and complication. Result: Twelve articles were eligible to be reviewed. Mean secondary enucleation, metastasis, and death rate is lower in endoresection group (6.29% vs 12.94%; 8.00% vs 20.85%; 6.86% vs 20.43) while recurrence rate is lower in proton beam group (4.78% vs 6.86%). The most common complication that observed is retinal detachment. Other complications that were reported includes cataract formation, radiation retinopathy, neovascular glaucoma, vitreous hemorrhage, elevated intraocular pressure (IOP), iris neovascularization, and optic neuropathy. Conclusion: Endoresection as primary treatment for choroidal melanoma shows better efficacy compared to proton beam therapy, regarding the ability to preserve the eyeball. The safety between endoresection and proton beam therapy, both therapy shows similar result.
Chemotherapy Compared with Radiotherapy as the First-line Therapy of Extranodal Marginal Zone Lymphoma: A Review Mutmainah Mahyuddin; Karina Luthfia; Neni Anggraini
Majalah Oftalmologi Indonesia Vol 48 No 2 (2022): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/journal.v48i2.100269

Abstract

Objective: To compare the efficacy and safety between chemotherapy and radiotherapy as the main therapy of Extranodal Marginal Zone Lymphoma (EMZL). Method: Literature searching was conducted using PubMed, ScienceDirect, Google Scholar, ProQuest, and SpringerLink. All studies that met the inclusion and exclusion criteria were categorized based on the level of evidence. The data of demographic of the patients, staging of disease, type of treatments, and outcomes of this review including the number of local control rate, disease-free survival rate, overall survival rate, dosage, adverse drug reaction, complication and recurrence and/or relapses were also reported. Result: From ten article, both radiotherapy and chemotherapy as the first-line treatment have high complete remission rate. Local control (complete remission) of chemotherapy group ranged from 56,25%-93,9%, while in radiotherapy group ranged from 70%-100%. Overal survival rate ranged from 92%-100% for chemotherapy group and 90,4%-100% for radiotherapy group. The most complication of the radiotherapy group were cataract formation, while the chemotherapy group showed systemic complications (hematologic or non-hematologic). The most relapse cases were shown in radiotherapy group. Conclusion: Radiotherapy and chemotherapy showed high local control rates and survival outcomes especially in the early stages of extranodal marginal zone lymphoma (EMZL). Radiotherapy had a relatively higher incidence of ophthalmic complications that could interfere with patient’s quality of life. Therefore chemotherapy could be considered especially in younger patients.
Extensive Primary Orbital Malignant Melanoma Associated with Nevus of Ota Mutmainah Mutmainah; Neni Anggraini; Evelina Kodrat
Majalah Oftalmologi Indonesia Vol 47 No 2 (2021): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/journal.v47i2.100299

Abstract

Primary orbital malignant melanoma is an extremely rare condition to present alone without previous extension of choroidal or conjunctival involvement. We reported the first case of malignant orbital melanoma without ocular involvement in a patient with nevus of Ota. A 52-year-old man presented with left proptosis and extensive bluish black pigmentation on left side of the face classified as Tanino type II of nevus of Ota and left ocular melanocytosis from birth. CT scan imaging showed extensive orbital mass occupying most of the orbital space. Transconjunctival biopsy was performed and a very pigmented mass was discovered, confirming the histopathology result of malignant melanoma. The patient was given up to five cycles of chemotherapy regimen. On serial orbital CT Scan, 33% of the tumor mass has disappeared after completing three cycles.
Clinical Feature of Langerhans Cell Histiocytosis of the Orbit : A First Case Series in Indonesia: Poster Presentation - Case Series - Ophthalmologist ZENDY SAGITA; NENI ANGGRAINI; MUTMAINAH
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/whwjjh75

Abstract

Introduction : Langer hans histiocytosis (LCH) is an inexplicable disease characterized by proliferation of Langerhans and intermixed with inflammatory cell, in particular eosinophil, which represents only 1% pediatric orbital tumours. Orbital involvement of LCH is a rare clinical entity as the disease simulate variety of malignancies and present as a diagnostic and management dilemma for ophthalmologist. Case Illustration : Two cases of toddler presented with unilateral progressive upper eyelid swelling and proptosis for more than a month. Both cases has history of orbital trauma 1 month before swelling was observed. Initial CT scan revealed extraconal mass, with destruction of lateral orbital wall and frontal bone. Both patients had histopathological biopsy confirmed eosinophlic cytoplasm. One patient confirmed immunohistochemistry markers S100 and CD1a which is specific for Langerhans cells. Both patients continue with chemotherapy as definitive treatment. Discussion : LCH is a wide clinical spectrum which manifestation simulate other pediatric orbital malignancies. Case illustration present unilateral eyelid swelling with history of trauma may resemble other diagnosis unless further work up is performed. This case series exhibits clinical manifestations that may be suggestive of LCH. Considering rapid progression of disease, definitive diagnosis is a mandatory based on histopatological analysis through biopsy surgery. Conclusion : LCH is rare disease, it should be considered as one of deferential diagnosis in pediatric orbital malignancy with initial presentation acute unilateral eyelid swelling, proptosis, history of trauma, extraconal mass and destruction of bones as radiological features. This might be helpful for early recognition and prompt treatment of disease suggestive of LCH.
The Impact of COVID-19 Pandemic on Ocular Oncology Services at Cipto Mangunkusumo Hospital, Indonesia Anggraini, Neni; Nursanti, Hanifah Rahmani; Mahyuddin, Mutmainah
Indonesian Journal of Cancer Vol 18, No 1 (2024): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i1.1011

Abstract

Background:: Delay of diagnosis and treatment in ocular oncology services due to the COVID-19 pandemic is very disadvantageous. This study aimed to evaluate the impact of COVID-19 on new patients with suspected eye tumors in terms of volume, characteristics, and waiting time for a procedure. Methods: : A retrospective study based on hospital records of new patients was held in the ocular oncology clinic of Cipto Mangunkusumo Hospital, a tertiary eye care center in Jakarta, Indonesia. Patients were analyzed descriptively based on three time periods: pre-COVID-19, COVID-19 social restriction, and post-COVID-19 social restriction. Each patient was stratified according to case priority during the COVID-19 pandemic suggested by Indonesia’s Ophthalmologist Association (IOA). Results: During the COVID-19 social restriction between March to June 2020, new patient volume decreased by 73.1%, with a 75.5% decline in referrals from the governmental hospital. Elderly, pediatric, and highly educated patients were less likely to visit the clinic. Patients with acute onset, invasive or metastatic tumors, and advanced T-stage were more likely to be referred to the hospital. Third-priority cases referred with a lower ratio during COVID-19 social restriction (29% vs 44.9% in pre-COVID-19 and 35.1% in post-COVID-19 social restriction) and had to wait longer for the procedure (41 (18–60) days vs 28.5 (11–63) days in pre-COVID-19 and 16.5 (7–67) days in post-COVID-19 social restriction). Conclusions: : As the healthcare service was overwhelmed by COVID-19 patients, referral to ocular oncology services was severely disrupted, particularly in elderly, pediatric, and early T-stage patients. Strategies are needed to ensure that highly prioritized cases may access the services.