Taryudi Suharyana
Department of Neurology, CMHC Research Center, Palembang, Indonesia

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Continuous 24-Hour Intraocular Pressure Monitoring with a Smart Contact Lens Predicts Visual Field Progression in Normal-Tension Glaucoma Taryudi Suharyana; Agnes Mariska
Sriwijaya Journal of Ophthalmology Vol. 8 No. 2 (2025): Sriwijaya Journal of Ophthalmology
Publisher : Department of Opthalmology, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjo.v8i2.135

Abstract

Introduction: Normal-tension glaucoma (NTG) may progress despite normal office intraocular pressure (IOP), suggesting that 24-hour IOP dynamics captured by a smart contact lens (SCL) sensor may improve risk stratification. This study evaluated whether SCL-derived nocturnal IOP parameters independently predict Humphrey 24-2 visual field (VF) progression in NTG. Methods: This prospective observational cohort enrolled 62 NTG eyes (62 patients; one eye per patient) who underwent 24-hour SCL monitoring and serial Humphrey 24-2 SITA-Standard VF testing over 24 months at a private hospital in Palembang, Indonesia. The primary outcome was VF mean deviation (MD) slope (dB/year). Multivariable linear regression and receiver operating characteristic (ROC) analysis were performed. Results: Eyes with a nocturnal IOP acrophase (n = 36) had a significantly faster MD decline (−1.24 ± 0.31 dB/year) than eyes without acrophase (n = 26; −0.42 ± 0.19 dB/year; mean difference −0.82 dB/year, 95% CI −0.97 to −0.67, p < 0.001; Cohen d = 3.20). Independent predictors of MD slope were nocturnal acrophase (β = −0.71, p < 0.001), number of long peaks (β = −0.18, p < 0.001), and baseline RNFL thickness (β = +0.034, p = 0.002); adjusted R² = 0.64. Nocturnal amplitude yielded an AUC of 0.83 (95% CI 0.74–0.91). Conclusion: SCL-derived nocturnal IOP parameters independently predict VF progression in NTG. Integration of 24-hour SCL monitoring may enhance risk stratification beyond office IOP measurement.
Diffusion Tensor Imaging and Resting-State Functional MRI Reveal Coupled Microstructural and Default-Mode Network Alterations in Mild Cognitive Impairment: A Diagnostic Accuracy Study Taryudi Suharyana; Akmal Hasan; Jason Willmare
Sriwijaya Journal of Radiology and Imaging Research Vol. 3 No. 2 (2025): Sriwijaya Journal of Radiology and Imaging Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjrir.v3i2.285

Abstract

Introduction: Early-stage neurodegeneration — clinically expressed as mild cognitive impairment (MCI) — lacks accessible imaging biomarkers that link microstructural white-matter injury to functional network disruption. We evaluated whether integrating diffusion tensor imaging (DTI) and resting-state functional MRI (rs-fMRI) at 3.0-Tesla improves detection of MCI and substantiates a structural-to-functional disconnection mechanism. Methods: In this STARD-2015-compliant, prospective cross-sectional diagnostic accuracy study at a tertiary hospital in Palembang, Indonesia, 85 participants (45 MCI, 40 age-, sex- and education-matched controls) underwent single-scanner 3.0-T MRI. DTI metrics (fractional anisotropy [FA], mean diffusivity [MD]) were derived by tract-based spatial statistics and posterior-cingulate-seeded Default Mode Network (DMN) connectivity by CONN. Consensus clinical diagnosis (Petersen criteria) was the blinded reference standard. Diagnostic accuracy used ROC/DeLong AUC, Wilson 95% confidence intervals (CIs), Cohen κ, and multivariable logistic regression. Results: Posterior-cingulum FA was lower (0.399 ± 0.058 vs 0.489 ± 0.052, p<0.001) and MD higher in MCI; PCC–mPFC connectivity was reduced (0.392 ± 0.124 vs 0.586 ± 0.136, p<0.001). FA discriminated MCI with AUC 0.903 (95% CI 0.831–0.974; sensitivity 82.2%, specificity 90.0%); a combined FA+FC model reached AUC 0.901 with sensitivity 95.6% and NPV 93.8% but did not exceed FA alone (DeLong p=0.90). FA and connectivity were strongly correlated (r=0.79, 95% CI 0.69–0.86, p<0.001). Inter-reader agreement was substantial (κ=0.74 and 0.67). Conclusion: Multimodal 3.0-T DTI and rs-fMRI provides an accurate, radiation-free signature of early-stage neurodegeneration; the coupling between cingulum microstructure and DMN connectivity is consistent with structural disconnection being associated with functional decoupling and offers a deployable tool for tertiary referral centres.
Continuous 24-Hour Intraocular Pressure Monitoring with a Smart Contact Lens Predicts Visual Field Progression in Normal-Tension Glaucoma Taryudi Suharyana; Agnes Mariska
Sriwijaya Journal of Ophthalmology Vol. 8 No. 2 (2025): Sriwijaya Journal of Ophthalmology
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjo.v8i2.135

Abstract

Introduction: Normal-tension glaucoma (NTG) may progress despite normal office intraocular pressure (IOP), suggesting that 24-hour IOP dynamics captured by a smart contact lens (SCL) sensor may improve risk stratification. This study evaluated whether SCL-derived nocturnal IOP parameters independently predict Humphrey 24-2 visual field (VF) progression in NTG. Methods: This prospective observational cohort enrolled 62 NTG eyes (62 patients; one eye per patient) who underwent 24-hour SCL monitoring and serial Humphrey 24-2 SITA-Standard VF testing over 24 months at a private hospital in Palembang, Indonesia. The primary outcome was VF mean deviation (MD) slope (dB/year). Multivariable linear regression and receiver operating characteristic (ROC) analysis were performed. Results: Eyes with a nocturnal IOP acrophase (n = 36) had a significantly faster MD decline (−1.24 ± 0.31 dB/year) than eyes without acrophase (n = 26; −0.42 ± 0.19 dB/year; mean difference −0.82 dB/year, 95% CI −0.97 to −0.67, p < 0.001; Cohen d = 3.20). Independent predictors of MD slope were nocturnal acrophase (β = −0.71, p < 0.001), number of long peaks (β = −0.18, p < 0.001), and baseline RNFL thickness (β = +0.034, p = 0.002); adjusted R² = 0.64. Nocturnal amplitude yielded an AUC of 0.83 (95% CI 0.74–0.91). Conclusion: SCL-derived nocturnal IOP parameters independently predict VF progression in NTG. Integration of 24-hour SCL monitoring may enhance risk stratification beyond office IOP measurement.