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Nursalim, Ade J.
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Biochemistry, Genetics & Molecular Biology Health Professions

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Perbandingan Ketebalan Retina Sentral Pasien Hipertensi Esensial tanpa Penurunan Visus Dibanding Orang Normal Nursalim, Ade J.; Sumual, Vera; Sumanti, Eugeni
e-CliniC Vol 7, No 2 (2019): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v7i2.23977

Abstract

Abstract: One of the complications of hypertension is hypertensive retinopathy with a prevalence of 2-17% in patients with hypertension without diabetes. Application of optical coherence tomography (OCT) tool enables the clinician to simplify the pathophysiological process of hypertensive retinopathy. This study was aimed to compare the central retina thickness of essential hypertensive patients without decreased vision to of normal people. This was a prospective comparative study using a quantitative method. There were 56 eyes in the hypertension group and 71 eyes in the normal group. The t test showed that central retina thickness in hypertension group was 201.66 μm (SD ±38,870) meanwhile in the normal group was 249.59 μm (SD±19,245) (p=0.004). In conclusion, there was a significant difference in central retinal thickness between essential hypertensive patients and normal people. It is suggested that ophthalmologic examination should be performed on patients with essential hypertension even without decreased vision.Keywords: hypertension, decrease of vision, retinal thickness Abstrak: Salah satu komplikasi hipertensi yaitu retinopati hipertensi dengan prevalensi 2-17% pada penyandang hipertensi tanpa diabetes. Aplikasi alat optical coherence tomography (OCT) memungkinkan klinisi untuk meneliti lebih lanjut mengenai proses patofisiologi retinopati hipertensi. Penelitian ini bertujuan untuk membandingkan ketebalan retina sentral pasien hipertensi esensial tanpa penurunan visus dibanding orang normal. Jenis penelitian ialah prospektif komparatif menggunakan metode kuantitatif. Hasil penelitian mendapatkan 56 mata untuk kelompok hipertensi dan 71 mata untuk kelompok normal yang memenuhi kriteria penelitian. Uji t menunjukkan terdapat perbedaan ketebalan retina sentral pada kelompok hipertensi dibanding kelompok normal. Rerata ketebalan retina pada kelompok hipertensi ialah 201,66 μm (SD±38,870) dibanding pada kelompok normal ialah 249,59 μm (SD±19,245) (p=0,004). Simpulan penelitian ini ialah terdapat perbedaan bermakna antara ketebalan retina sentral pasien hipertensi esensial tanpa penurunan visus dibanding orang normal. Disarankan untuk melakukan pemeriksaan mata pada penyandang hipertensi esensial meskipun belum disertai keluhan penurunan tajam penglihatan.Kata kunci: hipertensi, penurunan visus, ketebalan retina
Central Serous Chorioretinopathy Induced by Work Stress: A Case Report Nursalim, Ade J.; Sumual, Vera
e-CliniC Vol 8, No 2 (2020): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v8i2.31107

Abstract

Abstrak: Central serous chorioretinopathy (CSC) adalah terkumpulnya cairan serosa di bawah lapisan epitel pigmen retina yang mengakibatkan terlepasnya retina neurosensorik (detachment). Keadaan ini dapat disebabkan oleh berbagai faktor risiko, termasuk stres psikologik. Jenis kelamin laki-laki merupakan salah satu faktor risiko CSC. Terapi kondisi psikologik merupakan pena-nganan utama CSC yang diinduksi oleh stres kerja. Kami melaporkan seorang laki-laki berusia 27 tahun yang datang ke Poliklinik Mata RSUP Prof. Dr. R. D. Kandou Hospital dengan keluhan kekaburan mata kanan yang mendadak sejak seminggu lalu tanpa didahului oleh nyeri pada mata. Pasien juga mengalami kesulitan dalam membaca teks dan mengenali wajah bila hanya menggunakan mata kanannya. Pasien telah pergi ke optik tetapi tidak mendapatkan ukuran kacamata yang sesuai. Pasien bekerja sebagai tenaga administrasi dan akhir-akhir ini mendapatkan beban kerja berlebihan. Pasien mengakui bahwa ia mengalami kesulitan dalam mengatur aktivitasnya, dan merasakan kelelahan sepanjang hari serta kehilangan minat kerja. Hasil pemeriksaan mata mendapatkan visus 6/15 untuk mata kanan dan visus 6/6 untuk mata kiri, dan metamorphopsia sedangkan hasil pemeriksaan oftalmoskopi memperlihatkan adanya edema dengan lingkaran kekuningan dan berbatas tidak jelas pada mata kanan. Pemeriksaan lanjut dengan OCT menunjukkan adanya cairan subretinal pada mata kanan disertai terlepasnya lapisan epitel pigmen. Saat kontrol setelah 36 hari, visus mata kanan telah membaik 6/6F2 dan peme-riksaan OCT menunjukkan penurunan tebal makula dari 289 μm pada kunjugan pertama men-jadi 190 μm, serta tidak tampak adanya cairan subretinal. Simpulan kasus ini ialah central serous chorioretinopathy yang diinduksi oleh stres kerja, dengan penanganan utama ialah terapi psikologik untuk memperbaiki kualitas hidup.Kata kunci: central serous chorioretinopathy (CSC), stres kerja Abstract: Central serous chorioretinopathy (CSC) is a condition where serous fluid builds up in the retinal pigment epithelium layer which causes neurosensory retinal detachment. This condition is affected by many risk factors, including psychological stress. Male gender is one of the risk factors for CSC. Treatment to the patient's psychological condition can be the main therapy in handling CSC induced by work stress. We reported a 27-year-old male came to the eye clinic at Prof. dr. R. D. Kandou Hospital complaining of sudden blurred vision in his right eye a week ago without initial pain in the eye. The patient also experienced difficulty in reading text and recognizing people’s face using the right eye. The patient went to an optic store but he did not find suitable glasses. The patient works as an administrative employee and is currently getting a heavy workload at his workplace. The patient admitted that he had issues in managing his life in a day. Patients felt tired throughout the day and had no interest in making any activities. The results of the eye examination showed vision 6/15 in the right eye and 6/6 in the left eye, metamorphopsia, edema with a yellowish circle with an unclear border on the right eye using ophthalmoscopy examination, and a subretinal fluid image in the patient's right eye with epithelial detachment pigment acquired through the examination with OCT. After 36 days from the first visit, the right eye vision was improved to 6/6 F2 and OCT examination resulted in a decrease in macula thickness from 289 μm at the first visit to 190 μm, and there was no subretinal fluid. In conclusion, this was a CSC case induced by work stress, and the main treatment was psychological therapy in order to improve the quality of life (QoL).Keywords: central serous chorioretinopathy (CSC), work stress
Karakteristik Pasien Age-related Macular Degeneration (AMD) pada Fasilitas Kesehatan Tersier di Masa Pandemi Covid 19 Nursalim, Ade J.; Simanjuntak, Elbetty; Sumual, Vera
e-CliniC Vol 9, No 2 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v9i2.35645

Abstract

Abstract: Age-related macular degeneration (AMD) is a neurodegenerative disease that affects the macula and is characterized by age-related loss of the central visual field. AMD contributes greatly to blindness for people over 50 years old in the world. The prevalence of AMD is increasing from year to year. Albeit, during the Covid-19 pandemic the number of patient visits to health facilities tends to decrease. This study was aimed to report the clinical characteristics of patients with AMD in tertiary health facilities during the covid 19 pandemic and to compare them with previous reports. This was a retrospective and descriptive study using medical record data of the Ophthalmology Clinic of Prof. Dr. R. D. Kandou Hospital Manado from March 2020 to June 2021. There were 12 patients in this study consisting of 10 males and two females. Age range of 56-75 years had the highest percentage (58%). The non-neovascular subtype were found in 7 patients (58.3%) meanwhile the neovascular type in 5 patients (41.7%). The identified risks were hypertension (50%), diabetes mellitus (DM) (8.3%), and DM associated with hypertension (16,7%), meanwhile no risk factor was found in 8.3% of patients. The number of patient visits decreased in the study period compared to previous reports conducted before the pandemic. In conclusion, the majority of AMD patients were male, age group of 56-75 years, and had non-neovascular subtype. The identified risk factors were hypertension and diabetes mellitus.Keywords: age related macular degeneration (AMD); characteristics of patients Abstrak: Age-related macular degeneration (AMD) adalah penyakit neourodegeneratif yang mengenai bagian makula dan ditandai dengan hilangnya lapang pandang sentral yang berhu-bungan dengan usia. AMD berkontribusi besar terhadap angka kebutaan untuk usia di atas 50 tahun di dunia. Prevalensi AMD pun semakin meningkat dari tahun ketahun. Pandemi Covid 19 diketahui mengurangi angka kunjungan pasien ke fasilitas kesehatan. Penelitian ini bertujuan untuk melaporkan karakteristik klinik pada pasien AMD pada fasilitas kesehatan tersier di masa pandemi covid 19 dan membandingkannya dengan laporan sebelumya. Jenis penelitian ialah deskriptif retrospektif dengan menggunakan data rekam medik di Poliklinik Mata RSUP Prof. Dr. R. D. Kandou Manado periode Maret 2020-Juni 2021. Hasil penelitian mendapatkan sebanyak 12 pasien AMD; sebagian besar berjenis kelamin laki-laki (83,3%), berada dalam rentang usia 56-75 tahun (58%), dengan subtipe AMD non neovaskular (58,3%). Faktor risiko yang teridentifikasi ialah hipertensi (50%), diabetes melitus (DM) (8,3%), dan DM disertai hipertensi (16,7%), sedangkan yang tanpa faktor risiko hanya 8,3%. Jumlah kunjungan pasien berkurang di periode waktu penelitian dibandingkan dengan laporan yang dilakukan sebelum masa pandemi. Simpulan penelitian ialah mayoritas pasien AMD berjenis kelamin laki-laki, usia 56-75 tahun, dengan subtipe non neovaskular. Faktor risiko teridentifikasi ialah hipertensi dan diabetes melitus.Kata kunci: age-related macular degeneration (AMD); karakteristik pasien
Long-Term Outcomes of Cataract Surgery: Analysis of Visual Acuity and Intraocular Pressure in a Tertiary Care Center Nursalim, Ade J.; Sumual, Vera; Chietra, Andrew; Emily, Ardelia; Rusli, Richardo
e-CliniC Vol. 12 No. 3 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i3.58044

Abstract

Abstract: Posterior capsule opacity (PCO) is a common complication following cataract surgery, caused by the proliferation of residual lens epithelial cells. This study aimed to evaluate the long-term effects of Nd:YAG laser capsulotomy on intraocular pressure (IOP) and visual acuity in PCO patients. This was a retrospective descriptive study. Samples were 24 patients diagnosed with PCO who underwent Nd:YAG laser capsulotomy at Prof. Dr. R. D. Kandou Hospital, Manado, from January 1, 2022, to January 1, 2024. The study recorded pre- and post-procedure IOP and best-corrected visual acuity (BCVA) data. Descriptive analysis, including paired t-tests, was used to assess changes in IOP and BCVA over an average follow-up period of 19.2 months. The results showed a statistically significant improvement in BCVA (p=0.000), with mean values improving from 0.72 to 0.27 LogMAR. A significant reduction in IOP was also observed (p=0.015), with long-term IOP remaining stable. A weak correlation was found between follow-up duration and IOP variation (p=0.02). In conclusion, Nd:YAG laser capsulotomy significantly improves visual acuity and stabilizes intraocular pressure in the long term for PCO patients, suggesting its effectiveness in managing post-cataract surgery complications. Keywords: posterior capsule opacity; Nd:YAG laser capsulotomy; intraocular pressure; visual acuity; cataract surgery    
Successful Visual Rehabilitation After Penetrating Ocular Trauma via Yamane Scleral Fixation: A Case Report Nursalim, Ade J.; Emily, Ardelia
e-CliniC Vol. 14 No. 2 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i2.65520

Abstract

Abstract: Penetrating ocular trauma frequently leads to traumatic cataract with capsular and zonular disruption, complicating standard in-the-bag intraocular lens (IOL) implantation. Sutureless intrascleral fixation (Yamane technique) offers a minimally invasive posterior chamber IOL option that avoids long-term suture-related complications. We reported a 68-year-old woman presented one day after penetrating needle injury to the right eye with uncorrected visual acuity (UCVA) 1/300, full-thickness corneal laceration (positive Seidel), anterior capsule tear, and zonular dialysis from 7 to 1 o’clock with lens fragments in the anterior chamber. Under retrobulbar anesthesia, corneal wound closure was performed with interrupted 10-0 nylon, followed by cataract extraction and anterior vitrectomy. In the same operation, two transconjunctival sclerotomies were created 2.0 mm posterior to the limbus (superonasal and superotemporal) using 27-gauge thin-walled needles at ~20°. A three-piece foldable IOL was implanted by the Yamane flanged-haptic technique; haptics were externalized, cauterized to 0.3–0.5 mm flanges, and tucked into scleral tunnels. The IOL centered well without tilt; no conjunctival peritomy was required. Postoperatively, UCVA improved to 1/60 on day 1, 6/60 at 2 weeks (after suture removal), and 6/15 at 1 month (6/6 with pinhole). In three-month follow-up, the retina remained attached, intraocular pressure was stable, no cystoid macular edema, and the IOL remained well positioned. In conclusion, in complex open-globe injury with inadequate capsular support, single-session repair with immediate Yamane sutureless scleral fixation of a three-piece IOL can achieve rapid, stable visual recovery and anatomic stability in geriatric eyes. Careful wound closure, symmetric needle entry, and precise flange creation are key to IOL centration and complication avoidance; continued follow-up is advised to monitor long-term flange stability. Keywords: penetrating ocular trauma; traumatic cataract; zonular dialysis; scleral fixation; Yamane technique
Co-Authors Chietra, Andrew Emily, Ardelia Herny Poluan, Herny Latun, Erick Rusli, Richardo Simanjuntak, Elbetty Sumanti, Eugeni Vera Sumual