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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
Benda Asing dalam Kornea akibat Kurangnya Peralatan Keselamatan: Laporan Kasus Sumual, Vera; Nursalim, Ade J.
Jurnal Biomedik : JBM Vol 11, No 3 (2019): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.11.3.2019.26334

Abstract

Abstract: Poor Occupational Safety and Health (OSH) implementation can cause work accidents. Eye trauma related to work is still quite a lot worldwide. We reported a case of work accident due to lack of awareness of personal protective equipment. This case was a male of 21 years old, worked as a welder. Due to working without using any eye protection equipment the patient got an eye trauma. The patient washed his eye with water directly and applied some drops of an eyedrop containing dexamethasone, neomycin sulphate dan polymyxin B sulphate. After three days without improvement, he went to Prof. Dr. R. D. Kandou Hospital Manado. Eye examination revealed visual acuity of the right eye 6/9 and of the left eye 6/6. There were also blepharospasme and lacrimation on the right eye. Slit lamp examination showed a foreign particle of 0.5x0.5 mm in the right cornea, 8 o’clock direction, between paracentral and peripheral regions estimated to be 1/3 of the anterior stromal thickness. Foreign particle removal left an ulcer of 1/3 of the stromal thickness. Gentamycin eye ointment was aplied three times daily and eye patching was performed. After one day of treatment, visus of the right eye became 6/7.5. Slit lamp examination showed epithelialized ulcer sized less than 0.5x0.5 mm. Gentamycin eye ointment was further applied. The patients showed improvement of visus and corneal condition.Keywords: Occupational Health and Safety, welder, cornea, personal protective equipment Abstrak: Pelaksanaan Kesehatan dan Keselamatan Kerja (K3) yang kurang baik dapat menyebabkan terjadinya kecelakaan kerja. Kasus trauma mata yang berhubungan dengan kecelakaan kerja di seluruh dunia masih terbilang cukup banyak. Kami melaporkan kasus kecelakaan kerja akibat kurangnya kesadaran penggunaan alat pelindung diri pada seorang laki-laki pekerja las berusia 21 tahun. Oleh karena tidak menggunakan alat pelindung mata, saat kerja, mata pasien terkena serpihan besi. Segera setelah kejadian itu, pasien langsung mencuci mata dengan menggunakan air kran dan menggunakan tetes mata kombinasi dexamethasone, neomycin sulphate dan polymyxin B sulphate. Setelah tiga hari tidak terdapat perbaikan pasien akhirnya berobat ke RSUP Prof. Dr. R. D. Kandou Manado. Pada pemerik-saan didapatkan tajam penglihatan mata kanan 6/9 dan mata kiri 6/6. Terdapat blefarospasme dan lakrimasi. Pada pemeriksaan dengan slitlamp didapatkan serpihan benda asing dengan ukuran sekitar 0,5x0,5 mm pada kornea mata kanan di arah jam 8 antara regio parasentral dan perifer kornea sekitar 1/3 ketebalan storma anterior. Pengangkatan benda asing menyisakan ulkus 1/3 tebal stroma pasca tindakan. Pasien diberikan gentamycin salep mata dan dilakukan eye patching. Saat kontrol satu hari kemudian didapatkan tajam penglihatan mata kanan 6/7,5 dan mata kiri 6/6. Pada pemeriksaan dengan slit lamp didapatkan ulkus kornea mata kanan berukuran <0,5x0,5 mm yang telah terepitelisasi. Pengobatan dengan gentamycin salep mata dilanjutkan. dan terjadi perbaikan tajam penglihatan dan kondisi anatomis kornea.Kata kunci: Kesehatan dan Keselamatan Kerja, pekerja las, kornea, alat pelindung diri
PROFIL KLINIS ESODEVIASI DI PUSAT PELAYANAN KESEHATAN TERSIER Nursalim, Ade J.; Latun, Erick; Poluan, Herny
JURNAL BIOMEDIK : JBM Vol 10, No 1 (2018): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.10.1.2018.19003

Abstract

Abstract: Esodeviation is an ocular anomaly in which the visual axis has a manifest or latent misalignment. Diagnosis of this anomaly needs a further thorough examination of an ophthalmologist. This study was aimed to obtain the profile of esodeviation patients at Ophthalmology Clinic of Prof. Dr. R. D. Kandou Hospital Manado. This was a descriptive retrospective study using the medical record data of patients with esodeviation from January 2014 to August 2017. There were 21 patients with esodeviation during that period of time, consisted of 13 males (61.9%) and 8 females (38.1%). The age range was 1-12 years old with the highest percentage in 5 years old (16 patients; 76.1%). The esodeviation types were esotropia accounted in 15 patients (71.4%) and esophoria in 6 patients (28.6%). Refraction anomalies were the most common etiology of esodeviation (57.1%). Squint was the main complaint (61.9%) and 22 degree prism was the most deviation degree (66.7%). Conclusion: In this study, esodeviation was most common in males, age under 5 years, esotropia type, squint as the main complaint, with refraction anomaly as the main cause, and deviation less than 22 degrees prism.Keywords: esodeviation, esotropia, esoforia, etiology, deviation degreeAbstrak: Esodeviasi adalah keadaan dimana aksis visual tidak lurus baik manifes maupun laten. Diagnosis esodeviasi memerlukan pemeriksaan lebih lanjut dari seorang dokter ahli mata. Penelitian ini bertujuan untuk mendapatkan profil klinis esodeviasi di Poliklinik Mata RSUP Prof. Dr. R. D. Kandou Manado dengan menggunakan data rekam medik pasien dari Januari 2014 hingga Agustus 2017. Hasil penelitian mendapatkan sebanyak 21 pasien, terdiri dari 13 pasien (61,9%) laki-laki dan 8 pasien (38,1%) perempuan. Rentang usia berkisar 1-12 tahun dengan usia terbanyak di bawah 5 tahun sebanyak 16 pasien (76,1%). Tipe esodeviasi terbanyak ialah esotropia sebanyak 15 pasien (71,4%) dan esoforia sebanyak 6 pasien (28,6%). Etiologi terbanyak ialah kelainan refraksi (57,1%). Keluhan utama pasien berobat ialah mata terlihat juling (61,9%) dan derajat deviasi terbanyak ialah kurang dari 22 derajat prisma (66,7%). Simpulan: Pada penelitian ini, esodeviasi terutama dijumpai pada jenis kelamin laki-laki, usia <5 tahun, tipe esotropia, keluhan mata juling, dengan etiologi kelainan refraksi, dan derajat deviasi <22 derajat prisma.Kata kunci: esodeviasi, estotropia, esoforia, etiologi, derajat deviasi
ENDOFTALMITIS YANG DINDUKSI PENGGUNAAN LENSA KONTAK – LAPORAN KASUS Nursalim, Ade J.; Poluan, Herny
JURNAL BIOMEDIK : JBM Vol 10, No 2 (2018): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.10.2.2018.20094

Abstract

Abstract: Nowadays, the popularity of contact lens increases progressively, not only in refractive anomaly correction but also in fashion purposes. Albeit, among contact lens wearers, there is a tendency of the occurence of eye infection, especially the cornea. We reported a 13-year-old female that came to the Eye Departement of Prof. Dr. R. D. Kandou Hospital Manado with the main complaint of blurred left eye since a week ago. Physical examination resulted in normal right eye and its visual acuity was within normal limit (6/6). Examination of the left eye resulted in visual acuity of 1/300, palpebral blepharospasm, conjunctival and ciliar injections, anterior stromal defect of 3x5 mm in the cornea, and hypopion <1mm in the anterior chamber. The ultrasound examination showed spreading aggregations and turbidity of the vitreous body. This patient was diagnosed as emmetropia of the right eye and contact-lens-induced endophthalmitis of the left eye. The therapy consisted of tobramycin, artificial tears, polyvinylpyrrolidone, vitamin C, mefenamic acid, and chlorpheniramine maleate tablet. Although there was improvement of visual acuity and clinical signs during 8-day hospitalization, the prognosis was good for ad vitam but poor for functionam and sanationam. This case indicates that education to the contact lens wearers is still needed even in this modern era.Keywords: contact lens, endophthalmitisAbstrak: Dewasa ini, lensa kontak mengalami peningkatan popularitas yang pesat, bukan saja dalam hal kelainan refraksi tetapi juga untuk keperluan mode. Pemakaian lensa kontak berisiko terjadinya infeksi pada mata, terutama kornea. Kami melaporkan seorang perempuan berusia 13 tahun, datang ke Poliklinik Ilmu Kesehatan Mata, RSUP Prof. Dr. R. D. Kandou Manado dengan keluhan pandangan mata kiri kabur sejak satu minggu lalu. Pada pemeriksaan fisik ditemukan mata kanan (OD) dalam batas normal dengan visus 6/6. Pada mata kiri (OS) didapatkan visus 1/300, blefarospasme palpebra, injeksi konjungtiva dan silier, pada kornea terdapat defek 1/3 anterior stroma dengan ukuran 3x5 mm, dan pada kamera okuli anterior terdapat hipopion setinggi <1 mm. Hasil pemeriksaan USG dari OS menunjukkan gambaran agregat yang menyebar dan kekeruhan vitreus. Pasien didiagnosis dengan emetropia okuli dekstra dan endoftalmitis okuli sinistra yang diinduksi penggunaan lensa kontak. Terapi yang diberikan ialah antibiotika tobramisin, artificial tears, polyvinylpyrrolidone, vitamin C, asam mefenamat, dan klorfeniramin maleat tablet. Pasien mengalami perbaikan visus dan gejala klinis selama delapan hari rawat inap. Prognosis pasien tergolong baik untuk prognosis ad vitam tetapi tergolong buruk untuk functionam dan sanationam. Kasus ini mengindikasikan bahwa edukasi terhadap pengguna lensa kontak tetap diperlukan dalam era modern ini.Kata kunci: lensa kontak, endoftalmitis
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    
Co-Authors Chietra, Andrew Emily, Ardelia Herny Poluan, Herny Latun, Erick Rusli, Richardo Simanjuntak, Elbetty Sumanti, Eugeni Vera Sumual