Julie Dewi Barliana
Department Of Ophthalmology, Faculty Of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta

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Visual acuity assessment of preschool children in the inner city area in Jakarta Dian Estu Yulia; Yulinda Arty Laksmita; Julie Dewi Barliana; Laura Agnestasia Djunaedi; Lia Amanda; Hartono Gunardi
Paediatrica Indonesiana Vol 62 No 1 (2022): January 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.1.2022.1-6

Abstract

Background Visual acuity (VA) assessment is an important ocular examination to identify children with vision problems. Such early identification allows for early intervention to prevent childhood blindness. Objective To describe and compare visual acuity measurements in preschool children using two different visual acuity charts. Methods This cross-sectional study in children aged 36-60 months was done in a low-income area in the Central Jakarta District as a collaboration between Department of Ophthalmology and Department of Child Health, Universitas Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta. All children underwent visual acuity examinations using Lea symbols and Tumbling E charts. The VA results from two charts were analyzed with Bland-Altman plot for limits of agreement. Statistical analyses were performed to determine the differences between vision charts. Results A total of 113 children enrolled, but only 38 children completed the examinations. The mean age of subjects was 50.5 (SD 6.4) months. Overall, subjects’ mean VA was 0.29 (SD 0.18) for Lea symbols and 0.37 (SD 0.14) for Tumbling E. The mean difference of VA between Lea symbols and Tumbling E was 0.07 (SD 0.22) logMAR units, with upper and lower limits of agreement at 0.36 and 0.51, respectively. There was no statistical difference in VA score using Lea symbols and Tumbling-E based on gender and age. Conclusion Most preschool children in our study have normal visual acuity. Lea symbols and Tumbling E chart are comparable and can be used to efficiently measure VA in preschool children.
Screening Kesehatan Mata Anak pada Komunitas Kusta dalam Era Pandemi Covid-19 Yunia Irawati; Julie Dewi Barliana; Hindun Zakiyah; Hisar Daniel; Made Susiyanti
Media Karya Kesehatan Vol 5, No 1 (2022): Media Karya Kesehatan
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/mkk.v5i1.33560

Abstract

Indonesia masih merupakan negara endemis kusta terbanyak ketiga didunia. Tim KATAMATAKU telah melakukan program kesehatan pada penderita kusta dan komunitasnya selama tiga tahun terakhir. Sebagai generasi penerus bangsa, kesehatan mata anak di lingkungan tersebut perlu diperhatikan. Deteksi gangguan mata anak dan tatalaksananya harus sedini mungkin dilakukan. Pandemi Covid-19 di Indonesia berdampak pada banyak aspek. Pembelajaran dengan system daring/online membuat anak menatap layar digital lebih lama sedangkan kegiatan diluar rumah dibatasi, hal ini meningkatkan gangguan penglihatan. Pemeriksaan kesehatan mata anak di Indonesia masih jarang dilakukan secara rutin. Tujuan dari pengabdian masyarakat ini adalah untuk mendeteksi gangguan mata pada anak di lingkungan sosio-ekonomi rendah, komunitas kusta, Tangerang saat pandemi covid 19. Metode pelaksanaan kegiatan dengan penelusuran riwayat kesehatan, pemeriksaan ketajaman visual dengan chart dan autorefraktometri, segmen anterior, dan segmen posterior. Pemeriksaan dilaksanakan 12-13 Desember 2020 melibatkan total 103 anak dengan median usia 11 (4 - 18) tahun. Rasio laki-laki dan perempuan adalah 1: 1,2. Mayoritas anak yang terpapar digital screen time lebih dari 2 jam perhari sebesar (80/103, 77.7%) dengan (11/103, 10.7%) anak mengalami gangguan refraksi.  Waktu menatap layar gadget yang lama, seringnya melihat dalam jarak dekat dan kegiatan diluar ruangan yang kurang, dapat berpotensi meningkatkan progresivitas gangguan refraksi. Meskipun dengan banyak keterbatasan karena pandemi, screening kesehatan mata anak tetap perlu dilakukan dengan melakukan modifikasi kegiatan sesuai protokol kesehatan. Kegiatan ini diharapkan dapat meningkatkan pemahaman anak dan orang tua terkait pentingnya pemeriksaan mata pada anak secara rutin sejak dini dan dapat menjadi contoh pelaksanaan skrining kesehatan di masa pandemi. Kata kunci: COVID-19, daring, digital screen time, tajam penglihatan
The Prevalence of Myopia and its Associated Factors Among School-Aged Children in Pamijahan Village, Bogor District Julie Dewi Barliana; Yeni Dwi Lestari; Ghina Fedora; Laura Agnestasia Djunaedi; Anthea Casey; Tri Rahayu; Ratna Sitompul; Andi Arus Victor; Saleha Sungkar
eJournal Kedokteran Indonesia Vol 11, No. 1 - April 2023
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.11.210.3

Abstract

Globaly, the prevalence of refractive errors, especially myopia in children, has increased significantly. The cause of myopia is multifactorial. Near-work activities and family history are some suggested factors associated with myopia. However, there has not been enough data on these factors and their association with myopia in Indonesia. This study aims to determine the prevalence and factors associated with myopia in primary and middle schoolaged children in Pamijahan Village, Bogor District, West Java, Indonesia. Data were taken in a cross-sectional design based on the visual acuity, anterior and posterior eye examination. A 14-item questionnaire regarding myopia-associated factors including family history, playing outdoors, and near-work activities, was distributed to the subjects. The data were taken from June to September 2018. Analysis was conducted using SPSS version 20. The prevalence of myopia in Pamijahan Village is 4,9% out of 474 subjects. Family history, including parental (p=0.001, OR 4.49) and sibling history (p=0.001, OR 5.58), was shown to be associated with the increasing risk of myopia in children while near-work activities and playing outdoors were not associated with myopia in children of Pamijahan Village.
Prediction Errors and Accuracy of Intraocular Lens (IOL) Calculation Formulas in Pediatric Eyes Fitri Muslim; Julie Dewi Barliana
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.v46i2.100096

Abstract

Background: Acquiring an accurate intraocular (IOL) power in children undergoing cataract surgery is challenging. Different IOL calculation formulas in children have been previously studied to achieve a precise prediction of the IOL power. Larger errors in IOL formula predictions have shown in several studies on children as future growth of the eye affects the keratometry readings and axial length. Prediction error (PE) and absolute prediction error (APE) can be effective indicators in assessing the accuracy of IOL power calculation formulas. Therefore, this review aims to investigate the accuracy of IOL power calculation formulas in pediatric eyes by measuring PE and/or APE value. Methods: A comprehensive search was conducted from various electronic databases (Pubmed, Clinical Key, and Ophthalmology Advance) using relevant search terms. Included studies were screened using predefined inclusion and exclusion criteria to identify comparative studies comparing the accuracy of IOL calculation formulas in pediatric patients. Result: Ten studies including 964 eyes were identified to compare different IOL formulas: Hoffer Q, SRK/T, SRK II, Holladay 1, and Holladay 2. Smaller prediction error is related to better postoperative refraction. Among included studies, Holladay 2 had the smallest mean prediction errors (PE), while SRK/T formula was the best formula of all included studies in pediatric patients as it had the smallest mean absolute prediction errors (APE). Hoffer Q also had the smallest mean APEs in shorter eyes (axial length <22 mm). Conclusion: This study demonstrates that none of the established formulas found to be more superior than any other formulas in predicting IOL power in children. Biometry examination in patients with less than one year of age tends to show a lower accuracy.
Optical Iridectomy as An Alternative Clear Visual Axis for Peters Anomaly Laura Agnestasia; Julie Dewi i Barliana
Majalah Oftalmologi Indonesia Vol 47 No 1 (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.v47i1.100164

Abstract

Introduction and objective: Peters anomaly is a rare congenital disease presented with central leukoma, iridocorneal adhesion, and with or without a cataractous lens. The presence of central leukoma will block the visual axis and lead to a disruption in normal visual development. Therefore, optical iridectomy, which can overcome the high incidence of graft failure in penetrating keratoplasty (PK), has been proposed as the alternative treatment to clear the visual axis. This study aims to show the outcome of optical iridectomy in patients with Peters’ anomaly. Method: Systematic literature searched in Pubmed, Google Scholar, and Cochrane from their inception to August 2020 was conducted using keywords “iridectomy” and “Peters’ anomaly”. Full- text articles in English that report the outcome of iridectomy in Peters’ anomaly were included, and a manual review of article bibliographies was done. Outcome measures were analyzed using the following clinical questions: indication, age, visual acuity (VA), and intraocular pressure (IOP). Result: One case series and two case reports demonstrating the use of optical iridectomy in Peters anomaly were identified. In total, 26 patients aged one week to 7.7 years received optical iridectomy to establish a clear visual axis. All studies showed an improvement in visual acuity through clinical findings, and one of the studies showed a better postoperative VA in bilateral cases. Studies showed good control of IOP. Conclusion: Optical iridectomy can be used as a safe procedure to improve visual acuity in Peters anomaly patient.
Efficacy of Intravitreal Anti Vascular Endothelial Growth Factor Injection Compared to Focal Therapy in Pediatric Patients with Coats Disease Alia Nesa Utami; Julie Dewi Barliana
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.v48i2.100602

Abstract

Introduction: Coats disease is a retinal vascular disorder that may lead to progressive exudative retinal detachment. The standard regiment of treatment is focal therapy. However, its effectiveness may decrease when more than two quadrants of the retina exhibit vascular abnormalities. Thus, recent studies tried to use anti vascular endothelial growth factor (anti-VEGF) as therapy for the vascular problems. Aims: Comparing the efficacy between anti-VEGF injection and standard therapy regiment such as focal laser therapy. Methods: Literature searching was conducted through PubMed, ScienceDirect, Google Scholar, ProQuest, and SpringerLink. Search terms included "Coats’ Disease" and mesh terms of “Anti- VEGF". The efficacy is assessed based on Best-Corrected Visual Acuity (BCVA) and improvement in fundus manifestations. Results: All of the studies that conducted primary intravitreal anti-VEGF treatment were followed by necessary ablative treatment. These studies, such as by Yang Q and Zheng XX, et al. showed remarkable improvements in both visual acuity and anatomical outcomes. Laser therapy also gained satisfactory result in upgrading clinical stages, even though some complications including subretinal fibrosis, cataract, and vitreous hemorrhage were reported. A comparative study by Ray R, et al. noted that group undergoing anti-VEGF might require longer treatment sessions despite possible benefits. Conclusion: Anti-VEGF agents can be used as neoadjuvant in standard therapy. It did not reduce the time for full treatment, but the resolution of disease was seen in the most severe cases treated with combination therapy.
Nocturnal Lagophthalmos in Pediatric Patient with Hydrocephalus: Poster Presentation - Case Report - Resident IZZA ZUKHRUFIA; Yunia Irawati; Julie Dewi Barliana
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/egvmc937

Abstract

Introduction : Nocturnal lagophthalmos is a physiologic and asymptomatic condition observed in 1.4-5% of the population. In unconscious patients, using mechanical ventilation and neuromuscular blocker medication can worsen the lagophthalmos, causing the patient to have exposure keratopathy. This report aims to emphasize the importance of eye care in unconscious patients. Case Illustration : A 5-year-old girl came with a chief complaint of a whitish lesion on the right eye. She got the lesion when hospitalized in Pediatric Intensive Care Unit for two weeks due to seizure attacks. A red and watery eye accompanied the whitish lesion. The patient had history of nocturnal lagophthalmos and Dandy-Walker syndrome, a complex malformation characterized by agenesis or hypoplasia of the vermis and cystic enlargement of the fourth ventricle. The corneal ulcer was treated with antibiotic treatment. After several visits, her infection had subsided but left a corneal cicatrix on her right eye. Discussion : In unconscious patients, it’s important to pay attention to the eyelid. Lagophthalmos can be divided into three groups; where grade 1 has complete eyelid closure; grade 2 has conjunctival exposure; and grade 3 has corneal exposure. It’s important to lubricate the eye in each grade and keep it closed using eyelid tape or cover in grades 2 and 3 to prevent exposure keratopathy. Surgical intervention can be considered when there is a risk of corneal ulcer. Conclusion : Prevention is always better than cure. Establishing standardized eye care in the intensive care unit is crucial to prevent ocular complications and preserve visual acuity.
Imaging Mismatch of Nail in the Eyeball: What’s next? Poster Presentation - Case Report - Resident Christella Caroline; Gladys Kusumowidagdo; Burhana Mawarasti; Michael Hartono; Julie Dewi Barliana; Rio Rhendy; Yunia Irawati; Ari Djatikusumo
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: 10.35749/2payky76

Abstract

Introduction : A retained foreign body (FB) can lead to severe complications, the most devastating of which is eye loss. We present a discrepancy of imaging that resulted in a dilemma in the approach management of a mixed global-adnexal FB case. Case Illustration : A 31-year-old man came to the emergency room with blurry vision for 1.5 hours after a nail hit his right eye (RE). The visual acuity of RE is light perception. Ophthalmological examination revealed a central Y-shaped full-thickness corneal laceration with iris and vitreous prolapse. The lens appeared cloudy, and the posterior segment was difficult to assess. Imaging showed a foreign metal object asa nail in the oculi to intraconal without penetration to the orbital wall. He was planned to undergo FB extraction with corneal laceration repair and aspiration of lens mass irrigation. However, the nail was hard to find intraoperatively because the vitreous and choroid kept coming out. Hence evisceration with DFG was performed. The nail was found more posteriorly and attached to the bone. Discussion : While primary repair is the standard practice for open globe injury, managing retained intraocular metallic foreign bodies is controversial. Imaging such as CT scans can help determine the location of FB and approach management. In this case, imaging showed the FB was in the iris plane and not penetrating the orbital wall, so primary repair and FB extraction were planned. Conclusion : The imaging may not always be accurate in determining the exact location of FB, and the surgical approach may need to be adjusted accordingly.
Effectiveness and Timing of Congenital Nasolacrimal Duct Obstruction Probing: a Systematic Review: Oral Presentation - Observational Study - General practitioner Kharisma Zatalini Giyani; Dewi Alya Winarto; Julie Dewi Barliana
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: 10.35749/5t0yhc19

Abstract

Abstract Introduction & Objectives : Most congenital nasolacrimal duct obstruction (NLDO) cases could resolve spontaneously or only require minimal conservative treatment. In unresolved cases, lacrimal probing is considered a primary treatment; however, no consensus on the best timing to perform probing is available. Therefore, this study aims to compare the effectiveness of immediate probing with deferred probing and to assess the best time to perform primary probing. Methods : A search for relevant literature was performed on four electronic databases: PubMed, Cochrane Library, EMBASE, and Scopus with predetermined keywords. The inclusion criteria consist of systematic reviews, RCTs, and prospective/retrospective studies published between 2013-2023 regarding lacrimal probing as an intervention for congenital NLDO. Results : We included seven studies. Three studies compared immediate and deferred probing, while four focused on the success rate of probing for NLDO at various age groups. Studies suggest immediate and deferred probing had a comparable effectivity in treating NLDO; however, one systematic review suggests immediate probing was superior to deferred probing. Studies also demonstrate that the success rate of probing declines with age. Lacrimal probing performed on NLDO patients under 12 months old had a success rate of more than 80%. Conclusion : Despite findings of comparable effectiveness between immediate and deferred probing, probing performed at a younger age yielded a higher success rate. This suggests that doctors should consider the patient's age at diagnosis to decide between immediate and deferred probing. Further evidence is needed to determine cut-offs for the best time to perform primary probing.
Binocular therapy for amblyopia in children: a systematic review and meta- analysis of randomized controlled trials: Oral Presentation - Observational Study - General practitioner Diajeng Ayesha Soeharto; Abritho Zaifar; Natassha Priscillia Wibowo; Julie Dewi Barliana
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: 10.35749/374nnd84

Abstract

Abstract Introduction & Objectives : Concerns for low compliance and mixed outcomes with conventional deprivation therapy prompt the need to explore new modes of amblyopia treatment. Novel binocular therapy using movies or games may offer comparable outcomes with better compliance, theoretically strengthening the amblyopic eye by enhancing stereopsis. This study aims to elucidate current evidence regarding binocular therapy in comparison to conventional therapy in treating amblyopia in children. Methods : Comprehensive literature search across five electronic databases was conducted using keywords selected a priori. Randomized controlled trials (RCTs) on binocular therapy in children with amblyopia were included and critically appraised using Cochrane risk of bias tool by three reviewers. Primary outcome was improvement of amblyopic eye VA, and a meta-analysis was conducted for quantitative data analysis. Results : We included 16 RCTs eligible for inclusion with a total sample size of 1,520 patients. In comparing binocular therapy to either patching or spectacles, there was no overall significant difference in terms of VA change from baseline. Subgroup analysis suggests binocular therapy may be favorable within 2-4 weeks, although not statistically significant. Albeit subgroup analysis of video-based binocular therapy revealed significant improvement in VA compared to patching (0.39 logMAR, [0.03, 0.74], p = 0.03), yet the same was not found for game-based binocular therapy. Conclusion : Efficacy of binocular therapy as a substitute for conventional therapy in treating amblyopia is not yet substantiated. Further exploration to determine most effective treatment protocol is needed, including strategies to increase adherence. Video-based therapy shows potential for improving outcomes and warrants further investigation.