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SELENIUM SEBAGAI TERAPI OFTALMOPATI GRAVES DERAJAT RINGAN Laura Agnestasia Djunaedi; Ferdy Iskandar; Cisca Kuswidyati
Majalah Kedokteran Indonesia Vol 69 No 8 (2019): Journal of the Indonesian Medical Association Majalah Kedokteran Indonesia Volum
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.1234/jinma.v69i8.190

Oftalmopati Graves (OG) merupakan manifestasi ekstra-tiroid tersering dari penyakit Graves. Sebanyak lebih dari 50% penderita Graves akan mengalami OG, bahkan 10% diantaranya menderita OG derajat berat. Mekanisme terjadinya OG berhubungan dengan reaksi autoimun yang sangat kompleks dan dicurigai juga berhubungan dengan ketidakseimbangan kadar antioksidan serta oksidan di dalam tubuh. Selain itu, faktor lingkungan (rokok) dan juga kontrol yang buruk dari penyakit Graves semakin memicu progresifitas dari oftalmopati.Salah satu komponen antioksidan yang paling banyak terdapat pada kelenjar tiroid adalah selenium. Selenium diharapkan dapat membantu mengatasi OG terutama pada derajat ringan dengan memperbaiki ketidakseimbangan antara kadar oksidan dan antioksidan di dalam tubuh. Namun, pemberian selenium tidak dapat dilakukan secara bebas karena pemberian dalam jumlah yang tidak tepat dapat memicu timbulnya beberapa jenis kanker dan juga diabetes mellitus tipe II.

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

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, subjectsâ€™ 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.

Funduskopi untuk Prognosis Preeklampsia Ferdy Iskandar; Laura Agnestasia Djunaedi; Angela Shinta Dewi Amita; Sigit Pradono Diptoadi
Cermin Dunia Kedokteran Vol. 45 No. 3 (2018): Muskuloskeletal
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v45i3.816

Hipertensi dalam kehamilan (HDK) merupakan masalah kesehatan yang perlu mendapat perhatian karena mengakibatkan lebih dari 25% kematian ibu di Indonesia pada tahun 2013. Pada preeklampsia – yang merupakan salah satu HDK – terjadi disfungsi endotel berbagai organ ibu hamil, termasuk organ mata. Konsekuensi tersering adalah vasospasme umum disertai kebocoran plasma yang menyebabkan iskemi retina hingga kerusakan visus permanen. Derajat kelainan retina ibu hamil berdasarkan klasifikasi Keith-Wagener-Barker berbanding lurus dengan angka kematian serta angka kecacatan penglihatan. Funduskopi sebagai salah satu sarana pelengkap dapat menjadi sarana objektif memperkirakan prognosis ibu hamil dan status janin. Hypertension in pregnancy is a health problem since it causes more than 25% of maternal deaths in Indonesia in 2013. In preeclampsia – type of hypertension in pregnancy – there are endothelial dysfunctions in various organs, including eyes. The most common consequences are general vasospasms with plasma leakage causing retinal ischemia leading to permanent damage. There is a linear correlation between KeithWagener-Barker classification and probability of death and blindness. Funduscopy can be used as a supplementary examination to help decide the best management and may be an objective tool for estimating prognosis of mother as well as fetal status.

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

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.

Indikasi dan Jenis Transplantasi Kornea : Penelitian Retrospektif di RS Mata JEC periode 2014-2018 Sharita R Siregar; Laura A Djunaedi
Majalah Oftalmologi Indonesia Vol 46 No 1 (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.v46i1.100021

Purpose : Corneal disorders leading to corneal blindness was one of the major causes for blindness worldwide. This retrospective study was done to report the indications for corneal transplantation and also the latest surgical technique between lamellar and penetrating keratoplasty at JEC Hospital, Jakarta Indonesia from 2014 to 2018. Methods : Records of all patients who underwent penetrating and lamellar keratoplasties at our hospital between 2014 and 2018 were reviewed retrospectively. Patient demographic data such as age and gender, together with indications and surgical technique of corneal transplantation were recorded and analysed. Results : Pseudophakic bullous keratopathy, corneal scarring post infection, and corneal dystrophy were the most common indications for corneal transplantation in our centre (33.91%; 28%; 16.63%; respectively). In 2014, corneal ulcer was one of the leading causes for complete corneal transplantation (12.5%) but its incidence was decreasing each year. 66.55% of procedures performed were penetrating keratoplasty. However, the shift from penetrating to lamellar procedures such as DSAEK increases significantly since 2007 and even more increased by 2 times within the last 5 years (15.27%; 35%; respectively). Conclusion : The number of keratoplasties in JEC has increased from 2014 to 2018. Since 2007, posterior lamellar keratoplasties have increased and began to create some shift from penetrating to lamellar since then. There was a constant increase number of DSAEK due to donor availability from the new eye bank in 2017. The shorter recovery time after DSAEK seems to contribute to the trend toward earlier operative intervention in corneal endothelial disease. The leading indications for DSAEK was bullous keratopathy.

Uncommon Presentation of Wyburn-Mason Syndrome in a Pediatric Patient Julie Barliana; Syntia Nusanti; Manoa Panjaitan; Anggun Yudantha; Laura Djunaedi
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.v47i1.100146

We report an uncommon presentation of Wyburn-Mason syndrome in a pediatric patient. An 11-year- old girl presenting with no light perception in her right eye. Examination revealed an exotropia and a large and tortuous retina vessel in the posterior part of her right eye. However, other examinations, including dermatological and neurological examination, are within normal limits. Magnetic Resonance Angiography (MRA) showed vascular malformation at the basal cistern that extends to the retrobulbar area. Therefore, a thorough examination of the eye and brain, including MRA, is mandatory in every case, even in pediatric with normal neurological examinations.

Can Optical Coherence Tomography Angiography be a Useful Adjunctive Diagnostic Tool in Patient with Non Arteritic Ischaemic Optic Neuropathy? Poster Presentation - Case Series - Resident Laura Agnestasia Djunaedi; Syntia Nusanti; M. Sidik; Salmarezka Dewiputri; Sita Paramita
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: 10.35749/3zzp0093

Abstract Introduction : Perfusion deficiency of the optic nerve head is presumed to have an immense role in the pathogenesis of non-arteritic ischaemic optic neuropathy (NAION). Optical coherence tomography angiography (OCTA) is a non-invasive method that can assess posterior pole vasculature at multiple levels. Thus, these case series want to compare the OCTA in the acute (before four weeks) and chronic phases (after six weeks) of NAION with their fellow unaffected eyes to give an overview of vasculature changes in NAION. Case Illustration : This case series consists of four patients with NAION. Half of them came with a sudden painless blurry vision, and the remaining presented with an abrupt visual field defect. All of them have diabetes mellitus and hypertension. None of them have superimposed vascular pathology. The first OCTA was taken within seven days of the first symptoms, and the second OCTA was taken more than six weeks after. Discussion : The high percentage of systemic vascular risk factors and the acute onset supported the vascular occlusive hypothesis in the pathogenesis of NAION. Meanwhile, the OCTA provides an actual overview of the vasculature changes. Microvasculature is more likely to expand in the acute phase, and a more significant expansion was found in greater optic disc edema. On the other hand, microvascular tend to attenuate in the chronic phase, representing the pruning of capillaries. A swept-source OCTA with deeper penetration might give a better peripapillary choriocapillaris image in the acute phase. Conclusion : OCTA is a promising adjunctive tool for diagnosing and monitoring progression in patients with NAION.

Funduskopi untuk Prognosis Preeklampsia Ferdy Iskandar; Laura Agnestasia Djunaedi; Angela Shinta Dewi Amita; Sigit Pradono Diptoadi
Cermin Dunia Kedokteran Vol 45 No 3 (2018): Muskuloskeletal
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v45i3.816

Hipertensi dalam kehamilan (HDK) merupakan masalah kesehatan yang perlu mendapat perhatian karena mengakibatkan lebih dari 25% kematian ibu di Indonesia pada tahun 2013. Pada preeklampsia – yang merupakan salah satu HDK – terjadi disfungsi endotel berbagai organ ibu hamil, termasuk organ mata. Konsekuensi tersering adalah vasospasme umum disertai kebocoran plasma yang menyebabkan iskemi retina hingga kerusakan visus permanen. Derajat kelainan retina ibu hamil berdasarkan klasifikasi Keith-Wagener-Barker berbanding lurus dengan angka kematian serta angka kecacatan penglihatan. Funduskopi sebagai salah satu sarana pelengkap dapat menjadi sarana objektif memperkirakan prognosis ibu hamil dan status janin. Hypertension in pregnancy is a health problem since it causes more than 25% of maternal deaths in Indonesia in 2013. In preeclampsia – type of hypertension in pregnancy – there are endothelial dysfunctions in various organs, including eyes. The most common consequences are general vasospasms with plasma leakage causing retinal ischemia leading to permanent damage. There is a linear correlation between KeithWagener-Barker classification and probability of death and blindness. Funduscopy can be used as a supplementary examination to help decide the best management and may be an objective tool for estimating prognosis of mother as well as fetal status.

Selenium sebagai Terapi Oftalmopati Graves Derajat Ringan Laura Agnestasia Djunaedi; Ferdy Iskandar; Cisca Kuswidyati
Majalah Kedokteran Indonesia Vol 69 No 8 (2019): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.69.8-2019-190

Graves ophthalmopathy (GO) is the most common extrathyroid manifestation of Graves’ disease. More than 50% of Graves’ patients will experience it, even 10% of them will suffer severe GO. The mechanism of GO is associated with complex autoimmune reaction and suspected to be associated with an imbalance levels of antioxidants and oxidants in the body. Smoking and poor control of Graves’ disease also trigger the progression of ophthalmopathy.Selenium is one of the most abundant antioxidant components in the thyroid gland. Selenium can help overcome mild GO by correcting the imbalance between oxidant and antioxidant levels in the body. Nevertheless, selenium cannot be given carelessly because improper dosing can lead to the several types of cancer as well as type 2 diabetes mellitus.

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