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All Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Ophthalmologica Indonesiana
Ferdy Iskandar
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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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

Abstract

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.
Devastating Mooren Ulcer Halt by Timely Aggressive Treatment - A Case Report: Poster Presentation - Case Report - Resident Florentina Priscilia; Lily Raudah Putri; Annisa Windyani; Ferdy Iskandar; Triana Hardianti Gunardi; Yulia Aziza
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/bdmp6t90

Abstract

Introduction : Mooren ulcer is a progressive and painful peripheral ulcerative keratitis of unknown cause. Study aims to show effective aggressive treatment for Mooren ulcer. Case Illustration : A 43-year-old man was admitted with a marked clinical worsening of the white tissue covering the cornea, accompanied by pain, redness, and blurry vision of the left eye. Initial examination showed visual acuity of 6/21cc. Peripheral corneal ulcer was found from 6 to 2 clock hours with superficial vascularization and epithelial defect. Patient underwent ancillary examinations with unremarkable findings. Patient was diagnosed with Mooren Ulcer and treated with artificial tears and steroid topical. Patient had no significant improvement; therefore conjunctival resection with immunosuppressive therapy were performed. At follow up, no pain was reported, vision improved to 6/15cc, and the ocular surface inflammation resolved. Discussion : Mooren ulcer is usually misdiagnosed since the clinical signs are similar to other differential diagnoses. The examination must be performed carefully to rule out autoimmune and corneal infection. Treatment goals are to halt the destructive process and promote reepithelization. The stepwise aggressive approach of Mooren Ulcer treatments is crucial. It starts directly with topical steroid to control the progression of inflammation. However, when used alone, topical steroid usually cannot prevent the rapid progression so conjunctival resection is needed to remove the source of collagenase production by cutting the perilimbal blood vessels’ access to the area of the ulcer. Combination with an immunosuppressant will effectively maintain a stable condition. Conclusion : Early diagnosis and aggressive treatment for Mooren ulcer are needed to prevent the rapid progression.
Co-Authors Annisa Windyani Cisca Kuswidyati Florentina Priscilia Laura Agnestasia Djunaedi Lily Raudah Putri Triana Hardianti Gunardi Yulia Aziza