Devi Azri Wahyuni
Department Of Ophthalmology, Faculty Of Medicine, Universitas Sriwijaya Mohammad Hoesin Hospital, Palembang, South Sumatera

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Journal : Ophthalmologica Indonesiana

Visual Field Defect in Pulmonary Tuberculosis Patients with Ethambutol Therapy Agus Nugroho; Devi Azri Wahyuni
Majalah Oftalmologi Indonesia Vol 42 No 3 (2016): 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.v42i3.95

Abstract

Background: Ethambutol (EMB) is important as antimicrobal in the treatment of pulmonary TB which effects ethambutol toxic optic neuropathy (EON). EON can be detected with visual field examination. Research by Vimla Menon stated that toxicity condition of EMB obtained visual field defects by 7.69%. Currently, there is no data on visual field defects in patients with TB treated with (EMB) in Mohammad Hoesin Hospital (RSMH).Methods: This was a cross-sectional observational study with a follow-up studies without controls. The samples of this research was 24 and samples taken consecutive. Visual field examination using the Humphrey Field Analyzer was performed three times: before therapy, 1 month, and 2 months after EMB therapy. Data that can be carried out were analyzed by using SPSS program. Results: Average MD before administration of EMB was -2.36±1.21; average MD after 1 month administration of EMB was -2.35±1.41; and 2 months after was -3.09±1.85. There was a mean change of -0.73±1.43 MD 2 months after EMB administration. Abnormal MD enhancement of 6.52% occured 1 month after EMB administration and 28.26% 2 months after EMB administration. Arcuate visual field defects obtained 9.3% in 2 months after EMB aministration.Conclusion: There was no significant difference in visual field examination on the object before therapy and 1 month after EMB therapy. Examination after obtaining EMB for 2 months, based on the mean deviation of visual field defects, were minimal to moderate; while based on gray scale picture was obtained arcuate visual field defects.  Keywords: ethambutol, EON, visual field defect
The Alteration Visual Field Defect in Ischemic Stroke Patients After Three Months Therapy Frida Lestari; Devi Azri Wahyuni
Majalah Oftalmologi Indonesia Vol 42 No 3 (2016): 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.v42i3.99

Abstract

Background: Ischemic stroke are lack of blood flow to the brain and it could influence the visual field. Approximately more than half of the ischemic stroke patient have visual defect.Objective : Disturbance of blood flow on visual pathway have impact to the visual field defect.  In stroke ischemic patient, recirculation of penumbra at the brain on the third months after onset can  rehabilitate the visual pathway, also it will improve the outcome of visual filed defect. So it could be initial detection for rehabiltation of visual field defect.Methods: This study was intended to compere visual field defect of ischemic stroke patient after three months therapy conducted form September 2014 - February 2015 in Mohammad Hoesin General Hospital Palembang. A total of 12 patients who met the inclusion criteria were recruited by consecutive sampling. All patients were endure based on ophthalmology and visual field examination using Humphrey Field Analyzer twice. First after relieving from the attack of stroke and second after three months therapy. Measurement of standard have to compare the value of MD, VFI, PSD, PD and pattern visual field defect. Results: There were significant difference in value of MD, VFI, PSD  and PD<0,5% for both eyes on stroke ischemic patients after three months therapy. Almost all variable value were increasing to improvement of defect. The most common type of visual field defect  is homonymous hemianopia. Conclusion: There were improvement in visual field defect in patients with stroke ischemic after three months therapy.  Keywords: Ischemic stroke, visual field defect, penumbra, recirculation of brain, Mean Deviation (MD), Visual Field Index (VFI), Pattern Standard Deviasion (PSD), Pattern Deviation (PD)   
Management of Carotid Cavernous Fistula: a Case Report of Carotid Cavernous Fistula (CCF): Poster Presentation - Case Report - Resident ALAZI; Devi Azri Wahyuni
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: 10.35749/9nk7b453

Abstract

Abstract Introduction : Carotid-cavernous fistula (CCF) is an abnormal connection between the carotid arterial system and the sinus cavernous. Abnormal vascular shunt allowed blood to flow either direct or indirect from the carotid artery into the sinus cavernous. The indications for treatment of CCF are increased ocular pressure, double vision, bruits, severe headache, and severe proptosis resulting in keratopathy due to exposed cornea. Management of CCF include conservative management, endovascular intervention, surgery, and radiology intervention. Case Illustration : A 61 years old female came to the hospital complained redness on both eyes since 6 months ago, the redness in these eyes unrelieved even they had been treated. The patient have history given three types of drugs but there was not improvement. physical examination shown proptosis, injection of episcleral, cloudy lens with LOCSS NC2NO2C1P1 on both eyes, other examination also shown bruit on both eyes, Laboratory results was in normal limit. Funduscopic examination shown tigroid appearance. Discussion : Arterialization of the conjunctival vessels is a characteristic feature of CCF, other than physical examination, patient was planned for CT angiography examination to find external causes of injury assessing ICH and ischemia. Patient got external manual compression of the ipsilateral cervical carotid artery for about 30 to 40 seconds four times per hour several times daily for 4-6 weeks. Conclusion : Although CCF initially can be mistaken for conjunctivitis or episcleritis. Methods of therapy for CCF include conservative management, endovascular intervention, surgery, and interventional radiology. CCF itself is generally not life threatening but requires treatment to prevent worsening of the eye
Neuroophthalmic Manifestations and Management of Cryptococcal Meningitis in HIV-negative Pregnant Woman : A Rare Case: Poster Presentation - Case Report - Resident FARIMAH SYAKIRAH; DEVI AZRI WAHYUNI
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: 10.35749/79h96r51

Abstract

Abstract Introduction : Cryptococcal meningitis (CM) is Cryptococcus infection affecting mostly immunocompromise patients. However, immunocompetent and pregnant woman can also be affected. This condition can cause neuroophthalmic manifestations which may result in permanent vision loss or even death if not managed properly. However, literatures on neuroophthalmic manifestations and management of HIV-negative pregnant woman with CM are very scarce. Case Illustration : We present a rare case of 25 y.o. HIV-negative pregnant woman with neuroophthalmic manifestations associated with CM. The patient was consulted from neurology department with complaints of painless vision loss accompanied by diplopia, severe headache, nausea, and frequent vomitus. Ophthalmological examination showed best corrected visual acuity 20/40 in both eyes, ophthalmoplegia, and grade 4 papilledema. Lumbal puncture result was 89 cmH20. Cerebrospinal fluid (CSF) analysis showed mononuclear cells domination, increased protein, and decreased glucose. Indian ink stain showed Cryptococcus organism. Patient was given intravenous fluconazole, topical nonsteroid anti-inflammatory drug, and therapeutic lumbal punctures which result in clinical improvement. Discussion : CM can cause neuroophthalmic manifestations resulting from increase intracranial pressure (ICP) due to fungal load in arachnoid granulation which obstruct CSF outflow. The manifestations found in this patient were papilledema, ophthalmoplegia, and diplopia due to 6th nerve palsy. The management was multidisciplinary with obstetrics-gynecology and neurology department, focused in pathogen eradication and ICP management to prevent neuroophthalmic sequelae, with considerationof maternal-fetal life saving dilemma. Conclusion : Various neuroophthalmic manifestations can be involved in CM. Prompt and appropriate therapy in a rare case of HIV-negative pregnant woman with CM can decrease both maternal and fetal morbidity and mortality risk.