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THE ROLE OF OCULAR BLOOD FLOW IN THE PATHOGENESIS OF GLAUCOMA Yulia Primitasari; Evelyn Komaratih
Jurnal Kedokteran Syiah Kuala Vol 19, No 1 (2019): Volume 19 Nomor 1 April 2019
Publisher : Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/jks.v19i1.18052

Abstract. Glaucoma is currently the second leading cause of blindness worldwide and the prevalence is expected to increase. Despite lowering of IOP, vascular risk factors, genetics, and other systemic conditions could progress the glaucoma damage. Ocular blood flow has emerged as an increasingly prevalent glaucoma risk factor in large population-based trials. Abnormal perfusion and the subsequent ischemia of the ONH play a major role in the glaucomatous damage. Ocular Blood flow is unstable if IOP fluctuates on a high enough or blood pressure on a low enough level to exceed temporarily the autoregulation capacity. IOP fluctuation is also related to both an increase in scotomas and an increase in diffuse visual fields damage. OBF is unstable if autoregulation itself is disturbed. In glaucoma the response of retinal and optic nerve head blood flow to flicker stimulation is reduced. Primary vascular dysregulation appears to be associated with abnormal retinal neurovascular coupling, because vasospastic subjects show a reduced response to flicker stimulation.Keywords: ocular blood flow, glaucoma

Selection of Medical Therapy in Glaucoma Patients in the Outpatient Eye Clinic Soetomo General Academic Hospital Surabaya Venansya Maulina Praba; Yulia Primitasari; Mohammad Fathul Qorib; Rozalina Loebis
Folia Medica Indonesiana Vol. 57 No. 4 (2021): December
Publisher : Universitas Airlangga

Highlight:Medical therapy selection in the outpatient eye clinic were determined.Treatment of prostaglandin analogue therapyfor primary open angle glaucoma was the most common glaucoma type. Abstract:Glaucoma is the second leading cause of blindness and the third cause of visual impairment. Glaucoma management includes medical therapy, laser, and incisions. This study aims to determine the selection of medical therapy in the outpatient eye clinic Soetomo General Academic Hospital Surabaya. This study was a retrospective descriptive study. The variables were type of glaucoma, visual acuity, intraocular pressure, and drug therapy. Data processing was done by collecting, grouping, and describing data. Glaucoma was mostly common in 50-64 years old (37.66%), male (50.65%), most patients lived in Surabaya (53.68%), the most common type was Primary Open-Angle Glaucoma (32.90%), the most medical therapy given in the first visit in 2019 was single medical therapy (67.97%), the most single drug therapy was latanoprost (49.68%), the most drugs combination was timolol maleat with acetazolamide (35.14%), the most commonly drugs class were prostaglandin analogues (48.48%), most of the visual acuity values were 6/6 - 6/18 (1,00 – 0,33) (37.88%), most intraocular pressure was in the 11-21 mmHg (62.55%). The most common type of glaucoma was primary open angle glaucoma with the most therapy given was prostaglandin analogue.

Selection of Medical Therapy in Glaucoma Patients in the Outpatient Eye Clinic Soetomo General Academic Hospital Surabaya Venansya Maulina Praba; Yulia Primitasari; Mohammad Fathul Qorib; Rozalina Loebis
Folia Medica Indonesiana Vol. 57 No. 4 (2021): December
Publisher : Universitas Airlangga

Highlight:Medical therapy selection in the outpatient eye clinic were determined.Treatment of prostaglandin analogue therapyfor primary open angle glaucoma was the most common glaucoma type. Abstract:Glaucoma is the second leading cause of blindness and the third cause of visual impairment. Glaucoma management includes medical therapy, laser, and incisions. This study aims to determine the selection of medical therapy in the outpatient eye clinic Soetomo General Academic Hospital Surabaya. This study was a retrospective descriptive study. The variables were type of glaucoma, visual acuity, intraocular pressure, and drug therapy. Data processing was done by collecting, grouping, and describing data. Glaucoma was mostly common in 50-64 years old (37.66%), male (50.65%), most patients lived in Surabaya (53.68%), the most common type was Primary Open-Angle Glaucoma (32.90%), the most medical therapy given in the first visit in 2019 was single medical therapy (67.97%), the most single drug therapy was latanoprost (49.68%), the most drugs combination was timolol maleat with acetazolamide (35.14%), the most commonly drugs class were prostaglandin analogues (48.48%), most of the visual acuity values were 6/6 - 6/18 (1,00 – 0,33) (37.88%), most intraocular pressure was in the 11-21 mmHg (62.55%). The most common type of glaucoma was primary open angle glaucoma with the most therapy given was prostaglandin analogue.

Characteristics of Primary Open-Angle Glaucoma Patients in Dr. Soetomo General Hospital Surabaya Sherly Yolanda; Yulia Primitasari; Dewi Ratna Sari
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 12 No. 1 (2021): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V12I12021.6-9

Introduction: This research aimed to describe the characteristics of primary open-angle glaucoma (POAG) patients in Dr. Soetomo General Hospital Surabaya. Methods: This was a descriptive study to determine the characteristics of POAG in 42 patients recruited from Ophthalmology Outpatient Clinic, Dr. Soetomo General Hospital, Surabaya, from March to June 2018. This study was conducted because the epidemiological data about characteristics of patients with POAG in Surabaya are not available yet. Results: The ratio of male and female patients with POAG was 1:1, the largest age group of patients was 55-64 years old (38.10%), in which a few patients had history of hypertension (45.24%). Regression of visual acuity was the most common symptoms along with clinical sign of the patients (78.57%), and the most common location of POAG was both eyes (69.05%). Furthermore, the mean of visual acuity of patients with POAG was 0.38 ± 0.36, and the mean of intraocular pressure of patients with POAG was 22.22 ± 9.24 mmHg. Conclusion: POAG is generally bilateral disease that can occur in men and women with no differences with the largest age group of 55-64 years old, the most common symptom and clinical sign was regression of visual acuity.

A Rare Case of Chronic Primary Angle-Closure Glaucoma in a Young Woman with Coexisting Pathologic Myopia Ni Putu Ayu Reza Dhiyantari; Nurwasis Nurwasis; Evelyn Komaratih; Yulia Primitasari
Vision Science and Eye Health Journal Vol. 1 No. 1 (2021): Vision Science and Eye Health Journal
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga

Introduction: Primary Angle-Closure Glaucoma (PACG) is usually present in adults older than forty and is more common in hyperopic eyes. Angle-closure is usually related to structural or developmental ocular abnormalities in young individuals. Case presentation: We presented a rare case of PACG in a 32 years old woman with pathologic myopia of -23.0 RLE. The chief complaint was blurring of the right eye three months before the visit. Right eye Intraocular Pressure (IOP) was 30mmHg-38mmHg despite treatment with three intra-ocular pressure-lowering agents. Axial length was 32.36 mm and 31.19 mm RLE. Anterior chamber depth was 2.36 mm and 2.60 mm RLE. Lens thickness was 5.07 mm and 5.40 mm RLE. Signs of GON and pathologic myopia were found in both eyes. GON was present asymmetrically (0.9 and 0.6 RLE), with the myopic crescent as well as baring and peripapillary atrophy. The optic disc was slightly tilted with the myopic crescent. There was also a marked sign of retinal pigment epithelium thinning and attenuation along with myopic chorioretinal atrophy. Conclusions: PACG in a young myopic individual is challenging to diagnose because myopia and glaucoma share similar optic nerve head pathology. Comprehensive examinations including gonioscopy, biometry, and OCT may confirm the diagnosis. In the presented case, angle-closure was caused by thick lenses and a shallow anterior chamber, along with excessively long axial length. Primary angle-closure at a young individual with myopic eyes is highly uncommon. Nonetheless, clinicians should always consider glaucoma even in the presence of high axial length and myopic fundus.

The Difficulties of Trabeculectomy in a Primary Angle-Closure Glaucoma Patient Herdina Ramadhani; Nurwasis Nurwasis; Yulia Primitasari; Evelyn Komaratih
Vision Science and Eye Health Journal Vol. 1 No. 2 (2022): Vision Science and Eye Health Journal
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga

Introduction: Trabeculectomy is an incisional surgery for glaucoma patient. Performing trabeculectomy in primary angle-closure glaucoma (PACG) is quite difficult. Caution is needed for the occurrence of flat anterior chamber (FAC) and malignant glaucoma. We present a case management of trabeculectomy in a PACG patient. Case presentation: A 52-year-old male had blurred vision in his left eye since one year ago. The patient felt left visual field narrowing since eight months ago. Patient had type 2 diabetes mellitus. Visual acuity on the left eye was 5/7.5. Intraocular pressure (IOP) increased (29 mmHg). Gonioscopy showed closed angle and peripheral anterior synechiae. Glaucomatous optic neuropathy was found with C/D ratio value of 0.9 and superior-inferior RNFL thinning on optical coherence tomography (OCT). Anterior segment OCT revealed shallow anterior chamber depth (ACD) 2.54 mm. The right eye visual acuity was 5/5, normal IOP, and shallow ACD (2.66 mm). Patient was underwent left eye trabeculectomy. Postoperatively, left eye anterior chamber and bleb were formed. He had normal IOP without glaucoma medications. Conclusions: Trabeculectomy is a surgical procedure for glaucoma. Close monitoring is required to avoid the risk of postoperative FAC and malignant glaucoma in PACG.

Profile of Rhinosinusitis Patients with Orbital Complications at the Ear, Nose, and Throat (ENT) Outpatient Unit, Dr. Soetomo General Academic Hospital, Surabaya, from January 2015 to April 2022 Putri, Made Ayu Rheina; Sutikno, Budi; Primitasari, Yulia; Nugroho, Puguh Setyo
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 16 No. 1 (2025): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V16I12025.50-56

Highlights: Most rhinosinusitis patients with orbital complications were diagnosed as chronic rhinosinusitis. Orbital cellulitis (Chandler II) was the most common orbital complication degree. Rhinosinusitis patients with orbital complications commonly experience eye pain, swollen eyes, and persistent runny noses. Abstract Introduction: Rhinosinusitis is an inflammation of the mucosa of the nasal cavity and/or paranasal sinuses. The most common complication is orbital. The limited data available does not account for the high number of cases of rhinosinusitis. This study examined the profile of rhinosinusitis patients with orbital complications. Methods: This was an observational descriptive study with a retrospective design. It used secondary data from medical records of patients with rhinosinusitis and orbital complications at the Ear, Nose, and Throat (ENT) Outpatient Unit, Dr. Soetomo General Academic Hospital, Surabaya, from January 2015 to April 2022. Results: There were 40 samples that met the inclusion and exclusion criteria (n=40). As many as 80% of cases were chronic rhinosinusitis, and 20% were acute. The average age of chronic rhinosinusitis was in 6th decade, while acute rhinosinusitis (ARS) was in 3rd decade. The majority of patients were males and reside outside Surabaya. Signs and symptoms that ARS patients often experienced were eye pain and swelling, nasal congestion, persistent runny nose, and decreased vision. Meanwhile, chronic rhinosinusitis included eye swelling and pain, persistent runny nose, and facial pain. The most common Chandler’s degree was orbital cellulitis (Chandler II). The most common treatment for ARS was a combination of medicamentosa and non-medicamentosa or medicamentosa and surgery, while chronic rhinosinusitis was a combination of medicamentosa, non-medicamentosa, and surgery. Conclusion: There were outcome differences between patients with acute and chronic rhinosinusitis regarding age, manifestations, and treatments, but there were similarities in sex, domicile, and Chandler’s degree predominance.

Profile of Secondary Glaucoma at a Tertiary Hospital in East Java Komaratih, Evelyn; Rindiastuti, Yuyun; Primitasari, Yulia
Folia Medica Indonesiana Vol. 56 No. 1 (2020): March
Publisher : Universitas Airlangga

Glaucoma is the leading cause of irreversible blindness. The aim of this study was to review the profile of secondary glaucoma cases visiting a tertiary hospital in East Java. This is retrospective observational study, completed case records of new patients with secondary glaucoma who presented to glaucoma clinic from January 2014 to April 2016 were included. Out of the 363 case records screened, 66 cases were found to eligible for inclusion. The evaluation included a detailed history and examination performed including vision, anterior segment examination, intraocular pressure (IOP), gonioscopy, and fundus evaluation. Diagnosis of secondary glaucoma was made on the basis of presence of a secondary cause for presence of raised IOP. 66 cases were eligible for inclusion in the study, most of the cases was occurred in the range age 21-50 years. The male female ratio was 1.3:1. Frequent causes of secondary glaucoma were lens factor 30.8%, steroid induced 29.5%, uveitic 20.5%, neovascular15.4%, and surgical complication 3.8%. Most patients with secondary glaucoma have poor vision < 0.1 with high IOP at presentation. Assessment and early detection of underlying cause is the key guide to treatment strategy.

Bilateral Pigment Dispersion Syndrome (PDS) in a Young Female Patient Karunika, Anindya Ramadian; Komaratih, Evelyn; Nurwasis; Primitasari, Yulia
Vision Science and Eye Health Journal Vol. 4 No. 2 (2025): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v4i2.2025.55-59

Introduction: Pigment dispersion syndrome (PDS) is characterized by pigment accumulation in the anterior chamber and a concave peripheral iris. Many PDS patients are not diagnosed until the disease has progressed to pigmentary glaucoma or other visual problems. Since glaucoma is the primary cause of permanent blindness globally, it is crucial to perform a thorough examination on patients with PDS to identify early indicators of pigmentary glaucoma (PG). Case Presentation: A 17-year-old female presented to the ophthalmology outpatient unit with eye pain and headache. The intraocular pressure (IOP) in the right eye was 30 mmHg, while in the left eye, it was 20.5 mmHg due to the peripheral iris' concavity and heavy pigmentation in the trabecular mesh in both eyes. The patient was diagnosed with pigment dispersion syndrome in both eyes and was given timolol maleate 0.5% eye drops. A follow-up examination revealed a decrease in the IOP and pain. Conclusions: Many young PDS patients go undiagnosed, and those with glaucoma are misdiagnosed as having juvenile onset glaucoma or primary open angle glaucoma. When high IOP is seen in young myopic patients, a thorough evaluation of the anterior segment is required. The patient should be aware of the progression of PG, and regular follow-up is recommended.

CORRELATION OF VISUAL FIELD LOSS TO ACTIVITIES OF DAILY LIVING DISTURBANCE ON GLAUCOMA OUTPATIENTS IN SURABAYA Pryandhini, Pradistya Astri; Primitasari, Yulia; Setiawati, Yunias; Komaratih, Evelyn
The Indonesian Journal of Public Health Vol. 20 No. 2 (2025): THE INDONESIAN JOURNAL OF PUBLIC HEALTH
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijph.v20i2.2025.354-365

Introduction: Glaucoma is known as a thief of sight due to its progressive visual field loss with symptoms typically manifesting only at advanced stages. Visual field loss, particularly peripheral vision, can affect patients’ quality of life (QoL) in performing activities of daily living. Glaucoma cases are predicted to rise by 74% worldwide between 2013 and 2040. Aims: Assess the correlation between the degree of visual field loss and disturbance in activities of daily living in glaucoma outpatients. Methods: A total of 60 patients from Dr. Soetomo General Academic Hospital were interviewed using the NEI VFQ-25 on near vision, distance vision, peripheral vision, social function, driving, and dependency subscales. Visual field loss was assessed using the Humphrey Visual Field Analyzer (HFA) and categorized based on the Hodapp, Parish, and Anderson (HPA) classification using the better-eye mean deviation value. Meanwhile, Spearman’s rank correlation was used to determine the correlation between the patients’ visual field loss and NEI VFQ-25 interview results. Results: Significant moderate correlations were observed between visual field loss and the social function (r = 0.545) and dependency (r = 0.483) subscales. Significant weak correlations were observed in the near vision (r = 0.351), distance vision (r = 0.383), and peripheral vision (r = 0.398) subscales. An insignificant weak correlation was observed in the driving subscale (r = 0.262). Conclusion: Visual field loss in glaucoma patients is associated with impaired performance in activities of daily living, with the severity of limitation increasing in line with the progression of visual field loss.

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