Primitasari, Yulia
Department Of Ophthalmology, Faculty Of Medicine, Universitas Airlangga/ Dr.Soetomo General Hospital, Surabaya

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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

 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
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

Abstract

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1436.726 KB) | DOI: 10.20473/vsehj.v1i1.2021.10-16

Abstract

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (5082.62 KB) | DOI: 10.20473/vsehj.v1i2.2022.38-44

Abstract

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

Abstract

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.
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

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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

Abstract

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.
CONQUERING THE AMBIGUITY OF OPTIC ATROPHY IN NORMAL TENSION GLAUCOMA: FROM MYSTERY TO MASTERY: Poster Presentation - Case Report - Resident Hakim, Affannul; Komaratih, Evelyn; Nurwasis; Primitasari, Yulia
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/nha7y421

Abstract

Introduction : The dilemma in diagnosing glaucoma often arises when optic atrophy is found alongside nonspecific glaucomatous findings and normal intraocular pressure (IOP), particularly in cases of normal tension glaucoma (NTG). This gray zone often leads to doubt and misdiagnosis. Case Illustration : A 70-year-old man previously diagnosed with idiopathic bilateral optic atrophy complained of blurred vision in both eyes. The visual acuity was 5/5 in the right eye (RE) and hand movement in the left eye (LE). Both eyes had normal IOP, open angles with Sampaolesi lines on gonioscopy, fibrin deposits at pupillary margins, and a large cup-to-disc ratio with baring and peripapillary atrophy on funduscopy. The OCT examination revealed thinning in the ONH-RNFL, ILM-RPE, and GCL-IPL complexes. HFA revealed tunnel vision in RE and general depression in LE. The patient was suspected of having NTG. We performed BMO-MRW (less than 100 ?m in both eyes) and 24-hour ocular perfusion pressure (OPP) measurements (less than 50 mmHg at night) to support the diagnosis. Discussion : The BMO-MRW examination is a new parameter that can help establish the diagnosis of glaucoma. A thin BMO-MRW finding suggests that optic atrophy originates from glaucoma. It is important to perform a comprehensive examination in cases of NTG to identify risk factors and prevent the development of glaucoma. Decreased OPP to less than 50 mmHg and PEX syndrome may be risk factors for NTG. Conclusion : In cases of doubtful optical atrophy, it is important to consider the possibility of NTG by performing a comprehensive examination, including BMO-MRW and twenty-four hour OPP measurements.
ANGLE RECESSION, THE SEQUELA OF EIGHT-BALL HYPHEMA AFTER SPRAYED BY FIRE HYDRANT: A CASE REPORT: Poster Presentation - Case Report - Resident Asti, Annisa Kinanti; Komaratih, Evelyn; Nurwasis; Primitasari, Yulia
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/gkke0y72

Abstract

Introduction : Hyphema results from damage to the blood vessels of the iris or anterior ciliary body after blunt trauma, and in 56–100% of cases can occur angle recession. Case Illustration : A 40-year-old man complaints of pain and blurred left eye after being sprayed by a high-pressure fire hydrant five hours before coming to the emergency room. Visual acuity was 20/20 and hand movement in right and left eye, IOP is 13 mmHg and 18 mmHg in both eyes. Subconjunctival bleeding, conjunctival and pericorneal injections were found with punctate fluorescein test in the left eye. The cornea was edema and the anterior chamber was full of hyphema. Five days after being hospitalized and treated with topical atropine, antibiotics, and steroid in combination with oral tranexamic acid, the visual acuity was 5/6.5 and the hyphema was resolved. The IOP elevated after 1-6 weeks of follow-up in the outpatient clinic then timolol eyedrops were given. Gonioscopy showed widening of CBB, torn iris processus 2 clock hours in the inferior quadrant. The antiglaucoma medication was stopped due to the controlled IOP in the end episode of the treatment. Discussion : Angle recession involves a tear between the longitudinal and circular muscle fibres of the ciliary body. Medication is needed to control the IOP, while surgical management only indicated in cases where medical treatment fails to control the IOP and risk of progressive visual loss. Conclusion : Angle recession can occur after blunt eye trauma with hyphema and IOP control is needed to prevent the development of secondary glaucoma.
The Association Between Glaucoma Severity and Anxiety And Depression in Glaucoma Patients at DR. Soetomo General Hospital, Surabaya, Indonesia Milan Samudera, Raditya Effendi; Komaratih, Evelyn; Konginan, Agustina; Primitasari, Yulia
Jurnal KESANS : Kesehatan dan Sains Vol 5 No 3 (2025): KESANS: International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v5i3.509

Abstract

Introduction: Glaucoma is a chronic progressive disease and one of the leading causes of blindness worldwide. Vision loss due to glaucoma affects not only the physical aspect but also has an impact on the patient’s mental health. Poor mental condition may influence the success of therapy and reduce the patient’s quality of life. Objective: The objective of this study is to examine the association between the severity of glaucoma and anxiety and depression in the Eye Outpatient Unit of RSUD Dr. Soetomo Surabaya, Indonesia. Method: A cross-sectional study was conducted involving 50 glaucoma patients at the Ophthalmology Outpatient Unit of Dr. Soetomo General Hospital, Surabaya. Mental health status was assessed through interviews using the Hospital Anxiety and Depression Scale (HADS). The Spearman’s rho correlation test was applied to evaluate the association between glaucoma severity and the presence of anxiety and depression. Result and Discussion: Primary Open-Angle Glaucoma (POAG) was the most prevalent type, and most cases were bilateral. Statistical analysis demonstrated a significant correlation between glaucoma severity and anxiety (r = 0.599), between glaucoma severity and depression (r = 0.520), and also between anxiety and depression (p = 0.001). Conclusions: The severity of glaucoma is related to anxiety and depression