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CASE REPORT WAARDENBURG SYNDROME TYPE I WITH IRIS AND RETINAL COLOBOMA Atina Yustisia Lestari; Reni Prastyani
Jurnal SainHealth Vol 4, No 1 (2020): Maret 2020
Publisher : Faculty of Health Sciences Universitas Maarif Hasyim Latif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51804/jsh.v4i1.703.8-10

Abstract

We present a rare case report, Waardenberg syndrome type I, and ocular abnormalities related to the disease. A Boy, 11 months, presented with blue and hole in inferior iris. Patien also controlled to pediatric and ENT departement according his global developmental delayed, and unresponsiveness to sound stimulus since birth. Patient presented with distophia cantrorum, bilateral iris coloboma, brilliant blue iris, and retinal coloboma. Others systemic condition were skin hypopigmentation, bilateral sensorineural hearing lost, and global developmental delay equal to 6 months old baby. According to manifestations, this supporting diagnosis for Waardenberg syndrome type I. The management consists in treating the symptoms accordingly.  Careful follow up and work up is important to improve patient quality of life 
Penetrating Ocular Injury Management in Intraocular Foreign Body (IOFB) and Traumatic Cataract Nerissa Tamara Putri; Muhammad Firmansjah; Reni Prastyani
Folia Medica Indonesiana Vol. 58 No. 3 (2022): September
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (841.894 KB) | DOI: 10.20473/fmi.v58i3.12513

Abstract

Highlight: The management of penetrating ocular injury with IOFB and traumatic cataracts needs a thorough examination of the mechanism of injury, location, size, and composition of IOFB. Endophthalmitis, retinal detachment, and development of PVR are potentially vision-threatment.   Abstract: Most IOFB are metallic and found in males of productive age as a consequence of work-related accidents. A 45-year-old man complained of sudden blurred vision in the left eye (3/60 pinhole 5/12) after getting hit by a foreign body when cutting grass with a lawn mower. Anterior segment examination revealed a 10 mm long, one-plane, straight, full thickness, already sutured inferonasal corneal laceration, inferonasal traumatic iridectomy size 3x7 mm, and opaque lens. Head CT-scan revealed opacity with metallic density intraocularly. Ultrasonography revealed an echogenic lesion, particle-shaped with 100% RCS complex density, located at the inferonasal of the vitreous cavity. Focal laser photocoagulation was performed preoperatively because there was a tear at the superonasal of the retina. The patient underwent cataract extraction, intraocular lens implantation, vitrectomy, and IOFB extraction in a one-step procedure. IOFB was found at the inferonasal side of a vitreous cavity with size 3 x 1 mm, metallic, and not attached to the retina. Silicon oil tamponade was used as a precaution because there were retinal tears. Postoperatively, the left eye's visualacuity was 5/20. After 6 months, the silicon oil was evacuated and the visual acuity became 5/8.5.
SURGICAL OUTCOME OF THREE MUSCLES SURGERY IN ONE SINGLE PROCEDURE OF LARGE-ANGLE EXOTROPIA: A CASE REPORT: Poster Presentation - Case Report - Resident Anas Jatikusuma; Reni Prastyani
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: 10.35749/9r4c5228

Abstract

Introduction : The management of large-angle horizontal strabismus poses special difficulties. Literature has outlined large-angle strabismus in a variety of ways. A threshold of 40 to 60 PD has been employed to determine large-angle strabismus. Case Illustration : A 19-year-old male with complaint of right eye that had been crossed outward since he was 12 years old. There was 90 prism diopter exotropia in near, distance, upgaze, and downgaze. The patient underwent bilateral lateral rectus recession of 10 mm and unilateral medial rectus resection of 6.5 mm in the right eye. Post-operative outcome revealed orthophoria without any misalignment of prism diopter examination in 1 day, one week, and two weeks follow-up. Discussion : When the deviation exceeds 50 prism diopter, there is no established consensus regarding the number and quantity of extraocular rectus muscles for surgery. The lack of uniform criteria and suggested surgical dosage is the greatest obstacle in using three muscles surgery. In this case, we used surgical dose according to Kenneth Wright exotropia binocular surgery table. We performed bilateral rectus lateral recession of 10 mm and a right rectus medial resection of 6.5 mm. This surgical dose gives good outcome. Moreover, this option can leave one horizontal rectus muscle unharmed. Conclusion : Determination of the surgical dose is essential in the management of large-angle exotropia. Appropriate surgical dose results in excellent outcomes with low risk of residual deviation.
LARGE V PATTERN EXOTROPIA WITH BILATERAL INFERIOR OBLIQUE OVERACTION AND ITS CHALLENGING MANAGEMENT: Poster Presentation - Case Report - Resident Amelia Rahmah Kartika; Reni Prastyani
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/hhv5ax77

Abstract

Introduction : V pattern exotropia is a strabismus pattern with greater divergence in upgaze than downgaze. Various surgical treatment options were defined. This report demonstrates the management of largeV pattern exotropia with bilateral inferior oblique overaction (IOOA) by performing multiple surgeries. Case Illustration : A 20-year-old male came with a chief complaint of squinting eyes outward in both eyes since 9 years old. There was 90 PD exotropia in upgaze, 70 PD in primary gaze, 50 PD in downgaze. Bilateral IOOA grading was +3. Management in this patient was bilateral rectus lateral recession with partial hang back technique 11 mm and inferior oblique anteriorization of both eyes 1 mm posterior to inferior rectus muscle insertion. The IOOA on both eyes was eliminated post-operative, but there was 30 PD residual exotropia. The second step will be bilateral medial rectus resection. Discussion : A large V pattern with IOOA is challenging for management because it requires surgery of 2 muscles for each eye. The lateral rectus and inferior oblique muscles are close, so it was advantageous to operate simultaneously. Large exotropia requires surgery on many muscles, however operating on more than two muscles in one eye at a time can cause anterior segment ischemia. Therefore, bilateral medial rectus resection for residual exotropia will be done at different times. Conclusion : Large V pattern exotropia with inferior oblique overaction is a challenging case to manage. Due to its complex nature, it is advantageous to operate adjacent muscles.
Binocular Diplopia in Miller Fisher Syndrome Pediatric Patient: A Rare Case Report: Poster Presentation - Case Report - Resident Dinda Zhafira; Reni Prastyani; Prastiya Indra Gunawan; Riza Noviandi; Sunny Mariana Samosir
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: 10.35749/36zz6w74

Abstract

Introduction : Miller Fisher Syndrome (MFS) is a rare variant of Guillain-Barré syndrome that usually presents with ataxia, areflexia and ophthalmoplegia. It is more common among patients in their 40s and number of cases in pediatric patients is significantly smaller. Our objective is to report a rare case of diplopia in Miller Fisher. Case Illustration : An 11 years old boy came with complaint of double vision and history of gaze restriction. Patient had history of inpatient admission due to acute progressive generalized limb weakness and walking difficulty followed by respiratory failure. Patient also had history of chewing and swallowing difficulty. Inpatient treatment included intravenous immunoglobulin (IVIG) for 5 days which resultedin clinical improvement. Electromyography examination done while hospitalization showed normal results. Orthoptic examination revealed 15 degrees exotropia of left eye with 30 prism dioptres (PD) at near and far distance. Worth four dot test resulted in cross diplopia with no abnormality in head CT scan. After 2 months follow-up with push-up pencil exercise, patient showed improvement of symptoms. Discussion : MFS is a clinical diagnosis that can be assessed by clinical triad of ataxia, areflexia and ophthalmoplegia. Diagnosis can be supported by ancillary test such as cerebrospinal fluid analysis, electrophysiologic studies or antibody anti-GQ1b . Treatment of MFS are mainly for supportive care with respiratory support and immunotherapy if needed in severe cases. Conclusion : The outcome of MFS is usually good with a complete recovery. The improvements generally begin within two to four weeks after the onset of neurological symptoms and complete within six months.
A GOOD RESULT IN COMBINATION OF LARGE SUPERIOR RECTUS RECESSION AND PRISMATIC GLASSES IN UNILATERAL DISSOCIATION VERTICAL DEVIATION: A CASE REPORT: Poster Presentation - Case Report - Resident Nur Fitriana Corprianti Marchilia; Reni Prastyani
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/wgjfj090

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Introduction : Severe DVD is one of the indications for surgery. There are guidelines recommended for management based on grading of severity and the surgeon’s preference. Large recession of superior rectus muscle and prismatic glasses yield good result in unilateral DVD reported in this paper. Case Illustration : A 21 year-old student stated difficulty in working with his microscope since 2 years ago. He had a history of double vision since childhood. The visual acuity in both eyes were 5/5. Qualitative strabismus examination resulted in hypertropia RE and intermittent exotropia. When the occluder was removed from RE, a non fixating eye would appear elevated and did not correspond with the contralateral eye hypotropia. Krimsky test revealed RE hypertropia 30? PD, exotropia 10? PD. Sensory evaluation using WFDT was normal in near and crossed diplopia in distance. Patient diagnosed with unilateral DVD then underwent superior rectus recession in 10 mm. The following month, patient was still experiencing vertical diplopia. The patient was given 3 PD prismatic glasses. Consequently, diplopia was absent and stereoacuity test using TNO was 480 seconds of arch Discussion : DVD can’t be fully corrected by surgery due to central cortical innervational problem. The residual symptom can be corrected by conservative management. Large SR recession in combination with prismatic glasses was found to improve vertical deviation and reduce diplopia. Conclusion : While large superior rectus recession can significantly improve vertical deviation, it can not completely remove binocular symptom
Faktor Risiko Computer Vision Syndrome (CVS) pada Mahasiswa pada Masa Pandemi Covid-19 Safaryna, Alifia Merza; Kurniawati, Dian Prasasti; Syahrul, Fariani; Prastyani, Reni
Media Gizi Kesmas Vol 12 No 1 (2023): MEDIA GIZI KESMAS (JUNI 2023)
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mgk.v12i1.2023.200-206

Abstract

Background: Sophisticated technology provides many conveniences for humans, as well as education that cannot be separated from it, especially during this COVID-19 pandemic in which the learning methods are carried out online. This is what causes the intensity of using a computer or laptop to increase so that it can trigger the occurrence of visual impairment, namely Computer Vision Syndrome (CVS). There is no definite data regarding CVS and CVS research on university students, especially in Surabaya, is still very small. Objectives: This study aims to analyze the risk factors for CVS among college students during the COVID-19 pandemic. Methods: This research was analytic observational research with a cross-sectional research design. This research was conducted from December 2020 to June 2021. The sampling method used was a systematic random sampling addressed to 249 Public Health undergraduate students from the second, fourth, and sixth semesters. The instrument used was CVS-Q with additional questions related to respondent identity, medical history, and computer-usage behavior. Furthermore, the data were analyzed by calculating the Odds Ratio (OR) with a 95% confidence interval (CI). Results: Gender (OR = 2.54) and a history of eye disorders (OR = 4.01) were risk factors for Computer Vision Syndrome (CVS) in S1 Public Health Science students. Conclusions: This research shows that the risk factors for CVS are gender and a history of eye disorders. The students who use computers with high intensity should take CVS precautions, such as applying the 20-20-20 rule, using anti-radiation glasses, adjusting the brightness of the computer screen, adding an anti-glare on the computer screen, avoiding working in a dark room, and performing an ergonomic body position when using a computer.
Significant Role of Thyroid Stimulating Hormone in the Clinical Activity Score of Thyroid Eye Disease at a Tertiary Hospital in Surabaya, Indonesia Hasna Shahida Amatlulloh; Delfitri Lutfi; Soebagijo Adi Soelistijo; Reni Prastyani; Muhammad Valeri Alhakiim
Folia Medica Indonesiana Vol. 60 No. 1 (2024): March
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/fmi.v60i1.52948

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Highlights:1. This study, conducted at a tertiary hospital, was the first to analyze the correlation between thyroid status and clinical activity score in thyroid eye disease.2. This study offers valuable information regarding the crucial role of thyroid stimulating hormone (TSH) in determining the clinical activity score of thyroid eye disease.   Abstract Thyroid eye disease is an autoimmune disorder characterized by inflammation of the orbital and periorbital tissues. This condition can lead to vision impairment, which is a notable manifestation of thyroid disease. The symptoms of thyroid disease reflected the level of inflammatory activity, whereas the clinical activity score was indicative of active and inactive phases. This retrospective analysis explored the intricate association between thyroid status and clinical activity score in thyroid eye disease patients, with the hope of providing a foundation for further research on the association between thyroid status and the occurrence of TED. This study utilized medical records from the years 2019 to 2022 from the Outpatient Department of Ophthalmic Oncology of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. The variables examined in this study were thyroid status and the clinical activity score of thyroid eye disease. The statistical analysis was performed using Phi and Cramer's V as well as Spearman's correlation test (p<0.05). A total of 88 patients were diagnosed with thyroid eye disease during the study period. Thyroid eye disease primarily affected female patients (58%) and those who had a mean age of ≥41 years (58%). The Phi and Cramer's V analyses indicated no significant association (p > 0.05) between thyroid status and clinical activity score in thyroid eye disease patients. Intriguingly, the results exhibited the presence of euthyroidism as well as both overt and subclinical hypothyroidism and hyperthyroidism, regardless of the clinical activity score. Additionally, the Spearman test that incorporated the levels of thyroid hormones, i.e., triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH), and free thyroxine (FT4), showed a significant negative correlation (p<0.05) between TSH and clinical activity score. In conclusion, THS plays a crucial role in determining the clinical activity score of thyroid eye disease patients. This study underscores the imperative for further research to comprehensively elucidate the intricate correlation between TSH and clinical activity score.
Pengaruh Pengingat Elektronik dalam Meningkatkan Pemeriksaan Mata Retinopati Diabetik: A Meta-Analysis Aghnaita, Safira; Prastyani, Reni; Rochmanti, Maftuchah
Jurnal Manajemen Kesehatan Yayasan RS.Dr. Soetomo Vol 8, No 2 (2022): JMK Yayasan RS.Dr.Soetomo, Kedua 2022
Publisher : STIKES Yayasan RS.Dr.Soetomo

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (553.12 KB) | DOI: 10.29241/jmk.v8i2.988

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Pemeriksaan mata rutin diperlukan untuk melakukan penanganan dini. Promosi kesehatan yang tepat merupakan kunci peningkatkan pemeriksaan mata rutin. Salah satu promosi kesehatan yang dapat diterapkan yaitu dengan memanfaatkan media komunikasi elektronik ponsel. Metode telaah sistematis dan meta-analisis digunakan dalam penelitian ini, pelaporan mengacu pada diagram alur PRISMA 2020. Pencarian sistematis dilakukan secara daring di pangkalan data Scopus, ProQuest, Web of Science, EBSCO Host (CINAHL Plus), SAGE, Science Direct, PubMed, dan ClinicalTrials.gov registry, 8.782 artikel ilmiah relevan ditemukan. Penapisan artikel ilmiah dilakukan dengan bantuan web-application rayyan.qcri terhadap artikel duplikat serta artikel yang tidak memenuhi kriteria inklusi maupun kriteria eksklusi. Penilaian kritis studi dilakukan dengan EPHPP Quality Assesment Tool for Quantitative Studies, menghasilkan penilaian kuat pada delapan studi, penilaian moderat pada tiga studi dan penilaian lemah pada dua studi. Sintesis dan meta-analisis dilakukan pada sebelas studi dengan software Review Manager 5.4 menghasilkan tabel karakteristik studi, analisis Random Effect Models dengan overall RR 1,43 (1,23-1,66), p<0,00001, I2= 0,87, forrest plot serta funnel plot. Tingginya heterogenisitas pada studi ini terjadi karena perbedaan wilayah studi yang diteliti, yang justru menunjukkan bahwa studi ini dapat diterapkan secara umum. Studi ini menyimpulkan bahwa pengingat elektronik terbukti secara signifikan meningkatkan pemeriksaan mata rutin dalam upaya pencegahan penyakit retinopati diabetik.
Predictors of Success in Horizontal Strabismus Surgery: Insights from a Prospective Study Tjujitno, Aurellia Valmai; Prastyani, Reni; Susanto, Joni; Loebis, Rozalina; Indriaswati, Luki; Wulandari, Lely Retno
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.V16I12025.57-62

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Highlights: The younger age and shorter duration of misalignment are significant predictors of success in horizontal strabismus surgery. Younger patients tend to have higher success rates, and shorter durations of misalignment correlate with better surgical outcomes. Despite variations in population and surgical methods, the overall success rate of 82.3% for horizontal strabismus surgeries aligns with previous studies. This consistency underscores the reliability of surgical outcomes in different settings.   Abstract Introduction: Strabismus is an eye disorder characterized by misalignment of the eyes, which can occur in individuals of any age. This study explored the surgical outcomes of horizontal strabismus correction in patients, aiming to provide insights into the factors influencing success. Methods: A prospective study was conducted with 17 patients (n=17) who underwent surgery at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Preoperative factors, including age, duration of misalignment, and preoperative angle of strabismus, were analyzed for their impact on surgical success. The International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) for Macintosh version 27.0 was used for data analysis. Results: This study reviewed the medical records of 17 research samples (n=17). A significant change in the median angle of deviation prism diopters (PD) preoperatively was indicated by the median Postoperative Deviation (PD) (p<0.001). A significant difference in median age at surgery was observed between successful and unsuccessful cases (p=0.035), with younger individuals exhibiting a higher success rate. The duration of misalignment emerged as a crucial factor, with a shorter duration correlating positively with a higher probability of surgical success (p<0.001). Notably, successful outcomes were achieved by all children (100%), suggesting a potential trend indicating age as a predictor of success. While the preoperative angle of strabismus did not significantly impact success, a trend emerged (p=1), indicating a potential threshold effect for more significant angles. Conclusion: Knowing the significance of age and duration of misalignment on the success rate of strabismus surgery allows for enhanced preoperative assessments, optimized timing of surgery, and developed predictive models to assist in clinical decision-making, ultimately leading to more efficient and successful surgical outcomes.