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All Journal CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL Vision Science and Eye Health Journal
Lutfi, Delfitri
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Amelanotic Choroidal Melanoma with Extraocular Extension in a 51 Year-Old Female: A Rare Case Ervianti, Octarina; Lutfi, Delfitri
Vision Science and Eye Health Journal Vol. 3 No. 2 (2024): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v3i2.2024.40-44

Abstract

Introduction: Melanoma is a dangerous malignancy primarily involving the choroid, ciliary body, or iris. The most frequent primary intraocular malignant tumor is choroidal melanoma. The tumor most often affects Caucasians of Northern Europe ranging between the ages of 50 and 80. Most choroidal melanomas are pigmented, however, non-pigmented or mixed pigmented and non-pigmented forms can also happen. Compared with other amelanotic choroidal lesions, amelanotic choroidal melanoma showed markedly greater basal diameter, thickness, frequent connection with subretinal fluid, and ultrasonic hollowness. Extrascleral extension is currently detected in 10% to 28% of choroidal melanoma patients, and the mortality rate is much greater than in those without the extension. Case Presentation: We reported a rare case of extraocular extension in a 51-year-old female patient with amelanotic melanoma. The primary complaint was a painful and bleeding mass on her left eye that had developed two months prior to admission. On the conjunctiva of the left eye, there was a solid, palpable mass measuring 4 x 3.5 x 1 cm. It was red, well-defined, and had a hard, solid consistency. It was fixed at the base, had minimal bleeding, and pressed on her eyeball from the inferolateral direction. The cornea appears clear, and there is no light perception in visual acuity. The orbital focus computed tomography scan revealed an Enhancing solid mass containing a fat component. The mass was in the left intraocular, extending from intraconal to extraconal. Conclusions: Amelanotic melanoma with extraocular extension is a rare condition that can be difficult to detect due to its unclear clinical symptoms and wide range of possible causes. Patients and their families must be educated to receive the appropriate first therapy and prevent the illness from worsening. Melanoma management depends on several factors: tumor size, location, related characteristics, opposite eye status, systemic status, and patient preference. Orbital exenteration is one of the management options for choroidal melanoma with significant extraocular extension. By the time ocular treatment begins, the patient's survival may already be predetermined, and this realization could impact how uveal melanoma is treated in the years to come.
Correlation of TED Laterality with Thyroid Status among Thyroid Eye Disease (TED) Patients in a Tertiary Hospital in Indonesia Lutfiyah, Zahirah Siti; Lutfi, Delfitri; Susanto, Hermawan; Sutjipto
Current Internal Medicine Research and Practice Surabaya Journal Vol. 5 No. 1 (2024): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v5i1.51726

Abstract

Introduction: Thyroid eye disease (TED), an autoimmune thyroid disorder, is prevalent in Asian countries and exhibits a variety of manifestations. Orbital involvement in TED is usually bilateral but may occur unilaterally in some cases. While it is commonly associated with hyperthyroidism, it also manifests in individuals with hypothyroidism or euthyroidism. The purpose of this study was to investigate the relationship between TED laterality and thyroid status in TED patients treated at the Eye Oncology Clinic of Dr. Soetomo General Academic Hospital in Surabaya, Indonesia.Methods: The study was retrospective, analytical and observational. Patients diagnosed with TED who were treated at Dr. Soetomo General Academic Hospital between January 2019 and December 2021 were the focus of this study. SPSS analyses of medical records that satisfied the sample criteria were used to compile the data for this study.Results: There were 88 samples that were dominated by females (57.95%) and aged 41 – 50 (32.96%). Proptosis was the most common clinical manifestation (94.32%), with compressive optic neuropathy was the least common (3,41%). Eyelid retraction occurred in only 22.7% of the patients. TED was categorized into unilateral (44.32%) and bilateral (50%). The majority had hyperthyroidism (70.45%), followed by euthyroidism (25%), and hypothyroidism (4.55%). It was found that there was a significant correlation between thyroid status and TED laterality. Compared to euthyroidism, abnormal thyroid conditions such as hyperthyroidism and hypothyroidism develop bilateral TED more frequently than normal thyroid conditions.Conclusion: There was a correlation between TED laterality and thyroid status among patient TED.
The Challenge in Diagnosis and Management of Secondary Conjunctival Cysts Nurlistyani, Dinda Puspita; Lutfi, Delfitri
Vision Science and Eye Health Journal Vol. 4 No. 1 (2024): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v4i1.2024.1-3

Abstract

Introduction: Conjunctival cysts can be categorized as primary or secondary. This report emphasizes difficulties in diagnosing secondary conjunctival cysts and distinguishing them from other conjunctival lesions like conjunctival benign reactive lymphoid hyperplasia (BRLH). Case Presentation: A 43-year-old male had a painless progressive conjunctival mass for four months. He took anti-aging and muscle-enhancing injections for a year and changed the product brand four months ago. Our examination revealed a conjunctival translucent mass with distinct margins and surface-feeding vessels without visual disturbance. We provisionally diagnosed it as a conjunctival cyst with a differential diagnosis of BRLH. We treated the patient with oral methylprednisolone and dexamethasone eye drops and discontinuation of anti-aging injections. The mass completely disappeared after one month of treatment. Conclusions: This case presented a diagnostic challenge due to the presence of a feeding vessel, which indicated inflammation. This made differentiating from inflamed conjunctival masses, such as BRLH, difficult. The patient had a history of suspected inflammation from changing the brand of injectable drug. Initially, we used steroids to reduce inflammation and prevent mass growth, but surprisingly, the lesion completely disappeared. If it recurs, a biopsy may be needed to identify the exact cause, as we have not ruled out BRLH. Secondary conjunctival cysts can result from toxins, trauma, or allergies. A thorough history taking, eye examination, and biopsy may be necessary to rule out other causes of inflamed conjunctival masses.
Subconjunctival Hemorrhage as a Sign of Intraocular Retinoblastoma Progression to Orbital Retinoblastoma Jatikusuma, Anas; Lutfi, Delfitri; Cahyadi, Andi; Heriyawati
Vision Science and Eye Health Journal Vol. 4 No. 3 (2025): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v4i3.2025.95-99

Abstract

Introduction: Retinoblastoma is the most common intraocular malignancy of childhood. While treatable when detected early, a delayed diagnosis can lead to orbital extension, which significantly worsens the prognosis. We report an unusual case in which a subconjunctival hemorrhage signaled the progression of intraocular retinoblastoma to orbital involvement. Case Presentation: A 2-year-4-month-old child presented with a one-month history of left-eye leukocoria. Ocular ultrasound and computed tomography (CT) confirmed features of an intraocular retinoblastoma (Group E), and urgent enucleation was planned. The surgery was delayed by two months; shortly before the operation, the child developed an inferonasal subconjunctival hemorrhage that rapidly expanded. During enucleation, a reddish-brown extrascleral tumor was discovered beneath the hemorrhage, indicating orbital extension. Histopathology revealed Grade 3 retinoblastoma with optic nerve invasion (resection margin free of tumor). Adjuvant chemotherapy was initiated postoperatively. Conclusion: Subconjunctival hemorrhage can be an unusual warning sign of orbital tumor extension in retinoblastoma. This case highlights the importance of raising awareness and reducing diagnostic delays, particularly in resource-constrained settings.
Co-Authors Andi Cahyadi Ervianti, Octarina Heriyawati Hermawan Susanto, Hermawan Jatikusuma, Anas Lutfiyah, Zahirah Siti Nurlistyani, Dinda Puspita SUTJIPTO