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All Journal Biomolecular and Health Science Journal Majalah Biomorfologi (Biomorphology Journal) CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL Vision Science and Eye Health Journal Ophthalmologica Indonesiana Folia Medica Indonesiana

Lutfi, Delfitri

Division Of Orbital Ophthalmic Oncology, Department Of Ophthalmology, Faculty Of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya

Author-ID : 1891655

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

Published : 11 Documents Claim Missing Document

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Good Visual Acuity Outcome from an Ocular Blast Injury with Proper Management in Dr. Soetomo General Hospital Surabaya, Indonesia Rifat Nurfahri; Delfitri Lutfi; Ismi Zuhria
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: Ocular blast injury related to fireworks most often causing corneal erosion (29%), conjunctival erosion (11%), and conjunctival foreign body (10%) with children are more often than adults (65.9%:34.1%), and males far more often than female (71.9%:28.1%). Knowing proper management is very important to achieve the best result. Case presentation: We describe an ocular blast injury that experienced broad erosion and multiple foreign bodies on the corneal and pericorneal surface in the left eye and visual acuity decreased. The foreign body was scattered, and the fluorescein test was positive. We did proper foreign body extraction, irrigation, and ocular bandage. It was treated with chloramphenicol 0.5% eye ointment and homatropine eye drop. In two months, the patient’s left eye had clear cornea with a small scar formation near the visual axis. The visual acuity was 6/7 and BCVA was 6/6 with S-0.5 C-0.5 A 50° correction. Conclusions: Patients with ocular blast injury limited to superficial cornea erosion and and conjunctival erosion have a reasonable probability of achieving the best visual acuity. Foreign body extraction, proper irrigation, and topical medication show promising results. Scar formation near the visual axis can disrupt visual acuity however can be corrected in this case it can be corrected with glasses. Furthermore, public promotion and regulation to control firework using are very important.

Difficulty in Management of Advanced Pediatric Orbital Tumor Nandang Sudrajat; Delfitri Lutfi
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: Tertiary care centers often manage pediatric orbital tumors, especially in advanced lesions and complex management. We report a case of a young boy with a malignant orbital tumor involving intracranial infiltration. Case presentation: A four-year-old boy had proptosis on the left eye for two months accompanied with blurred vision, pain, and oftenly bleeds with ipsilateral nasal congestion. There was no history of trauma, eye disorders, systemic diseases, or growth disorders. The physical examination showed stable vital signs, however a weak general condition and no enlarged regional lymph nodes. Visual acuity of the left eye was no light perception. There was a mass with protrusion of the left eye, swelling of the eyelid with an irregular surface, and a tendency to bleeds. The cornea was hazy with partly scarring, so we could not evaluate the posterior segment. MRI of the head presented a malignant soft tissue mass of the left orbital region with intracranial infiltration. The patient was given adjuvant chemotherapy; however, he could not survive due to systemic complications. Conclusions: The definitive diagnosis for the orbital tumor is obtained by histopathological examination. The investigation with CT scan or MRI imaging could be considered if not possible. However, since the definitive diagnosis still not assessed, the management can be affected. It is essential to have a definitive diagnosis to provide adequate treatment for the patients. Delayed and inadequate management can make malignant orbital tumors potentially life-threatening.

Comparison of Autologous Blood Coagulum (ABC) and Suture at Recurrence Rate and Graft Stability of Postoperative Primary Pterygium Using Conjunctival Autograft: A Meta-Analysis From Randomized Controlled Trial Amelia Rahmah Kartika; Made Angga Putra; Delfitri Lutfi
Vision Science and Eye Health Journal Vol. 1 No. 3 (2022): Vision Science and Eye Health Journal
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga

Introduction: The main challenge of pterygium management is the postoperative recurrence rate. Currently, the use of surgical sutures for conjunctival autograft fixation, which has prolonged surgery duration, has a risk of increased inflammation and infection. Recently, some reports about autologous blood coagulum (ABC) for conjunctival autograft fixation. This technique has a minimal cost and minimal risk of infection. Purpose: The study aimed to evaluate the postoperative recurrence rate and graft stability after using ABC and sutures. Methods: A systematic research was done on Pubmed, Cochrane Library, and Science Direct online databases for all relevant randomized controlled trials (RCTs) up to 18 July 2020. The collected RCTs were independently screened and identified to match the inclusion criteria. The relevant data were compiled in population, intervention, control, outcomes (PICOs) format and analyzed with Review Manager 5.3 software. Results: Nine RCTs involving a total of 764 patients were assessed. The primary outcome indicates that ABC significantly reduced the recurrence rate compared to sutures (RR = 0.51, 95% CI 0.27 to 0.98, p = 0.04). Meanwhile, in graft stability, the suture was statistically better than ABC (RR = 1.95, 95% CI 1.27 to 3.01, p = 0.002). As a secondary outcome, the duration of surgery was significantly shorter in ABC than in sutures (MD -15.22, 95% CI -22.57 to -7.88, p<0.0001). Conclusions: Although the graft is less stable, ABC may be a promising approach after pterygium excision. The use of autologous blood for conjunctival autograft fixation in primary pterygium was associated with a lower recurrence rate and shorter duration of surgery.

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

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.

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

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

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 Alhakiim, Muhammad Valeri Alphania Rahniayu Amatlulloh, Hasna Shahida Amelia Rahmah Kartika Andi Cahyadi Ervianti, Octarina Fitria Kusumastuti Hasna Shahida Amatlulloh Hendrian Dwikoloso Soebagjo Heriyawati Hermawan Susanto Hermina Novida, Hermina Jatikusuma, Anas Linda Dewanti Luki Indriaswati Lutfiyah, Zahirah Siti Made Angga Putra Maria Debora Niken Larasati Muhammad Fariz Muhammad Valeri Alhakiim Nandang Sudrajat Nurlistyani, Dinda Puspita Prastyani, Reni Rifat Nurfahri Rizki Adrian Hakim Soelistijo, Soebagijo Adi Stella Agatha Widjaja Stepanus Massora Susy Fatmariyanti SUTJIPTO Zuhria, Ismi

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