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All Journal Damianus Journal of Medicine Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Cermin Dunia Kedokteran IJRETINA - International Journal of Retina Ophthalmologica Indonesiana Cermin Dunia Kedokteran
Iskandar, Ferdy
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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Aspirin Dosis Rendah untuk Pencegahan Preeklampsia dan Komplikasinya Iskandar, Ferdy; Limardi, Suryadi; Padang, Astrid Fransisca
Cermin Dunia Kedokteran Vol 44, No 5 (2017): Gastrointestinal
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (90.945 KB) | DOI: 10.55175/cdk.v44i5.802

Abstract

Preeklampsia merupakan penyebab utama morbiditas dan mortalitas ibu hamil (bumil), persalinan prematur, kematian perinatal, dan pertumbuhan janin terhambat (PJT). Aspirin dosis rendah dapat mengurangi risiko tersebut, terutama pada kehamilan risiko tinggi. Terapi ini menghambat vasokonstriksi yang diperantarai tromboksan dan mencegah kegagalan transformasi fisiologis arteri spiralis. Penggunaannya tidak berhubungan dengan komplikasi yang signifikan.Preeclampsia is the major cause of morbidity and mortality of pregnant women, premature delivery, perinatal mortality, and intrauterine growth retardation (IUGR). Low-dose aspirin can reduce the risk, especially in high-risk pregnancies. This therapy inhibits thromboxane-mediated vasoconstriction and prevents the failure of a physiological transformation of spiral arteries. Its use is not associated with significant complications.
Kontroversi Persalinan Spontan pada Miopia Tinggi Iskandar, Ferdy; Surya, Raymond; Sungkar, Ali; Debby Anggriany, Friska
Cermin Dunia Kedokteran Vol 47, No 12 (2020): Dermatologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (109.96 KB) | DOI: 10.55175/cdk.v47i12.1248

Abstract

Gangguan refraksi khususnya miopia tinggi pada wanita hamil sering dikaitkan dengan kejadian ablasio retina pasca-persalinan, sehingga persalinan per abdominam atau bantuan instrumen cenderung direkomendasikan pada wanita hamil dengan miopia tinggi. Padahal, indikasi persalinan per abdominam pada miopia tinggi adalah adanya neovaskularisasi koroid dan subretinal (dengan bintik Fuchs). Hingga saat ini belum didapatkan bukti bahwa miopia tinggi dan riwayat operasi retina sebelumnya meningkatkan risiko ablasio retina saat persalinan per vaginam.Refractive disorders, especially high myopia in pregnant women are often associated with postpartum retinal detachment, thus there is a tendency to recommend cesarean section or instrument-assisted labor in pregnant women with high myopia. In fact, the indications for cesarean section in patients with high myopia are choroidal and subretinal neovascularization (with Fuchs spots). There is no evidence of increased risk of retinal detachment during vaginal delivery in high myopia and previous history of retinal surgery.
Diquafosol Tetrasodium: Tatalaksana Terkini untuk Dry Eye Disease (DED) ? Iskandar, Ferdy
Cermin Dunia Kedokteran Vol 47, No 9 (2020): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (963.98 KB) | DOI: 10.55175/cdk.v47i9.921

Abstract

Keratokonjungtivitis sicca (dry eye disease/DED) adalah penyakit multifaktorial permukaan okular yang ditandai dengan hilangnya homeostasis film air mata disertai gejala okular. Diagnosis dan tatalaksana DED terbatas serta tidak memuaskan. Diquafosol tetrasodium “diquafosol” merupakan agonis reseptor P2Y2 yang dapat digunakan untuk mengobati DED dengan cara merehidrasi permukaan okular.Keratoconjunctivitis sicca (dry eye disease/DED) is a multifactorial disease of the ocular surface characterized by loss of tear film homeostasis accompanied by ocular symptoms. Diagnosis and treatment of DED is limited, and the result is not promising. Diquafosol tetrasodium “diquafosol” is a P2Y2 receptor agonist that can be used for DED treatment by rehydrating the ocular surface.
Manifestasi Okular Coronavirus Disease 2019 (COVID-19): Klinis dan pencegahan Priscilia, Florentina; Iskandar, Ferdy; Larasati, Fadima Fitri; Permanik, Gustiandari Fidhya
Cermin Dunia Kedokteran Vol 47, No 10 (2020): Optalmologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (318.464 KB) | DOI: 10.55175/cdk.v47i10.1078

Abstract

Pandemi global Coronavirus Disease 2019 (COVID-19) memiliki gejala utama batuk, demam, kelelahan, sesak napas, dan gejala respiratori lainnya. Didapatkan kasus pasien COVID-19 yang memiliki keluhan okular seperti konjungtivitis. Angiotensin-converting enzyme 2 (ACE2), yang merupakan reseptor SARS-CoV-2 juga didapatkan pada sel epitel konjungtiva dan kornea manusia, sehingga memungkinkan transmisi melalui okular. Tatalaksana gejala okular pada COVID-19 hingga saat ini masih terus dikembangkan serta diuji coba.The Global Coronavirus Disease 2019 (COVID-19) pandemic has cough, fever, fatigue, shortness of breath, and other respiratory symptoms as the main symptoms. There were cases of COVID-19 patients with ocular complaints such as conjunctivitis. Angiotensin-converting enzyme 2 (ACE2) – SARS-CoV-2 receptor, is also found in human conjunctival and corneal epithelial cells, thus allowing ocular transmission. Treatment for ocular symptoms in COVID-19 are still being developed and tested.
Neuromyelitis Optica Spectrum Disorder (NMOSD): Challenges and Updates Iskandar, Ferdy; Priscilia, Florentina; Casey, Anthea; Sidik, Mohamad
Bahasa Indonesia Vol 23 No 3 (2024): Damianus Journal of Medicine
Publisher : Atma Jaya Catholic University of Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25170/djm.v23i3.3973

Abstract

Pendahuluan: Neuromyelitis optica spectrum disorder (NMOSD) merupakan kondisi autoimun yang ditandai dengan inflamasi pada nervus optikus, saraf spinal, dan sistem saraf pusat. Meskipun NMOSD memiliki angka prevalensi yang relatif rendah, prognosis visual penyakit ini cukup buruk dan laju relapsnya tinggi. Tinjauan pustaka ini diharapkan dapat mendorong pembaca untuk bisa mendiagnosis secara lebih dini untuk menentukan tatalaksana serangan akut dan mencegah serangan berikutnya sesuai dengan kompetensi kedokteran. Metode: Artikel ini disusun berdasarkan kepustakaan yang diperoleh dari database Google Scholar, PubMed, dan ProQuest, menggunakan kata kunci “neuromyelitis optica spectrum disorder” dari publikasi tahun 2012 sampai dengan tahun 2022. Hasil: Penyebab NMOSD hingga saat ini masih tidak diketahui dengan pasti, namun diduga disebabkan oleh kondisi sistem imun humoral di dalam tubuh menyerang astrosit. Kriteria diagnosis NMOSD didasarkan pada konsensus yang dikeluarkan oleh International Panel for Neuromyelitis Optica Diagnosis. Myelitis akut, neuritis optik yang berat, muntah dan cegukan berulang merupakan gejala khas pada NMOSD. Lesi myelitis transversal ekstensif longitudinal merupakan penemuan khas pada magnetic resonance imaging (MRI). Tatalaksana NMOSD pada fase akut berupa kortikosteroid dosis tinggi, sedangkan pada fase pemeliharaan berupa imunosupresan. Kejadian relaps ditemukan pada 90% pasien dan komplikasi yang terjadi dapat berupa disabilitas visual, disabilitas motorik, hingga kematian. Simpulan: Diagnosis NMOSD ditegakkan berdasarkan penemuan klinis, pencitraan, dan laboratorium. Tatalaksana yang tepat dan adekuat berguna untuk mencegah disabilitas dan morbiditas di kemudian hari.
RESTORING VISION IN CENTRAL MACULAR EDEMA (CME) CAUSED BY CENTRAL RETINAL VEIN OCCLUSION (CRVO): SINGLE INTRAVITREAL BEVACIZUMAB INJECTION Iskandar, Ferdy; Pertiwi, Adinda Mulya; Hutapea, Mario Marbungaran
International Journal of Retina Vol 8 No 2 (2025): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2025.vol008.iss002.325

Abstract

Introduction: Central retinal vein occlusion (CRVO) stands as a prevalent contributor to vision impairment from retinal vascular issues, affecting approximately 0.08% of individuals over 30. Cystoid macular edema (CME) is the most frequent cause of reduced vision among these cases. This study aimed to report the promising outcome of a single intravitreal bevacizumab injection in treating CME secondary to CRVO. Case Report: A 41-year-old male came with a sudden blurry vision of the left eye (LE) 10 hours before admission, particularly in the superior and temporal areas. He denied any history of red eyes, sudden light flashes, curtain-like shadows, double vision, or pain with eye movements. He had a history of hypertension but was not on medication. His blood pressure was 180/120 mmHg, with visual acuity (VA) of 1/60, positive relative afferent pupillary defect (RAPD), edematous optic nerve head (ONH) with tortuous veins, and hemorrhages throughout the retina of the LE. Macular optical coherence tomography (OCT) of the LE showed massive intraretinal fluid (IRF) with a central macular thickness (CMT) of 779 µm. He had unremarkable laboratory results, with normal coagulation factors. Amlodipine 10 mg once daily (qd) and candesartan 16 mg qd was prescribed, and no antiplatelet or anticoagulant therapy was initiated by the internal medicine. A single intravitreal bevacizumab injection (1.25mg) was performed on the LE. During a 1-month follow-up, his best corrected visual acuity (BCVA) improved to 6/18, with a normal optic nerve head, tortuous veins, flame-shaped hemorrhages, with no IRF and a CMT of 240 on macular OCT. The BCVA and CMT remained stable at the 6-month follow-up, with no complications. Discussion: A Treat and extend (T&E) regimen was initially planned, with ≥ 3 consecutive monthly injections until disease inactivity was established, followed by a gradual extension of the treatment interval in increments of 2 to 4 weeks. We initially planned to administer bevacizumab intravitreal injections according to the T&E regimen. However, the patient showed significant clinical improvement, and macular OCT demonstrated resolution of the IRF after the first injection. Therefore, we decided to discontinue the remaining injections and switch to a pro re nata (PRN) approach, administering bevacizumab as needed. In real-life conditions, the number of anti-vascular endothelial growth factor (VEGF) injections was lower than in randomized controlled trials (RCTs), due to many factors, such as declining motivation after improvement, poor access to hospital facilities, and unaffordable travel expenses. The PRN regimen is also a good option to minimize costs and reduce the burden on both patients and healthcare providers. Conclusion: Single intravitreal bevacizumab is an effective treatment for CME secondary to CRVO. However, the decision to use the T&E and PRN regimen should be based on the patient’s improvement and clinical examination. Additionally, any systemic conditions related to the vascular condition must also be addressed and treated.
Selenium sebagai Terapi Oftalmopati Graves Derajat Ringan Djunaedi, Laura Agnestasia; Iskandar, Ferdy; Kuswidyati, Cisca
Majalah Kedokteran Indonesia Vol 69 No 8 (2019): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.69.8-2019-190

Abstract

Graves ophthalmopathy (GO) is the most common extrathyroid manifestation of Graves’ disease. More than 50% of Graves’ patients will experience it, even 10% of them will suffer severe GO. The mechanism of GO is associated with complex autoimmune reaction and suspected to be associated with an imbalance levels of antioxidants and oxidants in the body. Smoking and poor control of Graves’ disease also trigger the progression of ophthalmopathy.Selenium is one of the most abundant antioxidant components in the thyroid gland. Selenium can help overcome mild GO by correcting the imbalance between oxidant and antioxidant levels in the body. Nevertheless, selenium cannot be given carelessly because improper dosing can lead to the several types of cancer as well as type 2 diabetes mellitus.
Combined Virna Glaucoma Implant (VGI) Implantation and Pars Plana Vitrectomy for Refractory Aphakic Glaucoma: Poster Presentation - Case Report - Resident Herdian, Felicia Sesih; Augiani, Amani Sakinah; Lumintang, Agnesstacia Vania; Iskandar, Ferdy; Oktariana, Virna Dwi; Djatikusumo, Ari
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: 10.35749/7e24y445

Abstract

Introduction : Glaucoma drainage devices (GDDs) implantation are frequently indicated for refractory glaucoma. The preferable anterior chamber may be inaccessible for patients with anterior chamber abnormalities. Case Illustration : A 6-year-old boy presented with high intraocular pressure (IOP) on the right eye (RE) four months before admission. Cataract surgery on both eye was done four years prior, due to congenital cataract. On examination, the visual acuity of the RE was hand movement with IOP 61mmHg with medications. Anterior chamber was shallow, posterior synechiae was found and posterior segment was hard to be evaluated. The fellow eye was nonfunctional with IOP 31mmHg. Pars plana vitrectomy (PPV) was performed followed by implantation of GDD (Virna Glaucoma Implant) with posterior chamber sulcus tube placement without adding a new incision. Post-operatively, IOP was 3mmHg and choroidal detachment was found. With steroid medication, satisfactory IOP control was achieved within three weeks of follow-up. Visual acuity of RE was improved to 0.5/60. Discussion : In eyes with shallow anterior segments, tube placed in the anterior chamber may increase the risk of corneal endothelial injury. Placement of the silicone tube in the posterior chamber sulcus is an effective alternative technique. Although it is relatively safe in experienced hands, vitrectomy and insertion of the tube into the posterior segment carries significant risks, including choroidal detachment. Careful monitoring and management is needed to control IOP and maintain vision. Conclusion : Combined GDD implantation and PPV may be considered for refractory aphakic glaucoma, showing favorable outcomes with a relatively safe procedure.
Silent Progressive Glaucoma in Encephalofacial angiomatosis (Sturge-Weber Syndrome): A Vision-Preserving Trabeculectomy: Poster Presentation - Case Report - Resident Gunardi, Triana Hardianti; Iskandar, Ferdy; Herdian, Felicia Sesi; Amanda, Lia; Priscilla, Florentina; Oktariana, Virna Dwi
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/h8wd8052

Abstract

Introduction : Encephalofacial angiomatosis, also known as Sturge-Weber Syndrome (SWS), is a rare, non- hereditary condition affecting multiple organs. Glaucoma occurs in almost 70% SWS children, more commonly when the port-wine stain involves the upper eyelid skin. Secondary glaucoma was present due to elevated venous pressure. Case Illustration : An 8-year-old boy with typical port-wine stain involving eyelid, came with recurrent painful right eye (RE) and headache in the past 3 months. He was diagnosed with SWS at 1 year and was on daily doses of carbamazepine and valproic acid for seizure control. His best visual acuity and intraocular pressure were 0.5/60 RE, 6/38 LE, 38 mmHg RE, 28 mmHg LE, respectively. Examination revealed Cup-disc-ratio (CDR) 0.9-1.0 RE and 0.5-0.6 LE. During the first three months, he showed favourable outcome with timolol and latanoprost (controlled IOP with target of <12 mmHg and markedly similar Cup-Disc Ratio). However, at 4th and 5th month visit, his IOP significantly increased despite of additional regiments, thus underwent trabeculectomy on both eyes for preserving his sight. After procedure, his IOP remained stable <12mmHg with maintained bleb, deep anterior chamber, also attached posterior segment. Discussion : Treatments of secondary glaucoma of SWS typically involved surgery with significantly lower success rate compared to Primary Congenital Glaucoma. Trabeculectomy or tube shunt surgery should be performed with caution due to risks of choroidal effusion and hemorrhages. Conclusion : Secondary glaucoma in children with SWS is common and challenging. Trabeculectomy should be pursued when the benefit outweighs the risks, even with a slim chance, to preserve the vision.
INTO THE DARKNESS AND SILENCE: EVISCERATION IN A DEAF-MUTE- BLIND PATIENT WITH NEGLECTED GLAUCOMA: Poster Presentation - Case Report - Resident Lumita, Ferdinand Inno; Laksmita, Yulinda Arty; Sieman, Andrew John; Iskandar, Ferdy; Paramita, Carennia; Aziza, 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/n2m27f33

Abstract

Introduction : Glaucoma can have a potentially devastating effect on patient’s vision and quality of life if not treated properly. We described a neglected glaucoma case in a deaf-mute-blind patient that leads to evisceration. Case Illustration : A 64-year-old deaf-mute female came to our emergency room with chief complaint of bloody discharge from her right eye 12 hours prior to admission with no history of trauma. Patient’s right eye has been blind for the last four years; her left eye has been nonfunctional since she was in her 30s. She went to a primary clinic during this time but did not get any diagnoses. Physical examination revealed uveal prolapse of the right eye with infiltrates around the remaining cornea; and phtisical left eye with IOP of 30 mmHg and opaque cornea. We performed evisceration with dermato-fat graft of the right eye. Discussion : Glaucoma is a challenging disease, especially in developing countries. It is difficult to diagnose due to its nature to be asymptomatic until late in the disease course. The loss of vision is painless and insidious; resulting in late diagnosis unless patients are screened for glaucoma early on. Patient in this report is particularly difficult for the caretaker since she is a deaf-mute patient; resulting in a suspected undiagnosed glaucoma that leads to evisceration and blindness. Conclusion : Glaucoma care generally necessitates routine follow-up for monitoring of disease progression and medication adjustments. Good screening system, family support, and integration of eye care into existing healthcare systems is needed for early detection to reduce blindness from glaucoma.
Co-Authors Ali Sungkar Amanda, Lia Angelia, Maria Augiani, Amani Sakinah Aziza, Yulia Casey, Anthea Debby Anggriany, Friska Djatikusumo, Ari Djunaedi, Laura Agnestasia Gunardi, Triana Hardianti Herdian, Felicia Sesi Herdian, Felicia Sesih Hutapea, Mario Marbungaran Kuswidyati, Cisca Laksmita, Yulinda Arty Larasati, Fadima Fitri Limardi, Suryadi Lumintang, Agnesstacia Vania Lumita, Ferdinand Inno Oktariana, Virna Dwi Padang, Astrid Fransisca Paramita, Carennia Permanik, Gustiandari Fidhya Pertiwi, Adinda Mulya Priscilia, Florentina Priscilla, Florentina Raymond Surya Sidik, Mohamad Sieman, Andrew John