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Compressive Optic Neuropathy (CON) Secondary to Inflammatory Polyp Mimicking Lymphoma: A Rare Manifestation Danniswara, Fadia Ghaisani; Agustini, Lukisiari
Vision Science and Eye Health Journal Vol. 3 No. 1 (2023): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v3i1.2023.23-27

Abstract

Introduction: Compressive optic neuropathy (CON) is the impairment of optic nerve function by space-occupying lesions that mechanically compress the optic nerve or optic tract. CON can arise from either intrinsic or extrinsic compression, and determining the underlying cause is important to approach the correct management. The objective of this case report is to present a rare case of CON secondary to an inflammatory polyp that mimicking lymphoma. Case Presentation: A 68-year-old male patient came to the neuro-ophthalmology clinic with a chief complaint of blurry vision in his left eye since three months ago that was getting worse until he lost his vision accompanied by drooping of the upper left eyelid. He also felt pain in his left eye, nausea, vomiting, and headache. Visual acuity of the right eye was 5/5 and the left eye had no light perception. Ocular motility of the left eye was restricted in all gaze. The pupil was 6 mm with no light reflex, and edema in the optic nerve head in the left eye was found from the posterior segment. The patient's MRI showed soft tissue thickening on the left orbital apex – left optic canal – left anterior cavernous sinus and enlargement of left medial rectus muscle with encasement of the left optic nerve, and from post-contrast showed contrast enhancement that suggested a lymphoma. He was diagnosed with CON secondary to lymphoma and was given Methylprednisolone 32 mg three times a day orally. Conclusions: Several differential diagnoses resemble the findings of CON secondary to inflammatory polyp. Some diagnostic examination must be done to exclude the other diagnosis to give a proper treatment for the patient.
Clinical Profile of Diabetic Papillopathy Patients at a Tertiary Care Hospital in Indonesia Abdullah, Rizqy; Agustini, Lukisiari; Sunreza Millenia, Maasa; Susanto, Hermawan
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 5 No. 3 (2023): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v5i3.13443

Abstract

Background: Diabetic Papillopathy (DP) is a rare complication of Diabetes mellitus (DM) which affects visual function. The purpose of this study was to describe the profile of DP patients at a tertiary care hospital in Surabaya, Indonesia. Methods: A descriptive retrospective study using electronic medical records of DP patients at the eye outpatient unit of Dr. Soetomo General Hospital in Surabaya between 2017 and 2020. Demographic data such as clinical characteristics, and history of DM were included. Levels of fasting blood glucose (FBG), 2-hour post-prandial blood sugar (PPG), and HbA1c were taken. Examination of the optic disc and retina determines the diagnosis of DP. Results: There were 27 cases of DP with the mean age of the patients being 49.3±9.3 years, predominance in the 46-55 years group (59.26%). Patients with DP had average systolic and diastolic blood pressure was 131.74±21.94 mmHg, and 86.00±15.89 mmHg, and an average BMI of 24.6 ±3.54 kg/m2 (62.96%). Most patients had a history of type 2 DM (96.29%), mean fasting blood sugar (FBG) and postprandial blood (PPG) was 225±83.3 mg/dL, and 147.81±59.72 mg/dL; and HbA1c 8.6±1.5 mg%. Conclusion: DP findings are relatively low in DM patients, however, DP could result in decreased visual acuity and quality of life so a proper ocular examination is important in DM patients.
POLYPOIDAL CHOROIDAL VASCULOPATHY MANIFESTATION IN EXTRA-AXIAL CAVERNOUS TUMOR: A RARE FINDINGS IN CHRONIC PAPILLEDEMA Asti, Annisa Kinanti; Agustini, Lukisiari; Firmansjah, Muhammad
International Journal of Retina Vol 8 No 1 (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.iss001.306

Abstract

Introduction: Age-related macular degeneration (AMD) is a leading cause of blindness worldwide. Polypoidal choroidal vasculopathy (PCV), a subtype of neovascular AMD, is characterized by an abnormal branching network of vessels with aneurysmal dilations (polyps). Choroidal neovascularization can also result from chronic disc edema. This case presents a rare occurrence of PCV in a patient with an extra-axial cavernous tumor and explores the best management approach. Case Report: A 43-year-old man presented with an 8-month history of blurry vision in his right eye, double vision on left gaze, and left eye protrusion, accompanied by headaches and occasional nausea. Visual acuity was 2/60 in the right eye and 5/10 in the left improving with pinhole become 5/6.5. RAPD was found in left eye. Funduscopy revealed peripapillary atrophy in both eyes, with exudates in the right macula. OCT showed dome-shaped polyps in both eyes, larger in the right. MRI revealed a left sphenoid meningioma compressing the orbital cavity. The patient was diagnosed with both eyes PCV and compressive optic neuropathy, left eye multiple cranial nerve palsy and dyslipidemia. Intravitreal anti-VEGF injection was planned. Discussion PCV is a subtype of AMD characterized by recurrent serosanguineous detachments. Chronic papilledema, possibly due to intracranial tumors, may lead to visual loss from retinal nerve fiber damage or neovascularization. Chronic posterior globe flattening and choroidal vessel abnormalities likely contributed to PCV development. Conclusion: PCV may result from chronic papilledema due to intracranial tumors. Anti-VEGF therapy offers a viable treatment option, balancing polyp regression and visual acuity stabilization.
Pengaruh Linezolid terhadap Timbulnya Neuropati Optik pada Tuberkulosis Paru Multidrug Resistance: Laporan Kasus Aryanti, Yuni; Herawati, Fauna; Fatmawati, Umi; Soedarsono, Soedarsono; Agustini, Lukisiari
Indonesian Journal of Clinical Pharmacy Vol 14, No 2 (2025)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15416/ijcp.2025.v14i2.58296

Abstract

Penemuan kasus tuberkulosis (TB) resisten obat (RO) di Indonesia adalah sebesar 12.531 dengan cakupan 51% di tahun 2022. Linezolid merupakan antibiotik dari kelompok oksazolidinon, dan merupakan salah satu obat dalam terapi TB RO. Linezolid memiliki farmakokinetika nonlinier, distribusi di mata 40%, ikatan obat protein 15%, diperlukan penyesuaian dosis dan frekuensi pemberian secara individual. Kasus neuropati optik akibat linezolid di Indonesia hingga kini masih jarang ditemukan, sehingga menjadi nilai lebih bagi laporan kasus di Dr. Soetomo General Academic Hospital ini. Pasien wanita 46 tahun dengan berat badan 40 kg dan tinggi badan 157 cm (underweight), didiagnosis TB multidrug resistance (MDR) primer dan hipotiroid. Pasien menjalani pemeriksaan awal mata, dinyatakan normal fundus dan tidak ada kelainan. Pasien memulai terapi TB regimen individual (pengobatan jangka panjang) sejak 25 Mei 2023 dengan fase intensif enam bulan, yaitu kombinasi bedakuinin 400 mg, levofloksasin 750 mg, linezolid 450 mg, clofazimin 100 mg, sikloserin 500 mg, dan vitamin B6 100 mg. Neuropati optik muncul setelah penggunaan linezolid selama enam bulan yang ditandai dengan skotoma sentral. Linezolid dihentikan tanggal 18 Januari 2024, dan setelah 5 bulan kondisi mata pasien mengalami perbaikan. Neuropati optik akibat linezolid adalah proses reversibel, dan memiliki kemungkinan 2,6 kali lebih besar pada BMI <18,5 kg/m2 sehingga dosis linezolid 300 mg tiap 24 jam dapat disarankan pada pasien underweight. Pemantauan awal dan berkala setiap bulan efek neuropati optik akibat linezolid selama pengobatan sangat diperlukan, terutama pada pasien underweight.
Clinical Improvement in a Patient with Methanol-Induced Optic Neuropathy Rusydiana; Aritonang, Christina; Agustini, Lukisiari
Vision Science and Eye Health Journal Vol. 5 No. 1 (2025): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v5i1.2025.23-27

Abstract

Introduction: Due to optic nerve and retinal damage, methanol-induced optic neuropathy (Me-ION) may lead to permanent vision loss, including blindness, making it a serious condition. Here, we present a case demonstrating clinical recovery in a patient with Me-ION. Case Presentation: A 20-year-old man came to the emergency unit with a chief complaint of sudden visual loss in both eyes since the day before admission. It was accompanied by shortness of breath, headache, nausea, and vomiting. He reported ingesting methanol three days before presentation and had no history of systemic illness. Visual acuity (VA) was counting fingers at one meter in the right eye and counting fingers at three meters in the left eye. The intraocular pressure (IOP) in both eyes was measured at 12.2 mmHg. Optical Coherence Tomography (OCT) of the retinal nerve fiber layer (RNFL) revealed increased thickness in both superior and inferior quadrants bilaterally. Laboratory tests revealed metabolic acidosis. The patient was diagnosed with Me-ION in both eyes, accompanied by metabolic acidosis. Dialysis was started, and he was treated with a high-dose steroid. Subsequently, VA improved to 5/5 in the right eye and 5/12 in the left eye. Color vision improved in the right eye to 30/38 (Ishihara), while the left eye remained at 20/38. Conclusions: Early diagnosis and prompt treatment of Me-ION can result in significant clinical improvement in visual acuity and color vision, emphasizing the significance of early treatment in managing toxic optic neuropathy.