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Prevalensi Retinopati Diabetik di Puskesmas di Bandung Raya Periode Januari 2019-Desember 2020 Tiara Shaniaputri; Erwin Iskandar; Angga Fajriansyah
eJournal Kedokteran Indonesia Vol 10, No. 1 - April 2022
Publisher : Faculty of Medicine Universitas Indonesia

Peningkatan prevalensi penyandang Diabetes melitus (DM) dari tahun ke tahun berdampak terhadap peningkatan prevalensi retinopati diabetik. Penelitian ini bertujuan untuk mengetahui prevalensi retinopatidiabetik yang diharapkan dapat memberikan kontribusi dalam pencegahan dan penatalaksanaan retinopatidiabetik yang lebih baik. Penelitian ini merupakan penelitian deskriptif dengan metode penelitian potong lintangyang menggunakan data sekunder yaitu data dari 1.835 pasien DM yang mengikuti skrining retinopati diabetikdi puskesmas di Bandung Raya periode Januari 2019-Desember 2020. Variabel yang dinilai pada penelitian iniadalah prevalensi retinopati diabetik dan vision threatening diabetic retinopathy (VTDR) , usia, jenis kelamin,durasi DM Gula Darah Sewaktu (GDS), Gula Darah Puasa (GDP), Tekanan Darah Sistolik (TDS), TekananDarah Diastolik (TDD). Penelitian ini menunjukkan prevalensi retinopati diabetik dan VTDR sebesar 19,46%dan 7,68% secara berurutan. Prevalensi lebih tinggi pada perempuan. Pasien dengan durasi DM 10 tahunserta kadar GDS dan GDP 200 mg/dl memiliki prevalensi tertinggi. Berdasarkan pemeriksaan tekanan darah,prevalensi tertinggi terdapat pada pasien dengan nilai TDS 140 mmHg dan TDD < 90 mmHg. Pada penelitianini didapatkan bahwa kurang lebih 1 dari 4 pasien diabetes pada populasi ini menderita retinopati diabetik.

PACK-CXL sebagai Terapi Alternatif pada Ulkus Kornea Pradistya Yudiasari; Angga Fajriansyah
Majalah Oftalmologi Indonesia Vol 49 No 2 (2023): Ophthalmologica Indonesiana
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/journal.v49i2.100703

Introduction: Corneal ulcer is a leading cause of blindness worldwide. Many of these patients did not respond to conventional treatment with topical agents. Photo Activated Chromophore for Keratitis - Corneal Cross-Linking (PACK-CXL) has been suggested to treat baterial and fungal corneal ulcer that did not respond to antimicrobial agents. Purpose : To report a case series of corneal ulcer treated with PACK-CXL as adjuvant treatment Case Report: Four eyes with corneal ulcer underwent PACK-CXL with ultraviolet-A rays and transepithelial riboflavin according to Dresden procedure. Preoperative and postoperative slit lamp examination of cornea and visual acuity assessment was done. Postoperative outcome includes objective signs like improvement in epithelialization, corneal scarring and vascularization. Result: Three eyes healed completely with scarring at 1-month follow-up. One of the patients developed desematocele in 12 days. Epithelial defect completely healed over time but one underwent amniotic membrane transplant. Responed to treatment were defined by epithelialization and scar formation. Conclusion: The corneal cross-linking has a beneficial role as an adjuvant therapy for corneal ulcer. It helps in relief of pain and healing of ulcer. PACK-CXL can be a choice of adjuvant treatment if the corneal ulcer doesn't heal using topical treatment.

PANUVEITIS AS A MANIFESTATION OF OCULAR SYPHILIS IN PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS : A CASE SERIES: Poster Presentation - Case Series - Resident SITI AISYAH; Angga Fajriansyah; Susi Heryati; Arief Akhdestira Mustaram; Patrioka Muslima; Elfa Ali Idrus
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/m73f9e22

Introduction : Syphilis is a sexually transmitted disease caused by the spirochete bacterium Treponema pallidum. Syphilis can result in multiple organ involvement, including the eyes, and demonstrates various clinical findings. Ocular syphilis is an important cause of uveitis in the new era of co-infection with the human immunodeficiency virus (HIV). Case Illustration : Case 1: A 29-year-old male HIV-positive with 5 months of blurred vision, pain, and redness in left eye (LE) with skin rashes on the palms and foots (Figure 1). The visual acuity was 1/300 in LE, anterior segment showed flare cell (Figure 2). Fundus examination (Figure 3) revealed multiple exudative lesion of right eye (RE) and vitreus opacity of LE due to inflammation. VDRL and TPHA tests were positive. Case 2: 38-year-old male, HIV-positive and tuberculosis-positive, with 2 months of blurred vision,pain and redness in both eyes with skin rashes on the palms and foots (Figure 1). The visual acuity of the RE was 1/60 and 1,5/60 in the LE on the initial visit. Anterior segment eye examination revealed flare and cell (Figure 2). Fundus examination revealed (Figure 3) preretinal hemorrhage and exudate of both eyes. VDRL and TPHA testing were positive, CD4 count showed severe immunodeficiency. Discussion : This study depicts clinical features and outcomes of two cases of ocular syphilis with HIV co- infection. Poor visual outcome was associated with posterior segment-involving uveitis at presentation. Conclusion : An accurate diagnosis is crucial, treatment is adjusted according to the clinical stage. Comprehensive education is needed for patients and their families.

Combination of Superficial Keratectomy, Ethylenediaminetetraacetic (EDTA), and Amniotic Membrane Transplantation as A Treatment of Band keratopathy: A Case Report: Poster Presentation - Case Report - Resident Ilmah; Patriotika Muslima; Elfa Ali Idrus; Arief Akhdestira Mustaram; Angga Fajriansyah
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/ngsfpz46

Introduction : Band keratopathy is a degeneration of the cornea characterized by the presence of opacity, which isa deposit of calcium hydroxyapatite. These calcium deposits can be removed in several ways, including using ethylenediaminetetraacetic (EDTA), superficial keratectomy, or phototherapy keratectomy. Case Illustration : A 29-year-old male patient came with complaints of blurry vision in the right eye since 2-3 years ago, accompanied by the middle part of both eyes looking white, especially the right eye, since 17 years ago. The examination revealed a band keratopathy in the nasal to temporal region with neovascularization in the right eye, and keratopathy bands in the nasal and temporal parts, as wellas a cloudy lens in the right eye (Figure 1). Patients received treatment that included a combination of superficial keratectomy, administration of EDTA, and amniotic membrane transplantation (Figure 2). After the procedure, the clarity of the cornea improves (Figure 3). The patient was scheduled to undergo cataract surgery on his right eye. Discussion : Band keratopathy is a degenerative condition of the cornea characterized by grayish-white hazy deposits in the superficial layers of the cornea, primarily affecting Bowman's layer. In the treatment of individuals with symptomatic band keratopathy, chelation with EDTA, superficial keratectomy, laser keratectomy for phototherapy, or combining current procedures are the most often utilized therapeutic approaches. Conclusion : The combination of surgical management in cases of band keratopathy is expected to remove deposits on the cornea, improve the ocular surface, and reduce recurrences.

Management Strategies of Ocular Alkaline Chemical Injury: Poster Presentation - Case Report - Resident Nadia Ayu Destianti; Patrioka Muslima; Elfa Ali Idrus; Arief Akhdestira; Angga Fajriansyah
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/nq0p9c02

Introduction : Ocular chemical burns are true ophthalmic emergencies that can cause permanent corneal and intraocular damage leading to visual impairment or even blindness. When a case of chemical trauma occurs, immediate and appropriate management should be done. Case Illustration : A 24-year-old man came to Cicendo Eye Hospital with complaints of blurry eyes accompanied by burning and watery eyes after being doused with a bucket of cement mortar two weeks earlier. Ophthalmologic examination obtained visual acuity for the right eye 1/300 and left eye was 1/60. The anterior segment of both eyes showed corneal edema, conjunctivalization, persistent epithelial defects, limbal ischemia, and punctate epithelial erosion. There was an ulcer and thinning of the corneal layer in left eye. He was diagnosed with alkaline chemical injury Dua's classification grade VI on the right eye and grade V on the left eye (Figure 1). The patient then underwent a keratectomy, conjunctival resection, and amniotic membrane transplantation procedure. On the seventh day postoperatively, symptoms and clinical features improved with the visual acuity of both eyes improved to 1/60 (Figure 2). Discussion : Amniotic membrane graft was performed in late reparative phase which aims to preserve the surface of the corneal epithelium and prevent corneal perforation and inflammation. Conjunctival resection was performed to prevent neovascularization of the amniotic membrane. Conclusion : Management of ocular burn injury requires an immediate and comprehensive treatment to achieve good result. In this case successful treatment was achieved by improvement of visual acuity and no complication occured.

Management Strategies of Ocular Alkaline Chemical Injury: Poster Presentation - Case Report - Resident Nadia Ayu Destiani; Patriotika Muslima; Elfa Ali Idrus; Arief Akhdestira Mustaram; Angga Fajriansyah
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/svdapm67

Introduction : Ocular chemical burns are true ophthalmic emergencies that can cause permanent corneal and intraocular damage leading to visual impairment or even blindness. When a case of chemical trauma occurs, immediate and appropriate management should be done. Case Illustration : A 24-year-old man came to Cicendo Eye Hospital with complaints of blurry eyes accompanied by burning and watery eyes after being doused with a bucket of cement mortar two weeks earlier. Ophthalmologic examination obtained visual acuity for the right eye 1/300 and left eye was 1/60. The anterior segment of both eyes showed corneal edema, conjunctivalization, persistent epithelial defects, limbal ischemia, and punctate epithelial erosion. There was an ulcer and thinning of the corneal layer in left eye. He was diagnosed with alkaline chemical injury Dua's classification grade VI on the right eye and grade V on the left eye (Figure 1). The patient then underwent a keratectomy, conjunctival resection, and amniotic membrane transplantation procedure. On the seventh day postoperatively, symptoms and clinical features improved with the visual acuity of both eyes improved to 1/60 (Figure 2). Discussion : Amniotic membrane graft was performed in late reparative phase which aims to preserve the surface of the corneal epithelium and prevent corneal perforation and inflammation. Conjunctival resection was performed to prevent neovascularization of the amniotic membrane. Conclusion : Management of ocular burn injury requires an immediate and comprehensive treatment to achieve good result. In this case successful treatment was achieved by improvement of visual acuity and no complication occured.

A Rare Case of Congenital Corneal Keloids: Poster Presentation - Case Report - Resident Nurul Hikmah; Elfa Ali Idrus; Patriotika Muslima; Arief Akhdestira Mustaram; Angga Fajriansyah
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/xxq7gk11

Introduction : A corneal keloid is a uncommon ophthalmic condition that manifest as proliferation of fibrous tissue in the cornea and presents as an enlarging, white, elevated, well circumscribed corneal lesion. It is a relatively uncommon lesion that typically appears after surgery, injury, or corneal perforation. Pathological examination of the resected specimen leading to a diagnosis of corneal keloid. Case Illustration : A 6-year-old girl came with chief complaint was blurry vision in both eyes accompanied with a white opacity in her left eye that was gradually growing. The patient has been diagnosed with congenital glaucoma ever since birth. Nobody of her parents acknowledged having a history of inflammatory, infection, or ocular damage. At first glance, her visual acuity appeared to be light reflex in both eyes. Slit lamp biomicroscopy revealed a pearly white, enhanced opacity with sharp edges and smooth surface in the left eye (figure 1). New vessels were present in the lesion adjacent to the limbus. The patient is undergoing keloids excision, multilayer amnion membrane transplant and fine needle diathermy (figure2). Discussion : Corneal keloid can present at any age, present as a glistening white enlarging mass on the cornea and well demarcated from the adjacent normal tissue. Histopathologic examination demonstrates a thickened corneal epithelium overlying stroma and hyalinized collagen (figure 3). Conclusion : A corneal keloid should be suspected in cases of enlarging white glistening avascular corneal scars. Biopsy and histopathology confirmed the diagnosis.

Management of Recurrent Anterior Uveitis in Spondyloarthritis: A Case Report: Poster Presentation - Case Report - Resident nadida nurfadhila; Patriotika Muslima; Elfa Ali Idrus; Arief Akhdestira Mustaram; Angga Fajriansyah
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: 10.35749/8hr2qj05

Introduction : Non-infectious anterior uveitis is caused by underlying diseases, one of which is spondyloarthritis. Spondyloarthritis is a part of chronic rheumatic disease. The main goals of uveitis therapy are to prevent blindness, permanent organ damage, and recurrence. Case Illustration : A 19-years old woman came to Cicendo Eye Hospital with blurry vision for one week. The complaint was accompanied by redness, photosensitivity, and pain in her right eye. She had similar complaints in her right eye one month ago and in her left eye one year ago. She also had a history of morning stiffness in her knee joint and lower back pain. For those symptoms, the rheumatologist diagnosed her with spondyloarthritis. The uncorrected visual acuity examination for both eyes were 0,16. Anterior segment examination on right eye were blepharospasm, ciliary injection, corneal oedema, flare and cells while the left eye within normal limit. She was diagnosed with anterior uveitis and was treated with topical corticosteroid, oral corticosteroid, and immunomodulator. Knowing the treatment was not responding, the rheumatologist added biologic agents to the therapy. As a result, the patient’s conditions improved. Discussion : Topical steroid therapy was used as the first line of treatment, but for the recurrence of anterior uveitis, systemic medication, including biologic agents, is needed. Conclusion : Multidiscipline and stepwise approach to treat anterior uveitis with underlying disease is necessary.

Amnion Membrane Transplantation: A Therapy for Persistent Epithelial Defect as A Result of Neurotrophic Keratitis: Poster Presentation - Case Report - Resident Nathasya Maharani Susilo; Patriotika Muslima; Elfa Ali Idrus; Arief Akhdestira Mustaram; Angga Fajriansyah
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/e3c8d366

Introduction : A persistent epithelial defect (PED) is a failure of re-epithelialization and complete healing of the cornea. The primary goal of PED treatment is to create a favorable environment for corneal wound healing. Amniotic membrane transplants (AMT) become one of the refractory cases treated for PED. This study aims to report AMT as therapy for a PED. Case Illustration : A fifty-six-year-old male presents with a chief complaint of redness and pain in the left eye in the last2 weeks. The patient complained of blurred vision, tearing, and foreign body sensations. An ophthalmology examination of the left eye revealed that it was close to face finger counting in visual acuity and had a persistent epithelial defect, corneal edema, descemet fold, and a decrease in corneal sensation. The patient was diagnosed with PED and received autologous serum eye drops, levofloxacin eye drops, vitamin A palmitate eye gel, and acyclovir 400mg twice a day, but did not respond adequately. AMT was planned for the patient. The patient's pain level improved one week after surgery. Discussion : The most common symptom of PED is pain. There are various etiological factors for PED. Neurotropic keratitis has emerged as one of the causes of PED. Management for PED is carried out sequentially according to the protocol. Conclusion : Amniotic membrane transplantation has become an alternative therapy for PED. The amniotic membrane provides re-epithelialization of the cornea and anti-inflammatory properties. The prognosis for AMT as a therapy for PED is quite good.

Recalcitrant Epithelial Ingrowth After LASIK: An Unexpected Complication: Poster Presentation - Case Report - Resident Putri Pamulani; Angga Fajriansyah; Elfa Ali Idrus; Patriotika Muslima; Arief Akhdestira Mustaram
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/daqk0f55

Introduction : Post-LASIK Epithelial Ingrowth (PLEI) is an uncommon complication of laser in situ keratomileusis (LASIK). Treatment for PLEI can be done surgically and medically, but recurrence is possible. Case Illustration : A 20-year-old female came with the appearance of white opacity on her right cornea, which has grown bigger in size over the last two months (Figure 1A and 1B). She had undergone three debridement surgeries prior to the visit due to the same complaint and history of LASIK surgery two years before. Visual acuity of the right eye showed 0.32 pinhole 0.63, epithelial ingrowth Probst/Machat grade III in 9 o’clock direction approximately 3mm x 3mm (Table 1), pooling on fluorescein test, intact flap, and punctate epithelial erosion (PEE). A surgery of flap reopening, epithelial debridement, corneal suture, and corneal crosslinking was conducted (Figure 2 and 3). Discussion : The incidence of PLEI, as reported by published studies, is relatively low. Hence, treatment in such cases is largely based on anecdotal case reports and small case series. Treatment of choice can be done according to clinical manifestation and severity of PLEI. Conclusion : A thorough and careful management of PLEI should be carried out to prevent its progress and recurrence.

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