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CLINICAL FINDINGS AND MANAGEMENT OF ANGLE RECESSION GLAUCOMA: A CASE REPORT Madona Debora; Maulida Rifada; Andika Prahasta; Elsa Gustianty
Majalah Oftalmologi Indonesia Vol 48 No 1 (2022): 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.v48i1.100255

Abstract

Introduction: Angle recession is a common finding after blunt trauma and involves a tear between the longitudinal and circular fibers of ciliary body. The incidence of angle recession was 24.3%. It may occur months to years after ocular trauma. Purpose: To report clinical findings and management of a patient with angle recession glaucoma. Case report: A 51 years old female came with chief complaint of blurry vision of left eye since five months earlier. There was a history of trauma in left eye 26 years ago. She had been treated with antiglaucoma medication by an ophthalmologist. Visual acuity of right eye was 1.0 and left eye was light perception. Applanation Tonometer Goldmann of left eye was 42 mmHg. Slit lamp examination revealed traumatic iritis and lens opacity. Gonioscopy revealed widening of ciliary body band in three quadrants. Funduscopy showed cup/disc ratio enlargement and RNFL thinning. This patient was diagnosed as angle recession glaucoma with traumatic iritis and traumatic cataract. Combined phacoemulsification-trabeculectomy with intraocular lens implantation was performed. One month after surgery, intraocular pressure decreased with improvement of visual acuity. Conclusion: Classically clinical findings of angle recession glaucoma were unilateral glaucoma with history of trauma and widening of ciliary body band. Surgery is needed in uncontrolled intraocular pressure with medication. Combined phacoemulsification-trabeculectomy decreases intraocular pressure as well as improves visual acuity.
SINDROMA SCHWARTZ-MATSUO SEBUAH PENYAKIT LANGKA : LAPORAN KASUS Setiawan, Grace; Prahasta, Andika; Gustianty, Elsa; Rifada, Maula; Umbara, Sonie
Jurnal Medika Malahayati Vol 8, No 2 (2024): Volume 8 Nomor 2
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jmm.v8i2.14328

Abstract

Sindroma Schwartz-Matsuo adalah suatu kondisi langka yang ditandai dengan ablasi retina regmatogen, peningkatan tekanan intraokular (TIO), dan sel akuos di bilik mata depan. Pada kasus ini, seorang laki-laki berusia 46 tahun datang dengan keluhan penglihatan kedua mata buram. Pasien mempunyai riwayat miopia tinggi yang tidak terkoreksi sejak 30 tahun yang lalu dan maya kanan sudah tidak bisa melihat sejak 20 tahun yang lalu. Dua puluh enam tahun sebelumnya, dia mengalami cedera benda tumpul di mata kirinya. Tajam penglihatan mata kanan nolight perception (NLP) dan 1/300 untuk mata kiri dengan reaksi bilik anterior positif. TIO kedua mata masing-masing adalah 48 dan 28. Pemeriksaan segmen posterior menunjukkan ablasi retina di seluruh kuadran kedua mata. Pasien menjalani operasi pars plana vitrectomy pada mata kiri. TIO mata kiri kembali normal setelah operasi. Kesimpulannya, sindrom Schwartz-Matsuo merupakan penyebab penting glaukoma sekunder. Anamnesis menyeluruh, pemeriksaan mata, dan pencitraan okular diperlukan untuk menegakkan diagnosis dan pengobatan yang akurat.
PENGETAHUAN, SIKAP, DAN PERILAKU PASIEN GLAUKOMA DI PMN RS MATA CICENDO TERHADAP PENYAKIT GLAUKOMA Akbari, Anamika Lingga Anjani; Rifada, R. Maula; Gustianty, Elsa
Oftalmologi : Jurnal Kesehatan Mata Indonesia Vol 5 No 2 (2023): Jurnal Oftalmologi Vol 5 No 2 2023
Publisher : Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ojkmi.v5i2.52

Abstract

Pendahuluan: Glaukoma merupakan penyebab kedua kebutaan terbanyak secara global. Sebagian besar kasus glaukoma bersifat asimptomatik, sehingga pasien tidak sadar dengan penyakitnya sampai munculnya gangguan penglihatan hingga kebutaan. Melalui pengetahuan, sikap, dan perilaku (PSP) pasien yang baik dapat mendukung pengendalian keparahan penyakit glaukoma. Akan tetapi, di Indonesia penelitian yang menunjukkan tingkat PSP pasien glaukoma terhadap penyakit glaukoma masih tergolong sedikit. Oleh karena itu, penelitian ini bertujuan untuk menilai tingkat PSP pasien glaukoma di PMN RS Mata Cicendo terhadap penyakit glaukoma. Metode: Studi ini menggunakan metode kuantitatif dengan desain penelitian deskriptif cross-sectional melalui pengisian kuesioner pada 59 pasien glaukoma di PMN RS Mata Cicendo pada bulan Februari 2023. Pada penelitian ini terdapat tiga variabel yang dinilai, yaitu pengetahuan, sikap, dan perilaku. Hasil: Pasien glaukoma menunjukkan pengetahuan baik (35,6%), cukup (59,5%), dan kurang (5,1%) dengan hanya 42,4% pasien yang bersikap positif dan 49,2% pasien berperilaku baik. Secara keseluruhan tingkat PSP pasien adalah 47%. PSP yang baik banyak ditemukan pada pasien dengan durasi pengobatan ≥6 bulan.  Simpulan: Tingkat PSP pasien glaukoma terhadap penyakit glaukoma yang sudah cukup baik tetap harus ditingkatkan dengan strategi edukasi agar tingkat sikap dan perilaku pasien jauh lebih baik.
Karakteristik Klinis Pasien Low Vision Anak di Pusat Mata Nasional Rumah Sakit Mata Cicendo pada Tahun 2021 Rahma, Amelia Nafisah; Sirait, Susanti Natalya; Gustianty, Elsa
Oftalmologi : Jurnal Kesehatan Mata Indonesia Vol 6 No 1 (2024): Oftalmologi: Jurnal Kesehatan Mata Indonesia
Publisher : Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ojkmi.v6i1.64

Abstract

Background: In Indonesia, low vision poses a significant public health issue, especially to children, which could lead to challenges in performing daily activities and diminished quality of life. This study aimed to describe the clinical characteristics of pediatric patients with low vision diagnosis in Cicendo Eye Hospital Bandung. Methods: All medical records of low vision patients aged 0-17 at Cicendo Eye Hospital Bandung during 2021 were reviewed. Data collected were patient’s age, gender, area of origin, main diagnosis of low vision cause, visual acuity, and low vision aids and/or rehabilitation given. Result: From 172 medical records reviewed, majority of patients were male (54.07%). The age group of 10-17 years had the largest proportion (38.95%). Majority of patients lived in Bandung and its surroundings (51.16%). A total of 52.33% patient experienced moderate visual impairment and 34.3% experienced severe visual impairment. Most common anatomical cause of low vision was posterior segment abnormality, with Retinopathy of Prematurity as the main cause (13.37%), followed by retinal dystrophy (12.79%). Low vision aid that was most commonly prescribed were glasses, followed by telescope. Conclusion: Pediatric low vision patients at Cicendo Eye Hospital were mostly male, in the age group of 10-17 years, and lived in Bandung and its surrounding. The most common classification of low vision cause was posterior segment abnormality, with Retinopathy of Prematurity as the main diagnosis. The most widely used low vision aids were glasses. Keyword: Characteristic, low vision, visual impairment
Survival Analysis of Trabeculectomy and Phacotrabeculectomy in Primary Angle Closure Glaucoma Gustianty, Elsa; Shalim, Nikho Melga; Virgana, Rova; Prahasta, Andika; Rifada, R. Maula; Umbara, Sonie
Majalah Kedokteran Bandung Vol 56, No 4 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3594

Abstract

Glaucoma is the global leading cause of irreversible blindness. Primary angle closure glaucoma occurs most frequently in Asian populations, including in Indonesian population. Surgical management of Primary Angle Closure Glaucoma (PACG) includes cataract extraction, trabeculectomy, or combined phacotrabeculectomy. Many patients presented in the advanced stages of the disease with significant cataracts, requiring combined surgery. This study aimed to determine whether trabeculectomy alone was better in reducing intraocular pressure compared to phacotrabeculectomy in primary angle closure glaucoma. This was an analytic retrospective observational study reviewing medical records of  PACG patients underwent trabeculectomy or phacotrabeculectomy from January to December 2015, within a 5-year follow-up period of a tertiary eye hospital. The success rates of the two groups were assessed with Kaplan-Meier survival analysis. Success criteria were defined as > 20% reduction of IOP or  IOP <21 mmHg with or without medication. Results showed 104 and 41 eyes underwent trabeculectomy and  phacotrabeculectomy, respectively. The cumulative 5-year survival rate in trabeculectomy group was 58.6%, and 85.4% in phaco trabeculectomy. There was no statistical difference in the success rate between the trabeculectomy and phaco trabeculectomy groups (p=0.102). Postoperative complications observed in the phacotrabeculectomy group were one choroidal detachment,  one malignant glaucoma, and one vitreous prolapse. Thus, the cumulative success rate of phacotrabeculectomy was better than trabeculectomy after 5 years of follow up, albeit not statistically significant.
Karakteristik Klinis Glaukoma Uveitis di Pusat Mata Nasional Rumah Sakit Cicendo Bandung Tahun 2021-2022 Andrianto, Refandi Dwi; Gustianty, Elsa; Rifada, Raden Maula
Jurnal Kesehatan Andalas Vol. 12 No. 3 (2023): Online November 2023
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v12i3.2277

Abstract

Uveitic glaucoma is a complication of uveitis that can occur due to severe intraocular inflammation. Objective: To determined the clinical characteristics of uveitic glaucoma based on clinical features and management at the Cicendo Hospital National Eye Center from 2021 until 2022. Methods: This study used a retrospective descriptive method and a cross-sectional design with secondary data as subjects in the form of electronic medical records of patients at the National Eye Center Cicendo Hospital Bandung who had a diagnosis of uveitic glaucoma in the period January 2021 until December 2022. Results: 162 patients (228 eyes) met the inclusion criteria. Most of the patients were women, with a percentage of 66%. Anterior uveitis (44.3%) was the most common type of uveitis. The mean IOP at the initial visit was 30.1 mmHg. One hundred fourteen eyes (50%) were below 3/60 visual acuity. Infection (41.4%) was the most common cause of uveitis. A total of 107 eyes (46,9%) underwent surgery. There was a decrease in the average IOP in each follow-up period. Conclusions: Glaucoma uveitis is commonly found in women with an average age of 48.6 years. Anterior uveitis with an infectious cause is the most common type and cause of uveitis. The most common surgery is a combination of trabeculectomy, lens extraction, and IOL implantation.Keywords:  management of glaucoma,  secondary glaucoma, uveitic glaucoma
Relationship of Peripapillary Retinal Perfusion with Peripapillary Retinal Nerve Fiber Layer Thickness in Diabetes Mellitus Patients without Diabetic Retinopathy Dwijayanti, Sindi; Irfani, Irawati; Sirait, Susanti Natalya; Gustianty, Elsa; Iskandar, Erwin; Kartiwa, R. Angga
International Journal of Retina Vol 4 No 2 (2021): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2021.vol004.iss002.161

Abstract

Introduction: Impaired blood flow is an early sign of retinal dysfunction in diabetes. Impaired blood flow of the radial peripapillary capillaries can affect the Retinal Nerve Fiber Layer (RNFL) or ganglion cell function. Methods: This was an analytic cross-sectional study in February-April 2019 at Bandung. The subjects of this study were 41 people (79 eyes) divided into two groups, group A (healthy subjects) 19 people (37 eyes) and group B (DM type 2 without diabetic retinopathy) 22 people (42 eyes). Peripapillary retinal perfusion was assesed using OCT Angiography and RNFL thickness was assesed using OCT. Pearson or Spearman correlation statistics test was used to analyze the result. P value ≤0.05 was consiedered significant. Results: There was a decrease in peripapillary retinal perfusion density in the inferior quadrant (P = 0.003) and flux index throughout the peripapillary retinal quadrant (P = 0.0001) but an increase in RNFL thickness in the peripapillary temporal quadrant (P = 0.012) compared to control grup. Positive correlation was found between peripapillary retinal perfusion density and RNFL thickness globally (r = 0.480, P = 0.001), superior quadrant (r = 0.436, P = 0.004), and inferior quadrant (r = 0.608, P = 0.000). A positive correlation was also found between the peripapillary flux and RNFL thickness globally (r = 0.517, P = 0.000), superior quadrant (r = 0.630, P = 0.000), and inferior quadrant (r = 0.519, P = 0.000). Conclusions: There was a relationship between peripapillary retinal perfusion and RNFL thickness in DM patients without diabetic retinopathy. Keywords: Peripapillary perfusion, RNFL thickness, Diabetes.
COMPARISON OF ANGLE OPENING DISTANCE AND TRABECULAR IRIS SPACE AREA BEFORE AND AFTER LASER PERIPHERAL IRIDOTOMY IN ANGLE CLOSURE DISEASE: Abstract Only Ramdhani, Rizki Fasa; Rifada, R. Maula; Irfani, Irawati; Gustianty, Elsa; Umbara, Sonie
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/p64vmm95

Abstract

Introduction and Objective: Laser peripheral iridotomy (LPI) is the standard first-line therapy in angle closure disease to increase anterior chamber angle width. Spectral Domain Anterior Segment Optical Coherence Tomography (SD AS-OCT) is an instrument that has a quantitative parameter to measure anterior chamber angle. Angle opening distance (AOD) and trabecular iris space area (TISA) are quantitative parameters in SD AS-OCT. The purpose of this study is to compare AOD and TISA before and one week after LPI in angle closure disease. Methods: This is an analytical prospective study with a cross-sectional study design. Twenty-two eyes with angle closure disease that met inclusion and exclusion criteria underwent LPI and SD AS-OCT before and one week after LPI. Analysis was performed using SD AS-OCT parameters, such as AOD (AOD500, AOD750) and TISA (TISA500, TISA750) in the temporal, nasal quadrants, and average. Results: Twenty-two eyes with angle closure are divided into nine eyes with primary angle closure suspect, seven eyes with primary angle closure, and six eyes with primary angle closure glaucoma. The mean age of participants was 57.86±7.63 years. There was a significant increase in AOD500, AOD750, TISA500, and TISA750 in the temporal and nasal quadrants, as well as in the average (P=0.0001) based on a paired t test or Wilcoxon as an alternative. Average AOD750 had the highest T-value (T= 6.329) with a mean 0.20±0.096 before LPI and 0.31±0.144 one week after LPI. Conclusion: There was a significant increase in AOD and TISA after one week LPI in angle closure disease.
COMPARISON OF SITA STANDARD 24-2 WITH SITA FASTER 24-2C PROGRAM ON HUMPHREY FIELD ANALYZER IN ASSESSING VISUAL FIELD DEFECTS OF GLAUCOMA PATIENTS: Oral Presentation - Observational Study - Resident Rianti, Nuzul; Satari, Karmelita; Gustianty, Elsa; Prahasta, Andika; Rifada, R. Maula; Umbara, Sonie
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: 10.35749/5a6xfs73

Abstract

Introduction & ObjectivesIntroduction: Periodical perimetry examination to detect and determine the rate of glaucomaprogression continues to be a challenging task, because it depends on many factors. Besides, thereis now a paradigm shift which central visual field defects occur earlier. SITA Standard (SS) 24-2 isthe clinical standard for glaucoma examination, but there were studies reporting on the prevalenceof central visual field defects not detected. SITA Faster (SFR) 24-2C was developed to addresscurrent shortcomings, but the performance has yet to be formally and independently assessed.Objectives: To compare the global indices (Mean Deviation, Pattern Standard Deviation, Visual FieldIndex) and test duration between SS 24-2 and SFR 24-2C program. MethodsThis is an analytical observational study with a cross-sectional design. Subjects aged >18 years whodiagnosed with glaucoma and whose visual fields unaffected by other condition besides glaucomawere included. All subjects underwent testing of both programs. ResultsThis study was conducted in 94 eyes of 66 patients. Comparison of global indices and test durationbetween the two programs was carried out by the Wilcoxon test. The mean results of MD and PSDglobal indices were not significantly different, however there was a difference in the mean VFI of1.5% between the two programs. The test duration of SFR 24-2C was 55.03% faster. ConclusionThere was no significant difference in the MD and PSD global indices, but there was a significantdifference in the VFI, as well as the test duration between the two programs.
COMPARISON OF ANGLE OPENING DISTANCE AND TRABECULAR IRIS SPACE AREA BEFORE AND AFTER LASER PERIPHERAL IRIDOTOMY IN ANGLE CLOSURE DISEASE: Oral Presentation - Observational Study - Resident Ramdhani, Rizki Fasa; Rifada, R. Maula; Irfani, Irawati; Gustianty, Elsa; Umbara, Sonie
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: 10.35749/05vxs382

Abstract

Introduction & ObjectivesLaser peripheral iridotomy (LPI) is the standard first-line therapy in angle closure disease toincrease anterior chamber angle width. Spectral Domain Anterior Segment Optical CoherenceTomography (SD AS-OCT) is an instrument that has a quantitative parameter to measure anteriorchamber angle. Angle opening distance (AOD) and trabecular iris space area (TISA) are quantitativeparameters in SD AS-OCT. The purpose of this study is to compare AOD and TISA before and oneweek after LPI in angle closure disease. MethodsThis is an analytical prospective study with a cross-sectional study design. Twenty-two eyes withangle closure disease that met inclusion and exclusion criteria underwent LPI and SD AS-OCT beforeand one week after LPI. Analysis was performed using SD AS-OCT parameters, such as AOD(AOD500, AOD750) and TISA (TISA500, TISA750) in the temporal, nasal quadrants, and average. ResultsTwenty-two eyes with angle closure are divided into nine eyes with primary angle closure suspect,seven eyes with primary angle closure, and six eyes with primary angle closure glaucoma. The meanage of participants was 57.86±7.63 years. There was a significant increase in AOD500, AOD750,TISA500, and TISA750 in the temporal and nasal quadrants, as well as in the average (P=0.0001)based on a paired t test or Wilcoxon as an alternative. Average AOD750 had the highest T-value (T=6.329) with a mean 0.20±0.096 before LPI and 0.31±0.144 one week after LPI. ConclusionThere was a significant increase in AOD and TISA after one week LPI in angle closure disease.