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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

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.

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

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.

COMPARISON OF SITA STANDARD 24-2 WITH SITA FASTER 24-2C PROGRAM ON HUMPHREY FIELD ANALYZER IN ASSESSING VISUAL FIELD DEFECTS OF GLAUCOMA PATIENTS Rianti, Nuzul; Satari, Karmelita; Prahasta, Andika; Rifada, R. Maula; Umbara, Sonie
Majalah Oftalmologi Indonesia Vol 49 No S1 (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/a4syph39

Introduction: Periodical perimetry examination to detect and determine the rate of glaucoma progression continues to be a challenging task, because it depends on many factors. Besides, there is now a paradigm shift which central visual field defects occur earlier. SITA Standard (SS) 24-2 is the clinical standard for glaucoma examination, but there were studies reporting on the prevalence of central visual field defects not detected. SITA Faster (SFR) 24-2C was developed to address current shortcomings, but the performance has yet to be formally and independently assessed. Objective: To compare the global indices (Mean Deviation, Pattern Standard Deviation, Visual Field Index) and test duration between SS 24-2 and SFR 24-2C program. Methods: This is an analytical observational study with a cross-sectional design. Subjects aged >18 years who diagnosed with glaucoma and whose visual fields unaffected by other condition besides glaucoma were included. All subjects underwent testing of both programs. Results: This study was conducted in 94 eyes of 66 patients. Comparison of global indices and test duration between the two programs was carried out by the Wilcoxon test. The mean results of MD and PSD global indices were not significantly different, however there was a difference in the mean VFI of 1.5% between the two programs. The test duration of SFR 24-2C was 55.03% faster. Conclusion: There was no significant difference in the MD and PSD global indices, but there was a significant difference 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: 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

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

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

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.

REDUCTION OF INTRAOCULAR PRESSURE POST MICRO PULSE TRANSSCLERAL CYCLOPHOTOCOAGULATION IN REFRACTORY GLAUCOMA PATIENTS: Oral Presentation - Observational Study - Resident Rahayu, Annisa; Gustianty, Elsa; Knoch, Andrew M.H; Rifada, 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/tyq5vs98

Introduction & ObjectivesCyclodestructive laser is one of the last resource managements for refractory glaucoma, especiallywith low visual potential. Conventional laser using CW-TSCPC showed unstable IOP reduction withcollateral tissue damage. MP-TSCPC using on and off cyclic waves is considered to have a gooddegree of IOP reduction and fewer complications. The purpose of this study is to assess the IOPreduction after the MP-TSCPC procedures for patients with refractory glaucoma. MethodsThis is a prospective observational study for refractory glaucoma patients treated with the MPTSCPClaser procedure. Measurement of IOP was carried out preoperatively and on postoperativedays 1, 7, and 30 with the gold standard Goldmann applanation tonometry. ResultsA total of 33 eyes from 33 patients were enrolled in this study. The mean baseline IOP was 48.45 ±12,79 mmHg. The mean degree of IOP reduction on follow-up days 1, 7, and 30 were 14.39 ±23.52%, 45,83 ± 24,80 and 27.09 ± 23.86% respectively. On the 30th day after the laser treatment,no complications were observed. The number of anti-glaucoma medication was reduced from 2.39 ±0.49 at the baseline to 1.91 ± 0.58 at one month follow up. ConclusionMicro-pulse transscleral cyclophotocoagulation laser showed a good degree of IOP reduction with noincidence of complication observed at day 30.

SECONDARY GLAUCOMA AFTER VITREORETINAL SURGERY: A RETROSPECTIVE OBSERVASIONAL STUDY: Oral Presentation - Observational Study - Resident Gunawan, Liani Mulasari; Rifada, R. Maula; 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: 10.35749/49ss4368

Introduction & ObjectivesSecondary glaucoma is the most common complication after vitreoretinal surgery. Pars PlanaVitrectomy (PPV) is a common surgical procedure aimed at removing vitreous gel and replacing itwith variety of substances denominated tamponades. Vitreous removal and replacement may causeincreased intraocular pressure (IOP). The IOP can be reduced with medical treatment or surgery.The purpose of this study is to describe the characteristics of secondary glaucoma after vitreoretinalsurgery in National Eye Center Cicendo Hospital from January 2019 - December 2020. MethodsThis study was a retrospective descriptive study which data were obtained from medical records.Data such as age, gender, vitrectomy tamponades, IOP, onset of glaucoma, and glaucoma treatmentwere collected. ResultsOne hundred fifty-three eyes were referred to Glaucoma Unit with increasing IOP after vitreoretinalsurgery. PPV with tamponade was done in 141 eyes (92.16%) and silicone oil (SO) 1000 centistokes(cSt) was the most used tamponade in 101 eyes (66.07%). Secondary glaucoma with open angle wasthe most common type in 124 eyes (81.04%). Secondary glaucoma developed in 4-7 weeks aftersurgery, with the highest IOP recorded at 31-40 mmHg. The IOP decreased after SO evacuation withinitial glaucoma treatment in 121 eyes (79.09%), and glaucoma surgery was performed in 32 eyes(20.91%). ConclusionSilicon oil as a tamponade agent after PPV may cause rise IOP in the post-operative period.Evacuation SO needs to be done after retinal adhesion to prevent secondary glaucoma. Therefore,timely detection and anti-glaucoma treatment are important to decreased IOP, or filtration surgerycan be performed.

SELECTIVE LASER TRABECULOPLASTY AS A VALUEABLE MODALITY OF TREATMENT IN OPEN ANGLE GLAUCOMA PATIENT: Oral Presentation - Observational Study - Ophthalmologist TRIANGGADEWI, DYAH PURWITA; Umbara, Sonie; Rifada, R Maula; Gustianty, Elsa; Prahasta, Andika
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/r6cq3b33

Introduction & ObjectivesSelective Laser Trabeculoplasty (SLT) has became an established treatment to lower intraocularpressure (IOP) for open angle glaucoma (OAG) and ocular hypertension. The aim of this study was toevaluate IOP lowering effect of SLT and correlate its laser parameter to the successful rate in OAG. MethodsThis is a prospective study of seventeen eyes OAG patients in Cicendo Eye Hospital from 1stNovember 2022 to 31th December 2022. SLT performed once in OAG with uncontrolled IOP (IOP >21 mmHg). Outcome measured were IOP at post laser, 1week , 1 month, and 2 months of follow upafter SLT. Successful criteria determined as greater than 20% IOP reduction. Correlation betweensetting operational of SLT and primary outcome were measured. Student’s t-test (two-tailed,dependent) has been used to find the significance of study parameters. ResultsA total 17 eyes underwent SLT. Mean baseline IOP was 21,12 ? 4,0 mmHg. IOP was significantlydecreased from baseline post laser 18,06 ? 3,17 mmHg; at 1 week 17,06 ? 3,25 mmHg; 1 month15,53 ? 4,52 mmHg; and at 2 month follow up 15,47 ? 4,02 mmHg (p<0,001). The successful rate ofSLT after two months follow up from this study were 76,5% samples (13 eyes). Mean of total laserenergy was 75,6 ? 16,8 mJ. There was correlation between total laser energy with percentage of 1month IOP reduction (coefficient : 0,470 (p<0,029)). ConclusionSLT is effective and safe for reducing IOP in open angle glaucoma patient.

DIFFERENT APPROACHES IN MANAGING LENS-INDUCED ANGLE CLOSURE GLAUCOMA: A SERIAL CASE: Poster Presentation - Case Series - Resident Wardani, Sabrina Indri; Rifada, R. Maulana; Prahasta, Andhika; 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: 10.35749/9x275355

Introduction : Lens-induced angle-closure glaucoma can be caused by phacomorphic lens and ectopia lentis. Several factors affect the disease progression. Early diagnosis and appropriate management are important. Case Illustration : Case 1. A 67-year-old woman presented with acute redness and blurred vision in her left eye with visual acuity (VA) of 1/300 and intraocular pressure (IOP) of 60 mmHg. Axial length showed 23.66 mm and anterior chamber depth (ACD) was 1.61mm (Figure1). She was diagnosed with phacomorphic glaucoma. Phacoemulsification combined with trabeculectomy was performed (Figure2&3). Her VA was improved to 0.08 and her IOP was reduced to 19mmHg after surgery. Case2. A 67-year-old man came with painful blurred vision in his right eye. His VA was a perception of light with an IOP of 40 mmHg. He had axial length of 22.7 mm and ACD of 2.07 mm (Figure4). The lens was anteriorly subluxated and showed zonular laxity. Intracapsular cataract extraction combined with trabeculectomy was performed (Figure5&6). His VA was unchanged while his IOP was reduced to 18 mmHg after surgery. Discussion : Age older than 60 years old, female gender, short axial length (<23.7 mm), shallow ACD, and zonular laxity are factors for progressivity of lens-induced glaucoma. Cataract removal was a definitive treatment along with IOP-lowering medications. The choice of lens extraction technique varies among individuals. Conclusion : Removal of cataractous lens is a definitive treatment in conjunction with intraocular pressure and inflammatory regulations for managing lens-induced angle-closure glaucoma. Comprehensive clinical assessments in patients are necessary for managing the symptoms and preventing complications.

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