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All Journal Universa Medicina Jurnal Profesi Medika: Jurnal Kedokteran dan Kesehatan Jurnal Biomedika dan Kesehatan eJournal Kedokteran Indonesia IJRETINA - International Journal of Retina Ophthalmologica Indonesiana Cermin Dunia Kedokteran
Estu Yulia, Dian
Department Of Ophthalmology, Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Successful Management of Complex Congenital Cataract and Its Complication: A Case Report: Keberhasilan Tatalaksana Katarak Kongenital Kompleks dan Komplikasinya: Sebuah Laporan Kasus Dian Estu Yulia; Yulika Harniza; Lia Amanda
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.58.265-70

Abstract

Management of cataract and its complication after surgery in a child with complex congenital cataract where accompanied by other ocular abnormality can pose a great surgical challenge. This case report described a case of an 18-year-old girl with slowly decreasing vision after undergoing surgery charity on the right eye (RE) around 4 months ago due to cataract which she had since birth. Best corrected visual acuity (BCVA) preoperatively of the RE and LE was 6/60 and 0,5/60 respectively. Ocular assessment was pseudophakia with Posterior Capsular Opacity (PCO) on the RE and cataract on the left eye (LE) accompanied by microcornea, nystagmus and coloboma of iris and retina on both eyes. Secondary posterior capsulotomy surgery was done on the RE and cataract extraction, Primary Posterior Capsulotomy (PPC) on the LE with Anterior Vitrectomy (AV) on both eyes. Last follow-up postoperatively showed a significant improvement of uncorrected visual acuity on her RE from 0.5/60 preoperatively to 6/30, meanwhile only subjective improvement of VA was found on her LE. This case can achieve visual improvement with promptly surgical treatment without complication and routine monitoring still needs to be done.
Clinical Characteristics of Children with Refrative Amblyopia at Cipto Mangunkusumo National Referral Hospital Yulia, Dian Estu; Barliana, Julie Dewi; Sitorus, Rita Sita; Putri, Meuthia Rana; Soeharto, Diajeng Ayesha
Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan Vol 18 No 1 (2024): Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran UPN Veteran Jakarta Kerja Sama KNPT

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33533/jpm.v18i1.7582

Abstract

Amblyopia, commonly referred to as 'lazy eye’, manifests as a reduction in best corrected visual acuity (BCVA) in the absence of detectable ocular structural abnormalities. Refractive amblyopia specifically denotes a subtype of amblyopia arising from uncorrected refractive errors. A retrospective descriptive analysis was conducted on medical records of all pediatric patients with refractive amblyopia at the Department of Ophthalmology, Cipto Mangunkusumo Kirana National Referral Hospital, Jakarta, Indonesia in 2018 to 2022. A total of 391 eyes of 224 patients were included. Median age was 8 (5-18) years, with majority being older than 7 years of age (58.7%). Leading method of treatment was with spectacles alone (80.4%). Overall amblyopia improvement was mostly observed after six months of treatment. In conclusion, refractive amblyopia at our hospital was highly prevalent among children. Thus, early detection and treatment of refractive errors in children is essential to prevent refractive amblyopia.
The use of Artificial Intelligence for Diagnosing Retinopathy of Prematurity – A Systematic Review Pertiwi, Adinda Mulya; Yulia, Dian Estu; Lestari, Yeni Dwi
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.iss002.316

Abstract

Purpose: Retinopathy of prematurity (ROP) is a vaso-proliferative disease of the retina associated with prematurity and is well known to be the leading cause of childhood blindness worldwide. Given the prevalence of ROP and the increasing demand for efficient screening solutions, this systematic review aims to update the current development of Artificial Intelligence (AI) technologies for ROP diagnosis and screening, considering the appropriate AI types that align with the specific needs and workloads of ROP screening programs. Methods: We performed a systematic literature review of the English online literature databases by applying a general search strategy on April 20, 2024. Search phrases included multiple variants of terms including "ROP", "retinopathy of prematurity", "artificial intelligence", "diagnosis", "sensitivity analysis", "specificity", "area under the curve". Findings: A total of 12 studies were identified from varied countries. Summary: Review of the published literature demonstrate high sensitivity across different studies, indicating their strong potential for early detection of ROP but demonstrating variability in specificity. The review also underscores the importance of domain adaptation and validation across diverse populations to ensure generalizability. AI integration in clinical practice, especially in telemedicine, can enhance early detection, standardize diagnoses, and alleviate the burden on healthcare professionals, particularly in low-resource settings.
Single Arterial Oxygen Tension Elevation Increases the Risk of Stage of Acute Disease Retinopathy of Prematurity Pratiwi, Karina Satyani; Yulia, Dian Estu; Barliana, Julie Dewi; Sitorus, Rita Sita
International Journal of Retina Vol 6 No 2 (2023): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2023.vol006.iss002.242

Abstract

Introduction: Numerous studies have shown inconclusive results regarding ideal parameter for oxygen supplementation to balance the risk of mortality and retinopathy of prematurity (ROP) development. The purpose of this study is to compare mean partial oxygen tension (PaO2) level in ROP. Methods: This retrospective study was performed on premature infants undergoing ROP screening at our neonatal intensive care unit during 2021. All infants born at our hospital at ≤ 30 weeks, birth weight (BW) ≤ 1500 grams, or high-risk infants with prolonged ventilation were included. ROP screening was performed at chronological age four to six weeks, were followed and managed according to the severity. ROP severity was categorized by International Classification of ROP 3rd edition (ICROP3). We reviewed the characteristics of each group and compared mean PaO2 level in day 1, day 5, and day 10 between incomplete vascularization (IV) group, stage of acute disease (SAD) group, and Aggressive ROP (A-ROP) group. Result: We investigated 124 eyes from 62 eligible PI. The incidence of IV, stage 1, stage 2, stage 3, and A-ROP were 58.9%, 2.4%, 7.3%, 23.4%, and 8.1%, respectively. Mean PaO2 level in day 5 was higher in SAD group compared to IV group (p=0.002). For each level increase in PaO2, there was 1.042 times higher odds of developing SAD (p=0.004). Multivariate logistic regression analysis showed consistent results, simultaneously, each week increase in GA was associated with lower risk of SAD development (p=0.018) and each level increase in PaO2 was associated with higher risk for SAD development (p=0.005). Conclusion: A single elevation in PaO2 during early life of PI increases the risk of developing stage of acute disease ROP, particularly in younger infants. Careful monitoring for PaO2 is mandatory to prevent development of ROP.
CLINICAL OUTCOMES OF SURGERY FOR ADVANCED STAGE RETINOPATHY OF PREMATURITY: A CASE REPORT Yulia, Dian Estu; Jayawinata, Marissa; Hutapea, Mario Marbungaran
International Journal of Retina Vol 6 No 1 (2023): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2023.vol006.iss001.210

Abstract

Introduction: Advanced stages of Retinopathy of Prematurity (ROP) could lead to childhood blindness and retinal surgery is needed as the main treatment. This case aims to report the clinical outcomes after surgery for advanced-stage ROP Case Report: A female infant was admitted to the pediatric ophthalmology clinic in Cipto Mangunkusumo National Central Hospital Jakarta with a lack of visual contact in both eyes at 53 weeks of Post Menstrual Age (PMA). The infant was delivered at 28 weeks of gestational age with a birth weight of 1100 g. The baby was treated in NICU for 24 days and received oxygen therapy in the previous hospital. Retinal examination revealed that the patient had stage 5 ROP in the right eye and stage 4B ROP in the left eye. Furthermore, blinking reflect was absent in both eyes. Vitrectomy and endolaser were performed for the baby’s left eye. Surgery was not conducted for the infant’s right eye due to poor prognosis. Six weeks after surgery, the infant underwent examination under anesthesia (EUA) which showed that the retina was reattached with no vitreous hemorrhage, and intraocular pressure measurement was 7 mmHg. The result of the visual acuity test by Cardiff Acuity Cards was 6/60 on both eyes. Followed up EUA reported that the refraction test result on the left eye was S-3.75 C-5.75 x 85o and an undetermined result on the right eye due to opacity in the visual axis. Discussion: Several surgeries have been described as the treatment of choice for advanced-stage ROP, including scleral buckling and vitrectomy with or without the addition of endolaser. Previous studies illustrated that stage 5 ROP has a low success rate on lens-sparing vitrectomy compared to stage 4A and 4B. The outcome success rate was the best in stage 4A ROP. Moreover, stage 4B ROP had a moderate success rate with sufficient visual outcomes. Conclusion: The functional outcome of vitrectomy surgery may not equate to anatomic success. Retinal reattachment and moderate visual outcome were achieved by performing vitrectomy and endolaser in this case. Followed-up periodically is necessary for advanced stage ROP postoperatively.
Miopia pada Anak dan Faktor Risikonya Selama Pandemi COVID-19: Sebuah Tinjauan Sistematis Tan, Sabrina; Yulia, Dian Estu
Jurnal Biomedika dan Kesehatan Vol 7 No 3 (2024)
Publisher : Fakultas Kedokteran Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/JBiomedKes.2024.v7.362-373

Abstract

Myopia or near-sightedness is the most common ophthalmologic disorder in the world. Myopia prevalence has significantly increased over the last decade, especially in the pediatric population. During the COVID-19 pandemic, governments worldwide implemented home quarantine and school closures to contain and mitigate the virus’s spread. This resulted in increased screen time, more time doing near-work activities, and decreased time spent outdoors. This study was to compare myopia progression in children before and during the COVID-19 pandemic and examine pandemic-related lifestyle risk factors for myopia progression. Methods of this study were A comprehensive search of Ovid MEDLINE and PubMed for potential articles was conducted following the PRISMA 2020 guidelines. The data extracted from each included studies included epidemiologic data on myopia in children, changes in spherical equivalent (SE), and the amount of outdoor activity, screen time, and near work before and during the COVID-19 pandemic home quarantine. This review included six studies, comprising two retrospective cohort studies, three prospective cohort studies, and one cross-sectional study. Epidemiological data showed increased pediatric myopia cases and a greater SE difference during the COVID-19 pandemic. During the pandemic, it was reported that children spent more time on screens, engaging in near-work activities, and less time outdoors. Multiple logistic regression analyses consistently showed increased screen time as a significant risk factor for myopia in children during the pandemic, while outdoor time and time spent doing near-work activities were not statistically significant. Conclusion of this study where Myopia progression in children was more rapid during the COVID-19 pandemic, with increased screen time identified as a risk factor. More research is needed to further investigate other pandemic-related risk factors for myopia in children.
Childhood blindness from surge of advanced stage retinopathy of prematurity in premature infants during the COVID-19 pandemic: a case series Yulia, Dian Estu; Soeharto, Diajeng Ayesha
Universa Medicina Vol. 42 No. 3 (2023)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2023.v42.360-367

Abstract

Background Retinopathy of prematurity (ROP) is a proliferative disease of the ocular retinal vasculature in premature infants, being a leading cause of preventable childhood blindness. The COVID-19 pandemic serves as an additional barrier to access to care and referral, potentially leading to more cases of advanced stage ROP. Although surgery can be done, ROP at this stage is highly associated with poor functional outcome irrespective of surgery. This case series aims to report advanced stage (stage 5) ROP in premature infants during the COVID-19 pandemic. MethodsA retrospective case series of medical records of paediatric patients with ROP was performed at Cipto Mangunkusumo National Referral Hospital between March 1, 2020 and December 31, 2021. This case series included new patients that presented to our clinic from March 2020 to December 2021 with stage 5 ROP. ResultsA total of 19 eyes of 10 patients with stage 5 ROP were included in this study. Mean chronologic age at presentation to our referral centre was 7.0 4.0 months. Upon presentation, all had stage 5 ROP with negative blink reflex to light, and none of the eyes in this cohort underwent surgical intervention. Mean gestational age was 30.3 3.2 weeks and mean birth weight was 1,276.7 366.4 g. ConclusionThere was an observable surge of stage 5 ROP at our referral centre with irreversible blindness. This highlights the need for proper ROP screening in all hospitals in Indonesia to prevent delay in detection and care of advanced stage ROP.
FACTORS THAT INFLUENCE SURVIVAL RATE IN EXTRAOCULAR RETINOBLASTOMA PATIENTS AT CIPTO MANGUNKUSUMO HOSPITAL : 2018 Aprina, Dwie; Barliana, Julie Dewi; Yulia, Dian Estu; Sitorus, Rita Sita
Majalah Oftalmologi Indonesia Vol 50 No 1 (2024): 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/fvstnp93

Abstract

Introduction: Optimal therapeutic approach for extraocular retinoblastoma has not been determined. The prognosis of extraocular retinoblastoma compared with intraocular retinoblastoma remains relatively poor. The aim of our study is to describe the factors that influence the survival rate of extraocular retinoblastoma. Methods: A retrospective study. Patients diagnosed with extraocular retinoblastoma in Cipto Mangunkusumo Hospital, within 1 January to 31 December 2018 were reviewed for patient and tumor characteristic, ocular management, and patient survival. Result: During the study period, a total of  80 patients were diagnosed with retinoblastoma in our center, 41.2% had an extra-ocular extension The mean age at diagnosis was 25.57 months, with 56.7% being males. Leukocoria is the initial sign most often noticed by parents. The median lag period was 12 months. Neoadjuvant chemotherapy was performed in 96.7% of cases, that carried out an average of 3-4 cycles before enucleation/exenteration. At the end of September 2019, there were 17 deaths in our study. Overall survival was 19.82 months with a mean age of 27.6 months, whereas extraocular death time ranged from 4 months to 55 months.  Conclusion: Death was more common in patients with age at first symptom less than 24 months, bilateral retinoblastoma, lag period more than 12 months, advanced stage (IVB) and delayed therapy after proptosis more than 3 months.
OVERVIEW OF PATIENTS SCREENED FOR AND DIAGNOSED WITH ROP IN PEDIATRIC OPHTHALMOLOGY OUTPATIENT CLINIC BEFORE, DURING, AND AFTER THE COVID-19 PANDEMIC: Poster Presentation - Observational Study - Ophthalmologist BARLIANA, JULIE DEWI; Sitorus, Rita Rita; Yulia, Dian Estu; Casey, Anthea; Zahra, Raihanny Andrea
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/hwpgv162

Abstract

Introduction & Objectives : The COVID-19 pandemic has profoundly impacted healthcare systems worldwide, leading to significant changes in the delivery of medical services. Non-urgent ophthalmology visits were canceled. However, premature infants at risk of retinopathy of prematurity (ROP) require timely and in-person care to prevent vision loss. This study aims to report on the high-risk babies screened and diagnosed with ROP before, during, and after the COVID-19 pandemic Methods : This is a descriptive study conducted on premature infants who visited the pediatric ophthalmology outpatient clinic at Cipto Mangunkusumo Hospital Jakarta between January 2019 and December 2022. Data was collected using medical records and presented using tables and charts Results : A total of 368 babies were screened for ROP in 2019, and 75% were diagnosed with ROP. During the lockdown in 2020, the number of babies screened for ROP decreased to 286, and the incidence of ROP was 38.5%. In 2021 and 2022, ROP screening increased to 458 and 515 babies per year, respectively. After the COVID-19 pandemic subsided, ROP screenings increased significantly from 2020 to 2021. The number of babies screened in 2021 and 2022 was similar, but the incidence of ROP decreased from 45.4% in 2021 to 20.3% in 2022 Conclusion : This study highlights the impact of the COVID-19 pandemic on ROP screening and diagnosis in a pediatric ophthalmology outpatient clinic. After the COVID-19 pandemic, the number of babies screened for ROP increased due to the end of the lockdown
What do we miss in this Orbital Retinoblastoma? Poster Presentation - Case Report - Resident Caroline, Christella; Fedora, Ghina; Soraya, Siti Halida Zoraida; Yulia, Dian Estu
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/vexz2k86

Abstract

Introduction : Orbital retinoblastoma (RB) is a dire event with a bleak prognosis. This report highlights the severe complications of retinoblastoma resulting from insufficient diagnostic and treatment efforts due to inadequate medical resources and socio-economic challenges. Case Illustration : A 4-year-old boy was brought in with swelling on his left eye socket and jaw, present for two months.He had exhibited leukocoria followed by proptosis 12 months prior and underwent enucleation without dermato-fat graft (DFG) five months ago. Histopathology revealed retinoblastoma without optic nerve invasion. Despite referral to a regional hospital for chemotherapy, he did not receive treatment due to socio-economic constraints. Two months post-operation, the left eye prosthesis spontaneously dislodged, accompanied by an enlarging eye and a left jaw mass. An ophthalmologic assessment disclosed a mass in the left orbital socket, while the right eye appeared normal. A CT scan identified masses in the left orbit, parotid, and masticator spaces, as well as bilateral colli lymphadenopathy. The patient was diagnosed with residual retinoblastoma and received chemotherapy. Discussion : Imaging is crucial in proptosis patients to determine tumor extent and management strategies. The standard approach involves initial chemotherapy, surgery, radiotherapy, and additional chemotherapy. High-risk histological features (HHRF) also warrant chemotherapy, although the presence of such features remains undetermined in this case. Employing multiple treatment modalities may enhance prognosis. Conclusion : Thorough examination and management are essential in retinoblastoma cases. Patient family education and diligent care play a crucial role in preventing the progression and spread of retinoblastoma.
Co-Authors Aprina, Dwie Caroline, Christella Casey, Anthea Fedora, Ghina Hutapea, Mario Marbungaran Jayawinata, Marissa Julie Dewi Barliana Lia Amanda Paramita, Carennia Pertiwi, Adinda Mulya Pradiptama, Yura Pratiwi, Karina Satyani Putri, Meuthia Rana Sitorus, Rita Rita Sitorus, Rita Sita Soeharto, Diajeng Ayesha Soraya, Siti Halida Zoraida Tan, Sabrina Yeni Dwi Lestari Yulika Harniza Zahra, Raihanny Andrea