Nadia Artha Dewi
Department Of Ophthalmology, Faculty Of Medicine Universitas Brawijaya, Saiful Anwar General Hospital, Malang, Indonesia

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A Successful Management of 29 year old Female with Left Central Retinal Artery Occlusion due to Manifestation of Primary Antiphospholipid Syndrome Trianto, Herman Bagus; Wahono, Cesarius Singgih; Dewi, Nadia Artha
Indonesian Journal of Rheumatology Vol 8, No 2 (2016)
Publisher : Indonesian Rheumatology Association

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Abstract

Ocular involvement in Anti Phospolipid Syndrome (APS) includes a broad spectrum of manifestations from the anterior and posterior segment or the presence of neuro-ophthalmologic features. A female, 29 years old, came to ER handled by ophthalmology department, with chief complaint left visual loss suddenly since 4 hours before admission. Investigations revealed stable vital signs, VOD 20/20, VOS 1/300, funduscopy showedpale and cherry red spot on left retina, OCT revealed hyperreflective of left inner retinal layer, IgG aCL 51.7 U/mL (50.8 U/mL in OPD 3 months later), and the other examinations were within normal limit. Patient was diagnosed with Central Retinal Artery Occlusion due toPrimary Antiphospolipid syndrome. She was performed occular massage and anterior chamber paracintesis procedure, and given O2 6-8 lpm NRBM, Timolol 0.5% eye drop left eye bid, acetazolamide 250 mg bid, Kalium Slow Release 1 tab qd, Levofloxacine eye drop 1 drop/hour post surgery. After the result of IgM aCL available, we added warfarin 2 mg qd and aspirin 320 mg qd. Patient was discharged 2 days later as visual acuity improved with VOD 20/20 and VOS 0.5/60. Key words: Central retina artery occlusion, primary anti phospolipid syndrome, anti cardiolipin antibody
Bilateral Exudative Retinal Detachment Due to Hypertensive Retinopathy and Choroidopathy In Young Patient with Chronic Kidney Disease Kartikasari, Indha Dwi; Dewi, Nadia Artha; Metita, Mirza; Refa, Safaruddin
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Abstract

Introduction: Severe systemic hypertension in chronic kidney disease can cause significant damage to the eye. Although hypertensive retinopathy is a well-known complication, hypertensive optic neuropathy and choroidopathy are much less common. The aim of this study is to report retinal manifestation in young patient with chronic kidney disease. Method: A 26-year-old man with underlying disease chronic kidney disease (CKD) gr-V underwent bilateral bullous exudative retinal detachments. Retinal arteriolar narrowing, vascular tortuosity, arteriovenous nicking, optic disc swelling, retinal haemorrhage, elschnig spot, siegrist streak were identified in both eyes. Blood pressure was 200/140mmHg with visual acuity 0,5/60 OU. The patient was diagnosed with bilateral hypertensive retinopathy and choroidopathy with bulous exudative retinal detachments. Results: After antihypertensive treatment, visual acuity improved, but the exudative retinal detachments and retinal hemorrhages reduced. A patient with those findings should be considered as having hypertensive retinopathy and choroidopathy and treated as soon as possible because of the poor prognostic. Conclusion: Hypertensive choroidopathy is a rare finding associated with acute increases in blood pressure. When the choroid is associated, the hypertensive event is often more acute and associated with increased morbidity. It is necessary to obtain fundus exam in any patient with elevated blood pressure and concomitant vision complaints. Therefore, screening hypertensive patients involves close collaboration between internist and ophthalmologist.
Profile of Patients with Floaters in Saiful Anwar Hospital Malang Hidayah, Fenti Kusumawardhani; Dewi, Nadia Artha; Refa, Safaruddin
International Journal of Retina Vol 1 No 2 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Introduction: To report the profile of patients with floaters as a subjective complain in Saiful Anwar Hospital from July 2012 until June 2013. Methods: an observasional descriptive study was conducted, collecting data on gender, age, subjective complain (floaters, flashes and subjective vision reduction), best corrected visual acuity and diagnose from patient’s medical record. Result: 169 patients (215 eyes) were included in this study. Female patients contributed a higher percentage than male with mean of age was 49 years old. The subjective complain was floaters (67%), floater with blurred vision (22%), floater with flashes (6%) and patients with floaters, flashes, and blurred vision was 5%. Myopia was the most common refraction problem. Diagnose recorded from this study were posterior vitreous detachment (PVD) (34%), no abnormalities (13%), PDR (10%), RRD (9%), peripheral retinal degeneration (14%) retinal break (6%), corpus vitreous degeneration (3%), vitreous haemorhage (3%), posterior uveitis (2%) and others (6%). Conclusion: The most common cause of floaters is PVD. Even it is usually a save condition but there are some condition with floater as a subjective complain which is threatening vision, so accurate eye examination from anterior to posterior segment were needed.
HUBUNGAN ANTARA HBA1C DAN KADAR LIPID SERUM DENGAN DERAJAT BERAT RETINOPATI DIABETIKA Refa, Safaruddin; Dewi, Nadia Artha
Jurnal Kedokteran Brawijaya Vol 21, No 3 (2005)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (377.154 KB) | DOI: 10.21776/ub.jkb.2005.021.03.6

Abstract

Diabetic retinopathy is a leading cause of blindness in industrial world and is rapidly becoming an important cause in developing countries. Many factors related with theseverity of diabetic retinopathy, such as HbA1c and serum lipid. The study wants to know whether those factors have any  correlation with the severity of diabetic retinopathy or not. The objective this study was to determine the correlation between HbA1c and serum lipid with the severity  of diabetic retinopathy. An analytic cross sectional observational research had been done at Saiful Anwar hospital. The samples (diabetic retinopaty patients) were taken with consecutive sampling. These patient underwent funduscopy, fundus photography, laboratory examination including HbA1c, serum lipid (total serum cholesterol, LDL, HDL, triglycerides), and blood glucose. These patient were questioned about risk factors previously determined by the authors. The laboratory findings were thease are compared to the severity of diabetic retinopathy.
EFEK PEMBERIAN MATRIX METALLOPROTEINASE-9 ( MMP- 9) RNA INTERFERENCE TERHADAP EKSPRESI MMP- 9 PADA KULTUR SEL ENDOTEL VASKULAR Wulandari, Lely Retno; Suyuti, Hidayat; Dewi, Nadia Artha; Refa, Safaruddin
Jurnal Kedokteran Brawijaya Vol 22, No 2 (2006)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1391.743 KB) | DOI: 10.21776/ub.jkb.2006.022.02.1

Abstract

ABSTRACT Retinal neovascularization is the main problem that causes blindness in many types of eye desease. Neovascularization occurs in ischemic retina, and several important mediators that induce neovascularization is secreted by the surrounding cell and endothelial cell vessels. Matrix metalloproteinase-9 is an enzyme secreted by endothelial cell vessels and plays an important role in the pathogenesis of retinal induce neovascularization. Vascular endothelial cells were cultured and transfected with Matrix Metalloproteinase -9 RNA interference in two doses (100nM or 200nM) and the cells were taken at 24,  48  and  72  hours.  The  expression  of  Matrix  Metalloproteinase  -9  protein  levels  were  examined  by immunocytochemistry, and compared with control group. The data were analyzed with factorial anova. Statistical analysis showed that transfection with different doses of MMP-9 RNAi gave a significant different effect on MMP-9 expression (p-value < 0.05), while exposure time did not give significant difference (p-value < 0.05). This in-vitro study indicated that transfection  of  MMP-9  RNAi  with  dose  200nM  reduced the  expression  of  MMP-9  by  50%  compared  to  the  control. Because exposure time was not significant, the lowest expression of MMP-9 can be achieved by transfecting MMP-9 RNAi 200nM for 24 hours. This is the first study that demonstrates the effectiveness of RNA interference mediated targeting  of MMP-9 to reduce the MMP-9 expression in vascular endothelial cell lines Key Words  : Matrix Metalloproteinase -9 - RNA interference - vascular endothelial cell lines.
INDONESIAN PEOPLE RISK FACTORS OF NOCTURIA (TWO OR MORE VOIDS PER NIGHT) OLDER THAN 40 YEARS-OLD Besut Daryanto; Athaya Febriantyo Purnomo; Taufiq Nur Budaya; Seskoati Prayitnaningsih; Nadia Artha Dewi
MNJ (Malang Neurology Journal) Vol. 8 No. 2 (2022): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2022.008.02.6

Abstract

Background: Nocturia is a common urinary system disease. Objective: This study aimed to investigate the causes of nocturia in women Indonesian inhabitants aged≥ 40 years. Methods: A stratified sample strategy was used to conduct a randomized cross-sectional study on 562 residents under the age of 40 in Malang City, East Java, Indonesia. A questionnaire was completed, which included socioeconomic demographics, lifestyle characteristics, and clinical history. Each night, nocturia was defined as at least two voids. The chi-squared test was used to determine proportional differences between age and gender groups. Multivariate logistic regression analysis was used to assess gender-related factors. This was determined that P0.05 was statistically significant. Results: Data on 562 people aged 61.60 + 9.81 years eligible for statistical analysis at the end, comprising 185 (32.92%) men and 377 (67.08%) women. Overall nocturia prevalence was 31.8% (179/562). It rose significantly with age (P<0.001) and reached >48% in those above the age of 70. In both men and women, nocturia was linked with diabetes, hypertension, cardiovascular disease, and the overactive bladder symptom score (OABSS) (P0.05). There was no link discovered between nocturia and education, profession, civil status, BMI, female birth history, or the International Prostate Symptom Score. Conclusion: Nocturia is linked to aging, cardiovascular disease, hypertension, OABSS, and diabetes in Indonesians over the age of 40.
REMARKABLE RESULT TOWARDS RETINOPATHY ASSOCIATED AUTOIMMUNE HEMOLYTIC ANEMIA Rofa Husnul Khuluqi; Nadia Artha Dewi; Susanto Nugroho; Lely Retno Wulandari
International Journal of Retina Vol 5 No 1 (2022): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2022.vol005.iss001.190

Abstract

Introduction: To present the clinical findings of Autoimmune hemolytic anemia (AIHA) Retinopathy and its rapid resolutions following treatment with steroid. Case report: A 14-year-old female patient presented with decreased vision in the left eye. There was history of AIHA. Visual acuity was 1/60 in LE and 6/6 in RE. There was conjunctival pallor, and the other anterior segment were unremarkable. Fundus examination of left eye revealed flame shaped and dot blot hemorrhage, roth’s spots, optic disc swelling, venous turtuosity, and elevated macula. There were afferent pupil defect, red green deficiency, and contrast sensitivity decline. Hematological evaluation revealed anemia. A MRI Head and Orbital examination were unremarkable. Discussion: This patient was assessed with LE Anemic retinopathy due to AIHA. The patient’s visual acuity improved as the retinopathy resolved after 1 month of oral steroid therapy. Conclusion: Anemia may play a role in the occurrence of retinopathy. The diagnosis of retinopathy can be made by linking ophthalmic fndings with positive serological test. Accurate comprehensive examination can establish the systemic diagnosis, and control of systemic parameters will improve retinopathy, reverse vision loss, and avoid permanent blindness
Bilateral Exudative Retinal Detachment Due to Hypertensive Retinopathy and Choroidopathy In Young Patient with Chronic Kidney Disease Indha Dwi Kartikasari; Nadia Artha Dewi; Mirza Metita; Safaruddin Refa
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2018.vol001.iss001.20

Abstract

Introduction: Severe systemic hypertension in chronic kidney disease can cause significant damage to the eye. Although hypertensive retinopathy is a well-known complication, hypertensive optic neuropathy and choroidopathy are much less common. The aim of this study is to report retinal manifestation in young patient with chronic kidney disease. Method: A 26-year-old man with underlying disease chronic kidney disease (CKD) gr-V underwent bilateral bullous exudative retinal detachments. Retinal arteriolar narrowing, vascular tortuosity, arteriovenous nicking, optic disc swelling, retinal haemorrhage, elschnig spot, siegrist streak were identified in both eyes. Blood pressure was 200/140mmHg with visual acuity 0,5/60 OU. The patient was diagnosed with bilateral hypertensive retinopathy and choroidopathy with bulous exudative retinal detachments. Results: After antihypertensive treatment, visual acuity improved, but the exudative retinal detachments and retinal hemorrhages reduced. A patient with those findings should be considered as having hypertensive retinopathy and choroidopathy and treated as soon as possible because of the poor prognostic. Conclusion: Hypertensive choroidopathy is a rare finding associated with acute increases in blood pressure. When the choroid is associated, the hypertensive event is often more acute and associated with increased morbidity. It is necessary to obtain fundus exam in any patient with elevated blood pressure and concomitant vision complaints. Therefore, screening hypertensive patients involves close collaboration between internist and ophthalmologist.
CORRELATION BETWEEN SYSTEMIC LUPUS ERYTHEMATOSUS DISEASE ACTIVITY AND LUPUS RETINOPATHY USING MEX-SLEDAI SCORE Seravina Adila Izzati; Ovi Sofia; Cesarius Singgih Wahono; Nadia Artha Dewi; Ovi Sofia
International Journal of Retina Vol 4 No 1 (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.iss001.152

Abstract

Introduction: Lupus retinopathy and posterior uveitis are complications due to systemic lupus erythematosus which can threaten the vision. The presence of posterior segment manifestation is suggestive of high disease activity. The aim of this study is to identify posterior segment manifestation (Lupus Retinopathy and Posterior Uveitis) in SLE patient and their correlation with SLE disease activity using The Mexican-SLEDAI (MEX-SLEDAI) score. Methods: This was an analytical observational study with cross-sectional design, conducted from August to October 2020 and involved 114 SLE patients in Dr. Saiful Anwar General Hospital. We calculated MEX-SLEDAI score to assess SLE disease activity. All participant that met inclusion criteria underwent ophthalmology examinations using a portable slit-lamp, head indirect ophthalmoscope, and fundus finding were documented using portable fundus imaging. Result: Lupus retinopathy (LR) presents in 25/114 (21.9%) and posterior uveitis (PU) occurs in 2/114 (1.8%) SLE patients. The mean age of patient with LR, PU, and without retinopathy were 32.92; 37.00; and 31.08 years respectively. The posterior segment findings were hemorrhages, cotton wool spots, hard exudates, and vasculitis reflecting vascular damage. The most common manifestation found in retina was cotton wool spot. The mean of MEX-SLEDAI score of SLE patient with LR (7.200 ± 3.905) and SLE patient with PU (3.500 ± 2.121) was higher than the mean of SLE patient without LR and PU (2.871 ± 2.534). There was a significant association between LR and MEX-SLEDAI score (p=0.000). An insignificant association between PU and MEX-SLEDAI score was found (p=0.353) Conclusion There is a significance correlation between lupus retinopathy and SLE disease activity based on MEX-SLEDAI scores. The mean of MEX-SLEDAI score in SLE patients with lupus retinopathy was higher than SLE with posterior uvetis and SLE without posterior segment manifestations.
Usher Syndrome in Two Siblings, A Case Report Teddy Kristiyan; Nadia Artha Dewi; Safaruddin Refa
International Journal of Retina Vol 2 No 1 (2019): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2019.vol002.iss001.66

Abstract

Introduction: Usher Syndrome is a rare genetic disorder involving abnormalities in the retina and hearing, where the patients will experience blindness and hearing loss due to mutations of the gene. Blindness caused by Usher Syndrome has not been prevented until now, but the emphasis is more on focusing early diagnosis, especially patients with Retinitis Pigmentosa. Methods: This Case represent of two siblings with Retinitis Pigmentose (RP) and profound bilateral sensorineural deafness. Diagnosis based on patients decreases of vision since teenagers and worst at night, visual acuity and visual field examination in both patients, Ophthalmoscopic findings, and sensorineural deafness diagnosed by Ear, Nose, and Throat (ENT) department. Electroretinogram (ERG) was not carried out in the two patients because of the limitations of diagnostic facilities. Result: In both eyes of both siblings, ophthalmoscopic evaluation disclosed numerous bone spiculae at peripheral area. Humphrey perimetry showed a tunnel vision. The hearing test also showed a sensorineural hearing loss (SNHL). Conclusion: two affected member of the family were found to exhibit an usher syndrome, this pedigree supports the genetic cotransmission of the traits.