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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Journal of Community Empowerment for Health IJRETINA - International Journal of Retina Jurnal Kedokteran Meditek Indonesian Journal of Biomedicine and Clinical Sciences Ophthalmologica Indonesiana

Indra Tri Mahayana

Departemen Ilmu Kesehatan Mata, Fakultas Kedokteran, Kesehatan Masyarakat, Dan Keperawatan, Universitas Gadjah Mada, Yogyakarta, Indonesia

Author-ID : 2970553

Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Potential employment of transcranial magnetic stimulation as a beneficial intervention in children with amblyopia: a brief overview Indra Tri Mahayana; Dhimas Hari Sakti; Natalia Christina Angsana
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 4 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Amblyopia is an early functional imbalance between each eye and the brain that may result in visual cortex inhibition. Current conservative treatments involve altering the input from the ‘good eye’, for example, using patching or biochemical penalization. Direct brain stimulation to the amblyopic cortex might improve the condition. This paper aimed to systematically review the published scientific literature regarding the use of transcranial magnetic stimulation (TMS) as a potential method for treatment in the amblyopic visual cortex. This study was a systematic review of the published scientific literature related to theTMS for the treatment of amblyopia that was performed using “TMS, amblyopia” as keywords. However, only three research papers were found and included in the literature review. A study showed that repetitive TMS of the visual cortex can temporarily improve contrast sensitivity in the amblyopic visual cortex. Another study used continuous thetaburst stimulation (cTBS) delivered to the visual cortex while patients viewed a high contrast stimulus with their non-amblyopic eye. It was found that daily theta burst TMS stimulation improved amblyopic eye contrast sensitivity in five adult volunteers. The TMS also increased median visual acuity in the patient with amblyopia after stimulation with no significant changes in the placebo group.Protocol employing repetitive administration of TMS might result in beneficial effects in amblyopia treatment. TMS works in brain dynamics and experience-dependent plasticity, all of which could be important in investigating and treating amblyopia.

Literature review of conjunctivitis, conjunctival swab and chloroquine effect in the eyes: a current updates on COVID-19 and ophthalmology Indra Tri Mahayana; Natalia Christina Angsana; Alya Kamila; Nisrina Nur Fatiha; Devin Zen Sunjaya; Winanto Andajana; Suhardjo Suhardjo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 3 (2020): Special Issue: COVID-19
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

This overview briefly describes current literature findings in ophthalmology related to coronavirus disease 2019 (COVID-19) that become a worldwide pandemic. It included the current updates related to conjunctivitis that believed as the early sign of COVID-19, the effectiveness of conjunctival swab in detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compared to naso- or oropharyngeal swab and the long-term side effect of chloroquine use to the eyes. The analysis from four current published literatures revealed, overall sensitivity of conjunctivitis was 2.42% (CI 95%: 0.79-5.55) and conjunctival swab was 2.90% (CI 95%: 1.07-6.20). There were no current COVID-19-related literatures discussing the side effect of chloroquine to the eyes, however, previous literatures revealed there were potential long-term harmful effects of chloroquine treatment to the eyes.

The predictor factor of final visual acuity (VA) of acute retrobulbar neuritis patients receiving optic neuritis treatment trial (ONTT) regiment Tatang Talka Gani; Melvina Nidya Sandra; Indra Tri Mahayana; Datu Respatika; Hartono Hartono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 2 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

The study aimed to investigate the efficacy of intravenous optic neuritis treatment trial (ONTT) regiment on the treatment ofpatients with acute retrobulbar neuritis.This was a cross sectional studyusing medical records data of patients diagnosed with unilateral or bilateral retrobulbar neuritis by normal funduscopic findings and typical optic neuritis perimetry results within 14 days of onset fromtheNeuro-ophthalmology Clinic, Department of Ophthalmology, Dr. Sardjito General Hospital, Yogyakarta from January to December 2015. Medical records data of patients who received 1000 mg methylprednisolone IV per day for 3 days followed by 11 days 1 mg/kg body weight oral prednisolone were reviewed. Visual acuity (VA) at onset, final VA at time of follow up, delta VA improvement and time of follow up were included in the analyses.Twenty data of patients aged 33.95±8.07 years with VA at onset of 1.96±0.81 (~ 1 mCF) were analyzed in this study. Significantly improvement in final VAafter treatment to be 1.39±1.12 (~5mCF) was reported (p=0.001). The VA at onsetwas a predictive factor for final VA (p <0.001). Every 1.17 increase of final VA for every one-point decreased VA at onset (p<0.001). Time follow up showed to be trend (p=0.059),however, age and sex were not a predictive factorof final VA (p>0.05). In conclusion, there is VA improvement after the treatment of ONTT regiment. The VA at onset is a predictive factorof final VA on patients with acute retrobulbar neuritis.ABSTRAKPenelitian ini bertujuan mengkaji efektivitas regimen optic neuritis treatment trial (ONTT) intravena pada pengobatan pasien dengan neuritis retrobulbar faseakut. Penelitian potong lintang ini menggunakan rekam medis pasien yang didiagnosis neuritis retrobulbar unilateral atau bilateral dengan temuan funduskopi normal dan hasil perimetri neuritis optik yang khas dalam waktu 14 haris etelah onset dari Klinik Neuro-optamalmologi, Departemen Oftalmologi, Rumah Sakit Umum Pusat Dr. Sardjito, Yogyakarta dari Januari-Desember 2015. Data rekam medis pasien yang menerima1000 mg metilprednisolon IV per haris elama 3 hari diikuti oleh prednisolon oral selama 11 hari dengan dosis 1 mg/kg berat badan dianalisis. Ketajaman visual (VA) saat onset, VA akhir saat tindaklanjut, peningkatan VA, dan waktu tindak lanjut dianalisis. Sebanyak 20 data pasien berumur 33,95 ±8,07 tahun dengan VA saat onset 1,96 ±0,81 (~ 1 mCF) dianalisis dalam penelitian ini. Perbaikan VA akhir menjadi 1,39±1,12 (~5mCF) dilaporkan (p=0,001). Ketajaman visual saat onset merupakan factor predictor VA akhir (p<0,001). Setiap peningkatan VA akhir sebesar 1,17 menurunkan satu poin VA saat onset (p<0.001). Waktu tindak lanjut cenderung menjadi factor prediktor (p=0,059), namun demikian usia, jenis kelamin bukan factor predictor VA akhir (p>0,05). Dapat disimpulkan, terdapat peningkatan VA pasien setelah pengobatan regimen ONTT. Ketajaman visual saat onset merupakan factor prediktor VA akhir pada pasien dengan neuritis retrobulbar akut.

Analysis of systemic risk factors of occipital stroke-related vision loss Indra Tri Mahayana; Nyssa Alexandra Tedjonegoro; Tatang Talka Gani
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 2 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005402202203

Occipital stroke is associated with visual field defects and other visual perceptual deficits that might lead to detrimental effects on health-related quality of life. This study aimed to evaluate the possible association between systemic risk factors and the features of occipital stroke. It was a retrospective observational study involving patients diagnosed with occipital stroke in Dr. Yap Eye Hospital, Yogyakarta, Indonesia, between 2013 and 2014. A total of 72 patients with occipital stroke proven with CT/MRI who underwent detailed evaluation of ocular and systemic risk factors were included in this study. The patients were divided into two groups with or without risk factors. The risk factors were hypertension, diabetes mellitus, and cardiac diseases. The effect of risk factors on sex, age groups (≤40, >40 and ≤60, >60 y.o.), stroke lesions (left occipital, right occipital, bilateral), and visual field defects (homonymous hemianopia, homonymous quadrantanopia, and others) were analyzed. Out of 72 patients, there were 56 males (77.8 %), and 16 females (22.2 %), with a mean age of 58.46 ± 11.83 y.o. The study found there was a significant difference in age with risk factors compared with those without risk factors (p = 0.025), as well as visual acuity with age groups (p = 0.005) and stroke lesions (p = 0.024). Analysis of risk factors showed that hypertension was significantly correlated with stroke lesions, whereas cardiac disease was significantly associated with age groups (p<0.05). Predictive analysis was performed using a linear regression model, and it showed that risk factors could predict the occurrence of stroke lesions. In conclusion, patients’ systemic risk factors are significantly associated with the older onset of occipital stroke and lower visual acuity, although not significantly associated with stroke location and visual field defect characteristics.

The awareness of blindness related to misuse of illicit liquor containing methanol: A community study Indra Tri Mahayana; Tatang Talka Gani; Suhardjo Pawiroranu
Journal of Community Empowerment for Health Vol 1, No 1 (2018)
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Methanol is a cheap organic solvent and additive in the production of illicit liquors. There are many recorded incidences in Indonesia regarding methanol intoxication induced visual loss. We aimed to investigate the level of awareness of liquor-containing methanol misuse in the community related to its hazard of visual loss. Participants were recruited from 3 primary health care units which represent the population of rural communities in Yogyakarta, Indonesia and then divided into two groups: drinkers (cases) and nondrinkers (control). The participants answered closed questions in a questionnaire about knowledges related to the misuse of illicit liquor. Forty participants (mean age: 39.8 ± 13.39) completed the questionnaires. There were 40% and 60% of participants who reside in the city and suburbs; their education levels were 2.5%, 12.5%, 30%, 35%, and 7.5% for uneducated, elementary, junior, senior high school, and undergraduate, respectively. There were 6 drinker and 34 nondrinker participants (sex difference p <0.001). Only 1 drinker and 7 nondrinkers answered correctly regarding the ethanol based liquor. Fifty percent of drinkers and 32.35% of nondrinkers were aware that illicit liquors were most probably mixed with methanol. The drinkers were aware that liquor-containing methanol can cause sudden death (33.33%) or sudden visual loss (33.33%), while 55.8% nondrinker answered only sudden death. Participants’ awareness levels regarding the content and the visual outcome of methanol-containing liquor remain low. From this pilot study, we confirmed the need to conduct further research with a larger sample size, followed by clear ethical considerations for prevention.

Outcomes of manual small incision cataract surgery (mSICS) compared with phacoemulsification from population based outreach eye camp, in Yogyakarta and Southern Central Java Region, Indonesia Indra Tri Mahayana; Reny Setyowati; Tri Winarti; Suhardjo Prawiroranu
Journal of Community Empowerment for Health Vol 1, No 1 (2018)
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

In this study, we compared the effectiveness (comparison of post-operative visual acuity/VA) of phacoemulsification by ophthalmologists versus manual small incision cataract surgery (mSICS) by residents in a mass cataract surgery setting. This research was a cross-sectional study of 1137 cataract patients who underwent cataract surgery by ophthalmologists and residents in outreach eye camps during 2015-2017 (3 years). There were 554 patients who underwent phacoemulsification by ophthalmologists and 583 patients who underwent mSICS by residents. Basic patient characteristics data, such as: age, sex and pre-surgical VA were recorded and we compared pre- versus post-operative VA (best corrected VA/BCVA) and surgical adverse events in 4 weeks post-operative follow-up. In basic subject characteristics, there were no differences in age and sex between the 2 groups, in which 602 (52.9%) were men and 535 (47.1%) were women. Overall 583 (51.3%) eyes received mSICS and 554 (48,7%) eyes received phacoemulsification. Visual acuity improvement (≥6/18) was achieved in 59.61% of eyes after phacoemulsification and 53.5% eyes after mSICS. There were no statistical differences in visual outcome results between both groups (p=0.10). Severe surgical adverse events (nucleus drop and endophthalmitis) were found in 3 cases (0.26%) and choroidal bleeding in 1 eye (0.08%). The effectiveness of phacoemulsification and mSICS in improving visual acuity was found similar between ophthalmologists and residents. mSICS should be considered for more frequent use in high volume mass cataract surgery.KEYWORDS cataract surgery; phacoemulsification; manual small incision cataract surgery; outreach program; community ophthalmology

Perbandingan komplikasi antara fakoemulsifikasi dan manual Small-Incision Cataract Surgery (mSICS) pada operasi katarak massal: Sebuah penelitian kohort retrospektif Tri Winarti; Indra Tri Mahayana; Reny Setyowati; Suhardjo Pawiroranu
Journal of Community Empowerment for Health Vol 2, No 1 (2019)
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Cataract is the most common cause of reversible blindness, and its prevalence have been increasing in the community depend on the age. Phacoemulsification and manual Small-Incision Cataract Surgery (mSICS) were the techniques of cataract surgery that was frequently used in high-volume cataract surgery setting. This study aimed to compare the complications between phacoemulsification and mSICS in high-volume cataract surgery. This research was a retrospective cohort study with the data taken from the medical record of high-volume cataract surgery organized by Community Ophthalmology Division, Department of Ophthalmology Universitas Gadjah Mada (UGM) from January 2018 to November 2018. Cataract surgery was performed by consultant ophthalmologists, general ophthalmologist, and senior ophthalmology resident for phacoemulsification and by senior ophthalmology resident and junior ophthalmology resident for mSICS. Intraoperative and postoperative complications (i.e. posterior capsule rupture, vitreous prolapse, aphakia, iridodialysis, endophthalmitis) until four weeks of follow up were compared in both techniques. There were 483 patients who had been operated, 188 (38.9%) patients underwent phacoemulsification and 295 (61.1%) patients underwent mSICS. Intraoperative and postoperative complications in phacoemulsification and mSICS performed by senior ophthalmology resident were no statistically significant different (p > 0.05). Nevertheles, there was statistically significant different in the complication of posterior capsule rupture and aphakia in phacoemulsification based on the level of surgeon’s skill (p < 0.05). Most of them performed by senior ophthalmology resident in 11 (35.5%) cases and 5 (16.1%) cases respectively. However, complications in mSICS were no significantly different based on the level of surgeon’s skill performed by senior ophthalmology resident and junior ophthalmology resident (p > 0.05). Complications in phacoemulsification and mSICS performed by senior ophthalmology resident with relatively similar in the level of surgeon’s skill were not significantly different. However, the complication of posterior capsule rupture and aphakia in phacoemulsification was significantly different based on the level of surgeon’s skill.

Angka kejadian miopia pada anak usia sekolah dasar di Kecamatan Banjararum Kabupaten Kulon Progo, Daerah Istimewa Yogyakarta Reny Setyowati; Indra Tri Mahayana; Tri Winarti; Suhardjo Pawiroranu
Journal of Community Empowerment for Health Vol 2, No 1 (2019)
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Refractive disorders begin to affect many children and become a burden of disease in the community due to lack of awareness by parents and screening by health workers. This research was a cross-sectional study and carried out at screening of visual acuity in primary school-aged children. A total of 38 children aged 6 - 12 were the subjects in this study. This research was conducted in Banjararum sub-district, Kulon Progo Regency, Yogyakarta Special Province in September 2018. The average age of subjects was 8.8 ± 1.4 years. Result showed refraction status before correction (uncorrected refractive error/URE) with mean visual acuity of 0.3 logMAR (equivalent to 6/12 Snellen). The most common refractive disorders were myopia simplex (63.2%) and 38.8% of subjects experienced moderate visual impairment. After being corrected, as much as 97.4% of subjects reached normal vision. Burden of undiagnosed refractive disorders in rural population was high even though the visual disturbance is reversible.

Ocular involvment of coronavirus disease (COVID-19): A systematic review of conjunctival swab results Indra Tri Mahayana; Natalia Christina Angsana; Muhammad Zhafran Ayyasy; Anastasya Sondang Hutajulu; Suhardjo Suhardjo
Journal of Community Empowerment for Health Vol 3, No 2 (2020): Special Issue of COVID-19
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jcoemph.55543

Coronavirus disease (COVID-19) is a pandemic disease which is caused by the latest discovered coronavirus. Conjunctivitis is allegedly the first presentation of COVID-19 since it can spread by aerosol contact with the conjunctiva. The present study aimed to systematically review the employment of conjunctival swab with Real-time Polymerase Chain Reaction in detecting SARS-Cov-2. The research is a systematic review of the published scientific literature on findings of conjunctival swab of COVID-19 from PUBMED database and other additional sources (i.e: Google Scholar). The search method was done using “COVID-19 OR coronavirus OR SARS-COV2, AND conjunctivitis, AND ocular manifestations, AND conjunctival swab” as keywords. Inclusion criteria were any papers that related to the entered keywords and have conjunctival swab as a reported outcome. Letters, reviews, and editorials describing other studies reporting COVID-19 and conjunctival swab were excluded. Only four research papers were found and included in the literature review. From the four current research papers, positive SARS-CoV-2 results were yielded from 0-5.26% of conjunctival swab specimens. In conclusion, although the presence of the SARS-CoV-2 virus on the ocular surface remains unclear, the prevention of infection transmission through an ocular surface is mandatory by wearing goggles (or shield), mask (N-95 recommended) and gown.

COVID-19 eye infection: recommendations for ophthalmologist and patients Datu Respatika; Indra Tri Mahayana; Dwi Puspita; Guiddo Ilyasa; Agus Supartoto
Journal of Community Empowerment for Health Vol 3, No 2 (2020): Special Issue of COVID-19
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jcoemph.57095

Coronavirus disease (COVID-19) is a public health emergency of international concern as declared by the World Health Organization on 30 January 2020. Currently, COVID-19 is spreading rapidly worldwide, with no proven treatment nor vaccination, thus infection control measures are paramount. The severity of the majority of COVID-19 cases is mild to moderate, with fever as its most common symptoms, followed by dry cough and fatigue. COVID-19 initially reported to be transmitted from bats but then evolved into human-to-human via droplets. Coronavirus has been detected in tears and conjunctival secretions, but there is still a controversy about whether the virus can be transmitted through tears. However, the ocular transmission might be transported through a lacrimal duct to nasopharyngeal mucosa and then cause an infection. Because the nature of close contact in doctor-patient interaction during ophthalmologic practice, strict measures must be taken to minimize the impact both on the patients and health care workers.

Co-Authors Adiguno Suryo Wicaksono Agni, Angela Nurini Agus Supartoto Alya Kamila Aminuyati Anastasya Sondang Hutajulu BUDHI HARTIWI SATYAWATI Datu Respatika Devin Zen Sunjaya Dhimas Ali Firman Dhimas Hari Sakti Didik Setyo Heriyanto Dwi Puspita Dwima Faiqa Nafisha Firman Setya Wardhana Goenawan, Kristian Guiddo Ilyasa Hanifah, Shabrina Hartono Hartono Hartono Hartono Hartono Hartono Kristian Goenawan Melvina Nidya Sandra Muhammad Zhafran Ayyasy Natalia Christina Angsana Natalia Christina Angsana Natalia Christina Angsana Nisrina Nur Fatiha Novika Handayani Nurlaila, Prima Sugesty Nyssa Alexandra Tedjonegoro Nyssa Alexandra Tedjonegoro Pawiroranu, Suhardjo Purwoko, Agus Puspita Salfasari Rahmat Andi Hartanto Reny Setyowati Sasongko, Muhammad Bayu Satyawati, Budhi Hartiwi Stefani Melisa Karina Suhardjo Suhardjo Pawiroranu Suhardjo Pawiroranu Suhardjo Pawiroranu Suhardjo Prawiroranu Suhardjo Suhardjo Suhardjo Suhardjo Suhardjo Suhardjo Supartoto, Agus Tatang Talka Gani Tatang Talka Gani Tatang Talka Gani Tatang Talka Gani Teguh Triyono Tiara Putri Utami Tri Winarti Widhasari, Idhayu Anggit Winanto Andajana

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