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

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Atypical Anterior Optic Neuritis Resembles Anterior Ischemic Optic Neuropathy : A Unique Case Report Kristian Goenawan; Indra Tri Mahayana; Tatang Talka Gani; Hartono Hartono
Majalah Oftalmologi Indonesia Vol 43 No 2 (2017): 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.v43i2.149

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Purpose : We present a unique case of atypical anterior optic neuritis resemble anterior ischemic optic neuropathy Methods : This was a single case study, with a patient was followed up for 2 months. Visual acuity, visual field, color vision, intraocular pressure, and ocular anatomy, were examined. Results : A female patient 54 y/o with chief complain sudden blurred vision on both eyes after woke up in the morning without redness and tearing 4 days before day of visit. History of systemic and ocular diseases were denied. Visual acuity was 0.5/60 (superior) right eye and 1/60 (superior) left eye, couldn’t be corrected. Relative afferent pupillary defect was observed in right eye. Biomicroscopic examination of anterior segment and intraocular pressures were normal. Funduscopy revealed ill defined margin at optic nerve head for both eyes suggested papilledema. At the present we couldn’t examined color vision. Visual field examination showed inferior altitudinal defect (more severe in right eye). Consultation to internal medicine and laboratory examination such as: complete blood count, lipid profile, blood glucose, and electrocardiogram were done to confirm our diagnosis. Clinically, the diagnosis of the disease more likely to be the anterior optic neuritis. Follow-up after 2 months has normal visual acuity, visual field, and color perception after steroid treatment. Conclusion : Anterior optic neuritis might have a very similar clinical presentation of anterior ischemic optic neuropathy upon early manifestation.
Patient's Perspective of Eye Service Quality in Yogyakarta's Teaching Hospital Dhimas Hari Sakti; Indra Tri Mahayana; Firman Setya Wardhana; Dwima Faiqa Nafisha; Dhimas Ali Firman; Novika Handayani; Tiara Putri Utami
Majalah Oftalmologi Indonesia Vol 44 No 2 (2018): 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.v44i2.165

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Introduction : The eye care service in The Dr. Sardjito Hospital has one of the highest number of patients amongst other health care services provided. Thus evaluation of the patients' satisfaction upon the service provision is needed to improve the quality of the eye care service. Methods : A cross-sectional study was performed in the ophthalmology outpatient clinic at the teaching hospital in Daerah Istimewa Yogyakarta, Indonesia. Interviews were conducted on 77 patients using Patient Satisfaction Questionnaire Short Form (PSQ-18) in 2017. Results : Overall, patients were mostly satisfied with the interpersonal manner of the doctors (mean : 4.12  0.42) and least satisfied with the time spent with doctors (mean : 3.310.95). There was a statistically significant difference among each subscale (p=0.000). Gender, income, occupation, and education had no significant statistical difference to the aspects of quality. However, significant differences were found in the financial aspects of marital status, education level, and co-diagnoses group with p-value of 0.009, 0.043, and 0.048 respectively. Conclusions : Patient satisfaction could be improved by increasing the time spent at each visit with the doctor. Meanwhile, financial aspect is mostly affected by the patients’ background. This study needs to be continued to get wider perspectives on the larger population sample of eye patients. Therefore, the quality of eye care services may be improved.
Status Penglihatan Pasien Makroadenoma Hipofisis Pasca Bedah Transphenoid Reny Setyowati; Adiguno Suryo Wicaksono; Rahmat Andi Hartanto; Indra Tri Mahayana; Suhardjo Prawiroranu
Majalah Oftalmologi Indonesia Vol 45 No 2 (2019): 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.v45i2.178

Abstract

AIM: The main aim of surgery in pituitary macroadenoma are restoration of visual acuity and visual field defects by decompression of the optic chiasm. Pituitary macroadenoma has slow growth pattern. This study describes the visual status of patients with pituitary macroadenoma and the post operative results. METHODS: Retrospective, descriptive interventional study of patients with pituitary adenoma underwent transphenoid surgery at Dr Sardjito General Hospital, Yogyakarta. RESULTS: There were 7 patients age 29-65 years old, mean age was 42 years old, consist of 3 male and 4 female and were followed-up varies between 1 until 6 months. There was history of previous transphenoid surgery in 1 patients. Duration of patient’s complaint varies between 1 until 36 months and the mean duration was 12 months. In 6 patients there were bitemporal hemianopia and 1 patients had general depression visual field defect. Visual acuity pre operative was between 0,003 until 1,0 , and the mean visual acuity was 0,1 (right eye) and 0,18 (left eye). Visual acuity post operative was between no light preception until 1,0 , and the mean visual acuity was 0,27 (right eye) and 0,19 (left eye) but there were no statistically significant differences. Fundus examination reveal optic atrophy in all patients. CONCLUSION: Transphenoidal surgery is the treatment of choice in patients with pituitary macroadenoma. Prolonged duration of symptoms and delay of surgery may impact the visual status KEYWORDS: Visual status, visual field defect, pituitary macroadenoma, transphenoid surgery, post operative
The Comparison of Transepithelial versus Conventional Photorefractive Keratectomy: Trans vs conventional PRK Puspita Salfasari; Suhardjo; Indra Tri Mahayana
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.v48i1.100230

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Introduction : Photorefractive keratectomy (PRK) is the first choice in treating myopia for eyes with mildly irregular and/or thin corneas because it preserves corneal integrity. A laser-assisted method for epithelial removal, termed Transepithelial PRK (T-PRK), was introduced as an alternative to conventional PRK, which gives a smoother corneal surface than that achieved with mechanical ablation of the epithelium in conventional PRK. Objective: To compare emmetropization between patients treated with T-PRK and conventional PRK. Methods: This study was an observative comparative analytic study with case-control study design. Myopic eyes treated by T-PRK (study group) were compared with variable-adjusted eyes treated by conventional PRK (control group), from year 2015-2018 at Dr.YAP Eye Hospital Yogyakarta. Patients were divided into 3 groups based on the degree on myopia; mild (spherical minus 0-3D), moderate (4-6D), and severe (>7D). Emmetropization within 1 month follow-up and treatment time were analyzed. Results: In all of the cases reviewed, the total percentage of patients treated with T-PRK who reached emmetropization within 1 month follow-up was 21.51% (17/79 eyes), with 33.34% (9/27 eyes) in mild, 28.57% (6/21 eyes) in moderate, and 6.45% (2/31 eyes) in severe myopia group; compared to the control group which was 22.78% (18/79 eyes) (p=0.848), with 48.14% (13/27 eyes) in mild, 15% (3/20 eyes) in moderate, and 6.25% (2/32 eyes) in severe myopia group. Treatment time in the study group was relatively faster compared to the control group. Conclusions: The study group showed slightly better result in treating moderate myopia within 1 month follow-up. Treatment time was relatively faster compared to the control group.
Risk Factors of Occipital Stroke in Tertiary Eye Center in Yogyakarta, Indonesia: Oral Presentation - Observational Study - Resident BUDHI HARTIWI SATYAWATI; INDRA TRI MAHAYANA; HARTONO
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: 10.35749/3g2z3543

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Abstract Introduction & Objectives : Occipital stroke is a stroke involving occipital lobe of the brain which can impair the visual acuity in patient. Several risk factors have been identified as a predisposing conditions. Objectives The aim of this study is to investigate the risk factors for occipital stroke. Methods : It is a cross sectional research by analyzing secondary data from medical record of patients with occipital stroke hospitalized in Dr. Yap Eye Hospital in Yogyakarta from January 2021 to December 2022 were included in this study. Demographyy, clinical data, and risk factors associated with occipital stroke was recorded. The descriptive statistic was performed to evaluate risk factors for occipital stroke. Results : Subjects were analyzed 61, comprised of 44 males (72%) and 17 females (28%). Majority of subjects age ≥45 years old (93%). Attack occurred during activity (n=54, 89%), during wake up (n=7, 11%). The involvement right eye (n=8, 13%), left eye (n=9, 15%), & bilateral (n=44, 72%). From 122 eyes, 74 hemianopia (61%), 34 quadranopia (28%) and 14 bilateral hemianopia (11%). 29 subjects had right occipital stroke (48%), 25 subjects hadleft occipital stroke (41%) and 7 subjects had bilateral occipital stroke (11%). Most subjects had one risk factor (n=29, 48%) and two risk factors (n=23, 38%). Eight subjects had three risk factor (13%) and only one subject had four risk factors (2%). Conclusion : The majority of risk factors of occipital stroke involved only single risk factors and double risk factors. Only minority of subjects had multiple risk factors.
Neuro-ophthalmologic manifestations of COVID-19: a review Indra Tri Mahayana; Stefani Melisa Karina; Nyssa Alexandra Tedjonegoro
Indonesian Journal of Biomedicine and Clinical Sciences Vol 56 No 4 (2024)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v56i4.16836

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Several mechanisms for the pathogenesis of COVID-19 have been proposed. These are direct viral toxicity, endothelial cell damage and thromboinflammation, dysregulated immune response, and renin-angiotensin-aldosterone system (RAAS) dysregulation. The ophthalmic manifestations of COVID-19 vary, affecting the anterior, posterior, and neuro-ophthalmic components. However, the relationship between COVID-19 and neuro-ophthalmologic presentations is limited. This literature review focuses on discussing these manifestations. A manual search was performed using the following keywords “neuro-ophthalmology”, “ocular”, “manifestations”, COVID-19, and coronavirus. The searches were conducted in PubMed and Google Scholar, where any study type and online publications were included. The most common ocular manifestation found in COVID-19 patients is conjunctival involvement. Some reported neuro-ophthalmic manifestations of COVID-19 are papillophlebitis, optic neuritis, cranial nerve palsies, Miller Fisher syndrome, Tolosa-Hunt syndrome, Adie’s tonic pupil, and internuclear ophthalmoplegia. A physician should examine the presence of diplopia, pain during eye movement, declining vision, or any other neurological symptoms. Therefore, it is essential to perform a comprehensive eye examination which includes visual acuity, pupillary response, ocular motility, ptosis, and optic disc examination. Additional tests such as neuroimaging or angiography might be performed to detect cerebral infarction or any other abnormalities when necessary. It is vital to be vigilant and consider COVID-19 as one of the possible causes of disease during this pandemic.
DIFFERENCES OF APOLIPOPROTEIN A1 AND APOLIPOPROTEIN B LEVELS IN TYPE 2 DIABETES MELLITUS (T2DM) PATIENTS WITH DIABETIC RETINOPATHY AND WITHOUT DIABETIC RETINOPATHY hanifah, shabrina; Agni, Angela Nurini; Mahayana, Indra Tri; Suhardjo, Suhardjo; Triyono, Teguh
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.iss002.153

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Introduction Apolipoprotein A1 are antiatherogenic in blood serum and have an anti-inflammatory while Apolipoprotein B describes a protein structure that is potentially atherogenic.. Meanwhile, the inflammatory process plays a role in the diabetic retinopathy process. The aim of this study was to determine whether there were differences in the levels of apolipoprotein A1 and B in diabetic retinopathy patients and without diabetic retinopathy. Methods: This study used a cross sectional design. The subjects of this study were type 2 diabetes mellitus patients with diabetic retinopathy and without diabetic retinopathy at Dr. Sardjito General Hospital from July to September 2020. Subjects consisted of 32 patients in the group with diabetic retinopathy and 31 patients without diabetic retinopathy. The levels of apolipoprotein A1 and apolipoprotein B were analyzed using independent T test. The factors affecting apolipoprotein A1 and apolipoprotein B were analyzed using multiple regression tests. Result: There were no significant differences (p> 0.05) in age, gender, duration of diabetes, HDL, triglycerides, HbA1c, BMI, physical activity, and smoking history. The mean apolipoprotein A1 level in the diabetic retinopathy group was 1.46 ± 0.177 mg / dL higher than the non-diabetic retinopathy group, namely 1.44 ± 0.27 mg / dL (p = 0.699). The mean level of apolipoprotein B in the diabetic retinopathy group was 1.26 ± 0.289 mg / dl higher than the non-diabetic retinopathy group 1.01 ± 0.26 mg / dL (p = 0.001). The mean LDL levels were 162.5 ± 48.38 mmol / L in the diabetic retinopathy group and 127 ± 38.45 mmol / L in the group without diabetic retinopathy (p = 0.012). Conclusion: Apolipoprotein B levels were found to be higher in the group with diabetic retinopathy than in the group without diabetic retinopathy and there was a significant difference between the two assumed due to an atherogenic process in the diabetic retinopathy group. Further research is needed to assess the causal relationship between elevated levels of Apo B and the incidence of diabetic retinopathy by calculating the ratio of apolipoprotein B to apolipoprotein A1. Keywords: Apolipoprotein A1, Apolipoprotein B, Diabetic Retinopathy
Abducens Nerve Palsy Due to Coronavirus Disease (COVID-19) Goenawan, Kristian; Mahayana, Indra Tri
Jurnal Kedokteran Meditek Vol 29 No 3 (2023): SEPTEMBER
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v29i3.2805

Abstract

The main causes of N.VI paralysis in adults are microvascular disease, vasculopathy, tumors, and inflammatory conditions. However, recent studies suggest that neurotropic viruses may be the etiology of N.VI paralysis. COVID-19 also has neurotropic and neuroinvasive capabilities that make the eye susceptible to bilateral optic neuritis, papilledema, and cranial nerve paralysis, the most common of which is abducens nerve palsy. The aim of this literature review is to review studies that describe the occurrence of abducens nerve palsy in COVID-19 patients. The literature search began in the period April-May 2022 from the Google Scholar database (https://scholar.google.com/). This mini review used the AMSTAR (Assessment of Multiple Systemic Review 2, including randomized and nonrandomized studies) checklist and reviewers independently agreed on the selection of eligible studies and reached consensus regarding which studies to include with inclusion criteria. This mini review found that 75% of cases were strongly associated with viral infection and 25% of cases were strongly associated with COVID-19 vaccination. Only 50% of cases report improvement in abducens nerve palsy. This has the implication that with the increasing prevalence of COVID-19 worldwide, ophthalmologists should be aware that abducens nerve palsy may be part of COVID-19. 
RIRISK FACTORS OF OCCIPITAL STROKE IN A TERTIARY EYE CENTER IN YOGYAKARTA, INDONESIA Satyawati, Budhi Hartiwi; Hartono, Hartono; Mahayana, Indra Tri
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/cc57jz82

Abstract

Introduction: Occipital stroke involves the occipital lobe of the brain, which can impair the visual acuity in patients. Several risk factors have been proven as predisposing conditions for occipital stroke. This study investigates the risk factors for occipital stroke in tertiary eye center in Yogyakarta. Methods: The method of this study was cross-sectional research by analyzing secondary data from medical records of patients with occipital stroke hospitalized in Dr. Yap Eye Hospital, a tertiary eye center in Yogyakarta. Patients diagnosed with occipital stroke from January 2021 to December 2022 were included in this study. Demography, clinical data, and risk factors associated with occipital stroke were recorded. The descriptive statistic was performed to evaluate the risk factors for occipital stroke.  Results: Sixty-one subjects were analyzed, comprised of 44 males (72%) and 17 females (28%). The majority of subjects within age ?45 years old (93%). The attack occurred during activity (n=54, 89%) and wake-up (n=7, 11%). The involvement right eye (n=8, 13%), left eye (n=9, 15%), and bilateral (n=44, 72%). Of 122 eyes, 74 had hemianopia (61%), 34 had quadranopia (28%), and 14 had bilateral hemianopia (11%). Twenty-nine subjects had right occipital stroke (48%), 25 subjects had left occipital stroke (41%), and seven subjects had bilateral occipital stroke (11%). Most subjects had one risk factor (n=29, 48%) and two risk factors (n=23, 38%). Eight subjects had three risk factors (13%), and only one subject had four risk factors (2%).  Conclusion: Most risk factors of occipital stroke involve only single and double risk factors. Only a minority of subjects had multiple risk factors.
Increasing quantitative estrogen receptor beta expression in meningioma after exogenous hormonal contraception exposure Sakti, Dhimas Hari; Sasongko, Muhammad Bayu; Pawiroranu, Suhardjo; Heriyanto, Didik Setyo; Mahayana, Indra Tri; Respatika, Datu; Widhasari, Idhayu Anggit; Nurlaila, Prima Sugesty; Supartoto, Agus
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 4 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i4.19604

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Factors influencing estrogen receptor (ER) and progesterone receptor (PR) expression in meningioma are unclear. This study aimed to assess the expression of ER and PR in females with meningioma in relation to patient exogenous hormonal exposure. Cross-sectional study of females with meningioma in Yogyakarta, Indonesia, between 2010 to 2016 was conducted. Histories were obtained through interviews. Expressions of ERa, ERb, and PR were assessed from paraffin blocks containing patients’ meningioma tissue using real-time quantitative polymerase chain reaction (RT-qPCR). The study identified 28 female meningioma patients with a mean age of 45.6 ± 6.8 yr. Increased ERb expression was found in the ³10-yr group of hormonal contraception exposure duration (<10 yr vs ³10 yr = 7.63 (2.3-11.31) vs 12.56 (1.87-42.22), p=0.038). Positive correlation was found between ERb expression and the duration of hormonal contraception exposure (r=0.432; p=0.022), especially progesterone-only contraception (r=0.5; p=0.048), while no significant correlation was found between ERb expression and duration of progesterone-estrogen contraception exposure (r=0.382; p=0.22). No significant analyses were found in ERa and PR. In conclusion, expression of ERβ in meningioma increased in accordance with exogenous hormonal exposure duration, especially progesterone. This finding suggests the importance of ERβ in meningioma and warrants further study as a potential biomarker.