Rina L.D. Nora
Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta

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Glaucoma and dry eye disease: the role of preservatives in glaucoma medications Sitompul, Ratna; Nora, Rina L.D.
Medical Journal of Indonesia Vol 20, No 4 (2011): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (631.315 KB) | DOI: 10.13181/mji.v20i4.467

Abstract

Glaucoma is a common cause of irreversible blindness with increasing prevalence. Some of glaucoma patients will also experience dry eye. Dry eye is the most frequent side effect related to benzalkonium chloride (BAC)-containing eye drop  used for glaucoma patients. In addition, glaucoma and dry eyes have shared risk factors that are old age and female. Dry eye among glaucoma patients need to be treated promptly as it produces discomfort, reduces patients’ compliance and   decreases success rate of glaucoma therapy. Dry eye symptoms can be treated by applying preservative-free eye drop, giving combination of preservative containing and preservative-free eye drop to reduce BAC exposure, prescribing artificial tear and conducting surgery to minimize or eliminate the need of topical medication. (Med J Indones 2011; 20:302-5)Keywords: benzalkonium chloride, dry eye, glaucoma
Various factors affecting the bacterial corneal ulcer healing: a 4-years study in referral tertiary eye hospital in Indonesia Asroruddin, Muhammad; Nora, Rina L.D.; Edwar, Lukman; Sjamsoe, Soedarman; Susiyanti, Made
Medical Journal of Indonesia Vol 24, No 3 (2015): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (382.419 KB) | DOI: 10.13181/mji.v24i3.1044

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Background: Corneal ulcer is one of the most common causes of visual acuity impairment and blindness all over the world. The aim of the study was to evaluate various factors affecting the bacterial corneal ulcers healing, including the predisposing factors, causative organisms, antibiotic sensitivity, as well as the treatment outcomes.Methods: All data were taken retrospectively from medical records of patients who underwent corneal scraping for Gram examination and/or culture over a-4-year period (2008-2011) at the Cipto Mangunkusumo Hospital Jakarta. Treatment outcome were analyzed using Chi-square test, one-way ANOVA, and post-hoc analysis. Mean time required for complete epithelial healing was also investigated.Results: 220 cases of bacterial corneal ulcers in 216 patients were included. The most common risk factors were ocular trauma (45.8%). Gram-positive coccus were found in 65.7% cases other than other microbes. Pseudomonas sp. (25,0%) and Staphylococcus epidermidis (18.4%) were the most common isolates, sensitive to almost all kinds of antibiotics. About 83.0% (106 cases) were improved with antibiotics only, the rest were not improved and worsened. Mean time for complete epithelial healing was 17.5 ± 8.9 days with mild ulcer had the most rapid recovery. Eyes treated with fluoroquinolone eyedrops were healed in 14 days, faster than other regiments.Conclusion: Ocular trauma was the most common risk factor for corneal ulcer, and the most commonly isolated organism was Pseudomonas sp. Most cases were improved with antibiotics, and fluoroquinolone showed faster healing. Complete epithelial healing occurred in about 17.5 days.
Clinical characteristic and therapy results of presumed ocular tuberculosis and their relation to HIV status Nora, Rina L.D.; Sitompul, Ratna; Susiyanti, Made; Edwar, Lukman; Sjamsoe, Soedarman
Medical Journal of Indonesia Vol 21, No 4 (2012): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (507.984 KB) | DOI: 10.13181/mji.v21i4.509

Abstract

Background: Ocular tuberculosis (TB) emerges as an important cause of intraocular inflammation, partly due to the increasing number of HIV/AIDS patients. This study attempts to identify ocular signs that are associated with ocular TB and assess the efficacy of the treatment and their relation to HIV status.Methods: Medical records of all 56 patients diagnosed with presumed ocular TB in Cipto Mangunkusumo Hospital between January 2006 and December 2011 were reviewed. Demographic and clinical characteristics and HIV status were recorded as well as efficacy of treatments given.Results: There were 39 patients included with mean age 35.38 ± 13.1 and male to female ratio was 2:1. Unilateral involvement was in 26 (66.7%) patients. From all, four (10.3%) had anterior uveitis, 14 (35.9%) posterior uveitis, 21 (53.8%) panuveitis, and none had intermediate uveitis. Most of them (32/82.1%) have concurrent other organ TB. Five out of 8 (62.5%) HIV positive patients had granulomatous inflammation and 3 (37.5%) had non-granulomatous inflammation and all eight of them had concurrent other organ TB. The other 7 known non-HIV patients, six (85.7%) have non-granulomatous inflammation. Treatment with anti-tubercular therapy (ATT), combination ATT and steroid or steroid alone increased visual acuity. However steroid alone was slightly have more frequent recurrences (1.4 ± 0.89 episodes of inflammation).Conclusion: Ocular TB in our study had variable clinical manifestations and ocular inflammation was predominantly non-granulomatous in HIV negative patients and granulomatous in HIV infected patients. All HIV positive patients the ocular TB was always accompanied by manifestations in other organs. The treatment with steroids solely resulted in improved vision but was characterized by frequent recurrences. (Med J Indones. 2012;21:214-9)Keywords: HIV/AIDS, ocular tuberculosis, uveitis