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Exploring the Intricacies of Carotid Cavernous Fistula: A Case Series: Poster Presentation - Case Series - Resident SAPHIRA EVANI; PUTU YULIAWATI; NI MADE LAKSMI UTARI
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: 10.35749/876jnv84

Introduction : Carotid cavernous fistula (CCF) is caused by an abnormal connection between the carotid artery and the cavernous sinus, which can lead to eye-related problems. It is crucial to recognize its signs, as they can resemble other conditions. Case Illustration : First patient is a male 3-month-old baby, with unilateral right eye proptosis that was observed soon after birth and history of hypothyroid. Proptosis is more prominent while the baby is crying. Orbital ultrasonography revealed ophthalmica vein dilatation with S configuration, complex flow, and velocity of 10 cm/s. Second case is a 50-year-old male also with unilateral proptosis and orbital bruit with history of head trauma 2 months prior to admission. Patient came with complain of sudden blurry vision for 1 week. The results of the magnetic resonance venogram revealed tortuos dilated superior ophthalmica (SOV), cavernous sinus bulging, and dilated superior petrosal, sigmoid, transverse sinus, and internal jugular vein. Discussion : CCFs can occur at any age, but are more common between 40-60. Risk factors like head trauma, hypertension, connective tissue disorders increase the likelihood of developing CCF. They are often misdiagnosed as other conditions such as thyroid ophthalmopathy or conjunctivitis. Ocular doppler ultrasound can detect SOV dilation and arterial flow, while magnetic resonance imaging can show superior ophthalmic vein engorgement, muscle hypertrophy, and cavernous sinus dilatation. Treatment for symptomatic CCFs involves endovascular obliteration using balloons, embolic agents, or metallic coils, while asymptomatic and mildly symptomatic patients can be treated conservatively. Conclusion : Awareness of CCF symptoms, varied workup, prompt treatment is important to prevent severe complications.

Management of Lateral Canthal Coloboma in Goldenhar Syndrome: A Rare Case Report: Poster Presentation - Case Report - Resident KETUT PRAMANA ADIPUTRA; PUTU YULIAWATI; NI MADE LAKSMI UTARI
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/nkkfz643

Introduction : Goldenhar syndrome is a rare congenital disorder characterized by a wide range of physical anomalies affecting the face, ears, eyes, and spine. Case Illustration : Patient, female 19-year-old, complained of growing mass and blurry vision on right eye since childhood. The patient also has an asymetric face with the right side being smaller then left. She also has hearing disorder on her right ear. Ophthalmology examination revealed right eye's visual acuity is 6/120, lateral canthus coloboma , trichiasis and mass on the inferior palpebral, and conjunctiva attached to the cornea. Left eye is within normal limit. The right ear appears deformed, with no ear canal and preauricular skin tags. Patient underwent conjungtiva tumor excision and given labia mucosa graft with canthoplasty. Histology examination revealed benign lipomatous tumor. Patient feels more confident after oculoplasty surgery. Discussion : Goldenhar syndrome is a rare condition caused by abnormal development of the first and second branchial arches. It is characterized by a wide range of ocular features, including eyelid and iris coloboma, conjungtiva dermoid or dermolipoma, and more. Beside ocular features, other features are ear malformations, facial asymmetry, cleft lip or palate, and vertebral anomalies. It was unique case because an unformed canthus was found due to a large of conjunctival fornix mass. Appropriate management is necessary for a fulfilling life, though the disorder can have significant psychosocial effects. Conclusion : Goldenhar syndrome is a rare disease with numerous symptoms and its management is crucial for individuals to have a fulfilling life despite its potentially significant psychosocial impacts.

Management of Bilateral Ankyloblepharon with Hay-Wells Syndrome: A Rare Case Report: Poster Presentation - Case Report - Resident Junetta Airene Priskila Taba; Putu Yuliawati
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/kct3rd26

Introduction : Ankyloblepharon is a partial or complete fusion of the eyelid margins. This condition can be found as a common manifestation of Hay-Wells Syndrome along with lip and/or palate cleft and ectodermal dysplasia. This is an extremely rare case report demonstrating management of ankyloblepharon with Hay-Wells Syndrome. Case Illustration : A 5-day-old baby consulted from the Neonatal Intensive Care Unit (NICU) with multiple congenital abnormalities. The baby was born preterm (32 weeks) by C-section due to fetal malpresentation with low birth weight (1545 gram). There was no family history of congenital anomalies. Ocular examination revealed a partial ankyloblepharon on both eyes. The baby was also found with labiognatopalatoschizis, microtia, hyperkeratotic skin and nail dystrophy. Then, we planned to do an eyelid separation procedure at the NICU using only sterile conjunctival scissors with drops of Pantocaine 2%. Gentamicin eye ointment three times daily was prescribed. After the procedure, we can do a proper evaluation of the eye. Discussion : Hay-Wells Syndrome is a rare autosomal dominant disorder. This condition characterized by various congenital abnormalities such as ankyloblepharon, lip and/or palate cleft, and also other abnormalities involving the skin, hair, teeth, nails, and sweat glands. The management of ankyloblepharon can be done easily by excised the webs of skin that connecting the eyelid margins with topical anesthesia. The purpose of this management is mainly to prevent the risk of the development of deprivation amblyopia. Conclusion : Congenital ankyloblepharon has the potential to cause deprivation amblyopia. An immediate management is needed to provide a good prognosis regarding the visual development

Management of Post Tumor Resection in Inferolateral Eyelid using Periosteal Flap and Canthoplasty Technique – A Case Report: Poster Presentation - Case Report - Resident CLARA VALENTINA; Putu Yuliawati; Ni Made Laksmi Utari
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/vw8zen64

Introduction : Eyelid defect repair goals are providing supportive connecting tissue and functional mucosal epithelium. Posterior lamellar reconstruction for tumor resection defect is still challenging. In this case, lower eyelid reconstruction can be accomplished by elevation and rotation of periosteal flap as posterior lamella. Case Illustration : A 68-years-old male came with inferolateral eyelid mass of Left Eye (LE) that was increasing in last 3 months. On LE examination found solitary cystic cutaneous lesion in inferior palpebra near lateral canthal, sized7x5mm, fixated, regular, and chewy consistency. Anterior of mass has same color as adjacent skin with hyperpigmentation lesion and posterior side was translucent with telangiectasia. He was suspected with LE ductal dd epidermoid cyst. Discussion : Periosteal flap and canthoplasty is procedure to repair inferolateral eyelid defect that are large to be closed primarily, however it requires adequate lateral canthal skin and tarsal plate. Posterior lamellais restored to create connective tissue framework, proper contour, and vertical canthal height. Tumor was removed and preperiosteal plan inferior to inferior orbital rim was dissected. The anterior lamella then transposed superiorly to make sure it will cover posterior lamellar reconstruction. Periosteal flap from lateral canthal tendon of infraorbital margin was harvested, flap was crossed to form sharp canthal angle and sutured to tarsal edges of lower eyelids as posterior lamella. A week later, LE showed natural contour and good function without eyelid malposition. Conclusion : Periosteal flap as posterior lamella reconstruction of eyelid defects is effective and efficient to repair eyelid defect due to its simplicity, reliability, and low risk complication.

The Temporal Windows of Glycemic Injury: Association of Early and Late First-Week Hyperglycemia with Retinopathy of Prematurity in Low-Birth-Weight Infants Dharmi Lestari, Ni Putu; I Wayan Eka Sutyawan; Putu Junara Putra; I Gde Raka Widiana; Siska; Putu Yuliawati
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1379

Background: Retinopathy of prematurity (ROP) is a leading cause of childhood blindness, driven by aberrant retinal vascular development in preterm infants. While hyperglycemia is a recognized risk factor, its impact may vary depending on its timing relative to the biphasic pathogenesis of ROP. This study aimed to generate a hypothesis regarding the differential association of hyperglycemia on postnatal day 1 versus day 7 with the incidence of ROP in a high-risk neonatal population. Methods: We conducted a retrospective, cross-sectional, hypothesis-generating study at Prof. Dr. I.G.N.G. Ngoerah General Hospital. Medical records of 68 preterm (<37 weeks gestation) and low-birth-weight (<2500 grams) infants who underwent ROP screening were reviewed. The exposures of interest were hyperglycemia (blood glucose >125 mg/dL) on postnatal day 1 (D1) and day 7 (D7). The primary outcome was the diagnosis of any stage of ROP. Statistical analysis involved Chi-square tests and exploratory multivariate logistic regression to adjust for select confounders. Results: Of the 68 infants included (mean gestational age 30.5 ± 2.2 weeks, mean birth weight 1447.5 ± 373.0 grams), 11 (16.2%) were diagnosed with ROP. Hyperglycemia was present in 29.4% of infants on D1 and 13.2% on D7. In logistic regression analysis, a strong statistical association was observed between hyperglycemia and ROP for both D1 (Adjusted Odds Ratio [AOR] = 55.7; 95% Confidence Interval [CI]: 5.1–611.0; p=0.001) and D7 (AOR = 74.5; 95% CI: 9.0–613.4; p<0.001). However, the profoundly wide confidence intervals indicate significant statistical instability and imprecision. Conclusion: This study found a strong, albeit statistically imprecise, association between hyperglycemia on both the first and seventh day of life and the incidence of ROP. These findings support the hypothesis that the timing of glycemic dysregulation may be critical, potentially impacting different phases of ROP pathogenesis. The results, while preliminary, underscore the need for larger, prospective studies to confirm these associations and elucidate the role of glycemic control in ROP prevention.

The Temporal Windows of Glycemic Injury: Association of Early and Late First-Week Hyperglycemia with Retinopathy of Prematurity in Low-Birth-Weight Infants Dharmi Lestari, Ni Putu; I Wayan Eka Sutyawan; Putu Junara Putra; I Gde Raka Widiana; Siska; Putu Yuliawati
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1379

Background: Retinopathy of prematurity (ROP) is a leading cause of childhood blindness, driven by aberrant retinal vascular development in preterm infants. While hyperglycemia is a recognized risk factor, its impact may vary depending on its timing relative to the biphasic pathogenesis of ROP. This study aimed to generate a hypothesis regarding the differential association of hyperglycemia on postnatal day 1 versus day 7 with the incidence of ROP in a high-risk neonatal population. Methods: We conducted a retrospective, cross-sectional, hypothesis-generating study at Prof. Dr. I.G.N.G. Ngoerah General Hospital. Medical records of 68 preterm (<37 weeks gestation) and low-birth-weight (<2500 grams) infants who underwent ROP screening were reviewed. The exposures of interest were hyperglycemia (blood glucose >125 mg/dL) on postnatal day 1 (D1) and day 7 (D7). The primary outcome was the diagnosis of any stage of ROP. Statistical analysis involved Chi-square tests and exploratory multivariate logistic regression to adjust for select confounders. Results: Of the 68 infants included (mean gestational age 30.5 ± 2.2 weeks, mean birth weight 1447.5 ± 373.0 grams), 11 (16.2%) were diagnosed with ROP. Hyperglycemia was present in 29.4% of infants on D1 and 13.2% on D7. In logistic regression analysis, a strong statistical association was observed between hyperglycemia and ROP for both D1 (Adjusted Odds Ratio [AOR] = 55.7; 95% Confidence Interval [CI]: 5.1–611.0; p=0.001) and D7 (AOR = 74.5; 95% CI: 9.0–613.4; p<0.001). However, the profoundly wide confidence intervals indicate significant statistical instability and imprecision. Conclusion: This study found a strong, albeit statistically imprecise, association between hyperglycemia on both the first and seventh day of life and the incidence of ROP. These findings support the hypothesis that the timing of glycemic dysregulation may be critical, potentially impacting different phases of ROP pathogenesis. The results, while preliminary, underscore the need for larger, prospective studies to confirm these associations and elucidate the role of glycemic control in ROP prevention.

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