Komaratih, Evelyn
Departemen Ilmu Kesehatan Mata, Fakultas Kedokteran, Universitas Airlangga, Surabaya, Jawa Timur

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A Tear Inflammatory Biomarker in Dry Eye Disease Ni Made Inten Lestari; Evelyn Komaratih; Yuyun Rindiastuti; Cita Rosita Sigit Prakoeswa
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17613

Abstract

Background: Dry eye disease is a chronic ocular condition and significantly impacts visual function with multifactorial origin. It is characterized by tear instability and inflammation on the ocular surface. The inflammatory response initiates by synthesis and release of cytokines, Recently, there has been increasing scientific interest using tear film biomarkers that play a role in pathophysiology of dry eye disease. The objective of this study to explain relationship of tear film biomarker in dry eye.Methods: The research design of this study used literature review. The data was collected from electronic database in PubMed, Google Scholar, and website of science and predominantly published in the last 10 years.Result: The defect on the tear film component due to oxidative stress lead to ocular surface epithelial exposure, and intracellular signaling pathways are triggered, involving an inflammatory mediator which plays a role in the pathophysiology of dry eye. Using biomarker lead to better diagnosis, drug development, and effective management for dry eye disease.Conclusion: In conclusion, TNF-a, IL-6, IL-8, IL-1 by number studies to consistently reflect disease severity and strong correlation with schirmer tear test and another test for the ocular surface in dry eye disease.
THE ROLE OF OCULAR BLOOD FLOW IN THE PATHOGENESIS OF GLAUCOMA Yulia Primitasari; Evelyn Komaratih
Jurnal Kedokteran Syiah Kuala Vol 19, No 1 (2019): Volume 19 Nomor 1 April 2019
Publisher : Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/jks.v19i1.18052

Abstract

 Abstract. Glaucoma is currently the second leading cause of blindness worldwide and the prevalence is expected to increase. Despite lowering of IOP, vascular risk factors, genetics, and other systemic conditions could progress the glaucoma damage. Ocular blood flow has emerged as an increasingly prevalent glaucoma risk factor in large population-based trials. Abnormal  perfusion  and  the  subsequent  ischemia  of  the ONH  play  a  major  role  in  the  glaucomatous  damage. Ocular Blood flow is unstable if IOP fluctuates on a high enough or blood pressure on a low enough level to exceed temporarily the autoregulation capacity. IOP fluctuation is also related to both an increase in scotomas and an increase in diffuse visual fields damage.  OBF is unstable if autoregulation itself is disturbed. In  glaucoma  the  response  of  retinal  and  optic nerve head  blood flow to flicker  stimulation  is  reduced.  Primary  vascular  dysregulation appears  to  be  associated  with  abnormal  retinal  neurovascular  coupling,  because  vasospastic  subjects  show  a reduced  response  to  flicker  stimulation.Keywords: ocular blood flow, glaucoma
Matrix Metalloproteinase-3 Down Regulation and Cell Migration Inhibition in Human Pterygium Fibroblasts by Mitomycin-C, Curcumin and Fibrin Glue Ferdian Ramadhan; Jamaluddin Jamaluddin; Ismi Zuhria; Luki Indriaswati; Evelyn Komaratih
The Indonesian Biomedical Journal Vol 14, No 2 (2022)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v14i2.1825

Abstract

BACKGROUND: Pterygium is an ocular surface disease that often occurs in tropical countries with a high recurrence rate. Matrix metalloproteinase-3 (MMP-3) play a key role in the inflammatory process of pterygium. This study aims to investigate the ability of curcumin and fibrin glue (FG) in suppressing the expression of MMP-3, and whether can be expected as adjuvant therapy to reduce pterygium recurrence.METHODS: Human pterygium fibroblasts (HPF) obtained from primary cultured of pterygium were treated with no treatment, curcumin, mitomycin-C (MMC), and FG. MMP-3 expression was analyzed using immunocytochemistry and the intensity measurement was done using ImageJ software. Cell migration was measured by scratching and stratification of fibroblast culture after cell confluence, and assessed for 48 hours.RESULTS: The expression of MMP-3 were lower in the HPF treated with 100 mol/mL curcumin, 200 mol/mL, and FG (2205.84±86.1 pg/mL, 1002.51±25.22 pg/mL, 1131.55±17.71 pg/mL, respectively) in comparison with untreated HPF (4703.49±108.9 pg/mL). The expression of MMP-3 were significantly different between groups (p<0.001). Cell migration of HPF after scratching with curcumin intervention at 200 mol/mL decrease from 178.67±2.85 (24 hours) to 88.83±1.48 (48 hours). Meanwhile the migration in FG group also decrease from 180.4±2.56 (24 hours) to 72.45±1.25 (48 hours).CONCLUSION: Curcumin and FG able to reduce the expression of MMP-3 and inhibit the migration of HPF cells.KEYWORDS: curcumin, mitomycin C, fibrin glue, human pterygium fibroblast, MMP-3
A Rare Case of Chronic Primary Angle-Closure Glaucoma in a Young Woman with Coexisting Pathologic Myopia Ni Putu Ayu Reza Dhiyantari; Nurwasis Nurwasis; Evelyn Komaratih; Yulia Primitasari
Vision Science and Eye Health Journal Vol. 1 No. 1 (2021): Vision Science and Eye Health Journal
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1436.726 KB) | DOI: 10.20473/vsehj.v1i1.2021.10-16

Abstract

Introduction: Primary Angle-Closure Glaucoma (PACG) is usually present in adults older than forty and is more common in hyperopic eyes. Angle-closure is usually related to structural or developmental ocular abnormalities in young individuals. Case presentation: We presented a rare case of PACG in a 32 years old woman with pathologic myopia of -23.0 RLE. The chief complaint was blurring of the right eye three months before the visit. Right eye Intraocular Pressure (IOP) was 30mmHg-38mmHg despite treatment with three intra-ocular pressure-lowering agents. Axial length was 32.36 mm and 31.19 mm RLE. Anterior chamber depth was 2.36 mm and 2.60 mm RLE. Lens thickness was 5.07 mm and 5.40 mm RLE. Signs of GON and pathologic myopia were found in both eyes. GON was present asymmetrically (0.9 and 0.6 RLE), with the myopic crescent as well as baring and peripapillary atrophy. The optic disc was slightly tilted with the myopic crescent. There was also a marked sign of retinal pigment epithelium thinning and attenuation along with myopic chorioretinal atrophy. Conclusions: PACG in a young myopic individual is challenging to diagnose because myopia and glaucoma share similar optic nerve head pathology. Comprehensive examinations including gonioscopy, biometry, and OCT may confirm the diagnosis. In the presented case, angle-closure was caused by thick lenses and a shallow anterior chamber, along with excessively long axial length. Primary angle-closure at a young individual with myopic eyes is highly uncommon. Nonetheless, clinicians should always consider glaucoma even in the presence of high axial length and myopic fundus.
The Difficulties of Trabeculectomy in a Primary Angle-Closure Glaucoma Patient Herdina Ramadhani; Nurwasis Nurwasis; Yulia Primitasari; Evelyn Komaratih
Vision Science and Eye Health Journal Vol. 1 No. 2 (2022): Vision Science and Eye Health Journal
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (5082.62 KB) | DOI: 10.20473/vsehj.v1i2.2022.38-44

Abstract

Introduction: Trabeculectomy is an incisional surgery for glaucoma patient. Performing trabeculectomy in primary angle-closure glaucoma (PACG) is quite difficult. Caution is needed for the occurrence of flat anterior chamber (FAC) and malignant glaucoma. We present a case management of trabeculectomy in a PACG patient. Case presentation: A 52-year-old male had blurred vision in his left eye since one year ago. The patient felt left visual field narrowing since eight months ago. Patient had type 2 diabetes mellitus. Visual acuity on the left eye was 5/7.5. Intraocular pressure (IOP) increased (29 mmHg). Gonioscopy showed closed angle and peripheral anterior synechiae. Glaucomatous optic neuropathy was found with C/D ratio value of 0.9 and superior-inferior RNFL thinning on optical coherence tomography (OCT). Anterior segment OCT revealed shallow anterior chamber depth (ACD) 2.54 mm. The right eye visual acuity was 5/5, normal IOP, and shallow ACD (2.66 mm). Patient was underwent left eye trabeculectomy. Postoperatively, left eye anterior chamber and bleb were formed. He had normal IOP without glaucoma medications. Conclusions: Trabeculectomy is a surgical procedure for glaucoma. Close monitoring is required to avoid the risk of postoperative FAC and malignant glaucoma in PACG.
PERAN STEM CELL PADA GLAUKOMA Titiek Ernawati; Evelyn Komaratih; Wilson Christianto Khudrati; Kevin Anggakusuma Hendrawan; Alyssa Claudia Valerie Gunawan; Maria Jessica Rachman
Bahasa Indonesia Vol 2 No 2 (2021): Prominentia Medical Journal
Publisher : Universitas Ciputra Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37715/pmj.v2i2.4125

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Stem cell telah menarik minat yang cukup besar dalam beberapa dekade terakhir mengingat merupakan suatu metode terapeutik baru. Glaukoma adalah salah satu penyebab utama kehilangan penglihatan dan kebutaan total di dunia saat ini terutama di negara-negara Afrika dan Barat yang mempengaruhi lebih dari 60 juta orang. Peningkatan Tekanan intraokular (TIO) merupakan faktor risiko utama untuk kematian retinal ganglion cell (RGC), yang fungsinya menyampaikan informasi visual ke otak dari mata melalui saraf optik. Pengurangan TIO saat ini dicapai melalui berbagai cara, termasuk terapi obat dan intervensi bedah. Namun, tidak ada terapi yang bisa mengembalikan penglihatan pasien menjadi lebih baik oleh karena sudah terjadi kematian RGC yang luas dan tidak dapat ber-regenerasi. Oleh karena itu, stem cell dapat menjadi pilihan satu-satunya untuk mengembalikan penglihatan. Studi sebelumnya telah menunjukkan bahwa pluripotent stem cell (PSC), retinal progenitor cells (RPC) dan sel Muller dapat digunakan untuk meregenerasi RGC. Akan tetapi, ampai saat ini hanya beberapa terapi stem cell yang telah disetujui untuk digunakan dalam praktik klinis penyakit mata, diantaranya inherited retinal dystrophies dan age-related macular degeneration (AMD). Penelitian lain yang dilakukan oleh vilela et al. pada tahun 2015 pada 2 pasien dengan POAG stadium lanjut menggunakan pemberian stem cell yang berasal dari bone marrow pasien tersebut (autolog) secara intravitreal, setelah dilakukan pemeriksaan dengan menggunakan elektroretinografi tidak ada respon setelah terapi dan salah satu pasien mengalami ablasio retina disertai proliferative vitreoretinopati setelah 15 hari post injeksi. Stem Cell merupakan terapi yang sangat menjanjikan bagi pasien dengan glaukoma terutama dengan stadium lanjut oleh karena kerusakan saraf optik yang dialami pasien glaukoma yang tidak dapat diperbaiki dengan terapi yang telah dilakukan sampai sekarang yaitu obat penurun tekanan intraokular maupun dengan operasi. Namun, harus diperhatikan bagaimana Teknik dan pemilihan jenis yang paling baik untuk mencapai outcome terbaik dan dengan efek samping yang paling sedikit.
PERAN RHO KINASE INHIBITOR DALAM PENATALAKSANAAN GLAUKOMA: STUDI PUSTAKA KOMPREHENSIF MEKANISME, EFIKASI DAN EFEK SAMPING Wilson Christianto Khudrati; Evelyn Komaratih; Titiek Ernawati; Maria Jessica Rachman
Bahasa Indonesia Vol 4 No 2 (2023): Prominentia Medical Journal
Publisher : Universitas Ciputra Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37715/pmj.v4i2.4110

Abstract

Glaucoma ranks as the second-leading contributor to visual impairment, affecting a population of more than 76 million people worldwide. Glaucoma drugs currently work to reduce intraocular pressure (IOP) by reducing the production of aqueous humor (AH) in the ciliary corpus or increasing the drainage of AH through conventional or uveoscleral-uveovortex pathways. The newest hypotensive eye medicine, the Rho Kinase Inhibitor (ROCK), works to reduce TIO with the ROCK inhibitor. In addition, the use of ROCK inhibitors has been shown to be beneficial in the treatment of glaucoma, corneal endothelial healing, and progressive diabetic retinopathy. Although there is evidence that the use of Rho kinase-related inhibitors can cause conjunctive hyperemia, before the discovery of the ROCK inhibitor, there was no anti-glaucoma drug that could work with the trabecular meshwork targets, so ROCK is a very promising therapy for glaucoma patients as TM is responsible for 75% of the AH flow.
Anti-Inflammation and Anti-Fibrotic Effects of Amniotic Membrane on Post-Trabeculectomy Conjunctiva (Experimental Research on Oryctolagus cuniculus) Listya Dyah Rihardini; Suparman Suparman; Evelyn Komaratih
Majalah Oftalmologi Indonesia Vol 42 No 2 (2016): 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.v42i2.89

Abstract

Background: To evaluate the effects of amniotic membrane transplantation on the modulation ofwound healing after trabeculectomy.Methods: Eighteen eyes of nine New Zealand rabbits: nine left eyes underwent glaucoma filteringsurgery, nine right eyes underwent trabeculectomy and amniotic membrane transplantation. Freshfrozen human amniotic membranes were transplanted above scleral flap, below the conjunctiva withthe stromal side-up. Daily examination of anterior segment were performed using hand held slit lamp.After 7 days, all eyes were enucleated and sent for histopathology examination to evaluate theinflammatory and fibroblast cells. The rabbits were terminated. Blebs were well formed until 7 days.Results: There were statistically no significant difference between two groups in quantity ofinflammatory cells (p=0.258) and fibroblast cells (p=0.436). The tendency in the treatment group,however, the Masson’s Trichrome obtained less fibrosis (88.9%) compared to the control group(44.4%). Hematoxilin eosin staining revealed inflammatory reaction tends to be more severe than thecontrol group, suggesting a xenograft rejection.Conclusion: AMT is still potential as an alternative option to reduce fibrosis in glaucoma filteringblebs but need further research. In rabbits, human amniotic membrane elicited a xenograft reaction.Keywords: amniotic membrane, trabeculectomy, inflammation, fibrosis
CONQUERING THE AMBIGUITY OF OPTIC ATROPHY IN NORMAL TENSION GLAUCOMA: FROM MYSTERY TO MASTERY: Poster Presentation - Case Report - Resident Affannul Hakim; Evelyn Komaratih; Nurwasis; Yulia Primitasari
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/nha7y421

Abstract

Introduction : The dilemma in diagnosing glaucoma often arises when optic atrophy is found alongside nonspecific glaucomatous findings and normal intraocular pressure (IOP), particularly in cases of normal tension glaucoma (NTG). This gray zone often leads to doubt and misdiagnosis. Case Illustration : A 70-year-old man previously diagnosed with idiopathic bilateral optic atrophy complained of blurred vision in both eyes. The visual acuity was 5/5 in the right eye (RE) and hand movement in the left eye (LE). Both eyes had normal IOP, open angles with Sampaolesi lines on gonioscopy, fibrin deposits at pupillary margins, and a large cup-to-disc ratio with baring and peripapillary atrophy on funduscopy. The OCT examination revealed thinning in the ONH-RNFL, ILM-RPE, and GCL-IPL complexes. HFA revealed tunnel vision in RE and general depression in LE. The patient was suspected of having NTG. We performed BMO-MRW (less than 100 ?m in both eyes) and 24-hour ocular perfusion pressure (OPP) measurements (less than 50 mmHg at night) to support the diagnosis. Discussion : The BMO-MRW examination is a new parameter that can help establish the diagnosis of glaucoma. A thin BMO-MRW finding suggests that optic atrophy originates from glaucoma. It is important to perform a comprehensive examination in cases of NTG to identify risk factors and prevent the development of glaucoma. Decreased OPP to less than 50 mmHg and PEX syndrome may be risk factors for NTG. Conclusion : In cases of doubtful optical atrophy, it is important to consider the possibility of NTG by performing a comprehensive examination, including BMO-MRW and twenty-four hour OPP measurements.
ANGLE RECESSION, THE SEQUELA OF EIGHT-BALL HYPHEMA AFTER SPRAYED BY FIRE HYDRANT: A CASE REPORT: Poster Presentation - Case Report - Resident Annisa Kinanti Asti; Evelyn Komaratih; Nurwasis; Yulia Primitasari
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/gkke0y72

Abstract

Introduction : Hyphema results from damage to the blood vessels of the iris or anterior ciliary body after blunt trauma, and in 56–100% of cases can occur angle recession. Case Illustration : A 40-year-old man complaints of pain and blurred left eye after being sprayed by a high-pressure fire hydrant five hours before coming to the emergency room. Visual acuity was 20/20 and hand movement in right and left eye, IOP is 13 mmHg and 18 mmHg in both eyes. Subconjunctival bleeding, conjunctival and pericorneal injections were found with punctate fluorescein test in the left eye. The cornea was edema and the anterior chamber was full of hyphema. Five days after being hospitalized and treated with topical atropine, antibiotics, and steroid in combination with oral tranexamic acid, the visual acuity was 5/6.5 and the hyphema was resolved. The IOP elevated after 1-6 weeks of follow-up in the outpatient clinic then timolol eyedrops were given. Gonioscopy showed widening of CBB, torn iris processus 2 clock hours in the inferior quadrant. The antiglaucoma medication was stopped due to the controlled IOP in the end episode of the treatment. Discussion : Angle recession involves a tear between the longitudinal and circular muscle fibres of the ciliary body. Medication is needed to control the IOP, while surgical management only indicated in cases where medical treatment fails to control the IOP and risk of progressive visual loss. Conclusion : Angle recession can occur after blunt eye trauma with hyphema and IOP control is needed to prevent the development of secondary glaucoma.