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Amaurosis Fugax Preceeding Central Retinal Artery Occlusion : a Case Report Ade John Nursalim; Vera Sumual; Andrew Cietra; Elbetty Simanjuntak; Christian Maramis; Komaling Komaling; Stevanus Josafat Loho
Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan Vol 16, No 1 (2022): Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran UPN Veteran Jakarta Kerja Sama KNPT

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33533/jpm.v16i1.4254

Amaurosis fugax is a temporary condition characterized by transient visual loss which lasts several minutes or hours. This symptom can precede central retinal artery occlusion, which can cause permanent visual loss and bear several morbidity and mortality risks. We are reporting a case of a 59-year-old female with an unknown history related to risk factors who developed a painless vision loss in her right eye after experiencing similar symptoms for a short time. We describe the clinical features and other findings related to the diagnosis and discuss the further risk and management. Medical history, physical examination, and optical coherence tomography diagnosed acute central retinal artery occlusion. This includes a history of painless monocular vision loss, macular cherry-red spots, and papilledema. The diagnosis was confirmed by optical coherence tomography showing hyperreflectivity in the inner retinal layer, retinal edema, and hyperreflectivity in the outer retinal layer. Blood test including complete blood check, erythrocyte sedimentation rate (ESR), C reactive protein, lipid profile, and inflammatory markers within normal limit. The patient was then administered to further secondary vascular occlusion prevention, including a blood test, and referred to the neurology department for further examination. Early diagnosis and prompt treatment are necessary for this occlusive disease. A comprehensive examination to mitigate secondary vascular occlusion is needed to prevent morbidity and mortality.

Faktor-Faktor Yang Berhubungan Dengan Toleransi Nyeri Pada Pasien Dengan Terapi Panretina Photocoagulasi Untuk Pasien Proliferative Diabetic Retinopathy vera sumual; Ade John Nursalim; Stevanus Josafat Loho; Christian Maramis Komaling; Oktavianus Makatipu
Cermin Dunia Kedokteran Vol 50 No 7 (2023): Kardiovaskular
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i7.665

Pasien retinopati diabetik (diabetic retinopathy/DR) sering mengalami nyeri saat menjalani terapi panretina photocoagulation (PRP). Hubungan dokter – pasien yang baik dapat membantu membangun kepercayaan yang mampu mengubah persepsi nyeri pasien. Keluarga juga berperan penting dalam mendukung pasien dan memengaruhi persepsi nyeri. Selain itu, faktor psikologis seperti level depresi juga berdampak besar pada persepsi nyeri. Upaya meningkatkan toleransi nyeri pasien dengan membangun hubungan baik dokter - pasien serta mendukung keluarga dalam memberikan dukungan dan perhatian kepada pasien. Patients with diabetic retinopathy (DR) often experience pain during panretinal photocoagulation (PRP) therapy. A good doctor-patient relationship can help build trust that can change patients' pain perception. Family support is also important to influence their pain perception. Psychological factors such as level of depression also have a significant impact on pain perception. Efforts should be made to improve pain tolerance in patients by building a good doctor - patient relationship, as well as supporting the patient's family in providing support and attention to the patient.

Reconstruction Management for Neglected Tripod Fracture with Ophthalmic Injuries: A Case report: Poster Presentation - Case Report - Resident Priscillia Tondolambung; Vera Sumual; Victor Pamolango; Freili Akay
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: 10.35749/5vh07e40

Introduction : Tripod fracture or zygomatico-maxillary complex fracture are among the most common injuries to facial structures, which can make reconstruction more difficult. This case highlights the reconstruction of neglected tripod fracture. Case Illustration : A 17-year-old male was presented with enophthalmos in his right eye. He had an accident three months prior and had received head surgery. After that, the patient came back with a pan-facial fracture. VA on RE was 1/300, limited movement upwards, 4 mm lagophthalmos, negative Bell’s phenomenon, infiltrates and cicatrices on the cornea. CT-scan examination showed tripod fractures. The surgery was performed by the reconstruction division with an oral and maxillofacial surgeon. Nineteen days after surgery, there has been some improvement in the orbital misalignment. Discussion : Delayed intervention in this case, increased the difficulty of surgical treatment and could lower the success rate of surgery. If the indication is obvious, an immediate intervention will give better results because soft tissue scarring is minimized and fractures are easily reduced. During the procedure, we released the orbital muscle entrapment and repaired the deviated bone and callus with an osteotome to achieve mobility. Therefore, the tripod fracture was fixed with three-point fixation, followed by reconstruction of the maxilla and mandible. The result after surgery showed some improvements in aesthetics but not in vision. Conclusion : Orbital reconstruction with mini-plate implants in three-point fixation as the management of orbital fractures is effective, but its accuracy is difficult to assess during surgery, especially when coupled with delayed intervention cases. Early reconstruction is recommended for a better cosmetic result.

Sub-internal Limiting Membrane Hemorrhage Caused by Heavy Physical Activity Vera Sumual; Nursalim, Ade John; Andrew Chietra
Archives of The Medicine and Case Reports Vol. 5 No. 1 (2024): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v5i1.448

Sub-internal limiting membrane (sub-ILM) hemorrhage, a rare ocular condition, poses a challenge in ophthalmology due to its association with severe visual impairment. This case report presents a 27-year-old male with a sub-ILM hemorrhage following intense physical activity. Despite unsuccessful Nd:YAG laser treatments, vitrectomy with internal limiting membrane (ILM) peeling resulted in a remarkable improvement in visual acuity from hand movement to 6/6 within the first day post-surgery. The fundus photograph and OCT findings illustrated restored macular anatomy, highlighting the positive outcomes of surgical intervention.

Faktor-Faktor Yang Berhubungan Dengan Toleransi Nyeri Pada Pasien Dengan Terapi Panretina Photocoagulasi Untuk Pasien Proliferative Diabetic Retinopathy vera sumual; Ade John Nursalim; Stevanus Josafat Loho; Christian Maramis Komaling; Oktavianus Makatipu
Cermin Dunia Kedokteran Vol 50 No 7 (2023): Kardiovaskular
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i7.665

Pasien retinopati diabetik (diabetic retinopathy/DR) sering mengalami nyeri saat menjalani terapi panretina photocoagulation (PRP). Hubungan dokter – pasien yang baik dapat membantu membangun kepercayaan yang mampu mengubah persepsi nyeri pasien. Keluarga juga berperan penting dalam mendukung pasien dan memengaruhi persepsi nyeri. Selain itu, faktor psikologis seperti level depresi juga berdampak besar pada persepsi nyeri. Upaya meningkatkan toleransi nyeri pasien dengan membangun hubungan baik dokter - pasien serta mendukung keluarga dalam memberikan dukungan dan perhatian kepada pasien. Patients with diabetic retinopathy (DR) often experience pain during panretinal photocoagulation (PRP) therapy. A good doctor-patient relationship can help build trust that can change patients' pain perception. Family support is also important to influence their pain perception. Psychological factors such as level of depression also have a significant impact on pain perception. Efforts should be made to improve pain tolerance in patients by building a good doctor - patient relationship, as well as supporting the patient's family in providing support and attention to the patient.

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