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<![CDATA[THE ASSOCIATION BETWEEN SELECTION'S ASSESSMENT ITEMS AND RESIDENT'S PERFORMANCES IN THE OPHTHALMOLOGY DEPARTMENT OF A FACULTY OF MEDICINE ]]>
<![CDATA[Syntia Nusanti]]>;
<![CDATA[Anwar Jusuf]]>;
<![CDATA[Aria Kekalih]]>
<![CDATA[ Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Vol 9, No 1 (2020): MARET ]]>
Publisher : <![CDATA[Asosiasi Institusi Pendidikan Kedokteran Indonesia ]]>
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DOI: 10.22146/jpki.42770
<![CDATA[Background: The admission of residency program in the Ophthalmology Department, FKUI–RSCM is based on the accumulative score from some of the selection's assessment items. The coordinator expects the candidates who received high marks on selection process would also give excellent performance during the residency and therefore the resident would graduate as a qualified ophthalmologist. The aim of this study is to know the association between selection's assessment items and the performance during the residency program.Methods: This was a retrospective cross-sectional study using secondary data. The inclusion criteria were all ophthalmology residents with complete data information of selection, during, and at the end of the residency program from 1999 to 2006, in which results in 101 subjects. The selection data collection includes gender, age, the medical faculty origin, interview result, psychological test result, the entrance examination result, and the selection result. Data during the residency program involve the result from each end of the program's step, result of national examination, and difficulties encountered during the residency program. And lastly, data at the end of the residency program are the GPA and the duration of the residency.Results: There was a significant correlation between the residents' medical faculty origin and their results at the end of each step (p=0.004). There were also significant correlations between age (p=0.004), medical faculty origin (p=0.008), selection result (p=0.002) and their final GPA. Gender also have a significant correlation with difficulties encountered during the residency program (p=0.001). No significant correlation found between selection’s assessment items and duration of the residency.Conclusion: There were some significant correlations between some selection's criteria and the performance of ophthalmology residency program's participants. The medical faculty origin was found to be the strongest predictor to predict the performance of the residents. ]]>
<![CDATA[Reversible ethambutol-induced optic neuropathy: report of a rare case ]]>
<![CDATA[Syntia Nusanti]]>;
<![CDATA[Rasyidia Laksmita Putri]]>;
<![CDATA[Dearaini Dearaini]]>
<![CDATA[ Universa Medicina Vol. 41 No. 3 (2022) ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Trisakti ]]>
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DOI: 10.18051/UnivMed.2022.v41.271-276
<![CDATA[BackgroundEthambutol (EMB) is one of the first-line anti-tuberculosis therapy. One of its precarious side effects is ethambutol-induced optic neuropathy (EON). The ocular manifestations of EON include painless loss of central vision and cecocentral scotomas in the visual field. Case DescriptionA 60-year old man presented with gradual and painless visual loss since 3 months prior to visit. The accompanying symptoms were frequent headache without double vision and photophobia. He had been diagnosed with pulmonary tuberculosis (TB) for 9 months and consumed EMB for 7 months before being advised to discontinue. There was neither history of systemic diseases nor family history of neuropathy. Examination showed reduced visual acuity with positive relative afferent pupillary defect (RAPD) on right eye. Humphrey test showed bilateral generalized visual loss. Ocular computed tomography (OCT) showed retinal nerve fiber layer (RNFL) thickness was within normal limit. Magnetic resonance Imaging (MRI) brain indicated unremarkable result for optic neuropathy. Based on the examinations listed above, this patient was diagnosed as EON and EMB was stopped immediately. Patient was given oral citicoline 1000mg and zinc supplementation for one month. After 1 st and 3 rd month follow up, patient’s visual function was gradually improved. The ophthalmic examinations indicated recovery of the visual function. ConclusionsThis case suggested that an early detection and intervention in patient with EON has promising result in visual outcome. EON is a reversible optic neuropathy if the ocular toxicity is monitored closely among the tuberculosis patients who are prescribed EMB regiment.]]>
<![CDATA[Comparison of Wave Amplitude, Implicit Time and Comfort Level Using Dawson-Trick-Litzkow, Jet and Dencott Electrodes in Electroretinography in Normal Adults ]]>
<![CDATA[Theresia Yinski Pistari Gondosari]]>;
<![CDATA[Mohamad Sidik]]>;
<![CDATA[Syntia Nusanti]]>
<![CDATA[ International Journal of Retina Vol 3 No 2 (2020): International Journal of Retina (IJRetina) - INAVRS ]]>
Publisher : <![CDATA[Indonesian Vitreoretinal Society ]]>
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DOI: 10.35479/ijretina.2020.vol003.iss002.123
<![CDATA[Introduction: Several electrodes can be used in standard full-field electroretinography (ERG). However, there are no standard values for Indonesians yet. Therefore, this research aims to establish normal values, to compare them and to compare comfort levels using DTL, Dencott and Jet electrodes in Indonesian adults. Method: Through convenient sampling, 58 normal Indonesian subjects, age 19-49 years old were selected. ERG amplitudes and implicit time values were measured according to recommendations by the International Society for Clinical Electrophysiology of Vision (ISCEV). Evaluations consisted of scotopic 0.01, 3.0, OP and photopic 3.0 flicker. After examination, all subjects filled in a questionnaire about comfort levels, adopted from the visual analog scale. Result: We observed a statistically significant difference in ERG normal values between electrodes with higher wave amplitudes and longer implicit times in Dencott and jet electrodes, compared to DTL electrodes. Jet and DTL electrodes are more comfortable than Dencott electrodes for Indonesian adults in standard full-field electroretinography. Conclusion: DTL electrodes give the lowest wave amplitudes and the shortest implicit times and are the most comfortable electrode compared to Dencott and ERG jet electrodes, in standard full-field electroretinography in Indonesian adults.]]>
<![CDATA[A Rare Case of Unilateral Retinitis Pigmentosa ]]>
<![CDATA[Syntia Nusanti]]>;
<![CDATA[Mohamad Sidik]]>;
<![CDATA[Ari Djatikusumo]]>;
<![CDATA[Elyas Aditya]]>
<![CDATA[ International Journal of Retina Vol 2 No 1 (2019): International Journal of Retina (IJRetina) - INAVRS ]]>
Publisher : <![CDATA[Indonesian Vitreoretinal Society ]]>
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DOI: 10.35479/ijretina.2019.vol002.iss001.52
<![CDATA[Introduction: Retinitis pigmentosa (RP) is a hereditary disorder that diffusely involve photoreceptor and retinal pigment epithelial (RPE). It is characterized by progressive visual field loss and abnormal ERG. Unilateral RP is a rare condition that is usually sporadic. Clinical presentation and ancillary test results are similar to bilateral RP, with only one eye affected. In making the diagnosis of unilateral RP, clinicians must be able to rule out secondary causes, document a normal ERG in the unaffected eye, and follow-up the patient for at least 5 years to rule out bilateral but asymmetric disease. the aim of this case report is how to diagnose a rare case unilateral RP from clinical examination and ancillary tests. Methods: We report a case of a 33-year-old female with slowly progressive restriction of visual field of the left eye in the last one year before admission. Ophthalmological examination of the left eye revealed bone spicules spreading to peripheral fundus. Visual field examination revealed severely constricted visual field of the left eye. The multifocal electroretinogram (mfERG) examination showed severely depressed ERG function with reduced foveal responses. The fellow eye was within normal limit. Results: Patient was diagnosed with unilateral RP and must be followed-up for at least five years to rule out bilateral yet asymmetric disease. Making diagnosis of unilateral RP become one of the challenging case. Clinicians must be able to rule out the secondary causes that also have unilateral pigmentary retinal degeneration. Conclusion: With a good clinical examination and some simple ancillary tests, we could correctly diagnose unilateral RP. However, in this case we still need five years follow up to rule out bilateral RP yet asymmetric disease.]]>
<![CDATA[Macular Edema as Unusual Presentation of Non-Arteritic Ischemic Optic Neuropathy (NAION) ]]>
<![CDATA[Marsha Rayfa Pintary]]>;
<![CDATA[Ari Djatikusumo]]>;
<![CDATA[Salmarezka Dewiputri]]>;
<![CDATA[Syntia Nusanti]]>;
<![CDATA[Mohamad Sidik]]>
<![CDATA[ International Journal of Retina Vol 5 No 2 (2022): International Journal of Retina (IJRetina) - INAVRS ]]>
Publisher : <![CDATA[Indonesian Vitreoretinal Society ]]>
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DOI: 10.35479/ijretina.2022.vol005.iss002.193
<![CDATA[Introduction: Non-arteritic Ischemic Optic Neuropathy is the most common type of ischemic optic neuropathy. Nearly half of NAION patients presented with 20/30 or better visual acuity. Central vision is often preserved relative to the visual field loss. Macular edema in NAION patient is rare, and its occurrence may confuse to other disease and lead to unnecessary treatment. Case Report: We identified three NAION patients presented with macular edema. The patients' age was above 40 and had diabetes mellitus (DM). Our patients had clinical findings consistent with NAION with poor visual acuity at the early presentation. Optical coherence tomography examination was performed, and all patients had prominent subretinal fluid. Intravitreal anti-VEGF injection was done on our first patient and no treatment was given to our second and third patient. All patients showed a significant improvement of macular edema. Discussion: Macular edema is a rare clinical manifestation that may contribute a visual deterioration in NAION. The incidence of macular edema in NAION patients is difficult to measure since OCT of macula is not routinely performed. In our report, we encountered three cases of NAION complicated by macular edema that underwent a different approach in therapy. Spontaneous regression of subretinal fluid was seen during observation without any treatment given. Our patients achieved a stable visual acuity and visual field defect. This finding is under the literature that spontaneous recovery will be observed during the natural course of acute NAION. Conclusion: Macular edema is an unusual but self-limiting presentation of NAION. Therefore, a comprehensive examination is needed to prevent any unnecessary treatment.]]>
<![CDATA[Comparison of Amplitude and Implicit Time Between Jet Electrode, Dencott Electrode and Dawson-Trick-Litzkow Electrode in Multifocal Electroretinography Examination in Adult ]]>
<![CDATA[Syntia Nusanti]]>;
<![CDATA[Ika Citra Susanti]]>;
<![CDATA[M. Sidik]]>;
<![CDATA[Aria Kekalih]]>
<![CDATA[ International Journal of Retina Vol 5 No 2 (2022): International Journal of Retina (IJRetina) - INAVRS ]]>
Publisher : <![CDATA[Indonesian Vitreoretinal Society ]]>
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DOI: 10.35479/ijretina.2022.vol005.iss002.187
<![CDATA[Introduction: Multifocal electroretinography (ERG) is an examination which measures retinal electrical activity as a response to lighting stimulus and allows simultaneous recording in many topographic locations. Various electrodes have been developed to balance examination accuracy and also patients’ comfort. The objective of this study is to establish normal values of multifocal ERG and to compare the values and the comfort level using Jet, Dencott and DTL electrode in Indonesian Adult. Methods: Through convenient sampling 49 normal Indonesian subjects between 19 and 49 years old were selected. Multifocal ERG amplitudes and implicit time values were measured according to recommendation by the ISCEV. Evaluation consisted of N1 and P1 wave in ring 1 to 5. after the examination, all subjects filled in a questionnaire about comfort level, adopted from the visual analog scale. Result: We observed a statistically significant difference in multifocal ERG normal values between electrode with higher wave amplitudes and longer implicit time in Jet and Dencott electrodes compared to DTL electrodes. Jet and DTL electrodes are more comfortable than Dencott electrodes for Indonesian adults in multifocal ERG. Conclusion: DTL electrodes give the lowest wave amplitude and the shortest implicit time and are the most comfortable electrode compared to Jet and Dencott electrodes, in multifocal ERG in Indonesian adults.]]>
<![CDATA[Horner Syndrome Related to Nasopharyngeal Carcinoma ]]>
<![CDATA[Nova Diana]]>;
<![CDATA[Syntia Nusanti]]>;
<![CDATA[M. Sidik]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 41 No 2 (2015): Ophthalmologica Indonesiana ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/journal.v41i2.22
<![CDATA[Background: Horner syndrome classically presents with ipsilateral blepharoptosis, pupillary miosis, and facial anhidrosis. The syndrome results from interuption of the sympathetic innervation to the eye and ocular adnexae. Case Illustration: A 43-year-old male complaining of drop of upper eyelid right eye, anhidrosis right side of face, and numbness on his right face since 7 months previously. He had painless, slowly enlarging, right-sided neck mass that was first noticed approximately 7 months before presentation. The biopsy and CT scan confirmed nasopharyngeal carcinoma (NPC). Best corrected visual acuity of both eyes was 6/6, normal IOP and ocular movement. There was mild ptotic eyelid 2 mm of his right eye. Both anterior segment within normal limit. There was unequal pupils greater in the dark, with pupil size of the right eye 3 mm and left eye 5 mm. The pupils were reactive to light, without afferent pupillary defect. Both posterior segment examination were unremarkable. There was reduced sensibility of the right face at maxila and mandibular region. The patient was diagnosed with Horner syndrome with involvement of right trigeminal nerve at maxillary and mandibular division, and involvement of sweat glands corellate with preganglionic lesion. Conclusion: Nasopharyngeal carcinoma that affects oculosympathetic pathway may give clinical signs as Horner syndrome. There was found involved of sweat gland in this case, it is correlated with lesion in preganglionic. But the anhidrosis occurs only in maxila and mandibular region, therefore post ganglionic involvement can not be ruled out. Keywords: Horner syndrome, nasopharyngeal carcinoma]]>
<![CDATA[Diagnosis and Management of Devic’s Disease ]]>
<![CDATA[Desrina Desrina]]>;
<![CDATA[Syntia Nusanti]]>;
<![CDATA[M. Sidik]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 41 No 3 (2015): Ophthalmologica Indonesiana ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/journal.v41i3.38
<![CDATA[Background: To report diagnosis and management of Devic’s Disease with good visual outcome.Case Illustration: A 51 years-old male came with sudden blurred vision of his right eye since 3 days.The patient also complained of lower limbs weakness, urinary retention, and defecation disorder.Ophthalmology examination revealed visual acuity of no light perception in the right eye and 6/12 inthe left eye. Light reflex of both eyes decreased. Funduscopy examination of the right eye showed anindistinct edge and hyperemic optic nerve head, cup-disc ratio was hard to be evaluated, artery/vein ratioof 2/3, macular reflex was positive and the retina was good. Funduscopy of the left eye was within normallimit. No pathological finding in brain Magnetic Resonance Imaging (MRI). Thoracolumbal MRI supportlongitudinal transverse myelitis. The patient was diagnosed as Devic’s Disease and treated initiallywithintravenous methylprednisolone 1 g/day for five days followed by methyl prednisolone orally.Conclusion: Early diagnosis of Devic’s Disease is important because immediate therapeutic interventionis required to get excellent result, prevent relapse and further disability.]]>
<![CDATA[Methanol Toxic Optic Neuropathy (Characteristic and Evaluation of Therapy) ]]>
<![CDATA[Ardiella Yunard]]>;
<![CDATA[Syntia Nusanti]]>;
<![CDATA[M. Sidik]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 42 No 1 (2016): Ophthalmologica Indonesiana ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/journal.v42i1.62
<![CDATA[Background: Methanol toxic optic neuropathy is and optic neuropathy caused by methanolintoxication. Management of methanol toxic optic neuropathy is a therapeutic challenge and theoutcome is often unsatisfying. The aim of this study is to know the characteristics and evaluate theoutcome of corticosteroid therapy in methanol toxic optic neuropathy.Methods: Medical records of patients diagnosed with methanol toxic optic neuropathy from January2013 to December 2014 were reviewed retrospectively. Demographic characteristic, clinicalcharacteristic and visual acuity were evaluated.Results: During the period of January 2013 until December 2014, 31 patients were diagnosed withmethanol toxic optic neuropathy. All of them were males. The mean age was 31.87±9.23 years. Ocularsymptoms were found in 93.5%, most of them occured in 24-96 hours after methanol consumption.There were 85.4% patients at initial presentation had visual acuity (VA) less than 3 m finger counting,and 72.6% showed optic disc edema. Among the patients, 42% got intravenous high-dosemethylprednisolone, 19% got combination of intravenous high-dose methylprednisolone andhemodyalisis, 26% got oral methylprednisolone, and 3% got neuroprotector. VA improvement aftertherapy occured in 67.7%, no changes in 26.47%, and worsening in 5.88%. All patients who gottherapy in 6 days after methanol consumption showed VA improvement.Conclusion: The administration of intravenous high-dose steroids showed an improvement of visualstatus in most of the patients. Intravenous high-dose steroids gave benefit the visual status of patientswith methanol optic neuropathy, especially in patients with short interval between the consumption ofmethanol and starting the treatment. Keywords: methanol intoxication, optic neuropathy, methylprednisolone]]>
<![CDATA[Clinical Characteristics and Therapeutic Outcome of Carotid-Cavernous Fistula ]]>
<![CDATA[Ressa Yuneta]]>;
<![CDATA[M Sidik]]>;
<![CDATA[Syntia Nusanti]]>;
<![CDATA[Jacub Pandelaki]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 42 No 3 (2016): Ophthalmologica Indonesiana ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/journal.v42i3.98
<![CDATA[Background: Carotid-cavernous fistula (CCF) is an abnormal communication between the carotid arterial system and the cavernous sinus. It can manifest as proptosis, bruit, corkscrew appearance or other signs. The aims of this study were to evaluate the clinical characteristics and result of CCF therapy.Methods: This is a retrospective study which evaluated the clinical characteristic, outcome of therapy and complications after embolization in CCF patient confirmed by digital subtraction angiography (DSA) from January 2012 to December 2014.Results: Twenty-three patients, 16 male and 7 female, were diagnosed as CCF. Mean age was 26±10.5 years old. The most common etiology was trauma (91.3%) with onset ranging from immediately to 17 months after trauma. The frequent ocular manifestations were proptosis, bruit, and conjunctival abnormalities. Other ocular signs were ophthalmoplegia, secondary glaucoma, abnormalities of posterior segment, and decrease of visual acuity. Seventy-eight percent patient was type A CCF. Fifteen patients underwent embolization, 3 patients couldn’t be embolized then treated by manual carotid compression, 5 patients were still waiting for schedule of embolization. Clinical signs of 63% patients were improved in 1 week after embolization. After several months, 2 patients with carotid compression was improved and 1 patient had persistent signs. Complications of embolization include transient sensoric aphasia (1 pasien) and central retinal vein occlusion (2 patients).Conclusion: Clinical characteristics of CCF in this study were not different with previous descriptive studies and most cases showed improvement in clinical signs after therapy.  Keywords: CCF, embolization]]>
