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All Journal MNJ (Malang Neurology Journal) The Indonesian Biomedical Journal Universa Medicina Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education IJRETINA - International Journal of Retina Ophthalmologica Indonesiana
Syntia Nusanti
Ophthalmology Department, Faculty Of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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DAPSONE-INDUCED TOXIC MACULOPATHY IN LEPROSY PATIENT Ayuningtyas, Sita Paramita; Djatikusumo, Ari; Nusanti, Syntia; Dewiputri, Salmarezka; Sidik, Mohamad
International Journal of Retina Vol 6 No 1 (2023): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2023.vol006.iss001.226

Abstract

Introduction: Dapsone has been widely used as a part of multidrug therapy for leprosy patients. Ocular side effects are rare. Ocular toxicity manifestations include retinal necrosis, optic atrophy, macular infarction, bilateral exudative retinal detachment, and choroidal detachment. We reported a rare case of dapsone-induced toxic maculopathy in a leprosy patient. Case Report: A 32-year-old male complained of blurred vision and a gray spot in central vision in the left eye (LE) for one month prior to admission. He had been treated with multidrug therapy (MDT) for leprosy for seven months. The MDT consists of dapsone, clofazimine, and rifampicin. The best-corrected visual acuity (BCVA) of the right eye (RE) and the LE were 6/6 and 6/12, respectively. A funduscopy of the LE showed decreased macular reflex. A color vision defect following the tritan axis was found in the LE. The Humphrey visual field (HVF) test of the LE revealed a central scotoma. Macular optical coherence tomography (OCT) showed intraretinal hyperreflectivity and subretinal fluid. Dapsone was then stopped in collaboration with a dermatologist. Two months after the discontinuation of Dapsone, the BCVA of the LE improved to 6/7.5, then 6/6 three months later. Color vision, macular OCT, and HVF tests revealed improvements. Multifocal ERG of both eyes (BE) also showed improvement in N1 and P1 wave amplitude in both eyes on 9-month follow-up after dapsone discontinuation. Discussion: Instead of direct drug toxicity, the mechanism of ocular side effects is thought to be ischemia caused by two distinct mechanisms. Macular ischemia is caused by acute, severe peripheral hypoxia and the physical effect of red cell fragmentation due to the hemolytic process. After discontinuation of dapsone, this case showed improvement in visual function and macular structure. Conclusion: Toxic maculopathy may be present in leprosy patients receiving dapsone treatment, although it is uncommon. Regular follow-up and evaluation of visual function and macular involvement are essential. Early detection of dapsone-induced toxic maculopathy and prompt discontinuation of dapsone may result in an improvement of visual functions.
Multifocal Electroretinogram, Central Macula Thickness and Visual Acuity in Diabetic Macular Edema Following Intravitreal Injection of anti-VEGF Nusanti, Syntia; Sampurna, Kirana; Djatikusumo, Ari; Yudantha, Anggun Rama; Prihartono, Joedo
International Journal of Retina Vol 4 No 2 (2021): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2021.vol004.iss002.156

Abstract

Introduction : Diabetic Retinopathy (DR) is one of the major cause of visual acuity deterioration in diabetic patients. The loss of central visual acuity in diabetic patients are mainly due to macula edema, which is found in 29% diabetic patients with the over 20 years duration of disease. The aim of this study is to evaluate and investigate the possible correlation among changes of visual acuity (VA), central macular thickness (CMT) using Spectral Domain Optical Coherence Tomography (SD-OCT). Electrophysiological responses using multifocal electroretinography (MfERG) in diabetic macular edema (DME) following intravitreal injection of bevacizumab. Methods: Single arm clinical trial. Thirty-three eyes of 33 DME patients (16 non-proliferative diabetic retinopathy and 17 non-high-risk proliferative diabetic retinopathy), receives intravitreal bevacizumab 1,25mg. All patients underwent complete ophthalmic examination including ETDRS VA testing, Sixty-one scaled hexagon MfERG and SD-OCT scan at baseline, 1-week and 1-month post-injection. Components of the first order kernel (N1, N2 and P1) in central 2o were measured. Result : MfERG showed reduced P1 amplitude (P<0.05) at 1-week after injection followed by increased P1 amplitude (P>0.05) at 1-month after treatment as compared to the baseline in all subjects. There was 19% improvement CMT and 0.2Logmar VA improvement in 1-month post-injection compared to the baseline (P<005). This study showed no serious ocular adverse effects. There was no significant correlation between changes in visual acuity with changes in CMT or other MfERG parameters. Conclusion: Intravitreal injection bevacizumab resulting in improved VA, reduction in CMT and mild improvement in the MfERG responses. Although VA changes did not correlate with reduced CMT nor with improved responses of MfERG, the combined use of SD-OCT and MfERG may be used to evaluate macular function in DME patient with worsened visual acuity post anti-VEGF injection.
Adiponectin and Endothelin-1 are Correlated with the Development of Normal-tension Glaucoma in Metabolic Syndrome Patients Prayitnaningsih, Seskoati; Oktarina, Virna Dwi; Nusanti, Syntia; Diarsvitri, Wienta; Rif'ati, Lutfah; Siswanto, Bambang Budi; Santoso, Anwar
The Indonesian Biomedical Journal Vol 16, No 5 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i5.3196

Abstract

BACKGROUND: Glaucoma can lead to irreversible blindness, but normotension glaucoma (NTG) often shows no early symptoms. However, to date, there is limited knowledge regarding the potential parameters for early detection. Therefore, in this study, various metabolic parameters and biomarkers which may contribute to NTG in metabolic syndrome (MetS) patients were evaluated.METHODS: A retrospective cross-sectional study was conducted in the National Cardiac Center Harapan Kita Hospital. Mets were confirmed following the IDF criteria. NTG was determined based on normal intraocular pressure (IOP) with a mean defect (MD) of the visual field, thinning of the retinal nerve fiber layer (RNFL), and enlargement of cup disc ratio (CDR) by ocular coherence tomography (OCT). Metabolic parameters results of waist circumference (WC), body weight, body height, body mass index (BMI), blood pressures, HbA1c, fasting blood glucose (FBG), lipid profiles; and biomarkers including thiobarbituric acid reactive substance (TBARS) and ferric reducing antioxidant power (FRAP), leptin, adiponectin, high-sensitivity C-reactive protein (hs-CRP), and endothelin-1 (ET-1) were analyzed. Statistical analysis was performed using comparative and correlative tests.RESULTS: From 29 subjects, 19 subjects (65.5%) were included in the NTG group and 10 subjects (34.5%) were included in the non-NTG group. In the NTG group, we found significant correlation between MD with systolic blood pressure (p=0.035); CDR with ET-1 (p=0.049); and CDR with adiponectin (p=0.010). The non-NTG group had a significant correlation between MD with BMI (p=0.043); CDR with LDL (p=0.042); and CDR with TG (p=0.031).CONCLUSION: There are correlation between adiponectin and ET-1 with NTG in MetS patients. Therefore, they might be considered as potential early detectors for NTG in MetS patients.KEYWORDS: normal tension glaucoma, metabolic syndrome, biomarker, endothelin-1, adiponectin
CORRELATION BETWEEN PREOPERATIVE OPHTHALMOLOGIC EXAMINATION AND POSTOPERATIVE VISUAL FUNCTION IN PATIENTS WITH PITUITARY ADENOMA: A RETROSPECTIVE STUDY Rahma Putri, Herdanti; Nusanti, Syntia; Ananda Aman, Renindra; M, Sidik; Dewiputri, Salmarezka; Paramita Ayuningtyas, Sita
MNJ (Malang Neurology Journal) Vol. 12 No. 1 (2026): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.01.03

Abstract

Background: Pituitary adenoma is a benign tumor of the pituitary gland that can be treated surgically. Ophthalmological examination is a standard protocol to determine surgical indications and assess postoperative visual prognosis. Objective: This study aimed to evaluate postoperative visual function in pituitary adenoma patients and compare it with preoperative findings. Methods: Retrospective study using medical record data of all pituitary adenoma patients who underwent tumor removal surgery and neuro-ophthalmological examination at Cipto Mangunkusumo Hospital from 2019-2021 . Results: 63 pituitary adenoma patients were included in the study. Median best-corrected visual acuity (BCVA) at the last follow-up improved from 0.8 to 0.45 logMAR in the new case group and from 0.45 to 0.15 logMAR in the residual case group. The most common visual field defect in this study was temporal hemianopia with significant difference in mean deviation (MD) and visual field index (VFI) after surgery on both groups (p<0,05). Moreover, the correlation between initial and final VA, MD, and VFI was significant (0,781; 0,701; 0,594, respectively). The remaining tumor volume was also a significant factor in the improvement of MD and VFI, with better MD and VFI values shown in a smaller tumor volume postoperatively. Conclusion: Neuro-ophthalmological examination after surgery showed an increase in BCVA and improvement in visual field defects. It is shown to be correlated with preoperative BCVA, preoperative MD, and VFI on Humphrey Visual Field examination, and postoperative tumor volume.
Cavernous sinus thrombosis: a case series analysis Syntia Nusanti; Nadia Delima Andini; Lourisa Ruth Eldinia
Universa Medicina Vol. 44 No. 3 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.352-358

Abstract

BackgroundAlthough uncommon, cavernous sinus thrombosis (CST) is a serious and potentially life-threatening condition that often presents with nonspecific signs and symptoms. Cavernous sinus thrombosis is associated with high morbidity and mortality, estimated at approximately 15% and 11% respectively. The complex diagnostic and treatment processes pose a challenge for healthcare providers, considering its elevated mortality and morbidity. We present four cases with varying clinical presentations and outcomes to provide valuable insights into the manifestations and management of CST. Case descriptionOur case series explored CST across age groups, including a case involving a pregnant woman. The clinical manifestations, laboratory data, imaging findings, pathogens, medications, surgical treatment, and clinical outcomes were analyzed. All cases were associated with one or more ophthalmic symptoms. All patients exhibited eye symptoms, with proptosis occurring unilaterally or bilaterally. Etiologies ranged from infections stemming from pimples and tooth cavities to an initially non-septic cause. Of the four cases presented, two proved fatal: one due to severe sepsis in a young man and the other initially aseptic but later progressing into sepsis in a geriatric man. The remaining two cases exhibited septic complications with complete recovery after prompt treatment. ConclusionSeverity and clinical courses of CST varied, emphasizing the need for careful consideration and tailored management strategies in CST cases. The prognosis of CST has improved with the advancement in treatment, but complications are not infrequent. Raising awareness regarding the potential for severe complications, such as cavernous sinus thrombosis, initiated by a common infection, is strongly encouraged.
Co-Authors Agung Nugroho Aleddin, Rommel Amelya Permata Sari Andhika Rachman Andi Marsa Nadhira Anggun Yudantha Anindita Wicitra Annisa Nindiana Pertiwi Anwar Jusuf Anwar Santoso Ardiella Yunard Ari Djatikusumo Aria Kekalih Ayuningtyas, Sita Paramita Bambang Budi Siswanto Brigitta Marcia Bidihardja Brigitta Marcia Budihardja Budiman Bintang Prakoso CECILIA ANGGRAINI Claudia Claudia Hartomuljono Dearaini Dearaini Dearaini Dearaini Desrina Desrina Dewiputri, Salmarezka Dialika Dialika Dicky L Tahapary Dita Permatasari Dita Permatasari Djunaedi Abdul Rachim Elyas Aditya Elyas Aditya Pradana Erika Anggraini Erlina Burhan Fierda Ovita Azhari Gunawan, Calista Nathasya Hisar Daniel Ika Citra Susanti ikhwanuliman Putera Ikhwanuliman Putera Joedo Prihartono Julie Dewi Barliana Laura Agnestasia Djunaedi Lazuardiah Anandi Levina Chandra Khoe Lourisa Ruth Eldenia Lourisa Ruth Eldinia Luminta, Ferdinand Inno M Sidik M Sidik M Sidik M, Sidik M. M. Dio Syaputra M. Sidik M. Sidik M. Sidik Made Paramita Wijayati Manoa Panjaitan Mario Marbungaran Hutapea Marsha Rayfa Pintary Marsha Rayfa Pintary Miratasya Zulkarnaen Mohamad Sidik Mohamad Sidik Mohamad Sidik Muhamad Sidik Muhammad Sidik Muhammad Sidik Nabila Aljufri Nadia Delima Andini Nova Diana Nur Aisyah Rahmawati Oktarina, Virna Dwi Pandelaki, Jacub Paramita Ayuningtyas, Sita Pertiwi, Annisa Nindiana Pintary, Marsha Rayfa Rafika Sari Fadli Rahma Putri, Herdanti Rasyidia Lakmita Putri Rasyidia Laksmita Putri Renindra Ananda Aman Ressa Yuneta Rianti Wulandari Pratiwi Rif'ati, Lutfah Rona Ali Badjrai Salmarezka Dewiputri Salmarezka Dewiputri Sampurna, Kirana Sari, Amelya Permata Seskoati Prayitnaningsih Shidik, Muhammad Sidik, M Sidik, Mohamad Sita Paramita SITA PARAMITA AYUNINGTYAS Theresia Yinski Theresia Yinski Pistari Gondosari Valen Chia Valenchia Valenchia Wienta Diarsvitri Yudantha, Anggun Rama Yulika Harniza Yuri Dwi Mayasari