R. Maula Rifada
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Management of Uveitic Glaucoma in Children with Blau syndrome Ivone Caroline; Elsa Gustianty; Andika Prahasta; R. Maula Rifada
Majalah Oftalmologi Indonesia Vol 48 No 1 (2022): 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.v48i1.100196

Abstract

Introduction: Glaucoma in children is a condition that potentially cause blindness. Management of uveitic glaucoma is challenging because of the many mechanisms involved in its pathogenesis Purpose: To report clinical characteristic and management of uveitic glaucoma in children with Blau Syndrome. Methods: A 13 years old boy came to the hospital with chief complain blurred vision in both eyes. The patient was diagnosed as Blau Syndrome one year ago. He had history of trabeculectomy on his left eye. Scalling skin and swollen joints was found on physical examination. Visual acuity was hand movement in both eyes, intraocular pressure was 34 (right) and 40 (left). Gonioscopy of the right eye was schwabe line in superior and peripheral anterior synechia in three quadrants. At the left eye, there was scleral spur in all quadrant. At the anterior segment of right eye, there was band keratopathy, posterior synechia 360 o , peripheral anterior synechia, and cataract. While at the left eye, there was bleb, band keratopathy, posterior synechia, peripheral iridotomy, and cataract. Trabeculectomy, 5 fluorouracil, synechiolysis, iris retractor, and membranectomy was performed for the right eye. Conclusion: Uveitic glaucoma in children poses a significant risk of blindness and needs an aggressive treatment to control intraocular pressure and amblyopia therapy to preserve vision.
COMPARISON OF ANGLE OPENING DISTANCE AND TRABECULAR IRIS SPACE AREA BEFORE AND AFTER LASER PERIPHERAL IRIDOTOMY IN ANGLE CLOSURE DISEASE: Abstract Only Rizki Fasa Ramdhani; R. Maula Rifada; Irawati Irfani; Elsa Gustianty; Sonie Umbara
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/p64vmm95

Abstract

Introduction and Objective: Laser peripheral iridotomy (LPI) is the standard first-line therapy in angle closure disease to increase anterior chamber angle width. Spectral Domain Anterior Segment Optical Coherence Tomography (SD AS-OCT) is an instrument that has a quantitative parameter to measure anterior chamber angle. Angle opening distance (AOD) and trabecular iris space area (TISA) are quantitative parameters in SD AS-OCT. The purpose of this study is to compare AOD and TISA before and one week after LPI in angle closure disease. Methods: This is an analytical prospective study with a cross-sectional study design. Twenty-two eyes with angle closure disease that met inclusion and exclusion criteria underwent LPI and SD AS-OCT before and one week after LPI. Analysis was performed using SD AS-OCT parameters, such as AOD (AOD500, AOD750) and TISA (TISA500, TISA750) in the temporal, nasal quadrants, and average. Results: Twenty-two eyes with angle closure are divided into nine eyes with primary angle closure suspect, seven eyes with primary angle closure, and six eyes with primary angle closure glaucoma. The mean age of participants was 57.86±7.63 years. There was a significant increase in AOD500, AOD750, TISA500, and TISA750 in the temporal and nasal quadrants, as well as in the average (P=0.0001) based on a paired t test or Wilcoxon as an alternative. Average AOD750 had the highest T-value (T= 6.329) with a mean 0.20±0.096 before LPI and 0.31±0.144 one week after LPI. Conclusion: There was a significant increase in AOD and TISA after one week LPI in angle closure disease.
COMPARISON OF SITA STANDARD 24-2 WITH SITA FASTER 24-2C PROGRAM ON HUMPHREY FIELD ANALYZER IN ASSESSING VISUAL FIELD DEFECTS OF GLAUCOMA PATIENTS: Oral Presentation - Observational Study - Resident Nuzul Rianti; Karmelita Satari; Elsa Gustianty; Andika Prahasta; R. Maula Rifada; Sonie Umbara
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: 10.35749/5a6xfs73

Abstract

Introduction & ObjectivesIntroduction: Periodical perimetry examination to detect and determine the rate of glaucomaprogression continues to be a challenging task, because it depends on many factors. Besides, thereis now a paradigm shift which central visual field defects occur earlier. SITA Standard (SS) 24-2 isthe clinical standard for glaucoma examination, but there were studies reporting on the prevalenceof central visual field defects not detected. SITA Faster (SFR) 24-2C was developed to addresscurrent shortcomings, but the performance has yet to be formally and independently assessed.Objectives: To compare the global indices (Mean Deviation, Pattern Standard Deviation, Visual FieldIndex) and test duration between SS 24-2 and SFR 24-2C program. MethodsThis is an analytical observational study with a cross-sectional design. Subjects aged >18 years whodiagnosed with glaucoma and whose visual fields unaffected by other condition besides glaucomawere included. All subjects underwent testing of both programs. ResultsThis study was conducted in 94 eyes of 66 patients. Comparison of global indices and test durationbetween the two programs was carried out by the Wilcoxon test. The mean results of MD and PSDglobal indices were not significantly different, however there was a difference in the mean VFI of1.5% between the two programs. The test duration of SFR 24-2C was 55.03% faster. ConclusionThere was no significant difference in the MD and PSD global indices, but there was a significantdifference in the VFI, as well as the test duration between the two programs.
COMPARISON OF ANGLE OPENING DISTANCE AND TRABECULAR IRIS SPACE AREA BEFORE AND AFTER LASER PERIPHERAL IRIDOTOMY IN ANGLE CLOSURE DISEASE: Oral Presentation - Observational Study - Resident Rizki Fasa Ramdhani; R. Maula Rifada; Irawati Irfani; Elsa Gustianty; Sonie Umbara
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: 10.35749/05vxs382

Abstract

Introduction & ObjectivesLaser peripheral iridotomy (LPI) is the standard first-line therapy in angle closure disease toincrease anterior chamber angle width. Spectral Domain Anterior Segment Optical CoherenceTomography (SD AS-OCT) is an instrument that has a quantitative parameter to measure anteriorchamber angle. Angle opening distance (AOD) and trabecular iris space area (TISA) are quantitativeparameters in SD AS-OCT. The purpose of this study is to compare AOD and TISA before and oneweek after LPI in angle closure disease. MethodsThis is an analytical prospective study with a cross-sectional study design. Twenty-two eyes withangle closure disease that met inclusion and exclusion criteria underwent LPI and SD AS-OCT beforeand one week after LPI. Analysis was performed using SD AS-OCT parameters, such as AOD(AOD500, AOD750) and TISA (TISA500, TISA750) in the temporal, nasal quadrants, and average. ResultsTwenty-two eyes with angle closure are divided into nine eyes with primary angle closure suspect,seven eyes with primary angle closure, and six eyes with primary angle closure glaucoma. The meanage of participants was 57.86±7.63 years. There was a significant increase in AOD500, AOD750,TISA500, and TISA750 in the temporal and nasal quadrants, as well as in the average (P=0.0001)based on a paired t test or Wilcoxon as an alternative. Average AOD750 had the highest T-value (T=6.329) with a mean 0.20±0.096 before LPI and 0.31±0.144 one week after LPI. ConclusionThere was a significant increase in AOD and TISA after one week LPI in angle closure disease.
SECONDARY GLAUCOMA AFTER VITREORETINAL SURGERY: A RETROSPECTIVE OBSERVASIONAL STUDY: Oral Presentation - Observational Study - Resident Liani Mulasari Gunawan; R. Maula Rifada; Elsa Gustianty; Sonie Umbara
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: 10.35749/49ss4368

Abstract

Introduction & ObjectivesSecondary glaucoma is the most common complication after vitreoretinal surgery. Pars PlanaVitrectomy (PPV) is a common surgical procedure aimed at removing vitreous gel and replacing itwith variety of substances denominated tamponades. Vitreous removal and replacement may causeincreased intraocular pressure (IOP). The IOP can be reduced with medical treatment or surgery.The purpose of this study is to describe the characteristics of secondary glaucoma after vitreoretinalsurgery in National Eye Center Cicendo Hospital from January 2019 - December 2020. MethodsThis study was a retrospective descriptive study which data were obtained from medical records.Data such as age, gender, vitrectomy tamponades, IOP, onset of glaucoma, and glaucoma treatmentwere collected. ResultsOne hundred fifty-three eyes were referred to Glaucoma Unit with increasing IOP after vitreoretinalsurgery. PPV with tamponade was done in 141 eyes (92.16%) and silicone oil (SO) 1000 centistokes(cSt) was the most used tamponade in 101 eyes (66.07%). Secondary glaucoma with open angle wasthe most common type in 124 eyes (81.04%). Secondary glaucoma developed in 4-7 weeks aftersurgery, with the highest IOP recorded at 31-40 mmHg. The IOP decreased after SO evacuation withinitial glaucoma treatment in 121 eyes (79.09%), and glaucoma surgery was performed in 32 eyes(20.91%). ConclusionSilicon oil as a tamponade agent after PPV may cause rise IOP in the post-operative period.Evacuation SO needs to be done after retinal adhesion to prevent secondary glaucoma. Therefore,timely detection and anti-glaucoma treatment are important to decreased IOP, or filtration surgerycan be performed.
ND:YAG Laser Vitreolysis as The Management of Occluded Tube After Glaucoma Drainage Device Implantation (GDD): Poster Presentation - Case Report - Resident Raden Fitri Fatimah Iskandar; Elsa Gustianty; Sonie Umbara; Andhika Prahasta; R. Maula Rifada
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: 10.35749/1drs8325

Abstract

Introduction : Glaucoma Drainage Devices (GDD) implantation surgery can be an alternative therapy for patients with uncontrolled IOP after trabeculectomy. However, tube occlusion is a common complication of GDD implantation. Management of tube occlusion can be done using laser or with surgery. This case presents the management of vitreous occlusion of tube implant using ND:YAG laser-vitreolysis. Case Illustration : A 63 year-old male patient came with chief complaint of pain in his right eye. The patient had a history of cataract surgery on the right eye and was diagnosed with glaucoma. An examination showed IOP in the right eye was increased, vitreous in COA and lens was aphakic with posterior capsule rupture. The patient had undergone trabeculectomy, but IOP remained high, so an Aurolab Aqueous Drainage Implant (AADI) GDD implantation was performed. However, six weeks after the procedure, the IOP still increased, and an examination revealed vitreous occlusion of the GDD tube (Figure 1) . The patient underwent Zeiss ND-YAG laser-vitreolysis on his right eye (Figure 2) with laser spot size of 50?m and power of 2.1 MJ. Post laser IOP was decreased. Discussion : GDD implantation is a surgical option for primary or secondary therapy, but tube occlusion can cause implantation failure. Laser-vitreolysis is a non- invasive modality to treat tube occlusion caused by vitreous. Conclusion : GDD occlusion can occur due to various etiologies, but laser-vitreolysis is a non-invasive treatment option aimed at restoring tube patency and aqueous outflow.
DIFFERENT APPROACHES IN MANAGING LENS-INDUCED ANGLE CLOSURE GLAUCOMA: A SERIAL CASE: Poster Presentation - Case Series - Resident Sabrina Indri Wardani; R. Maula Rifada; Andhika Prahasta; Elsa Gustianty; Sonie Umbara
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: 10.35749/349t6495

Abstract

Introduction : Lens-induced angle-closure glaucoma can be caused by phacomorphic lens and ectopia lentis. Several factors affect the disease progression. Early diagnosis and appropriate management are important. Case Illustration : Case 1. A 67-year-old woman presented with acute redness and blurred vision in her left eye with visual acuity (VA) of 1/300 and intraocular pressure (IOP) of 60 mmHg. Axial length showed 23.66 mm and anterior chamber depth (ACD) was 1.61mm (Figure1). She was diagnosed with phacomorphic glaucoma. Phacoemulsification combined with trabeculectomy was performed (Figure2&3). Her VA was improved to 0.08 and her IOP was reduced to 19mmHg after surgery. Case2. A 67-year-old man came with painful blurred vision in his right eye. His VA was a perception of light with an IOP of 40 mmHg. He had axial length of 22.7 mm and ACD of 2.07 mm (Figure4). The lens was anteriorly subluxated and showed zonular laxity. Intracapsular cataract extraction combined with trabeculectomy was performed (Figure5&6). His VA was unchanged while his IOP was reduced to 18 mmHg after surgery. Discussion : Age older than 60 years old, female gender, short axial length (<23.7 mm), shallow ACD, and zonular laxity are factors for progressivity of lens-induced glaucoma. Cataract removal was a definitive treatment along with IOP-lowering medications. The choice of lens extraction technique varies among individuals. Conclusion : Removal of cataractous lens is a definitive treatment in conjunction with intraocular pressure and inflammatory regulations for managing lens-induced angle-closure glaucoma. Comprehensive clinical assessments in patients are necessary for managing the symptoms and preventing complications.