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Bilateral Optic Neuritis as an Atypical Presentation of Primary Sjögren’s Syndrome (pSS) Denisa Rosati; Lukisiari Agustini
Vision Science and Eye Health Journal Vol. 1 No. 3 (2022): Vision Science and Eye Health Journal
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga

Introduction: Primary Sjögren’s syndrome (pSS) is a chronic progressive autoimmune disease that primarily affects exocrine glands with varying symptoms. Here we discuss atypical optic neuritis as an initial presentation of pSS without any sicca symptoms. Case presentation: A 22-year-old woman came to the outpatient clinic with the chief complaint of rapid deteriorating visual acuity that had started one week before—no complaint of the eye or other mucosal dryness. At the initial visit, best corrected visual acuity (BCVA) was hand movement on the right eye and 6/7.5 on the left eye with decreasing color perception. Fundus examination showed bilateral optic nerve head edema. Schirmer test and tear-film break up time were within normal limits. After the initial one gram intravenous methylprednisolone treatment, no significant changes were observed for three consecutive days. Serological investigations revealed raised levels of SS-A native. Improvement happened after being given azathioprine. Conclusion: Optic neuritis may be the initial presentation of Sjögren’s syndrome without sicca symptoms. The presence of a specific antibody, including anti-SSA, is supportive for the diagnosis of such a case.

Neuropati Optik Kompresif Bilateral yang Terinduksi oleh Schwannoma Cinintha Nandini; Lukisiari Agustini
Jurnal Ilmiah Kedokteran Wijaya Kusuma Vol 9, No 1 (2020): MARET 2020 available online since April 2020
Publisher : Universitas Wijaya Kusuma Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30742/jikw.v9i1.733

The aim of this case report was to present further study about diagnosis and management of bilateral compressive optic neuropathy induced by schwannoma. This case report will discuss about the definition, classification, etiology, clinical diagnosis and treatment for compressive optic neuropathy. A case report. 43 years-old woman complained about blurred vision since 2 years ago. She also complained about pain on her right head while she was walking. There was no history of tinnitus or hearing loss. She had a history of contraception pill uses and progesterone injection every 3 months for 5 years alternately. She also suffered from schwannoma in cerebello pontine angle based on MRI and histopathology examination. From physical examination, best corrected visual acuity on right eye was 5/6 PHNI and on left eye was 5/8 PHNI. Ishihara test showed decreased colour vision. There was also ataxic gait. From anterior segment examination, there were decreased light reflex and RAPD. From posterior segment examination, there were papilloedema and elevation on both eyes proved by OCT and fundal imaging. Neuroprotector therapy and surgery show a good result. Ishihara test are improving, light reflex are increasing and there are no RAPD anymore. From posterior segment, papilloedema are slowly diminished. The patient presents a case of bilateral compressive optic neuropathy induced by schwannoma. Neuroprotector and surgery show a good result.

The Effect of Zinc Distribution for New TB Patients who Have Ethambutol Therapy Toward Visual Field Defect Neni Daniati; Kusdiantoro Kusdiantoro; Laksmi Wulandari; Nina Mauthia; Lukisiari Agustini
Majalah Oftalmologi Indonesia Vol 42 No 3 (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.v42i3.96

Background: Tuberculosis is an infection disease that is caused by Mycobacterium tuberculosis. Ethambutol therapy for TB patients can cause side effect such as decreased visual acuity, visual field defect, decreased contrast sensitivity, and disturbance of colour detection. Zinc in TB patients has decreased that causes broken cell on retina ganglion and disturbance of mytochondria function. The aim of this study is the effect of zinc supplementation for new TB patients who have ethambutol therapy toward visual field defect.Methods: This study involved 40 new TB patients who have ethambutol therapy which is classified as 20 patients who have ethambutol therapy with zinc supplementation and 20 patients who have ethambutol therapy without zinc supplementation. Each patient underwent a routine examination including visual acuity using Snellen chart which is converted to LogMAR, anterior segment using slit lamp biomicroscope, non-contact tonometry for intraocular pressure examination, posterior segment using direct ophthalmoscope, and Humphrey perimetry for visual field examination which is performed three times on first time when initial patient came, first month, and second month duration.Results: This study showed no correlation between gender with visual field defect (p=0,554), there is no correlation between age with visual field defect (p=0,418), no correlation between smoking behaviour with visual field defect (p=1), no correlation between amount of meals consumption containing Zn with visual field defect (p=0,608), and also no correlation between systematic illness history with visual field defect (p=0,305). The effect of Zn treatment to visual field defect was significant with p=0,0085. Conclusion: Zinc treatment for new TB patients with ethambutol treatment may prevent visual field defect. Â Keywords: ethambutol, new TB patients, zinc, visual field defect

The Effect of Zinc Distribution for New TB Patients who Have Ethambutol Therapy Toward Visual Field Defect Neni Daniati; Kusdiantoro Kusdiantoro; Laksmi Wulandari; Nina Mauthia; Lukisiari Agustini
Majalah Oftalmologi Indonesia Vol 42 No 3 (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.v42i3.115

Background: Tuberculosis is an infection disease that is caused by Mycobacterium tuberculosis. Ethambutol therapy for TB patients can cause side effect such as decreased visual acuity, visual field defect, decreased contrast sensitivity, and disturbance of colour detection. Zinc in TB patients has decreased that causes broken cell on retina ganglion and disturbance of mytochondria function. The aim of this study is the effect of zinc supplementation for new TB patients who have ethambutol therapy toward visual field defect.Methods: This study involved 40 new TB patients who have ethambutol therapy which is classified as 20 patients who have ethambutol therapy with zinc supplementation and 20 patients who have ethambutol therapy without zinc supplementation. Each patient underwent a routine examination including visual acuity using Snellen chart which is converted to LogMAR, anterior segment using slit lamp biomicroscope, non-contact tonometry for intraocular pressure examination, posterior segment using direct ophthalmoscope, and Humphrey perimetry for visual field examination which is performed three times on first time when initial patient came, first month, and second month duration.Results: This study showed no correlation between gender with visual field defect (p=0,554), there is no correlation between age with visual field defect (p=0,418), no correlation between smoking behaviour with visual field defect (p=1), no correlation between amount of meals consumption containing Zn with visual field defect (p=0,608), and also no correlation between systematic illness history with visual field defect (p=0,305). The effect of Zn treatment to visual field defect was significant with p=0,0085.Conclusion: Zinc treatment for new TB patients with ethambutol treatment may prevent visual field defect.Keywords: ethambutol, new TB patients, zinc, visual field defect

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