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All Journal E-Jurnal Medika Udayana Jurnal Kedokteran Brawijaya Universa Medicina ISM (Intisari Sains Medis) : Jurnal Kedokteran Bioscientia Medicina : Journal of Biomedicine and Translational Research Sriwijaya Journal of Ophthalmology Indian Journal of Forensic Medicine & Toxicology Bioscientia Medicina : Journal of Biomedicine and Translational Research Cermin Dunia Kedokteran Ophthalmologica Indonesiana Cermin Dunia Kedokteran
Ni Made Ayu Surasmiati
Bagian Ilmu Kesehatan Mata Fakultas Kedokteran, Universitas Udayana, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Neutrophil-to-Lymphocyte Ratio as a Predictive Biomarker for Retinopathy of Prematurity: A Systematic Review Ayu Diah Permatasari; I Wayan Eka Sutyawan; Ni Made Ayu Surasmiati
Sriwijaya Journal of Ophthalmology Vol. 8 No. 1 (2025): Sriwijaya Journal of Ophthalmology
Publisher : Department of Opthalmology, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjo.v8i1.130

Abstract

Introduction: Retinopathy of prematurity (ROP) remains a leading cause of childhood blindness, with its pathogenesis linked to aberrant vascular development and systemic inflammation. There is a critical need for accessible biomarkers to improve risk stratification beyond current screening standards. This systematic review critically appraises the evidence for the neutrophil-to-lymphocyte ratio (NLR), a widely available inflammatory marker, as a predictor of ROP. Methods: Following PRISMA 2020 guidelines, a systematic search was conducted in PubMed, ScienceDirect, ProQuest, and SpringerLink for observational studies published between January 1st, 2015, and December 31st, 2024. Studies assessing the association between NLR and ROP in preterm infants were included. Two reviewers independently performed study selection, data extraction, and a formal risk-of-bias assessment using the Newcastle-Ottawa Scale (NOS). A narrative synthesis was performed due to significant heterogeneity. Results: The search identified 32 records, with 6 retrospective studies ultimately meeting the inclusion criteria, encompassing a total reported sample of 1,065 infants. The methodological quality of the included studies was low to moderate, with NOS scores ranging from 5 to 7 out of a possible 9. The evidence base was defined by profound methodological heterogeneity, particularly in the timing of blood sample collection, which was unspecified in half of the studies, and inconsistent reporting of core population data. A narrative synthesis of the findings showed that several studies reported a statistical association between an elevated NLR or related inflammatory markers and ROP. However, one study reported no significant association, and the interpretation of others was complicated by a focus on different biomarkers or a lack of statistical significance. Conclusion: The available evidence, derived exclusively from retrospective studies of varying quality, suggests a possible association between elevated NLR and ROP, a link supported by strong biological plausibility. However, the current evidence base is severely limited by methodological flaws and profound heterogeneity, making it insufficient to support the adoption of NLR into clinical practice. NLR is not a standalone diagnostic or predictive tool for ROP. Its potential utility can only be realized through large-scale, methodologically rigorous prospective studies designed to overcome the limitations identified in this review.
Emerging Challenges of Acute Bilateral Diabetic Cataract in Pediatric: Insight to Early Detection and Management– A Case Report Valentina, Clara; Sutyawan, I Wayan Eka; Surasmiati, Ni Made Ayu; Kusumadjadja, I Made Agus; I Wayan Gede Jayanegara
Majalah Oftalmologi Indonesia Vol 51 No 2 (2025): 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.v51i2.101671

Abstract

Purpose: To report rare case of acute bilateral cataract in pediatric with Type 1 Diabetes Mellitus as ocular complication despite of good glycaemic controls and its management. Methods: A 17-year-old male patient complained of blurry vision and glare in both eyes(BE) since 3 months in newly diagnosed T1DM (HbA1c 10% --> now 6.3%). Visual Acuity (VA) was 6/45PH6/21f2, with correction S-1.50 advancing to 6/18 in BE. Slitlamp examination of BE revealed lens opacity (P3),central position, 3mm in diameter, retinometri 0.32. Posterior segment evaluation and intraocular pressure (IOP) were within normal limits. Right eye (RE) was underwent lensectomy and IOL insertion under GA. Results:  Postoperative RE with final VA of 6/18 PHNI and IOP of 43 mmHg. Patient was given antiinflammation eyedrops, oral and topical antiglaucoma, and received controlled final IOP of 8mmHg within 3 days and remain stable until now without antiglaucoma. Result was satisfying despite of uncomplicated secondary glaucoma as short-term complication that resolved with therapy. Evaluation and close monitoring postoperatively is needed and play significant role in visual outcome. Conclusions: Early detection for ocular complication in DM is needed as cataract genesis process still progressing despite of good glycaemic control. Ocular manifestation may present as early sign of undiagnosed T1DM or as its complications. Comprehensive and holistic multidicipline treatment, glycaemic control,  and routine evaluation is essential and play significant role in the success of metabolic cataract therapy and progression of microvascular complications due to DM. Lensectomy + IOL implantation still the mainstay therapy in pediatric cataract.  Awareness play vital role as it possibly cause decreased vision and or amblyopia, leading to blindness.  
Factors that influence refractive errors in premature infants Surasmiati, Ni Made Ayu; Handayani, Ariesanti Tri; Sutyawan, I Wayan Eka
Universa Medicina Vol. 43 No. 1 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.44-50

Abstract

Background The prevalence of refractive errors is reported to be higher in children born preterm. Factors such as gestational age, birth weight, and retinopathy of prematurity status, have a significant impact on the refractive development in preterm infants. Prematurity and low birth weight affect the development of organ systems in infants, including the eyes. In addition to immature retinas, other eye conditions, such as refractive status, are also observed. This study aimed to determine the risk factors of refractive status, specifically refractive errors (spherical equivalent, astigmatism, and anisometropia) in premature infants at a tertiary hospital in Bali. MethodsA cross-sectional study was conducted involving 53 premature infants. This study collected samples from January to August 2023 at the Neonatal Intensive Care Unit of Prof. dr. IGNG Ngoerah General Hospital. Data regarding gender, gestational age, birth weight, retinal condition, spherical equivalent, and refractive disorders were collected. The relationship between risk factors and spherical equivalent, astigmatism, and anisometropia were analyzed using multiple regression analysis with statistical significance set at p<0.05. ResultsHypermetropia is the most common finding in premature infants, followed by myopia and astigmatism. The prevalence of myopia (9.4%) and astigmatism (5.7%) is also more common among newborns of gestational age ≤30 weeks (p=0.024). Chronological age was significantly associated with spherical equivalent (β=0.424; p=0.019). ConclusionIn premature infants, chronological age was the risk factor of spherical equivalent. Other risk factors were not associated with the prevalence of refractive errors among premature infants.
Strabismus Surgery for Traumatic Ocular Misalignment: Twelve Cases in Five Years: Poster Presentation - Case Series - Ophthalmologist SURASMIATI, NI MADE AYU; RATNASARI, NI LUH MADE NOVI; HENDRAWAN, KEVIN ANGGAKUSUMA; SUTYAWAN, I WAYAN EKA
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/pdg34475

Abstract

Introduction : Trauma can cause an ocular misalignment due to damage of extraocular muscles, nerves and orbital tissue around the eye. Direct trauma causing extraocular muscle rupture needs immediate surgery, meanwhile indirect trauma resulting in traumatic sixth nerve palsy or other reversible ocular misalignment without orbital floor fracture can be observed for six months. This study describe the characteristic of patients undergo single-step strabismus surgery for traumatic ocular misalignment, mechanism of injury, eye alignment, amount of ocular deviation before and after strabismus surgery. Case Illustration : This was a case series based on medical record of patients underwent strabismus surgery secondary to head or eye injury from 2017 until 2022. Discussion : Twelve individuals with post-traumatic strabismus correction participated in this study. All subjects were male age ranging from 18-51 years. Direct trauma was observed in 6 (50%) patients causing medial rectus muscle rupture in 4 patients and inferior rectus muscle rupture in 2 patients. Indirect trauma was observed in 6 (50%) patients caused by sixth nerve palsy on 4 patients The misalignment was exotropia, esotropia, and hypertropia with amount of 5, 4, and 3 respectively. The deviation was between 30-90 prism dioptre (PD) and 7 (58%) patients had deviation less than 65 PD. Strabismus surgery performed was muscle transposition with or without recession of the antagonist muscle. Conclusion : Single step surgery for traumatic ocular misalignment can provide good result in cases of deviation less than 65 PD
Diagnosis dan Tata Laksana Dissociated Vertical Deviation Saphira Evani; Ni Made Ayu Surasmiati; I Wayan Eka Sutyawan
Cermin Dunia Kedokteran Vol 51 No 4 (2024): Oftalmologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i4.975

Abstract

Dissociated vertical deviation (DVD) is characterized by an upward deviation of one eye in the absence of any compensatory movement in the other eye. This condition is often seen in strabismus and can cause visual disturbances such as double vision and amblyopia. Its underlying causes are believed to be related to abnormalities of the visual pathways to control eye movements. Treatment options include observation, conservative management, and surgical intervention, depending on the severity and underlying cause. 
Congenital Orbital Teratoma of the Newborn: A Rare Case Report Yuliawati, Putu; Wetarini, Krisnhaliani; Sutyawan, I Wayan Eka; Surasmiati, Ni Made Ayu; Utari, Ni Made Laksmi; Sunariasih, Ni Nyoman
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.19

Abstract

Congenital orbital teratoma is a rare and complex congenital anomaly due to abnormal tissue growth within the orbit. This case report aims to highlight the significance of early prenatal screening in identifying congenital orbital teratoma and its potential complications. A 6-day-old male newborn presented with macrocephaly and a unilateral massive protrusion of the left eye. Prenatal ultrasonography performed at 36 weeks gestation showed a suspicion of fetal craniofacial mass. Further brain CT scan revealed an orbital heterogeneous mass, with calcified components dominantly in the anterior and middle cranial fossa into the left orbit, which was subsequently diagnosed as congenital orbital teratoma associated with non-communicating hydrocephalus. This finding prompted an urgent ventriculoperitoneal (VP) shunt. Unfortunately, despite prompt intervention, the patient passed away after the procedure. Pathological examination was compatible with an immature teratoma. Multidisciplinary management is warranted to improve diagnostic screening and refine management strategies for better outcomes in such cases.
Systemic Metastase in Late Management of Group D Retinoblastoma: A Case Report Suryawijaya, Ernes Erlyana; I Wayan Eka Sutyawan; Ni Made Ayu Surasmiati; I Made Agus Kusumadjaja
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 10 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i10.1085

Abstract

Background: Retinoblastoma (RB) is a common malignancy that affects children and is fatal if left untreated. This case report aims to raise awareness the importance of starting therapy immediately in RB patients. Case presentation: A girl aged 1 year 9 months, came with complaints that her left eye (LE) appeared white for 2 weeks. Anterior segment examination was normal. On funduscopic examination, optic nerve was difficult to evaluate, covered by a mass, multiple mass scars on the retina, a size of > 6 mm at the posterior pole, and vitreous seeding. Ultrasound examination and CT scan showed an intraocular mass with calcification. The patient was diagnosed with group D intraocular LE RB and was planned for enucleation but was postponed due to cost constraints. The patient came back after 1 year and was diagnosed with extraocular LE RB stage IVB. Conclusion: Early diagnosis without adequate therapy leads to tumor spread and reduces patient survival.
Co-Authors -, Elvira -, Siska ANAK AGUNG DEWI ADNYA SWARI Andayani, A. Ari Andayani Ariesanti Tri Handayani, Ariesanti Tri Ayu Diah Permatasari Cawis, Ni Luh Suras Amoura Christine Natalia Gunawan Desriyanti, Putri Tamia Elvira Elvira - Elvira, . Hendrawan, Kevin Anggakusuma I Wayan Eka Sutyawan I Wayan Gede Jayanegara Ida Bagus Putra Manuaba Juliari, I Gusti Ayu Made Karunika, Ni Luh Putu Pritha Dewi KEVIN ANGGAKUSUMA HENDRAWAN Krisnhaliani Wetarini Kusumadjadja, I Made Agus Kusumadjaja, I Made Agus Made Agus Kusumadjaja Made Dwi Surya Wibawa MADE KUSUMA WARDANI Mahesadhana Ardika, Putu Abhinaya Millah, Nurhidayatul Ni Made Ari Suryathi Ni Made Laksmi Utari Pande Putu Adityo Ananta Ardika Pantjawati, N.L.D. Pramita, I.A.A PRISCILLA DWIANGGITA Putrawati Triningrat, Anak Agung Mas Putu Anindya Agrasidi Ratna Suryaningrum, I Gusti Ayu Ratnasari, Ni Luh Made Novi SAPHIRA EVANI Sunariasih, Ni Nyoman Suryawijaya, Ernes Erlyana Sutyawan, I Wayan Eka Sutyawan, Wayan Eka Utari, Ni Made Laksmi Valentina, Clara Wetarini , Krisnhaliani Wibawa, Made Dwi Surya Wijayati , Made Paramita Wijayati, M.P Yovita Govert Yuliawati, Putu