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Kissing Nevus of Eyelid: A Rare Case Report: Poster Presentation - Case Report - Resident dr. Silva Roza; Dr. dr. Hendriati Sp.M(K); dr. Mardijas Efendi Sp.M; Dr. dr. Ardizal Rahman Sp.M(K)
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: 10.35749/6sjcjh37

Introduction : Kissing nevus, also known as kissing mole, is a rare dermatological condition in the world and characterized by the presence of congenital nevi on both the upper and lower eyelids in symmetrical fashion. Additionally, this report highlights the treatment options available for patients with kissing nevus and discusses the importance of regular monitoring. Case Illustration : An 11-year-old female patient came with a complaint of a mole on the upper and lower eyelids since birth. The mole was felt to be getting bigger and starting to bother her. The patient feels insecure with the presence of this mole. The patient underwent nevus excision followed by retroauricular graft placement on the superior and inferior eyelidss. Then a biopsy showed benign nevus. After follow-up, it was found that the graft had grown and there was no necrotic tissue. Discussion : Kissing nevus is a rare skin condition that affects babies and young children. It is characterized by two identical birthmarks that appear on either side of the body, such as on the eyelids. Surgery involves removing the birthmarks surgically. Our patient underwent wide excision and palpebral reconstruction. Conclusion : Kissing nevuse is a unique skin condition marked by the presence of congenital nevi on both the upper and lower eyelids in a symmetrical pattern. It is worth noting that while treatment may be effective, there is a risk of scarring, infection, and other side effects associated with these procedures.

Direct Closure Technique for Superior Palpebra Defect in Sebaceous Gland Carcinoma Palpebra Mandela, Kelvin; Mardijas Efendi; Hendriati
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 11 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i11.886

Background: Sebaceous Gland Carcinoma (SGC) palpebra is a malignancy tumor on the palpebra that originates from the sebaceous gland. These tumors can spread peripherally through intraepithelial or pagetoid growths. The main management is surgery, and the defect reconstruction is performed according to the size and area of the defect. Case presentation: A 53-year-old female patient came with a mass on the upper eyelid of the right eye for 1 year, which progressively grew in size and stuck to the eyelid, with no bleeding and no pain. The history of treatment has not provided an adequate response for the last 1 year. Visual acuity was 6/12 in both eyes, and a mass was found approximately 8x8 mm in size, nodular, fixed, and accompanied by madarosis. The histopathological examination showed a palpebral sebaceous gland carcinoma. There was no enlargement of submandibular or parotid lymph nodes. The patient underwent a wide excision of the upper eyelid lesion. Then, the defect was reconstructed by direct closure technique. The patient has been controlled 4 weeks of follow‑up. The functional and cosmetic outcomes were satisfied. Conclusion: After a month of follow-up, no recurrence occurred. Reconstruction with direct closure technique has good results in terms of anatomy, function, and cosmetics.

The Profile of Sinonasal Tumors with Orbital Involvement in Dr. M. Djamil General Hospital, Padang, Indonesia: A 10-Year Overview Pohan, Dwi Lestari; Ardizal Rahman; Mardijas Efendi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 6 (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.v8i6.1014

Background: Sinonasal tumors are rare tumors, either malignant or benign, that vary greatly based on the origin and primary tumor location in the sinonasal tract. The close anatomical relationship between the sinonasal tract and the orbital cavity makes orbital involvement very common (50%-80%) in sinonasal tumors, and this indicates a negative prognostic factor in sinonasal malignancy. The purpose of this study is to demonstrate the profile of sinonasal tumors with orbital involvement in our center. Methods: Retrospective study from oncology subdivision files and medical records from January 2011 – December 2020. Collected data including age, gender, the clinical manifestations of orbital involvement, primary location, histopathology, and management of sinonasal tumors. Results: There were 35 patients examined by the oncology subdivision either directly came or consulted from the ENT department, consisting of 18 (51.4%) males and 17 (48.6%) females. The age of patients ranged from 11 to 83 years old. with the most common age groups being 41-50 and 51-60 (25.7% in each age group). The majority of the patients (77.1%) had presented with proptosis. Maxillary sinus was the most common (45.7%) primary site of tumors, and squamous cell carcinoma was the most common (51.4%) histopathology found. Most of the patients (37.1%) were treated with a combination of chemotherapy and radiotherapy. Conclusion: Orbital involvement commonly occurs in malignant sinonasal tumors with proptosis as a major clinical presentation. A combination of chemotherapy and radiotherapy was the most common practice management because the tumors were unresectable at the time of presentation.

Two Walls Orbital Decompression pada Thyroid Eye Disease Efendi, Mardijas; Irfandy, Dolly; Primasakti, Pattih
Jurnal Kesehatan Andalas Vol 13, No 2 (2024): July 2024
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v13i2.2295

A patients with Grave Ophthalmopathy who underwent orbital decompression surgery involving two walls, medial and lateral. The surgery was performed in collaboration with an ENT specialist. This case report described a patient who presented with Thyroid Eye Disease NOSPEC V. It has been reported that a 35-year-old male had complained of bilateral proptosis, decreased visual acuity, and eye pain. The patient had been diagnosed with hyperthyroid 1 year before coming to the eye clinic. The patient was given a peribulbar steroid injection, but no improvement was observed. Visual acuity of the right eye was 3/60 and the left eye was 1/60. Lagophthalmos were seen on both eyes, 6mm in the right and 4mm in the left. The cornea of the right eye had infiltrated due to exposure keratitis. Proper eye movement was restricted to superonasal. The patient underwent medial and lateral orbital wall decompression of the left eye. Left eye visual acuity was improved to 20/150. Lagophthalmos was improved up to 3 mm. Medial and lateral orbital wall decompression are minimally invasive procedures involving removing a small portion of the bone from either the medial or lateral wall of the orbit. This allows more space for the eye to move backward, reducing pressure on the optic nerve and improving vision. This procedure also improves the cosmetic appearance of the eye. The ophthalmologic specialist performed the lateral wall decompression, and the ENT specialist performed the medial wall decompression. Medial and lateral orbital wall decompression has proven to be effective in treating patients with proptosis. The procedures have a low complication rate, and patients typically experience a significant improvement in their symptoms within a few weeks of the surgery. Keywords: orbital decompression, trans endoscopic decompression, thyroid eye disease

Kombinasi Injeksi Triamsinolon Asetat Intralesi dan Propanolol Oral pada Kasus Hemangioma Kapiler Palpebra Efendi, Mardijas; Hendriati, Hendriati; Rahman, Ardizal; Rahmadiansyah, Muhammad Fadhil
Jurnal Kesehatan Andalas Vol. 11 No. 2 (2022): Online July 2022
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v11i2.2082

Capillary hemangioma is a benign tumor developed from the abnormal proliferation of blood vessels. This tumor appears on eyelids and orbit. Around 75% of hemangioma resolves spontaneously in the first 4-5 years of life. Intervention is needed in hemangioma that obstructs the visual axis. It has been reported that a two-year-old girl came to Polyclinic with a mass on the left superior eyelid 1,5 years ago. At first, the left superior eyelid looked puffy, then developed slowly until it covered the left eye. On the examination of the left eye, visual acuity assessment was hard to perform. Mass in superior palpebral was 8mm x 8mm x 8mm, reddish colored (different with adjacent skin), consistency supple, mobile, painful (-), edema (+), horizontal palpebral fissure (FPH) 30 mm, vertical palpebral fissure (FPV) 0 mm. CT scan showed suspected hemangioma. The patient was diagnosed with capillary hemangioma and given an injection of triamcinolone acetate intralesional and oral propranolol under the supervision of a pediatrician. Significant clinical improvement was observed after 40 days of injection, where the mass was resolved completely. The FPV and FPH of the left eye had improved to 9 mm and 30 mm, respectively, with the patient finally able to follow the object. The combination of intralesional triamcinolone acetate and oral propranolol in this case is quite effective in providing complete resolution of capillary hemangioma.Keywords: Â capillary hemangioma, triamcinolone acetate injection, propanolol

Two Walls Orbital Decompression pada Thyroid Eye Disease Efendi, Mardijas; Irfandy, Dolly; Primasakti, Pattih
Jurnal Kesehatan Andalas Vol. 13 No. 2 (2024): July 2024
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v13i2.2295

A patients with Grave Ophthalmopathy who underwent orbital decompression surgery involving two walls, medial and lateral. The surgery was performed in collaboration with an ENT specialist. This case report described a patient who presented with Thyroid Eye Disease NOSPEC V. It has been reported that a 35-year-old male had complained of bilateral proptosis, decreased visual acuity, and eye pain. The patient had been diagnosed with hyperthyroid 1 year before coming to the eye clinic. The patient was given a peribulbar steroid injection, but no improvement was observed. Visual acuity of the right eye was 3/60 and the left eye was 1/60. Lagophthalmos were seen on both eyes, 6mm in the right and 4mm in the left. The cornea of the right eye had infiltrated due to exposure keratitis. Proper eye movement was restricted to superonasal. The patient underwent medial and lateral orbital wall decompression of the left eye. Left eye visual acuity was improved to 20/150. Lagophthalmos was improved up to 3 mm. Medial and lateral orbital wall decompression are minimally invasive procedures involving removing a small portion of the bone from either the medial or lateral wall of the orbit. This allows more space for the eye to move backward, reducing pressure on the optic nerve and improving vision. This procedure also improves the cosmetic appearance of the eye. The ophthalmologic specialist performed the lateral wall decompression, and the ENT specialist performed the medial wall decompression. Medial and lateral orbital wall decompression has proven to be effective in treating patients with proptosis. The procedures have a low complication rate, and patients typically experience a significant improvement in their symptoms within a few weeks of the surgery.Â Keywords: Â orbital decompression, trans endoscopic decompression, thyroid eye disease

The Molecular and Epidemiological Atlas of Primary Orbital Lymphoma: A Global Meta-Analysis of 3,832 Cases and Pathophysiological Correlates Silvia Roza; Ardizal Rahman; Mardijas Efendi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1425

Background: Primary orbital lymphoma is the most common orbital malignancy in adults, yet its global distribution and the prevalence of its histopathological subtypes remain poorly defined by large-scale evidence. This study provides a comprehensive quantitative synthesis of the global landscape of orbital lymphoma to inform diagnostic frameworks and guide future research. Methods: Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published between January 2015 and December 2023. We searched PubMed, Scopus, Web of Science, and Embase for observational studies reporting histopathological data on orbital lymphoma. Two independent reviewers performed study selection, data extraction, and quality appraisal using the Joanna Briggs Institute (JBI) checklist. Pooled prevalence for each lymphoma subtype was calculated using a random-effects model. Heterogeneity was explored via subgroup analyses and meta-regression, and the robustness of findings was confirmed with a sensitivity analysis. Results: Fifteen studies comprising 3,832 patients met the inclusion criteria. Extranodal marginal zone lymphoma (EMZL) was the most prevalent subtype globally, with a pooled prevalence of 57.1% (95% CI: 51.5-62.7%). This was followed by diffuse large B-cell lymphoma (DLBCL) at 16.5% (95% CI: 13.1-20.0%), follicular lymphoma (FL) at 10.2% (95% CI: 8.0-12.4%), mantle cell lymphoma (MCL) at 5.1% (95% CI: 3.6-6.6%), and small lymphocytic lymphoma (SLL) at 3.4% (95% CI: 2.2-4.5%). Subgroup analysis revealed a significantly higher prevalence of EMZL in Asia (61.3%) compared to Europe (54.2%) and North America (55.8%) (p=0.04), while FL was more common in North American (14.1%) and European (12.8%) cohorts versus Asian cohorts (4.5%) (p<0.01). Sensitivity analysis confirmed the stability of these estimates. Conclusion: This meta-analysis establishes EMZL as the predominant histopathological subtype of orbital lymphoma worldwide, while highlighting profound geographical disparities in the distribution of EMZL and FL. These findings provide a robust global benchmark critical for clinical practice and underscore the influence of distinct geographical, genetic, and microenvironmental factors in orbital lymphomagenesis.

Malignant Transformation of Primary Acquired Melanosis into Conjunctival Melanoma in an Adolescent Male: A Clinico-Pathological Case Report and Management Review Fitrah; Ardizal Rahman; Mardijas Efendi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1426

Background: Conjunctival malignant melanoma (CMM) is a rare but potentially lethal ocular surface malignancy, especially uncommon in adolescents. It often arises from a precursor lesion known as primary acquired melanosis (PAM) with atypia. We present a case of CMM developing from long-standing PAM in an 18-year-old male, highlighting the diagnostic and therapeutic challenges in this unusual demographic. Case presentation: An 18-year-old male presented with a pigmented conjunctival lesion in his right eye, which had been present for over a decade but had recently shown progressive enlargement and darkening. Slit-lamp biomicroscopy revealed a 5x2 mm, variegated, hyperpigmented lesion on the bulbar conjunctiva with a prominent feeding vessel. The patient underwent an excisional biopsy using a "no-touch" technique with 4 mm margins and adjunctive double freeze-thaw cryotherapy. Histopathological analysis confirmed an invasive malignant melanoma, Breslow thickness of 1.8 mm, arising from PAM with severe atypia. Surgical margins were clear of the tumor. Conclusion: This case underscores that malignant transformation of conjunctival melanocytic lesions can occur even in young patients. The presence of a changing pigmented lesion, regardless of patient age, necessitates a high index of suspicion and a low threshold for excisional biopsy. Meticulous surgical technique combined with adjuvant therapy and vigilant long-term surveillance is paramount for optimizing patient outcomes.

A Masquerading Giant: Unprecedented Sebaceous Gland Carcinoma with Massive Orbito-facial Invasion and the Diagnostic and Therapeutic Challenges of an Extreme Presentation Rizki Dwayana Putra; Mardijas Efendi; Ardizal Rahman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1434

Background: Sebaceous gland carcinoma (SGC) is a rare, aggressive adnexal malignancy of the eyelid, notorious for masquerading as benign inflammatory conditions. Presentations involving massive, destructive orbito-facial invasion are exceptionally rare and pose profound diagnostic and therapeutic challenges, often reflecting a confluence of biological aggression and systemic delays in care. Case presentation: A 68-year-old male presented with a one-year history of a progressively enlarging mass on his left upper eyelid, which had evolved into a giant, 15 x 15 x 7 cm fungating tumor, causing complete destruction of the orbital contents and extensive invasion into adjacent facial structures. An initial incisional biopsy was paradoxically interpreted as benign sebaceous hyperplasia. Due to the stark clinico-pathological discordance, a repeat, deeper biopsy was performed. The subsequent histopathological examination revealed a high-grade carcinoma, and the diagnosis was definitively confirmed by a panel of immunohistochemical stains, including strong positivity for Epithelial Membrane Antigen (EMA) and Cytokeratin 7 (CK7). The disease was staged as T4dN1M0 and deemed unresectable. Conclusion: This case documents a catastrophic outcome of SGC, resulting from a combination of delayed patient presentation and initial diagnostic error. It highlights that giant SGC, while rare, must be considered in the differential of destructive facial tumors and underscores that immunohistochemistry is mandatory for resolving clinico-pathological paradoxes in ocular adnexal pathology. This case serves as a call to action for improved public health awareness and enhanced diagnostic acumen to prevent such devastatingly advanced presentations.

The Molecular and Epidemiological Atlas of Primary Orbital Lymphoma: A Global Meta-Analysis of 3,832 Cases and Pathophysiological Correlates Silvia Roza; Ardizal Rahman; Mardijas Efendi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1425

Background: Primary orbital lymphoma is the most common orbital malignancy in adults, yet its global distribution and the prevalence of its histopathological subtypes remain poorly defined by large-scale evidence. This study provides a comprehensive quantitative synthesis of the global landscape of orbital lymphoma to inform diagnostic frameworks and guide future research. Methods: Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published between January 2015 and December 2023. We searched PubMed, Scopus, Web of Science, and Embase for observational studies reporting histopathological data on orbital lymphoma. Two independent reviewers performed study selection, data extraction, and quality appraisal using the Joanna Briggs Institute (JBI) checklist. Pooled prevalence for each lymphoma subtype was calculated using a random-effects model. Heterogeneity was explored via subgroup analyses and meta-regression, and the robustness of findings was confirmed with a sensitivity analysis. Results: Fifteen studies comprising 3,832 patients met the inclusion criteria. Extranodal marginal zone lymphoma (EMZL) was the most prevalent subtype globally, with a pooled prevalence of 57.1% (95% CI: 51.5-62.7%). This was followed by diffuse large B-cell lymphoma (DLBCL) at 16.5% (95% CI: 13.1-20.0%), follicular lymphoma (FL) at 10.2% (95% CI: 8.0-12.4%), mantle cell lymphoma (MCL) at 5.1% (95% CI: 3.6-6.6%), and small lymphocytic lymphoma (SLL) at 3.4% (95% CI: 2.2-4.5%). Subgroup analysis revealed a significantly higher prevalence of EMZL in Asia (61.3%) compared to Europe (54.2%) and North America (55.8%) (p=0.04), while FL was more common in North American (14.1%) and European (12.8%) cohorts versus Asian cohorts (4.5%) (p<0.01). Sensitivity analysis confirmed the stability of these estimates. Conclusion: This meta-analysis establishes EMZL as the predominant histopathological subtype of orbital lymphoma worldwide, while highlighting profound geographical disparities in the distribution of EMZL and FL. These findings provide a robust global benchmark critical for clinical practice and underscore the influence of distinct geographical, genetic, and microenvironmental factors in orbital lymphomagenesis.

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