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All Journal Medicina E-Jurnal Medika Udayana Jurnal Pengabdian Kepada Masyarakat (Indonesian Journal of Community Engagement) Universa Medicina ISM (Intisari Sains Medis) : Jurnal Kedokteran Vision Science and Eye Health Journal IJRETINA - International Journal of Retina Ophthalmologica Indonesiana
Ni Made Ari Suryathi
Departement Ilmu Kesehatan Mata, Fakultas Kedokteran Universitas Udayana, RSUP Sanglah Denpasar, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Journal : Universa Medicina

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Stereoacuity test as a screening tool for amblyopia and binocular vision in children 6-12 years of age Surasmiati, Ni Made Ayu; Wetarini , Krisnhaliani; Wijayati , Made Paramita; Suryathi, Ni Made Ari
Universa Medicina Vol. 43 No. 3 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.280-286

Abstract

BackgroundStereoacuity is essential for depth perception and daily activities, complementing visual acuity. Assessing stereoacuity in children is vital for detecting binocular vision disorders and amblyopia. This study aimed to compare the Toegepast Natuurwetenschappelijk Onderzoek (TNO) test and the Titmus Fly test in school-based vision screening for children aged 6-12 years. MethodsA cross-sectional study was conducted in social service settings with 122 elementary school children aged 6-12 years. Examinations included visual acuity, refraction, Ishihara color vision, and stereoacuity using both the TNO and Titmus Fly tests. Statistical comparisons were made using the Wilcoxon Signed-Ranks Test, and stereoacuity differences based on demographic factors and visual acuity were assessed using the Mann-Whitney U Test. The level of agreement between the two tests was determined using Bland-Altman analyses. Results Visual acuity significantly influenced stereoacuity results in the Titmus Fly test (p=0.001), with children having abnormal visual acuity performing worse. Approximately 68% of children reported that the Titmus Fly test was easier to perform. The mean difference between TNO and Titmus Fly measurements was 79.52 ± 63.75 (95% CI = 68.14–90.90; p=0.001), demonstrating a consistent bias between the two tests. Conclusion The Titmus Fly test is easier for children (6–12 years) to perform, but it tends to overestimate stereoacuity values compared to the TNO test, making the two methods non-interchangeable and not reliable. Stereoacuity assessment remains essential in school-based vision screening for evaluating binocular vision and amblyopia, especially in children with refractive errors.
Diabetic retinopathy: pathogenesis, pathophysiology, and treatment Yudistira, Yudistira; Hendrawan, Kevin Anggakusuma; Andayani, Ari; Suryathi, Ni Made Ari
Universa Medicina Vol. 44 No. 2 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.270-284

Abstract

Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus (DM) and one of the leading causes of vision impairment worldwide. Prolonged hyperglycemia initiates a cascade of molecular events including chronic inflammation, oxidative stress, advanced glycation end products, and the activation of plasma kallikrein and protein kinase C signaling pathways, which leads to endothelial damage and pericyte loss. The resulting endothelial barrier dysfunction promotes serum leakage and retinal edema, while advanced disease stages are characterized by ischemia-driven retinal neovascularization mediated by elevated intraocular vascular endothelial growth factor (VEGF) levels. Current therapeutic strategies for diabetic retinopathy include laser therapy, intravitreal administration of anti-VEGF agents or corticosteroids, and vitreoretinal surgery. Despite their efficacy, a number of patients experience suboptimal responses. Consequently, novel therapeutic approaches are under investigation, including alternative anti-angiogenic agents, gene therapies, and visual cycle modulators currently undergoing clinical trials. A comprehensive understanding of the pathogenesis and pathophysiology of diabetic retinopathy is essential to improve existing treatment modalities and address current limitations in patient outcomes. In this review, we systematically searched and analyzed articles published in English from 2014 to 2024 using PubMed, ScienceDirect, SpringerLink, and Google Scholar. Relevant search terms included “diabetic retinopathy,” “pathophysiology,” “pathogenesis,” “treatment,” and “diabetic macular edema.” This review presents recent insights into the pathogenesis of diabetic retinopathy, including oxidative stress, inflammation, and neurodegeneration, followed by an overview of its pathophysiology such as microvascular dysfunction and neovascularization. Finally, current and emerging treatment modalities, encompassing both pharmacological and surgical approaches, are discussed. This structured approach provides essential background to understand the complexity of diabetic retinopathy and recent advances in its management.
Co-Authors Agung Bagus S. Satyarsa Alit, Ida Bagus Putu Anak Agung Ayu Githasari Dewi Anak Agung Ayu Sukartini Djelantik Anak Agung Mas Putrawati Triningrat Anasary, Anak Agung Ayu Putri Prematura Sri Angelo Doniho Anthea Casey Ari Andayani Ariesanti Tri Handayani, Ariesanti Tri Bobby Kristianto DUDUT RUSTYADI, DUDUT Fabiola Supit Gde Aditya Putra Deva Giovani Faustine Haikal Hamas Putra Iqra Hendrawan, Kevin Anggakusuma I Gde Raka Widiana I Gusti Ayu Ratna Suryaningrum I Putu Budhiastra I Putu Budhiastra, I Putu I Wayan Eka Sutyawan I Wayan Gede Jayanegara Ida Bagus Putra Manuaba Juliari, IGAM Kadek Tresna Yuwana Kunthi Yulianti Made Agus Kusumadjaja Ni Made Ayu Surasmiati Ni Made Suryanadi Noviantari, I Gusti Agung Ratna Pande Putu Adityo Ananta Ardika Pantjawati, Ni Luh Diah Pitanatri, Nyoman Brahmani Siska Takarai Sukmawati, Nurindah Suryanadi, Ni Made Suryawijaya, Ernes Erlyana Tridiyoga, Komang Putra Triningrat, A.A. Mas Putrawati Triningrat, Anak Agung Mas Putrawati Wetarini , Krisnhaliani Wibawa, I Made Dwi Surya Wijayati , Made Paramita Winly Yudiskara, Ni Nyoman Elza Yudistira Yudistira Yuliawati, Putu