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All Journal Medical Journal of Indonesia Paediatrica Indonesiana Molecular and Cellular Biomedical Sciences (MCBS) Cermin Dunia Kedokteran IJRETINA - International Journal of Retina Ophthalmologica Indonesiana Cermin Dunia Kedokteran
Lukman Edwar
Department Of Ophthalmology, Universitas Indonesia
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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BOTULINUM TOXIN A FOR BLEPHAROSPASM WITH DRY EYE: A SYSTEMATIC REVIEW: Poster Presentation - Observational Study - General practitioner dr. Muthia Despi Utami; Yulia Aziza; Lukman Edwar; Made Susiyanti; Rina La Distia Nora; Ratna Sitompul
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/d2xzdv11

Abstract

Introduction & Objectives : Essential blepharospasm is a neurological condition that is defined by uncontrolled and abnormal eyelid closure from a central cerebral disorder. Between 40%-85% of blepharospasm occurs in conjunction with dry eye symptoms. Botulinum neurotoxin (BoNT) injections are commonly used treatment for reducing spasms in blepharospasm. Furthermore, it is often suggested for dry eye therapy due to their ability to reduce lacrimal drainage. The purpose of this review is to assess the effectiveness of BoNT treatment for blepharospasm with dry eye symptoms. Methods : A literature research was conducted on online databases such as PubMed, Cochrane library and Google scholar. All studies of BoNT and dry eye with full-text journals published in English within the last 10 years were included. We assessed Tear Breakup Time (TBUT), Schirmer Test, and Blepharospasm Disability Index (BSDI). Results : 204 patients from 6 publications were analyzed. In five trials, the BoNT treatment statistically significant increased TBUT (p<0,5), with mean final TBUT 5,7 ±1.1 s. Furthermore, the Schirmer test also increased with the mean final score 6,29 ± 4,6 mm. The mean BSDI score dropped by 6,05 ± 3,7 in two studies. Conclusion : It is confirmed that BoNT injection is an effective treatment for essential blepharospasm with dry eye symptoms. Clinicians should be screened for dry eye in all blepharospasm patients prior to BoNT treatment.
Recurrent Orbital Subperiosteal Abscess in Patient with Nasopharyngeal Carcinoma: Poster Presentation - Case Report - Resident Mefina Aulia Mufidah; Lukman Edwar; Mutmainah; Rwtno Sulistyo Wardani
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/b5jry486

Abstract

Introduction : Subperiosteal abscess (SPA) is a rare finding in cancer patients with orbital cellulitis. Severe complications associated with this condition are permanent visual loss, intracranial extension, and death. Case Illustration : A 38-year-old male with history of nasopharyngeal carcinoma (NPC) came with progressive right eyelid swelling, non-axial proptosis, and visual acuity was NLP. CT scan revealed right SPA associated with frontal sinusitis. NPC staging was T3N2M0. Despite the treatment of intravenous antibiotics and drainage incision of SPA, there was recurrence of right SPA two weeks after procedure and re-staging revealed T4N3M0. A joint operation with otolaryngology department to do debulking of the mass, frontal sinus surgery, and drainage incision was held. Culture resulted in Talaromyces marneffei. Patient was assessed with talaromycosis and given itraconazole for ten weeks. Moreover, patient came again with proptosis seven weeks postoperatively. Re-drainage incision was performed and clinical presentation was improved. Discussion : This case describes rare biological nature of NPC where extensive blockage of paranasal sinuses allows microorganism overgrowth and infection. The anatomical changes and cancer-related immunosuppression contribute to recurrent SPA. Chemotherapy and radiotherapy are ideal treatments for our patient, however, infection must be treated adequately first. Surgical interventionis needed to manage the infection by SPA drainage where antimicrobial has poor penetration into the abscess and debulking of tumor to clear the blockage of drainage pathway. Conclusion : Recurrent orbital SPA could happen in patients with NPC, therefore appropriate medical treatment and timely surgical intervention are essential in managing orbital SPA. Multidisciplinary management is required to optimize patient outcomes.
MULTIPLE GIANT CHALAZIA IN HYPERIMMUNOGLOBULINEMIA E SYNDROME: A CASE REPORT: Poster Presentation - Case Report - Resident Lily Raudah Putri; Florentina Priscilia; Dany Petra Pranata Barus; Annisa Windyani; Muhammad Shafiq Advani; Lukman Edwar
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: 10.35749/6c6g4758

Abstract

Abstract Introduction : Hyperimmunoglobulinemia E syndrome (HIES) is a rare primary immunodeficiency disorder that manifests as elevated level of serum immunoglobulin E (IgE) higher than 1.000 IU/mL and multisystem disorder characterized by recurrent skin and pulmonary abscesses caused by autosomal dominant or recessive disorder with gene mutation. We present a case of multiple giant chalazion ina patient with HIES. Case Illustration : A 15-year-old boy was referred to Ophthalmology Department with multiple giant lumps on the left eyelid for the last 2 weeks. He had a history of recurrent multiple lumps on the left lower eyelid in the last 1 year. He was diagnosed with HIES since 8 years ago. He had normal visual acuity of both eyes. Multiple giant chalazion were observed on the left upper and lower eyelid. The patient also presented with scalp and neck infection. Laboratory studies showed elevated total serum IgE level of 53,032 IU/mL and eosinophilia. Discussion : Ocular manifestations in HIES patients are not common. Some cases reported chalazia, keratoconus, and blepharitis. Surgical incision drainage was performed in our patient. Medications and surgical intervention had produced only transient improvement. The patient was treated conservatively. Riskof chalazia recurrence remains unknown as reported cases presented with diverse clinical presentation and follow-up serum IgE evaluation is not routinely performed. Conclusion : Recurrent multiple giant chalazia may occur as an ophthalmic feature of HIES. HIES should be considered and investigated in patients presenting with recurrent giant chalazia.
Efek Tetes Mata Kombinasi Sodium Hialuronat dan Hydroxypropyl-Guar terhadap Stabilitas Lapisan Air Mata pada Mata Kering Terkait Sindrom Sjögren Indira Priya Darsini; Lukman Edwar; Iris Rengganis; Lisnawati; Joedo Prihartono
Cermin Dunia Kedokteran Vol 46 No 1 (2019): Obstetri-Ginekologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i1.521

Abstract

Penelitian ini bertujuan untuk menilai stabilitas lapisan air mata pada mata kering terkait sindrom Sjögren (SS) yang diberi terapi tetes mata kombinasi sodium hialuronat 0,1% (SH) dan hydroxypropyl (HP)-guar, atau monoterapi tetes mata sodium hialuronat (SH). Sebanyak 17 pasien SS dibagi dalam 2 kelompok. Kelompok pertama mendapat kombinasi SH dan HP-guar, kelompok kedua mendapat terapi SH. NIKBUT, Schirmer, skor pewarnaan okular, dan sitologi impresi, serta keluhan subjektif dinilai sebelum dan sesudah pemberian obat. Setelah terapi selama 28 hari, terdapat peningkatan median NIKBUT, Schirmer, skor pewarnaan okular, densitas sel Goblet, dan perbaikan keluhan subjektif pada mata kering terkait SS. The objectives of the study is to assess the stability of dry eye LAM associated with Sjögren syndrome (SS) during combination therapy of sodium hyaluronate 0.1% (SH) and hydroxypropyl (HP) -guar, or monotherapy sodium hyaluronic (SH). A total of 17 SS patients in this study were divided into 2 groups. The first group received a combination of SH and HP-guar while the second group received SH therapy. NIKBUT, Schirmer, ocular staining score, and impression cytology, as well as subjective complaints was assessed before and after drug administration. After 28 days of therapy, there was a median increase in NIKBUT, Schirmer, ocular staining scores, Goblet cell density, and subjective complaints on SS-related dry eyes.
Peripheral Lesion Finding Discrepancies between Ultra-Widefield and Simulated 50° Fluorescein Angiography in Uveitis Wulandari, Rina; Nora, Rina La Distia; Edwar, Lukman
International Journal of Retina Vol 9 No 1 (2026): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2026.vol009.iss001.238

Abstract

Introduction: With the advance of ultra-widefield fundus imaging, its usefulness for fluorescein angiography study compared to the conventional (50°) for uveitis management is not fully studied. We aimed to compare ultra-widefield fluorescein angiography (UWFFA) and simulated conventional (50°) FA in terms of peripheral fundus findings and its correlation with clinical activity and therapeutic decision changes in uveitis cases. Methods: We performed a descriptive retrospective study in uveitis patients who underwent UWFFA (Optos P200DTx California) in March-May 2021. We compared the presence of peripheral abnormalities between UWFFA images and its simulated 50° FA. We correlated them with clinical uveitis activities and therapeutic decision changes by two uveitis experts. Results: We included 12 uveitis patients and found that 44.4% of peripheral vascular leakage, 83.3% of the peripheral lesion, and 100% of peripheral neovascularization in UWFFA were missed in simulated 50° FA. From 5 clinically inactive patients, 4 out of 5 were assessed as active uveitis on simulated 50° FA interpretation, and all the inactive patients were active uveitis based on UWFFA. 1 out of 12 had a diagnosis and therapeutic changes after UWFFA. Conclusions: We found more peripheral findings in UWFFA than in conventional ones. This discrepancy could alter clinical activity and therapy decisions, and long-term studies are needed to assess the clinical benefit.
Affordable HLA-B27 Detection in Resource-Limited Settings: Evaluating Conventional PCR for Uveitis and Spondyloarthropathy in Indonesia Nora, Rina La Distia; Edwar, Lukman; Susiyanti, Made; Aziza, Yulia; Putera, Ikhwanuliman; Sifyana, Ulifna Alfiya; Riasanti, Mei; Waliyuddin, M Zakiy; Wibawa, Maria Valentina; Ethelind, Rachel; Widodo, Erica; Sitompul, Ratna
Majalah Oftalmologi Indonesia Vol 52 No 1 (2026): 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/oi.v52i1.102039

Abstract

Introduction: HLA-B27 is a genetic marker strongly associated with spondyloarthropathy (SpA) and acute anterior uveitis (AAU). Detection of this allele can support earlier diagnosis and targeted management. However, commercially available HLA-B27 tests are costly and often inaccessible in low- and middle-income countries, including Indonesia. Methods: A cross-sectional study was conducted involving 42 subjects: 14 with SpA, 19 with AAU, and 9 healthy controls. DNA was extracted from peripheral blood samples and analyzed using both conventional PCR (targeting exon 3 of HLA-B27) and a commercial HLA-B27 strip assay. Sensitivity, specificity, and diagnostic accuracy of conventional PCR were calculated against the commercial kit as the reference standard. Results: Conventional PCR showed high sensitivity (100%) and accuracy (85.71%) in SpA patients, indicating its potential as a reliable screening tool in this group. However, its performance in AAU patients was suboptimal, with lower sensitivity (40%) and specificity (55.56%). False positives and false negatives were observed, likely due to limitations in allele coverage by conventional primers. Conclusion: Conventional PCR is a promising, affordable alternative for HLA-B27 detection in SpA patients, particularly in resource-limited settings. However, its lower reliability in AAU cases highlights the need for careful clinical application and further optimization. Larger studies and local allele mapping are recommended to enhance diagnostic precision in diverse populations.
Versatile, low-cost ophthalmic wet lab device to improve diagnostic and surgical eye training Mardianto, Umar; Victor, Andi Arus; Yusuf, Prasandhya Astagiri; Juniantito, Vetnizah; Kekalih, Aria; Rahayu, Tri; Bustamam, Alhadi; Edwar, Lukman
Medical Journal of Indonesia Online First
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.bc.257865

Abstract

Ophthalmologists rely on wet lab training for both diagnostic procedures and surgical techniques. Existing wet lab devices are limited to surgical training and lack functionality for performing required perioperative diagnostic examinations. This study aimed to develop an affordable, easily manufactured eye holder to enhance ophthalmology training for wet lab simulations. A three-dimensional (3D)-printed animal eye holder was designed in 3D with a funnel-shaped structure resembling an orbital eye socket. The design was optimized for optimal wet lab activities. The animal eye holder device demonstrated potential use for ultrasound biometry, handheld keratometry, tonometry, and ophthalmological surgical training. These activities can be performed effectively after the animals’ eyes are stabilized inside the holder in flat and inclined positions. This innovative animal eye holder is the first designed to provide flexible diagnostic practice and surgical training, especially during wet lab activities.
Co-Authors -, Lisnawati Andi Arus Victor Andi Marsa Nadhira Anna Rozaliyani Annisa Windyani Aria Kekalih Aziza, Yulia Brenda Hayatulhaya Bustamam, Alhadi Dany Petra Pranata Barus Diana Aulia Djatikusumo, Ari dr. Muthia Despi Utami Eko Parulian Ethelind, Rachel Florentina Priscilia Ibnu Agus Ariyanto Ikhwan Rinaldi Ikhwanuliman Putera Ina S. Timan Indira Priya Darsini Indira Priya Darsini Iris Rengganis Iris Rengganis Iris Rengganis Joedo Prihartono Joedo Prihartono Kusumowidagdo, Gladys Lia Amanda Lily Raudah Putri Lisnawati Lisnawati - Lisnawati Rachmadi Made Susiyanti Mardianto, Umar Mefina Aulia Mufidah Monica Matturungan Muhammad Asroruddin, Muhammad Muhammad Shafiq Advani Muslim, Fitri MUTMAINAH Nora, Rina La Distia Partini P. Trihono Patricia Price Prasandhya Astagiri Yusuf Priya Darsini, Indira Ratna Sitompul Ratna Sitompul Ratna Sitompul Ratna Sitompul Riasanti, Mei Rina L.D. Nora Rina La Distia Nora Rina Wulandari Rwtno Sulistyo Wardani Selita Agnes Tanudjaja Sifyana, Ulifna Alfiya Silvia Lee Soedarman Sjamsoe Supriyadi Bektiwibowo Tania Tri Rahayu Vetnizah Juniantito Waliyuddin, M Zakiy Wibawa, Maria Valentina Widodo, Erica Yudantha, Anggun R. Yulia Aziza