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A CASE REPORT OF WOODEN STICK IMPALEMENT AND PALPEBRAL RUPTURE : ORBITAL PENETRATION TRAUMA: Poster Presentation - Case Report - Resident NOVIAN ADI SAPUTRA; MARDIJAS EFENDI; HENDRIANTI
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/rqpexw51

Introduction : Orbital penetration trauma is a severe injury caused by the penetration of a foreign object into the orbit of the eye. It is a potentially life threatening condition that can cause significant damage to the surrounding structures, including the eye, the optic nerve, and the brain. Case Illustration : 49 y.o M came with The left eye was impaled by a wooden stick 12 hours before entering the hospital, causing pain, bleeding, and loss of vision.Visual acuity of the left eye was no light perception, extensive palpebral rupture, and left eye movement was limited in all directions. The CT scan of left orbit was orbital floor fracture, hypodense lesion in the left retrobulbar oculi which appeared to obliterate the left optic nerve, and orbital floor fracture.He underwent surgery for the removal of the wood and underwent a wide palpebral reconstruction. . Discussion : The severity of orbital penetration trauma can vary depending on several factors, including the size and shape of the penetrating object. In some cases, the injury may be relatively minor and only result in minor bruising and swelling around the eye. However, more severe cases can cause significant damage to the eye itself, including rupture of the eyeball or damage to the optic nerve. Conclusion : Orbital penetration trauma treatments typically involves immediate medical attention to assess the extent of the injury and determine the best course of action. In some cases, surgery may be required to repair the damage and prevent further complications.

CICATRICIAL ECTROPION REPAIR DUE TO TRAUMA : A CASE REPORT: Poster Presentation - Case Report - Resident Rino Agustian Praja; Hendrianti; Mardijas Efendi
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/qngcjx67

Introduction : Cicatricial ectropion is a complication that can occur after trauma. Scar tissue formation causes anterior lamellae shortening (skin and orbicularis muscle), resulting in outward lid margins rotation. Case Illustration : A 16 y.o male patient came with complaints of the left upper and lower eyelids folding outwards since 3 months ago after trauma, watery eye. Examination VOD 20/20, VOS 20/50. Scar on the superior and inferior lids, the inferior lid margin is folded out, inferior tarsal conjunctiva is visible, lagophthalmus 4 mm, fissure palpebral vertical (FPV) 12 mm, margin reflex distance (MRD) 1 = 4 mm, MRD2 = 8 mm, fissure palpebral horizontal (FPH) 30 mm, conjunctival injection. Corneal (macular) scars central-peripherally at 3-6 o'clock. Patient was diagnosed with cicatrical ectropion with left eye corneal scar and ectropion repair was performed with full-thickness skin graft from retroarticular. One week and six weeks after surgery, FPV improved to 10 mm, MRD1 = 4, MRD2 = 6 mm, FPH 30 mm, and lagophthalmos 2 mm became 1 mm. Discussion : Cicatricial ectropion is usually treated in 3 procedures: release vertical scar traction, horizontal lid tightening, repair anterior lamella can be done with full-thickness skin graft. horizontal lid tightening in this case not carried out because of no laxity. Conclusion : Scar traction release and repair anterior lamella with full-thickness skin graft from retroauricular was choice in this case because extensive defect and ectropion grade 3. After surgery anatomical structure of the lids and looks better aesthetically.

A Rare Embryological Phenomenon: Kissing Nevus Incidence and Clinical Features: Poster Presentation - Observational Study - Resident atika syafendra; mardijas efendi; hendrianti
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: 10.35749/71gks843

Introduction & Objectives : Kissing nevus is a condition where the nevus extends up to the lid margins, its edges touch or “kiss” when the eyelids are closed. Although commonly presenting at birth, there have been cases where it appeared in later life. This occurs due to a rare embryological phenomenon and thus only 30 cases have been reported worldwide until 2020. Meanwhile in M Djamil Hospital Padang we found 4 cases during 2020-2022. This paper is aim to present this so called rare cases in a modest way Methods : This is a descriptive study related to kissing nevus cases in M Djamil Hospital Padang during 2020-2022. We diagnosed it clinically based on ophthalmology examination. The data were collected into master table and being analyzed. We put patient’s identity (name, age, and gender), nevus location, size, gross anatomy of the nevus and surgical procedure Results : Four patients were discussed in this study. Most of the patients (75%) is a woman. We found more cases in the first 2 decades of life (50%). The predilection location is at the temporal eyelid (50%), it’s size is equal, both (10-19 mm and 20-29 mm) is 50%. In study we only found a melanotic lesion (100%). Most of the patient were treated with excision biopsy + skin flap (75%) Conclusion : The prevalence of kissing nevus in M Djamil Hospital is high. Kissing nevus mostly suffered by young women, most cases affected temporal eyelid, the size 10-29 mm so that skin flap is the most suitable surgical procedure

Modified Hughes Tarsoconjunctival Flap Procedure for Lower Eyelid Defect: Poster Presentation - Case Series - Resident aulia; hendriati; mardijas efendi
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/fqfns990

Introduction : Hughes procedure of tarsoconjunctival flap is a method of choice in reconstructing full thickness inferior eyelid defect that involves >50% of eyelid margin to restore anatomical integrity, function, and cosmetic of the eyelid. The modified Hughes procedure includes sparing of the marginal upper lid tarsus and removal of the levator muscle aponeurosis from the tarsoconjunctival flap.This article reports 2 patients who underwent modified Hughes procedure after basal cell carsinoma excision. Case Illustration : Two patients underwent inferior eyelid reconstruction using modified Hughes procedure. After wide excision of the tumor, tarsoconjunctival flap was made to reconstruct posterior lamella of the eyelid. Subsequently, anterior lamella of the eyelid were reconstructed using full thickness skin graft and advancement flap, respectively. Both patient then underwent second surgery, tarsus flap release, 6-8 week after the first surgery. Discussion : A tarsoconjunctival flap from the upper eyelid replaces the posterior lamella, whereas a skin graft, a skin flap, or a skin-muscle flap restores the anterior lamella. After surgery, tarsal flap apposition, skin flap/graft, and stitches were intact. After tarsus flap release, wound healing was good. Tumor biopsy showed basal cell carcinoma. Conclusion : Modified Hughes procedure is a treatment of choice in reconstructing full thickness inferior eyelid defect involving >50% of eyelid margin. Full thickness skin graft and advancement flap to reconstruct anterior lamella of the eyelid is choosen after considering skin color and texture similarity and laxity of eyelid and cheek.

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.

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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