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Batari Todja Umar
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Health Professions Medicine & Pharmacology Public Health

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EARLY DIAGNOSIS AND TREATMENT OF VOGT-KOYANAGI-HARADA SYNDROME WITH OPTIC DISC SWELLING : A CASE REPORT: Poster Presentation - Case Report - Resident Zulkarnaen Husain; Batari Todja Umar; Hasnah 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: 10.35749/1a8hsk92

Abstract

Introduction : Vogt-Koyanagi-Harada (VKH) syndrome is characterized as a multisystem autoimmune disease that affects the pigmented tissues of the eye, auditory system, skin, and central nervous system. Optic disc swelling is a common finding during the prodromal and acute uveitis stage and must be considered seriously. Case Illustration : A 41-year-old woman presented with blurred vision in both eyes in the last month, accompanied by headache, nausea, and vomiting. There is no history of penetrating ocular trauma or surgery. Examination findings for visual acuity were light perception, bilateral posterior synechia, optic disc swelling, and serous retinal detachment. A steroid injection was given due to swelling of the optic disc, and four months later, the visual acuity improved to 20/120 and 20/60, respectively, and optic disc swelling and serous retinal detachment decreased. Discussion : In the acute uveitic stage, VKH can be presented with bilateral optic disc edema and various degrees of serous retinal detachment. The key to the management of VKH is early diagnosis and systemic corticosteroid in the acute uveitis stage, otherwise, improper and inadequate treatment can lead to chronic recurrent VKH disease. Our patient presented with acute uveitis and was treated promptly and adequately. Conclusion : Optic disc swelling may occur in VKH and worsen the visual prognosis, early diagnosis and treatment of VKH syndrome focused on optic disc swelling can improve the visual prognosis.
Kearns–Sayre Syndrome with Bilateral Ptosis and External Ophthalmoplegia: A Rare Case Report: Poster Presentation - Case Report - Resident Philipus Putra Raharjo; Yunia Mansyur; Batari Todja Umar
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/dyz23y26

Abstract

Abstract Introduction : Kearns-Sayre syndrome (KSS) is a rare genetic disorder caused by a deletion of mitochondrial DNA (mtDNA) segment, typically characterized by a triad of symptoms includes external ophthalmoplegia, pigmentary retinopathy and appeared before the age of 20. The prevalence rate is about 1–3 per 100.000 individuals. It was diagnosed based on clinical features and supported by biochemical, radiological, histologic, and molecular genetic tests. Case Illustration : 26-year-old male with bilateral ptosis, chronic progressive external ophthalmoplegia, pigmentary retinopathy was shown from ophthalmology examination and associated with hearing loss. Physical examination showed short stature, wasting, and weakness of limb muscles. MRI examination revealed focal brain atrophy on bilateral parietal regions. Discussion : Mitochondrial DNA defect led to dysfunction of the central nervous system, endocrine system, extraocular muscle, myocardium, skeletal muscle, and other multiple systems. The clinical findings in this patient are appropriate for classical signs and symptoms of KSS. Central nervous involvementis shown by the neuroimaging result. There is no cardiac involvement suggested by normal cardiology examination. Although muscle pathology and molecular genetic analysis can play a great role to diagnose KSS, the classical triad of clinical signs plus one of the other symptoms could establish KSS diagnosis. Conclusion : KSS is a rare genetic disorder and challenging to diagnose. However, if a patient presents with the classic triad of symptoms, clinicians should have a high level of suspicion for the disorder. Additionally, It is important to perform a thorough evaluation to rule out other conditions that can cause similar symptoms.
HISTOLOGICAL FEATURES OF ETHAMBUTOL INDUCED MICE EYES: A PRE- EXPERIMENTAL STUDY ON TOXIC OPTIC NEUROPATHY CASE: Oral Presentation - Experimental Study - Ophthalmologist BATARI TODJA UMAR; Itzar Chaidir Islam
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/tdpqn025

Abstract

Abstract Introduction & Objectives : Toxic Optic Neuropathy (TON) is a visual disease caused by toxic substances damaging the optic nerve. It can be caused by inflammation, infection, or long-term drug use. Over 10% of ethambutol- treated optic neuropathy patients developed major complications. Cellular changes should be observed histologically. This study examines ethambutol-induced mice's eye histology in the fibrous, vasculous, nervous tunica, optical media, and optic nerve tissue. Methods : This pre-experimental study used 20 eyes of 10 white mice aged 1-2 weeks weighing 50-65 grams. Group 1 consisted of healthy mice without therapy and group 2 received 35 mg/kgBW/day of ethambutol for 60 days. (group 2). Hematoxylin eosin staining was used to observe binocular experimental animal eyes after enucleation. All measurements used Olympus® CX-20 microscope with 40x objective resolution. Results : The average thickness of the cornea was 72.238 ± 10.542 and 60.572 ± 10.25, while the sclera was 336.533±40.851 μm and 331.339±34.219 μm. In groups 1 and 2, no significant changes were foundin the cell layer morphology of both tissues (p > 0.05). Iris, ciliary body, and choroid were observedin the tunica vasculosa. Groups 1 and 2 had eye and ciliary body lengths of 595.148±137.805 μm and 497.705±213.866 μm, respectively, and choroid thicknesses of 161.369±37.925 and 162.605±25.160 (p>0.05). Group 1 had 402.268±55.666 μm retinal thickness in the tunica nervosa, while group 2 had 399.854±27.585 (p>0.05). Conclusion : Ethambutol-induced and normal experimental animals had substantial histological differences in optic nerve thickness, but no significant difference in the other ocular structures.
Co-Authors Hasnah Eka Itzar Chaidir Islam Philipus Putra Raharjo Yunia Mansyur Zulkarnaen Husain