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All Journal Majalah Biomorfologi (Biomorphology Journal) Ophthalmologica Indonesiana
Lukisiari Agustini
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience Public Health

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LONG-TERM FOLLOW-UP ON A RARE CASE OF PERIOPERATIVE POSTERIOR ISCHEMIC OPTIC NEUROPATHY: FINDING HOPE IN THE DARKNESS: Poster Presentation - Case Report - Resident Affannul Hakim; Lukisiari Agustini; Gatot Suhartono
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: 10.35749/5ghmr549

Abstract

Abstract Introduction : Perioperative posterior ischemic optic neuropathy (PION) following maxillectomy is a rare and devastating condition that leads to permanent vision loss in most reported cases. This case report offers a different perspective through long-term follow-up, providing valuable insights into the prognosis and potential treatments for PION. Case Illustration : Following a left maxillectomy for ameloblastoma, a 28-year-old female experienced sudden vision loss in her left eye. The visual acuity was 5/60, and an altitudinal inferior visual field defect with a superior extension was present. Ishihara's color vision examination revealed 15/38. The patient was diagnosed with perioperative PION and treated with neurotropic and folic acid. After 16 months, optic atrophy was observed. However, there are complete recovery in visual acuity to 5/5 and Ishihara score to 38/38, along with a significant improvement in the visual field defect. Discussion : The current management of perioperative PION is focused on prevention, because once vision loss occurs, it is usually severe and irreversible. In our case, the patient exhibited a favorable outcome after a long follow-up period, suggesting that there is still potential for improvement in PION patients. The finding is consistent with previous study, which reported that a small percentage of patients may still experience improved vision during follow-up. The role of neurotropics in improving patient outcomes is further supported by in vitro studies that demonstrate early neurotropic treatment significantly prevents loss of retinal ganglion cells in PION. Conclusion : Visual improvement is still possible in perioperative PION and early neurotropic administration may be considered in therapy
GOOD OUTCOMES OF OCULAR MYASTHENIA GRAVIS IN A YOUNG ADULT MALE: A CASE REPORT: Poster Presentation - Case Report - Resident Muhammad Wahyu Aghdhi Pradipta; Lukisiari Agustini
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: 10.35749/99th5294

Abstract

Abstract Introduction : Myasthenia gravis (MG) is characterized by fluctuating weakening and fatigability of skeletal muscles. Ocular MG (OMG) occurs when the symptoms of MG are limited to the ocular muscles. Case Illustration : A 21-year-old male presents with a two-month history of drooping both eyelids. The drooping eyelids improved in the morning or after a nap, and got worse in the evening. Ocular examination revealed limitation towards all gazes with bilateral ptosis. Visual acuity, anterior segment, visual fields, slit lamp, and fundus examinations were unremarkable. The ice pack and rest test resulted in a significant improvement after two minutes of ice pack application and 30-minute rest, raising suspicion for the diagnosis of MG. Acetylcholine receptor antibody (AChR) test was positive for AChR binding antibody. Treatment for OMG is initiated with an oral acetylcholinesterase inhibitor, pyridostigmine, and corticosteroid. The ptosis and ophthalmoplegia improved after one week follow- up and recovered completely after eight weeks of follow-up. Discussion : The hallmarks of MG are fluctuating fatigable muscle weakness that worsen with activity and improve on rest. Neurological exam and clinical neurological history are essential to establish the diagnosis. Bedsite tests, electrophysiologic test, and the antibody test all support the clinical diagnosis of MG. Conclusion : OMG progresses to its generalized form 90% of the time during the first two years of the onset of ocular symptoms. Early detection and prompt treatment are the key which may help to prevent or minimize the occurrence of myasthenia crisis.
AUTOIMMUNE OPTIC NEUROPATHY (AON) PROFILE AT OPHTHALMOLOGY OUTPATIENT CLINIC OF A TERTIARY HOSPITAL IN SURABAYA, INDONESIA Devanty Dwi Santosa; Lukisiari Agustini; Artaria Tjempakasari
Majalah Biomorfologi Vol. 34 No. 1 (2024): MAJALAH BIOMORFOLOGI
Publisher : Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mbiom.v34i1.2024.19-25

Abstract

Highlights Autoimmune optic neuropathy (AON) is one of the diseases that involve the central nervous system (CNS) and can result in disability if not treated quickly and appropriately. The autoimmune optic neuropathy (AON) patient's profile, including disease etiology and therapy, is essential to minimize the incidence of AON.   Abstract Background: Autoimmune optic neuropathy (AON) is a kind of optic neuritis that causes progressive and severe vision loss. The presence of an autoimmune disease usually characterizes the diagnosis of this disease. Several autoimmune processes that can cause AON are Multiple Sclerosis (MS), Neuromyelitis Optica Spectrum Disorder (NMOSD), Myelin Oligodendrocyte Glycoprotein Immunoglobulin (MOG-IgG), and other disorders, specifically systemic autoimmune disease, such as Systemic Lupus Erythematous (SLE), Sjogren's Syndrome, and Sarcoidosis. Risk factors for AON involve young adults and women. Most of the patients received therapy according to the ONTT protocol and underwent outpatient treatment with oral methylprednisolone or prednisone. Objective: The study aimed to obtain the autoimmune optic neuropathy (AON) profile in patients at the Ophthalmology Outpatient Installation of Dr. Soetomo General Academic Hospital Surabaya, Indonesia, in the 2017-2022 Period. Material and Method: This retrospective descriptive study used medical records; 70 subjects were included. Result: Most subjects suffered from SLE (55.7%) as the cause of AON and received therapy according to the ONTT protocol, namely oral methylprednisolone or prednisone (67.1%) with outpatient therapy. Some patients were given other therapies (25.7%), such as mecobalamin and other B complex vitamins. Conclusion: AON is an uncommon condition. However, if not treated promptly and effectively, it can result in handicaps. This study may serve as a reference for future relevant research and as an attempt to prevent the disease.
FEATURES OF THE CLINICAL MANIFESTATIONS OF AUTOIMMUNE OPTIC NEUROPATHY IN MULTIPLE SCLEROSIS ON CORTICOSTEROID THERAPY Dalia Sharliz Raihana; Lukisiari Agustini; Deasy Fetarayani
Majalah Biomorfologi Vol. 34 No. 2 (2024): MAJALAH BIOMORFOLOGI
Publisher : Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mbiom.v34i2.2024.123-133

Abstract

Highlights Intravenous corticosteroid treatment followed by oral clinical treatment can reduce the incidence of post-treatment optic neuritis recurrenc Visual acquisition increases at one-month post-treatment.   Abstract Background: The clinical picture of autoimmune optic neuropathy, known as neuritis, is strongly influenced by the unique structure of the human anterior visual pathway. The central nervous system autoimmune is related to multiple sclerosis (MS). Optic neuropathy is an injury that frequently results in acute inflammatory damage. Objective: This study aimed to determine the clinical manifestations of autoimmune optic neuropathy in multiple sclerosis and identify diseases with appropriate corticosteroid therapy using systematic review methods. Material and Method: This study used a systematic review method to analyze topic-related kinds of literature on  Scopus, PubMed, and Google Scholar databases. The literature screening process was carried out based on the PRISMA 2020 guidelines. Result: Regarding the post-treatment recurrence rate of optic neuritis, the use of intravenous corticosteroids alone and intravenous corticosteroid followed by oral administration may clinically reduce the incidence of recurrence in the patients compared those receiving placebo and oral administration. This suggests that intravenous corticosteroid followed by oral corticosteroid treatment is effective in helping to reduce the incidence of recurring optic neuritis. Conclusion: Intravenous corticosteroid treatment followed by oral administration may clinically reduce the incidence of post-treatment recurrence of optic neuritis in multiple sclerosis (MS) patients.
Co-Authors Affannul Hakim Artaria Tjempakasari, Artaria Dalia Sharliz Raihana Deasy Fetarayani Devanty Dwi Santosa Gatot Suhartono Muhammad Wahyu Aghdhi Pradipta