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All Journal Ophthalmologica Indonesiana The International Journal of Medical Science and Health Research
Fierda Ovita Azhari
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Retinal Nerve Fiber Layer as The Preferred Objective Measure in Differentiating Pseudopapilledema with True Papilledema: A Systematic Review: Oral Presentation - Observational Study - General practitioner Lourisa Ruth Eldenia; Rona Ali Badjrai; Lazuardiah Anandi; Fierda Ovita Azhari; Erika Anggraini; Brigitta Marcia Bidihardja; Syntia Nusanti
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/pcx3g043

Abstract

Abstract Introduction & Objectives : Distinguishing pseudopapilledema from true papilledema may generate confusion for some cases. Regardless of the subjective judgment on clinical examination alone, objective measurement for confirmation of diagnosis might be costly, operator-dependent, invasive, or not readily available. This study aims to evaluate whether retinal nerve fiber layer (RNFL) could be the reliable and efficient objective measure to ascertain the diagnosis. Methods : Literatures were obtained by comprehensive searching on PubMed, ProQuest, Google Scholar, and Cochrane between 2012 - 2023. Last search was March 26, 2023. Non-english study, animal study, review articles, case studies, and editorial letters were excluded. We included studies with available full-text containing both groups of papilledema and pseudopapilledema. The result was presented according to Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guideline. Results : A total of 615 participants were included from 8 different studies all comprising a group of papilledema and pseudopapilledema with or without optic disc drusen (ODD). Studies resulted in good accuracy on RNFL in differentiating pseudopapilledema with papilledema as the area under curve ranging from 0,78 to 0,91. However, specificity and sensitivity were varied between 65-100% and 33-91% respectively. Lower accuracy was found when pseudopapilledema only includes patients with ODD or papilledema was narrowed to mild papilledema. Conclusion : RNFL is a useful objective measure with favorable accuracy in differentiating pseudopapilledema with papilledema especially in acute settings or whenever operator-dependent examination is not obtainable
Predictive Efficacy of the STOP-BANG Scoring System in Obstructive Sleep Apnea After Multilevel Airway Reconstructive Surgery: A Comprehensive Clinical Case Study Analysis Fierda Ovita Azhari; Gustav Syukrinto
The International Journal of Medical Science and Health Research Vol. 31 No. 1 (2026): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/kz5fpj81

Abstract

Obstructive Sleep Apnea (OSA) is a sleep disorder characterized by recurrent collapse of the upper airway. The STOP-BANG questionnaire has been validated as a highly sensitive screening tool to identify surgical patients at high risk for OSA. This report aims to evaluate multilevel surgical management in a patient with a high STOP-BANG score and review the literature regarding its clinical efficacy. A 55-year-old male presented with chronic snoring, daytime fatigue, and witnessed apnea episodes over the last six months. Physical examination revealed a Body Mass Index (BMI) of 28.4 Kg/m2, a neck circumference of 45 cm, tonsillar hypertrophy, an elongated uvula, and turbinate hypertrophy. The patient's STOP-BANG score was 6, indicating a high risk for moderate-to-severe OSA. A STOP-BANG score ≥ 5 has a strong correlation with OSA severity and an increased risk of postoperative respiratory complications. Multilevel surgery is more effective than single-level procedures because it targets multiple collapse sites simultaneously (nasal and oropharyngeal). Integrating the STOP-BANG score into preoperative evaluations allows for accurate risk stratification. Multilevel surgery in well-selected patients can provide significant symptomatic improvement and reduce the long-term morbidity burden of OSA.
Co-Authors Brigitta Marcia Bidihardja Erika Anggraini Gustav Syukrinto Lazuardiah Anandi Lourisa Ruth Eldenia Rona Ali Badjrai Syntia Nusanti