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All Journal Jurnal Kesehatan Andalas Bioscientia Medicina : Journal of Biomedicine and Translational Research Ophthalmologica Indonesiana
Rahmadiansyah, Muhammad Fadhil
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Clinical Insights into Internuclear Ophthalmoplegia: A Case Report Rahmadiansyah, Muhammad Fadhil; Muhammad Hidayat
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.v7i11.891

Abstract

Background: Internuclear ophthalmoplegia (INO) is a rare neuro-ophthalmological disorder characterized by impaired horizontal eye movement coordination due to lesion in the medial longitudinal fasciculus. INO commonly results from demyelinating diseases, vascular lesions, or structural brain abnormalities. Case presentation: A 60-year-old male patient presented with diplopia for the past 4 days. He had history of hypertension and diabetes mellitus and “mild” stroke for past years. Clinical examination revealed normal primary gaze, limited medial movement of the left eye, and diplopia in all gaze positions. Hess screen examination demonstrated underaction of the left medial rectus muscle and overaction of the right lateral rectus muscle. The laboratory results an elevated blood sugar level. Brain CT scan revealed multiple infarcts in the right parietal and cerebellar lobes and left parieto-occipital lobe, with evidence of brain atrophy. The patient was diagnosed with INO. Management involved addressing the underlying systemic diseases, namely diabetes and hypertension, in collaboration with internist and neurologist. The patient also received citicoline therapy and underwent regular follow-up. In the third-month follow-up, the patient demonstrated significant improvement, with reduction in diplopia and enhancement in left eye medial movement. Conclusion: This case report highlights the importance of considering INO in patients presenting with diplopia and a history of vascular risk factors. Timely diagnosis and comprehensive management with regular follow-up is crucial to monitor the progress and enhance the patient's quality of life.
Kombinasi Injeksi Triamsinolon Asetat Intralesi dan Propanolol Oral pada Kasus Hemangioma Kapiler Palpebra Efendi, Mardijas; Hendriati, Hendriati; Rahman, Ardizal; Rahmadiansyah, Muhammad Fadhil
Jurnal Kesehatan Andalas Vol. 11 No. 2 (2022): Online July 2022
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v11i2.2082

Abstract

Capillary hemangioma is a benign tumor developed from the abnormal proliferation of blood vessels. This tumor appears on eyelids and orbit. Around 75% of hemangioma resolves spontaneously in the first 4-5 years of life. Intervention is needed in hemangioma that obstructs the visual axis. It has been reported that a two-year-old girl came to Polyclinic with a mass on the left superior eyelid 1,5 years ago. At first, the left superior eyelid looked puffy, then developed slowly until it covered the left eye. On the examination of the left eye, visual acuity assessment was hard to perform. Mass in superior palpebral was 8mm x 8mm x 8mm, reddish colored (different with adjacent skin), consistency supple, mobile, painful (-), edema (+), horizontal palpebral fissure (FPH) 30 mm, vertical palpebral fissure (FPV) 0 mm. CT scan showed suspected hemangioma. The patient was diagnosed with capillary hemangioma and given an injection of triamcinolone acetate intralesional and oral propranolol under the supervision of a pediatrician. Significant clinical improvement was observed after 40 days of injection, where the mass was resolved completely. The FPV and FPH of the left eye had improved to 9 mm and 30 mm, respectively, with the patient finally able to follow the object. The combination of intralesional triamcinolone acetate and oral propranolol in this case is quite effective in providing complete resolution of capillary hemangioma.Keywords:  capillary hemangioma, triamcinolone acetate injection, propanolol
Axenfeld Rieger Syndrome: an unusual case report: Poster Presentation - Case Report - Resident RAHMADIANSYAH, MUHAMMAD FADHIL; SAYUTI, KEMALA
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/mf7nvf10

Abstract

Introduction : Axenfeld-Rieger Syndrome (ARS) is a rare autosomal dominant disorder that characterized by ocular manifestation, especially the cornea, iris, glaucoma, and systemic abnormalities in teeth, face, abdomen, heart and genitals. Case Illustration : A 7-year-old boy patient presented to policlinic with complaint of blurry vision in both eyes. No other abnormalities in history. On examination, visual acuity of right eye 5/60 and left eye 4/60. Slit lamp examination revealed hypoplasia iris, corectopia, and polycoria. Intraocular pressure (IOP) on right eye 25 mmHg and left eye 24 mmHg. Non ocular manifestation were flat face and teeth deformity. This patient was diagnosed ARS with secondary glaucoma. We managed the patient together with the dental and pediatric department in order to confirm and treat any systemic abnormality. Patient underwent cycloplegic refractive correction to achieve best corrected visual acuity right eye 20/200 and left eye 20/150 (LEA chart). Timolol 0,25% eye drop was given twice a day with IOP right eye 19 mmHg and left eye 20 mmHg after 2 weeks. Discussion : The diagnosis of patient was ARS with secondary glaucoma. The patients with ARS have a 50% lifetime risk of glaucoma. Comprehensive management to confirm and treat the systemic abnormalities from dental and pediatric departments was important. Management in our department includes correction of refractive errors and lowering of IOP. Conclusion : Axenfeld Rieger Syndrome that manifest ocular and non-ocular need to investigated thoroughly. Multidisciplinary contribution of this case is necessary to maintain the ocular stabilization and prevent any harm from systemic abnormalities.
Co-Authors Hendriati, Hendriati Kemala Sayuti Mardijas Efendi Muhammad Hidayat Rahman, Ardizal