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All Journal JOURNAL LA MEDIHEALTICO Ophthalmologica Indonesiana
Anoez, Azizah
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Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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METHOTREXATE FOR REBOUND PHENOMENON OF VOGT-KOYANAGI-HARADA IN JUVENILE: A RARE CASE REPORT Bachmid, Humairah; Eka, Hasnah; Anoez, Azizah; Fikri, Bahrul
Majalah Oftalmologi Indonesia Vol 49 No S1 (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/x2ytbm20

Abstract

Introduction: Vogt-Koyanagi-Harada (VKH), an auto-immune disorder driven by melanocyte antigen, is rare in children. The mainstay treatments are corticosteroid and immunomodulators. Methotrexate is one of immunomodulator that widely used due to its effectiveness with minimal side effects. Case Report: A 9-years-old boy get diagnosed Vogt-Koyanagi-Harada. His best corrected visual acuities (BCVA) were 20/400 in both eyes. Anterior segment examination showed granulomatous uveitis. Posterior segment examination revealed optic disk swelling, Dallen Fuch’s nodule and exudative retinal detachment. We also found poliosis and vitiligo in his lips. He had been previously treated with topical corticosteroids, oral corticosteroids and topical cycloplegics. The dose was tapered every month. After taking medication for 5 months with the last dose oral corticosteroid 16 mg/day and topical corticosteroid every 8 hours, his BCVA recovered to 20/25 RE and 20/40 LE. During the treatment time, the patient discontinued the medication due to parental disobedience and then came with decrease of vision. Based on the consideration of rebound phenomenon and the use of maximum dose of corticosteroids, we consulted the patient to the pediatrician, and decided to give methotrexate as an immunosuppressant. After receiving 15 mg/week of methotrexate for 3 months, inflammation calmed down but unfortunately the vision did not improve. Discussion: In children, the main treatment for VKH disease is high-dose corticosteroids. Considering the side effects of prolonged systemic corticosteroid therapy, methotrexate become the first line of corticosteroid sparing agent, especially in chronic stage. Conclusion: Methotrexate can be an effective treatment option for rebound VKH.  Keywords: Juvenile Vogt-Koyanagi-Harada, Steroid Sparing Agents, Rebound Phenomenon, Methotrexate.
Visual Outcomes of Senile Cataract Patients Post-Cataract Surgery at JEC-Orbita Eye Clinic Makassar Basalamah, Hadijah; Kusumawardhani, Sri Irmandha; Hidayat, Muh. Fadly; Anoez, Azizah; Namirah, Hannah Aulia
Journal La Medihealtico Vol. 5 No. 6 (2024): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v5i6.1831

Abstract

Cataracts are a major cause of blindness worldwide. World Health Organization (WHO) data in 2020, cataract is the most common eye disorder that causes blindness and visual impairment. Postoperative visual acuity is a simple direct parameter that can reflect the quality of cataract surgery and postoperative care. Descriptive in nature with a cross-sectional approach (cross-sectional) using secondary data obtained from medical records. The sampling technique used random sampling with a total of 97 samples. A study conducted at the JEC-ORBITA Main Eye Clinic in Makassar City from January 2024 to June 2024 on patients diagnosed with senile cataracts found 3466 patients. This study showed that the highest proportion occurred in female gender 54 (55.7%), elderly age category (60-74 years) 67 (69.1%), phacoemulsification surgery technique 97 (100%), unilaterally operated eyes on the left eye 35 (36.1%), nuclear cataract morphology 73 (75.3%), pre-operative vision dominated by moderate vision 62 (63.9%), post-operative vision on day 1 mild vision 51 (52.6%), day 7 mild vision 81 (83.5%) and day 30 it improved and increased in 86 (88.7%). Research result Visual Outcome Senile Cataract Patients Post Cataract Surgery at JEC-Orbita Makassar Main Eye Clinic from January 2024 to June 2024 showed improvement at the end of the fourth week of visits, by looking at the vision before and after cataract surgery.
Co-Authors Bachmid, Humairah Basalamah, Hadijah Eka, Hasnah Fikri, Bahrul Hidayat, Muh. Fadly Namirah, Hannah Aulia Sri Irmandha K