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Ethelind, Rachel
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Health Professions Medicine & Pharmacology Public Health

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Development and Application of Targeted Multi-plex Polymerase Chain Reaction to Help Diagnose Infectious Uveitis Ethelind, Rachel; Rina La Distia Nora
Majalah Oftalmologi Indonesia Vol 51 No 1 (2025): Ophthalmologica Indonesiana
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/journal.v51i1.101730

Abstract

Introduction: Clinical pattern recognition is paramount in uveitis diagnosis. Pathogen detection from ocular fluid samples is often necessary to support infectious uveitis diagnosis, particularly in cases presenting with atypical clinical appearance. This study aims to present the process of developing targeted multiplex PCR and evaluate its application in infectious uveitis diagnosis.   Methods: This was a cross-sectional study to evaluate the diagnostic performance of targeted multiplex PCR in infectious uveitis. We obtained ocular fluid samples and reviewed medical records of uveitis patients who underwent ocular fluid analysis at Cipto Mangunkusumo Hospital from February 2022 to March 2023. PCR detection threshold values (DNA copies/mL) were 10.9 for Mycobacterium tuberculosis (Mtb), 672 for Epstein-Barr virus (EBV), 4.77 for Cytomegalovirus (CMV), 6.37 for Toxoplasma gondii (T. gondii), and 5.53 for Herpes simplex virus (HSV). With multiple pathogen selection, this method requires a lower volume of samples than single-plex PCR, as the latter will increase the sample volume linearly with each additional pathogen tested.   Discussion: Forty-seven aqueous or vitreous samples were analyzed. The positivity rate was 23.4% (11/47) with Mtb yielding the highest positivity (7/41; 17.1%). With final diagnosis as a reference, targeted multiplex PCR resulted in 32.3% (95% CI: 16.7 – 51.4%) sensitivity, 93.8% (95% CI: 69.8 – 99.8%) specificity, 90.9% (95% CI: 58.4 – 98.6%) positive predictive value, and 41.7% (95% CI: 35.2 – 48.4%) negative predictive value.   Conclusion: With its high specificity, targeted multiplex PCR is useful as a confirmatory but not screening tool in uveitis diagnosis. Ocular fluid analysis is an important part of the stepwise diagnostic approach in uveitis.
A systematic review comparing Mytomicyn-C subtenon injection to sponge during trabeculectomy in open angle glaucoma: Oral Presentation - Observational Study - General practitioner Ethelind, Rachel; Puspa, Prizka Avilia; Santoso, Wildan Iman
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/x94ab172

Abstract

Introduction & ObjectivesMitomycin-C (MMC) is an effective agent to prevent scarring during the healing process followingtrabeculectomy procedure by inhibiting the multiplication of cells producing scar tissue. The aim ofthis study is to compare the efficacy of Mitomycin-C (MMC) delivered by either subtenon injection orsponge application during trabeculectomy surgery in open angle glaucoma patients. MethodsA systematic search was done using several databases including Pubmed, Medline, Embase, Scopus,and Jstor. Inclusion criteria were open angle glaucoma patients underwent trabeculectomy surgery,given either MMC via subtenon or sponge application, article in English, Randomized ControlledTrial (RCT) studies which published in the last 10 years. Intra-Ocular Pressure (IOP), EndothelialCell Counts (ECC) and Bleb Morphologic features with at least 1 month follow-up were evaluated. ResultsTwo RCT studies were included in this study. Both studies demonstrated that sub-tenon injectionand sponge application has no significant difference regarding IOP reduction from the baseline.Regarding morphologic features, both studies favor subtenon to conventional sponge application.Lastly, ECC in both studies conclude that there was no marked differences. ConclusionThe outcome of administration of MMC through subtenon injection and sponge application werecomparable to one another. However, less vascularization are shown in subtenon injection group.
Affordable HLA-B27 Detection in Resource-Limited Settings: Evaluating Conventional PCR for Uveitis and Spondyloarthropathy in Indonesia Nora, Rina La Distia; Edwar, Lukman; Susiyanti, Made; Aziza, Yulia; Putera, Ikhwanuliman; Sifyana, Ulifna Alfiya; Riasanti, Mei; Waliyuddin, M Zakiy; Wibawa, Maria Valentina; Ethelind, Rachel; Widodo, Erica; Sitompul, Ratna
Majalah Oftalmologi Indonesia Vol 52 No 1 (2026): Ophthalmologica Indonesiana
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/oi.v52i1.102039

Abstract

Introduction: HLA-B27 is a genetic marker strongly associated with spondyloarthropathy (SpA) and acute anterior uveitis (AAU). Detection of this allele can support earlier diagnosis and targeted management. However, commercially available HLA-B27 tests are costly and often inaccessible in low- and middle-income countries, including Indonesia. Methods: A cross-sectional study was conducted involving 42 subjects: 14 with SpA, 19 with AAU, and 9 healthy controls. DNA was extracted from peripheral blood samples and analyzed using both conventional PCR (targeting exon 3 of HLA-B27) and a commercial HLA-B27 strip assay. Sensitivity, specificity, and diagnostic accuracy of conventional PCR were calculated against the commercial kit as the reference standard. Results: Conventional PCR showed high sensitivity (100%) and accuracy (85.71%) in SpA patients, indicating its potential as a reliable screening tool in this group. However, its performance in AAU patients was suboptimal, with lower sensitivity (40%) and specificity (55.56%). False positives and false negatives were observed, likely due to limitations in allele coverage by conventional primers. Conclusion: Conventional PCR is a promising, affordable alternative for HLA-B27 detection in SpA patients, particularly in resource-limited settings. However, its lower reliability in AAU cases highlights the need for careful clinical application and further optimization. Larger studies and local allele mapping are recommended to enhance diagnostic precision in diverse populations.
Co-Authors Aziza, Yulia Ikhwanuliman Putera Lukman Edwar Made Susiyanti Nora, Rina La Distia Puspa, Prizka Avilia Ratna Sitompul Riasanti, Mei Rina La Distia Nora Santoso, Wildan Iman Sifyana, Ulifna Alfiya Waliyuddin, M Zakiy Wibawa, Maria Valentina Widodo, Erica