Devi Azri Wahyuni
Department Of Ophthalmology, Faculty Of Medicine, Universitas Sriwijaya Mohammad Hoesin Hospital, Palembang, South Sumatera

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Karakteristik Klinis Kelainan Mata pada Pasien dengan Massa Intrakranial di RSUP Dr. Moh. Hoesin Palembang Periode1 Januari 2013-31 Desember 2015 Yuventius Odie Devanand; Devi Azri Wahyuni; Nyayu Fauziah Zen
Majalah Kedokteran Sriwijaya Vol 49, No 2 (2017): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v49i2.8530

Abstract

Massa intrakranial merupakan suatu lesi ekspansif yang dapat meluas secara volume dan menggantikan struktur normal di dalam ruang tengkorak (intrakranial). Massa intrakranial menyebabkan timbulnya berbagai tanda dan gejala umum ataupun lokal dari sistem saraf tergantung dari lokasi dan tingkat pertumbuhan massa. Gejala dan tanda pada mata akibat massa intrakranial meliputi kehilangan penglihatan, penglihatan ganda,palsi saraf kranial, abnormalitas pada pupil, proptosis, dan defekpada kepala nervus optikus. Penelitian ini bertujuan memberikan informasi mengenai karakteristik klinis kelainan mata yang terjadi akibat massa intrakranial sehingga memudahkan penegakan diagnosis dan penentuan tatalaksana.Penelitian ini menggunakan data sekunder berupa rekam medik di Instalasi Rekam Medik RSUP Dr. Mohammad Hoesin Palembang.Didapat 143 pasien massa intrakranial periode 1 Januari 2013-31 Desember 2015, namun hanya 73 pasien yang  memenuhi kriteria inklusi untuk dijadikan sampel penelitian. Penurunan visus merupakan kelainan mata terbanyak. Mayoritas pasien memiliki visus buruk. Kelainan kedudukan bola mata terbanyak adalah eksotropia.Kelainan gerak mata terbanyak disebabkan oleh parese N. III.Defek lapang pandang terbanyak adalah hemianopsia bitemporal.Kelainan jaringan orbito-okular terbanyak adalah ptosis.Kelainan gambaran papil terbanyak adalah papiledema.
CORRELATION OF Hba1c LEVELS WITH PUPILLARY RESPONSE TO APRACLONIDINE 0,5% EYE DROPS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS Devi Azri Wahyuni; Nafila Mahida Sukmono; Erial Bahar
Majalah Kedokteran Sriwijaya Vol 52, No 3 (2020): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v52i3.12503

Abstract

Pupillary reflex abnormalities can result from disorders of the innervation or iris structure of the eye. In people with diabetes mellitus, the pupil size becomes smaller than normal due to neuropathy in innocent sympathetic innervation of the pupil. This neuropathy is associated as a manifestation of uncontrolled diabetes complications. Pupillary response is associated as a general indication of autonomic neuropathy disorders in diabetes mellitus patients. Apraclonidine as an ophthalmic sympathomimetic agent can cause mydriasis, which is likely to identify pupillary sympathetic denervation in type 2 diabetes mellitus patients. This study aimed to find out the correlation between HbA1c levels and pupillary response to 0.5% Apraclonidine eye drops in diabetes mellitus type 2 patients at Mohammad Hoesin Hospital Palembang. Observational research with a correlation test design to investigate the correlation of HbA1c levels with pupillary response to apraclonidine 0.5% eye drops in patients with type 2 diabetes mellitus has been conducted from March to May 2019. The study sample met the inclusion and exclusion criteria of 31 diabetics mellitus type 2 with HbA1c level> 6.5% in the Eye clinic at the Mohammad Hoesin Palembang hospital. In this study 31 patients with type 2 diabetes mellitus with HbA1c levels >6.5 mg% were obtained. The average HbA1c level was 9.5 ± 1.4 mg%, which ranged from 7.6 - 12.6 mg%. The glycemic status of the patients in this study were all (100.0%) in an uncontrolled condition (HbA1c> 7.5 mg%). The estimated duration of diabetes mellitus is 2.7 ± 1.8 years, with a minimum value of 1 year and the largest being 8 years. The average change in pupillary diameter before - after dropping 0.5% apraclonidine was 1.16 ± 1.06 mm, ranging from 0 - 4 mm. There were 9 (29.0%) eyes that did not show any changes. Significant enlargement of pupillary size after dropping 0.5% apraclonidine (p = 0,000). This change in pupil size correlated with the estimated duration of diabetes mellitus (r = 0.436, p = 0.014) and HbA1c levels (r = 0.492, p = 0.005). Pupil size after using 0.5% apraclonidine has a distribution value of 4 (3-6) mm can be interpreted that there are subjects who have no change, but there are patients who have pupils dilated to 6 mm.
CORRELATION BETWEEN ETHAMBUTOL THERAPY DURATION AND ZINC SERUM LEVEL WITH COLOUR VISION DEFICIENCY IN TUBERCULOSIS PATIENTS Devi Azri Wahyuni; Mira Retna Tetiana; Mgs Irsan Saleh; Ahmad Rasyid
Majalah Kedokteran Sriwijaya Vol 52, No 2 (2020): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v52i2.11975

Abstract

Tuberculosis is one of the most common disease in Indonesia. Ethambutol is one of the main regiment therapy for patient with tuberculosis. Duration of ethambutol therapy depends on what category of tuberculosis patient. Ethambutol intake can cause optic neuropathy with colour vision deficiency as an early symptom. Ethambutol therapy can also cause decrease of zinc serum level and it is cause by zinc chelate that can be found in ethambutol. The purpose of this study was to determine the correlation between duration of ethambutol therapy and zinc serum level with colour vision deficiency which examined with Farnsworth Munsell 100 Hue in tuberculosis patients. This is an observational explorative study. Colour vision is xamined with Farnsworth Munsell 100 Hue and zin serum level is detected by blood sample. Data was analyzed by correlation study. Correlation statistic between ethambutol therapy duration with colur vision using Spearman coreelation study found that r = 0,5 and p = 0,00, whereas in correlation between zinc serum level with colour vision found that r = 1,68 and p = 0,32. There is significant correlation and positive direction between ethambutol therapy duration with colour vision deficiency. Even though there is no significant correlation between zinc serum level with colour vision deficiency, there is a strong correlation.
COMPARISON OF COPPER LEVEL AND COLOR VISION IN PULMONARY TUBERCULOSIS PATIENTS BEFORE AND AFTER ETHAMBUTOL TREATMENT IN CATEGORY I AND II Devi Azri Wahyuni; Febria Restissa; Ahmad Rasyid; Erial Bahar
Majalah Kedokteran Sriwijaya Vol 52, No 2 (2020): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v52i2.11969

Abstract

Copper as a metal chelator in ethambutol may interfere oxidative phosphorylation and mitochondrial function that are useful in the formation of ATP, so that long-term damage can cause apoptosis and interfere color vision. This study aims to determine the correlation between duration of ethambutol and copper levels in serum with color vision disorder examined with Farnsworth Munsell 100 Hue (FM100) in patients with tuberculosis. This study was an explorative observation of 20 samples during November 2017 - January 2018 period. Comparative analysis using independent t-test, paired t-test, Wilcoxon test and Mann-Whitney test, while correlation analysis using Spearman's test and Pearson's test. There was a significant difference of FM100value before and after in category I (p=0.000) with increase of total error value 11.80+5.31 or category II (p=0.000) with increase of total error value 15.00+7.41. There was significant difference of Cu2+  level before and after in category I (p=0.005) with decrease of  Cu2+ level 15.57+5.04 mg/dL or category II (p=0.005) with decrease of  Cu2+ level 31.66+7.35 mg/dL. The duration of Ethambutol was related to changes in color vision examined with FM100.
Comparison of Copper Level and Color Vision in Pulmonary Tuberculosis Patients Before and After Ethambutol Treatment in Category I and II Febria Restissa; Ahmad Rasyid; Devi Azri Wahyuni
Sriwijaya Journal of Ophthalmology Vol. 3 No. 1 (2020): Sriwijaya Journal of Ophthalmology
Publisher : Department of Opthalmology, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (167.702 KB) | DOI: 10.37275/sjo.v3i1.39

Abstract

Introduction: to determine the correlation between duration of ethambutol and copper levels in serum with color vision disorder examined with Farnsworth Munsell 100 Hue (FM100) in patients with tuberculosis. Methods: This study was an explorative observation of 20 samples during November 2017 - January 2018 period. Comparative analysis using independent t-test, paired t-test, Wilcoxon test and Mann-Whitney test, while correlation analysis using Spearman's test and Pearson's test. Results: There was a significant difference of FM100 value before and after in category I (p=0.000) with increase of total error value 11.80+5.31 or category II (p=0.000) with increase of total error value 15.00+7.41. There was significant difference of Cu2+ level before and after in category I (p=0.005) with decrease of Cu2+ level 15.57+5.04 mg/dL or category II (p=0.005) with decrease of Cu2+ level 31.66+7.35 mg/dL. There was significant correlation between color vision and duration of ethambutol (p=0.000), but there was no significant correlation of Cu2+ with color vision (p>0.05). Conclusion: The duration of Ethambutol was related to changes in color vision examined with FM100.
Factors Affecting Generalization of Ocular Myasthenia Gravis in Palembang Zahratul Riadho Farid; Devi Azri Wahyuni
Sriwijaya Journal of Ophthalmology Vol. 3 No. 2 (2020): Sriwijaya Journal of Ophthalmology
Publisher : Department of Opthalmology, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjo.v3i2.55

Abstract

Introduction: Ocular myasthenia gravis (OMG) is an autoimmune disease which is characterized by weakness of extraocular muscles, levator palpebrae and orbicularis oculi, resulting in ptosis and binocular diplopia. Nearly all patients present with eyelid and extra ocular muscles involvement. Approximately 30% to 80% of patients with OMG experience a conversion to generalized myasthenia gravis (GMG) within 2 years. There are not only have ptosis and diplopia but also limb weakness,bulbar symptoms, or even respiratory failure. Objective: To observe the clinical features of OMG to GMG and risk factors and median time to conversion of OMG to GMG of myasthenia gravis patients in Dr. Mohammad Hoesin General Hospital Palembang. Methods: This study is a cohort retrospective study and the data were collected from the medical records of 91 patients who were registered as myasthenia gravis patients during September 2018 to March 2020. Sosiodemographic and clinical characteristics, including onset of OMG to GMG, history of smoking, presence of thymic abnormalities, and medications received were reviewed retrospectively. Results: A total of 91 OMG patients were observed in this study with 32 (35,2%) patients converted from ocular myastenia gravis to general myastenia gravis. Median conversion time to GMG was 34 months. Risk factor for convertion cases of OMG to MGG was receiving immunosupressive agents (Risk: 14.7, 95% CI 4.83, 44.7), thymus hyperplasia (Risk: 3.36, CI 95% 0.33, 33.6), Female (Risk: 2.41, 95% CI 0.94, 6.17), Smoking (Risk: 1.56, 95% CI 0.31, 7.81). Conclusion: Ptosis was the definitive sign for OMG in this study, with all patients had ptosis, thus it needs the colaboration from neuroophthalmologist and neurologist to diagnose and manage this case. Most of converted case was female and those who receive an immunosupressive agent therapy.
Visual Field Defect in Pulmonary Tuberculosis Patients with Ethambutol Therapy Agus Nugroho; Devi Azri Wahyuni
Majalah Oftalmologi Indonesia Vol 42 No 3 (2016): 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.v42i3.95

Abstract

Background: Ethambutol (EMB) is important as antimicrobal in the treatment of pulmonary TB which effects ethambutol toxic optic neuropathy (EON). EON can be detected with visual field examination. Research by Vimla Menon stated that toxicity condition of EMB obtained visual field defects by 7.69%. Currently, there is no data on visual field defects in patients with TB treated with (EMB) in Mohammad Hoesin Hospital (RSMH).Methods: This was a cross-sectional observational study with a follow-up studies without controls. The samples of this research was 24 and samples taken consecutive. Visual field examination using the Humphrey Field Analyzer was performed three times: before therapy, 1 month, and 2 months after EMB therapy. Data that can be carried out were analyzed by using SPSS program. Results: Average MD before administration of EMB was -2.36±1.21; average MD after 1 month administration of EMB was -2.35±1.41; and 2 months after was -3.09±1.85. There was a mean change of -0.73±1.43 MD 2 months after EMB administration. Abnormal MD enhancement of 6.52% occured 1 month after EMB administration and 28.26% 2 months after EMB administration. Arcuate visual field defects obtained 9.3% in 2 months after EMB aministration.Conclusion: There was no significant difference in visual field examination on the object before therapy and 1 month after EMB therapy. Examination after obtaining EMB for 2 months, based on the mean deviation of visual field defects, were minimal to moderate; while based on gray scale picture was obtained arcuate visual field defects.  Keywords: ethambutol, EON, visual field defect
The Alteration Visual Field Defect in Ischemic Stroke Patients After Three Months Therapy Frida Lestari; Devi Azri Wahyuni
Majalah Oftalmologi Indonesia Vol 42 No 3 (2016): 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.v42i3.99

Abstract

Background: Ischemic stroke are lack of blood flow to the brain and it could influence the visual field. Approximately more than half of the ischemic stroke patient have visual defect.Objective : Disturbance of blood flow on visual pathway have impact to the visual field defect.  In stroke ischemic patient, recirculation of penumbra at the brain on the third months after onset can  rehabilitate the visual pathway, also it will improve the outcome of visual filed defect. So it could be initial detection for rehabiltation of visual field defect.Methods: This study was intended to compere visual field defect of ischemic stroke patient after three months therapy conducted form September 2014 - February 2015 in Mohammad Hoesin General Hospital Palembang. A total of 12 patients who met the inclusion criteria were recruited by consecutive sampling. All patients were endure based on ophthalmology and visual field examination using Humphrey Field Analyzer twice. First after relieving from the attack of stroke and second after three months therapy. Measurement of standard have to compare the value of MD, VFI, PSD, PD and pattern visual field defect. Results: There were significant difference in value of MD, VFI, PSD  and PD<0,5% for both eyes on stroke ischemic patients after three months therapy. Almost all variable value were increasing to improvement of defect. The most common type of visual field defect  is homonymous hemianopia. Conclusion: There were improvement in visual field defect in patients with stroke ischemic after three months therapy.  Keywords: Ischemic stroke, visual field defect, penumbra, recirculation of brain, Mean Deviation (MD), Visual Field Index (VFI), Pattern Standard Deviasion (PSD), Pattern Deviation (PD)  Â