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All Journal Medical Journal of Indonesia Cermin Dunia Kedokteran
Lukman Edwar
Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
Health Professions Medicine & Pharmacology Public Health

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Various factors affecting the bacterial corneal ulcer healing: a 4-years study in referral tertiary eye hospital in Indonesia Asroruddin, Muhammad; Nora, Rina L.D.; Edwar, Lukman; Sjamsoe, Soedarman; Susiyanti, Made
Medical Journal of Indonesia Vol 24, No 3 (2015): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (382.419 KB) | DOI: 10.13181/mji.v24i3.1044

Abstract

Background: Corneal ulcer is one of the most common causes of visual acuity impairment and blindness all over the world. The aim of the study was to evaluate various factors affecting the bacterial corneal ulcers healing, including the predisposing factors, causative organisms, antibiotic sensitivity, as well as the treatment outcomes.Methods: All data were taken retrospectively from medical records of patients who underwent corneal scraping for Gram examination and/or culture over a-4-year period (2008-2011) at the Cipto Mangunkusumo Hospital Jakarta. Treatment outcome were analyzed using Chi-square test, one-way ANOVA, and post-hoc analysis. Mean time required for complete epithelial healing was also investigated.Results: 220 cases of bacterial corneal ulcers in 216 patients were included. The most common risk factors were ocular trauma (45.8%). Gram-positive coccus were found in 65.7% cases other than other microbes. Pseudomonas sp. (25,0%) and Staphylococcus epidermidis (18.4%) were the most common isolates, sensitive to almost all kinds of antibiotics. About 83.0% (106 cases) were improved with antibiotics only, the rest were not improved and worsened. Mean time for complete epithelial healing was 17.5 ± 8.9 days with mild ulcer had the most rapid recovery. Eyes treated with fluoroquinolone eyedrops were healed in 14 days, faster than other regiments.Conclusion: Ocular trauma was the most common risk factor for corneal ulcer, and the most commonly isolated organism was Pseudomonas sp. Most cases were improved with antibiotics, and fluoroquinolone showed faster healing. Complete epithelial healing occurred in about 17.5 days.
Clinical characteristic and therapy results of presumed ocular tuberculosis and their relation to HIV status Nora, Rina L.D.; Sitompul, Ratna; Susiyanti, Made; Edwar, Lukman; Sjamsoe, Soedarman
Medical Journal of Indonesia Vol 21, No 4 (2012): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (507.984 KB) | DOI: 10.13181/mji.v21i4.509

Abstract

Background: Ocular tuberculosis (TB) emerges as an important cause of intraocular inflammation, partly due to the increasing number of HIV/AIDS patients. This study attempts to identify ocular signs that are associated with ocular TB and assess the efficacy of the treatment and their relation to HIV status.Methods: Medical records of all 56 patients diagnosed with presumed ocular TB in Cipto Mangunkusumo Hospital between January 2006 and December 2011 were reviewed. Demographic and clinical characteristics and HIV status were recorded as well as efficacy of treatments given.Results: There were 39 patients included with mean age 35.38 ± 13.1 and male to female ratio was 2:1. Unilateral involvement was in 26 (66.7%) patients. From all, four (10.3%) had anterior uveitis, 14 (35.9%) posterior uveitis, 21 (53.8%) panuveitis, and none had intermediate uveitis. Most of them (32/82.1%) have concurrent other organ TB. Five out of 8 (62.5%) HIV positive patients had granulomatous inflammation and 3 (37.5%) had non-granulomatous inflammation and all eight of them had concurrent other organ TB. The other 7 known non-HIV patients, six (85.7%) have non-granulomatous inflammation. Treatment with anti-tubercular therapy (ATT), combination ATT and steroid or steroid alone increased visual acuity. However steroid alone was slightly have more frequent recurrences (1.4 ± 0.89 episodes of inflammation).Conclusion: Ocular TB in our study had variable clinical manifestations and ocular inflammation was predominantly non-granulomatous in HIV negative patients and granulomatous in HIV infected patients. All HIV positive patients the ocular TB was always accompanied by manifestations in other organs. The treatment with steroids solely resulted in improved vision but was characterized by frequent recurrences. (Med J Indones. 2012;21:214-9)Keywords: HIV/AIDS, ocular tuberculosis, uveitis
Acanthamoeba keratitis: a challenge in diagnosis and the role of amniotic membrane transplant as an alternative therapy Muslim, Fitri; Sitompul, Ratna; Edwar, Lukman
Medical Journal of Indonesia Vol 27, No 4 (2018): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (451.082 KB) | DOI: 10.13181/mji.v27i4.2007

Abstract

Acanthamoeba keratitis (AK) is a very rare, sight-threatening corneal disease caused by the infection of a free-living amoeba. The aim of this report was to demonstrate the challenges in the diagnosis of AK with an atypical presentation. Amniotic membrane transplantation (AMT) was done in this case to accelerate wound healing. A woman who frequently used contact lens came with redness and a whitish spot in her left eye 2 weeks before admission. There was a history of rinsing contact lens in tap water. The patient had already been on a topical steroid for 2 weeks. Visual acuity of the left eye was light perception with wrong projection. Examination of the left cornea showed a semi-circular central ulcer with a 5.8-mm area and 1/3 stromal depth. It is surrounded by a feathery-edge infiltrate with positive satellite lesions but without hypopyon. It was diagnosed as corneal ulcers due to mixed infection (bacteria and fungi). After 2 weeks of bacterial and fungal therapy, the size of the ulcer decreased, but the corneal infiltrate remained; therefore, an Acanthamoeba culture was done to determine the possibility of Acanthamoeba infection. Two weeks after the Acanthamoeba topical therapy, the visual acuity improved. AMT was performed to accelerate wound healing. Two months post-AMT, visual acuity improved to 1/60 with no conjunctival or ciliary vasodilation, and the ulcer was resolved. The patient was planned to undergo keratoplasty. The diagnosis of AK with an atypical presentation is challenging. AMT can be used as an alternative therapy to accelerate wound healing.
Efek Tetes Mata Kombinasi Sodium Hialuronat dan Hydroxypropyl-Guar terhadap Stabilitas Lapisan Air Mata pada Mata Kering Terkait Sindrom Sjögren Priya Darsini, Indira; Edwar, Lukman; Rengganis, Iris; -, Lisnawati; Prihartono, Joedo
Cermin Dunia Kedokteran Vol 46, No 1 (2019): Obstetri - Ginekologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (798.864 KB) | DOI: 10.55175/cdk.v46i1.539

Abstract

Penelitian ini bertujuan untuk menilai stabilitas lapisan air mata pada mata kering terkait sindrom Sjögren (SS) yang diberi terapi tetes mata kombinasi sodium hialuronat 0,1% (SH) dan hydroxypropyl (HP)-guar, atau monoterapi tetes mata sodium hialuronat (SH). Sebanyak 17 pasien SS dibagi dalam 2 kelompok. Kelompok pertama mendapat kombinasi SH dan HP-guar, kelompok kedua mendapat terapi SH. NIKBUT, Schirmer, skor pewarnaan okular, dan sitologi impresi, serta keluhan subjektif dinilai sebelum dan sesudah pemberian obat. Setelah terapi selama 28 hari, terdapat peningkatan median NIKBUT, Schirmer, skor pewarnaan okular, densitas sel Goblet, dan perbaikan keluhan subjektif pada mata kering terkait SS.The objectives of the study is to assess the stability of dry eye LAM associated with Sjögren syndrome (SS) during combination therapy of sodium hyaluronate 0.1% (SH) and hydroxypropyl (HP) -guar, or monotherapy sodium hyaluronic (SH). A total of 17 SS patients in this study were divided into 2 groups. The first group received a combination of SH and HP-guar while the second group received SH therapy. NIKBUT, Schirmer, ocular staining score, and impression cytology, as well as subjective complaints was assessed before and after drug administration. After 28 days of therapy, there was a median increase in NIKBUT, Schirmer, ocular staining scores, Goblet cell density, and subjective complaints on SS-related dry eyes. 
Co-Authors -, Lisnawati Iris Rengganis Joedo Prihartono Made Susiyanti Muhammad Asroruddin, Muhammad Muslim, Fitri Priya Darsini, Indira Ratna Sitompul Rina L.D. Nora Soedarman Sjamsoe