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All Journal Folia Medica Indonesiana Jurnal SainHealth Ophthalmologica Indonesiana
Reni Prastyani
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Biochemistry, Genetics & Molecular Biology Chemistry Health Professions Immunology & microbiology Medicine & Pharmacology Public Health Other

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CASE REPORT WAARDENBURG SYNDROME TYPE I WITH IRIS AND RETINAL COLOBOMA Atina Yustisia Lestari; Reni Prastyani
Jurnal SainHealth Vol 4, No 1 (2020): Maret 2020
Publisher : Faculty of Health Sciences Universitas Maarif Hasyim Latif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51804/jsh.v4i1.703.8-10

Abstract

We present a rare case report, Waardenberg syndrome type I, and ocular abnormalities related to the disease. A Boy, 11 months, presented with blue and hole in inferior iris. Patien also controlled to pediatric and ENT departement according his global developmental delayed, and unresponsiveness to sound stimulus since birth. Patient presented with distophia cantrorum, bilateral iris coloboma, brilliant blue iris, and retinal coloboma. Others systemic condition were skin hypopigmentation, bilateral sensorineural hearing lost, and global developmental delay equal to 6 months old baby. According to manifestations, this supporting diagnosis for Waardenberg syndrome type I. The management consists in treating the symptoms accordingly.  Careful follow up and work up is important to improve patient quality of life 
SURGICAL OUTCOME OF THREE MUSCLES SURGERY IN ONE SINGLE PROCEDURE OF LARGE-ANGLE EXOTROPIA: A CASE REPORT: Poster Presentation - Case Report - Resident Anas Jatikusuma; Reni Prastyani
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: 10.35749/9r4c5228

Abstract

Introduction : The management of large-angle horizontal strabismus poses special difficulties. Literature has outlined large-angle strabismus in a variety of ways. A threshold of 40 to 60 PD has been employed to determine large-angle strabismus. Case Illustration : A 19-year-old male with complaint of right eye that had been crossed outward since he was 12 years old. There was 90 prism diopter exotropia in near, distance, upgaze, and downgaze. The patient underwent bilateral lateral rectus recession of 10 mm and unilateral medial rectus resection of 6.5 mm in the right eye. Post-operative outcome revealed orthophoria without any misalignment of prism diopter examination in 1 day, one week, and two weeks follow-up. Discussion : When the deviation exceeds 50 prism diopter, there is no established consensus regarding the number and quantity of extraocular rectus muscles for surgery. The lack of uniform criteria and suggested surgical dosage is the greatest obstacle in using three muscles surgery. In this case, we used surgical dose according to Kenneth Wright exotropia binocular surgery table. We performed bilateral rectus lateral recession of 10 mm and a right rectus medial resection of 6.5 mm. This surgical dose gives good outcome. Moreover, this option can leave one horizontal rectus muscle unharmed. Conclusion : Determination of the surgical dose is essential in the management of large-angle exotropia. Appropriate surgical dose results in excellent outcomes with low risk of residual deviation.
LARGE V PATTERN EXOTROPIA WITH BILATERAL INFERIOR OBLIQUE OVERACTION AND ITS CHALLENGING MANAGEMENT: Poster Presentation - Case Report - Resident Amelia Rahmah Kartika; Reni Prastyani
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/hhv5ax77

Abstract

Introduction : V pattern exotropia is a strabismus pattern with greater divergence in upgaze than downgaze. Various surgical treatment options were defined. This report demonstrates the management of largeV pattern exotropia with bilateral inferior oblique overaction (IOOA) by performing multiple surgeries. Case Illustration : A 20-year-old male came with a chief complaint of squinting eyes outward in both eyes since 9 years old. There was 90 PD exotropia in upgaze, 70 PD in primary gaze, 50 PD in downgaze. Bilateral IOOA grading was +3. Management in this patient was bilateral rectus lateral recession with partial hang back technique 11 mm and inferior oblique anteriorization of both eyes 1 mm posterior to inferior rectus muscle insertion. The IOOA on both eyes was eliminated post-operative, but there was 30 PD residual exotropia. The second step will be bilateral medial rectus resection. Discussion : A large V pattern with IOOA is challenging for management because it requires surgery of 2 muscles for each eye. The lateral rectus and inferior oblique muscles are close, so it was advantageous to operate simultaneously. Large exotropia requires surgery on many muscles, however operating on more than two muscles in one eye at a time can cause anterior segment ischemia. Therefore, bilateral medial rectus resection for residual exotropia will be done at different times. Conclusion : Large V pattern exotropia with inferior oblique overaction is a challenging case to manage. Due to its complex nature, it is advantageous to operate adjacent muscles.
Binocular Diplopia in Miller Fisher Syndrome Pediatric Patient: A Rare Case Report: Poster Presentation - Case Report - Resident Dinda Zhafira; Reni Prastyani; Prastiya Indra Gunawan; Riza Noviandi; Sunny Mariana Samosir
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: 10.35749/36zz6w74

Abstract

Introduction : Miller Fisher Syndrome (MFS) is a rare variant of Guillain-Barré syndrome that usually presents with ataxia, areflexia and ophthalmoplegia. It is more common among patients in their 40s and number of cases in pediatric patients is significantly smaller. Our objective is to report a rare case of diplopia in Miller Fisher. Case Illustration : An 11 years old boy came with complaint of double vision and history of gaze restriction. Patient had history of inpatient admission due to acute progressive generalized limb weakness and walking difficulty followed by respiratory failure. Patient also had history of chewing and swallowing difficulty. Inpatient treatment included intravenous immunoglobulin (IVIG) for 5 days which resultedin clinical improvement. Electromyography examination done while hospitalization showed normal results. Orthoptic examination revealed 15 degrees exotropia of left eye with 30 prism dioptres (PD) at near and far distance. Worth four dot test resulted in cross diplopia with no abnormality in head CT scan. After 2 months follow-up with push-up pencil exercise, patient showed improvement of symptoms. Discussion : MFS is a clinical diagnosis that can be assessed by clinical triad of ataxia, areflexia and ophthalmoplegia. Diagnosis can be supported by ancillary test such as cerebrospinal fluid analysis, electrophysiologic studies or antibody anti-GQ1b . Treatment of MFS are mainly for supportive care with respiratory support and immunotherapy if needed in severe cases. Conclusion : The outcome of MFS is usually good with a complete recovery. The improvements generally begin within two to four weeks after the onset of neurological symptoms and complete within six months.
A GOOD RESULT IN COMBINATION OF LARGE SUPERIOR RECTUS RECESSION AND PRISMATIC GLASSES IN UNILATERAL DISSOCIATION VERTICAL DEVIATION: A CASE REPORT: Poster Presentation - Case Report - Resident Nur Fitriana Corprianti Marchilia; Reni Prastyani
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/wgjfj090

Abstract

Introduction : Severe DVD is one of the indications for surgery. There are guidelines recommended for management based on grading of severity and the surgeon’s preference. Large recession of superior rectus muscle and prismatic glasses yield good result in unilateral DVD reported in this paper. Case Illustration : A 21 year-old student stated difficulty in working with his microscope since 2 years ago. He had a history of double vision since childhood. The visual acuity in both eyes were 5/5. Qualitative strabismus examination resulted in hypertropia RE and intermittent exotropia. When the occluder was removed from RE, a non fixating eye would appear elevated and did not correspond with the contralateral eye hypotropia. Krimsky test revealed RE hypertropia 30? PD, exotropia 10? PD. Sensory evaluation using WFDT was normal in near and crossed diplopia in distance. Patient diagnosed with unilateral DVD then underwent superior rectus recession in 10 mm. The following month, patient was still experiencing vertical diplopia. The patient was given 3 PD prismatic glasses. Consequently, diplopia was absent and stereoacuity test using TNO was 480 seconds of arch Discussion : DVD can’t be fully corrected by surgery due to central cortical innervational problem. The residual symptom can be corrected by conservative management. Large SR recession in combination with prismatic glasses was found to improve vertical deviation and reduce diplopia. Conclusion : While large superior rectus recession can significantly improve vertical deviation, it can not completely remove binocular symptom
Significant Role of Thyroid Stimulating Hormone in the Clinical Activity Score of Thyroid Eye Disease at a Tertiary Hospital in Surabaya, Indonesia Hasna Shahida Amatlulloh; Delfitri Lutfi; Soebagijo Adi Soelistijo; Reni Prastyani; Muhammad Valeri Alhakiim
Folia Medica Indonesiana Vol. 60 No. 1 (2024): March
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/fmi.v60i1.52948

Abstract

Highlights:1. This study, conducted at a tertiary hospital, was the first to analyze the correlation between thyroid status and clinical activity score in thyroid eye disease.2. This study offers valuable information regarding the crucial role of thyroid stimulating hormone (TSH) in determining the clinical activity score of thyroid eye disease.   Abstract Thyroid eye disease is an autoimmune disorder characterized by inflammation of the orbital and periorbital tissues. This condition can lead to vision impairment, which is a notable manifestation of thyroid disease. The symptoms of thyroid disease reflected the level of inflammatory activity, whereas the clinical activity score was indicative of active and inactive phases. This retrospective analysis explored the intricate association between thyroid status and clinical activity score in thyroid eye disease patients, with the hope of providing a foundation for further research on the association between thyroid status and the occurrence of TED. This study utilized medical records from the years 2019 to 2022 from the Outpatient Department of Ophthalmic Oncology of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. The variables examined in this study were thyroid status and the clinical activity score of thyroid eye disease. The statistical analysis was performed using Phi and Cramer's V as well as Spearman's correlation test (p<0.05). A total of 88 patients were diagnosed with thyroid eye disease during the study period. Thyroid eye disease primarily affected female patients (58%) and those who had a mean age of ≥41 years (58%). The Phi and Cramer's V analyses indicated no significant association (p > 0.05) between thyroid status and clinical activity score in thyroid eye disease patients. Intriguingly, the results exhibited the presence of euthyroidism as well as both overt and subclinical hypothyroidism and hyperthyroidism, regardless of the clinical activity score. Additionally, the Spearman test that incorporated the levels of thyroid hormones, i.e., triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH), and free thyroxine (FT4), showed a significant negative correlation (p<0.05) between TSH and clinical activity score. In conclusion, THS plays a crucial role in determining the clinical activity score of thyroid eye disease patients. This study underscores the imperative for further research to comprehensively elucidate the intricate correlation between TSH and clinical activity score.
Co-Authors Amelia Rahmah Kartika Anas Jatikusuma Atina Yustisia Lestari Delfitri Lutfi Dinda Zhafira Hasna Shahida Amatlulloh Muhammad Valeri Alhakiim Nur Fitriana Corprianti Marchilia Prastiya Indra Gunawan Riza Noviandi Soebagijo Adi Soelistijo Sunny Mariana Samosir