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All Journal Medical Journal of Indonesia Universa Medicina
Ratna Sitompul
Faculty of Medicine Universitas Indonesia, Jakarta
Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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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
Glaucoma and dry eye disease: the role of preservatives in glaucoma medications Sitompul, Ratna; Nora, Rina L.D.
Medical Journal of Indonesia Vol 20, No 4 (2011): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (631.315 KB) | DOI: 10.13181/mji.v20i4.467

Abstract

Glaucoma is a common cause of irreversible blindness with increasing prevalence. Some of glaucoma patients will also experience dry eye. Dry eye is the most frequent side effect related to benzalkonium chloride (BAC)-containing eye drop  used for glaucoma patients. In addition, glaucoma and dry eyes have shared risk factors that are old age and female. Dry eye among glaucoma patients need to be treated promptly as it produces discomfort, reduces patients’ compliance and   decreases success rate of glaucoma therapy. Dry eye symptoms can be treated by applying preservative-free eye drop, giving combination of preservative containing and preservative-free eye drop to reduce BAC exposure, prescribing artificial tear and conducting surgery to minimize or eliminate the need of topical medication. (Med J Indones 2011; 20:302-5)Keywords: benzalkonium chloride, dry eye, glaucoma
Effectiveness of Piper betle leaf infusion as a palpebral skin antiseptic Amalia, Husnun; Sitompul, Ratna; Hutauruk, Johan; Andrianjah, Andrianjah; Mun’im, Abdul
Universa Medicina Vol 28, No 2 (2009)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2009.v28.83-91

Abstract

The goal of an antiseptic is to eliminate or greatly reduce the number of microorganisms in the surgical field at the time of the surgery. The objective of this study was to verify the effectiveness of 20% Piper betle leaf infusion as an antiseptic solution in pre-surgery cataract patients. A clinical trial with partner-matching design was conducted on 31 pairs of eyelids. From each pair of eyelids, one eyelid was asigned to the Piper betle infusion group and the opposite one to the povidone-iodine group. The microorganisms were collected by swab from the patient’s palpebral skin, inoculated on nutrient agar, and incubated at 37oC for 20 hours. The antiseptic effectiveness was measured by counting the microbial colonies before and after administration of the antiseptic solutions. This study demonstrates that the mean colony counts after application of 20% Piper betle leaf infusion showed a significant reduction of 27-100% compared with those before administration (p=0.001). Mean colony counts after 10% povidone-iodine administration showed a significant reduction of 88-100% compared with the mean counts before the solution was applied (p=0.000). The 20% Piper betle infusion has an antiseptic potential. Nevertheless, the 10% povidone-iodine solution has more effective antiseptic capability.
The burden of ocular diseases in an underdeveloped village in Southwest Sumba, Eastern Indonesia, 2016 Sitompul, Ratna; Lestari, Yeni D.; Siregar, Simon; Ayudianingrum, Asti; Isfiyanto, Isfiyanto; Kusumowidagdo, Gladys; Sari, Della P.; Matiur, Eiko B.; Sungkar, Saleha
Medical Journal of Indonesia Vol 26, No 4 (2017): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (429.797 KB) | DOI: 10.13181/mji.v26i4.1808

Abstract

Background: Prevalence estimates of ocular diseases in a given district are important to plan the programs of eye care services. This study aimed to describe the burden of ocular diseases as an initial step in improving eye care services in underdeveloped areas in Indonesia.Methods: A cross-sectional study was performed among residents of Perobatang Village in Southwest Sumba district in July 2016. Eye examinations were conducted by ophthalmologists, and visual acuity was measured by optometrists. Participants were provided with appropriate treatment according to diagnosis. Surgical services were offered two months after the examination.Results: After eximining a total of 667 of 1,459 (46%) residents, the result showed that the most frequent ocular problems were presbyopia (30.8%), cataract (12.8%), refractive error (11.3%), and pterygium (10.7%). The proportion of myopia was 5.9%, hyperopia was 5.0%, and astigmatism was 2.2%. Moreover, the proportion of blindness was 10%. Cataract caused blindness in 44 participants. Other causes of blindness included age-related macular degeneration, retinopathy, optic atrophy, glaucoma, retinal detachment and trauma.Conclusion: The burden of ocular problems in Perobatang Village, Southwest Sumba, Eastern Indonesia was high. These findings showed the importance of public health action from local government and non-governmental organizations to improve eye care services in Southwest Sumba district.
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.
Hospital-based analysis of eye diseases at Karitas Hospital, Southwest Sumba, 2015 Sitompul, Ratna; Sungkar, Saleha
Medical Journal of Indonesia Vol 27, No 3 (2018): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (271.462 KB) | DOI: 10.13181/mji.v27i3.2686

Abstract

Background: This study aimed to determine the profile of eye diseases at Karitas Hospital in Southwest Sumba during 2015.Methods: The cross-sectional and descriptive study was conducted by analyzing medical records of 1706 patients who presented with eye complaints at Karitas Hospital, Southwest Sumba, in 2015. Complete medical records were recovered from 1363 patients, who served as subjects for this study.Results: Thirty-six percent of subjects were elderly (>55 years old) and 9.9% were children (<18 years old). Female patients comprised 56.4% of the study population and males 43.6%. Non-infectious eye diseases dominated (89.8%; 95%CI: 88.2%–91.4%) compared to infectious diseases (8.2%; 95%CI: 6.7%–9.7%) and mixed cases (2%; 95%CI: 1.3%–2.7%). Avoidable causes of blindness, cataract (34%), and refractive error (17.3%), were mostly found among non-infectious cases, while conjunctivitis (52.7%) and keratitis (17%) were the most commonly encountered infectious diseases.Conclusion: Eye diseases at Karitas Hospital in Southwest Sumba mostly comprised non-infectious diseases. The most commonly noted non-infectious diseases were cataracts and refractive errors, while conjunctivitis and keratitis were the most commonly found infectious diseases. Due to the high amount of patients seeking eye care within Southwest Sumba, ophthalmologists and proper equipment are needed at the Karitas Hospital.
Co-Authors Andrianjah Andrianjah, Andrianjah Ayudianingrum, Asti Husnun Amalia, Husnun Isfiyanto, Isfiyanto Johan Hutauruk Kusumowidagdo, Gladys Lukman Edwar Made Susiyanti Matiur, Eiko B. Mun’im, Abdul Muslim, Fitri Rina L.D. Nora Saleha Sungkar Sari, Della P. Siregar, Simon Soedarman Sjamsoe Yeni D. Lestari, Yeni D.