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A Tear Inflammatory Biomarker in Dry Eye Disease Ni Made Inten Lestari; Evelyn Komaratih; Yuyun Rindiastuti; Cita Rosita Sigit Prakoeswa
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17613

Background: Dry eye disease is a chronic ocular condition and significantly impacts visual function with multifactorial origin. It is characterized by tear instability and inflammation on the ocular surface. The inflammatory response initiates by synthesis and release of cytokines, Recently, there has been increasing scientific interest using tear film biomarkers that play a role in pathophysiology of dry eye disease. The objective of this study to explain relationship of tear film biomarker in dry eye.Methods: The research design of this study used literature review. The data was collected from electronic database in PubMed, Google Scholar, and website of science and predominantly published in the last 10 years.Result: The defect on the tear film component due to oxidative stress lead to ocular surface epithelial exposure, and intracellular signaling pathways are triggered, involving an inflammatory mediator which plays a role in the pathophysiology of dry eye. Using biomarker lead to better diagnosis, drug development, and effective management for dry eye disease.Conclusion: In conclusion, TNF-a, IL-6, IL-8, IL-1 by number studies to consistently reflect disease severity and strong correlation with schirmer tear test and another test for the ocular surface in dry eye disease.

THE ROLE OF OCULAR BLOOD FLOW IN THE PATHOGENESIS OF GLAUCOMA Yulia Primitasari; Evelyn Komaratih
Jurnal Kedokteran Syiah Kuala Vol 19, No 1 (2019): Volume 19 Nomor 1 April 2019
Publisher : Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/jks.v19i1.18052

Abstract. Glaucoma is currently the second leading cause of blindness worldwide and the prevalence is expected to increase. Despite lowering of IOP, vascular risk factors, genetics, and other systemic conditions could progress the glaucoma damage. Ocular blood flow has emerged as an increasingly prevalent glaucoma risk factor in large population-based trials. Abnormal perfusion and the subsequent ischemia of the ONH play a major role in the glaucomatous damage. Ocular Blood flow is unstable if IOP fluctuates on a high enough or blood pressure on a low enough level to exceed temporarily the autoregulation capacity. IOP fluctuation is also related to both an increase in scotomas and an increase in diffuse visual fields damage. OBF is unstable if autoregulation itself is disturbed. In glaucoma the response of retinal and optic nerve head blood flow to flicker stimulation is reduced. Primary vascular dysregulation appears to be associated with abnormal retinal neurovascular coupling, because vasospastic subjects show a reduced response to flicker stimulation.Keywords: ocular blood flow, glaucoma

The Effect of Subconjunctival Bevacizumab on Angiogenesis in Rabbit Model Nurwasis Nurwasis; Diana Yuliawati; Evelyn Komaratih; Heriyawati Heriyawati
Folia Medica Indonesiana Vol. 55 No. 4 (2019): December
Publisher : Universitas Airlangga

The wound healing process is major cause of glaucoma surgery failure and enhances the incapability of controlling the IOP. This aim of study was to evaluate the angiogenesis effect of Bevacizumab injection on the amount and density of blood vessels in the rabbit model after trabeculectomy. It was a true experimental study using 16 eyes of 16 New Zealand White Rabbit (Oryctolagus cuniculus) that divided into two groups. The control group was treated with 0.05 ml of Balanced Saline Solution (BSS). The experimental group was treated with subconjunctival injection of 1.25 mg Bevacizumab in 0.05 BSS. All rabbit was sacrificed, and the eye was enucleated. Thus, the bleb area was dissected after 14 days. Histopathological analysis was performed to evaluate the amount and density of blood vessels. The mean amount of blood vessels in the control group was 22.63 ± 11.02, and the experimental group was 14,75 ± 4.92 (p=0.043). The mean of blood vessel density in the control group was 19.10 ± 1.69 %, and the experimental group was 16.53 ± 2.90 % (p=0.029)%. There was a statistically significant difference between the two groups (p<0.05). Subconjunctival bevacizumab in the rabbit model reduces the amount and density of blood vessels compared with subconjunctival BSS injection.

Profile of Secondary Glaucoma at a Tertiary Hospital in East Java Evelyn Komaratih; Yuyun Rindiastuti; Yulia Primitasari
Folia Medica Indonesiana Vol. 56 No. 1 (2020): March
Publisher : Universitas Airlangga

Glaucoma is the leading cause of irreversible blindness. The aim of this study was to review the profile of secondary glaucoma cases visiting a tertiary hospital in East Java. This is retrospective observational study, completed case records of new patients with secondary glaucoma who presented to glaucoma clinic from January 2014 to April 2016 were included. Out of the 363 case records screened, 66 cases were found to eligible for inclusion. The evaluation included a detailed history and examination performed including vision, anterior segment examination, intraocular pressure (IOP), gonioscopy, and fundus evaluation. Diagnosis of secondary glaucoma was made on the basis of presence of a secondary cause for presence of raised IOP. 66 cases were eligible for inclusion in the study, most of the cases was occurred in the range age 21-50 years. The male female ratio was 1.3:1. Frequent causes of secondary glaucoma were lens factor 30.8%, steroid induced 29.5%, uveitic 20.5%, neovascular15.4%, and surgical complication 3.8%. Most patients with secondary glaucoma have poor vision < 0.1 with high IOP at presentation. Assessment and early detection of underlying cause is the key guide to treatment strategy.

Matrix Metalloproteinase-3 Down Regulation and Cell Migration Inhibition in Human Pterygium Fibroblasts by Mitomycin-C, Curcumin and Fibrin Glue Ferdian Ramadhan; Jamaluddin Jamaluddin; Ismi Zuhria; Luki Indriaswati; Evelyn Komaratih
The Indonesian Biomedical Journal Vol 14, No 2 (2022)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v14i2.1825

BACKGROUND: Pterygium is an ocular surface disease that often occurs in tropical countries with a high recurrence rate. Matrix metalloproteinase-3 (MMP-3) play a key role in the inflammatory process of pterygium. This study aims to investigate the ability of curcumin and fibrin glue (FG) in suppressing the expression of MMP-3, and whether can be expected as adjuvant therapy to reduce pterygium recurrence.METHODS: Human pterygium fibroblasts (HPF) obtained from primary cultured of pterygium were treated with no treatment, curcumin, mitomycin-C (MMC), and FG. MMP-3 expression was analyzed using immunocytochemistry and the intensity measurement was done using ImageJ software. Cell migration was measured by scratching and stratification of fibroblast culture after cell confluence, and assessed for 48 hours.RESULTS: The expression of MMP-3 were lower in the HPF treated with 100 mol/mL curcumin, 200 mol/mL, and FG (2205.84±86.1 pg/mL, 1002.51±25.22 pg/mL, 1131.55±17.71 pg/mL, respectively) in comparison with untreated HPF (4703.49±108.9 pg/mL). The expression of MMP-3 were significantly different between groups (p<0.001). Cell migration of HPF after scratching with curcumin intervention at 200 mol/mL decrease from 178.67±2.85 (24 hours) to 88.83±1.48 (48 hours). Meanwhile the migration in FG group also decrease from 180.4±2.56 (24 hours) to 72.45±1.25 (48 hours).CONCLUSION: Curcumin and FG able to reduce the expression of MMP-3 and inhibit the migration of HPF cells.KEYWORDS: curcumin, mitomycin C, fibrin glue, human pterygium fibroblast, MMP-3

Anti-Inflammation and Anti-Fibrotic Effects of Amniotic Membrane on Post-Trabeculectomy Conjunctiva (Experimental Research on Oryctolagus cuniculus) Listya Dyah Rihardini; Suparman Suparman; Evelyn Komaratih
Majalah Oftalmologi Indonesia Vol 42 No 2 (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.v42i2.89

Background: To evaluate the effects of amniotic membrane transplantation on the modulation ofwound healing after trabeculectomy.Methods: Eighteen eyes of nine New Zealand rabbits: nine left eyes underwent glaucoma filteringsurgery, nine right eyes underwent trabeculectomy and amniotic membrane transplantation. Freshfrozen human amniotic membranes were transplanted above scleral flap, below the conjunctiva withthe stromal side-up. Daily examination of anterior segment were performed using hand held slit lamp.After 7 days, all eyes were enucleated and sent for histopathology examination to evaluate theinflammatory and fibroblast cells. The rabbits were terminated. Blebs were well formed until 7 days.Results: There were statistically no significant difference between two groups in quantity ofinflammatory cells (p=0.258) and fibroblast cells (p=0.436). The tendency in the treatment group,however, the Massonâ€™s Trichrome obtained less fibrosis (88.9%) compared to the control group(44.4%). Hematoxilin eosin staining revealed inflammatory reaction tends to be more severe than thecontrol group, suggesting a xenograft rejection.Conclusion: AMT is still potential as an alternative option to reduce fibrosis in glaucoma filteringblebs but need further research. In rabbits, human amniotic membrane elicited a xenograft reaction.Keywords: amniotic membrane, trabeculectomy, inflammation, fibrosis

A Rare Case of Chronic Primary Angle-Closure Glaucoma in a Young Woman with Coexisting Pathologic Myopia Ni Putu Ayu Reza Dhiyantari; Nurwasis Nurwasis; Evelyn Komaratih; Yulia Primitasari
Vision Science and Eye Health Journal Vol. 1 No. 1 (2021): Vision Science and Eye Health Journal
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga

Introduction: Primary Angle-Closure Glaucoma (PACG) is usually present in adults older than forty and is more common in hyperopic eyes. Angle-closure is usually related to structural or developmental ocular abnormalities in young individuals. Case presentation: We presented a rare case of PACG in a 32 years old woman with pathologic myopia of -23.0 RLE. The chief complaint was blurring of the right eye three months before the visit. Right eye Intraocular Pressure (IOP) was 30mmHg-38mmHg despite treatment with three intra-ocular pressure-lowering agents. Axial length was 32.36 mm and 31.19 mm RLE. Anterior chamber depth was 2.36 mm and 2.60 mm RLE. Lens thickness was 5.07 mm and 5.40 mm RLE. Signs of GON and pathologic myopia were found in both eyes. GON was present asymmetrically (0.9 and 0.6 RLE), with the myopic crescent as well as baring and peripapillary atrophy. The optic disc was slightly tilted with the myopic crescent. There was also a marked sign of retinal pigment epithelium thinning and attenuation along with myopic chorioretinal atrophy. Conclusions: PACG in a young myopic individual is challenging to diagnose because myopia and glaucoma share similar optic nerve head pathology. Comprehensive examinations including gonioscopy, biometry, and OCT may confirm the diagnosis. In the presented case, angle-closure was caused by thick lenses and a shallow anterior chamber, along with excessively long axial length. Primary angle-closure at a young individual with myopic eyes is highly uncommon. Nonetheless, clinicians should always consider glaucoma even in the presence of high axial length and myopic fundus.

The Difficulties of Trabeculectomy in a Primary Angle-Closure Glaucoma Patient Herdina Ramadhani; Nurwasis Nurwasis; Yulia Primitasari; Evelyn Komaratih
Vision Science and Eye Health Journal Vol. 1 No. 2 (2022): Vision Science and Eye Health Journal
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga

Introduction: Trabeculectomy is an incisional surgery for glaucoma patient. Performing trabeculectomy in primary angle-closure glaucoma (PACG) is quite difficult. Caution is needed for the occurrence of flat anterior chamber (FAC) and malignant glaucoma. We present a case management of trabeculectomy in a PACG patient. Case presentation: A 52-year-old male had blurred vision in his left eye since one year ago. The patient felt left visual field narrowing since eight months ago. Patient had type 2 diabetes mellitus. Visual acuity on the left eye was 5/7.5. Intraocular pressure (IOP) increased (29 mmHg). Gonioscopy showed closed angle and peripheral anterior synechiae. Glaucomatous optic neuropathy was found with C/D ratio value of 0.9 and superior-inferior RNFL thinning on optical coherence tomography (OCT). Anterior segment OCT revealed shallow anterior chamber depth (ACD) 2.54 mm. The right eye visual acuity was 5/5, normal IOP, and shallow ACD (2.66 mm). Patient was underwent left eye trabeculectomy. Postoperatively, left eye anterior chamber and bleb were formed. He had normal IOP without glaucoma medications. Conclusions: Trabeculectomy is a surgical procedure for glaucoma. Close monitoring is required to avoid the risk of postoperative FAC and malignant glaucoma in PACG.

Anti-Inflammation and Anti-Fibrotic Effects of Amniotic Membrane on Post-Trabeculectomy Conjunctiva (Experimental Research on Oryctolagus cuniculus) Listya Dyah Rihardini; Suparman Suparman; Evelyn Komaratih
Majalah Oftalmologi Indonesia Vol 42 No 2 (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.v42i2.89

Background: To evaluate the effects of amniotic membrane transplantation on the modulation ofwound healing after trabeculectomy.Methods: Eighteen eyes of nine New Zealand rabbits: nine left eyes underwent glaucoma filteringsurgery, nine right eyes underwent trabeculectomy and amniotic membrane transplantation. Freshfrozen human amniotic membranes were transplanted above scleral flap, below the conjunctiva withthe stromal side-up. Daily examination of anterior segment were performed using hand held slit lamp.After 7 days, all eyes were enucleated and sent for histopathology examination to evaluate theinflammatory and fibroblast cells. The rabbits were terminated. Blebs were well formed until 7 days.Results: There were statistically no significant difference between two groups in quantity ofinflammatory cells (p=0.258) and fibroblast cells (p=0.436). The tendency in the treatment group,however, the Massonâ€™s Trichrome obtained less fibrosis (88.9%) compared to the control group(44.4%). Hematoxilin eosin staining revealed inflammatory reaction tends to be more severe than thecontrol group, suggesting a xenograft rejection.Conclusion: AMT is still potential as an alternative option to reduce fibrosis in glaucoma filteringblebs but need further research. In rabbits, human amniotic membrane elicited a xenograft reaction.Keywords: amniotic membrane, trabeculectomy, inflammation, fibrosis

CONQUERING THE AMBIGUITY OF OPTIC ATROPHY IN NORMAL TENSION GLAUCOMA: FROM MYSTERY TO MASTERY: Poster Presentation - Case Report - Resident Affannul Hakim; Evelyn Komaratih; Nurwasis; Yulia Primitasari
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/nha7y421

Introduction : The dilemma in diagnosing glaucoma often arises when optic atrophy is found alongside nonspecific glaucomatous findings and normal intraocular pressure (IOP), particularly in cases of normal tension glaucoma (NTG). This gray zone often leads to doubt and misdiagnosis. Case Illustration : A 70-year-old man previously diagnosed with idiopathic bilateral optic atrophy complained of blurred vision in both eyes. The visual acuity was 5/5 in the right eye (RE) and hand movement in the left eye (LE). Both eyes had normal IOP, open angles with Sampaolesi lines on gonioscopy, fibrin deposits at pupillary margins, and a large cup-to-disc ratio with baring and peripapillary atrophy on funduscopy. The OCT examination revealed thinning in the ONH-RNFL, ILM-RPE, and GCL-IPL complexes. HFA revealed tunnel vision in RE and general depression in LE. The patient was suspected of having NTG. We performed BMO-MRW (less than 100 ?m in both eyes) and 24-hour ocular perfusion pressure (OPP) measurements (less than 50 mmHg at night) to support the diagnosis. Discussion : The BMO-MRW examination is a new parameter that can help establish the diagnosis of glaucoma. A thin BMO-MRW finding suggests that optic atrophy originates from glaucoma. It is important to perform a comprehensive examination in cases of NTG to identify risk factors and prevent the development of glaucoma. Decreased OPP to less than 50 mmHg and PEX syndrome may be risk factors for NTG. Conclusion : In cases of doubtful optical atrophy, it is important to consider the possibility of NTG by performing a comprehensive examination, including BMO-MRW and twenty-four hour OPP measurements.

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