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Putu Ayu Wulansari
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Health Professions Medicine & Pharmacology Public Health

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Journal : Ophthalmologica Indonesiana

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Searching The New Culprit of Optic Neuritis: The Role of Vitamin D: Poster Presentation - Case Report - Ophthalmologist ANAK AGUNG MAS PUTRAWATI TRININGRAT; Made Paramita Wijayati; Putu Ayu Wulansari
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/ga8bd617

Abstract

Abstract Introduction : Low vitamin D status has long been associated in multiple sclerosis patient with higher risk of disease progression and frequent relapses. Vitamin D plays an important role in modulating the immune process responsible for demyelination. To this date, the study on vitamin D deficiency in optic neuritis case is still rare. Case Illustration : Female, 20 years old, presenting with bilateral sudden visual loss since 1 week prior. The patient looked relatively pale and complained of accompanying headache and myalgia. Visual acuity in both eyes were light perception with dilated pupils and posterior segment showing optic disc swelling. CBC, infection and autoimmune screening came within normal limit and brain MRI further confirmed the presence of optic neuritis. The patient was given high dose intravenous steroid but showed no improvement. Later, she was screened for nutrient deficiency and found sign of low serum 25-hydroxyvitamin D. After one week of oral supplementation and neuroprotective agents, her vision drastically improved to 6/6 in both eyes. Discussion : Vitamin D deficiency nowadays is getting more prevalent in high risk individuals with low dietary intake and sunlight exposure. Recent study found that mean serum vitamin D level were significantly lower in autoimmune optic neuritis (ON) and were associated with ON attack severity. Vitamin D sufficiency is associated with better inflammatory outcome and long term neurodegenerative measures in demyelinating diseases, as shown by improvement in RNFL thickness after attack. Conclusion : Screening for vitamin D deficiency is essential to consider in managing patient with atypical optic neuritis.
Clinical Correlation of CD4 Count and Dry Eye Disease (DED) Severity Among HIV Patients: A Case Study in Voluntary Counseling and Testing Clinic Prof Ngoerah General Hospital, Bali: Oral Presentation - Observational Study - Resident PUTU AYU WULANSARI
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: 10.35749/889m8k12

Abstract

Abstract Introduction & Objectives : Dry Eye Disease is a multi-factorial ocular surface and tear film instability disease. It has been reported as one of the most frequent anterior segment ocular manifestations in HIV patients, occurring late in the disease. The study aimed to investigate clinical correlation of CD4 count and severity of the disease. Methods : This study was a hospital based cross-sectional study where 75 HIV patients (150 eyes) aged 18-50 years old were referred to ophthalmology clinic in VCT for ocular surface related complaints and were included in the study. Results : The study showed significant moderate positive correlation between CD4 count with Tear Break Up Time (TBUT) (r-value=0.509;p-value=0.05) and negatively correlated with Ocular Surface Disease Index (OSDI) score (r-value=-0.252, p-value=0.035). There were a significant difference in CD4 count between mild and moderate dry eyes (p-value=0.005) and between mild and severe dry eyes (p-value=0.005), however no significant difference was observed between moderate and severe dry eyes (p value=0.435). The severity of dry eye in HIV patients also tends to differ in-between clinical stage of the disease (p value=0.513) and with the presence of co-infection (p value=0.228), although the result was not statistically significant. Conclusion : There is a correlation between CD4 Count and Dry Eye Disease severity among HIV patients. The lower the CD4, the higher the risk for HIV patients to get severe dry eye disease. This shows the importance of CD4 control and monitoring to prevent various ocular disease and manifestations related to HIV.
Co-Authors Anak Agung Mas Putrawati Triningrat Made Paramita Wijayati