The predictor factor of final visual acuity (VA) of acute retrobulbar neuritis patients receiving optic neuritis treatment trial (ONTT) regiment

The study aimed to investigate the efficacy of intravenous optic neuritis treatment trial (ONTT) regiment on the treatment ofpatients with acute retrobulbar neuritis.This was a cross sectional studyusing medical records data of patients diagnosed with unilateral or bilateral retrobulbar neuritis by normal funduscopic findings and typical optic neuritis perimetry results within 14 days of onset fromtheNeuro-ophthalmology Clinic, Department of Ophthalmology, Dr. Sardjito General Hospital, Yogyakarta from January to December 2015. Medical records data of patients who received 1000 mg methylprednisolone IV per day for 3 days followed by 11 days 1 mg/kg body weight oral prednisolone were reviewed. Visual acuity (VA) at onset, final VA at time of follow up, delta VA improvement and time of follow up were included in the analyses.Twenty data of patients aged 33.95±8.07 years with VA at onset of 1.96±0.81 (~ 1 mCF) were analyzed in this study. Significantly improvement in final VAafter treatment to be 1.39±1.12 (~5mCF) was reported (p=0.001). The VA at onsetwas a predictive factor for final VA (p 0.05). In conclusion, there is VA improvement after the treatment of ONTT regiment. The VA at onset is a predictive factorof final VA on patients with acute retrobulbar neuritis.ABSTRAKPenelitian ini bertujuan mengkaji efektivitas regimen optic neuritis treatment trial (ONTT) intravena pada pengobatan pasien dengan neuritis retrobulbar faseakut. Penelitian potong lintang ini menggunakan rekam medis pasien yang didiagnosis neuritis retrobulbar unilateral atau bilateral dengan temuan funduskopi normal dan hasil perimetri neuritis optik yang khas dalam waktu 14 haris etelah onset dari Klinik Neuro-optamalmologi, Departemen Oftalmologi, Rumah Sakit Umum Pusat Dr. Sardjito, Yogyakarta dari Januari-Desember 2015. Data rekam medis pasien yang menerima1000 mg metilprednisolon IV per haris elama 3 hari diikuti oleh prednisolon oral selama 11 hari dengan dosis 1 mg/kg berat badan dianalisis. Ketajaman visual (VA) saat onset, VA akhir saat tindaklanjut, peningkatan VA, dan waktu tindak lanjut dianalisis. Sebanyak 20 data pasien berumur 33,95 ±8,07 tahun dengan VA saat onset 1,96 ±0,81 (~ 1 mCF) dianalisis dalam penelitian ini. Perbaikan VA akhir menjadi 1,39±1,12 (~5mCF) dilaporkan (p=0,001). Ketajaman visual saat onset merupakan factor predictor VA akhir (p0,05). Dapat disimpulkan, terdapat peningkatan VA pasien setelah pengobatan regimen ONTT. Ketajaman visual saat onset merupakan factor prediktor VA akhir pada pasien dengan neuritis retrobulbar akut

The predictive factor for conjunctival melanoma recurrence

Conjunctival melanoma potentially deadly tumor. While many cases of conjunctival melanoma appeared to be a recurrence, there is no valid data about parameters to predict the recurrence of this tumor. This study intended to evaluate whether histopathologic features can be used as a predictor for recurrence in conjunctival melanoma. This was a retrospective study, involving patients with conjunctival melanoma by the year 2013-1017 in Dr. Sardjito General Hospital and Dr. Yap Eye Hospital, Yogyakarta. Patient’s characteristic was determined by age, sex, laterality, tumor size, tumor location, histopathological dominancy, MMC application, recurrence, and metastases. Sixteen cases were found: male (62.5%) and female (37.5%). Age from 5-79 years, mean was 56.19 years. Tumor location was in bulbar in 11 patients (68.7%), palpebral in 5 patients (31.3%).There was significant association between metastasis and the tumor recurrence (OR 13.0; 95% CI 1.9-85.4; p = 0.007). A favorable trend of association was also found between location and the recurrence of melanoma (OR 15.0; 95% CI 0.9-228.8; p = 0.06). In summary, our study showed that the patients that developing distant metastasis were at a greater risk for tumor recurrence

The eyelid tumor in Yogyakarta, Indonesia

Many types of eyelid tumors may easily be diagnosed from a clinical point of view. However only a small number of large studies exist exploring the frequency of eyelid lesions from different regions. According to the epidemiology of various eyelid lesions happened in Yogyakarta Special Region, this study was aimed to investigate the prevalence of eyelid tumors in Yogyakarta Special Region. A total of 94 patients were enrolled in a descriptive study. The data were taken retrospectively from the medical record. All patients were diagnosed with eyelid tumors from January 2014 until December 2017 by histopathological examination. Among the subjects, 56 (59.6%) were male and 38 (40.4%) were female. There was no difference found in laterality (OD 46% vs OS 50%). Sebaceous carcinoma was found in 15 (16%) patients, followed by squamous cell carcinoma (SCC) 13 (13.8%), basal cell carcinoma (BCC) 11 (11.7%), epidermoid cyst 7 (7.4%), non-Hodgkin lymphoma 7 (7.4%), and others. We also found that 11 (11.7%) of patients showed an inflammation appearance only. The therapy was varied from extirpation and biopsy (39.4%), wide excision (27.7%), excision and biopsy (18.1%), exenteration (10.6%), and also anterior and lateral orbitotomy (2.1%) for each procedure. The eyelid tumor was found equally in the right and the left eye. Sebaceous carcinoma followed by SCC and BCC were the most common eyelid tumor found in this study. A further study is needed to determine the risk factor of each tumor

The risk factor of metastatic status of retinoblastoma patient in Yogyakarta Tertiary Hospital

The metastases of the tumor become a serious problem malignancy including retinoblastoma. This study aimed to observe the correlation between several risk factors with the metastatic status of retinoblastoma patients in Yogyakarta Tertiary Hospital. Records of patients with retinoblastoma treated between 2011 and 2017 were obtained for observational analytic study. The gender, laterality, age, Body Mass Index (BMI) classification, BMI for age, type of retinoblastoma, and metastatic status were analyzed. The association was statistically analyzed by the correlation ratio of Eta test. Thirty-seven cases of retinoblastoma were enrolled in this study, with mean age 29.44 (±14.1) months; 14 females and 23 males. Ten patients (27.0%) have no metastases, while 27 patients (72.9%) exhibit metastases. The multivariate logistic regression analysis demonstrated that male gender (OR 8.3; 95% CI 1.07–64.5; p = 0.04) and age below 24 months (OR 17.6; 95% CI 1.26-248.31; p = 0.03) were a predictive of the metastatic status for retinoblastoma. On the other hand, the laterality, BMI classification, BMI for age, and types of retinoblastoma were not associated with the metastatic status of retinoblastoma. The gender and age were significantly associated with the metastatic status of retinoblastoma. Male patients and age below 24 months were more likely to have metastatic disease of retinoblastoma

Oral Acetazolamide Administration to Control Intraocular Pressure on First Day Post Phacoemulsification Surgery : Is It Necessary ?

Introduction : The incidence of early postoperative intraocular pressure (IOP) increase is reported to be 2.3–8.9% in phacoemulsification surgery. This increase typically peaks at 3–7 hours after surgery and persists during the first 24 hours. Although most eyes can tolerate the transient IOP elevation that occurs after cataract surgery, IOP spikes are potentially more dangerous if it persist. In order to minimize postoperative intraocular pressure (IOP) rise, routine medication by oral acetazolamide has been widely used among ophthalmologists. Objective of this study is to investigate the relationship between IOP changes on first day after phacoemulsification with administration of oral acetazolamide. Method : This is a descriptive study. The samples were include 50 patients diagnosed with cataract who underwent phacoemulsification surgery with intraocular lens implantatios. Samples were randomized divided into two groups. First group is patient who treated with 250 mg acetazolamide post operative and other group is untreated. All respondents must have no history of glaucoma or ocular hypertensive and attend follow up on the first day postoperative. IOP is measured with non-contact tonometer. Results : Mean age of respondents is 61 9.8 years old. Preoperative IOP mean is 18.04 3.6 mmHg and postoperative IOP mean is 18.58 6.9 mmHg. This study revealed that there is no significant relation between oral administration of acetazolamide and the lowering of intraocular pressure on first day post phacoemulsification(p = 0.2) Visual acuity pre operative and nuclear density of cataract are also no relationship with the IOP on first day postoperative (p = 0.2 ) Conclusion : The use of oral acetazolamide is not significantly related to the IOP on first day post phacoemulsification surgery

Lag time, high-risk histopathological features, metastasis, and survival interrelation in retinoblastoma: a perspective from lower-middle income country

AIM: To investigate the impact of lag time to metastasis and survival rates among patients with retinoblastoma. METHODS: This retrospective study was conducted with 52 patients from the Department of Ophthalmology and the Department of Pediatrics of Dr. Sardjito General Hospital, between 1st January 2014 and 31st December 2020. Lag time was defined as the time delay between the first sign of retinoblastoma to the diagnosis of retinoblastoma. The subjects with lag time > one year were included in the case group, while the subjects with lag time < one year were included in the control group. RESULTS: The lag time was significantly correlated with American Joint Committee on Cancer and Intraocular Classification of Retinoblastoma staging of retinoblastoma (P=0.005 and P=0.006, respectively). The lag time was also significantly correlated with both metastasis event [odds ratio (OR): 5.06, 95%Cl: 1.56-16.44, P=0.006] and mortality (OR: 4.54, 95%Cl: 1.37-15.07, P=0.011). The follow-up was continued for 32 subjects for 3y after initial diagnoses. Survival analysis revealed a significant difference among these two groups (P=0.021). Furthermore, lag time was significantly correlated with survival of retinoblastoma (r=-0.53, P=0.046). CONCLUSION: The study highlights the importance of lag time between the onset of first symptoms and the time of retinoblastoma diagnosis which significantly contribute to metastasis and mortality of patients with retinoblastoma. Examinations for the early detection of retinoblastoma should be performed for individuals at-risk to minimize lag time and improve the outcomes

Relationships Between Neurofibromatosis-2, Progesterone Receptor Expression, the Use of Exogenous Progesterone, and Risk of Orbitocranial Meningioma in Females

Background: The pathogenesis of meningioma in females and its association with exogenous progesterone is remained unclear. This study was aimed to examine expression of Progesterone receptor (PR) and Neurofibromatosis-2 (NF2) and assess their relationships to history of exogenous progesterone use and risk of meningioma. Methods: Our study was a case-control study that involves 115 females, 40 cases who diagnosed with orbito-cranial meningioma and 75 controls of healthy, that has been presented in previous study. The demographic characteristics, reproductive factors, and history of progesterone use were obtained in-depth face-to-face interviews. PR and NF2 mRNA were assessed by real-time quantitative polymerase chain reaction (RT-qPCR) on serum specimens. Results: The mean age of participants in cases vs. controls were 46.6 ± 6.2 vs. 46.5 ± 7.45 (P = 0.969). The expression of PR and NF2 in cases was significantly lower than in controls. The longer duration of progesterone exposure was significantly associated with lower expression of PR and NF2. Significant association between lower expression of PR (OR 11.7; 95% CI 4.17-32.9; P < 0.001 comparing the lowest quartile vs. 3 highest quartile of PR) and NF2 (OR 4.23; 95% CI 1.85-9.67; P = 0.001 comparing the 2 lowest quartiles vs. 2 highest quartiles) with increased risk of meningioma were also reported. Conclusion: In this study we showed that the longer the exposure to exogenous progesterone, the lower the expression of PR and NF2 mRNA in the serum. Low expression of PR and NF2 were associated with higher risk of meningioma, suggesting that low PR expression and inactivation of NF2 might play a key role in progesterone-associated meningioma tumorigenesis and may be potential clinical marker for females at higher risk of meningioma