Aspek klinik dan penanganan karsinoma sel basal

ABSTRACT Agus Supartoto, Senyum Indrakila, PardE wan - Clinical aspect and management of basal cell carsinoma Objective: To identify the pattern, clinic:al aspect and management of Basal Cell Carsinoma (BCC) at Ophthalmology Department, Dr. Sardjito Hospital, Yogyakarta from 1997 to 2002. Methods: The author reviewed eligible medical records of all patients with BCC diagnosis based on clinical symptoms and histopatologic examination. Operative management with frozen section procedure. Results: Based on the collected data we found 31 cases of BCC in 1997 to 2002. Most of these cases (30) were noduloulcerative types, while 1 case was morphea in type. Most location of lesion were inferior palpebral region. In these cases, the range of age was between 49-75 years. Wide excision with skin graft was performed on 11 cases and 9 cases with orbital exenteration and skin graft, 6 cases with wide excision and skin flap, 5 cases orbital exenteration âwide excisionâ skin graft, as well as the ensuring 17 cases with radiotherapy. Most of the cases (30 cases) were good at follow up with a period of follow up between 2-14 month, while 1 case died. Conclusions: The most frequent of BCC were ulcerative nodular type, most location in the inferior palpebral region. Wide excision and skin graft management in the majority of cases clinical good result. Key words: BCC-Noduloulcerative type- Wide excision and skin graft

Rekonstruksi Kelopak Mata Pasca-Ekstirpasi Tumor

ABSTRACT: Eyelid reconstruction after extirpation of lid tumor Extirpation of eyelid benign tumor, while the vision is still good, must be followed by lid reconstruction to protect the eyeball. The means of such reconstruction to make the lid function are optimal. A case of lid reconstruction after lid benign tumor extirpation with the remain of skin and the orbicular oculi muscle has been reported. The reconstruction was carried out by replacing the lost tarsoconjunctival tissue with the opposite tarsoconjuncdval tissue. The blepharoraphy was maintained until the cicatrical tissue formation was completed. Key Words: lid tumor extirpation - reconstruction of superior levator palpebral muscle - replacement of tarsoconjunctival tissue - blepharoraphy - ophthalmic surger

Effectiveness of subconjunctival mitomycin-C compared with subconjunctival triamcinolon acetonide on the recurrence of progresive primary pterygium which underwent Mc Reynolds method

Background: The main problem in the management of pterygium is how to diminish the recurrence rateafter surgical treatment. Mitomycin-C an antineoplastic, antifibrotic has been used to prevent recurrencerate of pterygium after excision, however, it correlated with some complications. Subconjunctivaladministration before excision has been proposed to avoid them.Objective: To know the effectivity of subconjunctival of mitomycin-C to decrease the recurrence rate ofprogresive primary pterigyum after Mc Reynold method compared with subconjunctival triamcinolonacetonide.Materials and methods: Randomized clinical trial of 41 progresive primary pterygium in Dr Sardjito Hospitaland Dr Yap Eye Hospital. They were randomly assigned to receive subconjunctival 0.1 ml triamcinolonacetonide or 0.1 ml mitomycin-C and underwent pterygium excision one week later using Mc Reynoldmethod. The follow up period was 6 months to detect any recurrence and complication of the drugsResults: The recurrence rate after subconjunctival mitomycin-C and triamcinolon acetonide was 4.7% and25%, respectively, however the different was not statistically significant (p=0.67). There were nostatistical difference in conjunctival hiperemia, lacrimation and granulation. Blepharospasm was significantlydifferent in seven days. The pain after injection and after excision was statistically different between twotwo groups.Conclusion: The recurrence rate of progressive primary pterygium in triamcinolon acetonide group washigher than mitomycin-C group but there was no statistical difference.Key words : Progressive primary pterygium – mitomycin-C – triamcinolon acetonide – Mc Reynold metho

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

Exposure to Exogenous Female Sex Hormones is Associated with Increased Risk Oforbito- Cranial Meningioma in Females: A Case-Control Study

Objective: This study aimed to investigate the association of exposure to exogenous female sex hormones with orbito-cranial meningioma among females. Methods: This was a case-control study of 115 women (40 orbitocranial meningioma cases and 75 healthy controls). All cases were confirmed by Multi-sliced head CT scan and histopathological examination following the surgical procedure. Age-matched control (±2 years) were meningioma-free, confirmed by clinical examination and head CT-scan. Detailed history of previous hormonal contraception, menstrual cycle, parity history and other demographic data were obtained by interview. The association of hormonal contraception with incident meningioma was estimated using logistic regression, adjusted for education level, age of menarche, length of menstrual cycle and number of parity. Results: The median age of cases vs. control was 46 vs. 47 years (p=0.92). Cases had older age of menarche (13 vs. 11 years; p<0.001) and had used longer hormonal contraception (55% vs. 27% had used more than 10 years; p=0.005) compared to controls. The use of hormonal contraception containing progesterone was significantly associated with increased risk of orbito-cranial meningioma (Odds Ratio [OR] 2.47; 95% Confidence Interval [CI] 1.08-5.64; P=0.03). Exposure to hormonal contraception for more than 10 years was also significantly associated with increased risk of developing meningioma (OR 3.95, 95%CI 1.67-7.64; p= 0.002). After adjusting for education level, age of menarche, length of menstrual cycle and number of parity, only exposure to hormonal contraception for more than 10 years remained significant. Conclusion: In this study, the use of hormonal contraception containing progesterone was associated with increased risk of developing orbitocranial meningioma in females. This finding highlights the public health importance of the use of hormonal contraception and suggests that further studies to understand its mechanisms are warranted. Keywords Orbitocranial meningioma; Hormonal contraception; Risk factor

The risk of elevated plasma fibrinogen level in hypertensive and normotensive patientsafter bevacizumabintravitreal injection in diabetic retinopathy

Bevacizumab intravitreal injection (IVB) could be detected in plasma that might cause an imbalance in the coagulation system. A hypercoagulable state is potentially involved in the risk for thrombosis, which is associated with high cardiovascular mortality.The objective of the current study was to investigate the risk of elevated plasma fibrinogen levelsin hypertensive and normotensive patients after IVB in diabetic retinopathy. This study was conducted at Dr. Sardjito General Hospital, Yogyakarta from March to June 2019. A total of 64 patients were enrolled in the study, included of 32 hypertensive and 32 non-hypertensive patients with diabetic retinopathy who underwent IVB. Patients were interviewed and investigated for physical condition and opthalmological examination. Fibrinogen levelwas measured before and 1 week after IVB. The mean fibrinogen level beforeand after IVB was slightly high in hypertensive patients than normotensive but not significantly different(p>0.05). There was no significant risk of increased fibrinogen levels after IVB in the hypertension group compared to the normotension group in diabetic retinopathy patients. The proportion of patients at high risk for cardiovascular disease after IVB was not significantly different between both groups

Clinical aspect and management of basal cell carsinoma

Objective: To identify the pattern, clinic:al aspect and management of Basal Cell Carsinoma (BCC) at Ophthalmology Department, Dr. Sardjito Hospital, Yogyakarta from 1997 to 2002.Methods: The author reviewed eligible medical records of all patients with BCC diagnosis based on clinical symptoms and histopatologic examination. Operative management with frozen section procedure. Results: Based on the collected data we found 31 cases of BCC in 1997 to 2002. Most of these cases (30) were noduloulcerative types, while 1 case was morphea in type. Most location of lesion were inferior palpebral region. In these cases, the range of age was between 49-75 years. Wide excision with skin graft was performed on 11 cases and 9 cases with orbital exenteration and skin graft, 6 cases with wide excision and skin flap, 5 cases orbital exenteration –wide excision– skin graft, as well as the ensuring 17 cases with radiotherapy. Most of the cases (30 cases) were good at follow up with a period of follow up between 2-14 month, while 1 case died.Conclusions: The most frequent of BCC were ulcerative nodular type, most location in the inferior palpebral region. Wide excision and skin graft management in the majority of cases clinical good result.Key words: BCC-Noduloulcerative type- Wide excision and skin graft

PERBEDAAN EKSPRESI TRANSFORMING GROWTH FACTOR b(beta) (TGF b(beta)) PADA PTERIGIUM STASIONER, PTERIGIUM PROGRESIF, DAN PTERIGIUM PROGRESIF SETELAH PEMBERIAN KORTIKOSTEROID TOPIKAL

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