Diagnostic and surgical challenges of pediatric sympathetic ophthalmia without posterior segment visibility Itzar Chaidir Islam, Marlyanti Nur Rahmah, Hasnah Eka Journal of Clinical Ophthalmology and Research, 2026 Sympathetic ophthalmia (SO) is a rare bilateral granulomatous uveitis occurring after ocular trauma or intraocular surgery. Pediatric case has special diagnostic challenges due to limited cooperation and overlapping presentations with other inflammatory disorders. An 8-year-old boy presented with progressive bilateral visual impairment 6 months after sustaining a penetrating corneoscleral injury to the right eye caused by a metallic object. At the initial presentation, the right eye showed corneal edema with sutures from the previous corneal repair. The previously uninjured left eye also demonstrated active inflammatory changes. Both eyes showed severe anterior segment inflammation characterized by iris bombe, irregular pupil, pupillary membrane formation, lens opacity, and choroidal thickening consistent with bilateral panuveitis. Based on the history of penetrating trauma, the latent period, and the presence of bilateral granulomatous uveitis, a clinical diagnosis of SO was established. Initial management consisted of topical and systemic corticosteroids, followed by surgical intervention, including corneal wound revision with anterior chamber washout in the right eye and synechiolysis, anterior chamber irrigation–aspiration, posterior capsulotomy, anterior vitrectomy, and foldable intraocular lens implantation in the left eye. Postoperatively, visual acuity did not improve significantly, but the intraocular inflammation and other clinical symptoms were successfully controlled. SO is a case that could occur after penetrating ocular trauma or intraocular surgery. In pediatric patients, the disease often follows a more aggressive pattern with rapid progression and a higher risk of complications. Therefore, early recognition, prompt systemic immunosuppression, and timely surgical intervention remain essential to preserve ocular structure and prevent further deterioration. This case emphasized that every child presenting with bilateral intraocular inflammation after ocular trauma should be promptly evaluated for SO to avoid irreversible vision loss through early multidisciplinary intervention and long-term follow-up.
effectiveness of low-concentration atropine as myopia control Ika PUSPITA, Marlyanti N. RAHMAH, Purnamanita SYAWAL, Ratih NATASHA, Rani Y. PATONG Gazzetta Medica Italiana Archivio Per Le Scienze Mediche, 2024 INTRODUCTION: One of the many methods to successfully control myopia is atropine. Even though multiple studies have confirmed the usefulness, there is ongoing discussion on the ideal dosage. Low-concentration atropine had the most efficacy, according to several reports on atropine for the treatment of childhood myopia (ATOM) and low-concentration atropine for myopia progression (LAMP). Therefore, the aim of this study was to assess the relationship between ocular biometric components and the efficacy of low-concentration atropine as a myopia management.EVIDENCE ACQUISITION: A literature search was performed on PubMed, ScienceDirect, and SpringerLink databases using the key words “low concentration atropine,” “myopia control,” and “ocular biometric.”EVIDENCE SYNTHESIS: The results showed that eight papers in all, most of which came from Asia, were reviewed. Based on the investigations, atropine significantly affected the development of axial length (AL) and spherical equivalent (SE). Compared to placebo, low-dose atropine caused a noticeably delayed progression of SE over a period of 9-36 months.CONCLUSIONS: Based on the results, myopia can be effectively controlled with low dosages of atropine. This was demonstrated by a reduction in AL and SE advancement, and a significant decrease in myopia.
Major intrinsic protein (MIP)/aquaporin 0 (AQP0) mRNA gene expression in congenital cataracts Gerhanawati GERHANAWATI, Budu BUDU, Marlyanti N. RAHMAH, Joko HENDARTO, Habibah S. MUHIDDIN, Ahmad ASHRAF Gazzetta Medica Italiana Archivio Per Le Scienze Mediche, 2024 BACKGROUND: Congenital cataracts can cause visual impairment and blindness in infants, and approximately 50% of all congenital cataract cases have a genetic basis. The most abundant membrane protein in lens fiber cells is major intrinsic protein (MIP)/aquaporin 0 (AQP0), which facilitates the movement of water into and across the lens fiber cells and acts as an adhesion molecule by forming “thin junctions.” A lens that lacks AQP0 loses its regular shape and has a clear disorganization of the fiber cells causing the formation of cataracts. This study aimed to assess mRNA expression of the MIP/AQP0 gene in congenital cataract patients.METHODS: This study used analytic observation with a cross-sectional approach on 14 congenital cataract patients. Whole blood samples were tested for feasibility using a spectrophotometer and examined for mRNA expression of the MIP/AQP0 gene using RT-PCR. The Chi-squared and Mann-Whitney Tests were used to analyze the relationships, with a significance value of P<0.05.RESULTS: The results showed a decrease in mRNA expression of the MIP/AQP0 gene in 57.1% of cases. Nuclear cataracts displayed the greatest increases and decreases in expression. There were no significant relationships between gender, cataract type, or comparisons between the case and control groups and the mRNA expression of the MIP/AQP0 gene.CONCLUSIONS: In this study, a decrease in mRNA expression of the MIP/AQP0 gene was found in patients with congenital cataracts. The majority of patients who experienced increased and decreased expression of MIP/AQP0 mRNA were those with nuclear cataracts.
Expression of mrNa forkhead box protein e3 (Foxe3) in congenital cataracts: a cross-sectional study Meiliana LAY, Budu BUDU, Marlyanti N. RAHMAH, Joko HENDARTO, Habibah S. MUHIDDIN, Batari T. UMAR Gazzetta Medica Italiana Archivio Per Le Scienze Mediche, 2023 BACKGROUND: The genetic causes of congenital cataracts vary widely and are related to mutations in specific genes. Forkhead box protein E3 (FoxE3) is a transcription factor required in the morphogenesis and differentiation of the anterior segment of the eye. This study aims to evaluate the FoxE3 gene mRNA expression in congenital cataract patients.METHODS: This was an analytic observational study with a cross-sectional design. The study sample comprised 14 congenital cataract patients and 12 non-cataract control samples. Blood samples were taken, and RT-PCR examined FoxE3 gene mRNA expression.RESULTS: The results showed a decrease in FoxE3 gene mRNA expression in 85.7% of case samples and increased expression in controls (91.7%). A relationship existed between the type of cataract and decreased FoxE3 gene mRNA expression in patients with congenital cataracts (P=0.000). A significant difference was found in the FoxE3 mRNA expression values between the congenital cataract and control groups (P=0.001).CONCLUSIONS: This study’s results indicate a decrease in FoxE3 gene mRNA expression in patients with congenital cataracts, along with a relationship between the type of cataract and decreased FoxE3 gene mRNA expression in patients with congenital cataracts, especially nuclear cataracts.
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