47 results on '"Putera, Ikhwanuliman"'
Search Results
2. The Infectious Uveitis Treatment Algorithm Network (TITAN) Report 2—global current practice patterns for the management of Cytomegalovirus anterior uveitis
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Thng, Zheng Xian, Putera, Ikhwanuliman, Testi, Ilaria, Chan, Kevin, Westcott, Mark, Chee, Soon-Phaik, Dick, Andrew D., Kempen, John H., Bodaghi, Bahram, Thorne, Jennifer E., Barisani-Asenbauer, Talin, de Smet, Marc D., Smith, Justine R., McCluskey, Peter, La Distia Nora, Rina, Jabs, Douglas A., de Boer, Joke H., Sen, H. Nida, Goldstein, Debra A., Khairallah, Moncef, Davis, Janet L., Rosenbaum, James T., Jones, Nicholas P., Nguyen, Quan Dong, Pavesio, Carlos, Agrawal, Rupesh, and Gupta, Vishali
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- 2024
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3. The Infectious Uveitis Treatment Algorithm Network (TITAN) Report 1—global current practice patterns for the management of Herpes Simplex Virus and Varicella Zoster Virus anterior uveitis
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Thng, Zheng Xian, Putera, Ikhwanuliman, Testi, Ilaria, Chan, Kevin, Westcott, Mark, Chee, Soon-Phaik, Dick, Andrew D., Kempen, John H., Bodaghi, Bahram, Thorne, Jennifer E., Barisani-Asenbauer, Talin, de Smet, Marc D., Smith, Justine R., McCluskey, Peter, La Distia Nora, Rina, Jabs, Douglas A., de Boer, Joke H., Sen, H. Nida, Goldstein, Debra A., Khairallah, Moncef, Davis, Janet L., Rosenbaum, James T., Jones, Nicholas P., Nguyen, Quan Dong, Pavesio, Carlos, Agrawal, Rupesh, and Gupta, Vishali
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- 2024
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4. Increased serum interferon activity in sarcoidosis compared to that in tuberculosis: Implication for diagnosis?
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Schrijver, Benjamin, Göpfert, Jens, La Distia Nora, Rina, Putera, Ikhwanuliman, Nagtzaam, Nicole M.A.N., Smits te Nijenhuis, Marja A.W., van Rijswijk, Angelique L.C.T., ten Berge, Josianne C.E.M., van Laar, Jan A.M., van Hagen, P. Martin, and Dik, Willem A.
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- 2024
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5. Vitamin D deficiency and non-infectious uveitis: A systematic review and Meta-analysis
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Rojas-Carabali, William, Pineda-Sierra, Juan Sebastián, Cifuentes-González, Carlos, Morales, María Sofía, Muñoz-Vargas, Paula Tatiana, Peña-Pulgar, Luisa Fernanda, Fonseca-Mora, María Alejandra, Cruz, Danna Lesley, Putera, Ikhwanuliman, Sobrin, Lucia, Agrawal, Rupesh, and de-la-Torre, Alejandra
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- 2024
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6. Tuberculosis: Integrated Studies for a Complex Disease 2050
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Rezaei, Nima, Hosseini, Nastaran-Sadat, Saghazadeh, Amene, Fateh, Abolfazl, Duse, Adriano, Ahmad, Aijaz, Braley, Alexander E., Tahta, Alican, Kamboj, Alisha, Khan, Amer Hayat, Coelho, Ana Cláudia, Fuso, Andrea, Varón, Andrés, Trajman, Anete, Saxena, Anil Kumar, Ganeshpurkar, Ankit, Casapao, Anthony M., Tkachenko, Anton, Devnikar, Anushka V., Moshiri, Arfa, Muñoz-Barrutia, Arrate, Dasgupta, Arunava, Natarajan, Arvind, Gupta, Ashish, Coyne, Ashlan J. Kunz, Jordan, Ashly E., Kumar, Ashok, Ergeshov, Atadzhan, Pourakbari, Babak, Joshi, Basant, Chavarro-Portillo, Bibiana, Soto, Carlos Y., Kanipe, Carly, Schmidt, Christiane Mello, Cox, Christophe, Gómez-Cruz, Clara, Cardoso, Claudete Aparecida Araújo, Sant´Anna, Clemax Couto, Johnson, Courtney, Rodríguez-Silva, Cristhian N., Rosales, Cristian, Licona-Cassani, Cuauhtémoc, Fast, Cynthia D., Pérez-Martínez, Damián, Pizzol, Damiano, Perlman, David C., Philips, Dennis, Viveros, Diana, Fisher, Dina A., Butov, Dmytro, Egelund, Eric F., de Igartua, Everest, Bhatt, Garima, Mgode, Georgies, Quaglio, Gianluca, Putoto, Giovanni, Mini, G. K., Thomas-Richardson, Govind, Wylie, Greg, dos Santos Fernandes, Guilherme Felipe, Bermúdez, Gustavo, Quintas, Hélder, Verma, Himanshu, Eoh, Hyungjin, Putera, Ikhwanuliman, Sivokozov, Ilya, Pires, Isabel, Lee, Jae Jin, Lombard, Jason E., dos Santos, Jean Leandro, Zellweger, Jean-Pierre, Thomas-Richardson, Jenu, Lordson, Jinbert, Prates, João Lucas, Cervantes, Jorge, Porcel, José M., Vaquero, Juan José, Prada, Justina, Kamboj, Kamal, Tabbara, Khalid F., Mussie, Kirubel Manyazewal, Patel, Krupesh, Porcel, Laura, Fiebig, Lena, Mohan, Malu, Yadav, Mange Ram, López-R, Marcela, Correia-Neves, Margarida, da Conceição Fontes, Maria, de Fátima Pombo Bazhuni Sant´Anna, Maria, Cañadas-Ortega, Marina, Singh, Meenakshi, Lause, Michael, Maya-Hoyos, Milena, Omrani, Mir Davood, Palmer, Mitchell V., Ahmad, Mohammad Naiyaz, Seid, Mohammed Assen, Chauhan, Monica, Saxena, Mridula, Marimani, Musa, Srinivas, Nanduri, Beyene, Negussie, Arenas, Nelson E., Cardoso, Nicole, Oliveira, Olena, Silakari, Om, Inlamea, Osvaldo, Tanrıverdi, Özgür, Boggiatto, Paola M., Santos, Paola, Mejía-Ponce, Paulina, Soares, Pedro, Sell, Philip, Murumkar, Prashant R., Devanandan, Praveen, Zheng, Qi, Lim, Rachel K., Aurílio, Rafaela Baroni, Ghuge, Rahul B., Barot, Rahul R., Rahul, Puvvada, Ranadheer Chowdary, Duarte, Raquel, Singh, Ravi, Sinha, Richa, La Distia Nora, Rina, Burny, Robert, Zenteno-Cuevas, Roberto, Mali, Sagar, Shoughy, Samir S., Tarashi, Samira, Mishra, Sapna, Malasala, Satyaveni, Mamishi, Setareh, Siadat, Seyed Davar, Choudhary, Shalki, Mahmoudi, Shima, Chopra, Sidharth, Nandi, Sisir, Faisal, Sobia, Goel, Sonu, Huszár, Stanislav, Field, Stephen K., Singh, Sushil Kumar, Rito, Teresa, Butova, Tetiana, Manning, Thomas, van der Werf, Tjip S., Myasoedov, Valeriy, Vásquez, Vanessa, Muthukumar, Vijey Aanandhi, Singh, Vinayak, Hall, Walter A., Hikmahwati, Wandya, Turgut, Yaşar Barış, Thaker, Yatri, Kawabata, Yoshinori, de Reus, Yvette A., and Rezaei, Nima, Editor-in-Chief
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- 2023
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7. Ocular Tuberculosis: Biomarkers for Risk Stratification
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La Distia Nora, Rina, Hikmahwati, Wandya, Putera, Ikhwanuliman, and Rezaei, Nima, Editor-in-Chief
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- 2023
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8. Antiviral treatment for acute retinal necrosis: A systematic review and meta-analysis
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Putera, Ikhwanuliman, Ridwan, Asri Salima, Dewi, Metta, Cifuentes-González, Carlos, Rojas-Carabali, William, Sitompul, Ratna, Edwar, Lukman, Susiyanti, Made, Aziza, Yulia, Pavesio, Carlos, Chee, Soon-Phaik, Mahendradas, Padmamalini, Biswas, Jyotirmay, Kempen, John H., Gupta, Vishali, de-la-Torre, Alejandra, La Distia Nora, Rina, and Agrawal, Rupesh
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- 2024
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9. The immune response in tubercular uveitis and its implications for treatment: From anti-tubercular treatment to host-directed therapies
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Putera, Ikhwanuliman, Schrijver, Benjamin, ten Berge, Josianne C.E.M., Gupta, Vishali, La Distia Nora, Rina, Agrawal, Rupesh, van Hagen, P. Martin, Rombach, Saskia M., and Dik, Willem A.
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- 2023
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10. The impact of aqueous humor polymerase chain reaction and serological test results for establishing infectious uveitis diagnosis: An Indonesian experience
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Putera, Ikhwanuliman, La Distia Nora, Rina, Utami, Nunik, Karuniawati, Anis, Yasmon, Andi, Wulandari, Dewi, Edwar, Lukman, Susiyanti, Made, Aziza, Yulia, Jessica, Priscilla, Riasanti, Mei, and Sitompul, Ratna
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- 2022
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11. Viral Anterior Uveitis: A Practical and Comprehensive Review of Diagnosis and Treatment.
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Feng, Yun, Garcia, Ruby, Rojas-Carabali, William, Cifuentes-González, Carlos, Putera, Ikhwanuliman, Li, Jingyi, La Distia Nora, Rina, Mahendradas, Padmamalini, Gupta, Vishali, de-la-Torre, Alejandra, and Agrawal, Rupesh
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HERPES simplex virus ,WEST Nile virus ,LITERATURE reviews ,VARICELLA-zoster virus ,RUBELLA virus ,IRIDOCYCLITIS - Abstract
Anterior uveitis is the most common type of uveitis worldwide. The etiologies of anterior uveitis can be divided into infectious and non-infectious (idiopathic, autoimmune, autoinflammatory, trauma, and others). The viral pathogens most commonly associated with infectious anterior uveitis include Herpes Simplex Virus, Varicella-Zoster Virus, Cytomegalovirus, and Rubella Virus. Other emerging causes of viral anterior uveitis are West Nile Virus, Human-Immunodeficiency Virus, Epstein-Barr Virus, Parechovirus, Dengue Virus, Chikungunya Virus, and Human Herpesvirus type 6,7, and 8. Early recognition allows prompt management and mitigates its potential ocular complications. This article provides an updated literature review of the epidemiology, clinical manifestations, diagnostic tools, and treatment options for viral anterior uveitis. [ABSTRACT FROM AUTHOR]
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- 2024
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12. Evaluating the Diagnostic Accuracy and Management Recommendations of ChatGPT in Uveitis.
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Rojas-Carabali, William, Cifuentes-González, Carlos, Wei, Xin, Putera, Ikhwanuliman, Sen, Alok, Thng, Zheng Xian, Agrawal, Rajdeep, Elze, Tobias, Sobrin, Lucia, Kempen, John H., Lee, Bernett, Biswas, Jyotirmay, Nguyen, Quan Dong, Gupta, Vishali, de-la-Torre, Alejandra, and Agrawal, Rupesh
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NATURAL language processing ,CHATBOTS ,ARTIFICIAL intelligence ,CHATGPT ,DIAGNOSTIC errors - Abstract
Introduction: Accurate diagnosis and timely management are vital for favorable uveitis outcomes. Artificial Intelligence (AI) holds promise in medical decision-making, particularly in ophthalmology. Yet, the diagnostic precision and management advice from AI-based uveitis chatbots lack assessment. Methods: We appraised diagnostic accuracy and management suggestions of an AI-based chatbot, ChatGPT, versus five uveitis-trained ophthalmologists, using 25 standard cases aligned with new Uveitis Nomenclature guidelines. Participants predicted likely diagnoses, two differentials, and next management steps. Comparative success rates were computed. Results: Ophthalmologists excelled (60–92%) in likely diagnosis, exceeding AI (60%). Considering fully and partially accurate diagnoses, ophthalmologists achieved 76–100% success; AI attained 72%. Despite an 8% AI improvement, its overall performance lagged. Ophthalmologists and AI agreed on diagnosis in 48% cases, with 91.6% exhibiting concurrence in management plans. Conclusions: The study underscores AI chatbots' potential in uveitis diagnosis and management, indicating their value in reducing diagnostic errors. Further research is essential to enhance AI chatbot precision in diagnosis and recommendations. [ABSTRACT FROM AUTHOR]
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- 2024
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13. A serum B-lymphocyte activation signature is a key distinguishing feature of the immune response in sarcoidosis compared to tuberculosis.
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Putera, Ikhwanuliman, Schrijver, Benjamin, Kolijn, P. Martijn, van Stigt, Astrid C., ten Berge, Josianne C. E. M., IJspeert, Hanna, Nagtzaam, Nicole M. A., Swagemakers, Sigrid M. A., van Laar, Jan A. M., Agrawal, Rupesh, Rombach, Saskia M., van Hagen, P. Martin, La Distia Nora, Rina, and Dik, Willem A.
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BLOOD proteins , *SARCOIDOSIS , *CELLULAR signal transduction , *UVEITIS , *TUBERCULOSIS - Abstract
Sarcoidosis and tuberculosis (TB) are two granulomatous diseases that often share overlapping clinical features, including uveitis. We measured 368 inflammation-related proteins in serum in both diseases, with and without uveitis from two distinct geographically separated cohorts: sarcoidosis from the Netherlands and TB from Indonesia. A total of 192 and 102 differentially expressed proteins were found in sarcoidosis and active pulmonary TB compared to their geographical healthy controls, respectively. While substantial overlap exists in the immune-related pathways involved in both diseases, activation of B cell activating factor (BAFF) signaling and proliferation-inducing ligand (APRIL) mediated signaling pathways was specifically associated with sarcoidosis. We identified a B-lymphocyte activation signature consisting of BAFF, TNFRSF13B/TACI, TRAF2, IKBKG, MAPK9, NFATC1, and DAPP1 that was associated with sarcoidosis, regardless of the presence of uveitis. In summary, a difference in B-lymphocyte activation is a key discriminative immunological feature between sarcoidosis/ocular sarcoidosis (OS) and TB/ocular TB (OTB). Sarcoidosis patients exhibit higher level of serum B cell activation signature compared to tuberculosis, regardless of uveitis manifestation. [ABSTRACT FROM AUTHOR]
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- 2024
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14. Relapse in ocular tuberculosis: relapse rate, risk factors and clinical management in a non-endemic country
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Putera, Ikhwanuliman, primary, ten Berge, Josianne C. E. M., additional, Thiadens, Alberta A. H. J., additional, Dik, Willem A., additional, Agrawal, Rupesh, additional, van Hagen, P. Martin, additional, La Distia Nora, Rina, additional, and Rombach, Saskia M., additional
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- 2024
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15. Antiviral treatment for acute retinal necrosis:A systematic review and meta-analysis
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Putera, Ikhwanuliman, Ridwan, Asri Salima, Dewi, Metta, Cifuentes-González, Carlos, Rojas-Carabali, William, Sitompul, Ratna, Edwar, Lukman, Susiyanti, Made, Aziza, Yulia, Pavesio, Carlos, Chee, Soon Phaik, Mahendradas, Padmamalini, Biswas, Jyotirmay, Kempen, John H., Gupta, Vishali, de-la-Torre, Alejandra, La Distia Nora, Rina, Agrawal, Rupesh, Putera, Ikhwanuliman, Ridwan, Asri Salima, Dewi, Metta, Cifuentes-González, Carlos, Rojas-Carabali, William, Sitompul, Ratna, Edwar, Lukman, Susiyanti, Made, Aziza, Yulia, Pavesio, Carlos, Chee, Soon Phaik, Mahendradas, Padmamalini, Biswas, Jyotirmay, Kempen, John H., Gupta, Vishali, de-la-Torre, Alejandra, La Distia Nora, Rina, and Agrawal, Rupesh
- Abstract
Acute retinal necrosis is a progressive intraocular inflammatory syndrome characterized by diffuse necrotizing retinitis that can lead to a poor visual outcome, mainly from retinal detachment. The antiviral treatment approach for acute retinal necrosis varies as there are no established guidelines. We summarize the outcomes of acute retinal necrosis with available antiviral treatments. Electronic searches were conducted in PubMed/MEDLINE, EMBASE, Scopus, and Google Scholar for interventional and observational studies. Meta-analysis was performed to evaluate the pooled proportion of the predefined selected outcomes. This study was registered in PROSPERO (CRD42022320987). Thirty-four studies with a total of 963 participants and 1,090 eyes were included in the final analysis. The estimated varicella-zoster virus and herpes simplex virus polymerase chain reaction-positive cases were 63% (95% CI: 55–71%) and 35% (95% CI: 28–42%), respectively. The 3 main antiviral treatment approaches identified were oral antivirals alone, intravenous antivirals alone, and a combination of systemic (oral or intravenous) and intravitreal antivirals. The overall pooled estimated proportions of visual acuity improvement, recurrence, and retinal detachment were 37% (95% CI: 27–47%), 14% (95% CI: 8–21%), and 43% (95% CI: 38–50%), respectively. Patients treated with systemic and intravitreal antivirals showed a trend towards better visual outcomes than those treated with systemic antivirals (oral or intravenous) alone, even though this analysis was not statistically significant (test for subgroup differences P = 0.83).
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- 2024
16. Vitamin D deficiency and non-infectious uveitis:A systematic review and Meta-analysis
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Rojas-Carabali, William, Pineda-Sierra, Juan Sebastián, Cifuentes-González, Carlos, Morales, María Sofía, Muñoz-Vargas, Paula Tatiana, Peña-Pulgar, Luisa Fernanda, Fonseca-Mora, María Alejandra, Cruz, Danna Lesley, Putera, Ikhwanuliman, Sobrin, Lucia, Agrawal, Rupesh, de-la-Torre, Alejandra, Rojas-Carabali, William, Pineda-Sierra, Juan Sebastián, Cifuentes-González, Carlos, Morales, María Sofía, Muñoz-Vargas, Paula Tatiana, Peña-Pulgar, Luisa Fernanda, Fonseca-Mora, María Alejandra, Cruz, Danna Lesley, Putera, Ikhwanuliman, Sobrin, Lucia, Agrawal, Rupesh, and de-la-Torre, Alejandra
- Abstract
Background: Vitamin D plays a critical role in immunomodulation, and its deficiency is implicated in the pathogenesis of several autoimmune diseases. Nevertheless, its relationship with non-infectious uveitis (NIU), an inflammatory ocular disorder, remains inconclusive. Methods:A systematic search was conducted in three databases from database inception until May 8, 2023, to investigate the potential relationship between vitamin D deficiency and NIU. We included observational studies reporting the measurement of vitamin D levels in patients with NIU and healthy controls without restriction of language or date of publication. Three pairs of authors independently screened the title and abstracts for potential eligibility and then in full text. A third author resolved disagreements. Three pairs of independent reviewers abstracted the data from the fully reviewed records and evaluated the risk of bias. We followed The MOOSE and PRISMA guidelines. Random effects meta-analyses were used for primary analysis. Studies not included in the meta-analysis were summarized descriptively. This review was registered in PROSPERO: CRD42022308105. Findings: Of 933 records screened, 11 studies were included, and five were meta-analyzed, encompassing 354 cases and 5728 controls (mean participant age ranging from 7.1 to 58.9 years). Patients with vitamin D deficiency exhibited an Odds Ratio of 2.04 (95% CI = 1.55–2.68, P < 0.00001) for developing NIU compared to controls. Overall, potential sources of bias were low across most studies. Interpretation: Our findings suggest that vitamin D may play an essential role in the pathophysiology of NIU. While the included studies demonstrated generally low potential bias, additional rigorous prospective studies are necessary to confirm these findings and further elucidate the underlying mechanisms involved. Vitamin D supplementation could represent a possible therap
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- 2024
17. Ocular Tuberculosis Diagnosis Through Biomarkers: Clinical Relevance of Serum C1q and Whole Blood Interferon Gene Signature Score.
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La Distia Nora, Rina, Putera, Ikhwanuliman, Schrijver, Benjamin, Singh, Gurmeet, Bakker, Marleen, Riasanti, Mei, Edwar, Lukman, Susiyanti, Made, Aziza, Yulia, ten Berge, Josianne C.E.M., Rombach, Saskia M., van Hagen, P. Martin, Sitompul, Ratna, and Dik, Willem A.
- Abstract
PurposeMethodsResultsConclusionsTo assess the clinical relevance of pathophysiology-based biomarkers, specifically serum C1q and whole blood interferon gene signature score (IGSS), in ocular tuberculosis (OTB) diagnosis by conducting an integrative analysis of clinical presentations and treatment response.This retrospective cohort study analysed data from 70 patients with suspected OTB at a tertiary care uveitis practice in Indonesia. Serum C1q levels and whole blood IGSS were quantified. Patients were categorized into four quadrants based on their biomarker profiles: quadrant 1 (high C1q & low IGSS), quadrant 2 (high C1q & high IGSS), quadrant 3 (low C1q & high IGSS), and quadrant 4 (low C1q & low IGSS). Characteristics of clinical presentations, work-up results, and treatment outcomes were explored according to the predefined quadrants.We identified that the majority of OTB patients diagnosed with concurrent active pulmonary TB were in quadrant 1, 2, or 3 (20/23, 87.0%). Twenty-seven patients (27/47, 57.4%) with clinically undifferentiated uveitis were in quadrant 4 (
p < 0.001). Among patients in quadrants 1, 2, and 3, completion of a full course of antitubercular treatment (ATT) was associated with a lower number of patients showing persistence or recurrence of ocular inflammation compared to those who were not fully treated with ATT (14.3% vs 85.7%,p = 0.001).Based on the analysis of clinical features and treatment outcomes, patients with elevated levels of either or both serum C1q and whole blood IGSS may reflect active TB disease in the eye, necessitating full ATT management. [ABSTRACT FROM AUTHOR]- Published
- 2024
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18. Response to the Comment on “Evaluating the Diagnostic Accuracy and Management Recommendations of ChatGpt in Uveitis”
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Rojas-Carabali, William, primary, Cifuentes-González, Carlos, additional, Wei, Xin, additional, Putera, Ikhwanuliman, additional, Sen, Alok, additional, Thng, Zheng Xian, additional, Agrawal, Rajdeep, additional, Elze, Tobias, additional, Sobrin, Lucia, additional, Kempen, John H., additional, Lee, Bernett, additional, Biswas, Jyotirmay, additional, Nguyen, Quan Dong, additional, Gupta, Vishali, additional, de-la-Torre, Alejandra, additional, and Agrawal, Rupesh, additional
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- 2023
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19. Evaluating the Diagnostic Accuracy and Management Recommendations of ChatGPT in Uveitis
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Rojas-Carabali, William, primary, Cifuentes-González, Carlos, additional, Wei, Xin, additional, Putera, Ikhwanuliman, additional, Sen, Alok, additional, Thng, Zheng Xian, additional, Agrawal, Rajdeep, additional, Elze, Tobias, additional, Sobrin, Lucia, additional, Kempen, John H., additional, Lee, Bernett, additional, Biswas, Jyotirmay, additional, Nguyen, Quan Dong, additional, Gupta, Vishali, additional, de-la-Torre, Alejandra, additional, and Agrawal, Rupesh, additional
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- 2023
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20. Antiviral treatment for acute retinal necrosis: A systematic review and meta-analysis
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Putera, Ikhwanuliman, primary, Ridwan, Asri Salima, additional, Dewi, Metta, additional, Cifuentes-González, Carlos, additional, Rojas-Carabali, William, additional, Sitompul, Ratna, additional, Edwar, Lukman, additional, Susiyanti, Made, additional, Aziza, Yulia, additional, Pavesio, Carlos, additional, Chee, Soon-Phaik, additional, Mahendradas, Padmamalini, additional, Biswas, Jyotirmay, additional, Kempen, John H., additional, Gupta, Vishali, additional, de-la-Torre, Alejandra, additional, Nora, Rina La Distia, additional, and Agrawal, Rupesh, additional
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- 2023
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21. Anti-tubercular therapy in the treatment of tubercular uveitis: A systematic review and meta-analysis
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Betzler, Bjorn Kaijun, primary, Putera, Ikhwanuliman, additional, Testi, Ilaria, additional, La Distia Nora, Rina, additional, Kempen, John, additional, Kon, Onn Min, additional, Pavesio, Carlos, additional, Gupta, Vishali, additional, and Agrawal, Rupesh, additional
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- 2023
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22. The immune response in tubercular uveitis and its implications for treatment:From anti-tubercular treatment to host-directed therapies
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Putera, Ikhwanuliman, Schrijver, Benjamin, ten Berge, Josianne C.E.M., Gupta, Vishali, La Distia Nora, Rina, Agrawal, Rupesh, van Hagen, P. Martin, Rombach, Saskia M., Dik, Willem A., Putera, Ikhwanuliman, Schrijver, Benjamin, ten Berge, Josianne C.E.M., Gupta, Vishali, La Distia Nora, Rina, Agrawal, Rupesh, van Hagen, P. Martin, Rombach, Saskia M., and Dik, Willem A.
- Abstract
Tubercular uveitis (TB-uveitis) remains a conundrum in the uveitis field, which is mainly related to the diverse clinical phenotypes of TB-uveitis. Moreover, it remains difficult to differentiate whether Mycobacterium tuberculosis (Mtb) is present in the ocular tissues, elicits a heightened immune response without Mtb invasion in ocular tissues, or even induces an anti-retinal autoimmune response. Gaps in the immuno-pathological knowledge of TB-uveitis likely delay timely diagnosis and appropriate management. In the last decade, the immunopathophysiology of TB-uveitis and its clinical management, including experts' consensus to treat or not to treat certain conditions with anti-tubercular treatment (ATT), have been extensively investigated. In the meantime, research on TB treatment, in general, is shifting more toward host-directed therapies (HDT). Given the complexities of the host-Mtb interaction, enhancement of the host immune response is expected to boost the effectiveness of ATT and help overcome the rising burden of drug-resistant Mtb strains in the population. This review will summarize the current knowledge on the immunopathophysiology of TB-uveitis and recent advances in treatment modalities and outcomes of TB-uveitis, capturing results gathered from high- and low-burden TB countries with ATT as the mainstay of treatment. Moreover, we outline the recent progress of HDT development in the pulmonary TB field and discuss the possibility of its applicability to TB-uveitis. The concept of HDT might help direct future development of efficacious therapy for TB-uveitis, although more in-depth research on the immunoregulation of this disease is still necessary.
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- 2023
23. Diagnosis and biomarkers for ocular tuberculosis:From the present into the future
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Ludi, Zhang, Sule, Ashita Ashish, Samy, Ramar Perumal, Putera, Ikhwanuliman, Schrijver, Benjamin, Hutchinson, Paul Edward, Gunaratne, Jayantha, Verma, Indu, Singhal, Amit, La DIstia Nora, Rina, Van Hagen, P. Martin, Dik, Willem A., Gupta, Vishali, Agrawal, Rupesh, Ludi, Zhang, Sule, Ashita Ashish, Samy, Ramar Perumal, Putera, Ikhwanuliman, Schrijver, Benjamin, Hutchinson, Paul Edward, Gunaratne, Jayantha, Verma, Indu, Singhal, Amit, La DIstia Nora, Rina, Van Hagen, P. Martin, Dik, Willem A., Gupta, Vishali, and Agrawal, Rupesh
- Abstract
Tuberculosis is an airborne disease caused by Mycobacterium tuberculosis (Mtb) and can manifest both pulmonary and extrapulmonary disease, including ocular tuberculosis (OTB). Accurate diagnosis and swift optimal treatment initiation for OTB is faced by many challenges combined with the lack of standardized treatment regimens this results in uncertain OTB outcomes. The purpose of this study is to summarize existing diagnostic approaches and recently discovered biomarkers that may contribute to establishing OTB diagnosis, choice of anti-tubercular therapy (ATT) regimen, and treatment monitoring. The keywords ocular tuberculosis, tuberculosis, Mycobacterium, biomarkers, molecular diagnosis, multi-omics, proteomics, genomics, transcriptomics, metabolomics, T-lymphocytes profiling were searched on PubMed and MEDLINE databases. Articles and books published with at least one of the keywords were included and screened for relevance. There was no time limit for study inclusion. More emphasis was placed on recent publications that contributed new information about the pathogenesis, diagnosis, or treatment of OTB. We excluded abstracts and articles that were not written in the English language. References cited within the identified articles were used to further supplement the search. We found 10 studies evaluating the sensitivity and specificity of interferon-gamma release assay (IGRA), and 6 studies evaluating that of tuberculin skin test (TST) in OTB patients. IGRA (Sp = 71-100%, Se = 36-100%) achieves overall better sensitivity and specificity than TST (Sp = 51.1-85.7%; Se = 70.9-98.5%). For nuclear acid amplification tests (NAAT), we found 7 studies on uniplex polymerase chain reaction (PCR) with different Mtb targets, 7 studies on DNA-based multiplex PCR, 1 study on mRNA-based multiplex PCR, 4 studies on loop-mediated isothermal amplification (LAMP) assay with different Mtb targets, 3 studies on GeneXpert assay, 1 study on GeneXpert Ultra assay and 1 study for MTBDRp
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- 2023
24. Ocular Toxoplasmosis.
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Goh, Eunice Jin Hui, Putera, Ikhwanuliman, La Distia Nora, Rina, Mahendradas, Padmamalini, Biswas, Jyotirmay, Chee, Soon-Phaik, Testi, Ilaria, Pavesio, Carlos E, Curi, Andre Luiz Land, Vasconcelos-Santos, Daniel Vitor, Arora, Atul, Gupta, Vishali, de-la-Torre, Alejandra, and Agrawal, Rupesh
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TOXOPLASMOSIS , *IRIDOCYCLITIS , *VISION disorders , *LITERARY sources , *AGE groups , *UVEITIS - Abstract
Introduction: Ocular toxoplasmosis is the leading cause of posterior uveitis worldwide, affecting individuals acrossdifferent age groups. The key to reducing vision loss includes prompt diagnosis and treatment. However, despite the prevalence of ocular toxoplasmosis, there has been little consensus regarding its pathophysiology,clinical features, diagnosis, and especially management. Methods: The data sources were literature reviews, including Pub Med and Medline databases. Search terms included toxoplasmosis, retinitis, vasculitis, vitritis, uveitis alone or in combination with, serum, aqueous, vitreous eye, ocular and review. Results: In this review paper, we have sought to provide an overview of the pathophysiology, epidemiology, and clinical features of the disease, both based on current literature and our own clinical experience. We have also discussed the use of serology, ocular fluid, and ophthalmic investigations that could further facilitate the diagnosis of ocular toxoplasmosis.Different management strategies have been reported worldwide, including newer approaches such as local therapy. Conclusion: A better understanding of critical aspects of ocular toxoplasmosis will hopefully lead to reduced morbidity, including blindness associated with this condition. [ABSTRACT FROM AUTHOR]
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- 2023
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25. Interferon-gamma release assay and chest X-ray to classify intraocular tuberculosis among clinically undifferentiated uveitis
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Riasanti, Mei, primary, Putera, Ikhwanuliman, additional, Jessica, Priscilla, additional, Waliyuddin, Muhammad Zakiy, additional, Tagar, Faiz Alwan, additional, Karlina CH, Andini, additional, Aziza, Yulia, additional, Susiyanti, Made, additional, Edwar, Lukman, additional, Sitompul, Ratna, additional, and La Distia Nora, Rina, additional
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- 2023
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26. Diagnosis and biomarkers for ocular tuberculosis: From the present into the future
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Ludi, Zhang, primary, Sule, Ashita Ashish, additional, Samy, Ramar Perumal, additional, Putera, Ikhwanuliman, additional, Schrijver, Benjamin, additional, Hutchinson, Paul Edward, additional, Gunaratne, Jayantha, additional, Verma, Indu, additional, Singhal, Amit, additional, Nora, Rina La Distia, additional, van Hagen, P. Martin, additional, Dik, Willem A, additional, Gupta, Vishali, additional, and Agrawal, Rupesh, additional
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- 2023
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27. Comparative Assessment of Short-Term Tendon-Scleral Postoperative Inflammation and α-Smooth Muscle Actin Expression following Oral and Topical Diclofenac Administration for Strabismus Surgery in Rabbits
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Bani, Anna Puspitasari, primary, Putera, Ikhwanuliman, additional, Susanto, Eka, additional, and La Distia Nora, Rina, additional
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- 2022
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28. Response to the Comment on "Evaluating the Diagnostic Accuracy and Management Recommendations of ChatGpt in Uveitis".
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Rojas-Carabali, William, Cifuentes-González, Carlos, Wei, Xin, Putera, Ikhwanuliman, Sen, Alok, Thng, Zheng Xian, Agrawal, Rajdeep, Elze, Tobias, Sobrin, Lucia, Kempen, John H., Lee, Bernett, Biswas, Jyotirmay, Nguyen, Quan Dong, Gupta, Vishali, de-la-Torre, Alejandra, and Agrawal, Rupesh
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CHATBOTS ,CHATGPT ,ARTIFICIAL intelligence ,UVEITIS ,OPHTHALMOLOGISTS - Abstract
This document is a response to a comment on a study titled "Evaluating the Diagnostic Accuracy and Management Recommendations of ChatGPT in Uveitis." The authors appreciate the comments and acknowledge the importance of continuous evaluation in the field of artificial intelligence (AI) applications in healthcare. They explain that their study aimed to compare the diagnostic accuracy of ChatGPT with that of uveitis specialists, as they wanted to evaluate its effectiveness against the highest standard of diagnosis and treatment. The authors also address the limitation of their study focusing on standard uveitis cases and express the need for future research to encompass a wider range of cases. They emphasize the importance of considering the individual contexts and specifications of AI systems when generalizing the results. The authors agree with the ethical considerations and potential limitations of AI in healthcare and highlight the need for sophisticated algorithms and diverse training data to minimize errors and biases. They appreciate the constructive critique and express their commitment to further research in the field of AI in medical diagnostics. [Extracted from the article]
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- 2024
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29. Ocular Toxoplasmosis
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Goh, Eunice Jin Hui, primary, Putera, Ikhwanuliman, additional, La Distia Nora, Rina, additional, Mahendradas, Padmamalini, additional, Biswas, Jyotirmay, additional, Chee, Soon-Phaik, additional, Testi, Ilaria, additional, Pavesio, Carlos E, additional, Curi, Andre Luiz Land, additional, Vasconcelos-Santos, Daniel Vitor, additional, Arora, Atul, additional, Gupta, Vishali, additional, de-la-Torre, Alejandra, additional, and Agrawal, Rupesh, additional
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- 2022
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30. The role of a multicentre data repository in ocular inflammation: The Ocular Autoimmune Systemic Inflammatory Infectious Study (OASIS)
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Ng, Sean Ming Sheng, Low, Rebecca, Pak, Clara, Lai, SerSei, Lee, Bernett, McCluskey, Peter, Symes, Richard, Invernizzi, Alessandro, Tsui, Edmund, Sitaula, Ranju Kharel, Kharel, Muna, Khatri, Anadi, Utami, Anna Nur, La Distia Nora, Rina, Putera, Ikhwanuliman, Sen, Alok, Agarwal, Manisha, Mahendradas, Padmamalini, Biswas, Jyotirmay, Pavesio, Carlos, Cimino, Luca, Sobrin, Lucia, Kempen, John H., Gupta, Vishali, and Agrawal, Rupesh
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In the current literature, clinical registry cohorts related to ocular inflammation are few and far between, and there are none involving multi-continental international data. Many existing registries comprise administrative databases, data related to specific uveitic diseases, or are designed to address a particular clinical problem. The existing data, although useful and serving their intended purposes, are segmented and may not be sufficiently robust to design prognostication tools or draw epidemiological conclusions in the field of uveitis and ocular inflammation. To solve this, we have developed the Ocular Autoimmune Systemic Inflammatory Infectious Study (OASIS) Clinical Registry. OASIS collects prospective and retrospective data on patients with all types of ocular inflammatory conditions from centers all around the world. It is a primarily web-based platform with alternative offline modes of access. A comprehensive set of clinical data ranging from demographics, past medical history, clinical presentation, working diagnosis to visual outcomes are collected over a range of time points. Additionally, clinical images such as optical coherence tomography, fundus fluorescein angiography and indocyanine green angiography studies may be uploaded. Through the capturing of diverse, well-structured, and clinically meaningful data in a simplified and consistent fashion, OASIS will deliver a comprehensive and well organized data set ripe for data analysis. The applications of the registry are numerous, and include performing epidemiological analysis, monitoring drug side effects, and studying treatment safety efficacy. Furthermore, the data compiled in OASIS will be used to develop new classification and diagnostic systems, as well as treatment and prognostication guidelines for uveitis.
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- 2023
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31. Clinical characteristics and treatment outcomes of cytomegalovirus anterior uveitis and endotheliitis: A systematic review and meta-analysis
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La Distia Nora, Rina, primary, Putera, Ikhwanuliman, additional, Mayasari, Yuri Dwi, additional, Hikmahwati, Wandya, additional, Pertiwi, Adinda Mulya, additional, Ridwan, Asri Salima, additional, Sitompul, Ratna, additional, Westcott, Mark, additional, Chee, Soon-Phaik, additional, Pavesio, Carlos, additional, Thng, Zheng Xian, additional, Gupta, Vishali, additional, and Agrawal, Rupesh, additional
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- 2022
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32. The Utility of Nonroutine Intraocular Fluid Polymerase Chain Reaction for Uveitis in Indonesia
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Putera,Ikhwanuliman, Riasanti,Mei, Edwar,Lukman, Susiyanti,Made, Sitompul,Ratna, Aziza,Yulia, Jessica,Priscilla, Rukmana,Andriansjah, Yasmon,Andi, La Distia Nora,Rina, Putera,Ikhwanuliman, Riasanti,Mei, Edwar,Lukman, Susiyanti,Made, Sitompul,Ratna, Aziza,Yulia, Jessica,Priscilla, Rukmana,Andriansjah, Yasmon,Andi, and La Distia Nora,Rina
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Ikhwanuliman Putera,1,2 Mei Riasanti,1 Lukman Edwar,1 Made Susiyanti,1 Ratna Sitompul,1 Yulia Aziza,1 Priscilla Jessica,1 Andriansjah Rukmana,3 Andi Yasmon,3 Rina La Distia Nora1,2,4 1Department of Ophthalmology, Faculty of MedicineUniversitas Indonesia â Cipto Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia; 2Department of Immunology, Erasmus Medical Center, Rotterdam, the Netherlands; 3Department of Microbiology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia; 4University of Indonesia Hospital (RSUI), Depok, West Java, IndonesiaCorrespondence: Rina La Distia Nora, Department of Ophthalmology, Faculty of Medicine Universitas Indonesia â Cipto Mangunkusumo Kirana Eye Hospital, Jl. Kimia No. 8, Menteng, Central Jakarta, Jakarta, 10320, Indonesia, Tel +62811198910, Email rina.ladistia@ui.ac.idPurpose: To investigate the utility of nonroutine polymerase chain reaction analysis of intraocular fluid to guide the diagnosis of infectious uveitis.Patients and Methods: A retrospective cohort study was conducted by reviewing medical record data from intraocular fluid samples of uveitis patients who underwent single-plex real-time polymerase chain reaction analysis at the Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia â Cipto Mangunkusumo Kirana Eye Hospital between January 2014 and December 2018.Results: The positivity rate of nonroutine polymerase chain reaction analysis was 17.2%. The vitreous sample tended to show a higher positive outcome (28.6%) than the aqueous sample (16.2%), even though the outcome was not statistically significant. Mycobacterium tuberculosis and Toxoplasma gondii were the most frequently observed microorganisms in the polymerase chain reaction analysis among uveitis patients in our setting. The duration of symptoms, type of sample fluid (aqueous/vitreous), or presence of anterior chamber cells ⥠2 were not significantly associated with polymerase chain reaction positivity (p > 0.05).Conclusion
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- 2022
33. The Utility of Nonroutine Intraocular Fluid Polymerase Chain Reaction for Uveitis in Indonesia
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Putera, Ikhwanuliman, Riasanti, Mei, Edwar, Lukman, Susiyanti, Made, Sitompul, Ratna, Aziza, Yulia, Jessica, Priscilla, Rukmana, Andriansjah, Yasmon, Andi, Nora, Rina La Distia, Putera, Ikhwanuliman, Riasanti, Mei, Edwar, Lukman, Susiyanti, Made, Sitompul, Ratna, Aziza, Yulia, Jessica, Priscilla, Rukmana, Andriansjah, Yasmon, Andi, and Nora, Rina La Distia
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Purpose: To investigate the utility of nonroutine polymerase chain reaction analysis of intraocular fluid to guide the diagnosis of infectious uveitis. Patients and Methods: A retrospective cohort study was conducted by reviewing medical record data from intraocular fluid samples of uveitis patients who underwent single-plex real-time polymerase chain reaction analysis at the Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo Kirana Eye Hospital between January 2014 and December 2018. Results: The positivity rate of nonroutine polymerase chain reaction analysis was 17.2%. The vitreous sample tended to show a higher positive outcome (28.6%) than the aqueous sample (16.2%), even though the outcome was not statistically significant. Mycobacterium tuberculosis and Toxoplasma gondii were the most frequently observed microorganisms in the polymerase chain reaction analysis among uveitis patients in our setting. The duration of symptoms, type of sample fluid (aqueous/vitreous), or presence of anterior chamber cells ≥2 were not significantly associated with polymerase chain reaction positivity (p > 0.05). Conclusion: Nonroutine polymerase chain reaction analysis of intraocular fluid among a cohort of Indonesian patients demonstrated low positivity. The sensitivity and specificity of nonroutine single-plex polymerase chain reaction could not be estimated due to limitations such as lost to follow-up patients and incomplete monitoring data. The use of multiplex polymerase chain reaction in the future may be beneficial in our setting.
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- 2022
34. The impact of aqueous humor polymerase chain reaction and serological test results for establishing infectious uveitis diagnosis:An Indonesian experience
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Putera, Ikhwanuliman, La Distia Nora, Rina, Utami, Nunik, Karuniawati, Anis, Yasmon, Andi, Wulandari, Dewi, Edwar, Lukman, Susiyanti, Made, Aziza, Yulia, Jessica, Priscilla, Riasanti, Mei, Sitompul, Ratna, Putera, Ikhwanuliman, La Distia Nora, Rina, Utami, Nunik, Karuniawati, Anis, Yasmon, Andi, Wulandari, Dewi, Edwar, Lukman, Susiyanti, Made, Aziza, Yulia, Jessica, Priscilla, Riasanti, Mei, and Sitompul, Ratna
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Objective: To assess the clinical value of aqueous humor real-time polymerase chain reaction (RT-PCR) and serological antibody tests among uveitis patients in Indonesian cohort. Methods: In this prospective cohort study, single-plex RT-PCR analysis of aqueous samples from 86 new uveitis patients was performed to detect Mycobacterium tuberculosis, Toxoplasmosis gondii, cytomegalovirus, herpes simplex virus, varicella-zoster virus, Epstein-Barr virus, and rubella virus. Specific serological antibodies for suspected pathogens were also obtained. Comparison of PCR and serological antibodies with the initial and final diagnosis were presented. Results: The diagnostic positivity of aqueous RT-PCR in our cohort was 20% (17/86). The rate of infection as final etiological classification was higher after RT-PCR was performed (45 patients, 52%) compared to initial diagnosis based on clinical presentation alone (38 patients, 44%). In particular, the RT-PCR positivity among patients with infection as the final etiological classification was 33.33% (15/45). A significant difference in the IgG but not IgM toxoplasma value among those with ocular toxoplasmosis as the final diagnosis compared to the other etiologies were observed (3953 (IQR 2707–19562) IU/mL vs 428 (IQR 82–1807) IU/mL; p < 0.0001). Conclusion: RT-PCR analysis of aqueous fluid from uveitis patients helped confirm a third of infectious uveitis cases in Indonesia. In ocular toxoplasmosis, high IgG but not IgM antibody value might help differentiate those with other etiology.
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- 2022
35. Diagnosis and biomarkers for ocular tuberculosis: From the present into the future.
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Zhang Ludi, Sule, Ashita Ashish, Samy, Ramar Perumal, Putera, Ikhwanuliman, Schrijver, Benjamin, Hutchinson, Paul Edward, Gunaratne, Jayantha, Verma, Indu, Singhal, Amit, Nora, Rina La Distia, van Hagen, P. Martin, Dik, Willem A., Gupta, Vishali, and Agrawa, Rupesh
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- 2023
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36. Comparative Assessment of Short-Term Tendon-Scleral Postoperative Inflammation and α-Smooth Muscle Actin Expression following Oral and Topical Diclofenac Administration for Strabismus Surgery in Rabbits.
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Bani, Anna Puspitasari, Putera, Ikhwanuliman, Susanto, Eka, and La Distia Nora, Rina
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TOPICAL drug administration , *MYOSITIS , *STAINS & staining (Microscopy) , *STRABISMUS , *ACTIN , *ENUCLEATION of the eye - Abstract
Wound healing and fibrosis modulation are considered pivotal for the long-term outcome of strabismus surgery. Nonsteroidal anti-inflammatory drugs, including diclofenac sodium, are inflammation suppressive drugs that may modulate wound healing, including postoperative inflammation. This study aimed to compare the effect of oral and 0.1% topical diclofenac sodium on short-term inflammation and α-smooth muscle actin (α-SMA) expression at the tendon-scleral attachment site following strabismus surgery in an experimental rabbit model. Superior rectus recession was performed in 12 eyes of six New Zealand rabbits. Rabbits were divided into three groups: oral diclofenac 2 × 5 mg/kg for three days (group A), 0.1% diclofenac sodium eye drops 3 times/day for three days (group B), and controls (group C). On postoperative day 14, enucleation was performed. Macroscopic adhesion score, microscopic adhesion score, percentage of postoperative inflammation area (Masson's trichrome staining), and α-SMA (immunohistochemistry staining) were assessed. Data analysis was performed using a semi-quantitative and quantitative assessment with ImageJ. All groups were compared with reciprocal staining intensity (RSI) values to measure α-SMA expression. All groups showed no difference in macroscopic (p = 0.13) and microscopic adhesion scores (p = 0.28). The percentage of postoperative inflammation area in group B (12.44% (8.63–18.29)) was significantly lower than group A (26.76% (21.38–37.56) p = 0.03) and group C (27.80% (16.42–36.28), p = 0.04). Comparative RSI analysis found that group B had a significantly lower α-SMA expression than group C (174.08 ± 21.78 vs 212.58 ± 12.06, p = 0.04). The results suggest that compared to oral, the administration of topical diclofenac showed a more significant reduction of short-term postoperative inflammation and α-SMA expression at the tendon-scleral attachment site following strabismus surgery. [ABSTRACT FROM AUTHOR]
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- 2023
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37. The Utility of Ocular Imaging in Traumatic Optic Nerve Avulsion: A Case Report
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Putera, Ikhwanuliman, primary, Nusanti, Syntia, additional, Rahmawati, Nur Aisyah, additional, Nindiana Pertiwi, Annisa, additional, and Marbungaran Hutapea, Mario, additional
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- 2022
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38. The Utility of Nonroutine Intraocular Fluid Polymerase Chain Reaction for Uveitis in Indonesia
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Putera, Ikhwanuliman, primary, Riasanti, Mei, additional, Edwar, Lukman, additional, Susiyanti, Made, additional, Sitompul, Ratna, additional, Aziza, Yulia, additional, Jessica, Priscilla, additional, Rukmana, Andriansjah, additional, Yasmon, Andi, additional, and La Distia Nora, Rina, additional
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- 2022
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39. Ocular tuberculosis with Mycobacterium tuberculosisDNA presence in ocular fluid: will post-COVID era bring a difference?
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Putera, Ikhwanuliman, Widodo, Erica, Riasanti, Mei, Waliyuddin, Muhammad Zakiy, Sitompul, Ratna, Edwar, Lukman, Susiyanti, Made, Aziza, Yulia, Yasmon, Andi, van Hagen, P. Martin, and La Distia Nora, Rina
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- 2024
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40. The Impact of Polymerase Chain Reaction and Serological Test Results for Establishing Infectious Uveitis Diagnosis: An Indonesian Experience
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Putera, Ikhwanuliman, primary, La Distia Nora, Rina, additional, Utami, Nunik, additional, Karuniawati, Anis, additional, Yasmon, Andi, additional, Edwar, Lukman, additional, Susiyanti, Made, additional, Aziza, Yulia, additional, Jessica, Priscilla, additional, Riasanti, Mei, additional, and Sitompul, Ratna, additional
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- 2022
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41. A case of aseptic bilateral cavernous sinus thrombosis following a recent inactivated SARS-CoV-2 vaccination
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Nora, RinaLa Distia, primary, Nusanti, Syntia, additional, Putera, Ikhwanuliman, additional, Sidik, M, additional, Edwar, Lukman, additional, Koesnoe, Sukamto, additional, Rachman, Andhika, additional, Kurniawan, Mohammad, additional, Edi Tarigan, TriJuli, additional, Yunus, ReyhanEddy, additional, Saraswati, Indah, additional, Zoraida Soraya, SitiHalida, additional, and Pratomo, TiaraGrevillea, additional
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- 2022
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42. Interferon-gamma release assay and chest X-ray to classify intraocular tuberculosis among clinically undifferentiated uveitis.
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Riasanti, Mei, Putera, Ikhwanuliman, Jessica, Priscilla, Waliyuddin, Muhammad Zakiy, Tagar, Faiz Alwan, C. H., Andini Karlina, Aziza, Yulia, Susiyanti, Made, Edwar, Lukman, Sitompul, Ratna, and Nora, Rina La Distia
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TUBERCULOSIS diagnosis , *TUBERCULOSIS complications , *INTERFERON gamma release tests , *KRUSKAL-Wallis Test , *CHEST X rays , *CROSS-sectional method , *INFLAMMATION , *DIFFERENTIAL diagnosis , *UVEITIS , *TUBERCULOSIS , *RESEARCH funding , *VISUAL acuity , *DESCRIPTIVE statistics , *DATA analysis , *DATA analysis software - Abstract
BACKGROUND Tuberculosis (TB) is a common cause of intraocular inflammation in Indonesia. As no accurate biomarker can confirm the diagnosis, ophthalmologists often rely on systemic findings, such as tuberculin skin test, interferon-gamma release assay (IGRA), and chest X-ray (CXR) for TB suspicion. This study aimed to evaluate IGRA and CXR in classifying intraocular TB among patients with a clinically undifferentiated cause of uveitis. METHODS This cross-sectional study included 116 patients (a total of 163 affected eyes) with a clinically undifferentiated cause of uveitis. IGRA and CXR were performed as part of the workup. Data on visual acuity, anterior chamber inflammation grade, and anatomical classification of uveitis were recorded. As there were no confirmed ocular tuberculosis (OTB) in our cases, eyes were classified into probable OTB, possible OTB, and unclassified. RESULTS Overall, 93 patients (80.2%) with a clinically undifferentiated cause of uveitis had positive IGRA, whereas 10 (8.6%) had CXR results suggestive of TB. More than one- third of the patients were blind (visual acuity <3/60), and panuveitis was the commonest anatomical classification. A trend was identified in patients with panuveitis, who often showed ≥2+ cell anterior chamber inflammation (p for trend = 0.023), according to OTB criteria (probable OTB = 3/4, 75.0%; possible OTB = 44/67, 65.7%; unclassified = 2/9, 22.2%). Furthermore, the clinically undifferentiated uveitis cases were eligible to be stratified into probable (8.6%) and possible (75.0%) OTB categories after IGRA and CXR examinations. CONCLUSIONS The combination of IGRA and CXR is valuable for classifying and diagnosing TB-related uveitis. A multidisciplinary approach is essential when the cause of uveitis is unknown. [ABSTRACT FROM AUTHOR]
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- 2022
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43. The Infectious Uveitis Treatment Algorithm Network (TITAN) Report 1—global current practice patterns for the management of Herpes Simplex Virus and Varicella Zoster Virus anterior uveitis
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Thng, Zheng Xian, Putera, Ikhwanuliman, Testi, Ilaria, Chan, Kevin, Westcott, Mark, Chee, Soon-Phaik, Dick, Andrew D., Kempen, John H., Bodaghi, Bahram, Thorne, Jennifer E., Barisani-Asenbauer, Talin, de Smet, Marc D., Smith, Justine R., McCluskey, Peter, La Distia Nora, Rina, Jabs, Douglas A., de Boer, Joke H., Sen, H. Nida, Goldstein, Debra A., Khairallah, Moncef, Davis, Janet L., Rosenbaum, James T., Jones, Nicholas P., Nguyen, Quan Dong, Pavesio, Carlos, Agrawal, Rupesh, and Gupta, Vishali
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Aims: To present current expert practice patterns and to formulate a consensus for the management of HSV and VZV AU by uveitis specialists worldwide. Methods: A two-round online modified Delphi survey with masking of the study team was conducted. Responses were collected from 76 international uveitis experts from 21 countries. Current practices in the diagnosis and treatment of HSV and VZV AU were identified. A working group (The Infectious Uveitis Treatment Algorithm Network [TITAN]) developed data into consensus guidelines. Consensus is defined as a particular response towards a specific question meeting ≥75% of agreement or IQR ≤ 1 when a Likert scale is used. Results: Unilaterality, increased intraocular pressure (IOP), decreased corneal sensation and diffuse or sectoral iris atrophy are quite specific for HSV or VZV AU from consensus opinion. Sectoral iris atrophy is characteristic of HSV AU. Treatment initiation is highly variable, but most experts preferred valacyclovir owing to simpler dosing. Topical corticosteroids and beta-blockers should be used if necessary. Resolution of inflammation and normalisation of IOP are clinical endpoints. Conclusions: Consensus was reached on several aspects of diagnosis, choice of initial treatment, and treatment endpoints for HSV and VZV AU. Treatment duration and management of recurrences varied between experts.
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- 2023
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44. A case of aseptic bilateral cavernous sinus thrombosis following a recent inactivated SARS-CoV-2 vaccination.
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Nusanti, Syntia, Putera, Ikhwanuliman, Sidik, M., Edwar, Lukman, Koesnoe, Sukamto, Rachman, Andhika, Kurniawan, Mohammad, Tarigan, Tri Juli Edi, Yunus, Reyhan Eddy, Saraswati, Indah, Soraya, Siti Halida Zoraida, Pratomo, Tiara Grevillea, and La Distia Nora, Rina
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This case report aims to describe the first report of bilateral aseptic cavernous sinus thrombosis (CST) with a recent history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. A 50-year-old woman presented with bilateral proptosis, decreased vision, and ophthalmoplegia 16 days following CoronaVac® vaccine. The visual acuity of the left eye was 20/150, while the right eye was no light perception with a hyperemic optic nerve head. She had a history of hyperthyroidism and currently on warfarin consumption. Laboratory results depicted elevated free T4, free T3, international normalized ratio, and low protein S and C. Magnetic resonance imaging showed bilateral CST, and high-dose methylprednisolone along with fondaparinux was given. The symptoms were significantly resolved, with the visual acuity of the left eye being improved to 20/20 but not the right eye. Bilateral CST has not been previously reported following inactivated SARS-CoV-2 vaccination. The underlying systemic conditions should be taken into consideration for the possibility of the inactivated SARS-CoV-2 vaccine-related event. [ABSTRACT FROM AUTHOR]
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- 2022
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45. Clinical Insights: Antimicrobial Therapy for Infectious Uveitis.
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Leong, Evangeline, Cifuentes-González, Carlos, Hu Y. W., Jeremy, Perumal Samy, Ramar, Khairallah, Moncef, Rojas-Carabali, William, Putera, Ikhwanuliman, de-la-Torre, Alejandra, and Agrawal, Rupesh
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Infectious uveitis is a major global cause of vision impairment. Despite the eye’s immune privilege, afforded by the blood-ocular barrier that restricts microbial entry, several pathogens such as bacteria, viruses, fungi, and parasites can still infiltrate and cause ocular infections and complications. Clinicians often encounter significant challenges in treating infectious uveitis due to limited or ineffective treatment options. Modern molecular techniques and imaging can aid in diagnosing and assessing intraocular infections. Various antimicrobial therapies exist, spanning topical and systemic treatments, but these are constrained by issues like drug concentration, penetration, effective duration, toxicity, and side effects. Treatment approaches also differ based on the infection’s etiology. This review provides recent updates on antimicrobial therapies from a clinical perspective, covering topical, systemic, and regional treatments for infectious uveitis. [ABSTRACT FROM AUTHOR]
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- 2024
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46. Clinical Features and Predictors of Treatment Outcome in Patients with Ocular Tuberculosis from the Netherlands and Indonesia: The OculaR TB in Low versus High Endemic Countries (ORTEC) Study.
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Putera I, Ten Berge JCEM, Thiadens AAHJ, Dik WA, Agrawal R, van Hagen PM, La Distia Nora R, and Rombach SM
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Purpose: To describe and compare clinical features, treatment approaches, and treatment outcomes of ocular tuberculosis (OTB) patients in the Netherlands, a low tuberculosis (TB)-endemic country, and Indonesia, a high TB-endemic country. We also aimed to identify predictors of treatment outcomes., Methods: A medical chart review of 339 OTB patients ( n = 93 from the Netherlands and n = 246 from Indonesia) was performed. The primary outcome was response to treatment, whether with or without anti-tubercular treatment, after six months of treatment initiation (good versus poor responders)., Results: Indonesian OTB patients displayed a higher prevalence of chest radiograph findings indicative of TB infection ( p < 0.001) and concurrent active systemic TB ( p = 0.011). Indonesian cohort exhibited a more acute and severe disease profile, including uveitis duration ≤ 3 months ( p < 0.001), blindness ( p < 0.001), anterior chamber (AC) cells ≥ 2+ ( p < 0.001), and posterior synechiae ( p < 0.001). Overall proportions of good responders to treatment were 67.6% in the Netherlands and 71.5% in Indonesia. Presence of AC cell ≥ 2+ (adjusted odds ratio (aOR): 2.12, 95% CI: 1.09-4.14), choroidal lesions other than serpiginous-like choroiditis (SLC) or tuberculoma (aOR: 4.47, 95% CI: 1.18-16.90), and retinal vasculitis (aOR: 2.32, 95% CI: 1.10-4.90) at baseline were predictors for poor response to treatment., Conclusions: Despite a more severe initial clinical presentation in the Indonesian cohort, the overall treatment outcomes of OTB was comparable in both cohorts. Three baseline clinical features were identified as predictors of treatment outcomes.
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- 2024
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47. Long-term follow-up after treatment of tubercular uveitis: case series and review of the literature.
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Putera I, van Daele PLA, Ten Berge JCEM, Dik WA, La Distia Nora R, van Hagen PM, and Rombach SM
- Abstract
Introduction: There is a scarcity of long-term follow-up data and management strategies for recurrent uveitis in tubercular uveitis (TBU), especially in cases extending beyond 10 years after the completion of initial antitubercular treatment (ATT)., Methods: This retrospective study involved five TBU patients who were initially treated with a combination of four-drug ATT for 6 months, and the five of them had more than 10 years of follow-up after uveitis resolution upon ATT completion. We describe the occurrence of recurrent uveitis and present our approach to managing these recurrent episodes., Results: Recurrent uveitis and cystoid macular edema (CME) developed in three out of five included TBU patients with a median of 18 years (range 13-20 years) of follow-up. The anatomical sites of the recurrences were anterior, intermediate, and pan-uveitis. The recurrent episodes varied from 6 years to 15 years after ATT completion. Systemic or local corticosteroids/immunosuppressants successfully resolved all recurrent episodes, but one was also treated with the combination of isoniazid monotherapy again. Two patients needed anti-tumor necrosis factor-α therapy., Conclusion: Long-term monitoring of TBU patients after ATT completion is warranted. Further well-designed studies with larger sample sizes are required to better estimate the risk of recurrences, investigate the underlying mechanism of recurrences, and identify biomarkers that predict who is at risk for recurrences., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Putera, van Daele, ten Berge, Dik, La Distia Nora, van Hagen and Rombach.)
- Published
- 2023
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