Articles
<![CDATA[Prediction Errors and Accuracy of Intraocular Lens (IOL) Calculation Formulas in Pediatric Eyes ]]>
<![CDATA[Fitri Muslim]]>;
<![CDATA[Julie Dewi Barliana]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 46 No 2 (2020): Ophthalmologica Indonesiana ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/journal.v46i2.100096
<![CDATA[Background: Acquiring an accurate intraocular (IOL) power in children undergoing cataract surgery is challenging. Different IOL calculation formulas in children have been previously studied to achieve a precise prediction of the IOL power. Larger errors in IOL formula predictions have shown in several studies on children as future growth of the eye affects the keratometry readings and axial length. Prediction error (PE) and absolute prediction error (APE) can be effective indicators in assessing the accuracy of IOL power calculation formulas. Therefore, this review aims to investigate the accuracy of IOL power calculation formulas in pediatric eyes by measuring PE and/or APE value. Methods: A comprehensive search was conducted from various electronic databases (Pubmed, Clinical Key, and Ophthalmology Advance) using relevant search terms. Included studies were screened using predefined inclusion and exclusion criteria to identify comparative studies comparing the accuracy of IOL calculation formulas in pediatric patients. Result: Ten studies including 964 eyes were identified to compare different IOL formulas: Hoffer Q, SRK/T, SRK II, Holladay 1, and Holladay 2. Smaller prediction error is related to better postoperative refraction. Among included studies, Holladay 2 had the smallest mean prediction errors (PE), while SRK/T formula was the best formula of all included studies in pediatric patients as it had the smallest mean absolute prediction errors (APE). Hoffer Q also had the smallest mean APEs in shorter eyes (axial length <22 mm). Conclusion: This study demonstrates that none of the established formulas found to be more superior than any other formulas in predicting IOL power in children. Biometry examination in patients with less than one year of age tends to show a lower accuracy.]]>
<![CDATA[Optical Iridectomy as An Alternative Clear Visual Axis for Peters Anomaly ]]>
<![CDATA[Laura Agnestasia]]>;
<![CDATA[Julie Dewi i Barliana]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 47 No 1 (2021): Ophthalmologica Indonesiana ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/journal.v47i1.100164
<![CDATA[Introduction and objective: Peters anomaly is a rare congenital disease presented with central leukoma, iridocorneal adhesion, and with or without a cataractous lens. The presence of central leukoma will block the visual axis and lead to a disruption in normal visual development. Therefore, optical iridectomy, which can overcome the high incidence of graft failure in penetrating keratoplasty (PK), has been proposed as the alternative treatment to clear the visual axis. This study aims to show the outcome of optical iridectomy in patients with Peters’ anomaly. Method: Systematic literature searched in Pubmed, Google Scholar, and Cochrane from their inception to August 2020 was conducted using keywords “iridectomy” and “Peters’ anomaly”. Full- text articles in English that report the outcome of iridectomy in Peters’ anomaly were included, and a manual review of article bibliographies was done. Outcome measures were analyzed using the following clinical questions: indication, age, visual acuity (VA), and intraocular pressure (IOP). Result: One case series and two case reports demonstrating the use of optical iridectomy in Peters anomaly were identified. In total, 26 patients aged one week to 7.7 years received optical iridectomy to establish a clear visual axis. All studies showed an improvement in visual acuity through clinical findings, and one of the studies showed a better postoperative VA in bilateral cases. Studies showed good control of IOP. Conclusion: Optical iridectomy can be used as a safe procedure to improve visual acuity in Peters anomaly patient.]]>
<![CDATA[Efficacy of Intravitreal Anti Vascular Endothelial Growth Factor Injection Compared to Focal Therapy in Pediatric Patients with Coats Disease ]]>
<![CDATA[Alia Nesa Utami]]>;
<![CDATA[Julie Dewi Barliana]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 48 No 2 (2022): Ophthalmologica Indonesiana ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/journal.v48i2.100602
<![CDATA[Introduction: Coats disease is a retinal vascular disorder that may lead to progressive exudative retinal detachment. The standard regiment of treatment is focal therapy. However, its effectiveness may decrease when more than two quadrants of the retina exhibit vascular abnormalities. Thus, recent studies tried to use anti vascular endothelial growth factor (anti-VEGF) as therapy for the vascular problems. Aims: Comparing the efficacy between anti-VEGF injection and standard therapy regiment such as focal laser therapy. Methods: Literature searching was conducted through PubMed, ScienceDirect, Google Scholar, ProQuest, and SpringerLink. Search terms included "Coats’ Disease" and mesh terms of “Anti- VEGF". The efficacy is assessed based on Best-Corrected Visual Acuity (BCVA) and improvement in fundus manifestations. Results: All of the studies that conducted primary intravitreal anti-VEGF treatment were followed by necessary ablative treatment. These studies, such as by Yang Q and Zheng XX, et al. showed remarkable improvements in both visual acuity and anatomical outcomes. Laser therapy also gained satisfactory result in upgrading clinical stages, even though some complications including subretinal fibrosis, cataract, and vitreous hemorrhage were reported. A comparative study by Ray R, et al. noted that group undergoing anti-VEGF might require longer treatment sessions despite possible benefits. Conclusion: Anti-VEGF agents can be used as neoadjuvant in standard therapy. It did not reduce the time for full treatment, but the resolution of disease was seen in the most severe cases treated with combination therapy.]]>
<![CDATA[Nocturnal Lagophthalmos in Pediatric Patient with Hydrocephalus: Poster Presentation - Case Report - Resident ]]>
<![CDATA[IZZA ZUKHRUFIA]]>;
<![CDATA[Yunia Irawati]]>;
<![CDATA[Julie Dewi Barliana]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/egvmc937
<![CDATA[Introduction : Nocturnal lagophthalmos is a physiologic and asymptomatic condition observed in 1.4-5% of the population. In unconscious patients, using mechanical ventilation and neuromuscular blocker medication can worsen the lagophthalmos, causing the patient to have exposure keratopathy. This report aims to emphasize the importance of eye care in unconscious patients. Case Illustration : A 5-year-old girl came with a chief complaint of a whitish lesion on the right eye. She got the lesion when hospitalized in Pediatric Intensive Care Unit for two weeks due to seizure attacks. A red and watery eye accompanied the whitish lesion. The patient had history of nocturnal lagophthalmos and Dandy-Walker syndrome, a complex malformation characterized by agenesis or hypoplasia of the vermis and cystic enlargement of the fourth ventricle. The corneal ulcer was treated with antibiotic treatment. After several visits, her infection had subsided but left a corneal cicatrix on her right eye. Discussion : In unconscious patients, it’s important to pay attention to the eyelid. Lagophthalmos can be divided into three groups; where grade 1 has complete eyelid closure; grade 2 has conjunctival exposure; and grade 3 has corneal exposure. It’s important to lubricate the eye in each grade and keep it closed using eyelid tape or cover in grades 2 and 3 to prevent exposure keratopathy. Surgical intervention can be considered when there is a risk of corneal ulcer. Conclusion : Prevention is always better than cure. Establishing standardized eye care in the intensive care unit is crucial to prevent ocular complications and preserve visual acuity.]]>
<![CDATA[Imaging Mismatch of Nail in the Eyeball: What’s next? Poster Presentation - Case Report - Resident ]]>
<![CDATA[Christella Caroline]]>;
<![CDATA[Gladys Kusumowidagdo]]>;
<![CDATA[Burhana Mawarasti]]>;
<![CDATA[Michael Hartono]]>;
<![CDATA[Julie Dewi Barliana]]>;
<![CDATA[Rio Rhendy]]>;
<![CDATA[Yunia Irawati]]>;
<![CDATA[Ari Djatikusumo]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/2payky76
<![CDATA[Introduction : A retained foreign body (FB) can lead to severe complications, the most devastating of which is eye loss. We present a discrepancy of imaging that resulted in a dilemma in the approach management of a mixed global-adnexal FB case. Case Illustration : A 31-year-old man came to the emergency room with blurry vision for 1.5 hours after a nail hit his right eye (RE). The visual acuity of RE is light perception. Ophthalmological examination revealed a central Y-shaped full-thickness corneal laceration with iris and vitreous prolapse. The lens appeared cloudy, and the posterior segment was difficult to assess. Imaging showed a foreign metal object asa nail in the oculi to intraconal without penetration to the orbital wall. He was planned to undergo FB extraction with corneal laceration repair and aspiration of lens mass irrigation. However, the nail was hard to find intraoperatively because the vitreous and choroid kept coming out. Hence evisceration with DFG was performed. The nail was found more posteriorly and attached to the bone. Discussion : While primary repair is the standard practice for open globe injury, managing retained intraocular metallic foreign bodies is controversial. Imaging such as CT scans can help determine the location of FB and approach management. In this case, imaging showed the FB was in the iris plane and not penetrating the orbital wall, so primary repair and FB extraction were planned. Conclusion : The imaging may not always be accurate in determining the exact location of FB, and the surgical approach may need to be adjusted accordingly.]]>
<![CDATA[Effectiveness and Timing of Congenital Nasolacrimal Duct Obstruction Probing: a Systematic Review: Oral Presentation - Observational Study - General practitioner ]]>
<![CDATA[Kharisma Zatalini Giyani]]>;
<![CDATA[Dewi Alya Winarto]]>;
<![CDATA[Julie Dewi Barliana]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/5t0yhc19
<![CDATA[Abstract Introduction & Objectives : Most congenital nasolacrimal duct obstruction (NLDO) cases could resolve spontaneously or only require minimal conservative treatment. In unresolved cases, lacrimal probing is considered a primary treatment; however, no consensus on the best timing to perform probing is available. Therefore, this study aims to compare the effectiveness of immediate probing with deferred probing and to assess the best time to perform primary probing. Methods : A search for relevant literature was performed on four electronic databases: PubMed, Cochrane Library, EMBASE, and Scopus with predetermined keywords. The inclusion criteria consist of systematic reviews, RCTs, and prospective/retrospective studies published between 2013-2023 regarding lacrimal probing as an intervention for congenital NLDO. Results : We included seven studies. Three studies compared immediate and deferred probing, while four focused on the success rate of probing for NLDO at various age groups. Studies suggest immediate and deferred probing had a comparable effectivity in treating NLDO; however, one systematic review suggests immediate probing was superior to deferred probing. Studies also demonstrate that the success rate of probing declines with age. Lacrimal probing performed on NLDO patients under 12 months old had a success rate of more than 80%. Conclusion : Despite findings of comparable effectiveness between immediate and deferred probing, probing performed at a younger age yielded a higher success rate. This suggests that doctors should consider the patient's age at diagnosis to decide between immediate and deferred probing. Further evidence is needed to determine cut-offs for the best time to perform primary probing.]]>
<![CDATA[Binocular therapy for amblyopia in children: a systematic review and meta- analysis of randomized controlled trials: Oral Presentation - Observational Study - General practitioner ]]>
<![CDATA[Diajeng Ayesha Soeharto]]>;
<![CDATA[Abritho Zaifar]]>;
<![CDATA[Natassha Priscillia Wibowo]]>;
<![CDATA[Julie Dewi Barliana]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/374nnd84
<![CDATA[Abstract Introduction & Objectives : Concerns for low compliance and mixed outcomes with conventional deprivation therapy prompt the need to explore new modes of amblyopia treatment. Novel binocular therapy using movies or games may offer comparable outcomes with better compliance, theoretically strengthening the amblyopic eye by enhancing stereopsis. This study aims to elucidate current evidence regarding binocular therapy in comparison to conventional therapy in treating amblyopia in children. Methods : Comprehensive literature search across five electronic databases was conducted using keywords selected a priori. Randomized controlled trials (RCTs) on binocular therapy in children with amblyopia were included and critically appraised using Cochrane risk of bias tool by three reviewers. Primary outcome was improvement of amblyopic eye VA, and a meta-analysis was conducted for quantitative data analysis. Results : We included 16 RCTs eligible for inclusion with a total sample size of 1,520 patients. In comparing binocular therapy to either patching or spectacles, there was no overall significant difference in terms of VA change from baseline. Subgroup analysis suggests binocular therapy may be favorable within 2-4 weeks, although not statistically significant. Albeit subgroup analysis of video-based binocular therapy revealed significant improvement in VA compared to patching (0.39 logMAR, [0.03, 0.74], p = 0.03), yet the same was not found for game-based binocular therapy. Conclusion : Efficacy of binocular therapy as a substitute for conventional therapy in treating amblyopia is not yet substantiated. Further exploration to determine most effective treatment protocol is needed, including strategies to increase adherence. Video-based therapy shows potential for improving outcomes and warrants further investigation.]]>
<![CDATA[Validity and Reliability of Farra Eye Model as a Surgical Simulator for Capsulorhexis Training: Oral Presentation - Observational Study - Resident ]]>
<![CDATA[HANIFAH RAHMANI NURSANTI]]>;
<![CDATA[Julie Dewi Barliana]]>;
<![CDATA[Syska Widyawati]]>;
<![CDATA[Faraby Martha]]>;
<![CDATA[Levina Chandra Khoe]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/w12r3545
<![CDATA[Abstract Introduction & Objectives : Various simulation models are available for cataract surgery training. Farra Eye Model, a new cataract surgery simulator, was developed to provide the resident with more affordable options. This study aims to determine the validity and reliability of the Farra Eye Model as a surgical simulator for capsulorhexis training. Methods : A cross-sectional pilot study was performed among ophthalmology residents and consultants to assess face, content, and construct validity of a new surgical simulator. Subjects were divided into novice, intermediate, and expert groups according to their level of expertise. Face and content validity was assessed using a validated questionnaire with a 5-point Likert scale response. Construct validity was done by comparing capsulorhexis performance between the three groups. Two raters assessed performance using capsulorhexis indices in ICO-OSCAR: Phaco assessment tool, number of forceps grabs, and duration of capsulorhexis. Results : A total of 33 subjects were recruited and divided equally into three groups. The overall face validity score was favorable (3.67 ± 0.67). However, the capsule elasticity was rated poor (2.73 ± 1.1) among the intermediate group. The content validity was favorable regarding the overall score (4.15± 0.58) and each assessment component. In the construct validity test, intermediate and expert groups showed better capsulorhexis performance than the novice group on all parameters (p<0.001), with good inter-rater reliability (ICC>0.7). Conclusion : Farra Eye Model has a good face and content validity for capsulorhexis training and is able to differentiate the novice group from intermediate and expert groups. However, it remains a challenge to replicate human lens capsule elasticity.]]>
<![CDATA[Diagnostic Challenges in Retinoblastoma with Panophthalmitis-Like Manifestation: A Case Report ]]>
<![CDATA[Nugrahaputra, Rino]]>;
<![CDATA[Barliana, Julie Dewi]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 51 No 1 (2025): Ophthalmologica Indonesiana ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/journal.v51i1.101655
<![CDATA[Purpose: To highlight the importance and challenges of diagnostic examination and modalities to diagnose retinoblastoma with varieties of manifestation such as panophthalmitis-like. Case Report: A 4-year-old boy presented with red and swollen right eye since two days prior to admission. The position of the right eye was hypotrophy with restricted eye movement towards all directions and there was a presence of proptosis with edema, spasm, hyperemia with yellowish crust. Ultrasonography result came with severe anterior-posterior vitreous haziness with calcified mass suggesting an intraocular tumor of the right eye. Orbital CT-scan was performed and suggestive of panophthalmitis with superior palpebra abscess of the right eye. The inflammation was proposed due to prior intraocular surgery of cataract extraction and trabeculectomy that led to progression and worsening of the retinoblastoma, such invasive surgery led to atypical presentation of panopthalmitis-like. Patient initial visit was due to symptoms of leukocoria and squinting, but even though ocular ultrasonography was performed, the patient had failed to be diagnosed with retinoblastoma. Patient had CT scan and was confirmed of an intraocular mass with calcification inside the right eye with some palpebral abscess. MRI was performed to confirm the extension of the mass, which fortunately did not extend outside the eye. The patient then underwent chemo reduction therapy, before finally got enucleation with dermatofat graft surgery. Histologic examination confirmed the diagnosis of retinoblastoma. This case was an example of how sometimes clinical misdiagnosis among retinoblastoma can happen which can be due to inadequate diagnostic examination or atypical presentation. Preventing clinical misdiagnosis of retinoblastoma can improve the treatment and likelihood of survival of patients with retinoblastoma. Conclusion: Clinical misdiagnosis of retinoblastoma can happen without adequate diagnostic tools and prowess which may result in mismanagement and/or delayed treatment leading to poorer prognosis of patient with retinoblastoma.]]>
<![CDATA[Scleral Buckling for Retinopathy of Prematurity: A Case Report ]]>
<![CDATA[Permanik, Gustiandari Fidhya]]>;
<![CDATA[Barliana, Julie Dewi]]>;
<![CDATA[Yudantha, Anggun Rama]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 51 No 1 (2025): Ophthalmologica Indonesiana ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/journal.v51i1.101725
<![CDATA[IntroductionThe selection of management for advanced retinopathy of prematurity (ROP) requires careful consideration. The purpose of this study is to report the effectiveness of scleral buckling in patient with retinopathy of prematurity stage 4B of both eyes within 3 months. Case Description A 4-month-old female baby came to the Pediatric Ophthalmology Unit in Cipto Mangunkusumo General Hospital (RSCM) Kirana with chief complain did not make eye contact of both eyes. Her eyes were moving on their own since she was 3.5 months old, and sometimes squint. The patient came to the pediatrician and was referred to pediatric ophthalmology for further treatment. There was a history of premature delivery at 30 weeks with oxygen therapy for 3 weeks. The Pediatric ophthalmology division performed ultrasonography and retcam, and the diagnosis of retinopathy of prematurity stage 4B of both eyes was made. Scleral buckling was performed in the right and left eyes at the postmenstrual age of 49 weeks, and 52 weeks respectively by vitreoretinal division. Conclusion The management of ROP depends on the type ROP. For advanced ROP, surgery is indicated. The scleral buckle is a treatment option for advanced retinopathy of prematurity patients with retinal detachment if it is assumed that intraocular surgery presents a greater risk. In short-term period, for the right eye, the scleral buckling is effective. Further time to follow up is needed to show the long-term period effectiveness of scleral buckling in patients with advanced ROP.]]>
