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Treatment of Corneal Perforation Using Periosteal Graft Technique With the Continuation of Penetrating Keratoplasty: Poster Presentation - Case Report - Resident ADRIAN PRATAMA; Petty Purwanita; Anang Tribowo
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/v54aqe08

Introduction : Corneal perforation occurs due to various conditions and management are based on the underlying cause. Modalities to treat corneal leaks is dependent on the size of corneal defect and include tissue adhesive, conjunctival flap, grafts and transplants. Penetrating Keratoplasty (PK) is effective to treat large corneal defect and to improve visual acuity (VA), but unfortunately PK is usually delayed due to availability. Case Illustration : A 17-years-old teenager was diagnosed with corneal perforation on his left eye, VA at initial visit was 1/300, positive seidel test, and shallow anterior chamber. Patient immediately underwent periosteal graft with subsequent PK surgery one month later. First until eight days postoperatively, VA improved from 3/60 to 6/30. Ten days after PK, a mechanical trauma caused the transplant to be detached, and VA greatly decreased to 1/300. Patient underwent immediate repair surgery. First day after surgery, VA was light perception. Eight days later, VA increased to 1/60 with concurrent iris prolapse. Iris repair was done immediately and eight days later VA increased to 6/60. At day sixteen, the final VA is 6/30. Discussion : Periosteal graft was performed to maintain ocular integrity. After waiting for a month, PK was performed to improve vision. This combination therapy was successful proven by VA improvement from 1/300 to 6/30. Conclusion : Periosteal graft is necessary to maintain ocular integrity while waiting for availability of donor cornea. Penetrating keratoplasty is an appropriate procedure for patients with large corneal leaks. It replaces all corneal structures, and it also improve visual function.

Autologous Fascia Lata Graft in Scleromalacia Perforans: A Rare Case: Poster Presentation - Case Report - Resident ANCI WINAS; Petty Purwanita; Anang Tribowo
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/sbca0c12

Introduction : Scleromalacia perforans, also called anterior necrotizing scleritis without inflammation, is a rare disease with an initial lesion of yellow or greyish nodules that gradually develop into scleral necrosis with perforation and exposure of uvea. It typically occurs in elderly women. Surgical therapy to close the defect may be performed with the sclera, dermis, fascia lata, periosteum, aortic tissue, cartilage, and eventually amniotic membrane as grafts. Case Illustration : A 59-year-old woman presented with complaint of greyish discoloration of the sclera on the right eye since one years ago. The patient denied the history of arthritis, autoimmune diseases, and other systemic diseases. The patient claimed to have had pterygium surgery ten years ago. Visual acuity was 6/9 with an of IOP 13.1 mmHg. Slit lamp examination revealed thinning of the medial sclera. Posterior segment was within normal limits. Serum antibody screening obtained normal results. The patient was diagnosed with scleromalacia perforans and underwent autologous fascia lata graft surgery. Two weeks postoperatively, scleral of the fascia lata graft gave good results. Discussion : Scleromalacia perforans is diagnosed based on anamnesis and ophthalmological examination. A history of pterygium surgery is suspected as the trigger for scleral thinning. Surgical therapy was performed to maintain the integrity of the eyeball and prevent further thinning of the sclera. Autologous fascia lata graft is chosen because it is readily available, easy to perform, and has a low rejection rate. Conclusion : Autologous fascia lata graft is a surgery that provides good prognosis in scleromalacia perforans.

Treatment of Corneal Perforation Using Periosteal Graft Technique With the Continuation of Penetrating Keratoplasty: Poster Presentation - Case Report - Resident ADRIAN PRATAMA; Petty Purwanita; Anang Tribowo
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/0d3pap92

Introduction : Corneal perforation occurs due to various conditions and management are based on the underlying cause. Modalities to treat corneal leaks is dependent on the size of corneal defect and include tissue adhesive, conjunctival flap, grafts and transplants. Penetrating Keratoplasty (PK) is effective to treat large corneal defect and to improve visual acuity (VA), but unfortunately PK is usually delayed due to availability. Case Illustration : A 17-years-old teenager was diagnosed with corneal perforation on his left eye, VA at initial visit was 1/300, positive seidel test, and shallow anterior chamber. Patient immediately underwent periosteal graft with subsequent PK surgery one month later. First until eight days postoperatively, VA improved from 3/60 to 6/30. Ten days after PK, a mechanical trauma caused the transplant to be detached, and VA greatly decreased to 1/300. Patient underwent immediate repair surgery. First day after surgery, VA was light perception. Eight days later, VA increased to 1/60 with concurrent iris prolapse. Iris repair was done immediately and eight days later VA increased to 6/60. At day sixteen, the final VA is 6/30. Discussion : Periosteal graft was performed to maintain ocular integrity. After waiting for a month, PK was performed to improve vision. This combination therapy was successful proven by VA improvement from 1/300 to 6/30. Conclusion : Periosteal graft is necessary to maintain ocular integrity while waiting for availability of donor cornea. Penetrating keratoplasty is an appropriate procedure for patients with large corneal leaks. It replaces all corneal structures, and it also improve visual function.

Correlation Between the Severity of Dry Eye Disease and Fluorescein Break-Up Patterns (FBUP) Petty Purwanita; Putri Dwi Kartini
Sriwijaya Journal of Medicine Vol. 6 No. 3 (2023): Vol 6, No. 3, 2023
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sjm.v6i3.205

Dry eye disease is a disorder of the eye surface characterized by instability of the tear film. The FBUP examination is one of the examinations used to determine the stability of the tear film. The various symptoms that occur in each type of dry eye indicate differences in break-up patterns (BUP). This study aims to determine the correlation between the severity of dry eye disease and the appearance of FBUP at RSUP dr. Mohammad Hoesin Palembang. A correlative analytical cross-sectional study was undertaken at the Eye Polyclinic, Infection- Immunology Subdivision, Dr. Mohammad Hoesin General Hospital Palembang from January to June 2022. There were 32 patient samples with 60 dry eye samples that met the inclusion criteria. The correlation between the Schirmer Test, TBUT and the severity of dry eye disease with the appearance FBUP was analyzed using the Spearman Rho's test. All data were analyzed with SPPS version 23.0. In this study, the results showed that there was a moderate and significant positive correlation between the degree of the Schirmer test and the appearance FBUP (r = 0.482; p = 0.000) and a moderate and significant positive correlation between the TBUT degree and the appearance FBUP (r = 0.435; p = 0.001) . In addition, the results showed that there was a moderate and significant positive correlation between the severity of dry eye disease and the appearance of FBUP (r = 0.478; p = 0.000). Using the multivariate test, it was concluded that the degree of dry eye was statistically significantly related to age (p = 0.001) and gender (p = 0.001). There is a correlation between the severity of the disease and the appearance FBUP of patients with dry eye disease.

Edukasi komprehensif penyakit mata kering di Puskesmas Dempo Palembang Purwanita, Petty; Amin, Ramzi; Tribowo, Anang; Cicilia, Monica Putri
Jurnal Pengabdian Masyarakat: Humanity and Medicine Vol 6 No 1 (2025): Jurnal Pengabdian Masyarakat: Humanity and Medicine
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/Hummed.V6I1.167

Educational Outreach on Dry eye disease at Puskesmas Dempo Palembang. Dry eye disease is one of the most common eye health concerns worldwide, including in our community. With modern lifestyle changes, such as increased use of digital devices and exposure to less favorable environmental conditions, the prevalence of dry eye is rising. This condition not only causes daily discomfort but can also lead to serious vision problems if not properly addressed. The Community Ophthalmology Team from the Department of Ophthalmology, Faculty of Medicine, Sriwijaya University, conducted an outreach program to enhance participants' understanding of dry eye disease, covering its causes, symptoms, prevention, and treatment. Through effective education, we can help the community recognize early signs of the disease, adopt habits that support eye health, and seek appropriate treatment early on. A total of 32 participants, who were patients of Puskesmas Dempo, actively participated in the outreach program. The participants showed great enthusiasm during the Q&A session, and observations revealed an increase in their knowledge about dry eye disease. This outreach program successfully enhanced the community's awareness of dry eye disease and the steps to prevent it.

Clinical Characteristics of Ocular Toxoplasmosis Patients Frashad Fanseca Alvarez; Petty Purwanita; Indri Seta Septadina
Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan Vol 17 No 1 (2023): Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran UPN Veteran Jakarta Kerja Sama KNPT

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33533/jpm.v17i1.5653

Toxoplasma gondii infection causes posterior uveitis and blindness. The diagnosis of ocular toxoplasmosis is based on typical clinical findings accompanied by positive anti-Toxoplasma serology. This study aims to see the clinical characteristics of ocular toxoplasmosis patients. Cross-sectional observational descriptive research is done. This study used 2019-2021 medical records from RSUP Dr. Mohammad Hoesin Palembang patients. The highest incidence of ocular toxoplasmosis at RSUP Dr. Mohammad Hoesin Palembang in 2019-2021 occurred in 2021 (54.5%). The most common age range found in this case is the age group of 0-19 years (45.5%) and the majority are women (72.7%). The majority of patients are out of work (45.5%) and live outside Palembang (81.8%). The most lateralization was found in the right eye (63.6%). The most commonly complained clinical symptom is blurred vision (90.9%). Clinical signs were found lesions of retinochoroiditis in the macular (45,5%), in the extramacular (18,2%), chorioretinal scar (90,9%), vitritis (54,5%), decreased visual acuity (100%), and increased IOP (36,4%). Anti-Toxoplasma IgG was found positive in all patients. The highest incidence of ocular toxoplasmosis was found in 2021. The most commonly complained clinical symptom is blurred vision and the most commonly found clinical sign is a decrease in visual acuity.

Association of Foveal Avascular Zone Diameter with Best-Corrected Visual Acuity in Diabetic Retinopathy: A Cross-Sectional Optical Coherence Tomography Angiography Study Ramzi Amin; Rezandi Pratama; Petty Purwanita; Muhammad Aulia Molid Ogest Putra Calisanie
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 8 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i8.1659

Background: Foveal avascular zone (FAZ) enlargement reflects capillary loss in diabetic retinopathy (DR), but its relationship with visual acuity varies across protocols and populations. Objective: We assessed the association between swept-source optical coherence tomography angiography (OCTA)-derived FAZ diameter and best-corrected visual acuity (BCVA). Methods: This cross-sectional study included 32 adults with DR examined from April to December 2024. One eye per participant underwent 3×3-mm swept-source OCTA. Superficial and deep FAZ diameter, superficial vessel density, central subfield thickness, and LogMAR BCVA were assessed using correlations, severity-group comparisons, multivariable regression, and exploratory secondary analyses. Results: Mean age was 57.8±8.4 years; 17 participants (53.1%) were men. Mean superficial FAZ diameter was 617.6±171.6 µm and BCVA was 0.539±0.341 LogMAR. FAZ diameter correlated with worse BCVA (r=0.582, 95% confidence interval [CI] 0.293–0.774; p<0.001) and increased from 458.3±82.1 µm in mild nonproliferative DR to 812.5±125.8 µm in proliferative DR (F(3,28)=16.35; p<0.001; η²=0.637). FAZ was the largest standardized correlate in the exploratory adjusted model (β=0.485; p<0.001; adjusted R²=0.412). An exploratory 580-µm cutoff yielded an area under the curve of 0.847 (95% CI 0.723–0.971). Conclusion: Larger superficial FAZ diameter was associated with worse BCVA and greater DR severity. The proposed cutoff and secondary models require independent validation.

Retinal Neural Layer Thickness and Contrast Sensitivity in Type 2 Diabetes Without Clinical Retinopathy: A Cross-Sectional Study Ramzi Amin; Ririn Rahayu; Petty Purwanita; Muhammad Aulia Molid Ogest Putra Calisanie
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i7.1660

Background: Retinal neural dysfunction may occur in type 2 diabetes mellitus (T2DM) before clinically visible diabetic retinopathy. Objective: We evaluated whether retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCL-IPL) thickness were associated with contrast sensitivity in adults with T2DM without clinical retinopathy. Methods: This cross-sectional study included 30 eyes from 16 participants examined from September 2024 to June 2025. Swept-source optical coherence tomography measured average and quadrant RNFL thickness and macular GCL-IPL thickness. Monocular contrast sensitivity was assessed with the Pelli-Robson chart. Source-reported analyses included exploratory Spearman correlations, generalized estimating equations (GEE) for inter-eye clustering, and exploratory receiver operating characteristic (ROC) analysis. Results: Mean RNFL thickness was 101.3 ± 12.55 µm, GCL-IPL thickness was 81.53 ± 7.34 µm, and contrast sensitivity was 1.773 ± 0.227 logCS. Eye-level correlations with contrast sensitivity were ρ=0.758 for GCL-IPL and ρ=0.640 for average RNFL (both source-reported p<0.001). In the exploratory GEE model, coefficients were 0.0104 logCS per µm for GCL-IPL (95% CI 0.001-0.019) and 0.0062 for RNFL (95% CI 0.001-0.011). Exploratory AUCs were 0.872 and 0.804, respectively. Conclusion: Thicker GCL-IPL and RNFL measurements were associated with better contrast sensitivity in this small cohort. The estimates are hypothesis-generating and require confirmation with participant-level data, larger samples, and external validation before clinical use.

Adjunctive Diquafosol Sodium 3% and Tear-Ferning Recovery After Pars Plana Vitrectomy: An Exploratory Randomized Trial Petty Purwanita; Ramzi Amin; Rizka Yunanda
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 5 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i5.1661

Background: Ocular-surface disturbance after pars plana vitrectomy (PPV) may impair tear-film stability and mucin-related function. Diquafosol sodium stimulates aqueous and mucin secretion through P2Y₂-receptor signaling, but evidence after PPV remains limited. Objective: This study evaluated adjunctive diquafosol sodium 3% using tear-ferning grade as an exploratory outcome. Methods: This single-center randomized trial enrolled 36 adults after PPV. Participants received diquafosol sodium 3% six times daily for eight weeks plus standard postoperative care (n=18) or standard care alone (n=18). Treatment was open label; tear-ferning assessment was performed by a masked assessor. Ferning grade was measured at postoperative weeks 1, 2, 4, and 8. Between-group comparisons used the Mann–Whitney U test with multiplicity adjustment, and standardized effect magnitudes were summarized using Hedges g with 95% confidence intervals. Results: Mean ferning grades were similar at week 1 (3.94±0.236 vs 3.72±0.461; p=0.203), week 2 (3.67±0.594 vs 3.72±0.461; p=0.938), and week 4 (2.89±0.323 vs 3.00±0.000; p=0.584). At week 8, the diquafosol group had a lower mean grade than the control group (2.11±0.471 vs 2.72±0.461; p=0.003), with a standardized effect magnitude of 1.28 (95% CI 0.57–1.99). No adverse events were reported. Conclusion: Adjunctive diquafosol was associated with better tear-ferning grade at eight weeks after PPV. The finding is exploratory and requires confirmation using larger, multicenter, placebo-controlled trials with multidimensional ocular-surface outcomes.

Mechanism-Specific Tear Film Instability Across Diabetic Retinopathy Severity: Fluorescein Break-Up Pattern Classification in Type 2 Diabetes Mellitus Petty Purwanita; Ramzi Amin; Siti Shalihah Ramadhani Novizar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 6 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i6.1662

Background: Diabetic retinopathy and dry eye disease coexist in type 2 diabetes mellitus, yet conventional metrics treat tear film instability as one entity and cannot identify which layer has failed. Objective: This pilot study asked whether the Asia Dry Eye Society fluorescein break-up pattern classification tracks Early Treatment Diabetic Retinopathy Study (ETDRS) severity. Methods: Fifteen patients (30 eyes) with type 2 diabetes and any retinopathy grade were enrolled under a quota framework at RSUP Dr. Mohammad Hoesin Palembang, Indonesia, from November 2024 to July 2025. Break-up patterns were classified into five categories under cobalt-blue slit-lamp biomicroscopy on three consecutive observations; Ocular Surface Disease Index (OSDI) and tear break-up time (TBUT) were recorded. Analysis used rank correlation with exact permutation testing, proportional-odds regression and receiver operating characteristic analysis. Results: Pattern distribution differed across grades (Fisher–Freeman–Halton p = 0.007; Cramér's V = 0.536). Within the aqueous-deficiency pathway, line break progressed to area break (rho = 0.905, 95% CI 0.666–0.975, exact p = 0.002); within the decreased-wettability pathway, dimple break progressed to spot break (rho = 0.824, 95% CI 0.445–0.953, exact p = 0.009). Each one-grade increase multiplied the odds of a more severe pattern 7.442-fold (95% CI 2.555–21.673), and grade discriminated severe-mechanism patterns with an area under the curve of 0.87 (95% CI 0.681–0.955). OSDI and TBUT deteriorated monotonically (both p < 0.001), whereas random break showed no gradient (rho = 0.095, p = 0.618). Conclusion: Mechanism-specific tear film failure scales with retinopathy severity, supporting fluorescein-based tear film oriented diagnosis in Indonesian practice.

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