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All Journal MNJ (Malang Neurology Journal) IJRETINA - International Journal of Retina Ophthalmologica Indonesiana
Dewiputri, Salmarezka
Unknown Affiliation
Health Professions Medicine & Pharmacology Neuroscience Public Health

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Giant Intracranial Aneurysm Presenting as Temporal Hemianopia: When the Eyes Reveal a Hidden Danger Pertiwi, Annisa Nindiana; Nusanti, Syntia; Pintary, Marsha Rayfa; Dewiputri, Salmarezka; Ayuningtyas, Sita Paramita; Sidik, Muhammad
Majalah Oftalmologi Indonesia Vol 51 No 2 (2025): Ophthalmologica Indonesiana
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/journal.v51i2.101687

Abstract

Introduction: Giant intracranial aneurysms (GIA) are rare and deadly diseases due to the high risk of rupture. The purpose of this report is to describe a case of GIA presenting as temporal hemianopia. Case Report: A 52-year-old male presented with worsening blurry vision three weeks before admission. Visual acuity was light perception in the right eye and 6/18 in the left eye. Neuro-ophthalmic examination revealed a relative afferent pupillary defect in the right eye and bilateral optic atrophy. At the next visit, the visual acuity of the right eye recovered to 6/18. Visual field testing showed temporal hemianopia in the left eye and generalized depression in the right eye. Magnetic resonance imaging demonstrated a 0,4 cm x 2,5 cm x 1,9 cm saccular aneurysm, on the medial side of the left internal carotid artery (ICA). Discussion: A giant (diameter ≥2.5 cm) ICA aneurysm may compress the optic chiasm, leading to various stages of visual loss. Several factors are known to delicate balance between thrombogenesis and thrombolysis within the aneurysmal sac. Spontaneous intra-saccular thrombosis in an unruptured GIA may be induced by calcification within the atherosclerotic wall of the aneurysm and loss of elastic lamina. It is prone to occur in a narrow aneurysm neck (<0.4 cm). Thrombosis reduces the size of the aneurysm sac, in which the accumulated fluid is reabsorbed. This may explain the decompression effect on optic chiasm and spontaneous visual recovery.   Conclusion: Intracranial aneurysms are a rare cause of optic chiasm compression but can still be considered in cases of temporal hemianopia.
DAPSONE-INDUCED TOXIC MACULOPATHY IN LEPROSY PATIENT Ayuningtyas, Sita Paramita; Djatikusumo, Ari; Nusanti, Syntia; Dewiputri, Salmarezka; Sidik, Mohamad
International Journal of Retina Vol 6 No 1 (2023): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2023.vol006.iss001.226

Abstract

Introduction: Dapsone has been widely used as a part of multidrug therapy for leprosy patients. Ocular side effects are rare. Ocular toxicity manifestations include retinal necrosis, optic atrophy, macular infarction, bilateral exudative retinal detachment, and choroidal detachment. We reported a rare case of dapsone-induced toxic maculopathy in a leprosy patient. Case Report: A 32-year-old male complained of blurred vision and a gray spot in central vision in the left eye (LE) for one month prior to admission. He had been treated with multidrug therapy (MDT) for leprosy for seven months. The MDT consists of dapsone, clofazimine, and rifampicin. The best-corrected visual acuity (BCVA) of the right eye (RE) and the LE were 6/6 and 6/12, respectively. A funduscopy of the LE showed decreased macular reflex. A color vision defect following the tritan axis was found in the LE. The Humphrey visual field (HVF) test of the LE revealed a central scotoma. Macular optical coherence tomography (OCT) showed intraretinal hyperreflectivity and subretinal fluid. Dapsone was then stopped in collaboration with a dermatologist. Two months after the discontinuation of Dapsone, the BCVA of the LE improved to 6/7.5, then 6/6 three months later. Color vision, macular OCT, and HVF tests revealed improvements. Multifocal ERG of both eyes (BE) also showed improvement in N1 and P1 wave amplitude in both eyes on 9-month follow-up after dapsone discontinuation. Discussion: Instead of direct drug toxicity, the mechanism of ocular side effects is thought to be ischemia caused by two distinct mechanisms. Macular ischemia is caused by acute, severe peripheral hypoxia and the physical effect of red cell fragmentation due to the hemolytic process. After discontinuation of dapsone, this case showed improvement in visual function and macular structure. Conclusion: Toxic maculopathy may be present in leprosy patients receiving dapsone treatment, although it is uncommon. Regular follow-up and evaluation of visual function and macular involvement are essential. Early detection of dapsone-induced toxic maculopathy and prompt discontinuation of dapsone may result in an improvement of visual functions.
CORRELATION BETWEEN PREOPERATIVE OPHTHALMOLOGIC EXAMINATION AND POSTOPERATIVE VISUAL FUNCTION IN PATIENTS WITH PITUITARY ADENOMA: A RETROSPECTIVE STUDY Rahma Putri, Herdanti; Nusanti, Syntia; Ananda Aman, Renindra; M, Sidik; Dewiputri, Salmarezka; Paramita Ayuningtyas, Sita
MNJ (Malang Neurology Journal) Vol. 12 No. 1 (2026): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.01.03

Abstract

Background: Pituitary adenoma is a benign tumor of the pituitary gland that can be treated surgically. Ophthalmological examination is a standard protocol to determine surgical indications and assess postoperative visual prognosis. Objective: This study aimed to evaluate postoperative visual function in pituitary adenoma patients and compare it with preoperative findings. Methods: Retrospective study using medical record data of all pituitary adenoma patients who underwent tumor removal surgery and neuro-ophthalmological examination at Cipto Mangunkusumo Hospital from 2019-2021 . Results: 63 pituitary adenoma patients were included in the study. Median best-corrected visual acuity (BCVA) at the last follow-up improved from 0.8 to 0.45 logMAR in the new case group and from 0.45 to 0.15 logMAR in the residual case group. The most common visual field defect in this study was temporal hemianopia with significant difference in mean deviation (MD) and visual field index (VFI) after surgery on both groups (p<0,05). Moreover, the correlation between initial and final VA, MD, and VFI was significant (0,781; 0,701; 0,594, respectively). The remaining tumor volume was also a significant factor in the improvement of MD and VFI, with better MD and VFI values shown in a smaller tumor volume postoperatively. Conclusion: Neuro-ophthalmological examination after surgery showed an increase in BCVA and improvement in visual field defects. It is shown to be correlated with preoperative BCVA, preoperative MD, and VFI on Humphrey Visual Field examination, and postoperative tumor volume.
Co-Authors Ananda Aman, Renindra Ayuningtyas, Sita Paramita Djatikusumo, Ari M, Sidik Muhammad Sidik Paramita Ayuningtyas, Sita Pertiwi, Annisa Nindiana Pintary, Marsha Rayfa Rahma Putri, Herdanti Sidik, Mohamad Syntia Nusanti