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Elfa Ali Idrus
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Microperimetric Acoustic Biofeedback Training (MABFT) in Macular Dystrophy: A Case Report: Poster Presentation - Case Report - Ophthalmologist KARMELITA SATARI; Elfa Ali Idrus; Fikri Barran
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: 10.35749/450hg883

Abstract

Introduction : Microperimetry (MP3) measures local retinal sensitivity for retinal functional assessment and uses the result for a biofeedback training exam for low vision patients. It can relocate the preferred retinal locus to the most sensitive area from central visual field diseases. This paper is to report the MABFT effect on reading speed and visual acuity in young, low-vision macular dystrophy patients. Case Illustration : A 34-year-old Caucasian male has been diagnosed with macular dystrophy since childhood. He has difficulties reading and recognizing small items at school because of his central visual field defect. He has MABFT six times a week and reading practice at home. His best corrected visual acuity improved from 1.1 to 1.0 logMAR and his reading speed from 20 to 30 wpm with spectacles. His right eye fixation became worse, but the left eye remained unstable. Clinically, it is still not significant for the patient. His near-visual acuity remains the same. Discussion : Conclusion : Microperimetric Acoustic Biofeedback Training increases reading speed and visual acuity in low vision macular dystrophy patients.
PANUVEITIS AS A MANIFESTATION OF OCULAR SYPHILIS IN PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS : A CASE SERIES: Poster Presentation - Case Series - Resident SITI AISYAH; Angga Fajriansyah; Susi Heryati; Arief Akhdestira Mustaram; Patrioka Muslima; Elfa Ali Idrus
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/m73f9e22

Abstract

Introduction : Syphilis is a sexually transmitted disease caused by the spirochete bacterium Treponema pallidum. Syphilis can result in multiple organ involvement, including the eyes, and demonstrates various clinical findings. Ocular syphilis is an important cause of uveitis in the new era of co-infection with the human immunodeficiency virus (HIV). Case Illustration : Case 1: A 29-year-old male HIV-positive with 5 months of blurred vision, pain, and redness in left eye (LE) with skin rashes on the palms and foots (Figure 1). The visual acuity was 1/300 in LE, anterior segment showed flare cell (Figure 2). Fundus examination (Figure 3) revealed multiple exudative lesion of right eye (RE) and vitreus opacity of LE due to inflammation. VDRL and TPHA tests were positive. Case 2: 38-year-old male, HIV-positive and tuberculosis-positive, with 2 months of blurred vision,pain and redness in both eyes with skin rashes on the palms and foots (Figure 1). The visual acuity of the RE was 1/60 and 1,5/60 in the LE on the initial visit. Anterior segment eye examination revealed flare and cell (Figure 2). Fundus examination revealed (Figure 3) preretinal hemorrhage and exudate of both eyes. VDRL and TPHA testing were positive, CD4 count showed severe immunodeficiency. Discussion : This study depicts clinical features and outcomes of two cases of ocular syphilis with HIV co- infection. Poor visual outcome was associated with posterior segment-involving uveitis at presentation. Conclusion : An accurate diagnosis is crucial, treatment is adjusted according to the clinical stage. Comprehensive education is needed for patients and their families.
Combination of Superficial Keratectomy, Ethylenediaminetetraacetic (EDTA), and Amniotic Membrane Transplantation as A Treatment of Band keratopathy: A Case Report: Poster Presentation - Case Report - Resident Ilmah; Patriotika Muslima; Elfa Ali Idrus; Arief Akhdestira Mustaram; Angga Fajriansyah
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/ngsfpz46

Abstract

Introduction : Band keratopathy is a degeneration of the cornea characterized by the presence of opacity, which isa deposit of calcium hydroxyapatite. These calcium deposits can be removed in several ways, including using ethylenediaminetetraacetic (EDTA), superficial keratectomy, or phototherapy keratectomy. Case Illustration : A 29-year-old male patient came with complaints of blurry vision in the right eye since 2-3 years ago, accompanied by the middle part of both eyes looking white, especially the right eye, since 17 years ago. The examination revealed a band keratopathy in the nasal to temporal region with neovascularization in the right eye, and keratopathy bands in the nasal and temporal parts, as wellas a cloudy lens in the right eye (Figure 1). Patients received treatment that included a combination of superficial keratectomy, administration of EDTA, and amniotic membrane transplantation (Figure 2). After the procedure, the clarity of the cornea improves (Figure 3). The patient was scheduled to undergo cataract surgery on his right eye. Discussion : Band keratopathy is a degenerative condition of the cornea characterized by grayish-white hazy deposits in the superficial layers of the cornea, primarily affecting Bowman's layer. In the treatment of individuals with symptomatic band keratopathy, chelation with EDTA, superficial keratectomy, laser keratectomy for phototherapy, or combining current procedures are the most often utilized therapeutic approaches. Conclusion : The combination of surgical management in cases of band keratopathy is expected to remove deposits on the cornea, improve the ocular surface, and reduce recurrences.
Management Strategies of Ocular Alkaline Chemical Injury: Poster Presentation - Case Report - Resident Nadia Ayu Destianti; Patrioka Muslima; Elfa Ali Idrus; Arief Akhdestira; Angga Fajriansyah
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/nq0p9c02

Abstract

Introduction : Ocular chemical burns are true ophthalmic emergencies that can cause permanent corneal and intraocular damage leading to visual impairment or even blindness. When a case of chemical trauma occurs, immediate and appropriate management should be done. Case Illustration : A 24-year-old man came to Cicendo Eye Hospital with complaints of blurry eyes accompanied by burning and watery eyes after being doused with a bucket of cement mortar two weeks earlier. Ophthalmologic examination obtained visual acuity for the right eye 1/300 and left eye was 1/60. The anterior segment of both eyes showed corneal edema, conjunctivalization, persistent epithelial defects, limbal ischemia, and punctate epithelial erosion. There was an ulcer and thinning of the corneal layer in left eye. He was diagnosed with alkaline chemical injury Dua's classification grade VI on the right eye and grade V on the left eye (Figure 1). The patient then underwent a keratectomy, conjunctival resection, and amniotic membrane transplantation procedure. On the seventh day postoperatively, symptoms and clinical features improved with the visual acuity of both eyes improved to 1/60 (Figure 2). Discussion : Amniotic membrane graft was performed in late reparative phase which aims to preserve the surface of the corneal epithelium and prevent corneal perforation and inflammation. Conjunctival resection was performed to prevent neovascularization of the amniotic membrane. Conclusion : Management of ocular burn injury requires an immediate and comprehensive treatment to achieve good result. In this case successful treatment was achieved by improvement of visual acuity and no complication occured.
Management Strategies of Ocular Alkaline Chemical Injury: Poster Presentation - Case Report - Resident Nadia Ayu Destiani; Patriotika Muslima; Elfa Ali Idrus; Arief Akhdestira Mustaram; Angga Fajriansyah
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/svdapm67

Abstract

Introduction : Ocular chemical burns are true ophthalmic emergencies that can cause permanent corneal and intraocular damage leading to visual impairment or even blindness. When a case of chemical trauma occurs, immediate and appropriate management should be done. Case Illustration : A 24-year-old man came to Cicendo Eye Hospital with complaints of blurry eyes accompanied by burning and watery eyes after being doused with a bucket of cement mortar two weeks earlier. Ophthalmologic examination obtained visual acuity for the right eye 1/300 and left eye was 1/60. The anterior segment of both eyes showed corneal edema, conjunctivalization, persistent epithelial defects, limbal ischemia, and punctate epithelial erosion. There was an ulcer and thinning of the corneal layer in left eye. He was diagnosed with alkaline chemical injury Dua's classification grade VI on the right eye and grade V on the left eye (Figure 1). The patient then underwent a keratectomy, conjunctival resection, and amniotic membrane transplantation procedure. On the seventh day postoperatively, symptoms and clinical features improved with the visual acuity of both eyes improved to 1/60 (Figure 2). Discussion : Amniotic membrane graft was performed in late reparative phase which aims to preserve the surface of the corneal epithelium and prevent corneal perforation and inflammation. Conjunctival resection was performed to prevent neovascularization of the amniotic membrane. Conclusion : Management of ocular burn injury requires an immediate and comprehensive treatment to achieve good result. In this case successful treatment was achieved by improvement of visual acuity and no complication occured.
A Rare Case of Congenital Corneal Keloids: Poster Presentation - Case Report - Resident Nurul Hikmah; Elfa Ali Idrus; Patriotika Muslima; Arief Akhdestira Mustaram; Angga Fajriansyah
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/xxq7gk11

Abstract

Introduction : A corneal keloid is a uncommon ophthalmic condition that manifest as proliferation of fibrous tissue in the cornea and presents as an enlarging, white, elevated, well circumscribed corneal lesion. It is a relatively uncommon lesion that typically appears after surgery, injury, or corneal perforation. Pathological examination of the resected specimen leading to a diagnosis of corneal keloid. Case Illustration : A 6-year-old girl came with chief complaint was blurry vision in both eyes accompanied with a white opacity in her left eye that was gradually growing. The patient has been diagnosed with congenital glaucoma ever since birth. Nobody of her parents acknowledged having a history of inflammatory, infection, or ocular damage. At first glance, her visual acuity appeared to be light reflex in both eyes. Slit lamp biomicroscopy revealed a pearly white, enhanced opacity with sharp edges and smooth surface in the left eye (figure 1). New vessels were present in the lesion adjacent to the limbus. The patient is undergoing keloids excision, multilayer amnion membrane transplant and fine needle diathermy (figure2). Discussion : Corneal keloid can present at any age, present as a glistening white enlarging mass on the cornea and well demarcated from the adjacent normal tissue. Histopathologic examination demonstrates a thickened corneal epithelium overlying stroma and hyalinized collagen (figure 3). Conclusion : A corneal keloid should be suspected in cases of enlarging white glistening avascular corneal scars. Biopsy and histopathology confirmed the diagnosis.
Management of Recurrent Anterior Uveitis in Spondyloarthritis: A Case Report: Poster Presentation - Case Report - Resident nadida nurfadhila; Patriotika Muslima; Elfa Ali Idrus; Arief Akhdestira Mustaram; Angga Fajriansyah
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: 10.35749/8hr2qj05

Abstract

Introduction : Non-infectious anterior uveitis is caused by underlying diseases, one of which is spondyloarthritis. Spondyloarthritis is a part of chronic rheumatic disease. The main goals of uveitis therapy are to prevent blindness, permanent organ damage, and recurrence. Case Illustration : A 19-years old woman came to Cicendo Eye Hospital with blurry vision for one week. The complaint was accompanied by redness, photosensitivity, and pain in her right eye. She had similar complaints in her right eye one month ago and in her left eye one year ago. She also had a history of morning stiffness in her knee joint and lower back pain. For those symptoms, the rheumatologist diagnosed her with spondyloarthritis. The uncorrected visual acuity examination for both eyes were 0,16. Anterior segment examination on right eye were blepharospasm, ciliary injection, corneal oedema, flare and cells while the left eye within normal limit. She was diagnosed with anterior uveitis and was treated with topical corticosteroid, oral corticosteroid, and immunomodulator. Knowing the treatment was not responding, the rheumatologist added biologic agents to the therapy. As a result, the patient’s conditions improved. Discussion : Topical steroid therapy was used as the first line of treatment, but for the recurrence of anterior uveitis, systemic medication, including biologic agents, is needed. Conclusion : Multidiscipline and stepwise approach to treat anterior uveitis with underlying disease is necessary.
Amnion Membrane Transplantation: A Therapy for Persistent Epithelial Defect as A Result of Neurotrophic Keratitis: Poster Presentation - Case Report - Resident Nathasya Maharani Susilo; Patriotika Muslima; Elfa Ali Idrus; Arief Akhdestira Mustaram; Angga Fajriansyah
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/e3c8d366

Abstract

Introduction : A persistent epithelial defect (PED) is a failure of re-epithelialization and complete healing of the cornea. The primary goal of PED treatment is to create a favorable environment for corneal wound healing. Amniotic membrane transplants (AMT) become one of the refractory cases treated for PED. This study aims to report AMT as therapy for a PED. Case Illustration : A fifty-six-year-old male presents with a chief complaint of redness and pain in the left eye in the last2 weeks. The patient complained of blurred vision, tearing, and foreign body sensations. An ophthalmology examination of the left eye revealed that it was close to face finger counting in visual acuity and had a persistent epithelial defect, corneal edema, descemet fold, and a decrease in corneal sensation. The patient was diagnosed with PED and received autologous serum eye drops, levofloxacin eye drops, vitamin A palmitate eye gel, and acyclovir 400mg twice a day, but did not respond adequately. AMT was planned for the patient. The patient's pain level improved one week after surgery. Discussion : The most common symptom of PED is pain. There are various etiological factors for PED. Neurotropic keratitis has emerged as one of the causes of PED. Management for PED is carried out sequentially according to the protocol. Conclusion : Amniotic membrane transplantation has become an alternative therapy for PED. The amniotic membrane provides re-epithelialization of the cornea and anti-inflammatory properties. The prognosis for AMT as a therapy for PED is quite good.
Recalcitrant Epithelial Ingrowth After LASIK: An Unexpected Complication: Poster Presentation - Case Report - Resident Putri Pamulani; Angga Fajriansyah; Elfa Ali Idrus; Patriotika Muslima; Arief Akhdestira Mustaram
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/daqk0f55

Abstract

Introduction : Post-LASIK Epithelial Ingrowth (PLEI) is an uncommon complication of laser in situ keratomileusis (LASIK). Treatment for PLEI can be done surgically and medically, but recurrence is possible. Case Illustration : A 20-year-old female came with the appearance of white opacity on her right cornea, which has grown bigger in size over the last two months (Figure 1A and 1B). She had undergone three debridement surgeries prior to the visit due to the same complaint and history of LASIK surgery two years before. Visual acuity of the right eye showed 0.32 pinhole 0.63, epithelial ingrowth Probst/Machat grade III in 9 o’clock direction approximately 3mm x 3mm (Table 1), pooling on fluorescein test, intact flap, and punctate epithelial erosion (PEE). A surgery of flap reopening, epithelial debridement, corneal suture, and corneal crosslinking was conducted (Figure 2 and 3). Discussion : The incidence of PLEI, as reported by published studies, is relatively low. Hence, treatment in such cases is largely based on anecdotal case reports and small case series. Treatment of choice can be done according to clinical manifestation and severity of PLEI. Conclusion : A thorough and careful management of PLEI should be carried out to prevent its progress and recurrence.
Changes in Ocular Surface Parameter After Intense Pulsed Light Therapy in Ocular Demodicosis: A Case Report: Poster Presentation - Case Report - Resident Rizki Adi Santosa; Angga Fajriansyah; Elfa Ali Idrus; Patriotika Muslima; Arief Akhdestira Mustaram
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/rhpqnd96

Abstract

Introduction : Demodex infestation may manifest as blepharitis and dry eye syndrome. Intense Pulsed Light (IPL) therapy is an emerging option for managing ocular demodicosis. Case Illustration : A 77-years-old woman complained of itch and watery eyes since four years ago. Meibomian pouting, telangiectasias, foamy secretions, and sleeves were identified in both eyelids. Right eye examination showed 52% and 42% meibomian dropout in the superior and inferior eyelid, respectively, Schirmer test 6 mm, lipid layer thickness (LLT) 43 nm, tear meniscus height (TMH) 0.36 mm, and non-invasive tear break-up time (NIBUT) 9.6 seconds. Left eye examination showed 65% and 56% meibomian dropout in the superior and inferior eyelid, respectively, Schirmer test 5 mm, LLT 66 nm, TMH 0.16 mm, and NIBUT 5.8 seconds. Demodex mites were identified during eyelash wet mount examination. She underwent four sessions of IPL. At the two-month follow-up, complaints were alleviated. Signs of blepharitis were subsided. Right eye examination showed 36% and 34% meibomian dropout in the superior and inferior eyelid, respectively, Schirmer's test 9 mm, LLT 68 nm, TMH 0.49 mm, and NIBUT 10.7 seconds. Left eye examination showed 25% and 35% meibomian dropout in the superior and inferior eyelid, respectively, Schirmer's test 9 mm, LLT >100 nm, TMH 0.9 mm, and NIBUT 6.2 seconds. Discussion : IPL has a role in managing ocular demodicosis by local inflammation control, meibum liquefaction, and meibomian glands photomodulation. IPL is also thought to directly eradicate Demodex mites. Conclusion : Improvement of ocular surface parameters was observed after IPL therapy in ocular demodicosis.
Co-Authors Angga Fajriansyah ANNISAK FITRIYANA Arief Akhdestira Arief Akhdestira Mustaram Astari Nola Margaretha Bagus Ramdan Dian Purwitasari Feti Karfiati Memed Fikri Barran Ilmah Karmelita Satari Muhamad Adli Boesoirie Nadia Ayu Destiani Nadia Ayu Destianti nadida nurfadhila Nathasya Maharani Susilo NURUL HIKMAH Patrioka Muslima Patriotika Muslima Putri Pamulani Rizki Adi Santosa Siti Aisyah Surya Atmaja Susi Heryati