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All Journal Ophthalmologica Indonesiana
Kristian Goenawan
Department of Ophthalmology, Univesitas Gadjah Mada
Health Professions Medicine & Pharmacology Public Health

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Atypical Anterior Optic Neuritis Resembles Anterior Ischemic Optic Neuropathy : A Unique Case Report Kristian Goenawan; Indra Tri Mahayana; Tatang Talka Gani; Hartono Hartono
Majalah Oftalmologi Indonesia Vol 43 No 2 (2017): 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.v43i2.149

Abstract

Purpose : We present a unique case of atypical anterior optic neuritis resemble anterior ischemic optic neuropathy Methods : This was a single case study, with a patient was followed up for 2 months. Visual acuity, visual field, color vision, intraocular pressure, and ocular anatomy, were examined. Results : A female patient 54 y/o with chief complain sudden blurred vision on both eyes after woke up in the morning without redness and tearing 4 days before day of visit. History of systemic and ocular diseases were denied. Visual acuity was 0.5/60 (superior) right eye and 1/60 (superior) left eye, couldn’t be corrected. Relative afferent pupillary defect was observed in right eye. Biomicroscopic examination of anterior segment and intraocular pressures were normal. Funduscopy revealed ill defined margin at optic nerve head for both eyes suggested papilledema. At the present we couldn’t examined color vision. Visual field examination showed inferior altitudinal defect (more severe in right eye). Consultation to internal medicine and laboratory examination such as: complete blood count, lipid profile, blood glucose, and electrocardiogram were done to confirm our diagnosis. Clinically, the diagnosis of the disease more likely to be the anterior optic neuritis. Follow-up after 2 months has normal visual acuity, visual field, and color perception after steroid treatment. Conclusion : Anterior optic neuritis might have a very similar clinical presentation of anterior ischemic optic neuropathy upon early manifestation.
Clinical Efficacy of Fresh Amniotic Membrane Transplantation in Non- Healing Corneal Ulcer Reny Setyowati; Kristian Goenawan; Suhardjo Prawiroranu
Majalah Oftalmologi Indonesia Vol 45 No 2 (2019): 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.v45i2.189

Abstract

Objective: Severe corneal ulcer requires immediate intensive topical antibiotics, although potentially toxic to corneal epithelium and may contribute for prolonged corneal epithelial defect. Fresh-amniotic membrane transplantation (F-AMT) could act as an adjuvant therapy that counterbalances the epithelial toxicity effect and exerting antimicrobial actions. This study evaluates the clinical improvement and factors associated with the success rate of F-AMT using suturing technique. Methods: This was a retrospective cohort study of 28 patients (28 eyes) conducted at Dr Sardjito General Hospital, Yogyakarta. Inclusion criteria were patients with severe corneal ulcer unresponsive to conventional medical treatment who underwent multilayer F-AMT using suturing technique. Clinical improvement such as hypopyon, size of the corneal defect, and antibiotic medication were evaluated. Results: Corneal epithelial healing was effectively restored at 25 days post F-AMT. There were statistically significant difference in patient’s blepharospasm (p= 0,00) and pain scale postoperative (p=0,00). There was no significant difference in patients visual acuity postoperative. Factors such as the size of the corneal defect, hypopyon, leucocyte count and neutrophil count were not correlated to epithelial healing. Failure was noted in 7 patients (25%) because of a persistent corneal defect. No patient developed major immediate postoperative complications. Conclusion: F-AMT could be an optional adjuvant therapy with excellent results to treat non-healing severe corneal ulcer unresponsive to medical treatment by promoting epithelial healing.
The First Study Investigating the Clinical Outcomes of Boston Keratoprosthesis Type I Implantation in Indonesia Johan A. Hutauruk; Kristian Goenawan; Suhardjo Suhardjo
Majalah Oftalmologi Indonesia Vol 46 No 1 (2020): 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.v46i1.100016

Abstract

Introduction and Objective: Boston keratoprosthesis (Boston KPro) is an artificial cornea (collar button design) for a severely damaged cornea that is not suitable for penetrating keratoplasty (PKP). One main advantage of Boston KPro type I is there is no need to perform tarsoraphy. There were no previous studies investigating the clinical outcome of Boston KPro implantation in Indonesia, therefore we aimed to investigate the visual outcomes, device retention, and complications following Boston KPro type 1 keratoprosthesis. Case Presentation: This study was a case series of 11 patients conducted at Jakarta Eye Center with 18 months follow up period. The inclusion criteria were patients with severe corneal diseases that are not amenable for PKP. We found that VA baseline were LP (±72.72%) and HM (27.27%) (mean VA baseline=2.51±0.14 logMAR or equal to HM – LP VA) which significantly improved to 1.09 ± 0.69 logMAR (equal to 6/60 Snellen, ±36.3% were near normal vision based on WHO criteria), p=0.007. Two cases (±16.7%) were still HM because of implant explantation with corneal melting. There were 80.5% retention rates at final follow-up and other complications were retroprosthetic membrane formation (26.7%), elevated IOP (13.9%), and sterile corneal stromal necrosis (17.8%).There was no endophtalmitis found in this study. Conclusion: Boston K-Pro type 1 is a recommended option for patients with multiple corneal graft failure. It provides promising visual outcome with good retention rates. The number of Boston K-Pro type 1 implantations should be increased to counterbalance the corneal blindness burden in Indonesia.
Co-Authors Hartono Hartono Indra Tri Mahayana Johan A. Hutauruk Reny Setyowati Suhardjo Prawiroranu Suhardjo Suhardjo Tatang Talka Gani