Articles
<![CDATA[Uncommon Presentation of Wyburn-Mason Syndrome in a Pediatric Patient ]]>
<![CDATA[Julie Barliana]]>;
<![CDATA[Syntia Nusanti]]>;
<![CDATA[Manoa Panjaitan]]>;
<![CDATA[Anggun Yudantha]]>;
<![CDATA[Laura Djunaedi]]>
<![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.v47i1.100146
<![CDATA[We report an uncommon presentation of Wyburn-Mason syndrome in a pediatric patient. An 11-year- old girl presenting with no light perception in her right eye. Examination revealed an exotropia and a large and tortuous retina vessel in the posterior part of her right eye. However, other examinations, including dermatological and neurological examination, are within normal limits. Magnetic Resonance Angiography (MRA) showed vascular malformation at the basal cistern that extends to the retrobulbar area. Therefore, a thorough examination of the eye and brain, including MRA, is mandatory in every case, even in pediatric with normal neurological examinations.]]>
<![CDATA[A Five-Year Data in Descriptive Study of Systemic and Ocular Risk Factors of Non-arteritic Anterior Ischemic Optic Neuropathy (NAION) and The Correlation to The Clinical Condition ]]>
<![CDATA[Syntia Nusanti]]>;
<![CDATA[M. Sidik]]>;
<![CDATA[Andhika Rachman]]>;
<![CDATA[Miratasya Zulkarnaen]]>
<![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.v47i1.100162
<![CDATA[Purpose: To acknowledge the demographic, clinical characteristic and the systemic and ocular risk factors in patients with Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION) in 2012-2017 in Cipto Mangunkusumo Hospital. Methods: Retrospective descriptive study using the medical record data of 272 patients with NAION in the past 5 years (2012-2017). Results: In the past 5 years, most of the patient’s initial visit visual acuity was <3/60, most patient had 2-3 systemic risk factors, the most frequent risk factors were hypertension (73.9%), obesity(63.5.%), diabetes mellitus (54.6%), smoking habit (54.5%), dyslipidaemia (46%), hypercoagulable state (19%), history of cardiovascular disease (10.3%) and stroke (7.2%). The risk factors were similar in age range ? 50 or bellow. Based on the initial visit time, most of the patient came to CM hospital in average 15.16 (SD±38.3) weeks. Conclusion: This descriptive study showed classic demographic characteristic of NAION cases. Obesity as the second highest probable risk factor is rarely mention in the other studies. Should future detailed studies be done]]>
<![CDATA[Evaluasi 97 Pasien Oftalmopati Graves’ Selama 3 Tahun Menggunakan Algoritma Eugogo dan Konsensus Nasional ]]>
<![CDATA[Claudia Hartomuljono]]>;
<![CDATA[Syntia Nusanti]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 47 No 2 (2021): Ophthalmologica Indonesiana ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/journal.v47i2.100305
<![CDATA[Introduction and Objective: Graves’ ophthalmopathy (GO) is an autoimmune disorder of the orbit that is closely associated with Graves’ diseases. Various classification system was proposed to evaluate clinical findings in GO. As controversy exists in assessment and management of GO there is a need to evaluate and improve diagnostic criteria using practical guideline. Methods: We retrospectively reviewed Graves’ ophthalmopathy patients admitted between 2016 – 2018 to neuro-ophthalmology clinic. Clinical manifestation, the activity, severity and management of the disease were assessed using EUGOGO scale and Clinical Activity Score (CAS). Result: A total of 97 GO patients included in the study. Male to female ratio is 1:2.7 which is highest in the age range of 30-50 years. The majority of patients have hyperthyroid status (41.2%) and bilateral clinical characteristics (77%). A total of 92 patients (94.8%) had visual acuity ?6/18. The most commonly reported clinical sign at the time of assessment is eyelid edema followed by conjunctival injection. Patients with mild EUGOGO status was entirely GO inactive while 5 active GO patients were of moderate-to-severe (4 patients) and 1 patient with sight-threatening GO. Patients with active GO received 1x500 mg of intravenous methylprednisolone for 3 days every week for 4 cycles where at the follow-up there was a significant decrease in CAS score by an average of 3-4 points. Conclusion: The EUGOGO classification system provides diagnostic guidance and appropriate management algorithms for GO patients. Administration of high-dose intravenous methylprednisolone in active GO is still the first choice of therapy.]]>
<![CDATA[Prevalensi dan Karakteristik Buta Warna pada Populasi Urban di Jakarta ]]>
<![CDATA[Syntia Nusanti]]>;
<![CDATA[M. Sidik]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 47 No 2 (2021): Ophthalmologica Indonesiana ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/journal.v47i2.100307
<![CDATA[Purpose: To report the prevalence of color blindness in urban population in Jakarta Methods: This study is a part of the Urban Eye Health Study. Color vision examination was performed using Ishihara on adult and pediatric subjects with 6/6 vision. If incorrect reading was present, the examination was later continued by using Farnsworth Munsell Hue D 15, then proceeded with completing questionnaire. Results: The pediatric respondents in this study was 435 (6-16 years old). From that number of subjects, 5,97% of children had color blind. Meanwhile, the adult respondents (41-77 years old) in this study was 1040 with 3.26% of respondents had color blind. There were 100% of pediatric respondents diagnosed with congenital color blindness. Eighty-eight point twenty four percent of adult respondents were diagnosed with congenital color blindness while the remaining 11.76% were diagnosed with acquired color blindness. Conclusions: The prevalence of congenital color blindness in this study was 3,79%, as much as 88,24% from the adult group and 100% from the pediatric group.]]>
<![CDATA[Diagnostic Value of Optical Coherence Tomography and Electroretinogram in Early Detection of Ethambutol-Induced Optic Neuropathy ]]>
<![CDATA[M. Dio Syaputra]]>;
<![CDATA[Syntia Nusanti]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 47 No 2 (2021): Ophthalmologica Indonesiana ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/journal.v47i2.100309
<![CDATA[Background: Ethambutol-induced optic neuropathy (EON) is one of the most compelling adverse effect of tuberculosis treatment. Recovery often occur several months after treatment discontinuation. Unfortunately, some studies noted that nearly half of patients still have permanent visual loss. Early detection before clinical symptoms appear is necessary to prevent this devastating adverse effect. Therefore, this review aims to evaluate the diagnostic value of retinal nerve fiber layer (RNFL) thickness and ganglion cell inner plexiform layer (GCIPL) thickness changes with OCT, pattern and multifocal electroretinogram (ERG) changes during ethambutol treatment as early detection of EON. Methods: A comprehensive search was conducted from electronic databases (PubMed, EBSCO, Google Scholar, and Springerlink) using relevant search terms. Articles from offline resources were also included. Included studies were selected based on predefined inclusion and exclusion criteria. Result: Three studies reported significant thinning of RNFL after ethambutol initiation. Increased RNFL thickness in patients with EON and subclinical EON found in 3 studies. Significant macular GCPIL thinning was noted in 1 study. One study reported shortening of P50 implicit time and reduced N95 wave amplitude in pattern ERG. Conclusion: Macular GCIPL thinning suggested to be the first pathological changes detected on patients with ethambutol treatment. It can be concomitant with thickening of peripapillary RNFL and followed by peripapillary RNFL thinning. Pattern ERG may reveal abnormality due to retinal ganglion cell (RGC) dysfunction before RGC loss.]]>
<![CDATA[Neuropati Optik Traumatik: Gambaran 13 Kasus Berdasarkan Radiologi dan Awitan Terapi Kortikosteroid di Rumah Sakit Cipto Mangunkusumo ]]>
<![CDATA[Made Paramita Wijayati]]>;
<![CDATA[Syntia Nusanti]]>;
<![CDATA[M. Sidik]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 47 No 2 (2021): Ophthalmologica Indonesiana ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/journal.v47i2.100313
<![CDATA[Introduction and Objection: Traumatic Optic Neuropathy is a rare and potentially vision-threatening condition caused by ocular or head trauma. The optic nerve axons may be damaged either directly or indirectly. The management of traumatic optic neuropathy could be observed, giving steroids or decompression. At center which optic nerve decompression is not routinely performed, high dose steroid is preferred for traumatic optic neuropathy patients. The study aims to analyze characteristics (mean age and gender, onset trauma, most symptom, visual acuity, consensual reflex as a sign), radiology feature, and onset corticosteroid therapy on patient traumatic optic neuropathy. Methods: This study was a descriptive observational case series which data retrospectively analysis from medical record. Result: From 13 cases most common gender affected were males (76,9%). The mean age group 32.85±14.67 years old with blurry vision and bleeding are the most common symptom, the onset of trauma below 24 hours (76.9%), the initial visual acuity is no light perception and hand movement with a negative consensual reflex (76.9%). Visual acuity improves with initial corticosteroid therapy below 24 hours are 7 cases and more than 24 hours are 2 cases. From 9 cases with visual acuity improvement, there are 4 cases with orbital fracture and 5 cases without orbital fracture. Conclusion: Visual improvement in our cases happened more on initial corticosteroid therapy more than 24 hours and no orbital fracture.]]>
<![CDATA[The Utility of Ocular Imaging in Traumatic Optic Nerve Avulsion: A Case Report ]]>
<![CDATA[ikhwanuliman Putera]]>;
<![CDATA[Syntia Nusanti]]>;
<![CDATA[Nur Aisyah Rahmawati]]>;
<![CDATA[Annisa Nindiana Pertiwi]]>;
<![CDATA[Mario Marbungaran Hutapea]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 48 No 1 (2022): Ophthalmologica Indonesiana ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/journal.v48i1.100365
<![CDATA[Objective: To describe a detailed presentation and the utility of ocular imaging, both ocular ultrasound and orbital computed tomography (CT), to confirm the diagnosis of traumatic ONA in which megadose steroid would give no advantage. Case Presentation: A five-year-old boy came with a unilateral sudden visual loss after incidentally falling with his left eye struck to a handlebar of a parked bicycle. His left eye had no light perception, ophthalmoplegia, and showing 4+ relative afferent pupillary defect. A hallmark "pit" sign and a pale retina without a tear were noted. B-scan ocular ultrasound displayed retinal step sign, vitreous hemorrhage in front of the optic canal, lamina cribrosa defect, edematous retina, and retracted optic nerve. Orbital computed tomography scan showed a disruption of the optic nerve-globe junction. Steroid infusion was decided not to be given. Conclusion: Ocular imaging, especially ultrasound, along with a thorough examination, is satisfactorily adequate to confirm the diagnosis of traumatic ONA.]]>
<![CDATA[Neuro-Ophthalmology Practice During Covid-19 Pandemic ]]>
<![CDATA[Yuri Dwi Mayasari]]>;
<![CDATA[Syntia Nusanti]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 48 No 1 (2022): Ophthalmologica Indonesiana ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/journal.v48i1.100377
<![CDATA[Introduction: Ophthalmology practice including neuro-ophthalmology (NO) adopted the American Academy of Ophthalmology recommendation to provide only urgent or emergent care during the COVID-19 pandemic. Objective: This report aimed to present demographical and patient visit data regarding the characteristic of outpatient in neuro-ophthalmology clinic and to evaluate the patients regulation and priority mitigation according to IOA guideline during COVID-19 pandemic. Methods: Retrospective study using medical record data of neuro-ophthalmology outpatients at Dr. Cipto Mangunkusumo Hospital from April-June in 2019 and 2020. Result: There were 207 visits from 160 patients during the pandemic, which was 33.9% of the total visits before pandemic. Most patients were reffered from internal referral (54.5%). However, new patients from external referral mostly came with onset of more than 2 weeks (40.6%). Most common diagnosis during pandemic were NAION (12.6%), toxic optic neuropathy (8.7%), and paretic eye movement disorder (7.7%). The diagnosis were classified further into neuro-ophthalmology clinic guideline and IOA guideline based on diagnosis and tele-ophthalmology. The most common category were non-priority patients (55.6%), 3B priority level (26.5%), and first priority level (59,9%), respectively. Conclusion: A major difference characteristic of neuro-ophthalmology outpatients during pandemic was the number of patients visit. New patients mostly came from internal and local (Jabodetabek) referral which can be caused by mobility limitation, new hospital regulation and patients insecurity due to COVID-19. Priority mitigation in this study found non-priority patients were the majority who visited the clinic during COVID-19 pandemic, which may need further evaluation on referral and triage systems.]]>
<![CDATA[Citicoline in Non–arteritic Anterior Ischemic Optic Neuropathy: Pattern Electroretinography review ]]>
<![CDATA[Valen Chia]]>;
<![CDATA[M. Sidik]]>;
<![CDATA[Syntia Nusanti]]>
<![CDATA[ Majalah Oftalmologi Indonesia Vol 48 No 1 (2022): Ophthalmologica Indonesiana ]]>
Publisher : <![CDATA[The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami)) ]]>
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DOI: 10.35749/journal.v48i1.100495
<![CDATA[This study aims to assess 1000 mg citicoline each day given for 60 days on chronic phase NAION (non–arteritic anterior ischemic optic neuropathy) patients. Double masked randomized clinical trial divided the patients into 2 groups: citicoline group (C–NAION) and placebo group (P–NAION). Analysis was done in 17 patients in each group. There were increament of ? amplitude P50 30 days in C–NAION group (0,775±2,6 µV) and ? amplitude N95 60 days in C–NAION group (–0,356±2,992 µV) but statistically insignificant compared to P–NAION. Age has a good correlation with ? amplitude P50 (r = –0.517; p = 0.002). Subjects with 1 risk factor experienced a higher ? amplitude of P50 than the subjects with more than 1 risk factor (1.856 ± 2.121 ?V vs –0.26 ± 2.45; p = 0.025). Citicoline did not show any changes in Retinal Ganglion Cell Thickness. There were improvement of ? mean deviation 60 days in C–NAION group (3,13±6,467 dB), but statistically insignificant compared to P–NAION. Citicoline tends to increase the ? amplitude of P50, N95 and mean deviation in chronic phase NAION. Age and the number of risk factors affects the increase of ? amplitude P50.]]>
<![CDATA[The Role of Optical Coherence Tomography Angiography in Non-Arteritic Ischemic Optic Neuropathy: A Case Report ]]>
<![CDATA[Syntia Nusanti]]>;
<![CDATA[Brigitta Marcia Budihardja]]>;
<![CDATA[Lazuardiah Anandi]]>;
<![CDATA[Rona Ali Badjrai]]>
<![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.v48i2.100597
<![CDATA[Introduction: Non-arteritic ischemic optic neuropathy (NAION) is the second most common optic neuropathy in adults. Since circulatory insufficiency is presumed to have a role in pathogenesis of NAION, optical coherence tomography angiography (OCTA) is suggested as a tool in assessing NAION patients, while optical coherence tomography (OCT) can detect structural changes. This case report aims to describe the congruity of visual field defect with OCT and OCTA result in a case of bilateral NAION, highlighting the role of both OCT and OCTA in NAION. Case Report: A 52-years-old male came due to painless, progressive blurry vision in both eyes, especially in lower visual field, for the past 7 months. Humphrey visual field examination revealed inferior visual field defects in both eyes. OCTA showed reduced retinal perfusion in the superior part bilaterally. OCT revealed ganglion cell loss in the superior part of his right eye and almost all parts of his left eye. Retinal nerve fiber layer (RNFL) thinning was found in the superior part bilaterally. Discussion: In this case, the congruity of visual field defect, reduced perfusion, ganglion cell-inner plexiform layer (GCIPL), and RNFL thinning portrayed the connection of hypoperfusion as the presumed underlying mechanism of NAION, neuron loss as the result of the hypoperfusion, and the visual field loss as the presenting symptom in NAION. Conclusion: This finding demonstrates the role of OCT-A and OCT in diagnosing and monitoring progression in patients with NAION.OCT-A is a useful tool to evaluate microvascular changes, while OCT can be used to evaluate RNFL and GCIPL thinning.]]>
