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All Journal Medical Journal of Indonesia The Indonesian Biomedical Journal eJournal Kedokteran Indonesia IJRETINA - International Journal of Retina Ophthalmologica Indonesiana
Syntia Nusanti
Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Journal : Ophthalmologica Indonesiana

 1 
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.
Role of Optical Coherence Tomography Angiography (OCTA) in Anterior Ischemic Optic Neuropathy Gunawan, Calista Nathasya; Nusanti, Syntia
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.v51i2.101688

Abstract

Introduction: Anterior ischemic optic neuropathy (AION) is the most common type of optic neuropathy with symptoms of sudden and painless visual field defect and vision loss. Although evaluating the nonperfusion areas of the vascular ischemia have traditionally been visualized through fluorescein angiography, OCTA has proven to be effective in noninvasively representing the retinal vascular network. This literature review aims to evaluate the quantitaive OCTA assessment of peripapillary vessel density (VD) changes in AION. Methods: Literature search was performed in four databases (PubMed, ScienceDirect, ProQuest, and Cochrane Library) from 2018 to 2022 to identify relevant articles. Five studies were included in this review. Results: All five studies on OCTA findings of NAION eyes reported a reduction in the vessel density of peripapillary capillary plexus when compared to either the healthy control eyes or the fellow unaffected eyes. OCTA reveals vascular changes in both forms, aiding prognosis and treatment. One study comparing NAION and AAION indicates reduced vessel density in NAION and AAION, with more severe abnormalities and reduction of vessel density in AAION. Conclusion: OCTA can visualize alterations in vascular density in both types of AION, AAION and NAION, with a notably more pronounced reduction in peripapillary vessel density observed in AAION. Keywords: anterior ischemic optic neuropathy, optical coherence tomography angiography, peripapillary vessel density
Co-Authors Aleddin, Rommel Anwar Santoso Aria Kekalih Ayuningtyas, Sita Paramita Bambang Budi Siswanto Dewiputri, Salmarezka Dialika Dialika Dita Permatasari Djatikusumo, Ari Gunawan, Calista Nathasya Joedo Prihartono Luminta, Ferdinand Inno Muhammad Sidik Oktarina, Virna Dwi Pertiwi, Annisa Nindiana Pintary, Marsha Rayfa Rif'ati, Lutfah Sampurna, Kirana Sari, Amelya Permata Seskoati Prayitnaningsih Shidik, Muhammad Sidik, M Sidik, Mohamad Wienta Diarsvitri Yudantha, Anggun Rama