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All Journal Folia Medica Indonesiana Proceeding of the Electrical Engineering Computer Science and Informatics Vision Science and Eye Health Journal IJRETINA - International Journal of Retina Ophthalmologica Indonesiana
Firmansjah, Muhammad
Department Of Ophthalmology, Faculty Of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital Surabaya, Indonesia
Computer Science & IT Electrical & Electronics Engineering Health Professions Medicine & Pharmacology Public Health Other

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Automated Diagnosis System of Diabetic Retinopathy Using GLCM Method and SVM Classifier Ahmad Zoebad Foeady; Dian Candra Rini Novitasari; Ahmad Hanif Asyhar; Muhammad Firmansjah
Proceeding of the Electrical Engineering Computer Science and Informatics Vol 5: EECSI 2018
Publisher : IAES Indonesia Section

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (605.455 KB) | DOI: 10.11591/eecsi.v5.1630

Abstract

Diabetic Retinopathy (DR) is the cause of blindness. Early identification needed for prevent the DR. However, High hospital cost for eye examination makes many patients allow the DR to spread and lead to blindness. This study identifies DR patients by using color fundus image with SVM classification method. The purpose of this study is to minimize the funds spent or can also be a breakthrough for people with DR who lack the funds for diagnosis in the hospital. Pre-processing process have a several steps such as green channel extraction, histogram equalization, filtering, optic disk removal with structuring elements on morphological operation, and contrast enhancement. Feature extraction of preprocessing result using GLCM and the data taken consists of contrast, correlation, energy, and homogeneity. The detected components in this study are blood vessels, microaneurysms, and hemorrhages. This study results what the accuracy of classification using SVM and feature from GLCM method is 82.35% for normal eye and DR, 100% for NPDR and PDR. So, this program can be used for diagnosing DR accurately.
Penetrating Ocular Injury Management in Intraocular Foreign Body (IOFB) and Traumatic Cataract Nerissa Tamara Putri; Muhammad Firmansjah; Reni Prastyani
Folia Medica Indonesiana Vol. 58 No. 3 (2022): September
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (841.894 KB) | DOI: 10.20473/fmi.v58i3.12513

Abstract

Highlight: The management of penetrating ocular injury with IOFB and traumatic cataracts needs a thorough examination of the mechanism of injury, location, size, and composition of IOFB. Endophthalmitis, retinal detachment, and development of PVR are potentially vision-threatment.   Abstract: Most IOFB are metallic and found in males of productive age as a consequence of work-related accidents. A 45-year-old man complained of sudden blurred vision in the left eye (3/60 pinhole 5/12) after getting hit by a foreign body when cutting grass with a lawn mower. Anterior segment examination revealed a 10 mm long, one-plane, straight, full thickness, already sutured inferonasal corneal laceration, inferonasal traumatic iridectomy size 3x7 mm, and opaque lens. Head CT-scan revealed opacity with metallic density intraocularly. Ultrasonography revealed an echogenic lesion, particle-shaped with 100% RCS complex density, located at the inferonasal of the vitreous cavity. Focal laser photocoagulation was performed preoperatively because there was a tear at the superonasal of the retina. The patient underwent cataract extraction, intraocular lens implantation, vitrectomy, and IOFB extraction in a one-step procedure. IOFB was found at the inferonasal side of a vitreous cavity with size 3 x 1 mm, metallic, and not attached to the retina. Silicon oil tamponade was used as a precaution because there were retinal tears. Postoperatively, the left eye's visualacuity was 5/20. After 6 months, the silicon oil was evacuated and the visual acuity became 5/8.5.
Intraocular Foreign Body: Striving the Optimal Visual Outcome Muhammad Firmansjah; Nandang Sudrajat; Ima Yustiarini; Ady Dwi Prakosa; Sauli Ari Widjaja; Wimbo Sasono
Vision Science and Eye Health Journal Vol. 2 No. 2 (2023): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v2i2.2023.52-56

Abstract

Introduction: Intraocular foreign bodies (IOFBs) are defined as intraocularly retained, unintentional projectiles that require urgent diagnosis and treatment to prevent blindness or globe loss. Case Presentation: We report a case of IOFB due to occupational accidents. In this case, there were delays in extraction considering the health facilities and conditions related to COVID-19 infection. Initially, the patient underwent closure of the entrance wound, which was performed within the first 24 hours post-trauma. However, although there was no endophthalmitis, visual acuity at the end of the observation still showed an unexpected outcome. The patient was followed up for three months after IOFBs extraction. The timing of IOFBs removal depends on several factors, including the patient’s overall health status, the nature of the injury, and the composition of the IOFBs. The postoperative examinations focus on complications such as endophthalmitis, postoperative retinal detachment, proliferative vitreoretinopathy (PVR), and sympathetic ophthalmia. The numerical values can then be used to predict the expected visual acuity using the ocular trauma score system. Conclusions: Many factors could affect the outcome quality of visual acuity. Primary wound closure, foreign body extraction, and anatomic reconstruction of the holistic ocular should be performed as soon as possible. Delay in definitive treatment was thought to affect worsening prognosis due to tissue proliferation and the tendency for severe complications, including endophthalmitis.
SURGICAL MANAGEMENT ON POSTERIOR UVEITIS WITH VITREOUS OPACITY SUSPECTED RETINAL DETACHMENT Firda Ayu Muthie; Sauli Ari Widjaja; Wimbo Sasono; Muhammad Firmansjah; Ima Yustiarini; Ady Dwi Prakosa; Moestidjab Moestidjab; Gatut Suhendro
International Journal of Retina Vol 3 No 1 (2020): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2020.vol003.iss001.83

Abstract

Introduction: Posterior uveitis entities are varies between infective or non-infective in aetiology. It can affect the adjacent structures such as retina, vitreous, optic nerve head and retinal blood vessels. Vitreous opacity is the most common features of posterior uveitis and posterior segment evaluation is critical to determine the aetiology and management. Methods: Case report of 32-year-old male with gradual visual loss on right eye since 2 years ago and getting worse 1.5 months before admission. Visual acuity (VA) was hand movement. Posterior segment evaluation revealed vitreous opacity and ultrasound examination showed membrane shaped lesion attached to the optic nerve suggested retinal detachment. Result: Vitrectomy was done for diagnostic and therapeutic purpose. VA was remarkably improved by 6/6 and persist until 6 months post vitrectomy, and progressive improvement on posterior segment. Conclusion: Surgery in the management of posterior uveitis can be divided based on indication, either for therapeutic or diagnostic purposes or to manage its complications. Vitrectomy is one of the modality to manage vitreoretinal complications associated with uveitis
CHARACTERISTICS OF RETINAL DETACHMENT PATIENTS WITH PROLIFERATIVE VITREORETINOPATHY AT Dr. SOETOMO GENERAL ACADEMIC HOSPITAL Ifan Romadhon Lukmana; Sauli Ari Widjaja; Wimbo Sasono; Muhammad Firmansjah; Ima Yustiarini; Ady Dwi Prakosa; Moestidjab Moestidjab; Gatut Suhendro
International Journal of Retina Vol 2 No 2 (2019): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2019.vol002.iss002.75

Abstract

Introduction: The aim of this study is to evaluate the incidence and characteristics of retinal detachment patients with proliferative vitreoretinopathy. Methods: Retrospective review of medical record from primary retinal detachment (RD) patients with proliferative vitreoretinopathy (PVR) between 2013 and 2017 at Outpatient Department of Ophthalmology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Result: : The number of RD patients with PVR at Dr. Soetomo General Academic Hospital in 2013-2017 was 80 patients (21%), consisting of 59 men and 21 women with mean of age was 47.5 ± 14.3 years. The characteristics of the subjects were phakic 72.5%, aphakic 1.25%, high myopia 23.75%, history of trauma 18.75% and affected to right eye 60%. Retinal characteristics were break conditions in the retina (located at superotemporal (34%), horseshoe tear (56%), and single break (60%)), macula off (90%), area of detachments were 4 quadrants (43,75%), PVR conditions were grade B PVR (45%), mean duration of RD was 156 days, mean length of surgery waiting list was 61.1 days. The majority of treatment types were vitrectomy (70,4%), majority of tamponade using silicone oil (59.3%), majority of pre-operative and post-operative visual acuity were less than 3 meters counting finger, pre-operative (91.25%) , post-operative 1 month (76%) and 6 months (52.5%), and the majority of post-operative retinal reattachment were 77.3%. Conclusion: The results of this study indicate the number of RD patients with PVR was lower than previous studies. Various results of patient characteristics can be used as guidelines for ophthalmologists in determining actions and explaining the prognosis of the disease. Further research with a larger sample size and prospective methods will be better able to provide better results. Keywords: retinal detachment, proliferative vitreoretinopathy, characteristic pvr
IMPROVEMENT OF LEUKEMIC RETINOPATHY AFTER LEUKAPHERESIS IN CHRONIC MYELOGENOUS LEUKEMIA WITH LEUKOSTASIS Ruchyta Ranti; Sauli Ari Widjaja; Wimbo Sasono; Muhammad Firmansjah; Ima Yustiarini; Ady Dwi Prakosa; Moestidjab Moestidjab; Gatut Suhendro
International Journal of Retina Vol 3 No 1 (2020): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2020.vol003.iss001.87

Abstract

ABSTRACT Introduction: to report a case of bilateral leukemic retinopathy due to leukostasis that was successfully managed by leukapheresis. Case Presentation: 31-year-old male with mild visual disturbance was referred to ophthalmology department. He suffered from Chronic Myelogenous Leukemia (CML) with white blood cell (WBC) count 533.900/microL. He was started on hydroxyurea, allopurinol, and once leukapheresis. Ophthalmologic evaluation revealed visual acuity of 4/4 in the right eye and 4/6,3 in the left eye. Funduscopy examination showed the presence of bilateral papilledema, venous engorgement, tortuosity, and retinal hemorrhages. Then this patient continued with second leukapheresis. Result: Visual acuity, laboratory examination, and funduscopic finding was evaluated. His visual acuity was improved, papilledema and retinal blood vessels abnormality had markedly reduced concurring with the patient’s hematological remission. Decreasing WBC count after leukapheresis has improved blood flow that reflected from the retinal findings and visual acuity improvement. Conclusion: Leukapheresis treatment is sufficient to improved clinical condition for leukemic retinopathy caused by CML with leukostasis. Keywords: chronic myelogenous leukemia (CML), hyperleukocytosis, leukostasis, leukemic retinopathy
CONDENSING LENS ON BINOCULAR INDIRECT OPHTHALMOSCOPY AND SLIT-LAMP BIOMICROSCOPY Danang Yoga Wiguna; Sauli Ari Widjaja; Wimbo Sasono; Muhammad Firmansjah; Ima Yustiarini; Ady Dwi Prakosa; Moestidjab Moestidjab; Gatut Suhendro
International Journal of Retina Vol 2 No 2 (2019): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2019.vol002.iss002.76

Abstract

Condensing lens is a lens used as an auxiliary lens in indirect instruments to examines the fundus. This lens is used with binocular indirect ophthalmoscope and slit-lamp biomicroscope to reach a stereopsis image of fundus. Optical principle of condensing lens is to make the eye in myopic condition, so it can producesa real, aerial, inverted and reversed image. This lens was placed between the instruments and the eye of the patient which located closer to patient’s eye. Optimalized position of the lens can produce a good fundus image. Condensing lens have so many power of dioptre that each power produces different magnification and field of view. High powered lenses produces wider field of view than low powered ones. High powered lens can also used in patient with small dilated pupil and shorter distance of examination. Low powered lenses offer more magnification. Fundus examination with binocular indirect ophthalmoscope and slit-lamp biomicroscope have purpose to produces stereopsis image because of the binocularity system. These two instruments have each advantages and disadvantages. The advantages of binocular indirect ophthalmoscope are a portable instrument, relatively can be used in uncooperative patient and it can be used with scleral indentation to reach more peripheral view of the fundus. Meanwhile slit-lamp biomicroscope has the advantages to offer more magnification and flexible illumination system. With higher powered lens use in biomicroscope, it also give advantages in shorter distance of examination and wider field of view.
Challenges in Cytomegalovirus (CMV) Retinitis Management Denisa Rosati; Sauli Ari Widjaja; Wimbo Sasono; Muhammad Firmansjah; Ima Yustiarini; Ady Dwi Prakosa; Moestidjab Moestidjab; Gatut Suhendro
International Journal of Retina Vol 2 No 2 (2019): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2019.vol002.iss002.91

Abstract

Introduction: HIV infection can manifest in a variety of ways in and around the eyes and it is most commonly due to retinal microvasculopathy, neoplasm and also opportunistic infection. Those usually occur associated with a significantly reduced CD4 T-cell counts. In this era of Highly Active Anti Retroviral Therapy (HAART) has caused a major decreasing of the ocular involvement prevalence itself. Case presentation : A 31 year-old-male came with blurred vision on the right eye, which has started 3 years ago and slowly worsened. Central scotoma also presented previously. Patient was an HIV-AIDS, that placed him on HAART. CD4+ T-lymphocyte count was 3 cells/mm3. The initial visual acuity was light perception and fundus examination showed Roth spots, massive exudates and hemorrhages covering the optic disc and decreased foveal reflex. Laboratory examination revealed positive Rubella and anti-CMV immunoglobulin-G (IgG). He also suffered from lung tuberculosis and took tuberculosis medication regularly. Patient was diagnosed with Cytomegalovirus (CMV) retinitis based on history of illness, fundus examination as well as laboratory testing and given oral induction valganciclovir 900 mg once daily for 3 weeks followed by maintenance dosage . Result : After valganciclovir induction, there was significant changes with decreased peripapillary exudates, hemorrhages and vasculitis, but the optic disc appeared pale. The patient also had bicytopenia due to valganciclovir therapy that complicate his condition and passed away after 3 months follow up. Conclusion: CMV retinitis is reported to occur in patient with extreme CD4 count usually less than 50 cells/mm3. The sooner of proper treatment would likely following better outcome. Making diagnosis of immunosuppresed patient with ocular manifestations was challenging so that comprehensive eye examination in HIV-infected individuals should be conducted. Oral valganciclovir could give satisfactory response to decrease the progression of retinitis but risk of blindness may still occur.
POLYPOIDAL CHOROIDAL VASCULOPATHY MANIFESTATION IN EXTRA-AXIAL CAVERNOUS TUMOR: A RARE FINDINGS IN CHRONIC PAPILLEDEMA Asti, Annisa Kinanti; Agustini, Lukisiari; Firmansjah, Muhammad
International Journal of Retina Vol 8 No 1 (2025): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2025.vol008.iss001.306

Abstract

Introduction: Age-related macular degeneration (AMD) is a leading cause of blindness worldwide. Polypoidal choroidal vasculopathy (PCV), a subtype of neovascular AMD, is characterized by an abnormal branching network of vessels with aneurysmal dilations (polyps). Choroidal neovascularization can also result from chronic disc edema. This case presents a rare occurrence of PCV in a patient with an extra-axial cavernous tumor and explores the best management approach. Case Report: A 43-year-old man presented with an 8-month history of blurry vision in his right eye, double vision on left gaze, and left eye protrusion, accompanied by headaches and occasional nausea. Visual acuity was 2/60 in the right eye and 5/10 in the left improving with pinhole become 5/6.5. RAPD was found in left eye. Funduscopy revealed peripapillary atrophy in both eyes, with exudates in the right macula. OCT showed dome-shaped polyps in both eyes, larger in the right. MRI revealed a left sphenoid meningioma compressing the orbital cavity. The patient was diagnosed with both eyes PCV and compressive optic neuropathy, left eye multiple cranial nerve palsy and dyslipidemia. Intravitreal anti-VEGF injection was planned. Discussion PCV is a subtype of AMD characterized by recurrent serosanguineous detachments. Chronic papilledema, possibly due to intracranial tumors, may lead to visual loss from retinal nerve fiber damage or neovascularization. Chronic posterior globe flattening and choroidal vessel abnormalities likely contributed to PCV development. Conclusion: PCV may result from chronic papilledema due to intracranial tumors. Anti-VEGF therapy offers a viable treatment option, balancing polyp regression and visual acuity stabilization.
PEEK Acuity and its Potential to Improve Visual Acuity Screening Dipayana, Pikasa Retsyah; Firmansjah, Muhammad; Wahyuni, Indri; Nurfahri, Rifat
Vision Science and Eye Health Journal Vol. 4 No. 2 (2025): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v4i2.2025.42-45

Abstract

Introduction: Uncorrected refractive errors contribute to 43% of the leading causes of global visual impairment. Early screening is essential to detect visual impairment and to plan early intervention. Portable eye examination kit (PEEK) Acuity has the potential to help improve early detection; however, its validation needs to be studied. Purpose: To carry out a validation test of PEEK Acuity as a visual acuity examination tool compared to the Snellen Chart. Reviews: PEEK Acuity is a smartphone-based screening modality that can be used offline and has a low false positive rate. Several studies have been conducted to evaluate the accuracy of using the PEEK Acuity application. The duration of examination using PEEK Acuity is also said to be significantly shorter than that of using Snellen Chart in preschool-age children. Conclusions: The PEEK Acuity application can currently be considered a viable alternative for vision screening, especially for widespread screening in both the community and school-aged children who require a high level of specificity to avoid errors in identifying cases.
Co-Authors Ady Dwi Prakosa Ady Dwi Prakosa Ady Dwi Prakosa Ady Dwi Prakosa Agustini, Lukisiari Ahmad Hanif Asyhar Ahmad Zoebad Foeady Anastasia, Ruth Asti, Annisa Kinanti Bening, Daya Banyu Danang Yoga Wiguna Denisa Rosati Dipayana, Pikasa Retsyah Firda Ayu Muthie Foeady, Ahmad Zoebad Gatut Suhendro Ifan Romadhon Lukmana Ima Yustiarini Ima Yustiarini Ima Yustiarini Ima Yustiarini Indri Wahyuni Kartika, Amelia Rahmah Moestidjab Moestidjab Moestidjab Moestidjab Moestidjab Moestidjab Nandang Sudrajat Nerissa Tamara Putri Nurfahri, Rifat Prakosa, Ady Dwi Pramesti, Karina Ayu Prastyani, Reni Ramadhan, Ferdian Ruchyta Ranti Sari, Dian Candra Rini Novita Sasono, Wimbo Sauli Ari Widjaja Sauli Ari Widjaja Sauli Ari Widjaja Sauli Ari Widjaja Widjaja, Sauli Ari Yustiarini, Ima Zuhria, Ismi