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All Journal IJRETINA - International Journal of Retina Ophthalmologica Indonesiana
Yustiarini, Ima
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Health Professions Medicine & Pharmacology Public Health

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OBSERVATION VS. SURGERY IN TRAUMATIC MACULAR HOLE: A CASE REPORT HIGHLIGHTING FUNCTIONAL OUTCOME Kartika, Amelia Rahmah; Yustiarini, Ima; Prakosa, Ady Dwi; Widjaja, Sauli Ari; Firmansjah, Muhammad; Sasono, Wimbo
International Journal of Retina Vol 8 No 2 (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.iss002.322

Abstract

Introduction: Traumatic macular hole (TMH) is a rare consequence of blunt ocular trauma, often leading to visual impairment. While spontaneous closure is possible, the decision between observation and surgical intervention remains debated. Case Report: A 15-year-old male presented with blurry vision in his left eye two weeks after being punched. Examination revealed a macular hole, choroidal rupture, and vitreous hemorrhage. Optical coherence tomography (OCT) confirmed a full-thickness macular hole. Given the potential for spontaneous closure, a three-month observation period was chosen. Follow-ups showed no improvement in visual acuity or anatomical closure, leading to the decision against surgery. Discussion: While vitrectomy has high anatomical success rates, final visual acuity may not differ significantly between surgically and spontaneously closed holes. Factors such as initial visual acuity, ellipsoid zone integrity, and associated ocular injuries influence functional outcomes. In this case, the presence of choroidal rupture and vitreous hemorrhage supported the decision for conservative management. Conclusion: TMH management should balance anatomical and functional outcomes. Observation is a reasonable approach in select cases, particularly in younger patients with a chance of spontaneous closure. Individualized treatment decisions are essential, considering potential surgical risks and visual prognosis.
Minimally Invasive Management of Retinal Detachment: Insights from a Pneumatic Retinopexy Case Report Pramesti, Karina Ayu; Prakosa, Ady Dwi; Sasono, Wimbo; Firmansjah, Muhammad; Widjaja, Sauli Ari; Yustiarini, Ima
International Journal of Retina Vol 8 No 2 (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.iss002.326

Abstract

Introduction: Rhegmatogenous Retinal Detachment (RRD) caused by a tear in the retina, causes fluid accumulation and separation of neurosensory retina from retinal pigment epithelium which can lead to blindness. The goal for treatment is to reduce vitreoretinal tension and fix retinal tears and holes. The case report discusses about management in uncomplicated RRD. Case Report: Patient came with blurry vision on his right eye (RE) since two weeks ago. Four days before, He was seeing black curtain on lower left direction while working, but it did not get any wider. No complaints on his left eye. Patient has hypertension only known recently. No history of trauma, spectacles. His occupation was labourer. General examination within normal limits. Visual acuity (VA) RE 6/24. Anterior segment within normal limits. Posterior segment, detachment at 9-2 o'clock, horse shoe tear at 11 o'clock and a small hole at 1 o'clock. Lattice degeneration at 8-12 o'clock, macula on. Patient then underwent pneumatic retinopexy. Intraocular pressure (IOP) 13mmHg. Discussion: Retinal detachment occurs when subretinal fluid accumulates between the neurosensory retina and the retinal pigment epithelium. This can happen in three ways, and the cause for our patient was a tear of retina, for that reason we diagnosed with RRD. Prognosis for patients with RRD depends on the condition off the macula, and the symptom onset. Conclusion: Optimization of retinal detachment detection and the success of rapid-onset retinopexy still need improvement. Proliferative Vitreoretinopathy (PVR) remains a common cause of failure, necessitating new strategies for its management. However, the choice of technique is still influenced by the considerations and experience of each vitreoretinal surgeon.
GUIDELINES FOR THE DIAGNOSIS AND MANAGEMENT OF DIABETIC RETINOPATHY AND DIABETIC MACULAR EDEMA IN INDONESIA Harley, Ohisa; Hertanto, Martin; Sembiring, Sindy Boru; Yustiarini, Ima; Susilo, Teguh; Dharma, Andhika Guna; Sjahreza, Emil; Firmansyah, M; Iskandar, Erwin; Agustiawan, Referano; Andayani, Ari; Dewi, Nadia Artha; Andayani, Gitalisa; Djatikusumo, Ari; Elvioza, Elvioza; Ichsan, Andi M; Kartasasmita, Arief S
International Journal of Retina Vol 7 No 2 (2024): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2024.vol007.iss002.300

Abstract

Diabetic retinopathy (DR) and diabetic macular edema (DME) are among the microvascular complications in individuals with diabetes mellitus (DM) that can lead to blindness if not diagnosed early and managed appropriately. Both disorders can be diagnosed and treated using a variety of techniques. Treatment modalities include laser photocoagulation therapy, vitrectomy surgery, intraocular steroid injections, and anti-vascular endothelial growth factor (anti-VEGF) injections. These methods can help avoid blindness when used in conjunction with metabolic control. These recommendations were created with the use of evidence-based medicine principles to help medical professionals—particularly ophthalmologists—identify and treat cases of DR and DME.The primary objective is to provide consensus recommendations and hopefully reduce the incidence of blindness caused by DR and DME in Indonesia.
ASSOCIATION BETWEEN CENTRAL RETINAL THICKNESS AND VISUAL OUTCOME POST INTRAVITREAL RANIBIZUMAB INJECTION LOADING DOSES IN EXUDATIVE AGE RELATED MACULAR DEGENERATION Ramadhan, Ferdian; Yustiarini, Ima; Prakosa, Ady Dwi; Widjaja, Sauli Ari; Sasono, Wimbo; Firmansjah, Muhammad
International Journal of Retina Vol 4 No 2 (2021): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2021.vol004.iss002.169

Abstract

Introduction : Age Related Macular Degeneration (AMD) stills the leading cause of blindness in developing countries for age 50 and above, increasing along higher life expectations.Anti- VEGF is the mainstay management for exudative AMD and able to reduce the central retinal thickness (CRT) and to increase the visual outcome. The aim of this study is to correlate between CRT and visual outcome in exudative AMD post intravitreal ranibizumab injection loading doses in Soetomo general academic hospital, Surabaya Methods : This was a retrospective, cross sectional study. Fourty two eyes who met inclusion criterias were received monthly loading doses of 0.5 mg Ranibizumab intravitreal injection for three consequtives months. Baseline visual acuity (BCVA) was measured with Snellen Chart converted to LogMAR, CRT was measured by SD-OCT. Parameters was measured before the first injection and after completed three months injections. Result : Fourty two eyes were composed by 59.5% male and 40.5% female with higher incidence in 61-70 years old (47.6%). Mean BCVA were 0.831 before and 0.624 after injection of serial Ranibizumab. Mean CRT were 346.9 and 254.2 µm before and after injection respectively. There was significant comparison between CRT and BCVA (p=0.00) & no correlation between CRT and BCVA before and after injection of Ranibizumab loading doses (p=0.418 & p=0.275) Conclusion : There were no correlation statistically between CRT and BCVA before and after injection of loading doses Ranibizumab intravitreal in exudative AMD. Further studies may be needed to prove the etiology of this tendencies.
Neglected Coats Disease: Determining the Most Appropriate Treatment: Poster Presentation - Case Report - Resident Anastasia, Ruth; Yustiarini, Ima; Prakosa, Ady Dwi; Widjaja, Sauli Ari; Firmansjah, Muhammad; Sasono, Wimbo
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/bjhhjr84

Abstract

Introduction : Coats disease is defined as retinal telangiectasia and aneurysm with retinal exudation that typically found in unilateral eyes of young male. This condition remains a diagnostic challenge because of its varied presentation. Case Illustration : A 12-years-old boy presented with a chief complaints of vision loss and pain in the right eye in the last 3 months and gradually blurred vision for a year. Visual acuity was positive light perception in the right eye and 5/5 in the left eye. Intraocular pressure of the right eye was 43.4 mmHg and 15mmHg of the left eye. Slit lamp examination of the right eye revealed conjunctival hyperemia, slightly corneal oedema, iris neovascularization, xantocoria, dilated pupil. Bullous total exudative retinal detachment with telangiectasia in all quadrants was found in the ophthalmoscopy examination of the right eye and left eye is within normal limit. The patient was diagnosed with stage IV coats disease and antiglaucoma agents was given as initial treatment. Discussion : Coats disease is a clinical diagnosis that can be assessed by clinical triad of exudative retinal detachment, irregularly-dilated telangiectatic vessel, and peripheral nonperfusion and can be supported by the diagnostic tools such as Ultrasonography, OCT, CT-Scan and MRI. Treatment of coats disease varies depend on the stage. In stage IV coats disease, external drainage is the most appropriate treatment. The more advanced stages demonstrating poor visual acuity both at presentation and at the time of final visit Conclusion : Majority of coats disease cases present with advanced stage therefore cause limited treatment option and poorer prognosis.
UNILATERAL CMV RETINITIS IN HIV/AIDS PATIENT WITH MULTIPLE OPPORTUNISTIC INFECTIONS: Poster Presentation - Case Report - Resident Bening, Daya Banyu; Firmansjah, Muhammad; Zuhria, Ismi; Yustiarini, Ima; Widjaja, Sauli Ari
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: 10.35749/4fdqtz59

Abstract

Introduction : CMV Retinitis is the most common opportunistic infection in HIV/AIDS patient. Ocular manifestations in HIV/AIDS have similar clinical features though the management therapies are different. Case Illustration : A 47-year-old man was presented with blurred vision on LE since 4 months. Patient was diagnosed with HIV/AIDS since 2 years. Patient only had light perception on LE, and 5/10 on RE. The LE anterior segment showed flare and cell indicating active anterior uveitis. The LE posterior segment revealed extensive hemorrhage and exudate known as ‘pizza pie’ appearance, and cotton wool spot with multiple ischemic areas on RE. Laboratory tests revealed reactive IgG CMV and very low CD4 count (4 cell/?l). Patient was also diagnosed with Tinea Corporis, Scabies, and Pneumocystis carinii pneumonia. Oral Valganciclovir 900 mg was administered twice a day for 3 weeks, along with anti- retroviral therapy. Discussion : The anterior uveitis and ‘pizza pie’ appearance with positive CMV IgG indicate CMV Retinitis in fulminant form. Cotton wool spot found in the RE leads to retinal microvasculopathy due to HIV invading the vascular endothelium and causing increased plasma viscosity. This patient only had 4 cell/?l CD4 which indicates severe immune deficiency. If not treated immediately, patients with CD4 count <50 are at higher risk of contralateral eye involvement. Oral Valganciclovir was chosen considering the multiple opportunistic infections the patient had. Conclusion : It is important to distinguish CMV retinitis with other HIV/AIDS ocular manifestations. The choice of therapy needs be considered with the overall condition of patient.
Co-Authors Agustiawan, Referano Anastasia, Ruth Andayani, Gitalisa Ari Andayani Arief S. Kartasasmita Bening, Daya Banyu Dharma, Andhika Guna Djatikusumo, Ari Elvioza Elvioza, Elvioza Firmansjah, Muhammad Firmansyah, M Harley, Ohisa Ichsan, Andi M Iskandar, Erwin Kartika, Amelia Rahmah Martin Hertanto Nadia Artha Dewi Prakosa, Ady Dwi Pramesti, Karina Ayu Ramadhan, Ferdian Sasono, Wimbo Sembiring, Sindy Boru Sjahreza, Emil Susilo, Teguh Widjaja, Sauli Ari Zuhria, Ismi