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All Journal IJRETINA - International Journal of Retina Ophthalmologica Indonesiana
Prakosa, Ady Dwi
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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.
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.
Co-Authors Anastasia, Ruth Firmansjah, Muhammad Kartika, Amelia Rahmah Pramesti, Karina Ayu Ramadhan, Ferdian Sasono, Wimbo Widjaja, Sauli Ari Yustiarini, Ima