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Iswara, Delta
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Agriculture, Biological Sciences & Forestry Chemical Engineering, Chemistry & Bioengineering Dentistry Engineering Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Mechanical Engineering Medicine & Pharmacology Nursing Public Health Veterinary

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Posterior Ischaemic Optic Neuropathy (Pion) Secondary To Distal Segment Stenosis Of The Left Ophthalmic Artery: A Rare Case Report Iswara, Delta; Asyrofi, Hasna Okta; Hernawan Hernawan
International Journal of Health Engineering and Technology Vol. 5 No. 1 (2026): IJHET MAY 2026
Publisher : CV. AFDIFAL MAJU BERKAH

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55227/ijhet.v5i1.733

Abstract

Ischaemic optic neuropathy (ION) is a vision-threatening condition caused by impaired arterial blood supply to the optic nerve. Posterior ischaemic optic neuropathy (PION) is a rare subtype that often presents without funduscopic abnormalities in the acute phase, making diagnosis challenging. We report a case of a 50-year-old man who presented with sudden, painless monocular visual loss in the left eye, accompanied by hemisensory deficits. Ophthalmic examination revealed no optic disc abnormalities, while automated perimetry demonstrated an inferior arcuate visual field defect. Brain magnetic resonance imaging showed a right corona radiata infarction, and digital subtraction angiography confirmed stenosis of the distal branches of the left ophthalmic artery. These findings supported the diagnosis of PION secondary to ophthalmic artery stenosis, an uncommon etiology of ION. The patient had uncontrolled hypertension as a major vascular risk factor and was treated with antiplatelet therapy, resulting in clinical improvement of visual acuity. This case highlights the importance of comprehensive vascular evaluation in patients with suspected PION and emphasizes ophthalmic artery stenosis as a rare but significant cause of ischaemic optic neuropathy. Early recognition of the underlying vascular pathology may facilitate appropriate management and help prevent further ischemic complications.
Near-Fatal Asthma With Severe Hypercapnic Respiratory Failure Requiring Mechanical Ventilation In A Resource-Limited Setting: A Case Report Triagustina, Sinta; Iswara, Delta; Karera, Anggita Dian; Hasyim, Rois; Saksana, Rachmad Aji
International Journal of Health Engineering and Technology Vol. 5 No. 1 (2026): IJHET MAY 2026
Publisher : CV. AFDIFAL MAJU BERKAH

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55227/ijhet.v5i1.734

Abstract

Near-fatal asthma (NFA) is a life-threatening manifestation of acute severe asthma characterized by hypercapnia, respiratory acidosis, altered consciousness, and the need for invasive mechanical ventilation. Early recognition and timely airway stabilization are essential to prevent respiratory arrest and mortality, particularly in resource-limited settings. A 41-year-old woman with a history of asthma was brought to the emergency department with decreased consciousness and severe respiratory distress. On arrival, her Glasgow Coma Scale score was 5, respiratory rate was 35 breaths per minute, and oxygen saturation was 46% on room air. Arterial blood gas analysis demonstrated life-threatening hypercapnic respiratory failure (pH 6.954; PaCO₂ 95.4 mmHg; P/F ratio 87). Due to worsening respiratory failure and decreased level of consciousness, the patient underwent immediate endotracheal intubation and invasive mechanical ventilation and was admitted to the intensive care unit. She received systemic corticosteroids, repeated bronchodilator therapy, aminophylline infusion, and broad-spectrum antibiotics. Lung-protective ventilatory strategies with prolonged expiratory time were applied. The patient improved rapidly and was successfully extubated on the second day of mechanical ventilation, with subsequent discharge in stable condition. Appropriate ventilatory strategies combined with guideline-based pharmacological therapy are essential to improve outcomes in patients with near-fatal asthma presenting with severe hypercapnic respiratory failure, even in resource-limited settings.
Co-Authors Asyrofi, Hasna Okta Hasyim, Rois Hernawan Hernawan Karera, Anggita Dian Rachmad Aji Saksana Triagustina, Sinta