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Ophthalmologica Indonesiana
Published by Perhimpunan Dokter Spesialis Mata Indonesia
ISSN : 01261193     EISSN : 2460545X     DOI : 10.35749
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
Ophthalmologica Indonesiana is an open accessed online journal and comprehensive peer-reviewed ophthalmologist journal published by the Indonesian Ophthalmologist Association / Perhimpunan Dokter Spesialis Mata (PERDAMI). Our main mission is to encourage the important science in the clinical area of the ophthalmology field. We welcome authors for original articles (research), review articles, interesting case reports, special articles, clinical practices, and medical illustrations that focus on the clinical area of ophthalmology medicine.
Arjuna Subject : Kedokteran - Ophthalmology
Articles 869 Documents
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The Prediction of Visual Acuity after Open Globe Injury in Children Using Pediatric Ocular Trauma Score (POTS) Albaaza Nuady; Purjanto Tepo Utomo; Widyandana Widyandana
Majalah Oftalmologi Indonesia Vol 42 No 3 (2016): 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.v42i3.113

Abstract

Background: Open globe injury is one of the major causes of non-congenital ocular morbidities in children. Ocular trauma contributes 7% of all traumas and 10-15% of all ocular diseases. This study aims to assess VA after OGI in children at Sardjito General Hospital (SGH) and YAP Eye Hospital (YAP) using POTS.Methods: Children with OGI ≤15 years old from emergency unit from 2014 to 2016 was evaluated in retrospective design. Age, sex, admission time, operation time, cause of trauma, initial VA, final VA, and concomitant ocular pathology were collected, then classified with POTS. We compared initial VA and final VA to predict VA after OGI in children at SGH and YAP.Results: Twenty two (88%) patients were male and three (12%) patients were female with mean age of 8.84 years old. Nineteen cases were OGI with zone 1 involvement (76%), 2 cases with zone 2 (8%), and 4 cases with zone 3 (16%). After POTS classification, OGI in group 1 was 8 (32.6%), group 2 was 12 (48%), and group 3 was 5 (20%). Mean rate of initial VA was HM, 1 month after OGI was 1/60, 3 months was 3/60, 6 months was 3/60, and 12 months was 4/60. Classification using POTS was statistically significant for initial VA (p=0.046), VA in 1 month (p=0.046), and 3 months (p=0.46).Conclusion: OGI in children causes poor prognosis for VA. Zone involvement, delayed operation time and vitreous hemorrhage correlate with poor visual prognosis in OGI. Classification of injury with POTS shows prediction of VA after OGI. Keywords: open globe injury in children, pediatric ocular trauma score.
Toxic Effect of Topical DLBS1425 Towards Proliferation Degree and Mucin Secretion in Rabbit’s Eye Amy Aurelian; Trilaksana Nugroho; Dina Novita
Majalah Oftalmologi Indonesia Vol 42 No 3 (2016): 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.v42i3.114

Abstract

Background: Phaleria macrocarpa (DLBS1425) is a medicinal plant that has the effects of anti-cancer, anti-inflammation, anti-angiogenesis, and antioxidants. The potency of its toxicity is low towards normal cell. DLBS1425 is expected to be useable for eye drop, but its toxic effect towards goblet cell proliferation and mucin secretion still remain unknown.Methods: This is experimental study with design of comparison test. Twenty four rabbits’ eyes divided into 4 groups were given placebo and topical DLBS1425 with concentration of 1×10-1 mg/ml, 1×100 mg/ml, and 1×101 mg/ml. Goblet cell proliferation degree and mucin secretion were evaluated using histopathology examination from rabits’ conjunctiva.Results: In the group of goblet cell proliferation, compared to control group, there was decreased proliferation degree with topical DLBS1425 of 1×10-1 mg/ml; but the concentration of 1×100 mg/ml and 1×101 mg/ml did not affect goblet cell proliferation. In the group of mucin secretion, DLBS1425 with any concentration level decreased mucin secretion significantly.Conclusion: There was significant difference in goblet cell proliferation with topical DLBS1425 of 1×10-1 mg/ml and placebo. There was also significant difference in mucin secretion with topical DLBS1425 in any concentration level and placebo. Keywords: DLBS1425, goblet cell, mucin secretion
The Effect of Zinc Distribution for New TB Patients who Have Ethambutol Therapy Toward Visual Field Defect Neni Daniati; Kusdiantoro Kusdiantoro; Laksmi Wulandari; Nina Mauthia; Lukisiari Agustini
Majalah Oftalmologi Indonesia Vol 42 No 3 (2016): 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.v42i3.115

Abstract

Background: Tuberculosis is an infection disease that is caused by Mycobacterium tuberculosis. Ethambutol therapy for TB patients can cause side effect such as decreased visual acuity, visual field defect, decreased contrast sensitivity, and disturbance of colour detection. Zinc in TB patients has decreased that causes broken cell on retina ganglion and disturbance of mytochondria function. The aim of this study is the effect of zinc supplementation for new TB patients who have ethambutol therapy toward visual field defect.Methods: This study involved 40 new TB patients who have ethambutol therapy which is classified as 20 patients who have ethambutol therapy with zinc supplementation and 20 patients who have ethambutol therapy without zinc supplementation. Each patient underwent a routine examination including visual acuity using Snellen chart which is converted to LogMAR, anterior segment using slit lamp biomicroscope, non-contact tonometry for intraocular pressure examination, posterior segment using direct ophthalmoscope, and Humphrey perimetry for visual field examination which is performed three times on first time when initial patient came, first month, and second month duration.Results: This study showed no correlation between gender with visual field defect (p=0,554), there is no correlation between age with visual field defect (p=0,418), no correlation between smoking behaviour with visual field defect (p=1), no correlation between amount of meals consumption containing Zn with visual field defect (p=0,608), and also no correlation between systematic illness history with visual field defect (p=0,305). The effect of Zn treatment to visual field defect was significant with p=0,0085.Conclusion: Zinc treatment for new TB patients with ethambutol treatment may prevent visual field defect.Keywords: ethambutol, new TB patients, zinc, visual field defect
Sudut Pandang dan Tanggung Jawab Profesi Tjahjono D Gondhowiardjo
Majalah Oftalmologi Indonesia Vol 43 No 1 (2017): 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.v43i1.128

Abstract

Dalam era globalisasi infomasi ini, kita selalu dituntut untuk melakukan atau menerapkan semua tindakan atau keputusan berdasarkan bukti ilmiah (evidence-based). Ironinya, sebagian besar dari kita mungkin tidak pernah tersentuh atau memahami apakah evidence-based itu. Oleh karena itu, edisi ini memuat dua buah makalah meta-analisis yang berupaya untuk menjelaskan tahapan pencapaian kesimpulan yang berdasarkan bukti yang kuat dari berbagai tingkatan kesahihan suatu laporan; baik dalam prosedur diagnose klinik, maupun dalam pola penatalaksanaan terkini. Tanpa kesadaran akan proses pencapaian standar evidence-based, maka dengan mudah kita akan menggunakan suatu jenis obat, hanya berdasarkan hasil suatu makalah, misalnya efek penggunaan myrtogenol yang ditampilkan dalam edisi ini. Disisi lain, perlu disadari bahwa pemahaman dogmatis dari ketentuan evidence-based tsb, mempunyai dampak negatif, yaitu pembatasan terhadap pemikiran kreativitas dan innovasi untuk mengatasi masalah yang ada di negara berkembang, baik karena ketiadaan sarana maupun prasarana; apalagi membuat terobosan untuk kebaruan pengembangan keilmuan. Dengan kata lain, kita akan terus digiring untuk menjadi pengguna teknologi baru berdasarkan pengetahuan yang berkembang di negara-negara industri. Sebagaimana biasanya, makalah yang ditampilkan masih didominasi oleh institusi pendidikan; yang umumnya dibuat oleh peserta didik. Oleh karena itu, kita dapat melihat bahwa seringkali terkesan sebagai output dari tahapan pendidikan, yaitu belajar meneliti dengan membuktikan suatu keadaan / teknologi yang relatif sudah baku. Di sisi lain, hal ini mempunyai nilai positif karena dapat menunjukkan bahwa perlakuan atau tindakan yang sederhana dan baku, seperti metode pencil push up, suntikan oxytetracyclin intra lesi dapat memberi hasil pengobatan yang sesuai dengan harapan. Data retrospektif yang ditampilkan dapat dibaca sekedar sebagai data deskriptif, yang relatif juga merupakan informasi baku; seperti misalnya insiden kekeruhan kapsul posterior lensa pasca operasi katarak, dan keberhasilan tindakan fotokoagulasi laser pada robekan retina. Dari sisi lain, hal itu dapat dilihat, atau digunakan sebagai data pembanding terhadap kualitas pelayanan di insititusinya sendiri atau institusi lainnya. Hal itu disebabkan karena pada hakekatnya kekeruhan kapsul lensa posterior adalah akibat dari ketidaksempurnaan teknik operasi katarak yang kita lakukan; begitu pula dengan robekan retina pasca fotokoagulasi laser terkait dengan kecepatan waktu tindakan, serta ketepatan dosis dan tembakan laser pada proses fotokoagulasi tersebut. Makalah yang membahas perbandingan kadar Placenta Growth factor dengan dan tanpa intervensi Aflibercept; secara tidak langsung menunjukkan bahwa, kita membutuhkan peran disiplin lain untuk dapat memahami perkembangan ilmu dan teknologi kedokteran secara umum; dan tentunya diharapkan dapat mengembangkannya dengan melakukan inovasi yang lebih spesifik untuk profesi kita. Hal yang serupa dengan laporan penatalaksanaan tumor Triton langsung menunjukkan bahwa tanpa peran pemeriksaan histopatologi maka kondisi mata pasien berpotensi untuk menjadi buta dan bahkan mungkin kematiannya. Kedua contoh tersebut, pada hakekatnya menggambarkan kebutuhan kita untuk dapat bekerjasama baik dalam aspek inter-disiplin, maupun intra-disiplin (baca: sebagai profesi kita sendiri) dengan semangat kolegialitas untuk kemaslahatan pasien-pasien kita, profesi oftalmologi di masa mendatang. Perkembangan profesi yang sehat, menuntut adanya keseimbangan dalam berbagai aspek kehidupan profesi, namun kenyataan menunjukkan bahwa dalam berbagai kegiatan organisasi maupun ilmiah, mayoritas anggota yang berperan sebagai ujung tombak profesi kita di masyarakat dan yang berada di berbagai tingkatan pelayanan kesehatan relative bersikap pasif. Di sisi lain, hal itu merupakan alasan yang mendasar bagi mereka yang mengemban amanah organisasi profesi kita untuk dapat mengarahkan anggota untuk dapat menyamakan persepsi, kemampuan klinis dan keterampilan operatif yang siap untuk beradaptasi dalam gelombang perubahan saat ini dengan diterapkannya sistim Jaminan Kesehatan Nasional dan era pasar bebas ASEAN mendatang.
Malignant Triton Tumor without Von Recklinghausen’s Neurofibromatosis in a 16 year-old Indonesian Girl: A Case Report Neni Anggraini; Nurjati Chairani Siregar
Majalah Oftalmologi Indonesia Vol 43 No 1 (2017): 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.v43i1.129

Abstract

Background: To diagnose malignant peripheral nerve sheath tumor with rhabdomyoblastic differentiation in malignant triton tumor which has a rare incidence. Case Illustration: We reported a case in a 16 year-old girl who presented with progressively painless proptosis of the left eye and decreased visual acuity. There was no evidence of Recklinghausen’s disease. She underwent surgery and radiotherapy. The histopatologic findings showed malignant peripheral nerve sheath tumor (MPNST). Four years later, she suffered recurrence proptosis and decreased visual acuity. Histomorphology supported by immunostaining with S-100 protein confirmed the diagnosis of malignant triton tumor. She underwent chemotherapy and enucleation. Conclusion: This case highlights the prudent use of immunohistochemistry that is essential in making an early detection and a correct diagnosis.
Outcome and Safety of Different Cumulative Doses and Protocols of Intravenous Methylprednisolone in Moderate to Severe and Active Graves’ Ophthalmopathy Amelya Permata Sari; M Sidik; Syntia Nusanti
Majalah Oftalmologi Indonesia Vol 43 No 1 (2017): 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.v43i1.131

Abstract

Background: Graves’ ophthalmopathy (GO), also known as Graves’ orbitopathy or thyroid eye disease, has a potential sight-threatening complications. The activity and severity are important determinants in GO and are implications for treatment. Intravenous Glucocorticoid (GC) was associated with significantly greater efficacy and was better tolerated than oral route in the treatment of patients with moderate to severe and active GO. Intravenous GC has a variation cumulative dose and protocols; meanwhile the optimal treatment is still undefined. The aim of this literature review was to analyze the outcome and safety of different cumulative doses and protocols of intravenous methylprednisolone of patients with moderate to severe and active GO. Methods: The literature search was conducted from Google Scholar and Pubmed for journal articles that were published and related to the use of IVGC in moderate to severe and active GO Results: From the keywords mentioned, titles were screened for eligibility and seventeen articles were found. After being checked for the duplication, the articles were screened based on the abstracts and/or full texts. As many as eight articles met the inclusion criteria, others were excluded. Conclusion: Intravenous GC therapy in moderate to severe and active GO provide effect in reducing CAS, decreasing lid aperture size, decreasing proptosis size, and disappearing diplopia. A protocol uses a low cumulative doses (<5 g) of methylprednisolone weekly for 6 weeks and then halved dose weekly for another 6 weeks are preferred due to higher response in clinical outcome and safety profile.
Diagnostic Performance of Macular Ganglion Cell/Inner Plexiform Layer Thickness to Discriminate Normal Eye from Eye with Early Glaucoma Using Cirrus Spectral-Domain Optical Coherence Tomography Widya Artini; Baltazar Bimo Bisara
Majalah Oftalmologi Indonesia Vol 43 No 1 (2017): 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.v43i1.132

Abstract

Background: Glaucoma is a progressive optic neuropathy characterized by a progressive loss of retinal ganglion cells (RGC). In glaucomatous optic neuropathy, structural optic nerve changes may occur before detectable functional loss, which can be diagnosed early by detecting loss of RGC. This review was conducted to see the diagnostic performance of macular ganglion cell/inner plexiform layer (GC-IPL) thickness parameters to discriminate normal eye from early glaucoma eye using Cirrus Spectral-domain OCT compared to peri-papilarry Retinal Nerve Fiber Layer (RNFL) thickness parameters. Methods: Literature search was conducted from MEDLINE database using Pubmed, Clinical Key, and ScienceDirect. No publication date was set, and only articles published in English were included. Reference list from the included studies were also checked for potentially relevant articles. Results: Twenty articles were found related to search term. Seven articles met the inclusion criteria. Fourteen others were excluded. All studies revealed significant thinner GC-IPL and RNFL average thickness in glaucoma patients compared to normal patients. GC-IPL Average was inferior to GC-IPL Minimum and RNFL inferior in determining normal eye from early glaucomatous eyes. Studies evaluating the diagnostic performance of Ganglion Cells Complex (GCC) thickness also found low sensitivity values, ranging between 61.0% and 78.6% for average GCC. Conclusion: Diagnostic performance of GC-IPL is comparable to RNFL parameters measurement in detecting early glaucoma eyes. Best performance in detecting early glaucoma were showed by GC-IPL minimum and RNFL inferior.
Correlation Between Best Corrected Visual Acuity Acquired by Snellen Chart with Potential Visual Acuity of Retinometry in Ametropic Patients Dera Tresna Utami; Fatimah Dyah NA
Majalah Oftalmologi Indonesia Vol 43 No 1 (2017): 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.v43i1.133

Abstract

Introduction: Potential vision is determined by assessing macular function. Retinometer is a tool that is often used to assess the potential visual acuity. Refractive error is the most common cause of vision decline. Currently, examination of best visual acuity still uses Snellen chart, but if the result of vision correction with Snellen chart not maximized can cause the emergence of other problems such as amblyopia. Objective: To analyze correlation between best corrected visual acuity (BCVA) acquired by Snellen chart with potential visual acuity of retinometry in ametropic patients. Methods: This was an observational cross sectional study, enrolled at department of ophthalmology dr. Karidi General Hospital. This study involving 73 myopic eyes of 40 patient. After having their potential vision examined with retinometer, patient undergoing visual acuity assesment with Snellen chart. Statistical analysis using Spearman correlation. Result: In this study we found retinometry scale 0,8 for BCVA 1.0 (56,8%) and 0.32 for BCVA < 1.0 (48,4%) as the most common finding respectively. We found most of mild myopia cases in patients with BCVA 1,0 (52%) and high myopia in patients with BCVA < 1.0 (71%). Statistical analysis shows a moderate strength-positive correlation between potential visual acuity retinometry with best corrected visual acuity acquired by Snellen. Conclusion: BCVA acquired by Snellen shows moderate strength-positive correlation with potential visual acuity retinometry in ametropic patient. Scale 0.63 in retinometry can be used as benchmark for predicting visual acuity after correction reach 1.0.
The effect of mirtogenol towards the changes in retinal nerve fiber layer thickness and visual field in primary open angle glaucoma Astriviani Widyakusuma; Widya Artini; Virna Dwi Oktariana; Joedo Prihartono
Majalah Oftalmologi Indonesia Vol 43 No 1 (2017): 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.v43i1.134

Abstract

Objective: To evaluate the effect of Mirtogenol towards the changes in retinal nerve fiber layer (RNFL) thickness and visual field in patients with primary open angle glaucoma (POAG) with controlled IOP. Methods: This is a prospective, double blind, randomized study. Forty one POAG patients with IOP ≤ 18 mmHg were randomly assigned to receive either Mirtogenol or placebo. Changes in RNFL thickness and mean deviation of visual fields were evaluated before the treatment, as well as 4 weeks and 8 weeks after the treatment. Patients were asked for any side effects during the treatment period. Result: The average RNFL thickness in the Mirtogenol group decreased -0.70±1.63 μm from 87.29±19.39 μm before the treatment to 86.58±19.43 μm after 8 weeks of treatment, however the change was not significant (p=0.121). The average RNFL thickness in the placebo group decreased -1.74±1.79 μm from 97.14±17.19 μm before the treatment to 95.40±18.56 μm after 8 weeks of treatment, the change was statistically significant (p< 0.001). The average MD of visual field in the Mirtogenol group increased 0.542±1.93 dB after 8 weeks of treatment while the MD of visual field in the placebo group decreased -0.083±1.36 dB after 8 weeks of treatment. Hoewever the changes in MD of visual field was not significant (p>0.05). No side effect was found throughout the study. Conclusion: Mirtogenol seemed to maintain retinal nerve fiber layer thickness and increased mean deviation of visual fields.
Incidence and associated factors of posterior capsule opacification formation in pseudophakic patients at Cipto Mangunkusumo Hospital : January - December 2010 Sita Paramitha Ayuningtyas; Tjahjono D Gondhowiardjo
Majalah Oftalmologi Indonesia Vol 43 No 1 (2017): 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.v43i1.135

Abstract

Objective: Posterior capsule opacification (PCO) is the most common postoperative consequence of cataract surgery which may cause visual acuity reduction. The incidence of PCO in Indonesia has not been reported yet. The objectives of this study were to evaluate three years cumulative incidence of PCO and factors associated with PCO formation at Cipto Mangunkusumo (CM) Hospital. Methods: This was a retrospective descriptive study to patients with uneventful senile cataract surgery in year of 2010. All related data were retrieved from those medical records in year of 2013, which included patient demographics, type of surgery, time of PCO stated, IOL characteristics (material, optic edge design and diametere. Best corrected visual acuity (BCVA) pre operatively, when PCO was determined and Nd:YAG laser (Neodymium- doped yttrium aluminium garnet) was performed in decimal. Result: A total of 578 eyes (485 patients) was involved in this study. Three years cumulative incidence of the PCO was 8.82% (51 eyes). Phacoemulsification surgery was conducted in 496 (85.8%) eyes. The median time to PCO was being determined was 21 months (range 1 to 34 months) with the mean of BCVA was 0.50±0.26. Age, gender, and type of surgery had no related factors to PCO, but higher evidence in using of hydrophilic acrylic IOL (10.7%) was found. After laser Nd:YAG laser was performed, BCVA was improved. Conclusion: Three years cumulative incidence of PCO was 8.82% and there was no defined related factor to PCO reformation, but eye had been using hydrophilic acrylic IOL seem to be higher percentage

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