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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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Neuropati Optik Traumatik: Gambaran 13 Kasus Berdasarkan Radiologi dan Awitan Terapi Kortikosteroid di Rumah Sakit Cipto Mangunkusumo Made Paramita Wijayati; Syntia Nusanti; M. Sidik
Majalah Oftalmologi Indonesia Vol 47 No 2 (2021): 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.v47i2.100313

Abstract

Introduction and Objection: Traumatic Optic Neuropathy is a rare and potentially vision-threatening condition caused by ocular or head trauma. The optic nerve axons may be damaged either directly or indirectly. The management of traumatic optic neuropathy could be observed, giving steroids or decompression. At center which optic nerve decompression is not routinely performed, high dose steroid is preferred for traumatic optic neuropathy patients. The study aims to analyze characteristics (mean age and gender, onset trauma, most symptom, visual acuity, consensual reflex as a sign), radiology feature, and onset corticosteroid therapy on patient traumatic optic neuropathy. Methods: This study was a descriptive observational case series which data retrospectively analysis from medical record. Result: From 13 cases most common gender affected were males (76,9%). The mean age group 32.85±14.67 years old with blurry vision and bleeding are the most common symptom, the onset of trauma below 24 hours (76.9%), the initial visual acuity is no light perception and hand movement with a negative consensual reflex (76.9%). Visual acuity improves with initial corticosteroid therapy below 24 hours are 7 cases and more than 24 hours are 2 cases. From 9 cases with visual acuity improvement, there are 4 cases with orbital fracture and 5 cases without orbital fracture. Conclusion: Visual improvement in our cases happened more on initial corticosteroid therapy more than 24 hours and no orbital fracture.
Changes in Pattern and Multifocal Electroretinogram in Tuberculosis Patient with Ethambutol Therapy Syntia Nusanti; Budiman Bintang Prakoso; Muhamad Sidik; Erlina Burhan; Aria Kekalih
Majalah Oftalmologi Indonesia Vol 48 No 1 (2022): 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.v48i1.100315

Abstract

Introduction: Tuberculosis (TB) is a world health problem, especially in Indonesia as the third biggest country for new emerging TB patients. Ethambutol is one of the standard therapies to treat TB patients in Indonesia. Ethambutol has a side effect called ethambutol optic neuropathy which is hard to diagnose due to normal fundus appearance in most cases and therefore often detected late. Early detection is necessary so that permanent damage can be prevented. Examination pattern electroretinography (pERG) and multifocal electroretinography (mfERG) have the advantage to detect and confirm ocular toxicity by ethambutol after the clinical problem had emerged. It is not yet known neither pERG nor mfERG could detect any changes to detect ethambutol ocular toxicity before the clinical problem emerged. Methods: This study was a prospective clinical trial with 40 eyes samples and analyzed with paired t and Wilcoxon tests. The ocular examination was conducted using the Snellen chart, HRR Richmond Plates, Pelli Robson, pERG, and mfERG in tuberculosis category 1 patient with 2 months follow-up. Result: Visual acuity, color, and contrast sensitivity were normal in all patients for 2 months follow-up period. In pERG examination, the mean implicit time wave P50 was shortened by -1.27± 4.71 mS (p=0.049), and the mean amplitude wave N95 was reduced by -0.93± 4.49 ?V (p=0.038). Both were statistically significant. In the mfERG examination, we did not find any statistically significant changes in both wave N1 and P1. Conclusion: Changes in pattern ERG presented earlier compared to mfERG after ethambutol therapy for 2 months.
Characteristic of Secondary Intraocular Lens Implantation in Aphakic Children in Cicendo National Eye Hospital Lina Sudaryo
Majalah Oftalmologi Indonesia Vol 48 No 1 (2022): 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.v48i1.100318

Abstract

Background: Pediatric cataract is responsible for 200.000 of preventable blindness in children. Early cataract extraction and correction after the lens removal is critical. Secondary intraocular (IOL) implantation might be considered when the child is intolerant to contact lenses/spectacle wear. Only a few study has been done regarding secondary IOL implantation in aphakic children.  Objective: This study was aimed to describe the characteristic of secondary IOL implantation in aphakic children in Cicendo National Eye Hospital. Methods: This retrospective observational study took samples from medical records of patients who underwent secondary IOL implantation in 2016 – 2020  in Cicendo National Eye Hospital.  Results: Fifty nine eyes of forty pediatric patients underwent secondary IOL implantation surgery between 2016 – 2020. Two patients were excluded. From the 38 patients, 56 eyes were observed. Total of 20 patients were boys (52.6%) and 71.1% cases were bilateral cataract with congenital cataract as the main initial diagnosis (47.4%). Mean age of secondary IOL implantation was 71 ± 35 (20–201) months. Mean duration between cataract surgery and secondary IOL implantation was 51 ± 36 (2 – 189) months . Total of 80.4% of the IOL were fixated in the sulcus. Only 25% remained present for more than 12 months follow up and 65.8% of patients were corrected with bifocal spectacles. Conclusion: Secondary IOL implantation in aphakic children were mostly done in the age of six years old. Most of the IOL were fixated in the sulcus. Patients were mostly given bifocal spectacles.
The Utility of Ocular Imaging in Traumatic Optic Nerve Avulsion: A Case Report ikhwanuliman Putera; Syntia Nusanti; Nur Aisyah Rahmawati; Annisa Nindiana Pertiwi; Mario Marbungaran Hutapea
Majalah Oftalmologi Indonesia Vol 48 No 1 (2022): 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.v48i1.100365

Abstract

Objective: To describe a detailed presentation and the utility of ocular imaging, both ocular ultrasound and orbital computed tomography (CT), to confirm the diagnosis of traumatic ONA in which megadose steroid would give no advantage. Case Presentation: A five-year-old boy came with a unilateral sudden visual loss after incidentally falling with his left eye struck to a handlebar of a parked bicycle. His left eye had no light perception, ophthalmoplegia, and showing 4+ relative afferent pupillary defect. A hallmark "pit" sign and a pale retina without a tear were noted. B-scan ocular ultrasound displayed retinal step sign, vitreous hemorrhage in front of the optic canal, lamina cribrosa defect, edematous retina, and retracted optic nerve. Orbital computed tomography scan showed a disruption of the optic nerve-globe junction. Steroid infusion was decided not to be given. Conclusion: Ocular imaging, especially ultrasound, along with a thorough examination, is satisfactorily adequate to confirm the diagnosis of traumatic ONA.
Neuro-Ophthalmology Practice During Covid-19 Pandemic Yuri Dwi Mayasari; Syntia Nusanti
Majalah Oftalmologi Indonesia Vol 48 No 1 (2022): 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.v48i1.100377

Abstract

Introduction: Ophthalmology practice including neuro-ophthalmology (NO) adopted the American Academy of Ophthalmology recommendation to provide only urgent or emergent care during the COVID-19 pandemic. Objective: This report aimed to present demographical and patient visit data regarding the characteristic of outpatient in neuro-ophthalmology clinic and to evaluate the patients regulation and priority mitigation according to IOA guideline during COVID-19 pandemic. Methods: Retrospective study using medical record data of neuro-ophthalmology outpatients at Dr. Cipto Mangunkusumo Hospital from April-June in 2019 and 2020. Result: There were 207 visits from 160 patients during the pandemic, which was 33.9% of the total visits before pandemic. Most patients were reffered from internal referral (54.5%).  However, new patients from external referral mostly came with onset of more than 2 weeks (40.6%). Most common diagnosis during pandemic were NAION (12.6%), toxic optic neuropathy (8.7%), and paretic eye movement disorder (7.7%). The diagnosis were classified further into neuro-ophthalmology clinic guideline and IOA guideline based on diagnosis and tele-ophthalmology. The most common category were non-priority patients (55.6%), 3B priority level (26.5%), and first priority level (59,9%), respectively. Conclusion: A major difference characteristic of neuro-ophthalmology outpatients during pandemic was the number of patients visit. New patients mostly came from internal and local (Jabodetabek) referral which can be caused by mobility limitation, new hospital regulation and patients insecurity due to COVID-19. Priority mitigation in this study found non-priority patients were the majority who visited the clinic during COVID-19 pandemic, which may need further evaluation on referral and triage systems.
Prospective Comparative Study on Endothelial Corneal Cell After Cataract Surgery Using Torsional vs Longitudinal Phacoemulsification Precisza Fanny Faranita; Wisnu Sadasih; A. Rizal Fanany; Maharani Maharani
Majalah Oftalmologi Indonesia Vol 49 No 1 (2023): 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.v49i1.100403

Abstract

Objectives: Our aim was to compare endothelial corneal cell changes after cataract surgery performed with Torsional and Longitudinal phacoemulsification in patient with senile cataract. Methods: In this prospective study, the patients were divided into two groups, 24 eyes underwent cataract surgery using Torsional (OZil Infiniti Vision System, Alcon) and 23 eyes using Longitudinal phacoemulsification (Stelaris, Bausch & Lomb). Preoperative, 1 day, and 1-week post-operative examinations on endothelial corneal cells were performed using specular microscope. Cataracts were subdivided according to the LOCS III grading of nucleus. Intraoperative parameters using phacoemulsification time were evaluated. Results: On the results of CCT at 1 day and 1-week post-operative, there were significant changes in group Torsional and Longitudinal 601±68.67; 562.22±45.48 (p=0.033) and 561,71±36,37; 519.52±79.93 (p = 0.015). However, there were no significant changes of CD, CV, HEX 1 day and 1 week post operatively between two groups. The phacoemulsification time was lower in group Torsional 17.11±15.86 seconds than group Longitudinal 18.53±15.46 seconds (p=0.595) but not significantly different. Conclusions: Torsional phacoemulsification outperforms the Longitudinal with a lower phacoemulsification time on soft and medium cataracts, but the differences were not significant. Torsional caused more corneal edema at 1 day and 1 week postoperative significantly and more endothelial cell losses but insignificantly.
Fellow Eye Involvement in Low Compliance Patient with Non-Arteritic Ischemic Optic Neuropathy: A Case Report syntia nusanti; Dearaini Dearaini; Rasyidia Lakmita Putri; Rianti Wulandari Pratiwi
Majalah Oftalmologi Indonesia Vol 48 No 1 (2022): 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.v48i1.100411

Abstract

Introduction: The incidence of fellow eye involvement in non-arteritic anterior ischemic optic neuropathy (NAION) is 15% at 5 years after initial onset, although risk factors have not been identified. The aim of this article is to determine the risk factor that could influence the fellow eye involvement with NAION.  Case Report: A 72 year-old male presented with gradual painless vision loss in the left eye (LE) for 3 months. He did not have smoking habit. BCVA on the LE was 3/60 and RAPD was present. Funduscopic examination showed optic disc atrophy on LE. Humphrey test revealed altitudinal pattern on LE with visual field index (VFI) 63%. OCTA showed significant decreased capillary perfusion on LE retinal nerve fiber layer thinning and poor capillary perfusion on LE while the right eye (RE) was normal. Laboratory examination indicated diabetes mellitus, dyslipidaemia, and hypercoagulable state. He was prescribed antidiabetic medication, antithrombotic therapy, and statin. After a month, patient showed improvement in both ocular and laboratory examinations. He was advised to continue treatment until the next visit, but he didn’t comply. Two months later, patient was presented with painless vision loss, edematous optic disc, and altitudinal visual field defect in the RE. Laboratory examination also revealed unsatisfactory results. Discussion: Prior studies discovered that hypercoagulable states potentially contribute to NAION, presumably due to altered blood viscosity, which further leads to vascular occlusion. Our case showed hypercoagulable state patient with increased d-Dimer and fibrinogen level. Antithrombotic therapy was found beneficial to improve patient’s symptoms. However, he did not comply to therapy, thus vision loss of the fellow eye occurred. Conclusion: Non-compliant behaviour of patient could be the risk factor for fellow eye involvement.
Successful Management of Neonatal Orbital Cellulitis: A Rare Case Report Dian Estu Yulia; Kiara Nurmathias
Majalah Oftalmologi Indonesia Vol 48 No 1 (2022): 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.v48i1.100417

Abstract

Objective: To report a rare case of neonatal orbital cellulitis along with the successful management. Introduction: Orbital cellulitis is a sight- and life-threatening infection of the post-septal tissues of the orbit, and is a considerably rare finding in neonates. Prompt diagnosis and treatment is essential, as 11-26% of cases of orbital cellulitis result in death and visual loss. Case Presentation: A one-month-old neonate presented with rapidly progressive swelling and redness of the right eyelid along with persistent subfebrile fever seven days before admission to the hospital. Blinking reaction to light stimulation was good on the left eye. Ocular motility was difficult to be evaluated. Conjunctival appearance on the right eye showed severe chemosis, while the other parts of both eyes were within normal limit. Orbital Computed Tomography (CT) scan revealed diffuse soft-tissue swelling at the superior and inferior palpebra of the right eye and partial erosion of the lateral wall of the right ethmoidal sinus, suggesting sino-orbital inflammation. Diagnosis of orbital cellulitis was confirmed on the right eye in this patient. Incision and drainage surgery of the right eyelids were done immediately as improvement was only seen on the upper eyelid after empirical intravenous (IV) antibiotic administration. Strain of Methicillin-Resistant Staphylococcus Aureus (MRSA) was found from the discharge’s culture. At one month follow up, the swelling of the right eyelid had markedly decreased with no signs of inflammation. Conclusion: This case highlights and showed a rare case and successful management of neonatal orbital cellulitis. Early diagnosis and prompt treatment of neonatal orbital cellulitis may benefit patient and prevent sight- and life-threatening condition.
LATE-ONSET, BLEB-ASSOCIATED ENDOPHTHALMITIS CAUSED BY STAPHYLOCOCCUS AUREUS Riskha Pangestika; Fifin Luthfia Rahmi; Maharani Maharani
Majalah Oftalmologi Indonesia Vol 49 No 1 (2023): 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.v49i1.100429

Abstract

Introduction: Bleb-associated endophthalmitis (BAE) is a potentially sight-threatening complications of trabeculectomy and is associated with poor visual outcome. BAE denotes an ocular infection with involvement of the vitreous, which usually develops months or years after glaucoma filtering surgery. The purpose of this case report was to present a case about late onset BAE caused by Staphylococcus aureus. Methods: A 55-year-old male presented with a 3-days history of left eye pain, redness, hypopion decreased visual acuity and hypotony with Seidel test positive. He had a history of primary open angle glaucoma that was treated with a combined procedure of cataract surgery and trabeculectomy in the left eye ten years earlier. His visual acuity had decreased from 6/20 to light perception. This patient showed signs of hypotony, endophthalmitis, leak, and pain but no previous history of using anti-fibrotic agents. BAE causative organisms cultures grew the S.aureus, that frequent cause of acute-onset endophthalmitis. The patient underwent treatment with pars plana vitrectomy, vitreous taps, administered intravitreal antibiotic, and prescribed hourly topical antibiotic. Six months after his last treatment, his left eye shows no residual infection, and visual acuity increase to 1/60. Results: One case of late onset BAE with visual improvement after early vitrectomy, intravitreal, oral and topical antibiotic treatment. Conclusion: Despite the poor prognosis of BAE caused by S.aureus infection, after proper treatment can yield an adequate result, as demonstrated in this case.  
Management Ocular Syphilis in Human Immunodeficiency Virus (HIV) Patients Alexander Theodore Samosir; N. K. Niti Susila; I Gutsi Ayu Made Juliari; Ida Ayu Ary Paramita; I Made Agus Kusumadjaja
Majalah Oftalmologi Indonesia Vol 48 No 1 (2022): 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.v48i1.100455

Abstract

Introduction: Ocular syphilis is a rare manifestation of syphilis. Ocular syphilis manifestations vary and can occur at all stages of the disease. Syphilis can affect all eye structures, the main complaint is blurred vision, accompanied by non-specific symptoms such as pain in the eye, and does not respond to steroids. Case: The male patient, 54 years old, presents with complaints of both eyes slowly getting worse with a history of sexual multi-partners. Visual acuity in both eyes were light perception bad projection, ophthalmological examination showed cloudy lens, cloudy vitreous, cell (+) flare (+) right eye optic nerve, hyperemia, and left eye optic nerve, pale at temporal. VDRL results: reactive> 1: 512 and TPHA: reactive> 1: 5120. The patient was diagnosed with late latent syphilis and neurosyphilis observation from the Dermatology and Venereology Department and received benzathine penicillin injection therapy. From the Neurology Department the patient was diagnosed with neuro-syphilis and was consulted to VCT department with pre-HAART Stage IV HIV infection (WHO). After receiving penicillin therapy and topical steroids, the patient was experienced improvement in visual acuity. Conclusion: In HIV patients without antiretroviral therapy, Treponema pallidum infection is more common and has manifestations such as ocular syphilis and neurosyphilis. Treatment of ocular syphilis using topical steroids to reduce inflammation and penicillin as the main antibiotic.

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