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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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General Pratitioner: Poster Presentation - Observational Study - General practitioner Heryanti, dr. Carla Oktavia; dr. Giovani
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/xsgk0d91

Abstract

Introduction & Objectives : Glaucoma is disturbance of part or all of the visual field caused by damage to the optic nerve and increased intraocular pressure, and obstruction of the outflow of aqueous humor, which can lead to complete blindness. Primary angle-closure glaucoma (PACG) is a common cause of blindness. PACG affects more than 17 million people worldwide. This study aimed to provide prevalence of primary angle-closure glaucoma patients at Marianum General Hospital, Halilulik, Indonesia. Methods : This research was a descriptive observational study with secondary data, where there were 21 research subjects. This study presents clinical, sociodemographic, and management data of angle- closure glaucoma patients. Data analysis was carried out univariately with SPSS. Results : The majority of angle-closure glaucoma patients are older than 40 years old. Mens are found less likely to have PACG than woman. First degree relatives with glaucoma disorders has not provided optimal data in this study. The majority of glaucoma patients in this study have intraocular pressure ? 21 mmHg. The majority of research subjects do not have refractive disorders. The majority of patients receive medical therapy in the form of 2 types of eye drops. Conclusion : Primary angle-closure glaucoma (PACG) is the second most common for of Glaucoma that cause irreversible blindness. Early diagnosis is very important to prevent blindness. The majority of angle- closure glaucoma patients at Marianum General Hospital, Halilulik, Indonesia, have normal intraocular pressure without refractive errors and receive combination therapy of 2-3 eye drops.
ANGLE RECESSION, THE SEQUELA OF EIGHT-BALL HYPHEMA AFTER SPRAYED BY FIRE HYDRANT: A CASE REPORT: Poster Presentation - Case Report - Resident Asti, Annisa Kinanti; Komaratih, Evelyn; Nurwasis; Primitasari, Yulia
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/gkke0y72

Abstract

Introduction : Hyphema results from damage to the blood vessels of the iris or anterior ciliary body after blunt trauma, and in 56–100% of cases can occur angle recession. Case Illustration : A 40-year-old man complaints of pain and blurred left eye after being sprayed by a high-pressure fire hydrant five hours before coming to the emergency room. Visual acuity was 20/20 and hand movement in right and left eye, IOP is 13 mmHg and 18 mmHg in both eyes. Subconjunctival bleeding, conjunctival and pericorneal injections were found with punctate fluorescein test in the left eye. The cornea was edema and the anterior chamber was full of hyphema. Five days after being hospitalized and treated with topical atropine, antibiotics, and steroid in combination with oral tranexamic acid, the visual acuity was 5/6.5 and the hyphema was resolved. The IOP elevated after 1-6 weeks of follow-up in the outpatient clinic then timolol eyedrops were given. Gonioscopy showed widening of CBB, torn iris processus 2 clock hours in the inferior quadrant. The antiglaucoma medication was stopped due to the controlled IOP in the end episode of the treatment. Discussion : Angle recession involves a tear between the longitudinal and circular muscle fibres of the ciliary body. Medication is needed to control the IOP, while surgical management only indicated in cases where medical treatment fails to control the IOP and risk of progressive visual loss. Conclusion : Angle recession can occur after blunt eye trauma with hyphema and IOP control is needed to prevent the development of secondary glaucoma.
FILTRATION SURGERY OF TRABECTULECTOMIES WITH 5 – FLUOROURACIL IN ADVANCED POAG: Poster Presentation - Case Report - Resident Amrina, Fadillah; Fidalia; Sari, Prima Maya
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: 10.35749/8c2cqp88

Abstract

Introduction : Advanced Glaucoma (AG) is total cupping of optic nerve with or without severe visual field loss. The prevalence of AG in POAG, shows that 15% have a substantial visual field defect. Initial therapy for AG can use medications, surgical therapy is performed when adecuate medical treatment isn’t effective. Filtration surgery such as trabeculectomy and implantation of tube shunts can be performed. This case reports aims to understand the used of trabeculectomy+5FU in Advanced POAG. Case Illustration : A 55 years old woman came with blurry and tunnel vision accompanied by headache since 2 years ago. She got treatment yet stopped to control. Vision has progressively reduced since 2 months ago. Visual acuity OD 1/300 OS 1/60, IOP OD 25.1 mmHg and OS 29.8 mmHg with 4 drugs, cloudy lens, cupping, c/d ratio 0.9, nasalization, bayonet sign and peripapillary atrophy. The patient was diagnosed with Advanced POAG with immature senile cataract ODS. Patient was treated with trabeculectomy+5-FU due to uncontrolled IOP despite receiving adecuate therapy. Releasing sutures were used to control IOP after surgery. After surgery, the last IOP OS 12.6 mmHg, and bleb formed E1H1V0. Discussion : Conclusion : Patients was treated with trabeculectomy+5-FU, can control IOP stably in advance of POAG without serious complications, cost less than routine drugs and maintain visual function and improve quality of life. Filtration surgery such as trabeculectomy with AF agents is proven to reduce IOP more stably in advance of POAG.
A Case of Malignant Glaucoma Following a Trabekulectomy: Poster Presentation - Case Report - Resident Rumampuk, Irene M. A.; Kasih, Franky
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: 10.35749/7djvcj51

Abstract

Introduction : Malignant Glaucoma (MG) is characterized by a shallow anterior chamber (AC) associated with a raised intraocular pressure (IOP) usually following a filtration surgery in eyes with angle closure. Case Illustration : A 56-year-old female patient presented on the second day post trabeculectomy with a shallow AC. The patient experienced ocular pain on the 2nd day post-op. Visual acuity was 6/40 and NCT was 57 mmHg in her LE. Slit lamp examination showed an absent peripheral AC the patient was treated with oral acetazolamide, topical timolol, topical brimonidine, and topical cycloplegics. 24 hours later, the IOP was 34 mmHg, absent AC with mild corneal edema. The diagnosis was Glaucoma Maligna post Trabeculectomy ec Acute attack PACG. After a month, corneal edema has resolved, visual acuity was 6/12, IOP was 27.6mmHg. Discussion : The exact mechanism of MG remains unclear. There is likely to be an anatomical interaction between the ciliary processes, lens, and anterior vitreous face which causes the diversion of aqueous backwards into the vitreous cavity and causing the anterior rotation of the cilliary processes therefore blocking the aqueous outflow. Although, in our case this problem was moderated by cycloplegics and glaucoma medications, literature describes interventions such as lens extraction, posterior capsulotomy, anterior vitrectomy and pars plana vitrectomy was necessitated in some cases to decrease IOP. Conclusion : MG is a sight threatening condition caused by a raised IOP in the presence of a patent iridectomy usually occurring after an intraocular surgery. The management of this condition could vary from medications to surgical interventions.
RE-TRABECULECTOMY + 5-FLUOROURACIL IN PRIMARY ANGLE CLOSURE GLAUCOMA PATIENTS AGGRAVATED BY CONSUMPTION OF SCHIZOAFFECTIVE DRUG: Poster Presentation - Case Report - Resident Syafridon, M Fadhil; Fidalia; Sari, Prima Maya
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/nykrk915

Abstract

Introduction : PACG occurs when the anterior chamber angle is occluded by the iris thus reducing aqueous humor outflow. Most schizoaffective patients use anticholinergic drugs which may result in iridocorneal angle closure through deposition. This article reported a Re-Trabeculectomy + 5 FU surgery in PACG which was aggravated by the use of schizoaffective drugs Case Illustration : A 43 year old woman, underwent Re-Trabeculectomy + 5 FU on LE after increasing IOP and regularly took schizoaffective drugs. Tapering of schizoaffective therapy was done 1 month preoperatively. Patient presented with LE UCVA of 3/60 and LE IOP is 30.9 mmHg with three anti- glaucoma medications. LE examinations revealed VH1 AC, bayonet sign and cupping on funduscope, closed angle on gonioscope, nasal step defect on humphrey and diffuse RNFL thinning on OCT. On the first postoperative day LE IOP is 18.5 mmHg. The schizoaffective therapy was re-initiated from psychiatric and evaluation was done weekly Discussion : Re-trabeculectomy surgery have been done considering the failure of the first trabeculectomy and administration of 5-Fluorouracil as an anti-fibrosis. The benefits of reducing preoperative dose of schizoaffective drugs for a month due to having an anticholinergic effect and reduces IOP by 5 mmHg. Psychiatrists and ophthalmologists work together to try to administer basic schizoaffective drug doses and evaluate IOP to keep it under control. Conclusion : The re-operative action was carried out by adding anti-fibrosis and cooperating with psychiatry for postoperative tapering of schizoaffective drugs. Long-term use of antidepressant drugs and benzodiazepines increases PACG.
Virna Glaucoma Implant (VGI) as the Management of Secondary Glaucoma following TASS : A Case Report: Poster Presentation - Case Report - General practitioner Presialia, Athira; Witjaksono, Anissa Nindhyatriayu; Anissa, Gisela Haza; Widyawati, Syska
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: 10.35749/4sepeq10

Abstract

Introduction : Secondary glaucoma may occur in severe TASS. The inflammatory cell and debris can clog trabecular meshwork causing IOP to rise. In this case, we describe the successful management of secondary glaucoma due to TASS using Virna Glaucoma Implant (VGI). Case Illustration : A 66-year-old woman presented with decreased vision in the left eye one week after anterior vitrectomy and anterior segment lavage due to TASS. She had a history of phacoemulsification and intraocular lens placement with complication of PCR. On ocular examination, the visual acuity was 1/60 in the left eye with intraocular pressure (IOP) 55 mmHg. After maximum glaucoma medication using timolol, latanoprost, brinzolamide eye-drops and oral acetazolamide IOP was 22mmHg. Glaucoma Drainage Device (GDD) surgery using VGI was performed. After 2.5 weeks, IOP in the left eye was reduced to 19 mmHg without anti-glaucoma medication and visual acuity has improved to 6/60, showing a favourable outcome. Discussion : TASS may cause significant damage to the trabecular meshwork, which leads to secondary glaucoma. Although medical therapy is often used to control elevated IOP, surgical therapy may be required to treat refractor IOP elevation. GDD surgery has been reported to have effective outcomein secondary glaucoma and pseudophakic eyes. Conclusion : Secondary glaucoma is considered as one of the characteristics in the late stages of TASS, and required prompt treatment. VGI implantation is a promising choice of treatment in managing secondary glaucoma following TASS when medication is not effective.
GLAUCOMA SECONDARY TO NONSPECIFIC ORBITAL INFLAMMATION: A DIAGNOSIS NOT TO OVERLOOK: Poster Presentation - Case Report - Resident Prakoeswa, Camilla Amanda; Komaratih, Evelyn; Fatmariyanti, Susy
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/ft2tnq30

Abstract

Introduction : Nonspecific Orbital Inflammation (NSOI) is an inflammatory condition of unknown etiology manifesting as pain, ocular motility disturbances, eyelid edema, chemosis, and increased intraocular pressure (IOP). We illustrate a case of glaucoma secondary to NSOI and the importance of understanding the cause-effect relationship between the two conditions. Case Illustration : An eighteen-year-old girl presented with severe pain, ptosis, chemosis, ophthalmoplegia, and increased IOP (38 mmHg) despite a leaking trabeculectomy bleb, on the left eye. She was referredwith the diagnosis of primary angle-closure glaucoma (PACG) and a history of twice trabeculectomy surgeries done elsewhere two months before she came to our hospital. She could not move her lefteye nasally five months before the first surgery and felt joint pains for a year. After thorough diagnostics, she was assessed with left eye NSOI and secondary glaucoma with spondyloarthropathy. Oral prednisone 30 mg/day was given to manage the inflammation and the resultant glaucoma. One week follow-up showed an improved condition with decreased IOP (16 mmHg) despite the same anti-glaucoma therapy regimen. Discussion : NSOI can mimic various diseases, making diagnosis challenging. The raised IOP in NSOI is often caused by extraocular muscles and orbital tissue swelling, which compresses the superior and inferior ophthalmic veins, resulting in choroidal circulation problems. The IOP was quickly reduced once the inflammation was managed. This is a case of secondary glaucoma caused by an overlooked NSOI, aggravated by the immunological process in the orbit after trabeculectomy surgeries. Conclusion : Secondary glaucoma should be considered as a differential diagnosis of PACG in patients with NSOI.
Severe Case Of Delayed Diagnosed Of >10 Years Untreated Newborn Congenital Glaucoma: Poster Presentation - Case Report - General practitioner Yudakusuma, Cheryll; Siahaan, Yoseph M.P. A
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: 10.35749/38x06q20

Abstract

Introduction : Though cases of newborn primary congenital glaucoma (PCG) had poor prognosis, we couldn’t simply ignore that early proper diagnostic and treatment can still improves quality of one’s sight, which’s absent in this case. Presented with delayed diagnosed highly suspected case of newborn PCG, physician was compelled to make the best in condition of the already given poor prognosis to begin with. Case Illustration : A 13 years old female patient came to eye clinic with a very disturbing chronic condition of visual loss. Accompanied by her family, who also claimed had witnessed both the patient’s eyes appeared whitish since birth. Eye examination revealed visual acuity of 1/~ for right eye and no light perception for left eye, along with significant signs of buphthalmos, epiphora, nystagmus, megalocornea (diameter of 9x14mm right eye and 9x13.3mm left eye), cloudy cornea, leukocoria, and Schiotz tonometry of 60-100mmHg in both eyes. Patient then received oral Acetazolamide, Levofloxacin eye drop, and Timolol Maleate 0,5% eye drop; then advised to return for one week evaluation also to bring her siblings to be subjected to glaucoma screening. Discussion : The decision to perform surgical intervention in cases of newborn PCG commonly require further thoughts. This case immediately shifted our focus towards palliative care of the patient whilst continuing monitoring IOP, as glaucoma surgery possessed a more menacing risk to be performed this patient. Conclusion : All cases of pediatric glaucoma require a life time of comprehensive management that requires heedfulness especially from caregivers as it is a very challenging disease.
ACETAZOLAMIDE INDUCED SECONDARY ANGLE CLOSURE GLAUCOMA: A RARE CASE REPORT: Poster Presentation - Case Report - Resident Atisundara, Siti Mutia; Rifada, R Maula; Umbara, Sonie; Gustianty, Elsa; Prahasta, Andhika
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: 10.35749/5mw96e77

Abstract

Introduction : Drugs such as topiramate, acetazolamide, methazolamide, buproprion, and trimethoprim- sulfamethoxazole potentially cause an elevation of IOP. Drug-induced glaucoma may be an ophthalmic emergency if not treated promptly and can results in permanent visual loss. Case Illustration : A 36-years-old female came to Glaucoma Unit at Cicendo National Eye Hospital with progressive blurred vision since 1 year ago, worsening in the past six months. Accompanying symptoms included pain, headache, halo, and conjunctival hyperemia. She had been diagnosed with glaucoma and received timolol maleate, acetazolamide, and glycerin. Seven days later, her visual acuity worsened to 3/60 ph 0.15 RE and 2/60 ph 0.15 LE, with high IOP in both eyes, with the higher IOP being >30 mmHg. The cup-to-disc ratio was 0.3 RE and 0,8 LE. The anterior segment showed shallow anterior chamber, mid-dilated pupil, and conjunctival injection (Figure 1.). Gonioscopy examination showed Schwalbe line of both eyes (Figure 2.). Acetazolamide was stopped, and one week later the condition resolved (Figure 3.). Discussion : Secondary angle closure glaucoma caused by acetazolamide is important to consider because most people tolerate acetazolamide well. The mechanism of closed-angle glaucoma can be pupillary block and non-pupillary block. Non-pupillary block is caused by thickening, forward movement the iris-lens diaphragm, rotation of the ciliary body, and choroidal effusion. This process is an idiosyncratic reaction to certain systemic drugs. Conclusion : Few cases were reported about secondary bilateral angle closure glaucoma due to acetazolamide. Treatment of angle closure glaucoma involves stopping acetazolamide
MANAGEMENT OF PHACOMORFIC GLAUCOMA WITH FILTRATION SURGERY: Poster Presentation - Case Report - Resident Nabdakh, Alifvia; Subsp GL, Dr. dr. Fidalia Sp.M (K); Sari Sp.M (K) Subsp GL, dr. Prima Maya
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/qj1b6h79

Abstract

Introduction : Phacomorphic glaucoma is form of glaucoma that occurs due to a swollen cataractous lens. Filtration surgery in one of the option for managing phacomorphic glaucoma. This surgical approach can be effective in controlling intraocular pressure and preventing further damage to the optic nerve Case Illustration : A 53 yo female complaints of progressively blurry vision in her left eye. The LE visual acuity 6/30 and IOP 25,9. The gonioscopy showed a close-angle impression in all quadrants, VH gr 1. Also thereis increase lens opacity , Posterior segment examination revealed ]cup/disc ratio of 0.9 and cupping. The patient was diagnosed with secondary glaucoma (phacomorphic). Filtration surgery of trabeculectomy + 5-FU is performed Discussion : The patient was treated with trabeculectomy and 5-FU, resulting in IOP to 17 mmHg. The surgical procedure is aim to reduce intraocular pressure to create a channel and reservoir for blocked aqueous humor, resulting in decreased IOP and stopping the damage process to the optic nerve. This approach aims to increase the success rate and reduce the likelihood of complications during the operation. Conclusion : The limportance of prompt management of phacomorphic glaucoma to prevent permanent vision loss, and the use of trabeculectomy as an effective surgical approach in controlling intraocular pressure and preventing further damage to the optic. Cataract extraction surgery remains the definitive therapy for phacomorphic glaucoma cases, and this approach should be considered in the future management of the patient

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