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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 TREATMENT OF ACUTE ANGLE CLOSURE WITH HISTORY OF PSYCHOTROPIC AGENTS : A CASE REPORT: Poster Presentation - Case Report - Resident Rafika; Subsp GL, Dr. dr. Fidalia Sp.M (K); Sari Sp.M (K) Subsp GL, Dr. 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/hcr9bs49

Abstract

Introduction : Psychotropic agents may precipitate Acute Angle Closure (AAC) either by inducing pupil block via adrenergic or anticholinergic mechanisms, or via an idiosyncratic non-pupillary block mechanism. This is a serious condition that can diminished aquous humor (AH) outflow and increased intraocular pressure Case Illustration : A 60-year-old female complained of a sudden onset of a severe painful red eye on the right eye (RE)2 weeks ago and there was an IOP elevation. Anti-glaucoma medications were given with no succcess. The patient regularly consumed psychotropic drugs Trihexyphenidyl, Risperidone, and Chlopromazine since 2005 and Escitalopram since 2 years ago Discussion : Several classes of centrally acting drugs, including antidepressants such as selective serotonin receptor inhibitors (SSRIs) and antipsychotics have been implicated in precipitate AAC in individuals with pre-existing narrow angels. Rapid lowering of the IOP including medical treatment and relieved relative pupillary block with laser peripheral iridotomy (LPI) is an important initial step in treating AAC. Because the media is not clear due to corneal edema, trabeculectomy + 5 Fluorouracil can be considered for IOP control to prevent further damage. Conclusion : Trabeculectomy + 5 FU procedures may be a valuable and effective option in cases where LPI is too risky due to unclear visualization because of corneal edema. Trabeculectomy has been shown to effectively reduce IOP. Closed monitoring is necessary to assess ocular side effects due to the use of psychotropic agents
Management of Hypotony Maculopathy: Poster Presentation - Case Report - Ophthalmologist Nanditya, Sri Astri; Ayudianingrum, Asti; Sulastiwaty, Rini
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/cp4sd706

Abstract

Introduction : Hypotony is a common complicatons after glaucoma filtering surgery. Hypotony maculopathy is a serious condition that related to the significant decrease in visual acuity. This case report is to show the case of hypotony maculopathy and the risk factors. Case Illustration : A 28 yo female with juvenile glaucoma undergone trabeculectomy on her left eye. One day post surgery show significant inflamation forming fibrin in pupil area. POD 1 IOP decreased to 2 mmHg and remains hypotony after 2 weeks post surgery. Visual acuity decreased significantly even when the anterior chamber inflamation has resolved. Funduscopy showed typical appearance of hypotony maculopathy. Oral steroid of methylprednisolon 1 mg/kg per body weight, and topical prednisolon was administered since POD 1. Visual acuity gained and iop rised to 14 after 3 weeks with theraphy with oral and topical steroid. Discussion : Sudden drop of intraocular pressure may lead to many complications such as hipotony maculopathy. It was a frightening as it may decreased the visual acuity permanently. Young age and severe post operative inflamation are risk factors found in this patient. Conclusion : Hypotony after glaucoma filtering surgery may caused hypotony maculopathy. Young age and high inflamation are risk factors for developing hypotony maculopathy. Risk factors considerations and early treatment of hypotony is essential to prevent the sight threatening complications such as hypotony maculopathy.
Steroid Induced Glaucoma and Primary Angle Closure Glaucoma: A Case Report of Mixed Mechanism Glaucoma: Poster Presentation - Case Report - Resident Masloman, Anugrah Handini; 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/kgps5q05

Abstract

Introduction : Steroid induced glaucoma is a form of secondary open angle glaucoma (OAG) caused by adverse effects of steroid usage. Primary angle closure glaucoma (PACG) is characterized by shallow anterior chamber accompanied by peripheral anterior synechiae (PAS), elevated IOP and glaucomatous optic neuropathy (GON). Case Illustration : A 58 year-old woman presented with red eye, blurry vision, pain in her right eye radiating to the head, watery eye and halo. History of experiencing recurrent red eye, improving after taking steroid topical drug for about 3 months. Visual acuity 6/20 ph 6/20, IOP 39 mmHg, mixed conjunctival injection, shallow anterior chamber Van Herick 1-2, dilated pupil and iris pigment on anterior capsule of lens. Posterior segment showed glaucomatous optic neuropathy with cup disc ratio 0.8-0.9, anterior chamber depth 2.58, and thinning of optic nerve head layer. Patient was diagnosed with steroid induced glaucoma and mixed mechanism PACG. The patient underwent trabeculectomy procedure after mannitol injection was given to reduce IOP. Discussion : We diagnosed the patient with steroid induced glaucoma and mixed mechanism PACG based on history, clinical findings, and diagnostics. Steroid raised IOP by accumulating polymerized glycosaminoglycans (GAGs) in the trabecular meshwork, producing "biologic edema" thus increased outflow resistance. PACG was determined based on Van Herick and anterior chamber depth. Trabeculectomy remains an effective treatment in this case where medications were failed to control IOP. Conclusion : Steroid induced glaucoma commonly found in OAG, definitive treatment includes halting steroid drugs and trabeculectomy. Further follow-up is needed to evaluate angle closure mechanism.
One-Step Surgical Approach for Treating Lens-Induced Glaucoma with Iridodialysis Following Blunt Trauma: Poster Presentation - Case Report - Resident Haryono, Aditia Apriyanto; Gustianty, Elsa; Rifada, R Maula; Umbara, Sonie
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/g56hfd75

Abstract

Introduction : Traumatic glaucoma is one of secondary glaucoma that can be challenging to treat. Blunt trauma to the eye may result in iritis, hyphema, lens subluxation, or dislocation leading to increased intraocular pressure (IOP). Every complication needs to be addressed promptly. Here we present about one-step surgical approach to treat lens indued glaucoma with iridodialysis following blunt trauma. Case Illustration : A 65-year-old man presented with a chief complaint of blurred vision and pain in his right eye for a month following blunt ocular trauma where he was hit with piece of wood while operating a chainsaw. Ophthalmologic examination revealed RE VA of 2/60 with IOP 32 mmHg. Anterior examination revealed a shallow anterior chamber, iridodialysis 90 degrees, cloudy lens with phacodonesis (Fig 1). Patient was diagnosed with lens-induced glaucoma, lens subluxation, iridodialysis and traumatic cataract. Patient was treated with antiglaucoma agents prior to surgery. One-step surgical approach: trabeculectomy, phacoemulsification with capsular tension ring, and iridodialysis repair become the treatment of choice (Fig 2). After one month of surgery, IOP decreased to 16 mmHg without anti-glaucoma medication, final VA RE achieved 0.2 (Fig 3).DiscussionManagement of traumatic glaucoma depends on the underlying cause of increased IOP. Trabeculectomy combined with lens extraction should be considered with degree of subluxation that may cause pupillary block. Repair iridodialysis can be done using various techniques. Conclusion : Management of traumatic glaucoma can be done with trabeculectomy, lens extraction and repair iridodialysis in one-step surgery. Surgical technique should be considered depending on the patient’s eye condition.
Management of Secondary Angle Closure Glaucoma in Nanophthalmic Eye : A Challenging Case: Poster Presentation - Case Report - Resident Almira, Dwirianti; Umbara, Sonie
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/b5xt0p78

Abstract

Introduction : Nanophthalmos is a condition characterized by short eyeball length (AXL <20.0mm), short and dense anterior segment, high eye volume or lens ratio, hypermetropia (+8.00 to +20.00) and scleral thickening (>1.7mm) Case Illustration : A 63-year-old man came to the Glaucoma outpatient clinic at Cicendo Hospital with complaints of blurry eyes since 3 years ago. The visual acuity in the right eye was light perception, and in the left eye was hand movement. The anterior chamber was shallow, with seclusio pupil in both eyes (Figure1). Biometry showed axial length 17.06 mm in the right eye and 16.82 mm in the left eye. The patient underwent phacoemulsification surgery + IOL + iris retractor + pupiloplasty + synechiolysis + sclerectomy for the right eye with satisfactory result (Figure3). Discussion : This surgical procedure for nanophthalmos has its own challenges for the operator due to the shallow anterior segment and small corneal diameter. In this case, surgery was performed first in the right eye, with consideration of a greater anterior chamber depth than the left eye. The sclerectomy procedure performed on this patient was 4 mm from the limbus and was performed full thickness only in one quadrant (Figure2). Conclusion : Multiple anatomic abnormalities in nanophthalmic eyes make surgery extremely challenging and are associated with a high incidence of significant intraoperative and postoperative complications. Phocoemulsification with sclerectomy can be alternative option to manage secondary glaucoma in nanophthalmic eye.
SCHWARTZ-MATSUO SYNDROME : AN IMPORTANT CAUSE OF SECONDARY GLAUCOMA : RARE CASE: Poster Presentation - Case Report - Resident Perkasa, Teguh Ridho; 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/rkkb3g69

Abstract

Introduction : Schwartz-Matsuo syndrome is a rare ocular condition characterized by rhegmatogenous retinal detachment, elevated intraocular pressure, and open anterior chamber angle with presence of aqueous cells. The prevalence of Schwartz-Matsuo syndrome is quite low and only reported through case studies. Case Illustration : A 63 years old female complained a visual aquity was no light perception on the left eye (LE) since 2 months ago. The symptoms are gradually getting worse, history of ocular trauma, recent surgery, photopsia, peripheral visual field loss were denied. Patient came to the hospital with IOP elevation on left eye. On Gonioscopy we interpretated as open angle chamber and USG examination we founded retinal detachment, Anti-glaucoma medication were given but no success to lower the IOP. Discussion : Typically, retinal detachment is associated with low IOP. In Schwartz-Matsuo syndrome the opposite is observed with elevated IOP. Hypothesized that photoreceptor outer segments pass through the retinal break allows for fluid and photoreceptor outer segments to gain access, enter the anterior chamber and block aqueous outflow at the level of the trabecular meshwork. A significant increase in IOP can lead to visual loss and blindness complicated by glaucoma requiring further medical or surgical intervention. Referred to this patient, she came with IOP elevation, open angle anterior chamber and retinal detachment that clinically diagnosed as Schwartz-Matsuo syndrome. Conclusion : Schwartz-Matsuo syndrome is primarily a clinical diagnosis; Early detection of disease and prompt management of increased IOP and retinal detachment is essential for a good outcome.
INTO THE DARKNESS AND SILENCE: EVISCERATION IN A DEAF-MUTE- BLIND PATIENT WITH NEGLECTED GLAUCOMA: Poster Presentation - Case Report - Resident Lumita, Ferdinand Inno; Laksmita, Yulinda Arty; Sieman, Andrew John; Iskandar, Ferdy; Paramita, Carennia; Aziza, 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/n2m27f33

Abstract

Introduction : Glaucoma can have a potentially devastating effect on patient’s vision and quality of life if not treated properly. We described a neglected glaucoma case in a deaf-mute-blind patient that leads to evisceration. Case Illustration : A 64-year-old deaf-mute female came to our emergency room with chief complaint of bloody discharge from her right eye 12 hours prior to admission with no history of trauma. Patient’s right eye has been blind for the last four years; her left eye has been nonfunctional since she was in her 30s. She went to a primary clinic during this time but did not get any diagnoses. Physical examination revealed uveal prolapse of the right eye with infiltrates around the remaining cornea; and phtisical left eye with IOP of 30 mmHg and opaque cornea. We performed evisceration with dermato-fat graft of the right eye. Discussion : Glaucoma is a challenging disease, especially in developing countries. It is difficult to diagnose due to its nature to be asymptomatic until late in the disease course. The loss of vision is painless and insidious; resulting in late diagnosis unless patients are screened for glaucoma early on. Patient in this report is particularly difficult for the caretaker since she is a deaf-mute patient; resulting in a suspected undiagnosed glaucoma that leads to evisceration and blindness. Conclusion : Glaucoma care generally necessitates routine follow-up for monitoring of disease progression and medication adjustments. Good screening system, family support, and integration of eye care into existing healthcare systems is needed for early detection to reduce blindness from glaucoma.
Sudden Ocular Complication after Snake Bite: Poster Presentation - Case Report - General practitioner Hadrani, Farah Hayati; Oktaputri, Anita; Widodo, Galih; Susetio, Yoseph
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/wc0d6t06

Abstract

Introduction : A snakebite constitutes a common acute medical emergency and has several systemic and even ocular consequences. Snake venom neurotoxins act mainly on the peripheral nervous system at the neuromuscular junction and can affect the cranial nerves. Neurological symptoms that relate to cephalic muscle paralysis include exotropia, ptosis, diplopia and ophthalmoplegia. Case Illustration : A 17 years old man came to emergency department with painful swelling on his left hand and sudden blurred vision right after his left hand were bitten by venomous snake in the rice field. Diplopia and ptosis were developed several hours after admission. On eye examination, visual acuity was 0,05 on right eye and 0,8 on left eye, abnormal pupillary reflects on both eyes were present, pupil dilatation, limited eye movement and ptosis were present, Intraocular pressure were 23,7 mmHg on right eye and 24,5 mmHg on left eye. Antivenom was administered immediately. He received cycloplegic, timolol eyedrop, and prednisolone eyedrop for ocular treatment Discussion : Ocular complications are rare and uncommon but they may lead to sight-threatening conditions. Snake venom neurotoxins act mainly on the peripheral nervous system at the neuromuscular junction and can affect the cranial nerves. Mild neurological symptoms that relate to cephalic muscle paralysis include exotropia, ptosis, diplopia and ophthalmoplegia. Conclusion : This study presented a rare case of systemic ocular complication as a result of a snake bite. Ophthalmoplegia induced ocular discomfort for an extended period is a rare symptom of snake-bites. Combined treatment of steroid with antivenom may improve the recovery from sudden ocular manifestation in snake bite.
How to boost your cataract surgical rates during pandemic covid-19: Poster Presentation - Observational Study - Ophthalmologist Kusuma, Hendra; Armada, Dhani; Kumala, Marissa Mutiara
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/h64z1k80

Abstract

Introduction & Objectives : Cataracts are the number one cause of blindness in the world and a big burden in Indonesia. The Covid-19 pandemic has caused the cessation of health services to eradicate blindness (cataract lock down). This article discusses how to develop eye care services in one of the red zones of blindness in South Sulawesi, specifically in Jeneponto district during the Covid-19 pandemic. Methods : Observational research Results : Establishment of a safety protocol that is implemented and promoted to the public continuously, especially through social media, was able to increase trust in health facilities and increase the number of cataract surgeries. It has been proven that since being implemented, the number of cataract surgeries has continued to increase, marked by an increase in cataract surgical rates (CSR) year by year: 2019 (921 CSR); 2020 (1401 CSR); 2021 (2628 CSR). This allows Jeneponto district to gradually get out from the red zone of blindness. Conclusion : Social media is a powerful tool to increase cataract awareness and public trust, especially during Covid-19 pandemic.
A Case Report Intravitreal Anti VEGF Bevacizumab on Patient with Hypertension Retinopathy and Exudative Retinal Detachment: Poster Presentation - Case Report - Resident Sulamanda, Ivan Chandra; Watania, Dyana Theresia
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/kt4xr912

Abstract

Introduction : To present a case of intravitreal anti VEGF bevacizumab function on patient with hypertension retinopathy and exudative retinal detachment. Case Illustration : A 29 years old man presented with chief complaint blurry vision with visual acuity 1/60 on both eyes. History of hypertension sinced one year ago and already got hemodialisa treatment twice a week sinced 6 months ago. Ophthalmic examination showed decreased vision on both eyes and posterior segment both eyes we can find macular star and papil edema. Patient had diagnosed with hypertension retinopathy scheie 4 and exudative retinal detachment both eyes. Discussion : Hypertension will cause blood vessels to become damage in the form of sclerosis, thickening of blood vessel walls, and plasma leakage. Hypertension retinopathy acts as predictor of systemic morbidity and mortality due to organ target damage. Regulating systemic disease like blood pressure to become normal will improve clinical signs of hypertension retinopathy. Administration of anti-VEGF intravitreal injection therapy like bevacizumab can improve permeability of blood vessels in retina and decreased volume of exudate in retina. Visual acuity for this patient will improve to become 4/60 for both eyes. Conclusion : Uncontrolled hypertension can lead to organ target damage, which one of that was eyes. Hypertension retinopathy can make complications like exudative retinal detachment if the blood pressure still uncontrolled. Management of exudative retinal detachment caused by hypertension retinopathy was giving intravitreal anti VEGF injection in eyes to repair breakdown of blood retinal barrier, and the blood pressure must be well controlled to maintain permeability of blood retinal barrier.

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