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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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UNILATERAL CMV RETINITIS IN HIV/AIDS PATIENT WITH MULTIPLE OPPORTUNISTIC INFECTIONS: Poster Presentation - Case Report - Resident Bening, Daya Banyu; Firmansjah, Muhammad; Zuhria, Ismi
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/n3kv9x42

Abstract

Introduction : CMV Retinitis is the most common opportunistic infection in HIV/AIDS patient. Ocular manifestations in HIV/AIDS have similar clinical features though the management therapies are different. Case Illustration : A 47-year-old man was presented with blurred vision on LE since 4 months. Patient was diagnosed with HIV/AIDS since 2 years. Patient only had light perception on LE, and 5/10 on RE. The LE anterior segment showed flare and cell indicating active anterior uveitis. The LE posterior segment revealed extensive hemorrhage and exudate known as ‘pizza pie’ appearance, and cotton wool spot with multiple ischemic areas on RE. Laboratory tests revealed reactive IgG CMV and very low CD4 count (4 cell/?l). Patient was also diagnosed with Tinea Corporis, Scabies, and Pneumocystis carinii pneumonia. Oral Valganciclovir 900 mg was administered twice a day for 3 weeks, along with anti- retroviral therapy. Discussion : The anterior uveitis and ‘pizza pie’ appearance with positive CMV IgG indicate CMV Retinitis in fulminant form. Cotton wool spot found in the RE leads to retinal microvasculopathy due to HIV invading the vascular endothelium and causing increased plasma viscosity. This patient only had 4 cell/?l CD4 which indicates severe immune deficiency. If not treated immediately, patients with CD4 count <50 are at higher risk of contralateral eye involvement. Oral Valganciclovir was chosen considering the multiple opportunistic infections the patient had. Conclusion : It is important to distinguish CMV retinitis with other HIV/AIDS ocular manifestations. The choice of therapy needs be considered with the overall condition of patient.
Did the metal object hit the cornea? A case report of penetrating ocular injury with embedded foreign body: Poster Presentation - Case Report - Resident AGUNG NUGROHO; Dearaini; Annisa Windyani; Susantono, Diannisa Paramitha; Pangestika, Rishka; Laksmita, Yulinda Arty; Widyawati, Syska; Adriono, Gitalisa Andayani
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: 10.35749/7fy1ce37

Abstract

Introduction : Penetrating ocular injury with IOFBs may cause severe ocular damage. We demonstrate the diagnostic and treatment approach in a case of scleral laceration with a large IOFB. Case Illustration : A-24-year-old male presented with a rusty segment of fence wire, sized 15x11 mm, embedded near the nasal corneal margin of the right eye. Upon initial examination the vision was 6/9 with normal IOP. The object obstructed the view of the entry site, therefore corneal wound was suspected. CT scan showed penetrating metal object without posterior segment involvement. Anti-tetanus injection, topical and oral levofloxacin were given. He underwent exploration, foreign body removal and repair surgery. During surgery, the wound was revealed as a scleral laceration, 4 mm from nasal limbus. One day post-operative, vision was 6/20. A 0.1 mm hypopyon was found, along with fibrin at nasal vitreous. Oral and topical corticosteroids were given, and hypopyon disappeared the next day. One week after surgery, vision improved to 6/7.5, with clear vitreous and normal retina. Discussion : Ocular injuries with large IOFBs can hinder clinical examination. Corneal entry wound should be ruled out, due to potential permanent damage to visual axis. CT scan was helpful in assessing the depth of object penetration. The object was removed successfully, with no damage to the cornea and retina. Anti-tetanus, antibiotics and corticosteroids were able to control infection and inflammation. Conclusion : Large IOFBs which do not affect the visual axis, can be managed with successful outcome, by prompt removal and repair of the entry wound, and control of infection and inflammation.
Ocular Manifestations of Von Hippel-Lindau Disease: a Rare Sight- Threatening Condition: Poster Presentation - Case Report - Resident Elsyanty, Firda Muthia; Widyanatha, Made Indra; Ihsan, Grimaldi; Virgana, Rova; Iskandar, Erwin; Kartasasmita, Arief S.
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/hc3z9k23

Abstract

Introduction : Von Hippel-Lindau (VHL) disease is a rare phacomatosis characterized by multi-organ neoplasia which usually manifests in young adulthood. Ocular manifestations of this disease are frequently presented initially before the involvement of other organ systems. Case Illustration : An 18-year-old girl came with a chief complaint of photopsia in the left eye and complete vision loss in the right eye for five years. The visual acuity of the right eye was no light perception and the left eye was 0.8. The anterior segment of the right eye showed iris neovascularization. The posterior segment of the left eye demonstrated multiple elevated red-yellowish lesions fed by a dilated and tortuous vessel. The head CT scan revealed multiple lesions at the pons and cerebellum. The patient was diagnosed with multiple retinal and brain hemangioblastomas due to VHL disease, neovascular glaucoma, and chronic retinal detachment of the right eye due to sequelae of VHL. The patient was treated with cryotherapy and laser photocoagulation of the left eye. Five-month post-cryotherapy follow-up showed the lesions were still active then she underwent the second cryotherapy. The lesions became whitish in appearance with smaller feeder vessels one month after the second cryotherapy and the visual acuity was preserved. Discussion : Retinal hemangioblastoma is the most common ocular manifestation of VHL disease. Prolonged ischemia causes sight-threatening complications including neovascular glaucoma and exudative retinal detachment. Prompt treatment of detected lesions is crucial for visual preservation. Conclusion : Early detection of VHL ocular manifestations plays a critical role in establishing the diagnosis and initiating treatment for a better prognosis.
Classic Choroidal Neovascularization in Young Man: Poster Presentation - Case Report - Resident Mawarasti, Burhana; Augiani, Amani Sakinah; Pratiwi, Rianti Wulandari; Djatikusumo, Ari
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/kw1xdq52

Abstract

Introduction : Classic choroidal neovascularization (CNV 2) represent a pathological growth of blood vessels and can result in loss of visual function. The most common cause of CNV 2 in elderly patients is age- related macular degeneration, meanwhile in young age it is frequently due to inflammation, high myopia, angioid disks and hereditary disorders. Hence, the presented case reports the characteristic findings as well the management of the disease. Case Illustration : A 37-year-old man had two weeks history of metamorphopsia on both eyes. The left eye (LE) had a worse visual acuity, macular fibrosis with pigment epithelial detachment in funduscopy and Optical Coherence Tomography (OCT). A submacular hemorrhage and exudative lesion were recognized on the right eye (RE) with type 2 choroidal neovascularization. Fundus Fluorescence Angiography (FFA) was also performed. Systemic conditions were unremarkable. Intravitreal anti-VEGF injections on RE were given for three consecutive months and showed significant improvement. Discussion : The etiology of CNV 2 includes high myopia, and inflammation. However, none was found in this patient. Nonetheless, CNV type 2 is still uncommon in young age without predisposing conditions. As most common lesions involve the macula, symptoms shown include metamorphopsia, central scotoma and floaters. FFA is still considered to be the gold standard to differentiate the types of choroidal vascularization. Neovascularization and submacular hemorrhage can be treated with intravitreal injection of anti-VEGF, as previous studies reported significant improvement. Conclusion : This was a case of bilateral CNV type 2 in a young man without any previous predisposing conditions. Three monthly injections of anti-VEGF showed significant improvement.
Recurrence in Toxoplasma Chorioretinitis: A Case Report: Poster Presentation - Case Report - Resident Satyanegara, Pratistha; Helvinda, Weni
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/krvazm74

Abstract

Introduction : Toxoplasma is the most common cause of chorioretinitis and recurrency of toxoplasma chorioretinitis often occur. Recurrences risk factors are patients above 40 years, patients with de novo toxoplasmosis lesions or with less than one year after the first episode, macular area involvement, lesions greater than one disc diameter, congenital toxoplasmosis, and bilateral compromise. Case Illustration : Female, twenty years old, complained blurred vision on the RE for two years. The patient had a history of cat contact and no systemic manifestation. Anterior segment examination in both eyes is normal with right eye visual acuity 1/60 and left eye visual acuity VA 6/6. Posterior segment examination on the left eye showed normal limit while the right eye showed hyperpigmentation in inferotemporal optic disc and nasal macula. Retina showed hard exudate. Macula showed yellow- white exudate with subretinal bleeding and macular star appearance. Foveal reflex under normal limit. Toxoplasma serology was IgG (+) and IgM (-). The patient has been treated with cotrimoxazole 2x960mg and methylprednisolone 1x32mg. Discussion : Visual acuity is severely damaged in recurrence toxoplasma chorioretinitis. There are several factors that affect the recurrences of toxoplasma chorioretinitis. In this patient, the risk factors found are de novo lesion, lesions greater than 1 disc diameter, and macular involvement. Cotrimoxazole can reduce recurrence in toxoplasma chorioretinitis but still recurrency can occur. Conclusion : Recurrences in toxoplasma chorioretinitis affect visual acuity, and even with adequate therapy, recurrence is possible.
Pseudophakic Cystoid Macular Oedema: A Case Report: Poster Presentation - Case Report - General practitioner Simatha, Okky Imanuel; Ernawati, Titiek; Rofiq, Rofqi
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/p5evyt63

Abstract

EFFECT OF LOW-DENSITY LIPOPROTEIN (LDL) CHOLESTEROL VALUE ON NON-PROLIFERATIVE DIABETIC RETINOPATHY (NPDR) IN PATIENTS WITH TYPE II DIABETES MELLITUS (T2DM): A SYSTEMATIC REVIEW: Poster Presentation - Observational Study - General practitioner Nugraha, Satria Budi; Siahaan Sp. M, dr. 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: 10.35749/41d94z35

Abstract

Introduction & Objectives : Type 2 Diabetes Mellitus (T2DM) is a metabolic disease in which the body is unable to control blood sugar levels and is characterized by hyperglycemia caused by lack of insulin action. One of the most common microvascular complications of DM that can cause blindness to sufferers is Diabetic Retinopathy (DR). One of the risk factors that can exacerbate the progression of T2DM is the level of Low-Density Lipoprotein (LDL). However, there are still differences of opinion in several studies if LDL has a significant role in the occurrence of DR. This study aimed to determine whether there is a relationship between the value of LDL cholesterol and the occurrence of Non-Proliferative Diabetic Retinopathy. Methods : Systematic review utilizing MeSH terminology and PICO methods were done for information extraction of online database, including PubMed, and Google Scholar by utilizing the following keyword “Low-Density Lipoprotein”, “Non-Proliferative Diabetic Retinopathy”, “Diabetes Melitus”. The extracted studies were then analyzed using the New-Castle Ottawa Scale (NOS). Results : In total, 2 eligible studies (103 subjects) were found. Dornan et al., stated that total cholesterol levels were higher in NPDR Patients (5.1 +/- 0.7 mmol/l, p ? 0,02) and Mursi et al., shows that in patients with uncontrolled LDL cholesterol, NPDR was found (53,7%, p < 0,015). NOS was used to evaluate the quality of the studies and all studies showed to be in good quality. Conclusion : According to the results of this systematic review, there is a significant correlation between the degree of diabetic retinopathy and LDL cholesterol.
Stargardt Disease: A Rare Case Report: Poster Presentation - Case Report - Resident Masloman, Anugrah Handini; Kambey, Dave Abraham; Sumual, Gideon; Nursalim, Ade John
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/qa7rrg14

Abstract

Introduction : To report a stargardt disease case Case Illustration : A 14 year young boy presented with chief complaints of blurry vision in both eyes since childhood. Progressive loss in his ability to differentiate between faces, colors and point out details of objects. On ocular examination, his visual acuity was 1/60 with retinoscopy value revealed +2.00 Dsph and was unable to read plates of Ishihara chart in both eyes. On indirect ophthalmoscopy optic disc were normal with sharp margins and orange color and absent foveal reflex in both eyes. Numerous small whitish flecks were seen around the macula in both the eyes with an ill-defined circular lesion was seen at the macula with beaten bronze appearance. Supportive therapy such as correction with low vision aids or the provision of sun protective glasses can help in the daily lives of patients. Discussion : Stargardt disease is an inherited macular degeneration that typically presents in the first two decades of life. The prevalence is in the region of 1 in 8–10,000 individuals. Study reported an annual incidence of 0.127 per 100,000. This case was also rarely reported in Indonesia. The age of onset and rate of progression vary greatly, with most experiencing symptoms in their teens or earlier. Conclusion : Stargardt disease case has been reported in a 14 year young boy. Progressive vision loss can be the only vision complaint from the patient. Supportive therapy such as correction with low vision aids or the provision of sun protective glasses can help in the daily lives of patients.
Intravitreous aflibercept or vitrectomy for initial treatment of diabetic vitreous hemorrhage? A Systematic Review of Current Evidence: Poster Presentation - Observational Study - General practitioner Ningrum, Indra Utami Mutiara; Primarhyani, Marchia
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/zjwqv392

Abstract

Introduction & Objectives : To assess the efficacy and safety of intravitreous aflibercept versus vitrectomy in patients with diabetic vitreous hemorrhage (VH) Methods : Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE database were searched. No constraints based on language or publication date were applied. Only randomized controlled trials (RCTs) comparing intravitreal aflibercept injection with vitrectomy procedure were included. Search results were screened independently by two authors. Data extraction and synthesis were performed according to The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The primary outcome measures were best-corrected visual acuity obtained at least 6 months following interventions, rate of recurrent hemorrhage, and periprocedural ocular adverse events. The quality of evidence was assessed using the GRADE tools. Results : Two clinical trials that randomized 239 eyes were included in this review. There was no evidence ofa difference in primary outcome of mean visual acuity at six months between randomized groups. However, patients receiving intravitreous aflibercept were more likely to experience recurrent VH than those undergoing vitrectomy (RR 3.12 95% CI 1.95 - 4.99, absolute effect of 32 more people with recurrent VH per 100 people treated with aflibercept). Rates of periprocedural ocular complications were similar in both groups. Conclusion : Intravitreous aflibercept safety and efficacy appear to be non-inferior compared to vitrectomy for initial management of diabetic VH. Further well-designed studies are needed to investigate the long- term effects of treatments.
SERIAL CASES INTRAVITREAL TENECTEPLASE AND PNEUMATIC DISPLACEMENT OF SUBMACULAR HEMORRHAGE: Poster Presentation - Case Series - Ophthalmologist Dewi, Upik Mahna
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: 10.35749/065p2m33

Abstract

Introduction : OBJECTIVE Submacular hemorrhage {SMH} is uncommon complication of choroidal or retinal vascular abnormalities, including choroidal neovascularization {CNV}, polypoidal choroidal vasculopathy {PCV} and retinal macroaneurysm of these, PCV is condition most frequency associated with large SMH {reported in 20%-63% of eyes with PCV} PURPOSE To presence successful management of submacular hemorrhage with combination injection intravitreal {IVT} Tenecteplase and gas C3F8 100% Case Illustration : METHODES All patient with SMH already take foto fundus and OCT pre and post IVT methalyse and gas C3F8 100%. All patients undergone IVT gas C3F8 100% 0.2 cc and take a rest for 20 second after that IVT methalyse 0.1 cc was injected. Positioning 1st 24 hours: Free Positioning, 2nd 24 hour: Positioned face down, 3rd days: Follow up. Discussion : RESULT The submacular hemorrhage move out from macular for all of cases. Vision improvement occourred in all cases. Conclusion : CONCLUTION Intravitreal Tenecteplase in conjunction with pneumatic displacement appears effective in displacing submacular blood.

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