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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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Cataract Progression dan Lens Drop after Pars Plana Vitrectomy and Gas Tamponade : A Case Report: Poster Presentation - Case Report - Resident Suryawijaya, Ernes Erlyana; Suryathi, Ni Made Ari; Andayani, 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/m3zsvh92

Abstract

Introduction : Vitreous Hemorrhage (VH) in proliferative diabetic retinopathy (PDR) is common cause of acute vision loss.If the retina cannot be visualized and the etiology of the VH is unknown, pars plana vitrectomy (PPV) is indicated. 1Intraocular gases like SF6 or C3F8 are one of the most useful adjuncts in vitreoretinal surgery. Exposure to intraocular gases additionally increases retrolental oxygen levels, resulting in development of lens opacities. Case Illustration : Patient female 52 y.o, came with sudden blurry vision in the left eye since two weeks ago. History of Diabetes Mellitus 10 years with insulin treatment. From the examination left eye visual acuity 1/60, zonulysis, VH, and negative fundus reflect. On ultrasonography found vitreous opacity. The patient was diagnosed with left eye VH ec advanced PDR and scheduled PPV with C3F8 gas tamponade. Patient difficult to maintain prone position after surgery. 2 month after the surgery the patient scheduled with phacoemulsification surgery because progressive lens opacity. While prepare to the second operation, the lens found drop to the vitreous. The second surgery done with lens evacuation and Intraocular lens implantation. Last follow up, best correction visual acuity was 6/18. Discussion : PPV and Gas tamponade are presdisposing lens opacity progression. Lens opacity after gas tamponade include longer intraocular longevity gas and patients who fail to maintain a prone position. Risk factors for zonulysis in this patient increase the occurrence of lens drop after PPV with gas tamponade. Conclusion : Regular slit-lamp examination needs to be performed for early detection of cataract after PPV with gas tamponade.
MANAGEMENT EALES’ DISEASE GRADE III B: A RARE CASE: Poster Presentation - Case Report - Resident Evasha, Agung Putra; Amin, Ramzi; Ansyori, AK
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: 10.35749/92cbvg28

Abstract

Introduction : Eales' disease is an idiopathic occlusive retinal vasculopathy that mostly affects the peripheral retina bilaterally in young, predominately male patients. A hallmark of eales disease is recurrent vitreous hemorrage can all cause some patients to experience severe vision loss Case Illustration : A 39-year-old male with vitreous hemorrhage caused by Eales Disease grade III B with initial visual acuity 1/300. Ultrasound imaging showed the membrane like lesion with 1/2 retinal reflectivity, after moderate movement and vitreous hemorrhage on both eyes. The photo-fundus showed there is decreased fovea reflex and perimacular exudate with visible contours of sclerotic blood vessels, visible cotton wall spot, and macroaneurysm. There is also haze grade 3 on media, visible folds in the inferior part, visible shadows of cotton wall spots. The patient was managed with pars plana vitrectomy with endolaser Discussion : In this case, patient was diagnosed as vitreous hemorrhage caused by Eales Disease grade III B on both eyes but it getting worse on left eye further. We chose to perform PPV with endolaser on right eye. The outcome was good on right eye based on better visual acuity and decreased hemorrhage, but in the left eye, which not treated, worsen outcome occurred Conclusion : The management of this patient’s case showed good results in both anatomic and functional outcomes for right eye, but unfortunately left eye is on serious problem
Bilateral Ocular Ischaemic Syndrome due to Carotid Artery and Cardiovascular Disease: A Case Report: Poster Presentation - Case Report - Ophthalmologist FIBRIAN, KARTIKA CINDY
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/tn8enb65

Abstract

Introduction : Ocular ischemic syndrome (OIS) is a rare but potentially blinding and fatal condition caused by carotid artery disease or other systemic condition results in ocular hypoperfusion. Case Illustration : A 62-year-old male with sudden bilateral vision loss, swelling, redness and pain of both eye for 7 days. There were dilated conjunctival and episcleral vessels, visual acuity of the right eye was hand movement and 0.05 for left eye, intraocular pressure (IOP) was 33 mmHg in right eye and 37 mmHgfor left eye. Anterior segment evaluation revealed rubeosis iris, mild anterior chamber reaction, and temporal angle neovascularization on gonioscopy. Both direct and consensual light reflexes were sluggish. Fundus examination showed normal optic disc, minimal hemorrhages at mid-periphery, narrowed arterioles, and minimal cotton wool spot. Macular OCT demonstrated discrete hyperreflectivity of inner retinal layers. From Macular Angiography OCT, ETDRS Central vessel density were 11.2% and 17.6% for the right eye and left eye, respectively. In both eyes, paracentesisof anterior chamber, intravitreal and intracameral injections of anti-VEGF were performed. Brain Magnetic Resonance Angiography Imaging revealed moderate stenosis of both distal carotid artery circulation. Percutaneous Coronary Angiography showed extensive stenosis in coronary artery, with low Ejection Fraction. Discussion : For the cardiovascular management, a pacemaker was implanted. One week after procedure, BCVA were 1/60 and 0.15, and IOPs of 17 and 18 mmHg, for the right and left eye, respectively. The patient was scheduled to have laser retinal photocoagulation. Conclusion : Quick clinical diagnosis, targeted workup for systemic associations, and prompt treatment might preserve life and sight in OIS.
Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy With and Without Internal Limiting Membrane Peeling: A Case Series: Poster Presentation - Case Series - Resident WISESAPUTRA, TJOK AGUNG PURNAMA; Panjawati, Sp.M(K), dr. Ni Luh Diah
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/djyjwe94

Abstract

Introduction : Proliferative Diabetic Retinopathy (PDR) is a potentially blinding complication of diabetes mellitus, one of them because of tractional retinal detachment. Pars Plana Vitrectomy (PPV) is performed to treat it and in recent years internal limiting membrane (ILM) peeling has been employed as an additional treatment for patient with PDR. Case Illustration : Two patient, patient 1 (male, 64 years old) was diagnosed with right eye vitreous hemorrhage due to high-risk PDR and left eye vitreous hemorrhage due to early PDR + DME, and patient 2 (female, 58 years old) was diagnosed with right and left eye PDR + ERM + senile immature cataract. Both patients underwent PPV + membrane peeling + endolaser for both eyes, and additional ILM peeling on their left eye. The visual acuity 1 month after surgery without ILM peeling on right eye was improved to 6/30 and 6/18, and with ILM peeling on left eye was improved to 6/30 for both patients. Discussion : Removal of the ERM either with or without ILM peeling can significantly improve vision. However, many other comparison studies found no functional difference between both groups. In addition, one study found ILM removal was correlated with worse visual outcome. In this study, visual acuity 1 month after surgery in both with and without ILM peeling was improved compared with pre- operative. Conclusion : Although there are still pros and cons, PPV with additional ILM peeling gives results as good as PPV without ILM peeling for patient with PDR.
Management of Full Thickness Traumatic Macular Hole In An 7-Year-Old Boy : A Case Report: Poster Presentation - Case Report - Ophthalmologist Amin, Ramzi
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: 10.35749/724a2f15

Abstract

Introduction : Traumatic macular hole (TMH) formation is uncommon, usually occurs in young males, and the incidence varies in the literature from 1 to 9%.The study by Chen et al reported that early vitrectomy resulted in significantly higher rate of TMH closure compared to initial observation (100% vs 66.7%, respectively) Case Illustration : A 7yo boy presented with diminution of vision in right eye (RE) of 2 months duration.There was history of trauma on the right eye. Visual acuity (BCVA) was 6/60 and 6/6 in RE and LE (Left Eye) respectively.Dilated fundus examination of OD revealed a full thickness macular hole (FTMH). SSOCT of OD confirmed the presence of an FTMH (with minimal hole diameter of 850 microns) with cystoid changes at the edges.The patient underwent vitrectomy followed with ILM peeling and advised facedown position for a week. At postoperative week one, BCVA was improved 6/9. SSOCT showed type 3 hole closure. BCVA improved to 6/7.5 at 1 months. Discussion : The study by Chen et al. was the first multicenter, prospective, comparative case study that attempted to address the outcomes of patients with TMHs comparing observation to early vitrectomy. Authors reported that early vitrectomy resulted in significantly higher rate of TMH closure compared to initial observation (100% vs 66.7%, respectively). The child in our case was resulted in good outcome. Conclusion : Early vitrectomy in full thickness traumatic macular hole in a young age resulted the good outcome.
THE OPTICAL COHERENCE TOMOGRAPHY (OCT) IN A PATIENT WITH RETINOPATHY-ASSOCIATED ECLAMPSIA: WHAT TO EXPECT? Poster Presentation - Case Report - General practitioner Zain, Nurul Attikah; Sopha, Kasihana Hismanita
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/wsnk0588

Abstract

Introduction : Eclampsia is a common pregnancy complication, that has been associated with retinopathy. Screening of retinopathy in preeclampsia/eclampsia is essential for early detection and management. Various imaging modalities are used to diagnose retinopathy. However, because of the higher-resolution imaging demand, optical coherence tomography (OCT) suggests a better option. The present study aimed to report the OCT findings of retinopathy-associated eclampsia. Case Illustration : A 24-year-old pregnant woman in 27th-week gestation with eclampsia presented the new onset of bilateral sudden diminution of vision. The vision in her right eye was limited to hand movement and that in her left eye was light perception only. Clinical examination revealed Siegrist streaks, Elschnig spots, and flame shape hemorrhages. OCT of both eyes demonstrated subretinal fluid, intraretinal fluid, thickening of the retinal layer, also inner retinal hyperreflectivity. Two months after the follow-up, there was an improvement in the OCT findings and also in the visual acuity. Discussion : An increase in macular thickness could be a characteristic feature in the OCT of retinopathy- associated eclampsia caused by retinal arteriolar narrowing due to systemic hypertension and ischemia. Previous studies have demonstrated subretinal/intraretinal fluid with or without serous retinal detachment in preeclampsia. Following our case, we report subretinal fluid, intraretinal fluid in the outer plexiform layer with retinal detachment and macular edema. The subretinal fluid and serous detachment were most likely caused by the changes in the fluid and ion-transport function of the retinal pigment epithelium (RPE). Conclusion : OCT can provide valuable information for diagnosis and follow-up retinopathy in preeclampsia/eclampsia.
A RARE CASE OF STERILE ENDOPHTHALMITIS FOLLOWING INTRAVITREAL TRIAMCINOLONE ACETONIDE INJECTION IN VITRECTOMIZED EYE: Poster Presentation - Case Report - Resident Pitanatri, Nyoman Brahmani; Panjawati, Ni Luh Diah
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/qp8wgz24

Abstract

Introduction : Intravitreal Triamcinolone Acetonide (IVTA) has been widely used to treat Diabetic Macular Edema (DME). Sterile endophthalmitis is one of the major related complications after IVTA which occurs between 0.20% and 6.73% of the injections. We present a case of sterile endophthalmitis following IVTA injection in a patient with a vitrectomized eye and DME. Case Illustration : A 53?year?old female patient with a history of vitrectomy due to high-risk characteristic proliferative diabetic retinopathy on her right eye underwent IVTA for DME. One day after the injection, the visual acuity (VA) improved from 6/45 to 6/12 without any complication. Three days later, she complained of ocular discomfort and sudden diminution of vision. The VA had dropped to hand movement, with conjunctival injection, hypopyon, anterior chamber reaction, and an inaccessible fundus. The patient was treated with topical antibiotics, corticosteroids, and cycloplegic, followed by intravitreal antibiotics injection. Furthermore, vitrectomy and vitreous tap were performed. On one- week follow-up, the VA was improved to 6/60 with normal IOP. The anterior chamber and the vitreous cavity remained clear. Discussion : The etiology of sterile endophthalmitis following IVTA injection remains unclear. Compared to infectious endophthalmitis, the patient is usually in less pain, and the eye is less injected. Although it generally has a benign course, some studies have shown serious complications such as vitreous hemorrhage and retinal detachment. Therefore, caution should be taken to prevent such complications from developing. Conclusion : In presumed sterile endophthalmitis, a careful diagnosis and intervention must be reconsidered to avoid potential long-term visual loss due to its related complications.
UNILATERAL CMV RETINITIS IN HIV/AIDS PATIENT WITH MULTIPLE OPPORTUNISTIC INFECTIONS: Poster Presentation - Case Report - Resident Bening, Daya Banyu; Firmansjah, Muhammad; Zuhria, Ismi; Yustiarini, Ima; Widjaja, Sauli 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: 10.35749/4fdqtz59

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.
An Uneventful Case of Unresolved Suprachoroidal Hemorrhage After Cataract Surgery: When to Operate? Poster Presentation - Case Report - Resident Dearaini; Ivanovna, Regina; Lumintang, Agnesstacia Vania; Augiani, Amani Sakinah; Mawarasti, Burhana; 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/tvhx6r93

Abstract

Introduction : Suprachoroidal hemorrhage (SCH) is a rare, but potentially vision-threatening condition. The management options for SCH varied and still debatable. Case Illustration : Female 54 years old with chief complaint blurry vision of right eye (RE) since four days after she underwent cataract surgery. She also experienced radiating pain from RE with nausea and vomiting. No history of elevated intraocular pressure (IOP) before the surgery. Her left eye was blind for 20 years prior due to an unknown cause. Visual acuity (VA) on presentation was light perception good projection and IOP was 34mmHg. There was 2.5mm hyphema and fibrin on the anterior chamber. Lens appeared to be aphakic and there was lens material at pupillary margin. Ultrasonography (USG) of RE showed choroidal elevation with medium to high spike and positive after movement indicating SCH. She was hospitalised for IOP monitoring and serial USG was performed to monitor the hemorrhage. Six days after admission, IOP remain elevated despite medications and SCH didn’t resolve, then vitrectomy and scleral drainage was performed. Postoperative exam showed improved VA to 0.5/60, IOP to 16mmHg without medication, and reduced suprachoroidal hemorrhage on USG. Discussion : It’s imperative to perform complete evaluation of ocular and systemic conditions in preoperative period to prevent SCH. Ultrasonography is crucial during the close follow-up after developing SCH, it also aids in the timing of surgical intervention. Conclusion : Vitrectomy with scleral drainage is a valuable approach in managing extensive SCH, a condition generally associated with poor prognosis.
BARRAGE LASER PHOTOCOAGULATION IN HIGH-MYOPIC PATIENT WITH SYMPTOMATIC RETINAL TEARS BEFORE PHACOEMULSIFICATION: A CASE REPORT: Poster Presentation - Case Report - Ophthalmologist Budhiastra, I Putu; Tridiyoga, Komang Putra; Jayanegara, I wayan Gede; Suryathi, Ni Made Ari; Andayani, Ari; Pitanatri, Nyoman Brahmani
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/zdtpyp85

Abstract

Introduction : Retinal tears can be present in up to 2.4% of cases of lattice degeneration, which is considered an important risk of retinal detachment in a high-myopic patient. Laser photocoagulation has been shown to reduce the risks of retinal detachment before phacoemulsification thus improve in the visual outcome. We report a case of a high myopic patient with symptomatic retinal tears who underwent phacoemulsification that was treated prophylactically with barrage laser photocoagulation. Case Illustration : A 43 years-old female with a history of high myopia complained of flashes and floaters on both eyes. She had high myopia measuring -13.0 dioptres and -28.0 dioptres in the right and left eyes respectively. Unaided visual acuity was 2/60 in both eyes. Fundus examination showed lattice degenerations with a small tear found on both eyes with no retinal detachments. She was treated with a barrage laser on both eyes followed by phacoemulsification. On the last follow-up, the retina remained stable and the visual acuity was significantly improved with no development of macular edema or retinal detachment in both eyes. Discussion : Although most cases of lattice degeneration do not need intervention, some present a risk of retinal detachment. Barrage laser photocoagulation may have a place in high myopic patient lattice degeneration with symptomatic retinal tears to maintain retinal stability and to obtain the optimal outcome after phacoemulsification. Conclusion : Barrage laser photocoagulation is beneficial as a prophylactic treatment of symptomatic retinal tears before phacoemulsification in high-myopic patients.

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