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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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Detecting Keratoconus in Primary Healthcare: What general practitioners could do? Poster Presentation - Case Report - General practitioner Akbar, Muhammad Khalil; Samira, Cut Putri
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: 10.35749/0khakt62

Abstract

Introduction : Keratoconus (KC) is a rare eye disorder that causes corneal thinning and visual disturbances. KC prevalence in the pediatric population is 0.16%. Children with keratoconus experience faster disease progression and significant visual impairment at diagnosis, impacting their quality of life. This case report aims to raise awareness and provide knowledge regarding KC for general practitioners. Case Illustration : A 14-year-old male visited a primary healthcare facility complaining of difficulty seeing words on the classroom board for the past year. His best-corrected visual acuity was 6/15 (S-10.25 C-5.25x30) OD and 6/60 (S-25.00 C-2.75x150) OS. Upon examination, it was observed that the left cornea was more protruding than the right, with a positive Rizzuti and Munson sign. Based on the findings, the patient was suspected of having keratoconus with amblyopia and was referred to an ophthalmologist for further examination and management. Discussion : Keratoconus is severe and burdensome to society, impacting children's education and quality of life. Early detection and intervention are crucial to prevent worsening. KC can be detected in primary healthcare by observing external signs such as Rizzuti and Munson. KC can lead to severe vision problems and even amblyopia if left untreated. Treating pediatric KC involves improving vision using contact lenses. In cases where contact lenses cannot be used, keratoplasty may be necessary. Conclusion : Primary healthcare providers can identify and assess keratoconus in patients and make referrals to ophthalmologists for treatment to minimize the impact on vision and stop its progression.
Long-term outcomes of LASIK for myopia: Poster Presentation - Observational Study - General practitioner Mattarungan, Monica; Tania
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/yf7v9v14

Abstract

Introduction & Objectives : Myopia is a major healthcare burden worldwide. Refractive surgery is used to correct refractive error for patients who wanted less reliance on glasses and contact lenses. LASIK is one of the most commonly used procedures for correction of myopia. This study aims to evaluate the long-term outcomes of LASIK procedure for myopia. Methods : A literature search was conducted for the years of 2017 to 2013 from PubMed with the search term "LASIK" AND "myopia" AND ("efficacy" OR "long-term outcomes"). All abstracts were reviewed and evaluated, and articles relevant to the topic was reviewed for this study. Results : Out of 71 articles from search results, 7 articles were selected for review. At the last follow up from 3-12 years, uncorrected distance visual acuity (UDVA) of -0.03 – 0.39 logMAR was achieved. Around 64% - 90% patients achieved UDVA of 20/20 or better. Myopic progression was found with the mean of 0.63 – 0.97 D. The efficacy index and safety index was at 0.67 - 1.01 MR and 1.02 - 1.09 respectively at the end of follow up. Conclusion : The data showed that LASIK had an excellent long-term safety and efficacy for treatment of myopia, although small percentage of patients experienced mild myopic progression.
A SUCCESSFUL TREATMENT OF INTRAVITREAL MOXIFLOXACIN INJECTION IN ACUTE POST-CATARACT SURGERY ENDOPHTHALMITIS: A CASE REPORT: Poster Presentation - Case Report - General practitioner Ardityastiti, Khairani Azizah; Wibawaty, Halida
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/qqedxk93

Abstract

Introduction : Endophthalmitis is a severe form of ocular inflammation and one of the most dreaded cataract surgery complications which may lead to loss of vision. Post-cataract surgery endophthalmitis is a serious complication that occurs when infecting organisms invade the posterior segment of the eye during the time of surgery. Currently, intravitreal injection of vancomycin along with ceftazidime is the first-line treatment, but another study showed a good result of intravitreal moxifloxacin injection in patients with Postoperative endophthalmitis. Case Illustration : We reported a 59-year-old woman presented with blurred vision, redness, and pain in the left eye 4 days after phacoemulsification. Visual acuity of LE was hand movement and anterior segment examination found that there was a conjunctival and pericorneal injection, corneal edema, cells, and anterior chamber fibrin formation. Ultrasonography examination showed severe levels of debris in the vitreous humor. Patient was diagnosed with acute post-cataract surgery endophthalmitis and received an intravitreal moxifloxacin injection. Fortunately, one week after that injection, there wasa good result in the patient’s eye condition. Visual acuity of LE improved to 0,1 and the patient planned to receive the second moxifloxacin injection to get the best possible results. Discussion : Moxifloxacin expresses broad-spectrum microbial coverage with a very good diffusion and low adverse effects. Moxifloxacin also has a better penetration ability into inflamed ocular tissue than all other antibiotics. Based on that, other studies said that intravitreal moxifloxacin can replace vancomycin and ceftazidime combinations for the treatment of ocular infections. Conclusion : Intravitreal moxifloxacin injections have a good result in acute post-cataract surgery endophthalmitis.
SICS as a procedure for cataract with severe corneal scar: a case report: SICS as a procedure for cataract with severe corneal scar: a case report Yunita, Tina; Rahman Sp. M, dr. Faisal; Anggraeni Sp.M M.Kes, dr. Nila
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/ermdy597

Abstract

Introduction : Cataracts are the most common cause of visual impairment and blindness in Indonesia, according to the Rapid Assessment of Avoidable Blindness (RAAB) survey, which is around 70-80% of patients. Meanwhile, corneal disorders are the second cause of blindness after cataract in the world. Incidence of corneal scar in patients with cataracts can exacerbate visual disturbances to cause blindness and require special treatment. Case Illustration : A 75 years old woman with blurry eyes since 1 year ago. Acuity of the right eye (OD) was 1/300 and the left eye (OS) was 1/300. Extensive and severe scars were found on the corneas of both eyes. Lens opacities were found in the anterior eye segment. Patient was diagnosed with ODS mature senile cataract and ODS corneal scar. Surgical treatment was carried out using the small-incision cataract surgery (SICS) method, IOL inserted and iridectomy. Discussion : Mature cataract patients with advanced age tend to have a denser and harder lens. Cataract extraction performed by phacoemulsification procedure in very dense and hard cataracts requires higher ultrasound energy settings thereby increasing the risk of corneal endothelial trauma and burns which will exacerbate corneal scarring in patients. SICS is a better treatment compared to phacoemulsification in patients with complex situations such as corneal scarring in dense and hard cataracts with minimal surgical complications and optimal results. Iridectomy in cataract surgery can be performed if iris prolapse occurs due to high pressure from the posterior segment of the eye. Conclusion : The SICS procedure shows good results for cataract patients with severe corneal scars
Management of Iatrogenic Iridodialysis with Single-pass Four-Throw (SFT) Pupilloplasty : A Case Report: Poster Presentation - Case Report - General practitioner Setiabekti, Nisia Pratama; Kristianto, Bobby
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/sj3ktk81

Abstract

Introduction : Iridodialysis is a localized separation or tearing away of the iris from its attachment to the ciliary body. It occurs most commonly secondary to trauma, and it is more frequently associated with blunt traumas compared to penetrating eye injuries. Iridodialysis can also occur due to intraocular surgeries. The prevalence of iridodialysis secondary to blunt trauma was reported to be 9.3-14% as compared to 0.2% caused by cataract surgeries. Small and superiorly located iridodialysis may be left untreated. However, a more inferiorly placed, larger, or symptomatic iridodialysis warrants surgical repair. Case Illustration : A Male 62 years old came with chief complaint Glare on right eye after complicated cataract surgery 2 months before.Patient also complained blurry vison without redness. Examination found visual acuity 6/60 UCVA RE, iridodialysis at superior region from 10 o’clock until 1 o’clock, IOL (+) with good central, Normal Posterior Segment. Patient was treated with Single-pass Four-Throw (SFT) Pupilloplasty with local anesthesia and 1-month after Pupilloplasty we found visual acuity 6/30 UCVA RE and without any glare complaint anymore. Discussion : Management of this patient is a challenging case. The treatment og Single-pass Four-Throw (SFT) Pupilloplasty can give great outcome for visual acuity and glare symptom. SFT Pupilloplasty is also great and easy technique for beginner eye surgeon but for anesthesia, general anesthesia is more convenience than local ones. Conclusion : SFT Pupilloplasty is also great and easy techinique for iatrogenic iridodialysis.
ORBITAL TRAUMA IN A CHILD WITH RETROBULBAR HEMORRHAGE: Poster Presentation - Case Report - General practitioner Rachmawati, dr. Anita Dwi
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/vbqd2a43

Abstract

Introduction : Retrobulbar hemorrhage vision threatening condition associated with cranio- facial trauma. Rapidly fill the orbit and cause an “orbital compartment syndrome” that subsequently cuts off perfusion to vital ocular structures. Treatment must be initiated immidietly to prevent permanent visual loss. Case Illustration : 10-year-old boy, with left eye blurring of vision, swelling and multiple facial injury post motor accident. Visual acuity was perception of light on left eye, 6/5 and right eye with upper and lower lid laceration wounds. He had a dense afferent pupillary defect and the ocular movements of the left eye were limited in all directions of gaze. The orbit was tense with significant resistance to retropulsion. Diagnosed with acute retrobulbar haemorrhage following blunt trauma with medial wall fracture. Intravenous acetazolamide and timolol was commenced continued with emergency lateral canthotomy. His vision immediately improved to 6/60 and 3 hours later was 6/18. He was treated for left traumatic optic neuropathy with IV Mehtylprednisolone for 3 days followed two weeks oral prednisolone Discussion : Conclusion : Retrobulbar haemorrhage is a vision-threatening emergency often necessitating immediate lateral canthotomy for preservation of vision. In children, as the optic nerve canal is smaller, a lesser volume is available for the nerve to expand, thus early visual impairment could occur following trauma. Prompt recognition and appropriate treatment of this ocular emergency is imperative, for timely management determines the ultimate outcome.
Oral Vitamins for Lowering the Risk of Cataracts: Is It Needed? Poster Presentation - Observational Study - General practitioner Badruddin, gabriella Hafidha; Nathania, Stella; Safira, Nadya; Jutamulia, Jovita; Utami, Muthia Despi
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/dqzwae69

Abstract

Introduction & Objectives : Cataracts are a common age-related ocular disorder leading to blindness. As the role of oral vitamins in the prevention of cataracts remains controversial, various studies have investigated the potential association between oral vitamin supplementation and risk of cataracts. This review aims to find association between oral vitamins and the risk of cataracts. Methods : A thorough literature research was conducted on online databases (PubMed, ProQuest, and Cochrane) and hand-searching. This review incorporates human studies in the past decade (2013-2023), conducted concerning the correlation between various kinds of oral vitamins and cataracts. All studies shall be published in English and be available in full-text journals. Results : The majority of studies indicated that vitamin C, vitamin E, and multivitamin supplementations were associated with lower risks of cataract incidence. Two articles had similar relative risks (RR) for vitamin C (RR = 0.80-0.81), one article had RR of 0.90 for vitamin E, while two others had RR of 0.66 and hazard risk (HR) of 0.91 for multivitamin. However, one cohort stated otherwise as both vitamin C and vitamin E increased the risk of developing cataracts (HR = 1.21 and 1.59, respectively), while multivitamin had no association (HR = 0.96). Conclusion : Oral multivitamin, vitamin C, and E have a significant association with cataracts. Further research is needed to specify the efficacy of each vitamin.
Factors Associated with Poor Clinical Outcomes in Patients with Post- Cataract Surgery Endophthalmitis: A systematic review: Poster Presentation - Observational Study - General practitioner Amran, Rahmah; Zukhri, Sp.M, dr. Dicky Stevano
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: 10.35749/19synf94

Abstract

Introduction & Objectives : Postoperative Endophthalmitis has remained one of the rare yet most devastating complications of cataract surgery. The previous study mentioned that 15-30% of POE patients have an unfavorable outcome on visual acuity of less than 20/200 and may even result in the loss of the eye. Thus, this study aims to review and summarize prognostic factors that can affect the final outcome of postoperative endophthalmitis from cataract surgery. Methods : We systematically searched with PRISMA 2020 across 5 databases (PubMed, Scopus, SAGE, Embase, and Cochrane) with the search term “(prognosis OR prognostic factor) AND postoperative endophthalmitis) AND (cataract surgery)”, as well as reference screening for any additional relevant studies. The risk of bias from included studies will be assessed using Newcastle-Ottawa Quality Assessment Scale. Results : Out of 314 studies, we decided to only include 13 studies that match our inclusion and exclusion criteria. All of the studies are cohort studies with a total of 753 patients affecting 753 eyes and most of them are coming from Asian countries. Both diagnosis and intervention given are based on Endophthalmitis Vitrectomy Study (EVS) result. Conclusion : Prognostic factors for post-cataract surgery endophthalmitis are corneal involvement, microbiological investigation result, intervention timing, treatment modality, comorbidities, and other complications
Cataract Surgery After Keratoplasty: How Should We Prepare? Poster Presentation - Case Series - Resident Sadikin, Irma Suwandi; 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: 10.35749/5xx1gd17

Abstract

Introduction : Cataract surgery following corneal transplantation demands special attention to corneal graft stability and optimization to allow for excellent IOL selection, as well as corneal graft preservation since lens removal damages the corneal endothelium. This study aimed to determine how we should prepare for cataract surgery after keratoplasty. Case Illustration : Case 1: A 34-year-old male has phacoemulsification in his right eye (last eye). He had a history of eye surgery, including, keratoplasty for RE in 2019, and vitrectomy for RE because of endophthalmitis. The pre-operative visual acuity is 0.5/60 with PAS and an irregular pupil. Post-operative VA 3/60 with BCVA 6/40. Last follow-up, the grafted cornea was still clear with normal IOP. Case 2: A 50- year-old female underwent phacoemulsification for both eyes (BE). She had histories of keratoplasty in 1986, 1989, and 1997 for BE. She also had extreme myopia for BE (RE S -17.00, LE S-14.00). Pre- operative VA was 1/60 of BE, and BCVA was 6/20 a month after surgery. During the last check-up, both transplant corneas were clear with normal IOP. Last visit, her both grafts remained clear. Discussion : Conclusion : IOL calculations are challenging due to inaccuracy in corneal measurements, astigmatism, or corneal pathology. The best time to perform surgery is at least 2 years after keratoplasty. We suggest using total keratometry in the K-6 formula or Haigis for the IOL formula. Good dispersive viscoelastic, operating away from the corneal endothelium, and employing low phaco-energy/fluids will help to deliver a clear cornea after surgery. Last, steroid treatment will enhance graft survival rate.
Gelatinous Drop-Like Corneal Dystrophy in an Acehnese Family: Serial Cases.: Poster Presentation - Case Series - Ophthalmologist Samira, Cut Putri; Akbar, Muhammad Khalil
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/wne50q56

Abstract

Introduction : Gelatinous drop-like dystrophy (GDLD) is a rare type of corneal dystrophy with an autosomal recessive inheritance pattern. Although the prevalence in Japan is approximately 1 in 33,000, it is much less common in other nations. Lamellar or penetrating keratoplasty is needed for most patients to alleviate the symptoms. This case series aims to provide knowledge regarding rare cases of GDLD and its management. Case Illustration : Three male siblings from consanguineous marriage were found to have corneal dystrophy, characterized by a white-yellow nodular lesion with a kumquat-like appearance on the corneal surface. The visual acuity of each patient was light perception with good projection. To treat the condition, all patients underwent full-thickness penetrating keratoplasty. One month after the procedure, their visual acuity had improved to 3/60, 2/60, and 2/60, respectively. Discussion : GDLD is a genetic disease with gelatinous amyloid deposits in the cornea that typically manifests within the first decades of life. GDLD can present in three different phenotypes, including band keratopathy, mulberry, and kumquat-like appearance. In the case of these siblings, they have developed the severe kumquat-like phenotype. Detection by examining family involvement and the cornea's clinical presentation can help diagnose GDLD. Full-thickness penetrating keratoplasty can be an option for managing severely impaired visual acuity caused by GDLD. Conclusion : GDLD is a rare corneal dystrophy that can lead to severe visual impairment. The objective of treating GDLD is to enhance vision and prevent its progression. Vision loss can be alleviated througha surgical procedure such as full-thickness penetrating keratoplasty.

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