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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 effect of topical atropine 0.05% compared to atropine 0.01% for Myopia control in Children : A Meta-analysis: Poster Presentation - Observational Study - General practitioner DEWI, INGGRIANA SUKMA; SAVITA, SALMA
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: 10.35749/3frmf342

Abstract

Introduction & Objectives : Myopia is the most common ocular anomaly manifesting during primary school and progresses until a mean age of 16, but rarely beyond age of 25. Atropine, a nonselective muscarinic antagonist, has been studied widely in recent years as an option for myopia control. To analyse the efficacy of Atropine 0,05% compared with Atropine 0,01 % for myopia control in children aged 4-16 years toward the axial length examination through a meta-analysis. Methods : A systematic search was performed using Medline and Cochrane database up to December 2022. Review was performed according to the PRISMA Statement. The eligible studies were RCTs which comparing Atropine concentration 0.05% with 0.01%. Results : From 101 retrieved articles, 5 trials involving total 1035 patients were included. The follow-up period of the studies was 1-2 year. The analysis shows Atropine 0,05% significantly decrease axial length (Mean Difference [MD]: -0.11, 95%CI [-0.15-0.07], p<0.00001, I2= 99 %) comparing to Atropine 0,01%. Conclusion : In myopia control in children, atropine 0,05 % was more effective to reduce myopia progression in controlling axial length elongation over a period of 1-2 year comparing to atropine 0,01%.
Axenfeld Rieger Syndrome: an unusual case report: Poster Presentation - Case Report - Resident RAHMADIANSYAH, MUHAMMAD FADHIL; SAYUTI, KEMALA
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/mf7nvf10

Abstract

Introduction : Axenfeld-Rieger Syndrome (ARS) is a rare autosomal dominant disorder that characterized by ocular manifestation, especially the cornea, iris, glaucoma, and systemic abnormalities in teeth, face, abdomen, heart and genitals. Case Illustration : A 7-year-old boy patient presented to policlinic with complaint of blurry vision in both eyes. No other abnormalities in history. On examination, visual acuity of right eye 5/60 and left eye 4/60. Slit lamp examination revealed hypoplasia iris, corectopia, and polycoria. Intraocular pressure (IOP) on right eye 25 mmHg and left eye 24 mmHg. Non ocular manifestation were flat face and teeth deformity. This patient was diagnosed ARS with secondary glaucoma. We managed the patient together with the dental and pediatric department in order to confirm and treat any systemic abnormality. Patient underwent cycloplegic refractive correction to achieve best corrected visual acuity right eye 20/200 and left eye 20/150 (LEA chart). Timolol 0,25% eye drop was given twice a day with IOP right eye 19 mmHg and left eye 20 mmHg after 2 weeks. Discussion : The diagnosis of patient was ARS with secondary glaucoma. The patients with ARS have a 50% lifetime risk of glaucoma. Comprehensive management to confirm and treat the systemic abnormalities from dental and pediatric departments was important. Management in our department includes correction of refractive errors and lowering of IOP. Conclusion : Axenfeld Rieger Syndrome that manifest ocular and non-ocular need to investigated thoroughly. Multidisciplinary contribution of this case is necessary to maintain the ocular stabilization and prevent any harm from systemic abnormalities.
SUCESSFULL MANAGEMENT OF CHILDHOOD BASIC-TYPE ESOTROPIA IN ADULT PATIENT: Poster Presentation - Case Report - Resident VITRIANA, ANISA; M., Feti Karfiati; Caesarya, Sesy; Amiruddin, Primawita O.; Kuntorini, Mayasari Wahyu; Irfani, Irawati
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/b62wcv21

Abstract

Introduction : Strabismus in adults may indicate other pathological causes, such as neurological disorders or trauma. Diagnosis of esotropia in adult patients has to be made carefully to determine the right treatment. Management’s goal of strabismus in adult patients is mainly cosmetic by diminishing deviation. Case Illustration : A 46-year-old woman, complaint of inward deviation of both eyes since childhood. There were no complaints of double vision, headaches, nor trauma history. Visual acuity of right eye was 0.4 with BCVA and left eye was 0.8 with BCVA 0.8. Hirschberg test was 45o (Figure 2A). Prism cover test was 75 PD base out in near and distance. Patient was diagnosed with basic-type esotropia. The patient already given spectacles but the deviation persisted so she underwent bilateral medial rectus recess surgery (Figure 2B). Ocular alignment without spectacles 1 week after surgery showed orthotropia and small esophoria. (Figure 2C). Discussion : Each esotropia types has a different treatment approach. Basic-type esotropia with large deviation usually needs surgical treatment. Management of childhood onset strabismus in adult patients is challenging because those patients have lesser ability to maintain fusion. Older patients and large deviation are poor prognostic factors to achieve good functional and cosmetics outcome after strabismus surgery. Conclusion : Establishing a definite diagnosis in adult strabismus patients, including esotropia, is challenging. Careful diagnosis and management decision will determine the outcome of the patient’s condition.
A GOOD RESULT IN COMBINATION OF LARGE SUPERIOR RECTUS RECESSION AND PRISMATIC GLASSES IN UNILATERAL DISSOCIATION VERTICAL DEVIATION: A CASE REPORT: Poster Presentation - Case Report - Resident Nur Fitriana Corprianti Marchilia; Prastyani, Reni
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/wgjfj090

Abstract

Introduction : Severe DVD is one of the indications for surgery. There are guidelines recommended for management based on grading of severity and the surgeon’s preference. Large recession of superior rectus muscle and prismatic glasses yield good result in unilateral DVD reported in this paper. Case Illustration : A 21 year-old student stated difficulty in working with his microscope since 2 years ago. He had a history of double vision since childhood. The visual acuity in both eyes were 5/5. Qualitative strabismus examination resulted in hypertropia RE and intermittent exotropia. When the occluder was removed from RE, a non fixating eye would appear elevated and did not correspond with the contralateral eye hypotropia. Krimsky test revealed RE hypertropia 30? PD, exotropia 10? PD. Sensory evaluation using WFDT was normal in near and crossed diplopia in distance. Patient diagnosed with unilateral DVD then underwent superior rectus recession in 10 mm. The following month, patient was still experiencing vertical diplopia. The patient was given 3 PD prismatic glasses. Consequently, diplopia was absent and stereoacuity test using TNO was 480 seconds of arch Discussion : DVD can’t be fully corrected by surgery due to central cortical innervational problem. The residual symptom can be corrected by conservative management. Large SR recession in combination with prismatic glasses was found to improve vertical deviation and reduce diplopia. Conclusion : While large superior rectus recession can significantly improve vertical deviation, it can not completely remove binocular symptom
Virna Glaucoma Drainage Device Implantation On Pediatric Patient With Steroid Induced Glaucoma: Poster Presentation - Case Report - Resident CHRISTIAN ANDREW DARIAN SIANIPAR; 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/y1dyxh57

Abstract

Introduction : Steroid-induced Glaucoma (SIG) in pediatric patient is reported to have a more progressive and severe manifestations often unresponsive to glaucoma filtration surgery. We aim to report a successful management of SIG using Virna implant on pediatric patient. Case Illustration : A 10 years old boy underwent bilateral Virna GDD implantation following uncontrollable IOP after multiple trabeculectomies. The patient presented with a UCVA of 4/60 on both eyes. IOP of RE and LE is 31.8 mmHg and 29.7 mmHg respectively with four anti-glaucoma medications. Both eyes revealed conjunctival hyperemia with no bleb formation, VH3 AC, 12 o’clock iridectomy, C/D ratio of 0.9 with bayonet sign and nasalization on indirect funduscope, open angle on gonioscope, annular scotoma on Humphrey, and diffuse thinning of RNFL on OCT. Six months postoperatively, BCVA of RE and LE is 6/60 and 6/30 respectively with minimal progression on both ocular visual field defects. As for IOP, RE IOP is 18.7 mmHg with two anti-glaucoma medications and LE IOP is 14.3 mmHg without anti-glaucoma medications. Discussion : Multiple failed trabeculectomies is an indication for GDD. Virna implants are meant for adult subsequently making plate and tube placement crucial in pediatric patient because the globe is still growing and relatively thin. It is necessary to evaluate IOP periodically after implantation as IOP will enter hypertensive phase and stabilize in 3-6 months. Conclusion : GDD implantation, including Virna Implant, is a viable alternative to children with refractory SIG to prevent further glaucomatous damage.
Hemi-Jensen Procedure as Heavy Eye Syndrome Treatment: A Case Series: Poster Presentation - Case Series - Resident Farhani, Harlin; Julita
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/ye8c6848

Abstract

Introduction : Heavy eye syndrome is an acquired myopia-associated strabismus characterized by esotropia and hypotropia accompanied by abduction and elevation limitations. This case series reports two heavy eye syndrome patients that underwent hemi-Jensen procedure combined with medial rectus recession with good postoperative result. Case Illustration : A 60-year-old female had right eye (RE) fixed inward and bilateral high myopia (S-13.00 D). RE Hirschberg test: >45° esotropia and hypotropia and RE axial length (AL) 28.3 mm. Second patient, a 53-year-old female, had both eyes fixed inward and bilateral high myopia (S-12.00 D). Both eyes Hirschberg test: >45° esotropia and hypotropia, left eye AL 31.4 mm, and prephthisis RE. Intraoperative identification of both patients revealed displacement of superior and lateral rectus muscles. No surgery performed on prephthisis eye. Hemi-Jensen procedure combined with medial rectus recession resulted in orthophoria (first patient) and central position in primary gaze (second patient), with improved ocular motility on both patients. Discussion : Heavy eye syndrome occurs in eyes with high myopia. The elongated globe in high myopia results in superotemporal herniation of the globe and superior and lateral rectus muscles displacement, which increases depression and adduction force. Hemi-Jensen procedure is a loop myopexy procedure which corrects the deviated muscle paths in heavy eye syndrome. Concurrent medial rectus recession can be performed with hemi-Jensen procedure if there is likely contracture of medial rectus. Conclusion : Heavy eye syndrome is a strabismus fixus condition which occurs in eyes with high myopia. Hemi- Jensen procedure is an effective treatment for heavy eye syndrome which improves ocular alignment and motility.
Differential Diagnosis of Leukocoria : A Case Report: Poster Presentation - Case Report - Resident Rahman, Harrie Kurnia; Sayuti, Kemala
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/tap89h21

Abstract

Introduction : Leukocoria is an abnormal pupillary reflex more clearly seen after mydriasis or photography. It is often the first sign of a range of serious intraocular disorders, including congenital cataracts, Coats disease, retinoblastoma, Familial Exudative Vitreoretinopathy (FEVR). Case Illustration : Baby F, 10 months with chief complaint the vision in both eyes appears defocused since birth. A history of trauma to the head is denied, severe pain (-), a history of similar complaints in the family is denied. Pregnancy history: Mother had hypertension. The patient born spontaneusly at 39-40 weeks of gestation, crying immediately, birth weight 2700 grams. Ophtalmology Status ODS: VA Blink reflex(+), Following light (+), Following object (-), Konjungtiva : hiperemis (-), cornea : clear (+), Pupil : leukocoria (+). Funduscopy examination ODS: Vitreus : cloudy (+), papillae: cannot be assessed, blood vessels: visible images of raised blood vessels, retina: detached (+) retinal layers seen, macula: cannot be assessed. USG ODS: cloudy vitreus with hyperreflectivity moderate to high. Patient was diagnosed with Leucocoria ec Retinal Detachment ec Suspect FEVR differential diagnosis Retinoblastoma Bilateral. CT Scan : A mass with a calcified component in the right and left posterior bulbs, consistent with bilateral retinoblastoma Discussion : The clinical history of leukocoria, meaning loss of the normal red retinal reflex, is nonspecific. Key findings here are the normal size of the globes and the presence of calcifications, which are more compatible with retinoblastoma, Coats' disease, or FEVR. Conclusion Leucocoria in aterm baby has several differential diagnosis such as retinoblastoma that needs further examination.
COMBINED PAPILLECTOMY AND AUTOLOGOUS CONJUNCTIVAL MEMBRANE GRAFT AS MANAGEMENT FOR SEVERE, REFRACTORY PALPEBRAL VERNAL KERATOCONJUNCTIVITIS: A CASE REPORT: Poster Presentation - Case Report - Ophthalmologist ANNISA, DEVINA NUR; SUHARKO, HERNAWITA; GAOL, HASIANA LUMBAN
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/sdpeag60

Abstract

Introduction : Vernal keratoconjunctivitis (VKC) is a type of allergic conjunctivitis which often occurs repeatedly and chronically. It is unusual compared to other types of conjunctivitis due to its giant papillae (GP) manifestation that may cause serious complication on cornea and eventually lead to permanent vision loss. We present a surgical treatment—resection of GP—in conjunction with autologous conjunctival membrane graft to manage a severe case of VKC. Case Illustration : An 18-year-old male came with a prior history of recurrent acute allergic keratoconjunctivitis since seven years before. His GP had caused shield-like ulcer, which leads to corneal scar and interferes with his visual acuity. He also had mechanical ptosis due to the giant cobblestones. His symptoms were then managed by performing combined papillectomy and autologous conjunctival membrane graft. Discussion : During surgery, the GP on both of his eyes were excised until tarsus was visible. Autologous conjunctival membrane was grafted from superior quadrant of each eye, and sutured tightly onto the excised tarsus. Six month postoperatively, his superior tarsal conjunctiva remain relatively smooth, with well-controlled symptoms of keratoconjunctivitis. Conclusion : Combined papillectomy and autologous conjunctival membrane graft can be considered as an adjunctive intervention to medications, in patients with severe, refractory cases of palpebral vernal conjunctivitis. It can alleviate symptoms and reduce the possibility of permanent damage on corneal tissue.
DIAGNOSING OCULAR MALINGERING IN CHILDREN WITH SIMPLE TEST: IS IT POSSIBLE? Poster Presentation - Case Report - Resident KEVIN ANGGAKUSUMA HENDRAWAN; NI MADE AYU SURASMIATI; I WAYAN EKA SUTYAWAN; ANAK AGUNG DEWI ADNYA SWARI; MADE KUSUMA WARDANI
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/c3exwd43

Abstract

Introduction : Malingering is a condition in children which need a thorough and meticulous examination to diagnose the condition. According to several publication, simple test can be done to diagnose this condition without necessarily performing imaging and electrophysiologic tests. Case Illustration : An 8-year-old male patient, came to eye clinic with sudden visual loss on both eyes for the last 3 days, following pain on both eyes and headache which fluctuating over the last 3 weeks. Patient insisted on wearing black glasses during examinations. Preliminary examination revealed visual acuity no light perception on both eyes. Slit lamp examination and pupillary reflex were normal, fundus examination revealed normal fundus. We tried to do surprise test by suddenly swaying hand towards patient’s eyes and record a visual response. Afterwards we asked patient’s parent to wait outside while performing LEA test which revealed visual acuity 6/6 on both eyes. Further history taking revealed that patient got bullied on school that makes him try to avoid attending school. Discussion : Patient with malingering usually come with decreased vision but seldomly come with blindness. Though it was quite challenging, doing some simple test available in daily practice such as surprise test can help us to diagnose the suspicion. Handling such patient needs a cautious analysis towards patient’s condition and gentle approach towards the patient. It is crucial to rule out organic condition before diagnosing patient with malingering. Conclusion : Simple test such as surprise test can be done in assisting malingering diagnosis when carefully done with the support of thorough history taking and physical
Different Retinopathy of Prematurity Severity, Onset Therapy and Outcomes in Triplet Babies: A Case Report: Poster Presentation - Case Report - Resident PUTU ANINDYA AGRASIDI; I WAYAN EKA SUTYAWAN; NI MADE AYU SURASMIATI
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: 10.35749/1de12078

Abstract

Introduction : Retinopathy of prematurity (ROP) is a vasoproliferative disease of the premature infants, characterized by abnormal vascularization at the junction of vascular and avascular retina. Intravitreal anti-VEGF injection is one of promising management of ROP. The aim is to present the therapy outcomes of triplet babies with different severity and onset therapy. Case Illustration : This case shows ROP in triplets born at 25-26 weeks gestational age. First baby, weighed 630 g with Bilateral Stage 2 Zone II Posterior with Plus Disease treated with intravitreal ranibizumab injection at 11 weeks (PMA 36-37 weeks). Second baby, weighed 620 g and get bilateral intravitreal ranibizumab injection a week after first baby, left eye got worse on first week, but getting better on the last follow up. Third Baby, weighed 750 g with bilateral Stage 3 Zone I with Plus Disease (worst eye condition), but because he had worst general condition, so the latest got screening, got no intervention. Two babies were treated with anti-VEGF therapy – bevacizumab. All babies has outcome regression, no recurrence of ROP in those short term end point, and no adverse reactions were observed until the last follow up at 27 weeks old (PMA 52-53 weeks) recorded for all babies. Discussion : Conclusion : Primary prevention through well-managed screening programme for premature infants was the more effective way to manage the ROP. Intravitreal anti-VEGF treatment could be promising for management of ROP if it was given on the right time and early stadium.

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