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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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Augmented Surgical Treatment in Patient with Partially Accomodative Esotropia: Poster Presentation - Case Report - Resident PRADISTYA SYIFA YUDIASARI; Feti Karfiati; Mayasari Wahyu Kuntorini; Irawati Irfani; Primawita Oktarima; Sesu Caesarya
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: 10.35749/04zm5t36

Abstract

Introduction : Esotropia is a disorder of the position of the eyeball when the eye deviates inward. Surgical treatment is indicated when the eyes are not aligned with the glasses. We report a case of augmented surgical treatment in a partially accommodative esotropia patient. Case Illustration : A 18-year-old girl comes to the hospital with vision loss in both eyes since 1 year prior admission. Ocular alignment sinne correction was 300 (Figure 1) and cum correction was 150. Prism alternate cover test (PACT) showed deviation in sinne correction distance 60?BO dan near 50?BO, and deviation in cum correction distance 40?BO dan near 35?BO. Surgical formula with augmented surgery was (60?BO + 40?BO)/2 equal to 50?BO. Patient was diagnosed with Compositus Hypermetropia ODS + Partially Accommodative Esotropia. Patient underwent bilateral medial rectus recess surgery of 6 mm. Ophthalmology examination after 1 and 2.5 month surgery showed ocular alignment without spectacles showed microtropia and with spectacles showed orthotropia (Figure 2, 3a and 3b). Discussion : Various approaches can improve outcomes, including using different surgical formulas. Augmented surgery are the mean of deviation with and without surgery as the final deviation surgical formula. Conclusion : The amount of surgery in strabismus was based on the size of preoperative deviation. Augmented surgical treatment can be one of the choices to determine preoperative deviation in an esotropia patient.
BILATERAL SEROUS RETINAL DETACHMENT AS OCULAR MANIFESTATION IN ACUTE LYMPHOBLASTIC LEUKEMIA: A CASE REPORT: Poster Presentation - Case Report - General practitioner Anthea Casey; Dian Estu 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/tb4c3853

Abstract

Introduction : Acute lymphoblastic leukemia (ALL) is known to cause several ocular involvements. However, retinal detachment is a rare complication. This report aims to present unusual ocular manifestations in the form of bilateral serous retinal detachment in a pediatric patient. Case Illustration : An 11-year-old girl with a diagnosis of relapsed ALL and thrombocytopenia was referred to the Ophthalmology Department due to sudden blurred vision. The patient was undergoing chemotherapy on the third cycle due to the relapse. Visual acuity was 1/300 in both eyes. Fundus examination showed bilateral serous retinal detachment. No treatment in ophthalmology was given due to the unstable condition of this patient. Discussion : Up to 90% of all leukemia patients have fundus changes during the disease. The presence of unilateral or bilateral serous retinal detachment as a sign of choroidal infiltration may be one of the manifestations of acute leukemia, both as a primary sign and a relapse. Literature has shown that chemotherapy, radiation, and systemic prednisone would improve the visual acuity in these patients. However, in this case, when the patient is unstable and experiencing a series of complications, we decided that life-saving treatment comes first. Conclusion : The incidence of ocular involvements in ALL could be due to the treatment and the disease itself. Prompt recognition of disease led to early systemic treatment and restoration of visual function. The goal of sight-saving comes second after life-saving treatments.
Persistent Fetal Vasculature with Pediatric Cataract, Microcornea, Sensory Exotropia and Mental Retardation: A Case Report: Poster Presentation - Case Report - Resident MADE KUSUMA WARDANI; Dr. dr. Ni Made Ayu Surasmiati, M.Biomed, Sp.M(K); Dr. dr. I Wayan Eka Sutyawan, Sp.M(K); Kevin Anggakusuma Hendrawan; A. A. Dewi Adnya Swari
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/c208zx43

Abstract

Introduction : Persistent Fetal Vasculature (PFV) is a congenital, nonhereditary ocular malformation that frequently involves the lens. PFV is most frequently unilateral. The classical presentation is leukocoria, microphthalmia, and cataract. Case Illustration : A 16-year-old boy patient with mental retardation, came with chief complaint blurred vision and white appearance on the RE, noticed for 1 month ago. Visual acuity of the RE was LPBP and the LE was 6/120. There was microcornea on both eyes with diameter 8 mm. Lens opacity and exotropia with XT 30 0 on the RE. IOP on both eyes was normal. Funduscopic on the RE was negative and LE there was tigroid retina. Ultrasonography of the RE was echogenic with minimal after movement and low to moderate spikes. Planning for this patient were RE lens extraction with IOL. After that evaluate for the posterior segment. Discussion : Progressive cataract formation often occurs, sometimes leading to a complete cataract. Strabismus associated with a unilateral cataract. The most important was differentiating PFV from retinoblastoma. In patients with poor view of the fundus, ultrasonography should be performed. Retinal or optic nerve abnormalities cannot be definitively ruled out, however, until the posterior pole can be visualized directly. The opacity in the affected eye should be cleared to allow visual development and to save the eye from complications of untreated PFV. Conclusion : It is important to obtain a detailed history of the child’s growth, development, systemic disorders, family history, and need further comprehensive examination and multidiscipline consultation to establish the diagnose.
Intermittent Topical Bevacizumab for Treatment of Pediatric Corneal Neovascularization after Keratitis: Poster Presentation - Case Report - Ophthalmologist SRI NAWUNGHARTANTI; Vetty Rositawati
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: 10.35749/76arqq33

Abstract

Introduction : Corneal neovascularization imposes pediatric patients to risk of amblyopia. Current treatment of corneal neovascularization consists of topical steroids, nonsteroidal anti-inflammatory medications, immunomodulatory agents, anti-Vascular Endothelial Growth Factor (anti-VEGF) and few surgical procedures. Anti-VEGF shows promising results in treating corneal neovascularization but is difficultto obtain in developing countries such as Indonesia. We report intermittent topical use of Bevacizumab as antiVEGF in a child experiencing corneal neovascularization in the settings of limited antiVEGF availability. Case Illustration : A 5-year-old girl presented with corneal neovascularization after keratitis. Topical fluorometholone 4 times a day for 3 weeks was given with no clinical improvement. An intermittent topical Bevacizumab was started, each episode of treatment lasted 4 days. Corneal neovascularization regressed after 1 episode of treatment and thus continued until a total of 2 treatment episodes. She improved clinically on treatment, with some residual corneal scarring. Visual acuity improved from logMar 0.5 to logMar 0.2 following treatment. Discussion : Bevacizumab regresses corneal neovascularization by inhibiting proangiogenic factor VEGF which is upregulated in neovascularization. Topical Bevacizumab ability to penetrate cornea was contributed by defective corneal epithelial overlying neovascularization. Long-term use of antiVEGF may hinder VEGF beneficial role on wound recovery and trigger unwanted side effects. Conclusion : Intermittent short-term use of topical bevacizumab may be effective to treat corneal neovascularization during acute period in pediatric patient and is safely tolera
WHAT WE SHOULD DO FOR CROUZON SYNDROME ? Poster Presentation - Case Report - Resident RYAN AQUARI; Linda Trisna; Riani Erna
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/ts8b2590

Abstract

Introduction : Crouzon syndrome is a rare genetically disease characterized by craniosynostosis resulting in skull and facial deformities. Fortunately, not all patient requires surgery so we will review the workup of Crouzon syndrome and describes the collaboration of health professionals needed to manage this condition. Case Illustration : A 10 years old boy came to hospital with exophthalmos since birth. There is decreasing of visual acuity on RE caused by atrophy papil and leads to sensoric exotropia. There is also lagophthalmos 1 mm on the both eyes. Brain CT shown there are craniosynostosis and thickening of the rectus muscles. This patient also do a bone Survey with the result are asymmetrical calvarial thickening, cooper beaten skull, shallow orbits, depressed nasal bridge and hypoplasia maxilla. This case is managed by multidisciplinary to correct the maldevelopment of the midface and orbits to prevent blindness, airways obstruction and intellectual disability related. Discussion : The combination of detailed family history, the use of various imaging modalities and genetic testing help differentiate the spectrum of craniosynostosis syndromes. The management is complex and requires a team of subspecialists including pediatricians, oral maxillofacial surgeons, plastic surgeons, neurosurgeons, otorhinolaryngology, and ophthalmologists (pediatric and oculoplastics). Long-term follow up needed to monitor ocular development due to the propensity strabismic amblyopia and atrophy optic. Conclusion : An interprofessional team approach will provide the best outcomes and recognizing possible complications for crouzon syndrome.
Sympathetic Ophthalmia in Paediatric Post-Surgical Repair, A Case Report: Poster Presentation - Case Report - Resident Muhammad Akbar Wicaksana; Irawati Irfani; Mayasari Wahyu Kuntorini; Sesy Caesarya; Feti Karfiati; Amiruddin, Primawita O.
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/z5apmh49

Abstract

Introduction : Sympathetic Ophthalmia (SO) is a rare and devastating complication of ocular trauma. Incidence reached 0.26% among cohort in paediatric open globe injury. We present a case report of pediatric Sympathetic Ophthalmia. Case Illustration : An 8-year-old boy is present in an outpatient clinic with a history of corneal lacerating injury on LE 1 month ago and had surgical repair 7 days after the injury. The patient complained of redness and blurry vision in both eyes. VA RE 0.5 and LE 0.05. RE revealed ciliary injection, flare/cell (f/s) +2/+2, and vitreous cell +1. LE revealed ciliary injection, corneal scars, f/s +2/+2, and vitreous cell +2 (Fig. 1). Fundus and OCT revealed macular oedema with exudative retinal detachment RE and bilateral optic nerve head swelling (Fig. 2). Patient was diagnosed with sympathetic ophthalmia and treated with prednisolone acetate 8x per day for RLE with high-dose oral steroid methylprednisolone 1 mg/kg body weight (32 mg). One week after treatment, clinical findings were improved, and the steroid was tapered. After 2 months f/s, macular oedema, exudative retinal detachment and optic nerve head swelling were resolved with VA RE 1.0 and LE 0.4. Discussion : Although the etiology of SO is currently unknown, it is believed that hypersensitivity following trauma to the fellow eye may be the trigger. The severity of SO's clinical presentation might range from mild to severe. Conclusion : Sympathetic ophthalmia is a serious complication that rarely occurs after trauma, especially in the pediatric population. Prompt treatment of oral and topical corticosteroids may lower the inflammatory response.
An Alternative in Managing Duane Retraction Syndrome Type I Using Modified Nishida Procedure: A Case Report: Poster Presentation - Case Report - Resident Dearaini; Anna Puspitasari Bani
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/gj772668

Abstract

Introduction : Various surgical approaches have been proposed to address the challenge in managing abduction deficit in Duane Retraction Syndrome (DRS) Type I, with no clear guidelines to achieve optimal result. This report aims to describe the outcome of combining medial rectus (MR) recession and modified Nishida procedure to improve abduction in DRS Type I. Case Illustration : Twenty six year-old female came with inability to abduct her left eye (LE) since early childhood and an abnormal left head turn. No complaints of double vision nor visual impairment. There was -5 abduction on LE with a noticeable narrowing of vertical palpebral fissure during adduction. Prism alternate prism cover test shared a 30 PD esotropia with normal anterior and posterior segment. Patient was assessed with DRS Type I of LE and managed with 5mm MR recession combined with modified Nishida procedure (vertical rectus transposition without tenotomy and muscle splitting). On postoperative day 1 and last follow-up (1 year), the alignment was ortophoric, abduction improvement of -2, and diminished anomalous head posture. Discussion : Although studies have only reported successful cases of modified Nishida procedure in CN VI palsy, it can be assumed that the procedure can also be implemented to treat lateral rectus muscle innervation abnormality such as in DRS type I. Surgical intervention may not normalize abduction deficit. However, the procedure successfully corrects ocular alignment, eliminates anomalous head posture, and able to improve abduction with no complications. Conclusion : Modified Nishida procedure can be implemented as an alternative in managing DRS type I with relatively satisfactory result.
MANAGEMENT OF RECURRENT INTRAOCULAR LENS SUBLUXATION AFTER IOL REPOSITION IN APHAKIC PEDIATRIC PATIENT WITH SECONDARY GLAUCOMA AND DEPRIVATIVE AMBLYOPIA: Poster Presentation - Case Report - Resident INDRIYANI; Primawita O. Amiruddin; Sesy Caesarya; Irawati Irfani; Mayasari Wahyu Kuntorini; Feti Karfiati M
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: 10.35749/12mdey33

Abstract

Introduction : Malposition of the intraocular lens (IOL) can be in the form of decentration, subluxation, dislocation, or luxation. Conservative management and surgery are used to treat IOL subluxation. Case Illustration : A 14-year-old boy came to clinic with chief complaint of diplopia since 1 month ago. There were histories of cataract surgery of both eyes in 2014 and 2015 at a secondary hospital, secondary IOL implantation and membranectomy of right eye in December 2017, and IOL reposition of right eye in February 2022. Ophthalmologist examination revealed BCVA of right eye is 0.5 with S+10.00 C-2.25 x180 and left eye is 1/300. The right eye's intraocular pressure was 23 mmHg and the left eye's was 16 mmHg. Anterior segment examination of the right eye showed aphakia with subluxation of the IOL to the inferotemporal (Figure 1) and PC IOL of the left eye. Patient diagnosed with aphakia ODS with IOL subluxation OD, secondary glaucoma OD, astigmatisma Hypermetropia composite OD, astigmatism Myopia Compositus OS, Hypermetropia OD, Myopia Gravior OS, Deprivative Amblyopia ODS, and Last Eye OD. Patient given monofocal spectacles, prednisolone asetat eye drop tapering dose, and timolol maleate eye drop, with observation of IOL position Discussion : Recurrent IOL subluxation without clear signs of zonular or capsular instability in this patient was managed with conservative management using spectacles and medication due to secondary glaucoma. Long-term observation needed to evaluate possibility of repositioning or explanting the IOL in the future. Conclusion : Management of IOL subluxation could temporarily undergo conservative treatment. A surgical approach is considered in cases of recurrent dislocation
SUCCESSFUL DIFFERENT TREATMENT IN INTERMITTENT EXOTROPIA: CASE SERIES: Poster Presentation - Case Series - Resident NASIKA CELIA DENDY; Sesy Caesarya; Primawita O. Amiruddin; Mayasari Wahyu Kuntorini; Feti Karfiati
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/axxkqs12

Abstract

Introduction : In intermittent exotropia, management's goals are to diminish deviation by improving fusion control. Case Illustration : Case 1: A 19-year-old woman has complained of squinting and blurred vision since the age of 3 years. The visual acuity of both eyes (OU) was 0.05, with a BCVA of 0.63. Hirschberg's test was exotropia 15o . The exotropia after the cover test (Figure 1A) improved without blinking. The prism cover test was 35 D in near and distance. Patient was diagnosed with exotropia, an intermittent basic type with good control, astigmatism, and myopia compositus OU. Three months after, with refraction correction and occlusion, the Hirschberg test revealed orthotropia (Figure 1B). Case 2: A 7-year-old boy has suffered of squinting and blurred vision from the age of 6 years. The visual acuity of both eyes was 0.63 with a BCVA of 1.0. Hirschberg's test was exotropia 30° (Figure 2A). The prism cover test was 50 D in near and distance. Exotropia intermittent basic type, poor control, and bilateral astigmatism were diagnosed in the patients. The patient had surgery for bilateral lateral rectus recession. Hirschberg test 1 day Postoperatively, orthotropia was present (Figure 2B). Discussion : In exodeviation, control mechanisms relate to therapy compliance and different deviation angles. Intermittent exotropia can be progressive due to loss of fusion control and cause persistent deviation. Conclusion : For patients with exotropia with intermittent good control, non-surgical management can give good results. Surgical management is considered for large angle deviations in patients with poor control.
Ophthalmologic findings in Cornelia de Lange syndrome: Poster Presentation - Case Report - Resident Nizma Permaisuari; Dian Estu 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: 10.35749/6gjah961

Abstract

Introduction : Cornelia de Lange syndrome (CdLS) is a rare disease characterized by multisystem abnormalities, including various ophthalmologic problems. The purpose is to report this kind of rare case and highlight the role of ophthalmologist in visual development optimalization. Case Illustration : A 2-year-old boy with CdLS showing bilateral microcornea, cataracts with “dot opacities,” and chin lifts induced by ptosis. We also examined brow hypertrichosis, synophrys, and long arcuate eyelashes. High myopia and high astigmatism was found in the patient with spherical equivalent of 9.8 D. He was born with low birth weight, microcephaly, anteverted nostrils, depressed nasal bridge, thin upper lip, micrognathia, low posterior hairline, short neck, and syndactili. He also showed psychological lag and developmental impairment. Glasses was then prescribed to prevent amblyopia. Discussion : Individuals with CdLS may have multiple treatable ocular conditions. We recommend that patients have an initial ophthalmic examination after diagnosis of CdLS is first made, in order to establish a baseline and to assess for the presence of abnormalities that would benefit from early intervention. Examination under anesthesia may be required in some patients to adequately assess for any abnormalities, and to obtain a good refraction as well as an inspection of the retinal periphery in children with long axial length. Early intervention may greatly improve function and prevent vision loss due to amblyopia. Conclusion : Initial ophthalmic examination followed by routine annual screening is warranted when a diagnosis of CdLS is made, given that ocular anomalies are present in the majority of patients and may impact vision and daily functioning.

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