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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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Improving Low Vision through Bioptic Telescope: A Case Series: Poster Presentation - Case Series - Ophthalmologist ADISTI LUKMAN
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/p7102r88

Abstract

Introduction : Low vision (LV) is a condition when a person have binocular visual acuity of less than 6/18 to light perception, or a visual field of less than 10 degrees from the point of fixation, even after treatment and/or standard refractive correction. In Indonesia, it is known that the number of LV patients is around 4.8% of all blindness. Bioptics telescope is handsfree magnifying lenses, attached to the spectacles, used to enhance moderate to distant vision for patients with severely damaged eyesight. However, the use of this device is still uncommon in Indonesia. Case Illustration : Bioptic Telescope prescribed to 3 patients, adaptation time were less than 48 hours. The 1st patient, 11 years old male with chorioretinitis toxoplasmosis, initial visual acuity (VA) 6/60 both eyes improved to 6/18 both eyes, and able to write/type 30 words per minutes. The 2nd patient, 18 years old male with Familial Exudative Vitreoretinopathy, initial VA 1/60 Right Eye (RE) & 1/300 Left Eye (LE) improved to 6/18 RE, and able to write/type 10 words per 2 minutes. The 3rd patient, 25 years old female with congenital visual impairment, initial VA NLP RE & 6/60 LE improved to 6/24 LE, and able to write/type 20 words per minute. Discussion : Conclusion : This study reports the initial experience with bioptic telescope in low vision patients. This device proven to significantly increase visual acuity with short adaptation time and learning curve to watch, read, write, and type. The ability to escalate patient's quality of life makes bioptic telescope superior from other (hand-held) telescope
PANUVEITIS AS A MANIFESTATION OF OCULAR SYPHILIS IN PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS : A CASE SERIES: Poster Presentation - Case Series - Resident SITI AISYAH; Angga Fajriansyah; Susi Heryati; Arief Akhdestira Mustaram; Patrioka Muslima; Elfa Ali Idrus
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/m73f9e22

Abstract

Introduction : Syphilis is a sexually transmitted disease caused by the spirochete bacterium Treponema pallidum. Syphilis can result in multiple organ involvement, including the eyes, and demonstrates various clinical findings. Ocular syphilis is an important cause of uveitis in the new era of co-infection with the human immunodeficiency virus (HIV). Case Illustration : Case 1: A 29-year-old male HIV-positive with 5 months of blurred vision, pain, and redness in left eye (LE) with skin rashes on the palms and foots (Figure 1). The visual acuity was 1/300 in LE, anterior segment showed flare cell (Figure 2). Fundus examination (Figure 3) revealed multiple exudative lesion of right eye (RE) and vitreus opacity of LE due to inflammation. VDRL and TPHA tests were positive. Case 2: 38-year-old male, HIV-positive and tuberculosis-positive, with 2 months of blurred vision,pain and redness in both eyes with skin rashes on the palms and foots (Figure 1). The visual acuity of the RE was 1/60 and 1,5/60 in the LE on the initial visit. Anterior segment eye examination revealed flare and cell (Figure 2). Fundus examination revealed (Figure 3) preretinal hemorrhage and exudate of both eyes. VDRL and TPHA testing were positive, CD4 count showed severe immunodeficiency. Discussion : This study depicts clinical features and outcomes of two cases of ocular syphilis with HIV co- infection. Poor visual outcome was associated with posterior segment-involving uveitis at presentation. Conclusion : An accurate diagnosis is crucial, treatment is adjusted according to the clinical stage. Comprehensive education is needed for patients and their families.
Initial Outcome of Subconjunctival Bevacizumab for Corneal Neovascularization - a Case Series: Poster Presentation - Case Series - Resident DEZCA NINDITA; Anang Tribowo; Petty Purwanita
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: 10.35749/6rgqwz73

Abstract

Introduction : Corneal neovascularization (CNV) has a variety of causes and threatens corneal clarity, thus optimal visual acuity. Conventional medical management includes topical steroids and matrix metalloproteinase inhibitors like doxycycline. Anti-vascular endothelial growth factor (anti-VEGF) agents have demonstrated promise but remain off-label for this indication. Case Illustration : We present three patients with corneal neovascularization varied in etiology who underwent subconjunctival injection of Bevacizumab . Case 1: a-female-69 years old came with blurred vision after had Stephen Johnson Syndrome which affect her cornea. The examination revealed opacification of cornea accompanied by neovascularization at 5 until 9 o’clock position up to edge of pupil in the left. Case 2: a-male-47 years old presented corneal haze with neovascularization almostin all corneal region on background of fungal keratitis. Case 3: a-male-63 years old who underwent penetrating keratoplasty of indication corneal lekoma following an episode of fungal keratitis. There was opacity in all corneal region and neovascularization in 360 degree of limbus. All of these patients showed regression of neovessel after first injection of bevacizumab. Discussion : Corneal neovascularization is a condition caused by disruption homeostasis in which proangiogenic balanced by antiangiogenic, thereby maintaining avascularity. Bevacizumab as VEGF-A-binding proteins could prevent VEGF-A from binding cell surface receptors. Conclusion : Subconjunctival injection of Bevacizumab can be considered as a treatment for corneal neovascularization. It has shown promising effects in recess neovascularization in cornea regardlessthe etiology.
Combination of Superficial Keratectomy, Ethylenediaminetetraacetic (EDTA), and Amniotic Membrane Transplantation as A Treatment of Band keratopathy: A Case Report: Poster Presentation - Case Report - Resident Ilmah; Patriotika Muslima; Elfa Ali Idrus; Arief Akhdestira Mustaram; Angga Fajriansyah
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/ngsfpz46

Abstract

Introduction : Band keratopathy is a degeneration of the cornea characterized by the presence of opacity, which isa deposit of calcium hydroxyapatite. These calcium deposits can be removed in several ways, including using ethylenediaminetetraacetic (EDTA), superficial keratectomy, or phototherapy keratectomy. Case Illustration : A 29-year-old male patient came with complaints of blurry vision in the right eye since 2-3 years ago, accompanied by the middle part of both eyes looking white, especially the right eye, since 17 years ago. The examination revealed a band keratopathy in the nasal to temporal region with neovascularization in the right eye, and keratopathy bands in the nasal and temporal parts, as wellas a cloudy lens in the right eye (Figure 1). Patients received treatment that included a combination of superficial keratectomy, administration of EDTA, and amniotic membrane transplantation (Figure 2). After the procedure, the clarity of the cornea improves (Figure 3). The patient was scheduled to undergo cataract surgery on his right eye. Discussion : Band keratopathy is a degenerative condition of the cornea characterized by grayish-white hazy deposits in the superficial layers of the cornea, primarily affecting Bowman's layer. In the treatment of individuals with symptomatic band keratopathy, chelation with EDTA, superficial keratectomy, laser keratectomy for phototherapy, or combining current procedures are the most often utilized therapeutic approaches. Conclusion : The combination of surgical management in cases of band keratopathy is expected to remove deposits on the cornea, improve the ocular surface, and reduce recurrences.
Ocular Manifestation of Monkeypox: A Systematic Reviews: Poster Presentation - Systematic Review - General practitioner dr. Wilson Christianto Khudrati; Dr. Titiek Ernawati, dr., SpM; dr. Kevin Anggakusuma Hendrawan
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/mwzhfd65

Abstract

Introduction & Objectives : On July 23, 2022, the World Health Organization declared the monkeypox epidemic a global public health emergency. The majority of clinical studies on monkeypox have concentrated on its dermatological symptoms, but mounting data raises questions regarding its ocular side effects. Methods : Thirteen studies were found among the 541 distinct articles that were evaluated. Overall, ten studies were case reports, two studies of case series, and one observational cohort study. Ocular manifestations of monkeypox were vesicopapular lesions on the eyelid and conjunctiva, conjunctivitis, epiphora, photophobia, foreign body sensation, eye edema, vision changes, eye pain, itchy eyes, eye discharge, bilateral eye involvement, corneal involvement, keratitis, and subconjunctival nodules. Results : The most prevalent ocular symptoms of monkeypox were conjunctivitis, followed by eye pain and photophobia. It is still unknown whether the ocular involvement is due to self-inoculation or the systemic transmission of the virus during the early viral phase of the illness. Despite some theories involving the transit of monkeypox into the conjunctival secretions via the plasma compartment, this study also showed that conjunctival swab PCR is 100% positive, equal to skin lesion swabs. Conclusion : In conclusion, to the best of our knowledge, this is the first review with a larger sample and the newest study to report the ocular manifestations of monkeypox disease. The primary ocular symptoms were conjunctivitis, eye pain, and photophobia. In addition, it is advised that healthcare professionals, especially ophthalmologists, use eye protection goggles when close to patients.
Management Strategies of Ocular Alkaline Chemical Injury: Poster Presentation - Case Report - Resident Nadia Ayu Destianti; Patrioka Muslima; Elfa Ali Idrus; Arief Akhdestira; Angga Fajriansyah
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/nq0p9c02

Abstract

Introduction : Ocular chemical burns are true ophthalmic emergencies that can cause permanent corneal and intraocular damage leading to visual impairment or even blindness. When a case of chemical trauma occurs, immediate and appropriate management should be done. Case Illustration : A 24-year-old man came to Cicendo Eye Hospital with complaints of blurry eyes accompanied by burning and watery eyes after being doused with a bucket of cement mortar two weeks earlier. Ophthalmologic examination obtained visual acuity for the right eye 1/300 and left eye was 1/60. The anterior segment of both eyes showed corneal edema, conjunctivalization, persistent epithelial defects, limbal ischemia, and punctate epithelial erosion. There was an ulcer and thinning of the corneal layer in left eye. He was diagnosed with alkaline chemical injury Dua's classification grade VI on the right eye and grade V on the left eye (Figure 1). The patient then underwent a keratectomy, conjunctival resection, and amniotic membrane transplantation procedure. On the seventh day postoperatively, symptoms and clinical features improved with the visual acuity of both eyes improved to 1/60 (Figure 2). Discussion : Amniotic membrane graft was performed in late reparative phase which aims to preserve the surface of the corneal epithelium and prevent corneal perforation and inflammation. Conjunctival resection was performed to prevent neovascularization of the amniotic membrane. Conclusion : Management of ocular burn injury requires an immediate and comprehensive treatment to achieve good result. In this case successful treatment was achieved by improvement of visual acuity and no complication occured.
Ocular Syphilis in an Immunocompetent Young Man: Poster Presentation - Case Report - General practitioner Vincentius Handy Suria; Halida Wibawaty
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/e7np1h98

Abstract

Introduction : Syphilis is called the great imitator because its clinical presentations vary widely and overlap with many other etiologies. We present a case of ocular syphilis in an immunocompetent young man with negative HIV test and history of unprotected sexual activities. Case Illustration : A 27 year-old male initially presented to an outpatient Solo Eye Hospital with complain of blurred vision and sudden visual impairment in the right eye and acute onset left eye redness, pain, clear discharge. His right eye VA was counting finger and 0,2 in his left eye. The patient diagnosed with acute posterior uveitis in the RE and acute iridocyclitis in the LE. A detailed sexual history, he endorsed having unprotected sex with numerous men in the past. Patient was subsequently started on P-Pred ED/2 hourly, atropine ED and testing to evaluate cause of iridocyclitis was sent. Fundus RE : clouded fundus view, vascular occlusion, vitreous opacification. Fundus LE : within normal limit. Rheumatoid factor negative, HIV antigen antibody screen non-reactive, syphilis IgG reactive, RPR screen reactive, RPR quantitative titer 1:128. ANA screen negative. The patient was started on intravenous penicillin G, and both his genital lesion and bilateral visual acuity improved. He was discharged to complete 14 fays of iv penicillin G. Discussion : HIV-positive patients may often present with ocular syphilis before the HIV status is known. Ocular syphilis is considered to be neurosyphilis for treatment purposes. Conclusion : Ocular syphilis should be kept in the differential diagnosis in immunocompetent/HIV negative patient, and the importance of obtaining a detailed sexual history should not be forgotten.
Diagnosis of Ocular Toxocariasis: a case report: Poster Presentation - Case Report - Resident Irene Carolin Mulyadi; Ivonne Ramenusa; Josef Sem Berth Tuda; Melissa Ratag
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/f2b7xw42

Abstract

Introduction : Ocular toxocariasis (OT) is an eye parasitosis due to incidental ingestion of Toxocara cati or canis larvae. Although mostly affects young children, it can also occur in older individuals. It is usually uniocular with various presentations. Case Illustration : A 69-year-old woman came with a chief complaint of deteriorating vision and pain in her left eye (LE)2 weeks prior to the visit, accompanied by floaters, redness, itchiness, and glare. She had a contact history with neighborhood dogs. Her best corrected visual acuity (VA) was 6/12 in the right eye (RE) and 3/60 in the LE. The intraocular pressure of LE was 27mmHg. Examinations of the LE found corneal edema, keratic precipitates, worm-like foreign bodies that moved in the anterior chamber, lens and vitreous opacity, and obscured fundus. The ultrasound showed a membrane-like lesion and no vitreomacular traction. The examination of the RE was unremarkable. We performed prompt foreign body extraction with local anesthesia and prescribed oral albendazole, topical and oral antibiotics, and steroids afterward. The investigation of the specimen revealed Toxocara larvae. There was no VA improvement after 1 month of close observation. Discussion : The OT diagnosis is based on clinical findings and a history of exposure to dogs or cats, soil, and consuming raw or undercooked meat. The gold standard for diagnosis is specimen biopsy. While no acceptable treatment regimen exists, the combination of anthelmintics and corticosteroids appears useful in some cases. Conclusion : Clinical presentation, parasitologic confirmation, and close contact with pets may be key elements to making the diagnosis.
Fuchs’ uveitis syndrome in dark-colored eyes: a case report: Poster Presentation - Case Report - Ophthalmologist RINA WULANDARI; FRISMA SAGARA BRILLIYANTO
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/bzdcnp65

Abstract

Introduction : The prevalence of Fuchs’ uveitis syndrome (FUS), or Fuchs’ heterochromic iridocyclitis, tends to be higher in light colored-eyes population of developed countries, with iris heterochromia as one of the main features. That classic iris finding does not usually present in dark colored-eyes population like Indonesia, in such manner that FUS is often overlooked. Case Illustration : A 38-year-old male presented with decrease vision of right eye four months before admission. There was minimal anterior chamber reaction, dispersed non-pigmented stellate keratic precipitates (KP), moth-eaten iris, posterior subcapsular (PSC) cataract without posterior synechiae and grade 0.5 of vitreous cells. A diagnosis of FUS was made by presenting signs, then cataract surgery was safely performed, and vision significantly improved without exacerbation. Discussion : FUS is a typically mild unilateral uveitis, with iris heterochromia, cyclitis, and cataract without posterior synechiae as its classic findings. Otherwise, iris heterochromia is probably absent in dark- colored eyes, that iris may appear with nodules and or small diffuse atrophy called moth-eaten appearance. Misdiagnosis is mostly caused by holding that iris heterochromia should always be presented and inflammation should be limited in the anterior segment only. FUS responds poorly to steroid and mistreatment with it causes further complication. In addition, cataract surgery is considered safe in FUS. Conclusion : This case shows the importance of evaluating FUS’ atypical signs. Iris heterochromia is sometimes overvalued, and its absence often leads to misdiagnosis. Steroid treatment is controversial, moreover, cataract surgery is safe in this case.
Treatment of Corneal Perforation Using Periosteal Graft Technique With the Continuation of Penetrating Keratoplasty: Poster Presentation - Case Report - Resident ADRIAN PRATAMA; Petty Purwanita; Anang Tribowo
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/v54aqe08

Abstract

Introduction : Corneal perforation occurs due to various conditions and management are based on the underlying cause. Modalities to treat corneal leaks is dependent on the size of corneal defect and include tissue adhesive, conjunctival flap, grafts and transplants. Penetrating Keratoplasty (PK) is effective to treat large corneal defect and to improve visual acuity (VA), but unfortunately PK is usually delayed due to availability. Case Illustration : A 17-years-old teenager was diagnosed with corneal perforation on his left eye, VA at initial visit was 1/300, positive seidel test, and shallow anterior chamber. Patient immediately underwent periosteal graft with subsequent PK surgery one month later. First until eight days postoperatively, VA improved from 3/60 to 6/30. Ten days after PK, a mechanical trauma caused the transplant to be detached, and VA greatly decreased to 1/300. Patient underwent immediate repair surgery. First day after surgery, VA was light perception. Eight days later, VA increased to 1/60 with concurrent iris prolapse. Iris repair was done immediately and eight days later VA increased to 6/60. At day sixteen, the final VA is 6/30. Discussion : Periosteal graft was performed to maintain ocular integrity. After waiting for a month, PK was performed to improve vision. This combination therapy was successful proven by VA improvement from 1/300 to 6/30. Conclusion : Periosteal graft is necessary to maintain ocular integrity while waiting for availability of donor cornea. Penetrating keratoplasty is an appropriate procedure for patients with large corneal leaks. It replaces all corneal structures, and it also improve visual function.

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