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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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Combination Therapy of Amniotic Membrane Transplantation with Conjunctival Peritomy and Autologous Serum for Mooren's Ulcer: A Case Report: Poster Presentation - Case Report - Resident AUFAA SHAFIRA WIDOWATI; Suhardjo Pawiroranu; Reny Setyowati
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/qqmsja41

Abstract

Introduction : A case report of a patient with Mooren’s ulcer who received partial amniotic membrane transplantation and autologous serum eye drops. Case Illustration : A 44-year-old male patient presented with chief complaint of blurred vision, pain in left eye, and history of eye trauma 6 months prior. Empirical topical antibiotics didn’t improve his condition. VA of left eye was hand movement with good colour/light perception. We diagnosed the patient with marginal ulcer. Partial amniotic membrane transplantation with conjunctival peritomy was planned for this patient along with fortified antibiotic eye drops. Autologous serum eye drops were started at 2 weeks post-surgery. 2 months after surgery, his condition has significantly improved with visual acuity of 6/12 (Snellen), healed corneal defect, and subjective relief of symptoms. Discussion : Mooren’s ulcer is a severe ulcerative inflammation of the cornea with unclear exact pathogenesis. Many therapies of Mooren’s ulcer are recommended in literatures, including surgical and non- surgical treatment. It was reported that amniotic membrane transplantation and conjunctival peritomy may be chosen as alternative surgical procedure for Mooren’s ulcer, as peritomy displaces the source of inflammation away from the cornea and amniotic membrane helps in corneal reepithelialization. Autologous serum is considered as an effective adjuvant therapy for ocular surface diseases such as dry eye disease, cicatricial pemphigoid, Steven-Johnson syndrome, and Mooren’s ulcer—thus the decision to include the therapy in our regiment. Conclusion : The combination of amniotic membrane transplantation, conjunctival peritomy, and autologous serum may help in the overall improvement of patients with Mooren’s ulcer.
EFFECT OF CORTICOSTEROID ON OCULAR TUBERCULOSIS: A SYSTEMATIC REVIEW: Poster Presentation - Observational Study - General practitioner Rahmah Amran; dr. Dicky Stevano Zukhri, Sp.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/mkg0s959

Abstract

Introduction & Objectives : There are still some disagreements between experts regarding the use of corticosteroids as an adjunctive treatment for ocular tuberculosis. Even though corticosteroid is important for controlling the inflammation to reduce further damage to the eye, some evidence claim that corticosteroid may interfere with ATT and causes more damage. This study aims to summarize and assess the role of corticosteroids on ocular tuberculosis. Methods : This study reviews papers from PubMed and Ophthalmologica Indonesiana database published in English or Indonesia between the years 2017 and 2022. The search terms used are a combination of treatment or therapy, corticosteroid, and ocular tuberculosis. Results : A total of 8 studies are included in this review with a total of 992 patients. Ocular TB can be further differentiated into anterior uveitis, intermediate uveitis, posterior uveitis, panuveitis, retinitis and retinal, vasculitis, neuroretinitis, and optic neuropathy. Corticosteroids are delivered through different routes depending on the site and severity of the inflammation. Generally, patients treated with ATT and corticosteroids have a positive response but improper timing, dosage, or route may actually worsen the infection and inflammation. Conclusion : Corticosteroids are needed as adjunctive treatment to control the inflammation from further damaging the eye. However, further studies regarding the specificity of the usage should be done as there are still limited studies about the factors affecting the outcome
PEDIATRIC BLEPHAROKERATOCONJUNCTIVITIS WITH DESCEMETOCELE AND CORNEAL NEOVASCULARIZATION : A CASE REPORT: Poster Presentation - Case Report - Resident Fadia Ghaisani; Ismi Zuhria
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/pcfv7b13

Abstract

Introduction : Blepharokeratoconjunctivitis is a chronic and recurrent inflammatory eyelid disorder that is commonly associated with secondary conjunctival and corneal involvement that is frequently underdiagnosed in children. The objective is to report a descemetocele and corneal neovascularization as severe complications of blepharokeratoconjunctivitis in children. Case Illustration : A five years old girl complained blackish lump in the right eye since a month ago. She also had a whitish spot in her eye since a year ago with redness, glare and watery. Three years ago she had a lump in the right eyelid and eye redness intermittently that was getting better with eye drop and history of allergy of house dust mites. Visual acuity (VA) in right eye was hand movement. Anterior segment of the right eye showed telangiectasis of palpebra, hyperemic conjunctiva, with neovascularization of entire surface of the cornea, descemetocele, leucoma and corneal thinning around descemetocele. We injected subconjunctival anti-vascular endothelial growth factor (VEGF) injection then we performed amniotic membrane transplantation. Follow-up 2 months post surgery we found VA was 2 m counting finger and the corneal neovascularization was reduced. Discussion : This case represents severe blepharokeratoconjunctivitis can cause some complications, from this patient we found corneal neovascularization and descemetocele. Anti-VEGF injection was to inhibit new blood formation in the patient’s cornea and the amniotic membrane transplantation was to manage the descemetocele. Conclusion : Pediatric blepharokeratoconjunctivitis and the complications associated with its treatment can be sight threatening. Early recognition of this disease entity and adequate management may arrest the disease process and may minimize visual morbidity.
AMNIOTIC MEMBRANE TRANSPLANT AS ADJUVANT THERAPY FOR SEVERE INFECTIOUS CORNEAL ULCER: Poster Presentation - Case Report - General practitioner Yulis Kristanto
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/jhjsva20

Abstract

Introduction : Infectious corneal ulcer may lead to visual impairment and contribute to five percent of blindness worldwide. Amniotic membrane transplant is one of adjuvant therapies listed to aid in the management of corneal ulcer. Case Illustration : There were two cases of severe corneal ulcer, both patients had exposure from vegetative matter. Case 1: A 40 years old male came with decreased VA in left eye (VA OS 1/300) and VAS 4, corneal epithelial stromal defect measuring 3x5 mm with 2 mm hypopyon. After three days of inpatient management, AMT procedure was done followed by temporary tarsorrhaphy. On 14th day of observation, tarsorrhaphy was removed, VAS was decreased to 0 and hypopyon resolved. On 28th day, corneal leukoma was observed with visual acuity improved (VA OS 1/60). Case 2: A 63 years old female came with decreased visual acuity (VA OD 1/300), followed by VAS 4, epithelial stromal defect measuring 7.3x5.4 mm, and 1 mm hypopyon. AMT procedure was done in fourth day of hospitalization. On seventh day, VAS was reduced to 1-2. On 14th day, tarsorrhaphy was removed, corneal leukoma was observed and on 28th day of observation, visual acuity was improved (VA OD 6/21). Discussion : AMT may induce faster regeneration of wound healing, as it halts inflammation, fibrosis, angiogenesis, and protease activities. AMT also increases the stromal thickness, as the membrane becomes incorporated into the stroma. By placing a temporary tarsorrhaphy, it may promote healing further into the corneal defects. Conclusion : AMT is effective in promoting epithelialization and preventing corneal perforations in corneal ulcers.
Tuberculosis-related episcleritis: a case report: Poster Presentation - Case Report - Ophthalmologist RINA WULANDARI; Erdina Hana Jelita
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/vd6a5r21

Abstract

Introduction : Tuberculosis (TB) is a leading cause of infectious disease in developing and highly endemic countries. Primarily affects the lungs, but also invariably involves ocular tissue. Association of TB and episcleritis is very rarely documented and no such case has been reported in Indonesia. Case Illustration : A 39-year-old female presented with unilateral mild pain and redness of right eye two weeks before admission. It was her fourth episode in one year. Previous steroid and non- steroidal anti- inflammatory drug (NSAID) treatment partially ended her symptoms before reappeared. Rheumatoid disease also TB history of her and her family were denied. There was nodular episcleritis in the inferior part of the right eye. Systemic investigation showed leukocyte and erythrocyte sedimentation rate (ESR) elevation, positive Mantoux test, with normal chest radiograph. Later symptoms and lesion resolved after anti tubercular therapy (ATT). Discussion : Episcleritis is mostly idiopathic, only one third of cases are found to be related with systemic condition. Association of tuberculosis with episcleritis is very rare, only a few cases have been reported worldwide. We encountered a case of tubercular episcleritis by the history of recurrent episode which not responding with regular medication, positive Mantoux test and Indonesia’s TB endemic status. Additionally, improvement after ATT also confirmed the diagnosis. Conclusion : This case suggests that TB can cause episcleritis, especially in TB endemic countries. TB should be considered in facing recurrent episcleritis cases to avoid unnecessary complications.
Autologous Fascia Lata Graft in Scleromalacia Perforans: A Rare Case: Poster Presentation - Case Report - Resident ANCI WINAS; 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/sbca0c12

Abstract

Introduction : Scleromalacia perforans, also called anterior necrotizing scleritis without inflammation, is a rare disease with an initial lesion of yellow or greyish nodules that gradually develop into scleral necrosis with perforation and exposure of uvea. It typically occurs in elderly women. Surgical therapy to close the defect may be performed with the sclera, dermis, fascia lata, periosteum, aortic tissue, cartilage, and eventually amniotic membrane as grafts. Case Illustration : A 59-year-old woman presented with complaint of greyish discoloration of the sclera on the right eye since one years ago. The patient denied the history of arthritis, autoimmune diseases, and other systemic diseases. The patient claimed to have had pterygium surgery ten years ago. Visual acuity was 6/9 with an of IOP 13.1 mmHg. Slit lamp examination revealed thinning of the medial sclera. Posterior segment was within normal limits. Serum antibody screening obtained normal results. The patient was diagnosed with scleromalacia perforans and underwent autologous fascia lata graft surgery. Two weeks postoperatively, scleral of the fascia lata graft gave good results. Discussion : Scleromalacia perforans is diagnosed based on anamnesis and ophthalmological examination. A history of pterygium surgery is suspected as the trigger for scleral thinning. Surgical therapy was performed to maintain the integrity of the eyeball and prevent further thinning of the sclera. Autologous fascia lata graft is chosen because it is readily available, easy to perform, and has a low rejection rate. Conclusion : Autologous fascia lata graft is a surgery that provides good prognosis in scleromalacia perforans.
Risk Factors of Corneal Donor Contamination and Post-Keratoplasty Infectious Complication: Poster Presentation - Observational Study - General practitioner Tania; Monica Matturungan; Lukman Edwar
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: 10.35749/2fjx9779

Abstract

Introduction & Objectives : Infectious keratitis and endophthalmitis are rare yet devastating complications of corneal transplantation. Some studies have demonstrated increased incidence of infectious post-keratoplasty complications are related to contaminated corneal donor, although its risk factors remain controversial. This study provides concise review on possible risk factors of corneal donor contamination which related to post-keratoplasty infectious complications. Methods : This literature review was conducted by searching PubMed and Proquest for “corneal donor contamination” AND (“infectious complication” OR infection OR endophthalmitis) from the period of 2018-2023. Relevant articles were reviewed and selected for further understanding regarding various risk factors of corneal donor contamination leading to post-keratoplasty infectious complications and its preventive strategies. Results : The rate of corneal contamination varied between studies, ranging from 1,3 to 7,8%. The most common risks of contamination are donor’s diseases (e.g. cardiovascular, cerebrovascular accident) and prolonged time between death and donor retrieval. Longer preservation time (>5 days), environmental situation (temperature and humidity), and prolonged treatment duration on intensive care unit (>4 days) are also considered as its risk factors. Corneoscleral rim culture, addition of antifungal and antibacterial to corneal storage medium, and shortening of corneal processing time should be considered as probable preventive strategies. Conclusion : Donor diseases, prolonged donor retrieval time from death, and longer donor preservation and hospitalization duration, are associated with higher rates of corneal donor contamination. Rapid retrieval and donor handling time, together with corneoscleral rims culture, at least for fungus regarding its better predictive values, should be taken into consideration by corneal donors providing eye banks.
Bilateral Ocular Leprosy An Effect By Erythema Nodusum Leprosum : A Case Report: Poster Presentation - Case Report - Resident PETER SALMON; Monica Camilla Chandra; Elbetty Agustina br.Simanjuntak,MD; Ivonne Ramenusa, MD
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: 10.35749/2bxzyr03

Abstract

Introduction : Leprosy or Hansen’s disease is an infection caused by Mycobacterium leprae that primarily affects the skin, the peripheral nerves and the eyes, causing chronic granulomatous inflammation. Case Illustration : We present a case of lepromatous leprosy with erythema nodosum leprosum of a 47 years old man with bilateral and asymmetrical ocular complications. One year ago patient consumed multidrug therapy for leprosy for one year but didn’t finish the medication. On the right eye diagnose with chronic anterior and intermediate uveitis, on the left eye with panuveitis. Best corrected visual acuity (BCVA) was 2/60 for right eye and light perception for left eye. Intraocular pressure were within normal limits. Madarosis and corneal hypoesthesia were found on both eyes. On the right eye was found cells, synechia anterior and posterior, iris pearls and vitreous haze. On the left eye was found plasmoid iridocyclitis and vitreous opacities from USG. Slit skin smear (SSS) result positif acid fast bacilli (AFB) dan granular. Patients were treated with multidrug therapy for leprosy, topical antibiotics, atropine and steroids, oral antibiotics and treatment from a dermatologist. Discussion : The diagnosis of lepromatous uveitis (LU) in this patient is made through skin tissue biopsy and ophthalmological examination. The effective management of ocular leprosy depends on early diagnosis and appropriate treatment. Hence it is imperative for ophthalmologist to recognize the ocular clinical signs associated with leprosy. Conclusion : Most blindness and impaired vision resulting from leprosy is preventable. A multidisciplinary approach is to be taken in order to improve the prognosis.
THE EFFECTIVENESS OF INTRAVITREAL ANTI-VEGF INJECTION IN EALES' DISEASE: A CASE REPORT: Poster Presentation - Case Report - General practitioner Khairani Azizah Ardityastiti; 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: 10.35749/8j6t8y23

Abstract

Introduction : Eales’ Disease (ED) is an idiopathic inflammatory retinal vasculitis, affecting retinal veins of small and large caliber that results in extraretinal neovascularization with vitreous hemorrhage. The etiopathogenesis of ED is poorly understood. However, many studies have attributed inflammation as a response to mycobacterium tuberculosis. Treatment of this disease can be done with corticosteroids, anti-VEGF therapy, laser photocoagulation, and vitreoretinal surgery. Case Illustration : We reported a patient, a 31-year-old woman with complaints of blurred vision and floaters in both eyes. An initial examination showed the visual acuity of the RE was 0,1F1 and the LE was 0,1. Examination of the posterior segment found perivascular exudate and peripheral retinal neovascularization. We performed an OCT examination on both eyes and found that there was extensive macular edema, especially in the RE. Patient was diagnosed with ED and received steroidsas an initial treatment. But there was no improvement in both eyes. In addition, patient received two anti-VEGF injections in the RE and one injection in the LE and showed good improvement. After that injection, the posterior segment showed very minimal lesions on the macula and repeated OCT results showed normal central macular thickness. Discussion : Anti-VEGF may also play a role in the treatment and management of ED. This is because, besides inflammation, there is an increased expression of VEGF in vitreous patients with ED. Several case reported there is significant improvement in anti-VEGF injection in the management of patients with ED. Conclusion : Intravitreal anti-VEGF injection shows good results in ED that did not improve with steroid treatment.
EARLY DIAGNOSIS AND TREATMENT OF VOGT-KOYANAGI-HARADA SYNDROME WITH OPTIC DISC SWELLING : A CASE REPORT: Poster Presentation - Case Report - Resident Zulkarnaen Husain; Batari Todja Umar; Hasnah Eka
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: 10.35749/1a8hsk92

Abstract

Introduction : Vogt-Koyanagi-Harada (VKH) syndrome is characterized as a multisystem autoimmune disease that affects the pigmented tissues of the eye, auditory system, skin, and central nervous system. Optic disc swelling is a common finding during the prodromal and acute uveitis stage and must be considered seriously. Case Illustration : A 41-year-old woman presented with blurred vision in both eyes in the last month, accompanied by headache, nausea, and vomiting. There is no history of penetrating ocular trauma or surgery. Examination findings for visual acuity were light perception, bilateral posterior synechia, optic disc swelling, and serous retinal detachment. A steroid injection was given due to swelling of the optic disc, and four months later, the visual acuity improved to 20/120 and 20/60, respectively, and optic disc swelling and serous retinal detachment decreased. Discussion : In the acute uveitic stage, VKH can be presented with bilateral optic disc edema and various degrees of serous retinal detachment. The key to the management of VKH is early diagnosis and systemic corticosteroid in the acute uveitis stage, otherwise, improper and inadequate treatment can lead to chronic recurrent VKH disease. Our patient presented with acute uveitis and was treated promptly and adequately. Conclusion : Optic disc swelling may occur in VKH and worsen the visual prognosis, early diagnosis and treatment of VKH syndrome focused on optic disc swelling can improve the visual prognosis.

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