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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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Diagnostic Challenges in Retinoblastoma with Panophthalmitis-Like Manifestation: A Case Report Nugrahaputra, Rino; Barliana, Julie Dewi
Majalah Oftalmologi Indonesia Vol 51 No 1 (2025): Ophthalmologica Indonesiana
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/journal.v51i1.101655

Abstract

Purpose: To highlight the importance and challenges of diagnostic examination and modalities to diagnose retinoblastoma with varieties of manifestation such as panophthalmitis-like. Case Report: A 4-year-old boy presented with red and swollen right eye since two days prior to admission. The position of the right eye was hypotrophy with restricted eye movement towards all directions and there was a presence of proptosis with edema, spasm, hyperemia with yellowish crust. Ultrasonography result came with severe anterior-posterior vitreous haziness with calcified mass suggesting an intraocular tumor of the right eye. Orbital CT-scan was performed and suggestive of panophthalmitis with superior palpebra abscess of the right eye. The inflammation was proposed due to prior intraocular surgery of cataract extraction and trabeculectomy that led to progression and worsening of the retinoblastoma, such invasive surgery led to atypical presentation of panopthalmitis-like. Patient initial visit was due to symptoms of leukocoria and squinting, but even though ocular ultrasonography was performed, the patient had failed to be diagnosed with retinoblastoma. Patient had CT scan and was confirmed of an intraocular mass with calcification inside the right eye with some palpebral abscess. MRI was performed to confirm the extension of the mass, which fortunately did not extend outside the eye. The patient then underwent chemo reduction therapy, before finally got enucleation with dermatofat graft surgery. Histologic examination confirmed the diagnosis of retinoblastoma. This case was an example of how sometimes clinical misdiagnosis among retinoblastoma can happen which can be due to inadequate diagnostic examination or atypical presentation. Preventing clinical misdiagnosis of retinoblastoma can improve the treatment and likelihood of survival of patients with retinoblastoma. Conclusion: Clinical misdiagnosis of retinoblastoma can happen without adequate diagnostic tools and prowess which may result in mismanagement and/or delayed treatment leading to poorer prognosis of patient with retinoblastoma.
CORRELATION OF CENTRAL CORNEAL THICKNESS TO ACTUAL INTRAOCULAR PRESSURE IN MYOPIA PATIENTS Pandjaitan, Hadwer Wicaksono; Ariesti, Andrini
Majalah Oftalmologi Indonesia Vol 51 No 1 (2025): Ophthalmologica Indonesiana
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/journal.v51i1.101669

Abstract

Background : Central Corneal Thickness (CCT) is promote in the diagnosis and management of glaucoma, especially in myopic patients. Understanding the correlation between CCT and IOP (Intraocular Pressure) aids in glaucoma detection and control. The objective of this study is to determine the correlation between CCT and actual IOP in myopic patients. Methods : This research is an observational study with ethical committee approval, involving medical students from the Faculty of Medicine at Andalas University undergoing clinical clerkships at Dr. M Djamil Padang General Hospital. They were grouped into emmetropia, mild myopia, and moderate myopia. Data included visual acuity measurements, autorefraction, CCT measurements using OCT, and IOP with CCT correction. Samples with eye abnormalities, systemic conditions, myopia > 6D, a history of eye surgery, contact lens wear, and IOP > 21 mmHg were excluded. All data were analyzed statistically. Results : The study involved 78 eyes from 78 individuals, consisting of 26 eyes per group. The actual CCT and IOP values in mild myopia, moderate myopia and emmetropia are 506.31 ± 11,263 μm with 15.81 ± 1,234 mmHg, 533.96 ± 21,342 μm with 16.12 ± 1,336 mmHg, and 487.81 ± 28,272 μm with 15.35 ± 1.056 mmHg. There was a strong positive correlation between CCT and IOP (r=0.737, p=0.000), as well as a moderate negative correlation between CCT and actual IOP (r=-0.492, p=0.000). Conclusion : This research reveals a negative correlation between CCT and actual IOP in myopic patients, highlighting the importance of glaucoma screening for myopic patients due to their thinner corneas.
Outcomes of GDD Implantation in NVG Patients at Cipto Mangunkusumo Hospital: A 3-Year Study Sieman, Andrew John Widya; Oktariana, Virna Dwi
Majalah Oftalmologi Indonesia Vol 51 No 1 (2025): Ophthalmologica Indonesiana
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/journal.v51i1.101689

Abstract

Introduction: Neovascular glaucoma is a challenging type of glaucoma to manage, due to its progressive nature. Achieving good intraocular pressure (IOP) in neovascular glaucoma cases often requires the aid of filtering surgery, preferably with a glaucoma implant/drainage device. This study aims to evaluate the outcomes of glaucoma drainage device (GDD) implantation for neovascular glaucoma patients in Cipto Mangunkusumo Hospital.   Methods: A total of 77 eyes with neovascular glaucoma were included in this study, which underwent GDD implantation in Cipto Mangunkusumo Hospital between 2020 to 2022. Baseline data include age, gender, laterality, implant type used, underlying ocular condition, systemic comorbid, visual acuity (VA), IOP, and prescribed glaucoma medications. The postoperative VA and IOP were measured at 1 day, 1 week, 1 month, 3 months, 6 months, 1 year, and 18 months or above. Complications and additional surgical interventions were noted. Success criteria based on the IOP and amount of glaucoma medications were evaluated at least 6 months postoperatively.   Results: The mean IOP at baseline was 45.91 ± 13.9 mmHg with 3.42 ± 0.77 glaucoma medications. At 6 months postoperative, mean IOP was decreased to 13.84 ± 8.6 mmHg with 1.21 ± 1.18 glaucoma medications. At 6 months follow-up, 32.0% patients achieved complete success and 48.0% patients achieved qualified success. At 1 year postoperative, the Kaplan-Meier analysis for GDD success in neovascular glaucoma cases was estimated to be 79.2%.   Conclusion: GDD implantation is an effective surgical option in treating neovascular glaucoma cases.
Determining The Etiology of Uveitis in Indonesia: The Role of Clinical Manifestation and Serological Test in Infectious Uveitis Anissa, Gisela Haza; Rina La Distia Nora
Majalah Oftalmologi Indonesia Vol 51 No 1 (2025): Ophthalmologica Indonesiana
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/journal.v51i1.101692

Abstract

Introduction: Uveitis is a heterogeneous group of intraocular diseases that significantly causes vision disabilities in patients worldwide. Establishing an etiological diagnosis can be challenging because of the extensive and varied clinical patterns and differential diagnoses across regions. Knowledge of these patterns is crucial in aiding physicians with diagnosis, reducing the need for costly ancillary tests, and facilitating timely management.   Methods: We conducted a retrospective descriptive study using medical records data from a tertiary referral hospital in Indonesia over two years (2016-2017), involving 299 patients with uveitis.   Discussion: Among the 299 patients, 152 were men (152/299, 50.8%) with a median age of 36. Panuveitis was the most frequent anatomical entity (152/199, 53.2%). Infectious etiology, primarily toxoplasmosis and tuberculosis, remained prevalent. Despite various final diagnoses, serological tests for IgG Toxoplasma and CMV were predominantly reactive in 192/251 (76.5%) and 228/236 (96.6%) of tested patients. At presentation, 106/299 (35%) of patients were categorized as blind, and 64/106 (60%) were without improvement. Complications were observed in 167/299 (55%) of patients, including cataracts (133/299, 44%) and glaucoma (32/299, 10%), contributing to 70/106 (66%) of blindness in our series.   Conclusion: Panuveitis and infectious etiology, particularly toxoplasmosis and tuberculosis, were the most common causes of uveitis. Clinical patterns were better able to distinguish them than laboratory results. Understanding these uveitis patterns can guide physicians in diagnosing before performing expensive ancillary tests. Ocular complications were related to severe visual function; thus, timely referral in severe cases is essential.   Keywords: Uveitis, Indonesia, epidemiology
ISOLATED UNILATERAL PTOSIS DUE TO JUVENILE OCULAR MYASTHENIA GRAVIS, CASE REPORT Pramanto, Adji; Sutyawan, Eka
Majalah Oftalmologi Indonesia Vol 51 No 1 (2025): Ophthalmologica Indonesiana
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/journal.v51i1.101693

Abstract

Introduction: Ocular myasthenia gravis in children is an uncommon autoimmune condition impacting the neuromuscular junction. Typical manifestations include weakness in the levator palpebrae, orbicularis oculi, or extraocular muscles, leading to symptoms such as ptosis and binocular diplopia.   Case Report: a 5-year-old girl was brought in with the primary concern of her right eyelid drooping for the last 11 days. The weakness of the eyelid is more pronounced during daytime and nighttime but improves upon waking up in the morning. The patient did not experience difficulties in speaking, swallowing, or breathing. There was no extremity weakness. Ophthalmologic examination reveals orthophoric eye position without restriction of eye movement. The patient exhibited drooping of the right eyelid. Repetitive Nerve Stimulation (RNS) confirmed the presence of a lesion at the neuromuscular junction. Consequently, the diagnosis was made of myasthenia gravis causing the right eye ptosis. Seven months after beginning treatment with oral pyridostigmine, there was a noticeable improvement in the patient's condition during a follow-up examination.   Discussion: Juvenile ocular myasthenia gravis, can present with isolated unilateral ptosis. Diagnosis of mechanical/congenital ptosis, external ophthalmoplegia, and Horner syndrome has ptosis as a manifestation was ruled out.   Conclusion: The diagnosis and initial management of juvenile ocular myasthenia gravis play a crucial role in preventing disease progression. First-line therapy with oral pyridostigmine is safe and effective. The prognosis for ocular myasthenia gravis in prepubertal patients is generally favorable.
OCULAR GNATHOSTOMIASIS IN A FARMER FROM SOUTH SULAWESI, INDONESIA Trisnawaty, Dian; Umar, Batari Todja
Majalah Oftalmologi Indonesia Vol 51 No 1 (2025): Ophthalmologica Indonesiana
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/journal.v51i1.101699

Abstract

Introduction: Ocular Gnathostomiasis is a rare parasitic infection caused by the third-stage larvae of the spiruroid nematode. Gnathostome species are mostly seen in tropical and subtropical areas. It is a food-borne zoonosis caused by the consumption of raw or undercooked freshwater of fish, amphibians, reptiles, birds, and mammals, all of which are known to harbor the larval stages of Gnathostome species.   Case Report: A 37-year-old farmer complained of seeing moving objects in his left eye accompanied by blurred vision. At the previous visit, the patient had a history of red left eye with increased intraocular pressure, a visual acuity (VA) of 20/30 with the best corrected visual acuity (BCVA) of 20/20 and normal intraocular pressure. Slit lamp examination showed slight hyperemia of the conjunctiva and a live worm moving in the anterior chamber (AC). The worm was immediately removed using corneal clear incision and sent for parasitological examination.   Discussion: Ocular Gnathostomiasis by third-stage larvae of spiruroid nematode was found at the eye of a man from Siwa, South Sulawesi. Patients with complaints of recurrent redness of the eyes accompanied by increased intraocular pressure and a history of living in an area with a habit of eating raw freshwater fish should be considered the possibility of harboring helminth in the eye.   Conclusion: Patients with complaints of recurrent eye redness increased intraocular pressure, and a history of living in an area with a habit of eating raw freshwater fish should be considered the possibility of harboring helminth in the eye especially Gnathostome.
Scleral Buckling for Retinopathy of Prematurity: A Case Report Permanik, Gustiandari Fidhya; Barliana, Julie Dewi; Yudantha, Anggun Rama
Majalah Oftalmologi Indonesia Vol 51 No 1 (2025): Ophthalmologica Indonesiana
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/journal.v51i1.101725

Abstract

IntroductionThe selection of management for advanced retinopathy of prematurity (ROP) requires careful consideration. The purpose of this study is to report the effectiveness of scleral buckling in patient with retinopathy of prematurity stage 4B of both eyes within 3 months. Case Description A 4-month-old female baby came to the Pediatric Ophthalmology Unit in Cipto Mangunkusumo General Hospital (RSCM) Kirana with chief complain did not make eye contact of both eyes. Her eyes were moving on their own since she was 3.5 months old, and sometimes squint. The patient came to the pediatrician and was referred to pediatric ophthalmology for further treatment. There was a history of premature delivery at 30 weeks with oxygen therapy for 3 weeks. The Pediatric ophthalmology division performed ultrasonography and retcam, and the diagnosis of retinopathy of prematurity stage 4B of both eyes was made. Scleral buckling was performed in the right and left eyes at the postmenstrual age of 49 weeks, and 52 weeks respectively by vitreoretinal division. Conclusion The management of ROP depends on the type ROP. For advanced ROP, surgery is indicated. The scleral buckle is a treatment option for advanced retinopathy of prematurity patients with retinal detachment if it is assumed that intraocular surgery presents a greater risk. In short-term period, for the right eye, the scleral buckling is effective. Further time to follow up is needed to show the long-term period effectiveness of scleral buckling in patients with advanced ROP.
Treatment Strategies of an Iris Implantation Cyst: A Case Report Zarwan, Jessica; Maulidinia, Ayang Rashelda; Siregar, Astrid Mariam Khairani; Widyawati, Syska; Martha, Faraby; Rhendy, Rio
Majalah Oftalmologi Indonesia Vol 51 No 1 (2025): Ophthalmologica Indonesiana
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/journal.v51i1.101726

Abstract

Introduction: Iris cyst can be divided into primary and secondary, both originating from epithelial cells. Although rare, the entity has a high recurrence rate. This clinical case report highlights the treatment strategies to treat and prevent the recurrency of iris cyst. Case Report: We report a rare presentation of a secondary iris cyst in a 20-year-old male with a history of cataract surgery 17 years prior. The patient underwent fine-needle aspiration and intracystic alcohol injection. However, the iris cyst recurred eight months after the procedure. Afterward, the invasive strategy of iris cyst excision was conducted. Eight months after the secondary iris cyst surgery, the patient showed no signs of recurrence. Discussion: Iris cyst is known to have a high recurrence rate, however, a minimally invasive treatment is still preferred, supported by previous studies showing no recurrence in treatment with fine-needle aspiration and intracystic alcohol injection. In our case, the iris cyst relapsed eight months after this procedure, warranting for surgical excision. Eight months after the excision, the patient showed no signs of recurrence. Conclusion: Although the recurrency of iris cyst is high, the authors suggest starting with non-invasive treatment with follow-up ensuring no recurrence before opting for a more invasive treatment.
Development and Application of Targeted Multi-plex Polymerase Chain Reaction to Help Diagnose Infectious Uveitis Ethelind, Rachel; Rina La Distia Nora
Majalah Oftalmologi Indonesia Vol 51 No 1 (2025): Ophthalmologica Indonesiana
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/journal.v51i1.101730

Abstract

Introduction: Clinical pattern recognition is paramount in uveitis diagnosis. Pathogen detection from ocular fluid samples is often necessary to support infectious uveitis diagnosis, particularly in cases presenting with atypical clinical appearance. This study aims to present the process of developing targeted multiplex PCR and evaluate its application in infectious uveitis diagnosis.   Methods: This was a cross-sectional study to evaluate the diagnostic performance of targeted multiplex PCR in infectious uveitis. We obtained ocular fluid samples and reviewed medical records of uveitis patients who underwent ocular fluid analysis at Cipto Mangunkusumo Hospital from February 2022 to March 2023. PCR detection threshold values (DNA copies/mL) were 10.9 for Mycobacterium tuberculosis (Mtb), 672 for Epstein-Barr virus (EBV), 4.77 for Cytomegalovirus (CMV), 6.37 for Toxoplasma gondii (T. gondii), and 5.53 for Herpes simplex virus (HSV). With multiple pathogen selection, this method requires a lower volume of samples than single-plex PCR, as the latter will increase the sample volume linearly with each additional pathogen tested.   Discussion: Forty-seven aqueous or vitreous samples were analyzed. The positivity rate was 23.4% (11/47) with Mtb yielding the highest positivity (7/41; 17.1%). With final diagnosis as a reference, targeted multiplex PCR resulted in 32.3% (95% CI: 16.7 – 51.4%) sensitivity, 93.8% (95% CI: 69.8 – 99.8%) specificity, 90.9% (95% CI: 58.4 – 98.6%) positive predictive value, and 41.7% (95% CI: 35.2 – 48.4%) negative predictive value.   Conclusion: With its high specificity, targeted multiplex PCR is useful as a confirmatory but not screening tool in uveitis diagnosis. Ocular fluid analysis is an important part of the stepwise diagnostic approach in uveitis.
THE MULTIPLE OCULAR MANIFESTATIONS OF A NEGLECTED NEWLY DIAGNOSED MULTIBACILLARY LEPROSY WITH GRADE II DISABILITY Purnamasari, Suci; Sofia, Ovi
Majalah Oftalmologi Indonesia Vol 51 No 1 (2025): Ophthalmologica Indonesiana
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/journal.v51i1.101770

Abstract

Introduction: Leprosy is a chronic granulomatous infection cause by Mycobacterium leprae that could involving the eye with prevalence within 51,6% to 85%. Despite the high prevalence of leprosy and ocular manifestation, ophthalmologist consultation is not routinely performed, thus leads to unrecognized ocular complications. This case report aims to portrays the ocular manifestation of multibacillary leprosy with grade II disability. Case report: A 71-year-old woman presented with severe corneal ulcer with perforation leading to the iris-lens prolapse resulted in total blindness of the left eye; peripheral ulcerative keratitis and neurotropic ulcer of the right eye; lagophthalmos, corneal hypoesthesia, and madarosis of both eye. The Dermatovenereology Department consultation revealed claw hand, ulnar nerve thickening on both upper extremity, and hypoesthesia on both upper and lower limb. The acid fast bacteria were identified from auricula skin scraping specimens with +3 bacterial index (BI) and 75% morphological index (MI). The patient was diagnosed with LE severe corneal ulcer with iris-lens prolapse, RE peripheral ulcerative keratitis (PUK) and neurotropic ulcer, RLE lagophthalmos, and multibacillary leprosy with grade II disability newly diagnosed. Left eye evisceration was performed after initiated the multidrug therapy (MDT) regiment. Conclusion: The ocular manifestation found in this case are corneal hypoesthesia, madarosis, corneal ulcer with perforation, iris-lens prolapse, peripheral ulcerative keratitis, and neurotropic ulcer. The management is directed to pathogen eradication and specific management on ocular manifestation. The collaboration with Dermatovenereology Department is required for comprehensive screening and management.

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