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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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Non Metallic Anterior Chamber Foreign Body: A Case Report Afifah, Nabilah; Nina Handayani; Triana Budi Sulistya
Majalah Oftalmologi Indonesia Vol 51 No 2 (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.v51i2.101001

Abstract

Introduction: Intraocular foreign body (IOFB) is a serious form of open-globe injury that can cause a serious ocular trauma that lead to blindness (10–40% of all open eye injuries). This case report is aimed to report a challenging management of anterior chamber foreign body. Case Report: A 41 year-old man presented with discomfort on his right eye 4 days prior to visit. The slit lamp biomicroscopic examination revealed inferior anterior chamber foreign body (stone), measuring 5 x 2 mm and 5 mm scar at the area of a full thickness self-sealed corneal laceration. The corneal edema was localized hence it was possible to visualize the foreign body’s entire path through the cornea. The foreign body was removed with forceps from superior limbal incision. Post operative visual acuity was improved and the inflammation was decreased. Discussion: Management of such cases is not always easy because certain ACFB made of inert materials (stone, plastic, glass, and inert metals such as gold, silver, or platinum) excite minimal inflammation and may remain quiescent for a long period of time. An anterior IOFB is usually associated with a better final BCVA than a posterior IOFB. The self-sealing wounds were limited to the paracentral or peripheral cornea, resulting in no significant astigmatism. Conclusion: The risk of intraocular foreign body is associated with mechanism of injury and history taking must be accurate. Intraocular foreign bodies must have surgical removal to prevent of ocular inflammation and complication. Keywords: Anterior Chamber Foreign Bodies (ACFB), IOFB, Open Globe Injury, Penetrating Injury
Diffuse Granulomatous Conjunctivitis as an Ocular Manifestation of ANCA-Negative Limited Wegener’s Granulomatosis: A Case-Based Literature Review Hartono, Cindy; Pratiwi, Andi; Sungowati, Ni Ketut; Fikri, Bahrul; Eka, Hasnah
Majalah Oftalmologi Indonesia Vol 51 No 2 (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.v51i2.101588

Abstract

Introduction: Necrotizing granulomatous vasculitis, which is commonly known as Wegener's Granulomatosis (WG), frequently affects small to medium-sized blood vessels and is associated with anti-neutrophil cytoplasmic antibodies (ANCA). Despite ocular manifestations being prevalent in the disease, initial symptoms involving the eyelid and conjunctiva are infrequent. This study reports a case of an 11-year-old girl diagnosed with localized WG in the conjunctiva, with negative ANCA-test, and biopsy strongly suggested WG.   Case Report: An 11-year-old girl presented a red membrane covering the entire ocular surface and diminished vision in the left eye seven months before admission. At presentation, hand motion in the left eye was the best corrected visual acuity. There were granuloma formations in the palpebral and bulbar conjunctival, covering the entire ocular surface in the left eye. An incisional biopsy was performed in the conjunctiva, which revealed an ulcerative mucous membrane, prominent vasculitis, and necrotizing granulomas with giant cells and massive leukocyte infiltrate consistent with WG diagnosis.   Discussion: There is a need to consider the clinical manifestations suggesting the presence of vasculitis, ANCA determination, and histopathological evidence of the compromised organ to confirm the diagnosis. Overall, 82-94% of patients with WG were ANCA positive, leaving approximately 10% who tested negative, particularly those with limited WG. Moreover, a biopsy can confirm the diagnosis, specifically in ANCA-negative cases.   Conclusion: This case illustrated the consideration for WG diagnosis in limited form and negative ANCA-test. The clinical suspicion of WG and alternative diagnostic criteria using tissue biopsy might be helpful in such cases.
Secondary Glaucoma due to Mucopolysaccharodis: a Case Report Mulyadi, Irene Carolin; Franky Richard Kasih
Majalah Oftalmologi Indonesia Vol 51 No 2 (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.v51i2.101629

Abstract

Introduction: Mucopolysaccharidosis (MPS) is a rare, autosomal recessive inherited lysosomal storage disorder involved in glycosaminoglycans (GAG) degradation. Glaucoma, as a leading cause of irreversible blindness, in MPS patients has a very low occurrence rate, indicating that this condition needs attention and more research to improve MPS patients’ quality of life.   Case Report: A 15-year-old boy came with a chief complaint of progressive onset of blurred vision in both eyes 4 years prior to admission. He was being treated as hypermetropia since then. Opacity was noticed in both eyes in addition to deteriorating vision for the last 3 months. Genetic test supported the possibility of MPS type VI. Hence this patient was diagnosed as secondary glaucoma due to MPS. Glaucoma medications were unable to control the intraocular pressure, thus trabeculectomy was planned. After the surgery, the patient was given antibiotic, analgetic, steroid, and anti-glaucoma medications. Releasable suture was removed on the 14th day post-surgery due to elevated IOP. Unfortunately, the patient did not make any visit afterward for further follow-up.   Discussion: Our case faces several difficulties with anterior and posterior ophthalmological examinations. Corneal opacity with corneal thickening often occurs in MPS type  VI. The exact mechanisms underlying corneal opacities remain elusive. IOP measurements can be helpful for the diagnosis and monitoring of glaucoma. Changes in corneal thickness can affect IOP measurements, and corneal opacity can prevent accurate visualization of the optic nerve and cornea-sclera angle, as well as supportive diagnostic devices such as Funduscopy, Ultrasound Biomicroscopy (UBM), and Optical Coherence Tomography (OCT), are difficult to perform.   Conclusion: The underlying syndrome was suspected only after glaucoma occurred. Early detection and regular assessment play an important role in MPS. Routine follow-up is needed to ensure IOP control and determine the long-term outcome of IOP after trabeculectomy.     Keywords: Glaucoma, Mucopolysaccharidosis, trabeculectomy
Emerging Challenges of Acute Bilateral Diabetic Cataract in Pediatric: Insight to Early Detection and Management– A Case Report Valentina, Clara; Sutyawan, I Wayan Eka; Surasmiati, Ni Made Ayu; Kusumadjadja, I Made Agus; I Wayan Gede Jayanegara
Majalah Oftalmologi Indonesia Vol 51 No 2 (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.v51i2.101671

Abstract

Purpose: To report rare case of acute bilateral cataract in pediatric with Type 1 Diabetes Mellitus as ocular complication despite of good glycaemic controls and its management. Methods: A 17-year-old male patient complained of blurry vision and glare in both eyes(BE) since 3 months in newly diagnosed T1DM (HbA1c 10% --> now 6.3%). Visual Acuity (VA) was 6/45PH6/21f2, with correction S-1.50 advancing to 6/18 in BE. Slitlamp examination of BE revealed lens opacity (P3),central position, 3mm in diameter, retinometri 0.32. Posterior segment evaluation and intraocular pressure (IOP) were within normal limits. Right eye (RE) was underwent lensectomy and IOL insertion under GA. Results:  Postoperative RE with final VA of 6/18 PHNI and IOP of 43 mmHg. Patient was given antiinflammation eyedrops, oral and topical antiglaucoma, and received controlled final IOP of 8mmHg within 3 days and remain stable until now without antiglaucoma. Result was satisfying despite of uncomplicated secondary glaucoma as short-term complication that resolved with therapy. Evaluation and close monitoring postoperatively is needed and play significant role in visual outcome. Conclusions: Early detection for ocular complication in DM is needed as cataract genesis process still progressing despite of good glycaemic control. Ocular manifestation may present as early sign of undiagnosed T1DM or as its complications. Comprehensive and holistic multidicipline treatment, glycaemic control,  and routine evaluation is essential and play significant role in the success of metabolic cataract therapy and progression of microvascular complications due to DM. Lensectomy + IOL implantation still the mainstay therapy in pediatric cataract.  Awareness play vital role as it possibly cause decreased vision and or amblyopia, leading to blindness.  
Giant Intracranial Aneurysm Presenting as Temporal Hemianopia: When the Eyes Reveal a Hidden Danger Pertiwi, Annisa Nindiana; Nusanti, Syntia; Pintary, Marsha Rayfa; Dewiputri, Salmarezka; Ayuningtyas, Sita Paramita; Sidik, Muhammad
Majalah Oftalmologi Indonesia Vol 51 No 2 (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.v51i2.101687

Abstract

Introduction: Giant intracranial aneurysms (GIA) are rare and deadly diseases due to the high risk of rupture. The purpose of this report is to describe a case of GIA presenting as temporal hemianopia. Case Report: A 52-year-old male presented with worsening blurry vision three weeks before admission. Visual acuity was light perception in the right eye and 6/18 in the left eye. Neuro-ophthalmic examination revealed a relative afferent pupillary defect in the right eye and bilateral optic atrophy. At the next visit, the visual acuity of the right eye recovered to 6/18. Visual field testing showed temporal hemianopia in the left eye and generalized depression in the right eye. Magnetic resonance imaging demonstrated a 0,4 cm x 2,5 cm x 1,9 cm saccular aneurysm, on the medial side of the left internal carotid artery (ICA). Discussion: A giant (diameter ≥2.5 cm) ICA aneurysm may compress the optic chiasm, leading to various stages of visual loss. Several factors are known to delicate balance between thrombogenesis and thrombolysis within the aneurysmal sac. Spontaneous intra-saccular thrombosis in an unruptured GIA may be induced by calcification within the atherosclerotic wall of the aneurysm and loss of elastic lamina. It is prone to occur in a narrow aneurysm neck (<0.4 cm). Thrombosis reduces the size of the aneurysm sac, in which the accumulated fluid is reabsorbed. This may explain the decompression effect on optic chiasm and spontaneous visual recovery.   Conclusion: Intracranial aneurysms are a rare cause of optic chiasm compression but can still be considered in cases of temporal hemianopia.
Role of Optical Coherence Tomography Angiography (OCTA) in Anterior Ischemic Optic Neuropathy Gunawan, Calista Nathasya; Nusanti, Syntia
Majalah Oftalmologi Indonesia Vol 51 No 2 (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.v51i2.101688

Abstract

Introduction: Anterior ischemic optic neuropathy (AION) is the most common type of optic neuropathy with symptoms of sudden and painless visual field defect and vision loss. Although evaluating the nonperfusion areas of the vascular ischemia have traditionally been visualized through fluorescein angiography, OCTA has proven to be effective in noninvasively representing the retinal vascular network. This literature review aims to evaluate the quantitaive OCTA assessment of peripapillary vessel density (VD) changes in AION. Methods: Literature search was performed in four databases (PubMed, ScienceDirect, ProQuest, and Cochrane Library) from 2018 to 2022 to identify relevant articles. Five studies were included in this review. Results: All five studies on OCTA findings of NAION eyes reported a reduction in the vessel density of peripapillary capillary plexus when compared to either the healthy control eyes or the fellow unaffected eyes. OCTA reveals vascular changes in both forms, aiding prognosis and treatment. One study comparing NAION and AAION indicates reduced vessel density in NAION and AAION, with more severe abnormalities and reduction of vessel density in AAION. Conclusion: OCTA can visualize alterations in vascular density in both types of AION, AAION and NAION, with a notably more pronounced reduction in peripapillary vessel density observed in AAION. Keywords: anterior ischemic optic neuropathy, optical coherence tomography angiography, peripapillary vessel density
The Relationship Between Tumor Necrosis Factor-Alpha (TNF-α) with Retinal Nerve Fiber Layer (RNFL) Thickness in Diabetic Retinopathy Patients at Prof. CPL Universitas Sumatera Utara General Hospital and Affiliated Hospital Putra, Wahyu Medsa Yeltas; Delfi; Ashar, Taufik
Majalah Oftalmologi Indonesia Vol 51 No 2 (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.v51i2.101724

Abstract

Introduction: Retinal neurodegeneration may be an early indicator of diabetic retinopathy, the second most common complication after nephropathy. Tumor Necrosis Factor-Alpha (TNF-α) plays a role in the pathogenesis of inflammatory and neovascular eye disorders and is associated with intraocular inflammatory diseases like macular edema and proliferative diabetic retinopathy. This study aims to find the relationship between TNF-α levels and Retinal Nerve Fiber Layer (RNFL) thickness in diabetic retinopathy patients at Prof. CPL Universitas Sumatera Utara General Hospital and affiliated hospital.   Methods: This cross-sectional study included 45 patients with type 2 DM and diabetic retinopathy at Prof. CPL Universitas Sumatera Utara General Hospital and affiliated hospital from March to June 2024. RNFL and posterior segment examinations were conducted. TNF-α levels were measured from blood samples.Blood sugar data were taken from medical records.   Results: Of the 45 participants, 24 were men (53.3%) and 21 women (46.7%). 32 (71.1%) had DM for >5 years, and 27 (60%) experienced PDR. Highest location for RNFL thickness examination was superior (19, 42.2%). Average TNF-α with thin RNFL was 65.67 ng/L, and with thick RNFL was 64.78 ng/L. Mean TNF-α with thin superior RNFL was 65.74 ng/L, and thick was 63.70 ng/L. Mean TNF-α with thin inferior RNFL was 65.73 ng/L, and thick was 63.9 ng/L. Mean TNF-α with thin temporal RNFL was 68.73 ng/L, and thick was 67.19 ng/L. Mean TNF-α with thick nasal RNFL was 67.06 ng/L.   Conclusion: There was no statistically significant relationship between TNF-α and RNFL thickness in diabetic retinopathy patients.
Refractive and Visual Outcomes of Pediatric Cataract Surgery in Indonesian Tertiary Eye Center Memed, Feti Karfiati; Santosa, Rizki Adi; Irfani, Irawati; Caesarya, Sesy; Amiruddin, Primawita Oktarima; Kuntorini, Mayasari Wahyu
Majalah Oftalmologi Indonesia Vol 51 No 2 (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.v51i2.101763

Abstract

Introduction: Cataract remains as a leading cause of visual impairment in children. Surgical intervention and post-operative refractive correction remain fundamental. This study aims to describe the refractive and visual outcome of pediatric cataract surgery in a tertiary eye center in Indonesia.   Methods: This retrospective study was conducted utilizing medical records of all congenital and developmental cataracts patients undergoing cataract extraction procedures with or without primary IOL implantation between January and December 2022. Exclusion criteria included patients who did not undergo visual acuity and objective refraction examination 1-month post-cataract surgery and those with incomplete medical records data.   Results: A total of 118 eyes from 65 patients was included in this study. Most patients had bilateral cataracts (93.80%) and operated at the median age of 18 (0.96-212.64) months. Post-operatively, there were 71 (60.19%) aphakic and 47 (39.81%) pseudophakic patients with a respective refractive status of +18.00 (12.00 – 21.13) D and +0.60 (±2.37) D. Prediction error (PE) and absolute prediction error (APE) were obtained within 1.00 D. Most aphakic patients had unquantifiable visual acuity both before (91.50%) and after (83%) surgery. Among pseudophakic patients, nine (19.16%) had visual acuity of ≥ 6/12 and seven (14.89%) had visual acuity of <6/12 - 6/18 post-operatively. No patients had visual acuity ≥ 6/12 and <6/12 - 6/18 before surgery.   Conclusion: Post-operative refractive status of both aphakic and pseudophakic patients were well within correctable range. There was an improvement of vision after surgery. Limited visual potential may be attributed to the presence of amblyopia.
UNUSUAL CASE OF A METAL FOREIGN OBJECT IN ORBITOCRANIAL INJURY: UNLOCKING THE MACCARTY KEYHOLE Rahman, Fadiah Gazzani; Pratiwi, Andi; Halimah Pagarra; Suliati P. Amir
Majalah Oftalmologi Indonesia Vol 51 No 2 (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.v51i2.101859

Abstract

Introduction. Penetrating orbitocranial injuries are quite rare but very fatal if left untreated. Various metal objects have been reported as foreign bodies that have penetrated the orbit. However, unusual objects such as motorcycle locks have never been reported before. Case Illustration. A 14-year-old boy was brought to the emergency room with a motorcycle lock embedded in his left temporal region. Examination of the left eye showed decreased vision, clear serous ciliary secretions, conjunctival hyperemia, chemosis, and relative afferent pupillary defect. Investigations using a 3D Head MSCT Scan revealed the presence of a metal object that penetrates the left optic nerve, the rectus lateralis muscle, and the frontal process of the left zygoma bone in the left temporal region, which is located around the MacCarty keyhole. The operation in the form of exploration and foreign object removal was then carried out in collaboration with the neurosurgeon. No postoperative complications were reported, but the patient had restricted movement of the left eye. Discussion. Penetrating orbitocranial injury should be treated as an emergency. Diagnosis should include comprehensive ophthalmological and neurological examinations. CT Scan continues to be the best cranial imaging technique. In this case, the motorcycle lock penetration was around the MacCarty keyhole, a structure that is frequently used to enter both the orbit and the frontal fossa, which located 7 mm superior and 5 mm posterior to the frontozygomatic suture. An appropriate surgical strategy is mandatory for removing the object because it may lead to serious consequences, including cerebral, infectious, vascular complications, and even death. Conclusion. Metal foreign objects such as motorcycle lock was considered unusual, particulary when it unlock an important landmark such as MacCarty keyhole. This case emphasizes the significance of a surgical strategy based on accurate anatomical tracking.

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