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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 887 Documents
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Visual Acuity and Contrast Sensitivity Association Among Hemodialysis Patients Muhammad Firmansjah; Togar Erkasan Sitorus; Wimbo Sasono; Sauli Ari Widjaja; Ima Yustiarini; Ady Dwi Prakosa; Widodo; Ria Sandy Deneska
Majalah Oftalmologi Indonesia Vol 52 No 2 (2026): 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/oi.v52i2.102038

Abstract

Introduction: This study aimed to assess the association between visual acuity (VA) and contrast sensitivity (CS) in patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD), stratified by diabetes mellitus (DM) status. Methods: A cross-sectional study with a total of 100 HD patients was enrolled. Based on their HbA1c levels, they were categorized as having DM or as normal. They received a thorough eye examination, and those with corneal disease, cataracts, and macular disease were excluded. Best-corrected VA (BCVA) was evaluated using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart, and CS was assessed using the MARS numeral CS chart. Fisher’s exact test was employed to compare VA and CS based on DM status. Results: We analyzed 100 patients (185 eyes), consisting of 51 (51%) males and 49 (49%) females. The mean age of the study group was 47±12.8 (15-76) years. The BCVA in DM and non-DM was mostly in the 0.50-0.00 LogMAR category. CS values in DM and non-DM were mostly in >1.52 LogCS category. VA and CS were significantly different in both DM and non-DM groups (p=0.03; p=0.00, respectively). A strong correlation between VA and CS was also observed in both groups (r=0.644; r=0.573, respectively). Conclusion: Visual acuity and CS in ESRD patients with DM undergoing HD had significant differences from those without DM. BCVA was strongly correlated with CS in both groups. Monitoring VA and CS in HD patients with DM provides early detection of vision-threatening changes, helps prevent severe visual impairment and improves patients’ quality of life.
Preseptal Cellulitis: A Multidisciplinary Perspective on Diagnosis and Treatment Carennia Paramita; Erica Widodo; Made Susiyanti
Majalah Oftalmologi Indonesia Vol 52 No 2 (2026): 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/oi.v52i2.102112

Abstract

Introduction: Preseptal cellulitis is a common pediatric infection involving the eyelid and anterior orbital tissues, characterized by eyelid erythema and edema. Although most cases respond well to oral antibiotics, delayed diagnosis or inadequate treatment may lead to complications requiring more intensive management. Case Presentation: A febrile 7 year-old boy presented with progressive swelling, erythema, and purulent discharge of the right upper eyelid for two weeks despite prior oral antibiotic therapy. Examination revealed marked palpebral edema, tenderness, and a superior eyelid mass without proptosis or limitation of ocular motility. Laboratory findings showed elevated C-reactive protein levels. Orbital CT imaging confirmed preseptal cellulitis without orbital involvement. The patient was hospitalized and treated with intravenous ampicillin-sulbactam. Discussion: Preseptal cellulitis most commonly affects children under 10 years old. While mild cases can be managed with oral antibiotics, severe or unresponsive cases require intravenous therapy. The absence of proptosis and preserved ocular motility were key features distinguishing this condition from orbital cellulitis. Conclusion: Prompt recognition and timely intravenous antibiotic therapy are crucial in severe preseptal cellulitis to ensure clinical improvement and prevent progression to orbital complications.
Combined Scheimpflug-Derived Tomographic and Biomechanical Assessment Detection: A Systematic Review Yuniar Sarah Ningtiyas; Amalia Azrina; Farida Moenir; Sahata P.H. Napitupulu; Dini Dharmawidiarini
Majalah Oftalmologi Indonesia Vol 52 No 2 (2026): 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/oi.v52i2.102114

Abstract

Purpose: Keratoconus is the most common corneal ectatic disease, characterized by progressive and bilateral thinning of the cornea leading to visual loss. Early diagnosis is important, particularly in preoperative screening, and the utilization of another imaging modality remains crucial. This study aimed to explore the combination of corneal biomechanical tomographic assessment derived from Scheimpflug in diagnosing subclinical keratoconus. Methods: A systematic search was conducted in MEDLINE, Google Scholar, Clinical Key, and EBSCO. Two independent reviewers selected studies and extracted data. Risk of bias was assessed using the QUADAS-2 tool in RevMan 5.4. The primary outcome measures included the Belin-Ambrosio enhanced ectasia total deviation index (BAD-D), Stiffness Parameter at First Applanation (SPA-1), Tomographic & Biomechanical Index (TBI), and Corvis Biomechanical Index (CBI). Diagnostic accuracy was categorized based on the area under the curve (AUC) as low (AUC < 0.7), moderate (0.7 ≤ AUC < 0.9), or high (AUC ≥ 0.9). Results: Twelve studies involving 3483 eyes were included BAD-D and CBI demonstrated low to moderate AUC, while TBI demonstrated moderate to high AUC. According to the QUADAS-2, common methodological limitations included inappropriate reference standards, unclear patient selection, and inconsistent exclusion criteria. Limitations include numerous issues with methodological and findings reporting, thus a meta-analysis was not conducted. Conclusion: Scheimpflug-based corneal tomographic and biomechanical assessment shows promise as an adjunctive tool for detecting subclinical keratoconus. Among the indices, TBI appears to provide the highest diagnostic performance. However, further high-quality, longitudinal studies are required to validate these findings and to develop standardized diagnostic criteria.
The Hidden Costs of Inpatient Glaucoma Treatment: Out-of-Pocket Burden at a Tertiary Care Hospital in Yogyakarta Sang Ayu Putu Udara Pradnyadewi; Krisna Dwi Purnomo Jati; Meta Rahma An Nazzila; Tatang Talka Gani
Majalah Oftalmologi Indonesia Vol 52 No 2 (2026): 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/oi.v52i2.102146

Abstract

Introduction and Objective: Glaucoma requires lifelong care, generating out-of-pocket (OOP) costs despite insurance coverage. This study assessed OOP expenditure among hospitalized glaucoma patients covered by Indonesia’s National Health Insurance (JKN). Methods: A hospital-based cross-sectional study included 40 purposively selected glaucoma inpatients from December 2024 to February 2025. Self-reported data were collected through structured interviews. Multiple linear regression examined associations between sociodemographic and cost-related factors and total OOP expenditure. Results: Participants’ mean age was 56 years, with a male-to-female ratio of 1:1.9; 52.5% were unemployed and received subsidized JKN contributions. Mean OOP expenditure per hospitalization was IDR 640,090, comprising direct non-medical expenses (92%) and indirect costs (8%). Transportation (mean IDR 352,670; 61% of direct non-medical costs), meals for accompanying relatives (mean IDR 184,125; 32%), and indirect costs (mean IDR 50,375) were significantly associated with total OOP expenditure (all p < 0.001). The model explained 84.3% of expenditure variance (R² = 0.843). Conclusion: Transportation and meals for accompanying relatives dominated direct non-medical OOP costs, highlighting the need to strengthen financial protection for patients and their households.
Concurrent Graves’ Ophthalmopathy and Sjögren’s Syndrome: A Case Report Banu Aji Dibyasakti; Nikolaus Erik Darmawan; Safirah Khairuna
Majalah Oftalmologi Indonesia Vol 52 No 2 (2026): 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/oi.v52i2.102147

Abstract

Graves’ ophthalmopathy (GO) is the most common extrathyroidal manifestation of Graves’ disease, while Sjögren’s syndrome (SS) is a systemic autoimmune disease characterized by exocrine gland dysfunction. Although both conditions share autoimmune mechanisms, their coexistence remains underrecognized. We report a case of a woman presenting with progressive bilateral proptosis, ocular discomfort, xerophthalmia, and xerostomia. Ophthalmologic examination revealed bilateral proptosis with preserved visual acuity and normal intraocular pressure. Thyroid function tests demonstrated suppressed thyroid-stimulating hormone (TSH) and elevated free thyroxine (FT4), while orbital imaging showed bilateral extraocular muscle enlargement and exophthalmos, supporting the diagnosis of Graves’ ophthalmopathy. In addition, severe dry eye symptoms, reduced Schirmer test values, and xerostomia raised suspicion of coexisting Sjögren’s syndrome overlap. The patient demonstrated gradual clinical improvement following multidisciplinary management and systemic therapy. This case highlights the diagnostic challenge posed by overlapping ocular manifestations, particularly dual-mechanism dry eye resulting from both exposure-related and aqueous-deficient mechanisms. Early recognition of autoimmune overlap conditions is essential to optimize diagnosis, multidisciplinary management, and long-term outcomes.
Orbital Meningioma in Patients with Hormonal Contraceptive History: Investigating The Role of mTOR and PTEN Yunefesta Angka; Datu Respatika
Majalah Oftalmologi Indonesia Vol 52 No 2 (2026): 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/oi.v52i2.102154

Abstract

Introduction and Objective: Meningiomas are among the most common low-grade intracranial tumors that can spread to the orbital cavity. Long-term use of hormonal contraceptives has been suggested to play a role in the development of meningiomas. Increasing levels of the mammalian target of rapamycin (mTOR) are considered to promote cell proliferation and prevent apoptosis. Mutations in the phosphatase and tensin homolog (PTEN) gene may increase neoplasm severity. This study aims to determine the role of mTOR and PTEN in meningioma tissues. Method: This cross-sectional study included 21 patients with meningiomas confirmed by histopathological examination. Interviews were conducted to assess their background knowledge of obstetrics, gynecology, and contraceptive use. Expression of mTOR and PTEN was assessed by real-time PCR. Result: The average age in this study was 44.93 years (SD±6.69). We also found that the average age of first-time use of contraception was 24.00 years old (SD±5.01), while the average duration of contraceptive usage was 197.31 months (SD±73.55). Among 16 patients, all subjects showed an increased expression of mTOR and PTEN. Quantitatively, there was an increase in mTOR (27,9 + 16,5) and PTEN (5.9 + 3.2) expression in tumor tissue. Conclusion: There was a significant increase in mTOR and PTEN expression in tumor tissue. Thus, mTOR and PTEN may play an important role in meningioma development.
Restoring Sight, Transforming Vision: The Past, Present, and Future of Ophthalmology in Indonesia From institution-based services to an integrated, digital, and equitable national eye-care system Muhammad Bayu Sasongko
Majalah Oftalmologi Indonesia Vol 52 No 2 (2026): 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/oi.v52i2.102259

Abstract

The evolution of ophthalmology in Indonesia reflects substantial clinical progress achieved within a complex and demanding service environment. Across this vast archipelago, diagnostic and therapeutic technologies—including microsurgery, imaging, laser therapy, and pharmacotherapy—have been introduced and widely adopted. Yet these advances have not translated into equitable population benefit. Geographic isolation, the maldistribution of human and financial resources, and fragmented referral pathways continue to restrict access to timely, effective, and high-quality eye care, particularly in underserved communities. The central question is therefore no longer whether Indonesia can acquire modern ophthalmic capabilities, but whether these capabilities can be organised systematically into an accessible, equitable, and accountable national eye-care system. In 2022, the World Health Organization (WHO) launched its framework for integrated people-centred eye care (IPEC), which places the needs of individuals and communities at the centre of service delivery and promotes a coordinated continuum encompassing health promotion, prevention, diagnosis, treatment, disease management, and rehabilitation across all levels of the health system. Viewed through this lens, the evolution of ophthalmology in Indonesia should be assessed not solely by the adoption of modern technologies and procedures, but by the extent to which it serves a broader public purpose: from hospital-centred treatment to population-centred prevention and integrated care; from episodic charitable outreach to sustainable and equitable coverage; and from expertise concentrated in major cities to connected service networks across provinces. This Perspective traces major milestones in Indonesian ophthalmology, identifies persistent gaps, and proposes priorities for translating clinical and technological progress into equitable and effective population eye care.

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