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All Journal Ophthalmologica Indonesiana
Irma Suwandi Sadikin
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Health Professions Medicine & Pharmacology Public Health

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Anatomical and Functional Outcomes of Management Pediatric Retinal Detachment with High Myopia and History of Retinopathy of Prematurity: A Case Report: Poster Presentation - Case Report - Resident Irma Suwandi Sadikin; Anggun Rama Yudantha
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/ak2gz370

Abstract

Introduction : To report the anatomical and functional outcomes of management of pediatric retinal detachment in children with high myopia and a history of retinopathy of prematurity. Case Illustration : A 9-year-old boy had a sudden visual loss two months ago. The complaint is accompanied by photopsia and floaters. No history of trauma or infection. He had a history of myopia (S-6.00) and ROP in both eyes. The VA of the right eye was no light perception, and the left eye was 1/60. A retinal detachment with the macula off was discovered in the posterior examination. The axial length was 21 mm. He underwent a scleral buckle with vitrectomy and internal limiting membrane (ILM) peeling for his left eye. After surgery, the visual acuity was 3/60 with the retina attached. Re- detachment was found three weeks after surgery. The patient was scheduled for a second phacoemulsification and vitrectomy surgery. One month later, the best visual acuity reaches 6/48 with S -8.00 D on his left eye. The complication of high intraocular pressure (IOP) after surgery was managed successfully. Discussion : Conclusion : Management of retinal detachment cases in children is challenging. Hence, a thorough understanding is crucial in order to achieve anatomical and functional success. Myopia in ROP eyes was mainly lenticular, with an alteration in the anterior chamber that contributed to the patient's refractive status change. We encourage preterm patients to have regular follow-up not only for refractive status but also for structural changes in the anterior segment until adolescence.
Cataract Surgery After Keratoplasty: How Should We Prepare? Poster Presentation - Case Series - Resident Irma Suwandi Sadikin; Syska Widyawati
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: 10.35749/5xx1gd17

Abstract

Introduction : Cataract surgery following corneal transplantation demands special attention to corneal graft stability and optimization to allow for excellent IOL selection, as well as corneal graft preservation since lens removal damages the corneal endothelium. This study aimed to determine how we should prepare for cataract surgery after keratoplasty. Case Illustration : Case 1: A 34-year-old male has phacoemulsification in his right eye (last eye). He had a history of eye surgery, including, keratoplasty for RE in 2019, and vitrectomy for RE because of endophthalmitis. The pre-operative visual acuity is 0.5/60 with PAS and an irregular pupil. Post-operative VA 3/60 with BCVA 6/40. Last follow-up, the grafted cornea was still clear with normal IOP. Case 2: A 50- year-old female underwent phacoemulsification for both eyes (BE). She had histories of keratoplasty in 1986, 1989, and 1997 for BE. She also had extreme myopia for BE (RE S -17.00, LE S-14.00). Pre- operative VA was 1/60 of BE, and BCVA was 6/20 a month after surgery. During the last check-up, both transplant corneas were clear with normal IOP. Last visit, her both grafts remained clear. Discussion : Conclusion : IOL calculations are challenging due to inaccuracy in corneal measurements, astigmatism, or corneal pathology. The best time to perform surgery is at least 2 years after keratoplasty. We suggest using total keratometry in the K-6 formula or Haigis for the IOL formula. Good dispersive viscoelastic, operating away from the corneal endothelium, and employing low phaco-energy/fluids will help to deliver a clear cornea after surgery. Last, steroid treatment will enhance graft survival rate.
A snake venom ophthalmia: A case – report: Poster Presentation - Case Report - Resident Nabila Aljufri; Irma Suwandi Sadikin; Dany Petra; Diannisa Susantono; Virna Dwi Oktariani; Syska Widyawati
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/vm6dv861

Abstract

Introduction : Snake venom ophthalmia is caused by venoms of spitting snakes. Delayed treatment may result in corneal ulcer, corneal perforation and blindness. We aim to report a fortunate snake venom ophthalmia case. Case Illustration : A-54-year-old male complained of burning eye pain, watery, and redness of the right eye (RE) after being spat by a snake 3 hours before admission. The snake was identified as a cobra-snake, spitted at a distance of 1 meter without body bite. He rinsed his eyes with tap water and irrigated at a nearby hospital before referred. During the admission, the pH of both eyes (BE) was 8. The patient was irrigated with normal-saline. The visual acuity (VA) of the right eye was 6/12 and left eye 6/6. There was RE conjunctival and ciliary injection. Other examinations were unremarkable. The patient was discharged and treated with levofloxacin eye-drop, sulfas-atropine 1%, EDTA 1%, artificial tears, and vitamin C. He did self-eye irrigation. Two days later, he presented with VA of 6/6 for BE with normal ocular examinations and pH of 7 for BE. Discussion : The general principle is prompt and copious irrigation of the eyes in chemical contact. The snake venom mixture of chemicals was washed out, which local necrosis can be prevented. Managing snake venom as a chemical splash injury with considerable irrigation, lubricants, and topical antibiotics, resulted a good outcome and prevented sequelae in this patient. Conclusion : Urgent irrigation of the affected eyes and other mucous membranes is the key in treating snake venom ophthalmia
Unusual Presentation of Lipemia Retinalis Presented with Visual Field Defect: Poster Presentation - Case Report - Resident Regina Ivanovna; Irma Suwandi Sadikin; Dearaini; Eduard Jordi Luminta; Rina La Distia Nora; Yulia Aziza
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/axa0en30

Abstract

Introduction : Lipemia retinalis is an ocular presentation that associated to hypertriglyceridemia. Most cases are usually asymptomatic, with changes detected only from fundus examination. This case report highlights a case of lipemia retinalis with decreased peripheral visual field. Case Illustration : Thirty four year-old female came with complaint of blurry right eye (RE) 3 months before hospital visit, especially on inferotemporal part of her right eye. She had history of diabetes mellitus and hypertriglyceridemia. Her sister also has known history of hypertriglyceridemia. Ophthalmological examination revealed 6/6 visual acuity on both eyes, with normal anterior segment of both eyes. Fundus examination showed creamy retinal vessels on both eyes. Humphrey perimetry result showed inferotemporal visual field defect of RE. At time of visit, triglyceride level was 1440 mg/dL. Patient was prescribed fenofibrate 1x300 mg daily by Endocrinology Department. After 6 months of fenofibrate therapy, serum triglyceride level was decreasing to 185 mg/dL. Ophthalmology exam revealed a significant decrease of creamy white vessel on right eye and normal vessel of left eye. Humphrey perimetry showed decreased visual field defect Discussion : Hypertriglyceridemia can result from familial or secondary to systemic diseases. Creamy vessel appearance in lipemia retinalis is resulted from presence of triglyceride-laden chylomicrons in the plasma. Lipemia retinalis rarely manifests with reduced peripheral vision, which is presented in this case. Conclusion : Lipemia retinalis is often overlooked due to its asymptomatic nature. Prompt recognition might be live saving from life-threatening condition resulting from hypertriglyceridemia. Triglyceride- lowering drug therapy is very useful in improving peripheral field defect as presented in our case report.
Co-Authors Anggun Rama Yudantha Dany Petra Dearaini Diannisa Susantono Eduard Jordi Luminta Nabila Aljufri Regina Ivanovna Rina La Distia Nora Syska Widyawati Virna Dwi Oktariani Yulia Aziza