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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 13 Documents
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Search results for , issue "Vol 49 No 2 (2023): Ophthalmologica Indonesiana" : 13 Documents clear
Efek Penambahan Natrium Diklofenak Topikal pada Terapi Injeksi Intravitreal Bevacizumab terhadap Perubahan Visus dan Tekanan Intraokular Pasien dengan Edema Makula Diabetika Supanji Supanji; Widya Ramania; Melvina Nidya Sandra; Angela Nurini Agni; Suhardjo Suhardjo; Retno Ekantini; Muhammad Bayu Sasongko
Majalah Oftalmologi Indonesia Vol 49 No 2 (2023): 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.v49i2.100270

Abstract

Introduction dan Aim: Diabetic Macular Edema (DME) in Diabetic Retinopathy (DR) patients might threaten the patient's visual acuity. Therefore, a robust DME treatment is needed to prevent sight threatening condition in DR patients. In this study, we intended to compare the effects of intravitreal administration of bevacizumab versus bevacizumab and topical natrium diclofenac in DR patients who developed DME. Methods: This was a randomized controlled trial study with double blinds. Data were taken from April 2020 to June 2021 from the Dr. Sardjito Central General Hospital and the Dr. Suhardi Hardjolukito Indonesian Air Force Central Hospital, Yogyakarta. Our patients were assigned to a control group (intravitreal bevacizumab therapy only) and an intervention group (intravitreal bevacizumab and topical natrium diclofenac). Then, we evaluated best corrected visual acuity (LogMar) and intraocular pressure (IOP, mmHg) were recorded in both groups before and after therapy. Results: A total of 38 eyes from 36 patients with naive DME were included in this study. Both treatment groups showed a statistically significant improvement in visual acuity after treatment bevacizumab (pre = 0.8±0.5; post = 0.6±0.5; p-value = 0.033) and bevacizumab and natrium diclofenac (pre = 0.9±0.5; post = 0.5±0.3; p-value = 0.004). In contrast to the above findings, the IOP in both groups did not show a significant change in IOP after therapy, bevacizumab (pre = 15.7±4.1; post = 15.6±4.2; p-value = 0.810) and bevacizumab and natrium diclofenac (pre = 16.0±4.5; post = 16.0±3.9; p-value = 0.868). Conclusion: Our study showed that visual acuity was improved significantly in DME patients treated with either bevacizumab or bevacizumab and natrium diclofenac. This might be a valuable information on the improvement of DME therapy, given that no increased post-therapy IOP in patients treated topical natrium diclofenac.
The VARIATION OF THE AXIAL LOCATION OF BRUCH’S MEMBRANE OPENING, GANGLION CELL INNER PLEXIFORM LAYER AND FLUX INDEX IN NORMAL TENSION GLAUCOMA AND PRIMARY OPEN ANGLE GLAUCOMA PATIENTS Jehan Fauzi Jehan; Retno Ekantini; Tatang Talka Gani; Krisna Dwi Purnomo Jati
Majalah Oftalmologi Indonesia Vol 49 No 2 (2023): 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.v49i2.100660

Abstract

Introduction. Bruch’s membrane opening (BMO) at the most anterior point of the neural canal for quantification of cup depth /based on retinal surface position, area and volume, laminar position, and prelaminar connective tissue volume. If these deep structural parameters are to be used effectively in glaucoma detection and identification of progression. Purpose. This study explores variation in the axial location of Bruch’s membrane opening (BMO) to determine if this reference plane varies with NTG and POAG patients. Methods This was a cross-sectional prospective descriptive study with purposive sampling. This study enrolled 72 eyes in Sardjito General Hospital  underwent  cirrus – OCT 5000 Ver 11.0.0.29946  between 1st March 2022 and 10th May 2022. Results. We evaluated 72 (25 NTG and 47 POAG)  eyes on 37 outpatients service of Sardjito General Hospital. Median BMO, GCIPL, Flux index and CD ratio of NTG patients was 1.707 µm (1.387-2.182), 83,0µm (76-88), 0,40 (0.27-0,48), 0,64 (0,22-0,75). Median BMO, GCIPL, Flux index  and CD ratio of POAG patients was 1.612 (1.028-2.031) µm, 79,00 (56-98) µm, 0,40 (0,26-0,47) and 0,64 (0,28-0,92) for CDR. Bruch’s membrane opening position was more posterior relative to the sclera in older subjects with negative correlation (P value = 0,07). Variable BMO and GCIPL tested between NTG and POAG group showed significant difference with BMO P value =0,04 and GCIPL P value=0,01 except Perfusion, flux index and RNFL. Conclusion. Bruch’s membrane opening is more posteriorly located in older individuals. There was significant difference p value of BMO between the mean of NTG and POAG.
CHALLENGES IN MANAGEMENT OF ENDOGENOUS ENDOPHTHALMITIS IN CHILDREN: A CASE SERIES Eko Parulian; Lukman Edwar
Majalah Oftalmologi Indonesia Vol 49 No 2 (2023): 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.v49i2.100683

Abstract

Introduction: Endophthalmitis is one of the most feared disease in ophthalmology because it can lead to loss of vision and loss of the eyeball. Endophthalmitis from endogenous cause are very rarely found in young patients without immunocompromised condition, making it difficult to be diagnosed.  The lack of established guidelines for treating endogenous endophthalmitis also presents challenges for ophthalmologist.  In this case series, we present our management of two pediatric patients with different presentations of endogenous endophthalmitis. We manage to salvage both of the patient’s eye ball with two different approaches. Case Report: Our first patient was a 2-years-old boy with a chief complaint red eye since 10 days before admission. He was previously diagnosed with conjunctivitis. On admission the left eye was not very inflamed but we found hypopion and vitreous haze  from ultrasound, suggestive of endophthalmitis.  We gave the patient systemic antibiotics and did irrigation/aspiration of the anterior chamber. He responded well to our therapy and was discharged on tenth day of admission. 2. A 6-years-old girl with a chief complaint red painful eye since 2 days before admission.  On admission, the eye was very inflamed with limited movement. The USG revealed vitreous haze suggestive of endophthalmitis. She was then given systemic and intravitreal antibiotics but showed poor response. Intravenous steroid was then given and the condition was improved. She was discharged on the fifth day. Discussion: Our two patients came with two different presentations and responds to systemic antibiotics which was considered the mainstay of treatment in endogenous endophthalmitis. The first patient responded well with systemic and intracameral antibiotics while the second patient condition was improved only after the addition of intravenous steroid. Close observation with re-examination and re-evaluation should be done repeatedly to decide which treatment option should be administered. Conclusion: Diagnosis and management of young patient with endogenous endophthalmitis is challenging. Thorough history taking, physical examination, laboratory examination, and microbiology examination should be done to make a prompt diagnosis and management.  
PERBANDINGAN SIKLOKRIOTERAPI KOMBINASI DENGAN RETROBULBAR KLORPROMAZIN VS SIKLOKRIOTERAPI SAJA DALAM MENURUNKAN TEKANAN INTRAOKULAR DAN NYERI PADA GLAUKOMA TAHAP AKHIR Muhammad Raditya Fadhil Fadhil; Retno Ekantini; Tatang Talka Gani; Krisna Dwi Purnomo Jati
Majalah Oftalmologi Indonesia Vol 49 No 2 (2023): 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.v49i2.100690

Abstract

Introduction: Patients with end-stage glaucoma often came with a painful blind eye. One of the managements is cyclocryotherapy (CCT) or retrobulbar chlorpromazine (CPZ). In this study, we aimed to evaluate the combined use of cyclocryotherapy and retrobulbar chlorpromazine versus cyclocryotherapy alone in reducing the intraocular pressure (IOP) and Visual Analog Scale (VAS) pain scores in end-stage glaucoma patients. Methods: Samples were taken from patients who enrolled in the Ophthalmology Clinic of Dr. Sardjito General Hospital from October 2021 to March 2022. Samples were then divided into 2 groups, the CCT+CPZ group received the combination of cyclocryotherapy and retrobulbar chlorpromazine and the CCT group received only cyclocryotherapy. IOP and VAS pain scores pre-operation and 30th-day post-operation were examined.  Results: Thirty-three patients were included in the CCT+CPZ group and 17 patients were included in the CCT group. The mean IOP and VAS pain scores 30th-day post-operation in the CCT+CPZ group were 22.6±10.3 mmHg and 1.6±1.3 vs pre-operation 44.9±19.5 mmHg and 7.9±1.7 (p=0.000). Patients in the CCT group also show a significant reduction in both mean IOP and VAS pain scores 31.4±16 mmHg and 2.6±2.3 vs pre-operation 54.4±7.4 mmHg and 8.4±2.1 (p=0.001). Both IOP and VAS pain scores at 30th-day post-operation were significantly lower in the CCT+CPZ group compared to the CCT group (p=0.030 and p=0.013, respectively). Conclusion: There were statistically significant differences between patients who received a combination of cyclocryotherapy and retrobulbar chlorpromazine in reducing the IOP and VAS pain score compared with patients who received only cyclocryotherapy.
A RARE CASE OF SUBCONJUNCTIVAL HEMORRHAGE POST COVID-19 mRNA VACCINE: A CASE REPORT: A Rare Case of Subconjunctival Hemorrhage Post COVID-19 mRNA Vaccine: A Case Report Jovita Jutamulia; Arlin Chyntia Dewi; Salma Salsabila; Vicky Octaviani
Majalah Oftalmologi Indonesia Vol 49 No 2 (2023): 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.v49i2.100699

Abstract

Introduction: Concurrently with the administration of COVID-19 vaccine, adverse event following immunization (AEFI) began to be reported. Some reactions involve various systems of the human body, including the ocular system. Although uncommon, subconjunctival hemorrhage also can be found, as shown in this report. Case Report: We present a case of a 68-year-old woman with subconjunctival hemorrhage a couple hours before admission. Patient also came with complaints of sudden redness and pain in left eye. Two days prior, she had her first dose of Moderna vaccine. Left eye examination revealed hemorrhage on conjunctiva with normal visual acuity. Other ocular examinations couldn’t be done due to the lack of facilities and severe pain. No other symptoms were mentioned. Patient was advised to be referred to an ophthalmologist, but she refused. After a month, the patient reportedly experienced similar complaints after receiving the second dose of Moderna vaccine. another redness and discomfort in her left eye. Her left eye was red, itched, and swollen. However, she still refused to go to an ophthalmologist. Oral analgesic, oral antihistamine, and artificial tears were given. The symptoms were completely resolved in a couple days. Conclusion: Subconjunctival hemorrhage may occur as mRNA Vaccine AEFI specifically in patients with underlying disease, however further research is needed.
PACK-CXL sebagai Terapi Alternatif pada Ulkus Kornea Pradistya Yudiasari; Angga Fajriansyah
Majalah Oftalmologi Indonesia Vol 49 No 2 (2023): 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.v49i2.100703

Abstract

Introduction: Corneal ulcer is a leading cause of blindness worldwide. Many of these patients did not respond to conventional treatment with topical agents. Photo Activated Chromophore for Keratitis - Corneal Cross-Linking (PACK-CXL) has been suggested to treat baterial and fungal corneal ulcer that did not respond to antimicrobial agents. Purpose : To report a case series of corneal ulcer treated with PACK-CXL as adjuvant treatment Case Report: Four eyes with corneal ulcer underwent PACK-CXL with ultraviolet-A rays and transepithelial riboflavin according to Dresden procedure. Preoperative and postoperative slit lamp examination of cornea and visual acuity assessment was done. Postoperative outcome includes objective signs like improvement in epithelialization, corneal scarring and vascularization. Result: Three eyes healed completely with scarring at 1-month follow-up. One of the patients developed desematocele in 12 days. Epithelial defect completely healed over time but one underwent amniotic membrane transplant. Responed to treatment were defined by epithelialization and scar formation. Conclusion: The corneal cross-linking has a beneficial role as an adjuvant therapy for corneal ulcer. It helps in relief of pain and healing of ulcer. PACK-CXL can be a choice of adjuvant treatment if the corneal ulcer doesn't heal using topical treatment.
AN OVERVIEW OF REFRACTIVE ERRORS AMONG CHILDREN IN KOTA SOE DISTRICT, INDONESIA Willy Yahya; Maria Larasati Susyono
Majalah Oftalmologi Indonesia Vol 49 No 2 (2023): 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.v49i2.100724

Abstract

Introduction: Refractive error is one of the most common preventable causes of blindness in the world. Screen time and outdoor time are known as risk factors for its prevention. This study aims is to show the prevalence of children's refractive error and the difference between screen time and outdoor time. Methods: This study used a cross-sectional design to examine children's refractive error from 10 to 14 years old at five child development centers located across SoE from March 2020 to August 2021. Screen time and outdoor time data were obtained using a questionnaire, grouped into low-medium and high groups, and analyzed the differences between groups. Result: In this study, there are 429 participants with an average age of 12.65 ± 1.44 years old. The prevalence of refractive error is 9.56% and the most common error is mild myopia (43.59%). Refractive error in females is more common than in males (75.61%) and distributed in all age groups. There is no significant difference between refractive error prevalence and the amount of screen time (t 0.500; p: 0.480) and outdoor time (t: 0.944; p: 0.331). Conclusion: The most common refractive error in this study is mild myopia. There is no refractive error prevalence difference in screen time and outdoor time.
VISUAL IMPROVEMENT FOLLOWING THE REMOVAL OF CHRONIC ORBITAL CAVERNOUS HEMANGIOMA Raisha Pratiwi Indrawati; M. Rinaldi Dahlan
Majalah Oftalmologi Indonesia Vol 49 No 2 (2023): 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.v49i2.100761

Abstract

Introduction: Orbital cavernous hemangioma is a benign, well-defined vascular lesion, located mainly in the intraconal space. Surgical treatment is indicated in symptomatic cases, such as proptosis or visual disturbance. This study aims to report the visual improvement of the successfully-managed chronic orbital cavernous hemangioma. Case Report: A 51-year-old man came to Cicendo Eye Hospital with chief complaint of protrusion of the right eye for seventeen years, accompanied by blurred vision two years earlier. Ophthalmological examination revealed decreased visual acuity, together with ocular movement restriction and relative afferent pupillary defect. Computed tomography (CT) scan showed a retrobulbar mass, attached to the lateral and medial rectus muscle, and shifting the optic nerve superiorly. The tumor was removed through inferior anterior orbitotomy with a transconjunctival incision, and the histopathological finding revealed a cavernous hemangioma. Follow-up examination showed improvement in the patient's condition, measured by no protrusion remaining and the achievement of best-corrected visual acuity (BCVA) of 1.0. Discussion: In the case of a benign intraorbital tumor, the orbitotomy approach should be best selected based on its anatomical location and involvement of adjacent structures. Despite the size of the tumor, chronic duration, and disturbing manifestation, improvement of visual acuity and structural appearance could be achieved if the tumor is removed correctly and the adjacent structure has not been severely damaged. Conclusion: Cavernous hemangioma is a benign lesion in which surgical treatment is indicated in symptomatic cases. The right approach of orbitotomy is needed to give a good outcome anatomically and functionally.  
NON-NECROTIZING DIFFUSE ANTERIOR SCLERITIS SEBAGAI MANIFESTASI OKULER TERISOLASI DARI LUPUS ERYTHEMATOSUS SISTEMIK: LAPORAN KASUS Kara Citra Kalandra; Rifna Lutfiamida
Majalah Oftalmologi Indonesia Vol 49 No 2 (2023): 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.v49i2.100763

Abstract

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disorder with heterogeneous clinical manifestation in numerous organ systems, including the eye. Ocular involvements have been reported in up to one-third of patients with SLE, although scleritis is considered a less common manifestation of the disease found in only about 1% of cases Case Report: A 46-year-old female patient presented with a painful right eye for 1 week. She reported having the same symptom last year which resolved without treatment. There was no known history of systemic immune-mediated diseases and no prior ocular trauma. Ophthalmological examination revealed dilatation of deep scleral vessels on the right eye. The patient tested positive for the antinuclear antibody and anti-double-stranded deoxyribonucleic acid tests. She was diagnosed with non-necrotizing diffuse anterior scleritis caused by SLE and was treated with topical prednisolone acetate and systemic methylprednisolone. After 1 week of treatment, the patient showed an improvement in ocular signs and symptoms. Discussion: Scleritis is a rare inflammatory disease usually associated with systemic immune-mediated diseases such as SLE. It can cause significant visual loss and may be life-threatening. We reported a non-necrotizing diffuse anterior subtype of scleritis presented as an isolated manifestation in SLE, which benefited from early diagnosis and treatment of corticosteroids. Conclusion: Scleritis may present as an early or isolated manifestation of systemic immune-mediated disease. Therefore, a comprehensive examination is of the essence to exclude multisystem disease and treat the underlying cause even when there is no systemic manifestation.
MANAGEMENT OF SECONDARY ANGLE-CLOSURE GLAUCOMA IN ANTERIOR SEGMENT DYSGENESIS AND ANTERIOR MICROPHTHALMOS PATIENT syifa rahmani; Maula Rifada
Majalah Oftalmologi Indonesia Vol 49 No 2 (2023): 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.v49i2.100770

Abstract

Introduction: The majority of cases of anterior segment dysgenesis (ASD) and anterior microphthalmia are known to be complicated by angle-closure glaucoma, which is also the primary cause of visual loss. Medical therapy of this secondary glaucoma is frequently ineffective, necessitating surgery. However, managing the surgery in an eye with a crowded anterior chamber is difficult. This study aimed to report the management of secondary angle-closure glaucoma in anterior segment dysgenesis and anterior micropthalmos patient. Case Report: :  A  39-year-old  woman  presented  to  Glaucoma  unit  with  chief complaint  of  pain  on  the  right  eye.  She  also  noted  blurred  vision,  redness,  and headache  approximately  seven  months  before  presentation.  The  patient  had  a history of glaucoma since 5 years old, but hadn’t regularly visit for a long time. The  visual  acuity  was  1/60  and  intraocular  pressure  (IOP)  was  45.  Anterior segment   evaluation   revealed   scleral   thinning   with   injection,   microcornea, sclerocornea,  hazy  peripheral  cornea,  iridocorneal  adhesion,  shallow  anterior chamber, iris transillumination defect and lens opacity. A-scan biometry showed normal axial length. She was diagnosed with secondary angle-closure glaucoma with anterior segment dysgenesis, anterior microphthalmia and presenile cataract of the right eye. The patient underwent combined phacotrabeculectomy, pars plana vitrectomy and intraocular lens implantation. Discussion: Surgical procedure is indicated if pharmacological therapy cannot control IOP and glaucoma progressivity, including trabeculectomy combined with cataract extraction. However, cataract extraction is more difficult in shallow anterior eye chamber because the working field is narrower and the distance between the cornea and lens is closer. Some strategies to prevent this include pars plana vitrectomy (VPP). Conclusion: Anterior  segment  dysgenesis,  though  rare,  cause  vision  loss  by glaucoma as complication. Treatment of secondary glaucoma aim to lowering IOP to halt its progression. Combined phacotrabeculectomy, pars plana vitrectomy and intraocular  lens  implantation  was  a  safe  procedure  in  this  crowded  anterior chamber eye.

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