Raden Fitri Fatimah Iskandar, Elsa Gustianty, Sonie Umbara, Andhika Prahasta, R. M. Rifada
{"title":"ND:YAG Laser Vitreolysis as The Management of Occluded Tube After Glaucoma Drainage Device Implantation (GDD)","authors":"Raden Fitri Fatimah Iskandar, Elsa Gustianty, Sonie Umbara, Andhika Prahasta, R. M. Rifada","doi":"10.35749/1drs8325","DOIUrl":"https://doi.org/10.35749/1drs8325","url":null,"abstract":"Introduction : Glaucoma Drainage Devices (GDD) implantation surgery can be an alternative therapy for patients with uncontrolled IOP after trabeculectomy. However, tube occlusion is a common complication of GDD implantation. Management of tube occlusion can be done using laser or with surgery. This case presents the management of vitreous occlusion of tube implant using ND:YAG laser-vitreolysis. \u0000Case Illustration : A 63 year-old male patient came with chief complaint of pain in his right eye. The patient had a history of cataract surgery on the right eye and was diagnosed with glaucoma. An examination showed IOP in the right eye was increased, vitreous in COA and lens was aphakic with posterior capsule rupture. The patient had undergone trabeculectomy, but IOP remained high, so an Aurolab Aqueous Drainage Implant (AADI) GDD implantation was performed. However, six weeks after the procedure, the IOP still increased, and an examination revealed vitreous occlusion of the GDD tube (Figure 1) . The patient underwent Zeiss ND-YAG laser-vitreolysis on his right eye (Figure 2) with laser spot size of 50?m and power of 2.1 MJ. Post laser IOP was decreased. \u0000Discussion : GDD implantation is a surgical option for primary or secondary therapy, but tube occlusion can cause implantation failure. Laser-vitreolysis is a non- invasive modality to treat tube occlusion caused by vitreous. \u0000Conclusion : GDD occlusion can occur due to various etiologies, but laser-vitreolysis is a non-invasive treatment option aimed at restoring tube patency and aqueous outflow.","PeriodicalId":165753,"journal":{"name":"Ophthalmologica Indonesiana","volume":"42 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139782439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kurrotul Aini, Anny Sulistyowati, Wino Vrieda Vierlia, Holipah
{"title":"RELATIONSHIP OF PUPIL SIZE WITH REFRACTIVE ERROR IN METABOLIC SYNDROME AND NON METABOLIC SYNDROME: AMONG RURAL POPULATION IN MALANG","authors":"Kurrotul Aini, Anny Sulistyowati, Wino Vrieda Vierlia, Holipah","doi":"10.35749/n3rj1394","DOIUrl":"https://doi.org/10.35749/n3rj1394","url":null,"abstract":"Introduction & ObjectivesNearly one in four Indonesians has metabolic syndrome (MS). One of the microvascular side effectsin Metabolic Syndrome affects the eyes. The aim of this study to evaluate the relationship of pupilsize with refractive error in MS and non-MS groups among rural populations in Malang. \u0000MethodsA descriptive study was carried out in 2019 in three villages in Malang districts. A detailed ocularexamination was conducted on all participants who attended a research facility. We definedpupillary abnormalities and clinically important refractive errors. Blood samples were obtained todetermine the parameter of the metabolic syndrome by IDF 2006 criteria. Subjects were classifiedinto 2 groups: Metabolic Syndrome status and non metabolic syndrome. \u0000Results953 participants completed the examination which consists of 944 right eyes and 942 left eyes. Theresults of visual acuity on the right eye: emmetropia in 434 eyes, myopia with 252 eyes, hyperopiawith 141 eyes, and astigmatism with 17 eyes where if it is not significant if associated with pupillaryabnormalities (P-value 0.893). On the left eye, the emmetropia results were 444 eyes, while formyopia were 244 eyes, hyperopia as many as 138, and astigmatism in 116 eyes and if associatedwith pupillary abnormalities, the result also not significant (P-value 0.864). The result of pupil sizewith metabolic syndrome 499 eye and non syndrome metabolic 454 eye are not significant (p-value0.649). \u0000ConclusionRefractive error didn’t relate pupil size in metabolic syndrome and non metabolic syndrome.","PeriodicalId":165753,"journal":{"name":"Ophthalmologica Indonesiana","volume":"21 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139782676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JOSIAH IRMA, Saraswati Anindita Rizki, Jennifer Angelina, Jovita, Jennifer Handiokho
{"title":"Outcomes of Treating a late case of Herpes Zoster Ophthalmicus masquerading as Orbital Cellulitis: A Case Report","authors":"JOSIAH IRMA, Saraswati Anindita Rizki, Jennifer Angelina, Jovita, Jennifer Handiokho","doi":"10.35749/sa8pth15","DOIUrl":"https://doi.org/10.35749/sa8pth15","url":null,"abstract":"Abstract \u0000Introduction : Herpes zoster ophthalmicus (HZO) refers to a reactivated varicella-zoster virus involving the V1 nerve division. Although rare, previous reports have mentioned HZO cases masquerading as orbital cellulitis (HZO-OC). This report depicts the use of acyclovir, corticosteroids and citicoline in our HZO-OC patient with treatment delay. \u0000Case Illustration : A healthy 66 year old man presented to our clinic 4 weeks after signs of orbital cellulitis followed by vesicular rash following the CN V(1) dermatome were felt which was untreated. The right palpebra was edematous and erythematous. Hazy cornea, mixed injection, grade IV reverse RAPD, diminished direct and consensual reflex and external ophthalmoplegia of the right eye were noted. The diagnosis of HZO-OC with multiple cranial neuropathies OD was established. Topical and symptomatic treatment were given resulting no improvement. Ptosis of the right palpebra became present. The patient was then given systemic acyclovir, methylprednisolone and citicoline. Ophthalmoplegia improved after 2 months and ptosis improved after 4 months. \u0000Discussion : The use of systemic acyclovir and corticosteroids in HZO-OC patients were given promptly in previous literature. Multiple cranial nerve in our patient was thought to occur due to treatment delay. As improvement was not noted after topical treatment, these systemic treatments along with citicoline were added. Citicoline was added due to its ability to promote neural regeneration. \u0000Conclusion : Systemic acyclovir, corticosteroids and citicoline may still be beneficial for HZO-OC patients with delayed treatment.","PeriodicalId":165753,"journal":{"name":"Ophthalmologica Indonesiana","volume":"28 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139782691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"ACCURACY OF MEASUREMENT RESULTS ON SCHIOTZ TONOMETER TOWARDS GOLDMANN APPLANATION TONOMETER IN TYPE II DIABETES MELLITUS PATIENTS IN MOHAMMAD HOESIN HOSPITAL, PALEMBANG","authors":"Damal AN NASHER, Fidalia, Erial","doi":"10.35749/zkxbj229","DOIUrl":"https://doi.org/10.35749/zkxbj229","url":null,"abstract":"Introduction & ObjectivesThe Goldmann Applanation Tonometer is now the most accurate gold standard compared to othertonometers. IOP measurement errors using the Schiotz Tonometer can be caused by ocular rigidity,where the IOP is read higher in eyes with higher ocular rigidity and vice versa. Type II DiabetesMellitus (DM) patients are at risk for increased ocular rigidity \u0000MethodsThis research is a cross-sectional study with a diagnostic test design regarding the accuracy ofintraocular pressure results on the Schiotz Tonometer against the Goldmann Applanation Tonometerin type II Diabetes Mellitus patients with 35 research samples. The research was conducted at theMohammad Hoesin Hospital in Palembang from April 2022 – September 2022 until the sample sizewas met \u0000ResultsIntraocular pressure (IOP) as measured by The average Goldmann Applanation Tonometer was 15.5± 2.4 mmHg, with a Schiotz load of 7.5 grams the average was 16.2 ± 2.3 mmHg. Ocular rigidityhad a median of 0.0242 (0.0176 – 0.0341) From the results of this study the IOP examination withthe Schiotz Tonometer had a sensitivity of 92.9%, a specificity of 80.9%, a positive predictive valueof 76.5%, a negative predictive value of 94.4% and an accuracy value of 92.3% indicating astatistically strong level of accuracy \u0000ConclusionThe Schiotz tonometer has an accuracy rate of 92.3% in examining intraocular pressure using a loadof 7.5 type II diabetes patients which can replace the Goldmann Applanation Tonometer as the goldstandard if normal ocular rigidity is found","PeriodicalId":165753,"journal":{"name":"Ophthalmologica Indonesiana","volume":"16 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139782905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hemi-Jensen Procedure as Heavy Eye Syndrome Treatment: A Case Series","authors":"Harlin Farhani, Julita","doi":"10.35749/ye8c6848","DOIUrl":"https://doi.org/10.35749/ye8c6848","url":null,"abstract":"Introduction : Heavy eye syndrome is an acquired myopia-associated strabismus characterized by esotropia and hypotropia accompanied by abduction and elevation limitations. This case series reports two heavy eye syndrome patients that underwent hemi-Jensen procedure combined with medial rectus recession with good postoperative result. \u0000Case Illustration : A 60-year-old female had right eye (RE) fixed inward and bilateral high myopia (S-13.00 D). RE Hirschberg test: >45° esotropia and hypotropia and RE axial length (AL) 28.3 mm. Second patient, a 53-year-old female, had both eyes fixed inward and bilateral high myopia (S-12.00 D). Both eyes Hirschberg test: >45° esotropia and hypotropia, left eye AL 31.4 mm, and prephthisis RE. Intraoperative identification of both patients revealed displacement of superior and lateral rectus muscles. No surgery performed on prephthisis eye. Hemi-Jensen procedure combined with medial rectus recession resulted in orthophoria (first patient) and central position in primary gaze (second patient), with improved ocular motility on both patients. \u0000Discussion : Heavy eye syndrome occurs in eyes with high myopia. The elongated globe in high myopia results in superotemporal herniation of the globe and superior and lateral rectus muscles displacement, which increases depression and adduction force. Hemi-Jensen procedure is a loop myopexy procedure which corrects the deviated muscle paths in heavy eye syndrome. Concurrent medial rectus recession can be performed with hemi-Jensen procedure if there is likely contracture of medial rectus. \u0000Conclusion : Heavy eye syndrome is a strabismus fixus condition which occurs in eyes with high myopia. Hemi- Jensen procedure is an effective treatment for heavy eye syndrome which improves ocular alignment and motility.","PeriodicalId":165753,"journal":{"name":"Ophthalmologica Indonesiana","volume":"8 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139783005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Terson’s Syndrome due to Ependymoma: A Rare Case Report","authors":"Priscillia Tondolambung, Robby Tumewu","doi":"10.35749/h6a0e355","DOIUrl":"https://doi.org/10.35749/h6a0e355","url":null,"abstract":"Abstract \u0000Introduction : Terson's syndrome is often associated with subarachnoid hemorrhage. Other reported causes, include trauma, tumors, hypertension, perioperative and postoperative intracranial hemorrhage, or increased intracranial pressure. This case demonstrates a unique pathogenesis of Terson's syndrome. \u0000Case Illustration : A 14-year-old boy presented with the blurred vision on both eyes 3 weeks ago, accompanied with nausea, vomiting, and headache, with normal blood pressure measurement (126/80mmHg). He also had a history of head injury. His visual acuity was 6/20 uncorrected with pinhole on both eyes. Both intraocular pressures within normal limits. The anterior segment showed bilateral mid-dilated reactive pupil. Funduscopy revealed bilateral papilledema with peripapillary hemorrhage, similar to retinal vein occlusion, which is suggestive with Terson’s Syndrome. Magnetic Resonance Imaging (MRI) scan showed an ependymoma mass. We consulted this case with Pediatric Neurosurgeon, who planned for ventriculoperitoneal shunt with craniotomy tumor removal. \u0000Discussion : Terson's syndrome now defined as any intraocular hemorrhage associated with intracranial hemorrhage or elevated intracranial pressures. In this case, the etiology was thought to be increased intracranial pressure, which may be caused by ependymoma. Ependymoma is one of the most common central nervous system tumors in children. Intraocular hemorrhage in Terson’s syndrome is often self-limiting, but ependymoma needs neurosurgical intervention, which has lower survival rates for children with posterior fossa tumors. \u0000Conclusion : There are still controversies regarding the pathogenesis of Terson's syndrome. Not the occlusion, but the compression of the central retinal vein, by the increased pressure of cerebrospinal fluid due to high intracranial pressure, which increases the retinal venous pressure and causes retinal hemorrhage.","PeriodicalId":165753,"journal":{"name":"Ophthalmologica Indonesiana","volume":"25 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139783319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Corneal Collagen Cross-Linking (CXL) in Pediatric Keratoconus: Changes in Visual Acuity and Biomechanical Properties","authors":"Ganjar Sulaksmono","doi":"10.35749/nhfhjq57","DOIUrl":"https://doi.org/10.35749/nhfhjq57","url":null,"abstract":"Abstract \u0000Introduction & Objectives : Keratoconus is a progressive disease that changes the mechanical shape of the cornea due to thinning of the stromal layer of the cornea. Therefore, early detection and correct management should be able to slow the progression of the disease. This study aimed to compare changes in visual acuity and biomechanic properties of cornea in patients who underwent Corneal Collagen Cross- Linking (CXL) in Dr. Sardjito General Hospital \u0000Methods : This is a prospective study that included all pediatric keratoconus patients without any underlying disease that underwent CXL between July 2022 to December 2022. Uncorrected Visual Acuity (UCVA), Best Corrected Visual Acuity (BCVA), Central Corneal Thickness (CCT) and Intraocular Pressure (IOP) were evaluated preoperatively, 2 weeks, and 6 weeks following CXL. \u0000Results : Mean age of patients was 11 (range 6-18 y.o). UCVA were 1.00±0.34 logMAR preoperatively, 0.95±0.35 and 0.88±0.37 logMAR at 2 and 6 weeks after CXL (P=0.27 and P=0.02, respectively). BCVA were 0.37±0.28 logMAR preoperatively, 0.46±0.28 and 0.35±0.21 logMAR at 2 and 6 weeks after CXL (P=0.05 and P=0.46, respectively). Mean IOP were 15.21±3.99 preoperatively, 14.45±2.73 and 15.21±3.68 at 2 weeks and 6 weeks after CXL (P=0.33 and P=1.00, respectively). Mean CCT were 503.09±49.43 preoperatively, 508.18±47.68 and 506.82±48.41 at 2 weeks and 6 weeks after CXL (P=0.01 and P=0.11, respectively). No complications occurred during the observation period. \u0000Conclusion : UCVA and BCVA were improved after CXL. Analysis showed no significant change for IOP and CCT after CXL procedure. Overall, CXL was safe and significantly improve UCVA and BCVA in pediatric keratoconus.","PeriodicalId":165753,"journal":{"name":"Ophthalmologica Indonesiana","volume":"27 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139783367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical Characteristics and Compliance of Diabetic Macular Edema Patients to Intravitreal Anti-VEGF Injection Loading Dose at Cipto Mangunkusumo Hospital","authors":"Theresia Kania, A. R. Yudhanta","doi":"10.35749/e74s1782","DOIUrl":"https://doi.org/10.35749/e74s1782","url":null,"abstract":"Introduction & ObjectivesDiabetic retinopathy is the fifth most common cause of preventable blindness. In cases of diabeticmacular edema (DME), loading dose is a critical phase to achieve a stable concentration ofintravitreal vascular endothelial growth factor (VEGF) in order to prevent progressivity. This studyaims to determine the demographic and clinical characteristics, waiting time, compliance, as well asthe relationship between education, domicile and clinical outcomes to compliance during loadingdose in DME patients. \u0000MethodsIn this retrospective descriptive study, we reviewed medical records of DME patients who receivedanti-VEGF intravitreal injection between 1 January 2019 and 31 December 2020, while alsocomparing records in 2019 (pre-Covid-19) and 2020 (during Covid-19). \u0000ResultsThere were 160 patients (207 eyeballs) in 2019 and 83 patients (114 eyeballs) in 2020 who receivedloading dose with similar profiles of sex, age, education, initial visual acuity and central macularthickness (CMT). Median waiting times in 2019 and 2020 were 19 days and 23.5 days, respectively(p=0.016). Only 25 (30.5%) and 15 (35.7%) patients were punctual in 2019 and 2020, respectively.There was no significant relationship between education and domicile with compliance (p= 0.45, p=0.51). Furthermore, there were visual acuity improvements of -0.18 logMAR and -0.0 logMAR in thepunctual and unpunctual group, respectively, as well as CMT decrease of -181 ?m and -156 ?m,respectively. \u0000ConclusionMost patients who received loading dose were unpunctual. There was no significant relationshipbetween education and domicile with compliance. Furthermore, there were more significantimprovements in clinical outcomes among the punctual patients.","PeriodicalId":165753,"journal":{"name":"Ophthalmologica Indonesiana","volume":"23 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139783439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Widyana, FELICIA WIDYAPUTRI, Supanji, MUHAMMAD BAYU SASONGKO
{"title":"When do Ophthalmology Residents Study to Prepare for The National Exam?","authors":"Widyana, FELICIA WIDYAPUTRI, Supanji, MUHAMMAD BAYU SASONGKO","doi":"10.35749/s8v7c246","DOIUrl":"https://doi.org/10.35749/s8v7c246","url":null,"abstract":"Abstract \u0000Introduction & Objectives : Ophthalmology residents are occupied with clinical services in the hospital. They only have limited time to study. Since 2022, we established a progress test for residents to facilitate their study especially during the national examination preparation that is obligated to be completed once per year. To report the allocated time for completing the progress test by ophthalmology residents to inform educational centres about the recommended study time for residents. \u0000Methods : Data from the online progress test that was available from the Gadjah Mada eLearning (GAMEL) platform was extracted and analysed. The test was consisted of 60 multiple questions and opened for two weeks with a 24-hour access time. In this study, the scores, the time of the test, and time spent to complete the test were descriptively and quantitatively analysed. \u0000Results : Overall, 42 out of 55 (76.4%) and 42 out of 56 (75.0%) residents completed the progress test with a total test attempt of 60 and 51 times in 2022 and 2023, respectively. The mean score achieved was 43.3 (min-max 3.3-70.0). Majority of residents (65.8%) accessed the test at between 16.00 - 23.00 Western Indonesian Time (WIT), while 19.8% and 14.4% at between 09.00 - 16.00 and 03.00 - 9.00 WIT. The mean time spent to complete the test was 55.2 20.9 minutes. \u0000Conclusion : Most ophthalmology residents spent their time for completing the progress test after working hours with an average duration of less than an hour. Any national exam preparation programs can be scheduled in this time for better resident’s engagements.","PeriodicalId":165753,"journal":{"name":"Ophthalmologica Indonesiana","volume":"32 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139783473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}