bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenges in Managing Eyelid Basal Cell Carcinoma with Mohs Surgery and Close the Large Eyelid Defect after Tumor Removal
Authors: Rhendy Rio , Irawati Yunia , Sampurna Adhimukti
Published: January 2024

Background: Basal cell carcinoma (BCC) is the most common skin cancer of the eyelid. The important things management we have to emphasize are to prevent recurrence rate and to get the good cosmetic result after reconstruct the large defect. The aim of this case report is to show the management of both eyelid basal cell carcinoma and large eyelid defect after tumor removal.Methods: Case Report. A Woman 40 years old was reffered from Dermatovenereology Department of Cipto Mangunkusumo Hospital with aggressive type BCC. The location of the tumor was at inferior left eyelid with size of 18 x 19 mm. They planned to perform Mohsâ€™ surgery and consulted to Plastic and Reconstruction division of Ophthalmology Department for eyelid reconstruction. After Mohsâ€™ surgery the horizontal length of the eyelid defect was more than 50% and vertical defect was more than 15 mm. The Mustarde cheek advancement flap were choosen.Results: Post operation necrotic tissue was noted do to ischemic problem. Oral corticosteroid was given with tapering dose for six days. One month later, the condition was improved and Dermatovenereology department performed diode laser for the necrotic tissue and further showing good result.Conclusion: The management for eyelid BCC were still challenging including the technique to reconstruct the large eyelid defect, the risk of recurrence after the tumor removal and post operative result. The dicision to choose the proper technique to reconstruct the eyelid defect and tight follow-up after surgery will give optimal functional and cosmetic result.Â Keywords: basal cell carcinoma; Mohs surgery; Mustarde cheek advancement flap; necrotizing flap; corticosteroid; diode laser
Penggunaan Lensa Kontak untuk Astigmatisma Paska Keratoplasti
Authors: Rahayu Tri
Published: January 2024

Background: Fitting Contact Lenses for post penetrating keratoplasty patiens can be a great challenges to contact lens practitioner. Despite advances in surgical techniques for penetrating keratoplasty, post- operative ametropia and high irregular astigmatism still remain common. Patients who have such those problems may need contact lenses to achieve optimal vision.Case Illustration: Case 1. A 12 years old boy have a high myop and astigmatism after undergone penetrating keratoplasty combined with traumatic cataract extraction and IOL implantation. His right eye vision was 6/24 with corrections of S â€“ 8.00 C â€“ 6.50 x 150. His right eye was fitted with RGP contact lens with Base curve of 7.20 mm, Power of â€“ 10.25 D, and diameter of 8.80 mm. His RE vision with RGP contact lens was 6/12; Case 2. Female, 18 years old, was diagnosed with compound high myopia astigmatism of right eye due to disfigured cornea post keratoplasty and high astigmatism of the left eye due to corneal scar. Piggyback contact lens system is then used to treat her right eye.The patientâ€™s uncorrected visual acuity on the right eye was half meter counting finger, became 6/40 with spectacle and 2 meters counting finger became 3/60 with spectacle on the left eye. With piggyback contact lens consisting of soft contact lens 8.60/-10.00/14.20 and RGP lens 7.20/-4.00/8.8 on the right eye, and RGP lens 7.90/-5.00/9.2 on left eye, her visual acuity became 6/12 on her right eye became 6/9 on the left eye.Conclusion: Rigid gas-permeable and combination of rigid gas permeable and soft contact lenses can be fitted with piggy-back system successfully in patients unable to achieve optimal vision with spectacle correction after penetrating keratoplasty
Phacoemulsification in High Myopia with Silicon Filled Eye
Authors: Harmani Bondan , Victor Andi Arus
Published: January 2024

High myopia is a pathologic condition which has different anatomy from emmetropic eyes. The elongated vitreous chamber were increasing the shear stress of vitreous and retina, giving risk to several vitreoretinal disorders especially retinal detachment (RD). The extensive and complicated RD that happened in high myopic eyes make pars plana vitrectomy with silicon oil (SO) tamponade more preferable. Unfortunately, treatment of RD in high myopic eyes, especially with SO increase the incidence of cataract. The incidence of cataract in SO filled eyes is nearly 100% if the SO remains for several times. This paper reviews these issue, presenting the way to treat cataract in high myopic SO filled eye effectively with combination of phacoemulsification and SO removal with IOL implantation, helped with the usage of IOL Master. Â Keywords: phacoemulsification, high myopia, silicon filled eye
Cultivated Limbal and Oral Mucosal Epithelial Transplantation in Severe Ocular Surface Disease
Authors: Widyakusuma Astriviani , Susiyanti Made
Published: January 2024

Background: To evaluate and compare the clinical outcome and safety of Cultivated Limbal Epithelial Transplantation (CLET) and Cultivated Oral Mucosal Epithelial Transplantation (COMET) in severe ocular surface disease.Methods: Retrospective literature review. Studies reporting CLET or COMET as treatment of ocular surface disorder were included in this review. All studies were level IV or higher published between 2002 and 2012. The outcomes evaluated in each study include transplantation success rate, improvement of visual acuity, and the safety covered post operative complications. No publication data restriction was used.Results: Eight articles were reviewed. Steven-Johnson Syndrome (SJS) was found to be the most common cause of ocular surface disease in all studies. None of these studies compared CLET and COMET directly. All studies achieved success rate and 3-years survival rate of more than 50%. Visual acuity improvement ranged between 43.5-67.8%, while the mean duration unitl epithelization ranged between 13.7 days to 3 months. The most common complication was persistent epithelial defect (PED).Conclusion: Both CLET and COMET offer a viable and safe alternative in ocular surface reconstruction, and thus may be considered as the management of the ocular surface disorder following SJS or chemical injury.Â Keywords: Cultivated limbal epithelium transplantation, cultivated oral mucosal epithelium transplantation, ocular surface disorder, ocular surface disease
Primary Health Care and Our Profession
Authors: Gondhowiardjo Tjahjono D.
Published: January 2024

(No abstract available)
Management for Perforated Moorenâ€™s Ulcer
Authors: Putri Linda Wira , Vitresia Havriza , Sukmawati Getry
Published: January 2024

Background: To report the surgical management for perforated Mooren's ulcer by performing conjunctival resection with situational corneal suture and Amniotic Membrane Transplantation.

Case Illustration: There were six patients diagnosed with Mooren's ulcer between 2011-2013. Three of them were perforated Mooren's ulcer with iris prolaps, and the size of perforation was 2-4 mm. The sex distribution of the patient were 3 male and 3 female patients. The age of presentation of were varied from 11-48 yo. Three patients underwent surgery, one patient refused. The other 2 patients only got medical therapy. For perforated cases with iris prolaps, we performed conjunctival resection with situational corneal suture, overlying the perforation. The suture were made like a net or bridge, depend on cases, and then amniotic membrane were put over the suture. The corneal suture should not be tight because it can disrupt the corneal contour. Amniotic membrane were put on the net layer by layer, and then fixed by interrupted suture to the episclera and cornea, at least in 8 position. The eyes were patching about 4 days and give topical and systemic antibiotic, and corticosteroid systemic. All of patient have complete epithelization after surgery between day 7-10 and have visual acuity improvement. Some of the patient still followed up until now.

Conclusion: Conjunctival Resection with situational corneal suture and Amniotic Membrane Transplantation appeared to be an effective procedure for perforated Mooren's ulcer and iris prolaps, even more than 2 mm size of perforation.
Efficacy and Safety of Mydriatic Regiments Used in Screening Retinopathy of Prematurity
Authors: Irma Elisabeth , Barliana Julie D.
Published: January 2024

Background: ROP screening must be done under pupil dilation to examine the ocular fundus, in order to allow diagnosis and staging of ROP. The objectives of this literature review are to compare the efficacy and safety of topical cyclopentolate, phenylephrine, tropicamide and the combination of these regiments in infants for ROP screening. Methods: The search was conducted through electronic databases providing journal articles with keywords: cyclopentolate, phenylephrine and tropicamide on pupil dilation and systemic side effects in infants on screening Retinopathy of prematurity.The baseline of pupil diameter, frequency of instillation, mean difference amount of dilated pupil size and diameter of the pupil in 30 or 45 minutes and 60 minutes are presented in outcome. Results: The mydriatic agents used in this literature review were phenylephrine, tropicamide, cyclopentolate and the combination of those regiments. Doses of mydriatic agents used in this review are variables. The lowest dose for phenylephrine is 1%, cyclopentolate is 0.2% and tropicamide is 0.5%. The highest dose for phenylephrine is 2.5%, cyclopentolate is 1.0 % and tropicamide is 10 %. The use of mydriatic regiments during newborn ophthalmic examinations has been associated with systemic side effects. Most reports have implicated the sympathomimetic component of the mydriatic solutions as the hypertensive agents. Conclusion: Using only cyclopegic regimens did not produce adequate mydriasis in infants. The combination of low concentration sympathomimetic (phenylephrine 1%) and parasympatholytic (Cyclopentolate 0.2 %) produces adequate pupillary dilation and does not cause an increase in blood pressure and heart rate.
A Comparison 24 Hour Intraocular Pressures Between Travoprost 0.004% and Timolol Gel 0.1% on Controlled Primary Open Angle Glaucoma
Authors: Susetyo Puranto Budi , Oktariana Virna Dwi , Supiandi Edi , Prihartono Joedo
Published: January 2024

Background: To compare 24 hours intraocular pressure (IOP) in patients controlled primary open angle glaucoma treated with timolol gel 0.1% versus travoprost 0.004%. Method: 26 controlled primary open angle glaucoma patients were randomized to received travoprost 0.004% dosed in the evening or timolol gel 0.1% dosed in the morning. After 4 weeks of treatments 24 hours IOP curved was performed at 9 a.m until 6 a.m every 3 hours. Result: The mean IOP of travoprost 0.004% group was 12.2Â±1.5 mmHg and timolol 0.1% group was 13.4Â±1.9 mmHg (p>0.05). The IOP fluctuation of travoprost 0.004% was 3.9Â±1.4 mmHg and timolol gel 0.1% was 5.9Â±1.4 mmHg (p<0.05). Peak IOP travoprost 0.004% was 14.3Â±1.7 mmHg and timolol gel 0.1 % was 16.8Â±1.7 mmHg (p<0.05). Travoprost 0.004% has lower IOP in almost each point measurement compare to timolol gel 0.1%. Conclusion: Travoprost 0.004% has lower fluctuation, peak and mean IOP compare to timolol gel 0.1%. Keywords: Primary open angle glaucoma, IOP fluctuation, peak IOP, travoprost 0.004%, timolol gel 0.1%
Clinical Outcomes of Laser In Situ Keratomileusis (LASIK) Using Microkeratome and Laser Femtosecond Flap in Myopic Patients
Authors: Caesarya Sesy , Wangsaatmadja Hikmat , Rini Mayang , Karfiati Feti
Published: January 2024

Background: This study aimed to compare postoperative visual acuity and complications between flap LASIK creation using microkeratome and femtosecond laser. Method: This is a retrospective observational study. Data were collected from medical record, patient with microkeratome and femtosecond laser flap creations with best corrected visual acuity 6/6 preoperatively.Uncorrected postoperative visual acuity at 1 day, 1 week and 1 month, also complications were recorded. Result: The microkeratome and femtosecond laser group comprised of 130 and 184 eyes respectively. Visual acuity at 1 day follow up were 99.23% â‰¥6/12 in microkeratome group and 96.20% â‰¥6/12 in femtosecond laser group (P=0.19), at 1 week follow up were 99.23% â‰¥6/12 in microkeratome group and 97.82% â‰¥6/12 in femtosecond laser group (P=0.36) and 1 month follow up were 99.23% â‰¥6/12 in microkeratome group and 98.37% â‰¥6/12 in femtosecond laser group (P=0.60). There were significant differences in intraoperative (P=0.00) and postoperative (P=0.04) complications between two groups. Conclusion: There was no significant difference in visual acuity between LASIK flap creation using microkeratome and femtosecond laser at 1day, 1 week and 1month follow up. There were significant differences in intra and postoperative complications between two groups. Keywords: LASIK, microkeratome, femtosecond laser
Comparison of Laser Photocoagulation Using 810 nm with 20 ms and 100 ms Duration on the Progression of Neovascularization in Proliferative Diabetic Retinopathy
Authors: Yusran Muhammad , Elvioza Elvioza , Djatikusumo Ari , Andrisa Rossalyn Sandra
Published: January 2024

Background: The aim of this study was to compare the effectiveness of laser photocoagulation 810- nm with 20 ms and 100 ms duration to prevent the progression of proliferative diabetic retinopathy. Method: This study was prospective double blind randomized clinical trial. Twenty-eight participants who met the inclusion criteria divided into two groups to undergo laser photocoagulation by using 810 nm lasers. One group received 100 ms duration and the other received 20 ms duration. Grade 3 burns with a 200 Î¼m spot sized were placed with both parameters. The progression of PDR was evaluated in two months follow up by using seven fieldsâ€™ fundus photographs. Fluence, power and visual acuity were compared in this study. Result: Twenty five subjects completed the two months follow up. The proportion of non-progressive PDR in 100 ms group was 75.0% and in 20 ms was 76.9% (p=1.000). The power in 20 ms group increased twice than 100 ms group (1000 vs. 500 mW; p=0.000). The median fluence in 20 ms group was less than 100 ms group (6.36 vs. 15.91 J/cm2; p=0.000). Improvement of visual acuity in 20 ms and 100 ms was comparable (23.1% vs. 33,3%; p=1.000). Conclusion: The 20 ms duration showed similar result in preventing the progression of PDR compared to 100 ms duration. Keywords: Proliferative diabetic retinopathy, laser photocoagulation, diode 810 nm
Pupil Cycle Time in Household Contacts with Leprosy Patients
Authors: Ridhayani Waode , Syawal Siti Rukiah , Umar Batari Todja
Published: January 2024

Background: Household contacts of leprosy patients have a higher risk for infection of leprosy. This study is to determine the change in Pupil Cycle Time (PCT) in household contact with leprosy patients and compare them with normal people who are not in household contact with leprosy patients in Makassar. Methods: It was carried out in Tadjuddin Chalid hospital in Makassar and uses cross-sectional study to 61 subjects for each group. The study subjects are divided into two groups: normal people with household contact with leprosy patients, and normal people without household contact as a control group. PCT examinations were performed to the subjects in both groups using biomicroscope slit lamp and digital stopwatch to determine the value of PCT. Result: The study indicates that the average PCT OD and OS of the group with household contact with leprosy patients are 1119.80 (Â±169.51) milliseconds and 1123.67 (Â±189.92) milliseconds respectively. Meanwhile, the PCT OD and OS average of the normal people who are not household contact with leprosy patients are 772.67 (Â±87.75) milliseconds and 776.85 (Â±82.87) milliseconds respectively. There is a significant difference of PCT between people with household contact with leprosy and those who are not (p=0.000). The length of household contact with leprosy patients has a significant influence with the PCT (p=0.000). Conclusion: The result proves that the PCT of those in household contact with leprosy patient is longer than that of those without contact. The longer the household contact with leprosy patients, the longer the pupil cycle time. Keywords: Pupil Cycle Time, household contact with leprosy patients, leprosy
The Differences Between Tumor Necrosis Factor-Î± (TNF-Î±) Expression in Fleshy and Atrophy Pterygium
Authors: Satrio Reza , Winarto Winarto , Sundari Siti
Published: January 2024

Background: Pterygium is a conjungtival fibrovascular degenerative process which fleshy type was different to atrophy type, in which post operative recurrencies was high especially fleshy type. The exact pathogenesis were not clearly understood, it was reported that many inflammation mediators had a play role, including Tumor Necrosis Factor-Î± (TNF-Î±). Objective of the study was to revealed a different expression of TNF-Î± in fleshy and atrophy type. Method: Cross-sectional study design have been done with independent variable was TNF-Î± and dependant vaiable was pterygium type. Samples consist of 20 patients fleshy type and 20 patients atrophy type, both groups were given fluorometholone eye drop for 1 week prior surgery to suppress the degree of inflammation. The baseline data was recorded e.g. demography, the size of pterygium, Tear Break Up Time (TBUT), Schirmer test and Ferning test. Pterygium excission followed by limbal stem cell graft, and examination of TNF-Î± expression by immunohistochemistry. TNF-Î± expression was analyzed using 2 x 2 table. Result: Baseline data of both groups were not significantly different, except TBUT (p=0.000) and the clinical characteristic of pterygium (p=0.000). TNF-Î± expression in fleshy type tend to be higher (total Allred score mean 4.70) but not significantly different than atrophic type (total Allred score mean 4.54 and p=0.61). Previous fluorometholone treatment prior to surgery might be suppressed the inflammatory cytokine. Conclusion: No significant difference of the TNF-Î± expressions between fleshy and atrophy type of pterygium. Keywords: pterygium, fleshy type, atrophy type, TNF-Î±, immunohistochemistry
A Challenge in Diagnosing Aqueous Misdirection Glaucoma after Keratoplasty
Authors: Sari Yunita , Oktariana Virna Dwi
Published: January 2024

Background: The purpose of this case presentation is to report the difficulty of diagnosis and managementof an aqueous misdirection of glaucoma after penetrating keratoplasty (PK).Case Illustration: A 35-year-old male presented to the Glaucoma Division of Cipto MangunkusumoHospital with complain of painfull, redness on the left eye (LE), vomiting, headache. He was reffered fromInfection and Immunology Division with diagnosis of secondary glaucoma after keratoplasty due to cornealulcer and had been treated with glycerin, oral acetazolamide, timolol 0.5% eye drop (ED). The examinationshowed visual acuity of LE at presentation was 1/300 good projection and the intraocular pressure (IOP)was 48 mmHg. Slit lamp examination showed opaque corneal graft, shallow or flat central and peripheralanterior chamber. Iris, pupil, lens and funduscopy were hard to be evaluated. The patient assessed withaqueous misdirection of glaucoma after keratoplasty. Sclerotomy and anterior chamber reformation wasthen performed. One day after surgery, the examination revealed deep anterior chamber and decreased IOPto 24 mmHg, patient received no improvement on visual acuity.Conclusion: The goal addressed in management of aqueous misdirection of glaucoma after keratoplasty arereducing the IOP and preserving optimal graft clarity. However, until recently, there is no consensus aboutthe management of aqueous misdirection of glaucoma after keratoplasty. Scleromotomy with reformation ofan anterior chamber is the alternative treatment when medical therapy fail to control the IOP.
Comparison of Peripapillary Retinal Nerve Fiber Layer (RNFL) Thickness between the Normal and Glaucoma Eyes with the Same Vertical Cup Disc Ratio (CDR) using Optical Coherence Tomography (OCT)
Authors: Raiasih Ni Gusti Ari Ayu , Elvioza Elvioza , Oktariana Virna Dwi , Prihartono Joedo
Published: January 2024

Background: Glaucoma is a disease that belongs to a group of neurodegenerative diseases, such as impaired visual field and optic neuropathy with progressive damage to the optic nerve and retinal nerve fiber layer (RNFL) which is caused by the loss of ganglion cells and axon of the optic. Changes in the optic nerve and RNFL may occur prior to the abnormalities of the visual field nerves. Currently, the visual field examination should be performed to diagnose glaucoma but with patient-subjective result. Before it is detectable, visual field abnormalities are likely going to lose its ganglion cells by 40%. The purpose of this study was to assess and compare the peripapillary retinal nerve fiber layer (RNFL) between the normal and glaucoma eyes with vertical cup disc ratio (CDR) 0.4 to 0.7 in eye clinic Cipto Mangunkusumo Hospital (RSCM) Kirana. Methods: A total of 40 eyes of normal group and 34 eyes of glaucoma following Humphrey field analyzer examination and Optical Coherence Tomography (OCT) were evaluated. Peripapillary RNFL thickness between normal and glaucoma eyes were analyzed and compared each other. Eyes of glaucoma group then were grouped into early-stage glaucoma, according to the criteria in the initial stages of the examination results of Humphrey field analyzer. Result of peripapillary RNFL thickness was analyzed to get a cut off value. Results: Peripapillary RNFL thickness in the normal group with vertical CDR 0.4 to 0.7 was 111.3Â±9.8 Î¼m to 118.0Â±3.0 Î¼m, and glaucoma groups with vertical CDR 0.4 to 0.7 was 105.6Â±12.6 Î¼m to 113.7Â±6.1 Î¼m. Retinal nerve fiber layer thickness in normal group compared to glaucoma group in the superior quadrant, inferior, nasal, temporal and average on CDR 0.4 to 0.7 was not statistically significant (p>0.05), except on vertical CDR 0.6 average peripapillary RNFL (p<0.05). Cut off value of peripapillary RNFL in superior quadrant was 164 Î¼m, inferior 169.5 Î¼m, nasal 82.5 Î¼m, temporal 73.5 Î¼m and average 111.8 Î¼m. Conclusion: There was no difference in changes of peripapillary RNFL along with the progression of vertical CDR but clinically, peripapillary RFNL thickness in glaucoma group is thinner than that of normal group with the same vertical CDR except in temporal quadrant. Keywords: Retinal nerve fiber layer (RNFL), cup disc ratio (CDR), optical coherence tomography (OCT)
The Analysis of Vasculopathy Risk Factors to the Incidence of N-AION
Authors: Oktaviana Intan , Prihatningtias Riski
Published: January 2024

Background: Nonarteritic Anterior Ischemic Optic Neuropathy (N-AION) is an optic disc oedem caused by ischemic process. The disease often occured at old age population and threatening the vision. Vasculopathy was assumed to accelerate the ischemic process in the incidence of N-AION. The purpose of this study is to analyze the vasculopathy risk factors that play a role to the incidence of N-AION in Kariadi Hospital Semarang. Methods: This was an analytic observational study with chi square test. Samples were obtained from patientâ€™s medical record who were diagnosed as N-AION in Kariadi Hospital eyeâ€™s clinic from January 2012 to June 2014. The data included vasculopathy risk factors consisting of hypertension (blood pressure >140/80 mmHg), diabetic Mellitus (blood sugar >200mg/dl) and dislypidemia, including hypercholesterolemia (>200 mg/dl), hypertriglyceride (>150 mg/dl) and the increase of LDL level (>140 mg/dl). All the data was analysed by SPSS 15.0. Results: A total of 31 patients of N-AION were reviewed, 20 patients (64,5 %) had risk factors of hypertension and those with diabetic mellitus. Twenty five patients (80.6%) were hypercholesterolemia, 15 patients (48.4%) were hypertriglyceride and 11 patients (25.5%) had increasing LDL level. The statistical testing using chi square test (Î± = 0,05) resulted only hypercholesterolemia (p=0.001) which had a significant correlation with the incidence of N-AION, meanwhile hypertension (p=0.106), diabetic mellitus (p=0,106) and hypertriglyceride (p=0.857) had no significant correlation. Conclusion: Statistic analysis of vasculopathy risk factors to the incidence of N-AION indicates that hypercholesterolemia is the most influence risk factor. Keywords: N-AION, risk factor, vasculopathy
Amblyopia among Junior High School Students
Authors: Widadi Kuntadi Wahyu , Suhardjo Suhardjo , Hartono Hartono
Published: January 2024

Background: To determine the prevalence of amblyopia and correlation between the type of refractive error with the incidence of amblyopia on junior high school students in Yogyakarta Special Province. Methods: A cross-sectional study was conducted on one school in each district/city in Yogyakarta Special Province. All students underwent visual acuity, anterior segment and fundus examination. Best corrected visual acuity test was done on students with decreased visual acuity. Crowding phenomenon, neutral density filter, and eyeball alignment test were done on suspected amblyopic students. Amblyopia was defined if corrected visual acuity â‰¤6/12 or less in one or both eyes, or the difference of at least two best corrected visual acuity lines, without organic pathology. Results: A total of 1,664 students were examined, 1,590 were analyzed, 773 (48.6%) boys, 817 (51.4%) girls. There are 1,272 (80%) emetropia, 308 (19.4%) refractive errors, 1 (0.1%) anterior segment abnormality, 9 (0.6%) posterior segment disorders. On refractive error students obtained 359 (62.4%) eyes myopia, 2 (0.3%) eyes hyperopia, and 214 (37.2%) eyes astigmatism. Amblyopia prevalence was 1.07% (17 of 1,590 students), 8 (47.0%) boys and 9 (53.0%) girls. Astigmatism significantly affect the incidence of amblyopia, odds ratio 10.959 (95% CI: 3.189 to 37.667). The axis of astigmatism cylinder has no effect on the incidence of amblyopia. Anisometropia significantly affect the incidence of amblyopia, odds ratio 13.109 (95% CI: 4.618 to 37.208). Conclusion: Amblyopia prevalence on junior high school students in Yogyakarta Special Province was 1.07% with astigmatism and anisometropia influenced the occurrence. Keywords: Amblyopia, prevalence, refractive error, astigmatism, anisometropia
Red-Free Fundus Photograph and Fluoroscein Angiography Aggreement in Assessing Retinal Nonperfusion Area
Authors: Chalid Kurniawan , Erwin Iskandar , Mayang Rini
Published: January 2024

Background: Retinal nonperfusion area assessment in retinal vein occlusion (RVO) patient is valuable to evaluate progression, therapy, and prognosis. Noninvasive method such as red free fundus photograph that has been processed using a specific program are expected to have correspondence with fundus fluorescein angiography (FFA), as the gold standard in assessing nonperfusion area. Methods: A cross-sectional study. 24 pairs of red free image and FFA were collected from RVO patients at Cicendo Eye Hospital selective consecutively admission from March until August 2013. Red free digital image processing was done by a technician and nonperfusion area was deliminated by a vitreoretina expert. Statistical analysis Wilcoxon signed ranks test was used to compared the nonperfusion area, Spearman correlation test to assessed the correlation coefficient, and the overlapping ratio was used to assessed the morphology suitability between two method. Results: Nonperfusion area analysis between two method showed no statistical difference (Zw 4.257, p=0.161, Wilcoxon) and have a high correlation(r>0.988, p=0.000, Spearman). Suitability was determined by the ratio of morphology overlap that approaches one (overlapping ratio was 0.89). Conclusion: Red free fundus photograph digital image processing has compatibility with the FFA in assessing nonperfusion area. Itâ€™s a noninvasive method, easy, safe, and can be used as an alternative for assessing nonperfusion area of RVO patients. Keywords: Nonperfusion area, red free fundus photograph, FFA, retinal vein occlusion
The Application of Training Module about School Childrenâ€™s Central Vision Examination for Increasing Elementray School Teacherâ€™s Knowledge and Skill Level to Detect Poor Visual Acuity
Authors: Wijayaningrum Wijayaningrum , Nugraha Trilaksana , Inakawati Sri , Peni Hari
Published: January 2024

Background: Uncorrected refractive error children can lead amblyopia. To improve detection of refractive error in children, active participation of primary school teachers needed. These teachers need a guidance applied in a training to detect children poor visual aquity by examining central vision. This study objective is to prove the increase of both knowledge and skill level of school teachers in examining central vision to detect children poor visual aquity after the application of training modules. Methods: This is a quasy experimental study combined with indepth interview to take qualitatif data. One group pretest and posttest design of 45 subjects (primary school teachers from Semarang) who received a book dan tutorial compact disc modules applied in a training in April, 2013. Level of knowledge measured using questionnaire and level of skill measured using checklist. Results: Results showed both knowledge and skill level before application of training modules compared to after had significant difference (Wilcoxon, p<0,005). Qualitatif data informed a few of teachers didnot applied the skill and knowledge after the training. Conclusion: There were significant increase of primary school teachersâ€™ knowledge and skill level in examining central vision to detect children poor visual aquity after the application of training modules. Refreshing training should be scheduled periodically to maintain their knowledge and skill. Keywords: Children visual aquity, teachers detect vision, central vision training modules
Identification Insertion/Deletion 6bp of 3â€™-Untranslated Region Thymidylate Synthase Gene in Orbital Region Basal Cell Carcinoma
Authors: Kavotiner Lady , Ibrahim Ibrahim , Saleh Irsan
Published: January 2024

Background: Basal cell carcinoma (BCC) is the most common eyelid malignancy tumor. The risk factor for development of BCC related to environtmental factor especially prolonged sun exposure and individual factor. One of the internal risk factor contributes to BCC development is genetic instability including defects in folic acid synthesis or DNA synthesis. Enzyme participates in this process is 3â€™-untranslated region Thymidylate synthase gene (UTR TS). This study is to identify the insertion or deletion of 6bp of 3â€™-UTR TS gene in orbital region BCC. Methods: This study was a descriptive explorative study with case series which involved 13 orbital region basal cell carcinoma (BCC). The diagnosis was based on histological examination of the tumor. The frequencies of insertion/deletion 6bp of 3â€™-UTR TS gene were assessed by Polymerase Chain Reaction (PCR) and restriction fragment length polymorphism (RFLP) analyses using Dra I as restriction enzyme. Results: Thirteen patients consist of 9 males (69%) and 4 females (31%). Majority of subjects have history of sun exposure. The most common type of BCC is nodular type (80%). There was two subject with recurrent case. Identification result of insertion/deletion 6bp 3â€™-UTR TS gene found heterozigot mutant -6bp/+6bp in 7 samples (54%) at 152bp band and 158 bp band, homozigot mutant -6bp/-6bp in 6 samples (46%) at 152bp band. Conclusion: The results of this study were 7 samples (54%) are heterozigot mutant -6bp/+6bp and 6 sample (46%) are homozigot mutant -6bp/-6bp.
Case Series of Two Patients with Primary Malignant Melanoma of the Lacrimal Sac
Authors: Anindya Tessa H , Anggraini Neni , Kodrat Evelina
Published: January 2024

Background: To demonstrate two rare case of primary malignant melanoma of lacrimal sac.

Case Illustration: Patients were both female, 38-year-old and 46-year-old, with lacrimal sac mass,bloody discharge and epiphora. The first patient was previously diagnosed with chronic dacryocystitisand treated with antibiotics and anti-inflammation for two months which resulted in worsen conditionand enlarged swelling. Computed tomography scan revealed solid mass at lacrimal sac 13 x 12 x 7.4millimeters in size with no bone destruction. Patient underwent total mass removal surgery, whichrevealed solid highly pigmented mass. The second patient also had enlarged mass within two months.Other complaints include obstructed left nose and epistaxis. Computed tomography scan revealed solidmass at left medial canthal region involving inferior orbit, nasolacrimal duct, left nose cavity, andmaxillary sinus. Incisional biopsy revealed a malignant melanoma. Patient underwent eye exenteration,maxilectomy, and radical neck dissection.

Conclusion: Primary malignant melanoma of the lacrimal sac is a rare case and often mimics chronicdacryocystitis. Itâ€™s imporant to understand this disease entity to make accurate diagnosis and managementwith the help of imaging modality.
Characteristics and Management of Anterior Segment Dysgenesis in Pediatric Ophthalmology
Authors: Irfani Irawati , Ramadanti Sarah Nurul , Khairani Astrid Feinisia
Published: January 2024

Background: Anterior segment dysgenesis (ASD) is congenital anomaly caused by malformation of the eyeball during early pregnancy. Intrauterine ASD leads to disorder in maturation of anterior segment of the eye and its complications could interfere the normal visual development. There are several types of ASD and variability of its management. In this report, we described characteristic of ASD including its management in Cicendo Eye Hospital, Bandung. Methods: This is a retrospective descriptive study from medical records of patients with ASD in Cicendo Eye Hospital, Bandung since January 2012 until December 2014. Data were collected based on total sampling with inclusion criteria. All data were analyzed by statistical software. Results: There were 99 patients with range of age 1-day-old until 18-years-old who met the inclusion criteria of this study. Patient of ASD was commonly brought to the hospital at infant age (55.5%), boys in 51.5% patients and mostly came from out of town (70.7%). Thirty-seven percent of their mothers had history of drug consumptions during pregnancy and 30% born prematurity. Seventy percent cases of ASD were bilateral, 80.8% without systemic disease, and congenital glaucoma was the most common type of ASD (30.7%). The most common management was observation in 45.5% cases, followed by combination of surgical and medicamentosa in 30.3% cases. Conclusion: ASD is a congenital condition which has variability in types and management. Early recognition of this condition is necessary to decide the appropriate treatment to assist visual development and rehabilitation. Â Keywords: anterior segment dysgenesis, characteristics, management Â Â
Correlation between Axial Length with Central Corneal Thickness and Degree of Myopia
Authors: Andriani Riska , Eddyanto Eddyanto
Published: January 2024

Background: The axial length (AL) elongation of the eyeball is the characteristc of myopia. If this is the result of general growth, one might expect the cornea to have grown to be thicker than normal. If instead the myopic eye is larger due to a mechanism of stretching, one would expect the cornea to be thinner than normal. Several studies to determine the relationship of central corneal thickness (CCT) and the AL have reported different results. This study aims to investigate the association between AL with CCT and degree of myopia. Methods: It was a cross sectional study, involved 60 eyes of 32 myopic subjects. Axial length was measured using an A-scan ultrasound, CCT was measured with an ultrasonic pachymeter, and refractive errors was measured with trial and error method.Results: Thirty-two patients (60 eyes) were recruited for the study. The age of patients ranged from 21 to 47 years old, with a mean of 27.6Â±7.58 years. The mean axial length was 23.98Â±0.81 mm and the mean CCT was 535.98Â±26.95 Î¼m. There were 44 eyes with low myopia, 13 eyes with moderate myopia, and 3 eyes with high myopia. The analysis of covariance (Ancova) was used to verified correlation between AL and CCT (p=0.704). The Spearmanâ€™s correlation analysis was used to verified correlation between AL and degree of myopia (p=0.001). Conclusion: There was no correlation between AL and CCT. There was a significant positive correlation between AL and degree of myopia. Â Keywords: AL, CCT, degree of myopia Â Â
Vitreous Hemorrhage in Dr.Sardjito General Hospital
Authors: Darajati Irene Titin , Wardhana Firman Setya , Sasongko Mohammad Bayu , Supanji Supanji , Widayanti Tri Wahyu , Agni Angela Nurini
Published: January 2024

Background: Vitreous hemorrhage is the extravasation of blood in the vitreous cavity of the eye. It cause mild vision impaired to blindness. Moreover, vitreous hemorrhage obscures the posterior segment and if severe and non-traumatic, may lead to diagnostic dilemmas unless associated with classic systemic sign and symptoms. Objective : To provide data regarding causes and clinical aspects of vitreous hemorrhages to guide clinicians in better delineating the expected etiologic patterns of these hemorrhages. Methods: We collected medical records of patient who diagnosed vitreous hemorrhages inÂ  Dr. Sardjito General Hospital Jogjakarta between March 2015-March 2016. Characteristics of patients to be explored: age, visual acuity and gender. The data were analyzed descriptive quantitative.Results: There were 189 patients (200 eyes) who diagnosed vitreous hemorrhage in first examination. Fifty three percent of them were male and 47 % were female, most of themÂ  were over 50 years old (67.2%) and 32.8% were under 50 years old. The causes of vitreous hemorrhage were proliferative diabetic retinopathy in 131(69.3%), age-related macular degeneration (AMD) 17(9%), retinal vein occlusion 11(5.8%), retinal tear 8(4.2%), Posterior Vitreous Detachment 4(2.1%), vasculitis 3(1.6 %), Polypoidal Choroid Vasculopathy 2(1.1%), trauma 2(1.1%), Eales disease 1(0.5%), and unknown 10(5.3%) patients.Â  Vitreous hemorrhage caused by diabetic retinopathy had vast range of visual acuity (6/7,5- Light Perception) and the worst was among patients with AMD.Conclusion: Most of vitreous hemorrhages caused by proliferative diabetic retinopathy. AMD give the worst visual acuity. Â Keywords: Vitreous hemorrhage, etiology, visual acuity
Current Update of Primary Angle Closure Glaucoma
Authors: Artini Widya
Published: January 2024

Primary angle closure glaucoma is the most leading caused of permanent blindness among glaucoma patients.Â  We will describe up dated primary angle closure group management to resolved this devastated diseased. First step, a prompt diagnostic is a must, then laser peripheral iridotomy should be done. If the angle was found closed after LPI less than 1800, and intra ocular pressure increases more than 21 mmHg, the management should be followed by glaucoma medication or lens extraction. If the angle was closed more than 1800, more aggressive treatment is recommended, such as lens extraction, trabeculectomy or combined. Clear lens extraction as an early treatment is suggested in many eye centers, even though is it still controversial issue.
Situational Analysis of Eye Care Services in South Sulawesi
Authors: Amalius Ahmad Ashraf
Published: January 2024

Background: VISION 2020 as the global initiative program almost reaches the time limit. Every country in all over the world ran their programs in eye care services based on the strategic components of VISION 2020 including in Indonesia since the government declared it in 1999. The aim of this study is to report whether the condition in South Sulawesi as one of the province in east Indonesia sufficient to meet VISION 2020 target.Methods: This is a descriptive study with the qualitative and quantitative approach. Data were collected by interviewing and distributing semi-structured questionnaire to all stakeholders involved in eye care services in South Sulawesi, including ophthalmologists, ophthalmic nurses, Indonesian Ophthalmologists Association committee, provincial and district health office staffs.Results: South Sulawesi has population of 8,324,000, consists of 24 districts/city, 33 hospitals and 440primary health care (Puskesmas). Human resource data showed 67 ophthalmologists including subspecialists, 17 trained ophthalmic nurses, 6 refractionists, 3 optometrists, 1 orthoptist, and 3 counselours. Total number of cataract surgery in 2015 are 15,075 eyes. Complete data for refractive error screening and examination, glaucoma, diabetic retinopathy and corneal diseases are not available. Some advocacies and workshops had been held. Supported from government and NGO took role in building capacity for the services.Conclusion:According to VISION 2020 program, eye care services in our province is not yet ideal; but the process to build capacity, especially for 5 main focus eye disease, is still on the track.Â Keywords: VISION 2020, eye care services, cataract surgery, human resource, advocacy
The Prediction of Visual Acuity after Open Globe Injury in Children Using Pediatric Ocular Trauma Score (POTS)
Authors: Nuady Albaaza , Utomo Purjanto Tepo , Widyandana Widyandana
Published: January 2024

Background: Open globe injury is one of the major causes of non-congenital ocular morbidities in children. Ocular trauma contributes 7% of all traumas and 10-15% of all ocular diseases. This study aims to assess VA after OGI in children at Sardjito General Hospital (SGH) and YAP Eye Hospital (YAP) using POTS.Methods: Children with OGI â‰¤15 years old from emergency unit from 2014 to 2016 was evaluated in retrospective design. Age, sex, admission time, operation time, cause of trauma, initial VA, final VA, and concomitant ocular pathology were collected, then classified with POTS. We compared initial VA and final VA to predict VA after OGI in children at SGH and YAP.Results: Twenty two (88%) patients were male and three (12%) patients were female with mean age of 8.84 years old. Nineteen cases were OGI with zone 1 involvement (76%), 2 cases with zone 2 (8%), and 4 cases with zone 3 (16%). After POTS classification, OGI in group 1 was 8 (32.6%), group 2 was 12 (48%), and group 3 was 5 (20%). Mean rate of initial VA was HM, 1 month after OGI was 1/60, 3 months was 3/60, 6 months was 3/60, and 12 months was 4/60. Classification using POTS was statistically significant for initial VA (p=0.046), VA in 1 month (p=0.046), and 3 months (p=0.46).Conclusion: OGI in children causes poor prognosis for VA. Zone involvement, delayed operation time and vitreous hemorrhage correlate with poor visual prognosis in OGI. Classification of injury with POTS shows prediction of VA after OGI.Â Keywords: open globe injury in children, pediatric ocular trauma score.
Toxic Effect of Topical DLBS1425 Towards Proliferation Degree and Mucin Secretion in Rabbitâ€™s Eye
Authors: Aurelian Amy , Nugroho Trilaksana , Novita Dina
Published: January 2024

Background: Phaleria macrocarpa (DLBS1425) is a medicinal plant that has the effects of anti-cancer, anti-inflammation, anti-angiogenesis, and antioxidants. The potency of its toxicity is low towards normal cell. DLBS1425 is expected to be useable for eye drop, but its toxic effect towards goblet cell proliferation and mucin secretion still remain unknown.Methods: This is experimental study with design of comparison test. Twenty four rabbitsâ€™ eyes divided into 4 groups were given placebo and topical DLBS1425 with concentration of 1Ã—10-1 mg/ml, 1Ã—100 mg/ml, and 1Ã—101 mg/ml. Goblet cell proliferation degree and mucin secretion were evaluated using histopathology examination from rabitsâ€™ conjunctiva.Results: In the group of goblet cell proliferation, compared to control group, there was decreased proliferation degree with topical DLBS1425 of 1Ã—10-1 mg/ml; but the concentration of 1Ã—100 mg/ml and 1Ã—101 mg/ml did not affect goblet cell proliferation. In the group of mucin secretion, DLBS1425 with any concentration level decreased mucin secretion significantly.Conclusion: There was significant difference in goblet cell proliferation with topical DLBS1425 of 1Ã—10-1 mg/ml and placebo. There was also significant difference in mucin secretion with topical DLBS1425 in any concentration level and placebo.Â Keywords: DLBS1425, goblet cell, mucin secretion
Challenge in Diagnosing and Managing Carotid Caverous Fistula in Patient with Intermittent Angle Closure Glaucoma
Authors: Magdalena Maria , Oktariana Virna Dwi , Sidik M
Published: January 2024

Background: The purpose of this case report is to present a patient with Carotid Cavernous Fistula (CCF) superimposed angle closure glaucoma and how to manage the IOP and to describe treatment options for CCF. Case Report: A 72-year old female patient was consulted to Glaucoma Division with chief complain the redness of the right eye (RE). She also had blurred vision on both eyes and high IOP of the RE. The IOP of the RE tend to be fluctuated even after laser peripheral iridotomy (LPI) from prior hospital, and was different from the LE, which was stable on anti-glaucoma medication. A careful history taking, clinical examination including visual acuity and visual field defect test, and also ancillary test to confirm the diagnosis were done. The patient was assessed with intermittent angle closure glaucoma (ACG) of both eyes superimposed with carotid-cavernous fistula (CCF) of the RE and planned to undergo trabeculectomy and phacoemulsification surgery from glaucoma division, and also embolization procedure from neuro ophthalmology division. However, the schedule of embolization will be done one year later due to long waiting list at Radiology Departement.Conclusion: This case demonstrates CCF of the RE superimposed intermittent ACG of both eyes. The Clinical manifestation of CCF were subtle, therefore clinical examination and acillary test such as CT angiography were needed to establish the diagnosis and to exclude differential diagnosis. The definitive therapy for CCF is to closure the fistula, but due to long waiting list we have to consider carotid massage as conservative management. In this case carotid massage gave good result in reducing ocular manifestation of CCF. Â Keyword: Carotid Cavernous Fistula, Glaucoma, Angle-closure Glaucoma, Carotid Massage
Visual Field Defect in Pulmonary Tuberculosis Patients with Ethambutol Therapy
Authors: Nugroho Agus , Wahyuni Devi Azri
Published: January 2024

Background: Ethambutol (EMB) is important as antimicrobal in the treatment of pulmonary TB which effects ethambutol toxic optic neuropathy (EON). EON can be detected with visual field examination. Research by Vimla Menon stated that toxicity condition of EMB obtained visual field defects by 7.69%. Currently, there is no data on visual field defects in patients with TB treated with (EMB) in Mohammad Hoesin Hospital (RSMH).Methods: This was a cross-sectional observational study with a follow-up studies without controls. The samples of this research was 24 and samples taken consecutive. Visual field examination using the Humphrey Field Analyzer was performed three times: before therapy, 1 month, and 2 months after EMB therapy. Data that can be carried out were analyzed by using SPSS program. Results: Average MD before administration of EMB was -2.36Â±1.21; average MD after 1 month administration of EMB was -2.35Â±1.41; and 2 months after was -3.09Â±1.85. There was a mean change of -0.73Â±1.43 MD 2 months after EMB administration. Abnormal MD enhancement of 6.52% occured 1 month after EMB administration and 28.26% 2 months after EMB administration. Arcuate visual field defects obtained 9.3% in 2 months after EMB aministration.Conclusion: There was no significant difference in visual field examination on the object before therapy and 1 month after EMB therapy. Examination after obtaining EMB for 2 months, based on the mean deviation of visual field defects, were minimal to moderate; while based on gray scale picture was obtained arcuate visual field defects. Â Keywords: ethambutol, EON, visual field defect