bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between Retinal Nerve Fiber Layer with Visual Field Defect in Non Proliferative Diabetic Retinopathy
Authors: Alfurqon Alfurqon , Amin Ramzi , Ansyori AK
Published: January 2024

Background: In the early stages of diabetic retinopathy, neuronal abnormalities include changes in ganglion cell death. Neuronal apoptosis is suspected as one of the causes responsible for the occurrence of lesions at an early stage of diabetic retinopathy, which results in a decrease in number of ganglion cells and thinning of the layer of ganglion cells, which can be caused by several mechanisms including glutamat excitoxicitate, oxidatice stress, hyperglichemia, and neuroinflamation. Retinal ganglion cell death and axonal degeneration, will cause thinning of the retinal nerve fiber layer (RNFL) which may result in a decrease in neural function, which in turn have an impact on the occurrence of visual field defects. This study is to determine the relationship between the thickness of RNFL with visual field defects in patients with non-proliferative diabetic retinopathy (NPDR). Methods: This study is a comparative analytic cross-sectional design with sample of 66 eyes of 34 people in clinic of retina subdivision of Moh. Hoesin Hospital Palembang from July to November 2013. Patients of NPDR examined fundus photo, Oculo Coherence Tomograph and Humphrey Field analyzer. Results: RNFL thickness average in this study is 104.4Â±10.9 Î¼m. Visual field defect occur ini moderate and severe NPDR. Conclusion: There is a strong relationship between RNFL thickness with visual field defects in patients NPDR (r =-0.693). Keywords: RNFL thickness, visual field defect, NPDR Â
Measurement of the Cut Off Score of Visual Function Questionnaire on Vision Related Quality of Life to Predict Severity of Diabetic Retinopathy
Authors: Hayati Fauziah , Kartasasmita Arief , Rini Mayang , Karfiati Feti
Published: January 2024

Background: Diabetic retinopathy has a negative impact on quality of life. In order to investigate the effects of visual impairment in self-perception of quality of life, vision related questionnaires such as the National Institute Visual Function Questionnaire (NEI-VFQ-25) has been developed. The aim of this study is to predict severity of diabetic retinopathy using NEI-VFQ-25 Version 2000 by measuring the cut off score of visual function questionnaire on vision related quality of life Methods: Cross Sectional study by examining 49 diabetic retinopathy patients who meet the inclusion criteria. All patients requested to answer the questionnaire. All question have a score and all question scores then categorized into a number of subscales that can be averaged to yield the subscale scores (lowest to highest range 0-100). Higher score on the VFQâ€“25 indicates better visual function and health related quality of life. Average scoring then being analyzed by ROC curve in order to gain the cut off score value between retinopathy and sight threatening diabetic retinopathy. Results: The cut off score value between retinopathy and sight threatening diabetic retinopathy is 90.90. The VFQ-25 classification score is in the range of <90.90 consider threatening diabetic retinopathy and â‰¥90.90 consider retinopathy. Conclusion: VFQ-25 is one of the instruments to confirm that diabetic retinopathy significantly impair quality of life. The cut off score value between retinopathy and sight threatening diabetic retinopathy is 90.90. Keywords: Diabetic retinopathy, NEI-VFQ-25
Additional Intraocular Surgery after Pediatric Cataract Surgery
Authors: Papilaya Mario R , Memed Feti K , Knoch Andrew M
Published: January 2024

Background: Advances in pediatric cataract surgery have led to decrease in complication rates, nevertheless additional intraocular surgery (AIS) often still required after pediatric cataract surgery to maximize the outcome. This study aims to review the clinical characteristic of children who underwent AIS in National Eye Center Cicendo Eye Hospital Method: Patient medical records were reviewed retrospectively. Patients then divided into two groups depending on type of AIS. Group A were the children who underwent secondary intraocular lens (IOL) implantation and group B were the children who underwent surgery to repair visual axis opacity. Result: There were 24 eyes in group A and 16 eyes in group B. Mean age at cataract surgery in group A and B were 14.7 and 41.14 months, mean age at AIS in group A and B were 73.8 and 100.3 months, mean time length were 59.6 and 57.6 months in group A and B. Patient in group A had better visual outcome compared to group B. 68.75 % eyes in group B were pseudophakic. Conclusion: Patient in group A had a younger age compared to group B, mean length time between surgery were similar in both group. Patient in group A had better BCVA compared to group B with most of the patients who need VAO surgery were pseudophakic. Keywords: Additional intraocualar surgery, pediatric cataract, secondary IOL
Comparison of Corneal Thickness and Endothelial Cell Morphology in Myopic Patients with Daily Wear Hydrogel (Nelfilcon A) and Silicon Hydrogel (Lotrafilcon B) Contact Lenses: A Pilot Study
Authors: Samira Cut Putri , Rahayu Tri , Kekalih Aria
Published: January 2024

Background: To compare corneal thickness and endothelial cell morphology in myopic patients wearing 1 month hydrogel conventional and silicon hydrogel contact lenses in daily wear.Methods: This is a prospective, single blind, randomized study. Seventeen (34 eyes) myopic patients were randomly assigned to receive either nelfilcon A or lotrafilcon B. Central corneal thickness (CCT), coefficient of variation (CV), and percentage of six-sided cell (6A) were examined using specular noncon robo Konan microscope. Changes in CCT, CV, and 6A were evaluated before contact lenses fitting as well as 1 week and 1 month after the treatment. Patients were also evaluated for any subjective side effects and complications during the treatment period. Results: There were 64.7% subjects with history of contact lens wearers and 52.9% of them was hydrogel wearers. After 1 month daily wear of nelfilcon A and lotrafilcon B, no statistically differences changes in CCT (p=0.285; Mann Whitney test), CV (p=0.587; unpaired t-test), and 6A (p=0.353; unpaired t-test). General linear model analysis in follow up evaluation with test of within subject effect revealed decreased in CCT (p=0.001) and CV (p=0.001), also increased in 6A (p=0.022) in all subjects.Conclusion: There were no statistically difference in CCT, CV, and 6A between daily wear of nelfilcon A and lotrafilcon B. Subjects with history of contact lens wearers gained advantages in oxygen availability, which decrease corneal thickness and improve endothelial cell morphology. Â Keywords: nelfilcon A, lotrafilcon B, simple myopic, corneal thickness, endothelial cell morphology
The Accuracy Prediction of Cataract Surgery Refractive Results Using SRK/T and Haigis Formulas (with and without Personalized Constants)
Authors: Juhrie Dewi Megasari , Wahyu Mayasari , Knoch Andrew M
Published: January 2024

Background: Fourth generation of IOL calculation formula (Haigis formula) calculates the ACD which is important in determining the IOL position, so the calculation results expected to be more accurate than the previous generation formula. Haigis formula uses 3 constants that can be updated (optimal/personalized constants). This study aimed to compare the accuracy prediction of cataract surgery refractive results using SRK/T and Haigis formulas (with and without personalized constant).Methods: This is an analytic prospective comparative study. We used 198 medical records data to calculate the Haigis personalized constants. Keratobiometry examinations were performed to 23 eyes using the IOLMaster. The IOL power was calculated using 3 formulas. IOL power selected based on the Haigis formula calculation using personalized constants which gave the most closely result to plano. Best corrected subjective refraction and ME calculated 1 month after surgery.Results: The Haigis personalized constants for this study were a0 = -0.746, a1 = 0.184, and a2 = 0.208. The ME of SRK/T and Haigis formulas (with and without personalized constant) were -0.09Â±0.48 D, -0.13Â±0.36 D, and -0,18Â±0.37 D. ME percentage of SRK/T and Haigis formulas (with and without personalized constant) maximally reached at Â±1.25 D, Â±1.00 D, and Â±1.25 D. Conclusion: The Haigis formula with personalized constants was more accurate than the Haigis formula without personalized constants in predicting the refractive result of cataract surgery. The accuracy of SRK/T formula is equal to the Haigis formula (with and without personalized constants). Â Keywords: Haigis formula, SRK/T, personalized constants
The Effect of Zinc Distribution for New TB Patients who Have Ethambutol Therapy Toward Visual Field Defect
Authors: Daniati Neni , Kusdiantoro Kusdiantoro , Wulandari Laksmi , Mauthia Nina , Agustini Lukisiari
Published: January 2024

Background: Tuberculosis is an infection disease that is caused by Mycobacterium tuberculosis. Ethambutol therapy for TB patients can cause side effect such as decreased visual acuity, visual field defect, decreased contrast sensitivity, and disturbance of colour detection. Zinc in TB patients has decreased that causes broken cell on retina ganglion and disturbance of mytochondria function. The aim of this study is the effect of zinc supplementation for new TB patients who have ethambutol therapy toward visual field defect.Methods: This study involved 40 new TB patients who have ethambutol therapy which is classified as 20 patients who have ethambutol therapy with zinc supplementation and 20 patients who have ethambutol therapy without zinc supplementation. Each patient underwent a routine examination including visual acuity using Snellen chart which is converted to LogMAR, anterior segment using slit lamp biomicroscope, non-contact tonometry for intraocular pressure examination, posterior segment using direct ophthalmoscope, and Humphrey perimetry for visual field examination which is performed three times on first time when initial patient came, first month, and second month duration.Results: This study showed no correlation between gender with visual field defect (p=0,554), there is no correlation between age with visual field defect (p=0,418), no correlation between smoking behaviour with visual field defect (p=1), no correlation between amount of meals consumption containing Zn with visual field defect (p=0,608), and also no correlation between systematic illness history with visual field defect (p=0,305). The effect of Zn treatment to visual field defect was significant with p=0,0085.Conclusion: Zinc treatment for new TB patients with ethambutol treatment may prevent visual field defect.Keywords: ethambutol, new TB patients, zinc, visual field defect
Kebutaan Akibat Kelainan Mitokondria : Gejala, Diagnosis, dan Tata Laksana Suportif
Authors: Sitompul Ratna
Published: January 2024

Mitochondria is an important organelle in the cell acting as its powerhouse. Damage in the mitochondria leads to cell death thus it is crucial to organs utilizing plenty of energy such as the eyes. Mitochondrial disease in the eye can be primary or secondary. Primary mitochondrial diseases of the eye include dominant optic atrophy,Â  leber hereditary optic neuropathy, chronic progressive external ophthalmoplegia,Â  and retinitis pigmentosa. Secondary mitochondrial eye diseases include diabetic retinopathy, age-macular degeneration and glaucoma. Mitochondrial damage can also trigger growth of ocular neoplasm (retinoblastoma and uveal melanoma) are also part of mitochondrial eye diseases. However, it is still a challenge to diagnose mitochondrial eye diseases. Methods that can be used are genetic sequencing, radiological examinations to look for other syndromic signs, as well as biochemistry and histochemistry assays. Definitive therapy for mitochondrial eye diseases are still under research and to date the management is supportive in the form of food supplementation. Â Keywords: primary mitochondrial diseases, secondary mitochondrial disease, mtDNA.ROS, ocular tumour
The Alteration Visual Field Defect in Ischemic Stroke Patients After Three Months Therapy
Authors: Lestari Frida , Wahyuni Devi Azri
Published: January 2024

Background: Ischemic stroke are lack of blood flow to the brain and it could influence the visual field. Approximately more than half of the ischemic stroke patient have visual defect.Objective : Disturbance of blood flow on visual pathway have impact to the visual field defect.Â  In stroke ischemic patient, recirculation of penumbra at the brain on the third months after onset canÂ  rehabilitate the visual pathway, also it will improve the outcome of visual filed defect. So it could be initial detection for rehabiltation of visual field defect.Methods: This study was intended to compere visual field defect of ischemic stroke patient after three months therapy conducted form September 2014 - February 2015 in Mohammad Hoesin General Hospital Palembang. A total of 12 patients who met the inclusion criteria were recruited by consecutive sampling. All patients were endure based on ophthalmology and visual field examination using Humphrey Field Analyzer twice. First after relieving from the attack of stroke and second after three months therapy. Measurement of standard have to compare the value of MD, VFI, PSD, PD and pattern visual field defect. Results: There were significant difference in value of MD, VFI, PSDÂ  and PD<0,5% for both eyes on stroke ischemic patients after three months therapy. Almost all variable value were increasing to improvement of defect. The most common type of visual field defectÂ  is homonymous hemianopia. Conclusion: There were improvement in visual field defect in patients with stroke ischemic after three months therapy. Â Keywords: Ischemic stroke, visual field defect, penumbra, recirculation of brain, Mean Deviation (MD), Visual Field Index (VFI), Pattern Standard Deviasion (PSD), Pattern Deviation (PD) Â Â
Visual Finding in Patient with Pituitary Macroadenoma underwent Transphenoid Surgery
Authors: Setyowati Reny , Wicaksono Adiguno Suryo , Hartanto Rahmat Andi , Mahayana Indra Tri , Prawiroranu Suhardjo
Published: January 2024

AIM: The main aim of surgery in pituitary macroadenoma are restoration of visual acuity and visual field defects by decompression of the optic chiasm. Pituitary macroadenoma has slow growth pattern. This study describes the visual status of patients with pituitary macroadenoma and the post operative results.

METHODS: Retrospective, descriptive interventional study of patients with pituitary adenoma underwent transphenoid surgery at Dr Sardjito General Hospital, Yogyakarta.

RESULTS: There were 7 patients age 29-65 years old, mean age was 42 years old, consist of 3 male and 4 female and  were followed-up varies between 1 until 6 months. There was history of previous transphenoid surgery in 1 patients. Duration of patientâ€™s complaint varies between 1 until 36 months and the mean duration was 12 months. In 6 patients there were bitemporal hemianopia and 1 patients had general depression visual field defect. Visual acuity pre operative was between 0,003 until 1,0 , and the mean visual acuity was 0,1 (right eye) and 0,18 (left eye). Visual acuity post operative was between no light preception until 1,0 , and the mean visual acuity was 0,27 (right eye) and 0,19 (left eye) but there were no statistically significant differences. Fundus examination reveal optic atrophy in all patients.

CONCLUSION: Transphenoidal surgery is the treatment of choice in patients with pituitary macroadenoma.  Prolonged duration of symptoms and delay of surgery may impact the visual status

KEYWORDS: Visual status, visual field defect, pituitary macroadenoma, transphenoid surgery, post operative
Bilateral Idiopathic Neuroretinitis
Authors: Hidayat M , Liyanti Rince
Published: January 2024

Introduction : Neuroretinitis is a clinical entity characterized by acute loss of vision associated with disc edema and a star pattern of exudates in the macula. It can be divided into two, those with a specific infectious agent or idiopathic. Most infectious cases are due to cat-scratch disease, caused by Bartonella species and other infectious agents. Case with a clear infectious are categorized as idiopathic. Most patients with idiopathic neuroretinitis recover excellent visual acuity with or without intervention. Although the presentationis most often unilateral, bilateral cases of neuroretinitis have been reported. Method : A 20 years old woman with a 2-weeks history of sudden progressive visual loss both eyes (visual acuity : RE 3/60; LE 20/200). The optic disc were edema and the hard eksudat on the macular area. Two weeks follow up, funduscopic shows a macular star and the optic discâ€™s edema were reduced. Perimetric test shows general depressed in both eyes. The blood tests and the brain CT Scan were normal. She received methyl prednisolone 48 mg for 2 weeks. 8 months follow up, VA : RE 20/50, LE 20/40 with the pinhole 20/15 in both eyes. The funduscopic still edema and slightly pale.

Results : There was improvement in central visual acuity after steroid treatment, but leave residual abnormal funduscopic. Conclusion: Neuroretinitis is generally self-limited. The visual acuity recover excellent with the steroid, but the abnormal disc in this case related to a vaso-occlusive mechanism of prelamin ararterioles with subsequent disc infraction.
The First Study Investigating the Clinical Outcomes of Boston Keratoprosthesis Type I Implantation in Indonesia
Authors: Hutauruk Johan A. , Goenawan Kristian , Suhardjo Suhardjo
Published: January 2024

Introduction and Objective: Boston keratoprosthesis (Boston KPro) is an artificial cornea (collar button design) for a severely damaged cornea that is not suitable for penetrating keratoplasty (PKP). One main advantage of Boston KPro type I is there is no need to perform tarsoraphy. There were no previous studies investigating the clinical outcome of Boston KPro implantation in Indonesia, therefore we aimed to investigate the visual outcomes, device retention, and complications following Boston KPro type 1 keratoprosthesis.

Case Presentation: This study was a case series of 11 patients conducted at Jakarta Eye Center with 18 months follow up period. The inclusion criteria were patients with severe corneal diseases that are not amenable for PKP. We found that VA baseline were LP (±72.72%) and HM (27.27%) (mean VA baseline=2.51±0.14 logMAR or equal to HM – LP VA) which significantly improved to 1.09 ± 0.69 logMAR (equal to 6/60 Snellen, ±36.3% were near normal vision based on WHO criteria), p=0.007. Two cases (±16.7%) were still HM because of implant explantation with corneal melting. There were 80.5% retention rates at final follow-up and other complications were retroprosthetic membrane formation (26.7%), elevated IOP (13.9%), and sterile corneal stromal necrosis (17.8%).There was no endophtalmitis found in this study.

Conclusion: Boston K-Pro type 1 is a recommended option for patients with multiple corneal graft failure. It provides promising visual outcome with good retention rates. The number of Boston K-Pro type 1 implantations should be increased to counterbalance the corneal blindness burden in Indonesia.
Anti Tuberculosis Therapy Combined with Oral Corticosteroid and Intra Vitreal Anti-VEGF in Ocular Tuberculosis
Authors: Aldita Ira , Sirajuddin Junaedi , Taufik Sitti Soraya , Ichsan A Muhammad
Published: January 2024

Objective : To report a late diagnosed case of posterior uveitis tuberculosis and to create awareness to ophthalmologists for treating ocular tuberculosis as soon as possible.
Case Presentation : A 17-year old woman with a complaint of decreased vision in both eyes for the past 5 days. She had a history of non-purulent cough. In the initial examination, the patient was diagnosed and treated with papil edema and chorioretinitis with sub-retinal abscess and swollen disc, but she did not show any improvement. The patient was referred to the other ophthalmologist and diagnosed with ocular and systemic tuberculosis infection with choroidal neovascularization. The infection in the macula affected and aggravated visual acuity of counting finger at 1 meters. Anti-tuberculosis, oral corticosteroid and intravitreal anti-VEGF therapy were performed. The treatment showed significant improvement toward visual outcome and retinal condition.
Conclusion : Treatment with oral corticosteroid treatment along the systemic tuberculosis medication and intravitreal anti-VEGF showed good outcome on the right eye but deteriorated on the fellow eye.
Indikasi dan Jenis Transplantasi Kornea : Penelitian Retrospektif di RS Mata JEC periode 2014-2018
Authors: Siregar Sharita R , Djunaedi Laura A
Published: January 2024

Purpose : Corneal disorders leading to corneal blindness was one of the major causes for blindness worldwide. This retrospective study was done to report the indications for corneal transplantation and also the latest surgical technique between lamellar and penetrating keratoplasty at JEC Hospital, Jakarta Indonesia from 2014 to 2018.
Methods : Records of all patients who underwent penetrating and lamellar keratoplasties at our hospital between 2014 and 2018 were reviewed retrospectively. Patient demographic data such as age and gender, together with indications and surgical technique of corneal transplantation were recorded and analysed.
Results : Pseudophakic bullous keratopathy, corneal scarring post infection, and corneal dystrophy were the most common indications for corneal transplantation in our centre (33.91%; 28%; 16.63%; respectively). In 2014, corneal ulcer was one of the leading causes for complete corneal transplantation (12.5%) but its incidence was decreasing each year. 66.55% of procedures performed were penetrating keratoplasty. However, the shift from penetrating to lamellar procedures such as DSAEK increases significantly since 2007 and even more increased by 2 times within the last 5 years (15.27%; 35%; respectively).
Conclusion : The number of keratoplasties in JEC has increased from 2014 to 2018. Since 2007, posterior lamellar keratoplasties have increased and began to create some shift from penetrating to lamellar since then. There was a constant increase number of DSAEK due to donor availability from the new eye bank in 2017. The shorter recovery time after DSAEK seems to contribute to the trend toward earlier operative intervention in corneal endothelial disease. The leading indications for DSAEK was bullous keratopathy.
Sudden Visual Impairment In Sellar Region Tumor: A Case Of Pituitary Apoplexy
Authors: Wicitra Anindita , Nusanti Syntia , Sidik M
Published: January 2024

Objective : Pituitary apoplexy described as an acute hemorrhagic infarction of the pituitary adenoma causing sudden increase of intra sellar pressure. This condition is a life-threatening disease. The purpose of this article is to report about clinical symptom and methods to diagnose pituitary apoplexy.
Methods : A case presentation
Result :  A 40 y.o male came with a complain of blurry vision since 1 year. Two months before admission, he felt sudden worsening of his visual acuity. He went to private hospital and there was bleeding in his brain CT scan. His right eye visual acuity was 1/300 and his left best visual acuity was 6/12. Relative afferent pupillary defect was positive in the right eye. In funduscopic examination, both of optic nerve head were atrophy. Left eye visual field examination revealed temporal hemianopsia.
Cerebral MRI showed a hyper intense lesion on both T1WI and T2WI sequence in sellar region that extends into supra sellar region with sign of sellar floor ballooning. The result of MRI contrast was relatively same and the hormonal exam result was within normal limit. Then he was scheduled for removal tumor surgery from neurosurgery departement.
Conclusion : Pituitary apoplexy is a severe clinical syndrome and life-threatening disease. To rule out other disease presenting related symptoms, many ancillary examinations are require to be performed. The treatment of pituitary apoplexy, whether to treat surgically or conservatively, should be made by experts from a multidisciplinary team.
Hak Istimewa Profesi dan Situasi Penanggulangan Kebutaan
Authors: Tjahjono D. Gondhowiardjo
Published: January 2024

The basic paradigm of our profession are “blindness rehabilitation” and “prevention of blindness” could be seen in this edition, which is surprisingly dominated by the un-favorite Neuro Ophthalmology sub-speciality. Those manuscripts clearly showed that supported by cutting edge internal and external diagnostic devices and multi diciplines approach we successfully could preventing blindness. On the other side, due to the fact that in the Neurology dicipline there is a similar sub-speciality, thus we should reaching a minimal competency in Neuro Ophthalmology at least at similar level to their general competency.     
            In reverse is the relatively easy to be judge, the corneal blindness. However, visual rehabilitation could only be provide suppose that there is corneal donor availlability. There is a good news and bad news in the corneal tranplantation data reported in this edition; the good news is that we already been competent to do the sophisticated descemet endothelial automated keratoplasty, and sad to know that iatrogenic is a leading causes for corneal transplantation. These fact, indirectly referring to the weakness of our internal “quality control” and “quality assurance”  process in professional knowledge, skill and attitude to achieve the state of “a safe surgeon”.
            These is a serious profession’ issue, especially to the fact that it’s already coined as a negative perception to our national professional competency and achievement in relation to the reimbursement of cataract surgery from the  Indonesian Social Security Administrator for Health (BPJS); which in turn might have an impact to the national prevention of blindness activitis.  The rapid and steep raisement of reimbursement fund for ophthalmolgy problems since 2014; especially in relation to phacoemulsification cataract surgery, pterygium and medical fraud are the proper packaging for negative perception which successfully have an impact to the holistic and positive aspect of our effort to the prevention of blindness activity ; which unfortunately still classified “low” by International Agency in Prevention of Blindness (IAPB)....
Uncommon Presentation of Wyburn-Mason Syndrome in a Pediatric Patient
Authors: Barliana Julie , Nusanti Syntia , Panjaitan Manoa , Yudantha Anggun , Djunaedi Laura
Published: January 2024

We report an uncommon presentation of Wyburn-Mason syndrome in a pediatric patient. An 11-year- old girl presenting with no light perception in her right eye. Examination revealed an exotropia and a large and tortuous retina vessel in the posterior part of her right eye. However, other examinations, including dermatological and neurological examination, are within normal limits. Magnetic Resonance Angiography (MRA) showed vascular malformation at the basal cistern that extends to the retrobulbar area. Therefore, a thorough examination of the eye and brain, including MRA, is mandatory in every case, even in pediatric with normal neurological examinations.
Diagnostic Approach and Successful Treatment of Ocular Tuberculosis
Authors: Chadijah Siti , Sofia Ovi , Putranto Herwindo
Published: January 2024

Introduction: The prevalence of ocular tuberculosis (TB) are 1% in patients with pulmonary TB and 20% in patients with extrapulmonary TB. The definitive diagnosis and its management are still challenging. This case highlights the diagnostic approach and successful management of ocular tuberculosis
Purpose: To report the diagnostic approach and successful management of ocular tuberculosis.Case Presentation: A-15-Years-old-Girl, presented to outpatient clinic due to blurred vision on both eyes since 6 month ago. She was suffered from fever and solitaire mass along the neck lymph node 2 weeks before. The best corrected visual acuity (BCVA) of the right eye was 0.2 and the left eye 0.3. The ophthalmology examination of both eyes revealed mutton fat, 2+ flare, and 1+ cell, posterior synechia, koeppe and bussaca nodule, 4+ vitreous cells. Funduscopy were unremarkable due to

vitritis. There was an elevation of erythrocyte sedimentation rate, positive mantoux test and Quantiferon-TB Gold. Chest radiograph showed fibrosis of the right lung. Fine needle aspiration biopsy of neck mass showed fibrotic tissue. Patient was diagnosed with tuberculous granulomatous panuveitis. She received anti-tuberculous therapy (ATT) along with high dose methylprednisolone 0.5 mg/BW/days on tapered dose. At 3 weeks follow up, vitritis was subsided and we revealed snowball, snowbanking, and optic disc swelling of both eyes that showed improvement at 11 weeks follow up. The BCVA become 1.0 at week-17 of therapy and remains stable until 8 months follow up. Conclusion: Diagnosis of ocular tuberculosis diagnose was made based on symptoms and signs of granulomatous panuveitis and supporting evidence of pulmonary TB ancillary tests. Significant clinical improvement was achieved after administration of ATT along with high dose oral steroid.
Orbital Pseudotumor: Diagnosis and Management in A Secondary Hospital
Authors: Pratiwi Rianti , Setiawan Indra
Published: January 2024

Objective: To increase the awareness in diagnosing orbital pseudotumor and its management, especially in a peripheral secondary hospital with limited facilities.Case presentation: A 47 years old woman came with left eye (LE) protrusion, blurred vision, retrobulbar pain, and severe headache at regular intervals. This condition begun 8 months ago, and was diagnosed with orbital cellulitis, however the symptoms persisted until now. Physical examination of the LE showed a decreased in visual acuity, protrusion, chemosis and conjunctiva injection, increased in IOP, limited ocular motility, ipsilateral afferent pupillary defect and optic disc oedema. Plain and contrast CT-Scan showed a hypertrophy of ocular muscles with soft tissue swelling. Patient then diagnosed with idiopathic orbital inflammation and immediately prescribed with high dose steroid for 5 days with observation with glucose level observation for toxicity. Afterwards, she was given an oral corticosteroid and was tapered off for the next few weeks. At two months follow up, there were improvement in protrusion, motility and visual acuity.
Conclusion: A complete history taking, physical examination and appropriate additional examination are needed. In hospital or clinical setting with limited facilities, a thorough and comprehensive examination are needed in order to establish the diagnosis and management of orbital pseudotumor.
The Short-Term Efficacy and Safety of iStent Implantation Combined With Cataract Extraction on Lowering The Intraocular Pressure in Patients with Glaucoma: A Pilot Study in Indonesia
Authors: Sulastiwaty Rini , Syahril Q
Published: January 2024

Introduction: Minimally invasive glaucoma surgery (MIGS) is continuously being improved after it was first initiated in the early 2000s. This promising method is hoped to fill the gap between medication and traditional surgeries in management of glaucoma.Objective: To evaluate the efficacy and safety of iStents implantation combined with cataract extraction in managing intraocular pressure in glaucoma patients.
Methods: We collected data from 6 eyes of 5 patients with POAG and cataract pre-operatively. The extraction of cataract was then performed, combined with second generation iStents implantation. The follow up procedure included the change of intra ocular pressure (IOP), Visual acuity, and the need for IOP lowering Medication at 1 week and 1 month post-operatively.
Results: There was a reduction of mean IOP from the baseline, which was 21.33 ± 6.15 to 18.0 ± 6.0 and 18.11 ± 5.57 at 1-week and 1-month following the surgery. The reduction of IOP was also followed by the reduction of medications needed for the patients. The mean visual acuity following the surgery was also increased from the baseline 0.53 ± 0.41 to 0.85 ± 0.17 at 1 – week and 0.91 ± 0.16 at 1 – month. For safety outcomes, there were no major adverse effect nor complication from the procedures after 1 month of follow up.
Conclusion: The iStents implantation helped lowering the IOP of patients with glaucoma. It also reduced the need for further IOP lowering medication following the procedure.
Comparison of Intraocular Pressure After Water Drinking Test in Primary Open Angle Glaucoma Patients Controlled with Latanoprost and Trabeculectomy
Authors: Rusmayani Emma , Artini Widya , Indriatmi Wresti
Published: January 2024

Purpose: To compare intraocular pressure (IOP) after water drinking test in primary open angle glaucoma patients controlled with latanoprost 0.005% and trabeculectomy.Methods: Observational study with cross-sectional design of 28 eyes with primary open angle glaucoma (POAG) patients. Subjects were divided into two groups, 14 patients controlled with trabeculectomy and 14 patients with latanoprost monotherapy. All subjects were under clinical therapy and had an intraocular pressure (IOP) equal or lower than 18 mm Hg, monitored during the follow up period. All subjects were submitted to the water drinking test. The results of the water drinking test, which were peak and fluctuation of IOP, were then compared between groups.
Results: There were no significant difference between IOP peak between two groups (p=0.88). IOP fluctuation also showed no significant difference between groups (p=0.84). In both groups, baseline IOP strongly correlated with peak IOP in water drinking test with correlation coefficient r=0.96 (p<0.001) and r=0.71 (p=0.04), while baseline IOP in trabeculectomy group was strongly correlated with IOP fluctuation with correlation coefficient r=0.86 (p<0.001).
Conclusions: Peak and fluctuation of IOP after water drinking test in primary open angle patients controlled with latanoprost and trabeculectomy showed no significant difference.
Characteristic of Postoperative Visual Acuity and Complications of Surgical Procedure on Posterior Polar Cataract Patients at Cicendo Eye Hospital National Eye Center
Authors: Pitta Rani , Knoch Andrew , Budiman  , Sugiarti Emma
Published: January 2024

Introduction: Posterior polar cataract is a rare form of cataract with incidence from 3 to 5 in 1000. It is bilateral in 65–80% of the cases with no gender predilection. Posterior polar cataract presents a special challenge to the surgeon because of its predisposition to posterior capsular dehiscence and possible nucleus drop during surgery.
Purpose: The study aims to evaluate the visual outcome and complication of cataract surgery in patients with posterior polar cataract.Material and Methods: This is an observational study. Data were collected from the medical records within period of January 2016 – December 2018 in National Eye Center Cicendo Eye Hospital and reviewed retrospectively. Subjects in this study are patients with posterior polar cataract who underwent cataract surgery. The outcomes included visual acuity on the fourth week after surgery and complications during cataract surgery.
Results: There were 50 eyes of 37 patients included in the study. The mean age was 55.22±13.86 years. Best corrected visual acuity outcomes (BCVA) were 6/6-6/18 in 48 eyes (96%) after surgery. Complications during surgery were found in 7 eyes (14%), which was posterior capsular rupture with vitreous prolapse. Complications during phacoemulsification technique in 6 patients and 1 patient had SICS.
Conclusion: Posterior polar cataracts are surgical challenge. In our study, cataract surgery in posterior polar cataract leads to good visual outcome. Appropriate treatment in patients with complications yielding good outcome.
A Five-Year Data in Descriptive Study of Systemic and Ocular Risk Factors of Non-arteritic Anterior Ischemic Optic Neuropathy (NAION) and The Correlation to The Clinical Condition
Authors: Nusanti Syntia , Sidik M. , Rachman Andhika , Zulkarnaen Miratasya
Published: January 2024

Purpose: To acknowledge the demographic, clinical characteristic and the systemic and ocular risk factors in patients with Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION) in 2012-2017 in Cipto Mangunkusumo Hospital.
Methods: Retrospective descriptive study using the medical record data of 272 patients with NAION in the past 5 years (2012-2017).
Results: In the past 5 years, most of the patient’s initial visit visual acuity was <3/60, most patient had 2-3 systemic risk factors, the most frequent risk factors were hypertension (73.9%), obesity(63.5.%), diabetes mellitus (54.6%), smoking habit (54.5%), dyslipidaemia (46%), hypercoagulable state (19%), history of cardiovascular disease (10.3%) and stroke (7.2%). The risk factors were similar in age range ? 50 or bellow. Based on the initial visit time, most of the patient came to CM hospital in average 15.16 (SD±38.3) weeks.
Conclusion: This descriptive study showed classic demographic characteristic of NAION cases. Obesity as the second highest probable risk factor is rarely mention in the other studies. Should future detailed studies be done
Surgical Outcomes of Correction of Upper Eyelid Retraction in Thyroid Eye Disease
Authors: Veda Charissa  , Hernawita Suharko
Published: January 2024

Purpose: to evaluate the outcome of anterior blepharotomy in correcting eyelid retraction in patients with Thyroid Eye Disease (TED).
Methods: Literature search was conducted from MEDLINE database through PubMed, Google scholar and ClinicalKey. Outcomes included margin-reflex distance, palpebral fissure height, and upper eyelid margin-superior limbus distance.
Results: Sixteen articles were reviewed with a mean follow-up time in the studies varied, ranging from 6 to 61 months. The preoperative and postoperative mean MRDs varied. Although there were different success criteria, success rate for full thickness blepharotomy ranged from 59-93%, comparable with levator recession. The complication rates in 14 studies were less than 20%.
Conclusion: Full thickness anterior blepharotomy and Müller muscle and levator recession, are safe and effective in correcting upper eyelid retraction in patients with TED. The anterior blepharotomy is a relatively quick and simple procedure.
Optical Iridectomy as An Alternative Clear Visual Axis for Peters Anomaly
Authors: Laura Agnestasia  , I Barliana Julie Dewi
Published: January 2024

Introduction and objective: Peters anomaly is a rare congenital disease presented with central leukoma, iridocorneal adhesion, and with or without a cataractous lens. The presence of central leukoma will block the visual axis and lead to a disruption in normal visual development. Therefore, optical iridectomy, which can overcome the high incidence of graft failure in penetrating keratoplasty (PK), has been proposed as the alternative treatment to clear the visual axis. This study aims to show the outcome of optical iridectomy in patients with Peters’ anomaly.
Method: Systematic literature searched in Pubmed, Google Scholar, and Cochrane from their inception to August 2020 was conducted using keywords “iridectomy” and “Peters’ anomaly”. Full- text articles in English that report the outcome of iridectomy in Peters’ anomaly were included, and a manual review of article bibliographies was done. Outcome measures were analyzed using the following clinical questions: indication, age, visual acuity (VA), and intraocular pressure (IOP). Result: One case series and two case reports demonstrating the use of optical iridectomy in Peters anomaly were identified. In total, 26 patients aged one week to 7.7 years received optical iridectomy to establish a clear visual axis. All studies showed an improvement in visual acuity through clinical findings, and one of the studies showed a better postoperative VA in bilateral cases. Studies showed good control of IOP.
Conclusion: Optical iridectomy can be used as a safe procedure to improve visual acuity in Peters anomaly patient.
Usher Syndrome with Posterior Subcapsular Cataract
Authors: Bramantya Surya Pratama  , Dewi Nadia Artha
Published: January 2024

Introduction: Usher Syndrome (USH) is an autosomal recessive disorder characterized by congenital sensorineural deafness and progressive loss of vision due to retinitis pigmentosa. The aim of this report is to report rare cases of USH by perform diagnostic steps based on clinical examination and family history with expectations that if a similar case is found, an earlier diagnosis and rehabilitation can be done.
Methods: Diagnosis is based on history, ophthalmology examination and ear, nose, and ear (ENT) examination.
Results: A 23-year-old man came to the Ophthalmology Outpatient Department with complaints of bilateral blurred vision especially at night and visual field constriction starting 12 years ago. The patient experienced gradual vision deterioration followed by appearance of white spot in his left eye. Patient is deaf and mute since birth. Three family members of the paternal line exhibit the same symptoms. The best corrected visual acuity was right eye 6/15 and left eye hand movement. Bilateral cataract was found during eye examination. Posterior segment examination revealed peripheral bone spiculae appearance and waxy pallor optic disc in both eyes. Loss of neurosensory layer, worse in the left eye, was discovered through Optical Coherence Tomography (OCT). Humphrey perimetry of the right eye indicated tunnel vision. Examination by otorhinolaryngologist revealed a sensorineural hearing loss. In this patient, there is no management for the disorders due to the poor prognosis of visual acuity. What can be done to improve the patient's quality of life is supportive therapy. It is important to screen and educate families suffering from the same disorder for early diagnosis & rehabilitation.
Conclusion: Clinical examination and family history confirm the diagnosis of USH. Early diagnosis and early rehabilitation are essential to improve patient's quality of life. In this case, no management was carried out for the cataracts because the visual acuity of both eyes did not match the cloudiness of the lens so there are possibility the visual acuity could not improve. Rehabilitations that can be done for the patients are visual and social rehabilitation to improve quality of life.
AUROLAB AQUEOUS DRAINAGE IMPLANT IN YOUNG ADULT WITH NEOVASCULAR GLAUCOMA AND TUBERCULOSIS HISTORY: A CASE REPORT
Authors: Pramono Barii Hafidh , Sari Masitha Dewi , Sihotang Aslim D.
Published: January 2024

Introduction: Neovascular glaucoma (NVG) is historically known as rubeotic glaucoma, from “rubeosis iridis” that refers to the iris neovascularization. One of several causes that lead to rubeosis iridis is changes in Pigment Epithelium-Derived Growth Factor (PEDF) that may be caused by Mycobacterium tuberculosis. The influence of NVG may cause intraocular pressure (IOP) to rise rapidly. It can be decreased by Aurolab Aqueous Drainage Implant (AADI).
Case Report: A 34-year-old male complained of left eye pain and sudden decreased vision for the past 2 months. He had been diagnosed with tuberculosis since 8 months ago. The patient’s blood pressure, blood sugar, cholesterol, and triglycerides were within normal limit. Diabetes Mellitus (-). Human Immunodeficiency Virus (-). Visual acuity of left eye was hand movement. The pupil was dilated and non-reactive, anterior chamber depth is shallow, and rubeosis iridis (+). IOP is 60 mmHg. Medical management was failed to decrease the IOP. Funduscopy image showed cup-disc ratio was 0,7. Ganglion cell complex parameters showed 80,91. On the next day after AADI implantation surgery, the patient’s left eye IOP was reduced to 10 mmHg. On the 14th day post operative visual acuity was 2 meter counting finger. The anterior segment of the conjunctiva bulbi was hyperemic and conjunctival injection was reduced. The camera oculi anterior showed remainder of the implant. In the iris, rubeosis iridis disappeared, pupil was dilated, IOP was increased to 12 mmHg
Discussion: Neovascular glaucoma was caused by the growth of the fibrovascular membrane on the surface of the iris and the anterior chamber angle. The three most common causes of neovascular glaucoma were diabetes mellitus, central retinal vein occlusion, and carotid artery occlusion.
Conclusion:AADI is a safe and effective option for patients with neovascular glaucoma following tuberculosis.
SCLERAL WOUND HEALING IN PARS PLANA VITRECTOMY : A NARRATIVE REVIEW
Authors: Aulia Nabita , Muhiddin Habibah S. , Budu  , Andi Muhammad Ichsan  , Eka Hasnah
Published: January 2024

Background: Scleral wound healing involves cell death, migration, proliferation, differentiation, and ECM remodeling. Damaged connective tissue and blood arteries produce extravasation of blood cells, platelets, and plasma proteins when incisions are made in the conjunctiva and sclera (e.g. fibronectin, fibrinogen and plasminogen).
Aims: This literature review aims to elaborate scleral wounds constructions in general, wound healing process, and closure of the scleral wound after pars plana vitrectomy.
Methods: This literature review conducted 35 research publications from 2013-2022 who cited from some reputable sources using “wound healing”, “scleral”, “sutureless”, and “vitrectomy” as keywords.
Results: The self-healing process that takes place after scleral wounds are closed. On the second day, fibrous tissue grows to fill in the wound gap, marking the beginning of the wound healing process. On the third day, the connective tissue was then expanded to span the entire thickness of the wound. On day five, the connective tissue begins to thicken and begins to align with the lamellae of the normal connective tissue that is around it. This process continues until day seven. On the seventh day, it looked that the wound had healed and normal tissue creation had taken place.
Conclusion: Transconjunctival sutureless vitrectomy accelerated scleral wound healing. Small trocars and Zorro incisions speed scleral healing. Otherwise, silicone oil didn't affect scleral wound healing.
EFFICACY OF ATROPINE SULPHATE EYE DROPS IN CONTROLLING MYOPIA PROGRESSION: A REVIEW
Authors: Pradessatama Arcci , Mardianto Umar
Published: January 2024

Introduction: Myopia is major public health concern that has become increasingly common. Severe myopia has become one of the main causes of untreatable vision loss throughout the world, often due to its irreversible complications. Studies shows atropine can reduce myopia progression in children. Currently, there are no guidelines for the use of atropine specifically to control myopia progression. This study was made to review the efficacy of various atropine doses in controlling myopia progression.
Methods: Literature searching was conducted in four online databases (PubMed, EBSCOhost, ScienceDirect, and Scopus. Search terms included were “Atropine” and “Myopia”. Validity was assessed using assessment tool from Cochrane. Efficacy was evaluated using myopia progression in spherical equivalent per year and axial lengthening per year.
Results: Sixteen randomized controlled trial studies fulfilled our inclusion criteria and eligibility screening. Overall, atropine shows favorable results in spherical equivalent progression (D/year) compared to control, with SMD = -1.13, 95% CI (-0.58, -1.68). Less axial elongation (mm/year) was observed in atropine group, with SMD = -1.28, 95% CI (-0.18, -2.37). Atropine 0.01% concentration shows overall significantly better myopia progression and axial lengthening compared to control, with SMD = -0.76, 95% CI (-0.08, -1.44) and SMD = -0.63, 95% CI (-0.14, -1.12), respectively. Higher atropine doses showed larger effect sizes with higher occurrence of adverse effects.
Conclusion: Atropine eye drops in various doses shows overall effective myopia control in spherical equivalent and axial lengthening. Atropine 0.01% has significant myopia progression inhibition with less adverse effects than higher doses.