bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuroretinitis et causa Ocular Syphillis Vision Recovery after Multidisciplinary Management: Case Report
Authors: RANDY VINCENT SUHARTONO KINDANGEN  , Dr. dr. Made Susiyanti, SpM(K)  
Published: February 2024

Abstract
Introduction : Ocular syphilis is a sight-threatening condition caused by spirochete infection, Treponema pallidum, with varied clinical presentations. Although uncommon, human immunodeficiency virus (HIV) infection increases the risk of ocular syphilis. If left untreated, it may lead to blindness. The disease can be treated effectively with appropriate antibiotic therapy from a multidisciplinary department. Therefore, early investigation and timely management can prevent infection progression and save patients’ eyesight.
Case Illustration : A 29-year-old man complained of blurry vision with visual acuity light perception in both eyes one month before admission. The patient underwent examination and laboratory workup and was later diagnosed with HIV and ocular syphilis. A multidisciplinary approach was carried out with dermato- venerology, neurology, and internal medicine departments to treat the ocular and systemic infection. The patient was medicated with the antibiotic regimens Benzathine Penicillin 7.2 million IU and Ceftriaxone 1 g for 14 days. Visual acuity was later examined three weeks with a significant result for best corrected visual acuity (BCVA) in decimal 0.8 for the right eye and 0.67 for the left eye.
Discussion : The patient was in poor eyesight condition when initially examined. According to reports, syphilis could be cured if it was diagnosed early and completely treated. Therefore, an immediately established diagnosis helped the patient get suitable therapy thus improving visual acuity.
Conclusion : Early investigation and proper treatment are critical to managing systemic and ocular infections of HIV and syphilis. A multidisciplinary approach is required to achieve optimal results.
FILTRATION SURGERY OF TRABECTULECTOMIES WITH 5 – FLUOROURACIL IN ADVANCED POAG
Authors: Amrina Fadillah , Fidalia  , Sari Prima Maya 
Published: February 2024

Introduction : Advanced Glaucoma (AG) is total cupping of optic nerve with or without severe visual field loss. The prevalence of AG in POAG, shows that 15% have a substantial visual field defect. Initial therapy for AG can use medications, surgical therapy is performed when adecuate medical treatment isn’t effective. Filtration surgery such as trabeculectomy and implantation of tube shunts can be performed. This case reports aims to understand the used of trabeculectomy+5FU in Advanced POAG.
Case Illustration : A 55 years old woman came with blurry and tunnel vision accompanied by headache since 2 years ago. She got treatment yet stopped to control. Vision has progressively reduced since 2 months ago. Visual acuity OD 1/300 OS 1/60, IOP OD 25.1 mmHg and OS 29.8 mmHg with 4 drugs, cloudy lens, cupping, c/d ratio 0.9, nasalization, bayonet sign and peripapillary atrophy. The patient was diagnosed with Advanced POAG with immature senile cataract ODS. Patient was treated with trabeculectomy+5-FU due to uncontrolled IOP despite receiving adecuate therapy. Releasing sutures were used to control IOP after surgery. After surgery, the last IOP OS 12.6 mmHg, and bleb formed E1H1V0.
Discussion :
Conclusion : Patients was treated with trabeculectomy+5-FU, can control IOP stably in advance of POAG without serious complications, cost less than routine drugs and maintain visual function and improve quality of life. Filtration surgery such as trabeculectomy with AF agents is proven to reduce IOP more stably in advance of POAG.
Management of Recurrent Anterior Uveitis in Spondyloarthritis: A Case Report
Authors: Nadida nurfadhila  , Patriotika Muslima  , Elfa Ali Idrus  , Arief Akhdestira Mustaram  , Angga Fajriansyah  
Published: February 2024

Introduction : Non-infectious anterior uveitis is caused by underlying diseases, one of which is spondyloarthritis. Spondyloarthritis is a part of chronic rheumatic disease. The main goals of uveitis therapy are to prevent blindness, permanent organ damage, and recurrence.
Case Illustration : A 19-years old woman came to Cicendo Eye Hospital with blurry vision for one week. The complaint was accompanied by redness, photosensitivity, and pain in her right eye. She had similar complaints in her right eye one month ago and in her left eye one year ago. She also had a history of morning stiffness in her knee joint and lower back pain. For those symptoms, the rheumatologist diagnosed her with spondyloarthritis. The uncorrected visual acuity examination for both eyes were 0,16. Anterior segment examination on right eye were blepharospasm, ciliary injection, corneal oedema, flare and cells while the left eye within normal limit. She was diagnosed with anterior uveitis and was treated with topical corticosteroid, oral corticosteroid, and immunomodulator. Knowing the treatment was not responding, the rheumatologist added biologic agents to the therapy. As a result, the patient’s conditions improved.
Discussion : Topical steroid therapy was used as the first line of treatment, but for the recurrence of anterior uveitis, systemic medication, including biologic agents, is needed.
Conclusion : Multidiscipline and stepwise approach to treat anterior uveitis with underlying disease is necessary.
Herpes Zoster Keratouveitis : Are We Late in Dealing with It?
Authors: Nurul Akla  , Ferdian Ramadhan  , Nazhira Janani  
Published: February 2024

Introduction : Herpes zoster ophthalmicus (HZO) is the viral involvement of the ophthalmic division of the trigeminal nerve. The ocular disease affects approximately 50% of HZO cases and is an ophthalmologic emergency due to the risk of vision loss if not quickly treated. This case reports the ocular complication resulting from delayed management of herpes zoster.
Case Illustration : A 25-year-old woman presented with the decreased vision for one week. Physical examination revealed erythema, crusts, and multiple vesicles in the upper quadrant of the left face, with a positive Hutchinson sign. Ophthalmic examination showed a visual acuity of 0.6 on the left, with ciliary injection, a multiple dots pattern, and stromal edema in the left eye. Fine and fibrillar keratic precipitates were also present. The patient had previously received oral acyclovir 5x400 mg/day for five days after the onset of symptoms. The patient was given oral acyclovir 5x800 mg/day, amitriptyline 25 mg PO/day, homatropine ED 1 gtt/day, ofloxacin ED 4 gtt/day, Prednisolone acetate ED 4 gtt/day for the left eye.
Discussion : Early management of HZO within 72 hours of rash onset is optimal. The Hutchinson sign, characterized by herpetic lesions around the nose tip, indicates nasociliary branch involvement and increases the risk of ocular involvement. Delayed or inadequate treatment can lead to various ocular complications. The prognosis is unpredictable and dependent on long-term sequelae.
Conclusion : HZO keratouveitis, can result in stromal scarring or endothelial dysfunction, potentially requiring surgery if therapy is inadequate. Early recognition of ocular involvement is crucial to prevent complications and increase practitioner awareness.
Comparison of Endothelial Cell Loss after Phacoemulsification Surgery between Patients with Diabetes Mellitus and Non-Diabetic Patients at Kariadi Hospital: A Prospective Study
Authors: Nugraha Adiyasa  , Wisnu Sadasih  , A. Rizal Fanany  
Published: February 2024

Abstract
Introduction & Objectives : To compare the endothelial cell loss after phacoemulsification surgery in patients with DM and non- DM patients
Methods : This was a prospective study conducted at Kariadi Hospital, Semarang, Indonesia. A total of 20 eyes of 20 patients (10 DM and 10 non-DM) who underwent phacoemulsification surgery were included in this study. The central corneal thickness (CCT), endothelial cell density (ECD), coefficient of variation (CV), and hexagonality (HEX) were measured preoperatively and on day-7 postoperatively. The percentage of endothelial cell loss (%ECL) was calculated and compared between the two groups.
Results : The mean pre-operative and post-operative CCT was similar in both groups (DM =546.6±44.26μm, non-DM=516.7±42.2μm, p=0.949 ;DM=562.8±46.1μm, non-DM=533.7±46.6μm, p=0.997). The mean percentage of endothelial cell loss was slightly higher in the DM group compared to the non- DM group but not significant (6.66±2.36% vs. 2.31±1.72%, p=0.566). There were no significant differences between the CV and HEX on pre-operative and day-7 after surgery
Conclusion : Patients with DM have a slightly higher percentage of endothelial cell loss after phacoemulsification surgery compared to non-DM patients. The mean CCT, CV and HEX pre-operation and day-7 were quite similar in both groups. These findings suggest that patients with DM may require more careful monitoring and follow-up after phacoemulsification surgery.
GOOD OUTCOMES OF OCULAR MYASTHENIA GRAVIS IN A YOUNG ADULT MALE: A CASE REPORT
Authors: Muhammad Wahyu Aghdhi Pradipta  , Lukisiari Agustini  
Published: February 2024

Abstract
Introduction : Myasthenia gravis (MG) is characterized by fluctuating weakening and fatigability of skeletal muscles. Ocular MG (OMG) occurs when the symptoms of MG are limited to the ocular muscles.
Case Illustration : A 21-year-old male presents with a two-month history of drooping both eyelids. The drooping eyelids improved in the morning or after a nap, and got worse in the evening. Ocular examination revealed limitation towards all gazes with bilateral ptosis. Visual acuity, anterior segment, visual fields, slit lamp, and fundus examinations were unremarkable. The ice pack and rest test resulted in a significant improvement after two minutes of ice pack application and 30-minute rest, raising suspicion for the diagnosis of MG. Acetylcholine receptor antibody (AChR) test was positive for AChR binding antibody. Treatment for OMG is initiated with an oral acetylcholinesterase inhibitor, pyridostigmine, and corticosteroid. The ptosis and ophthalmoplegia improved after one week follow- up and recovered completely after eight weeks of follow-up.
Discussion : The hallmarks of MG are fluctuating fatigable muscle weakness that worsen with activity and improve on rest. Neurological exam and clinical neurological history are essential to establish the diagnosis. Bedsite tests, electrophysiologic test, and the antibody test all support the clinical diagnosis of MG.
Conclusion : OMG progresses to its generalized form 90% of the time during the first two years of the onset of ocular symptoms. Early detection and prompt treatment are the key which may help to prevent or minimize the occurrence of myasthenia crisis.
HOMONYMOUS HEMIANOPIA IN CEREBRAL INFARCTION: CASE REPORT
Authors: Hadwer Wicaksono Pandjaitan  
Published: February 2024

Abstract
Introduction : Homonymous hemianopsia is a visual field defect characterized by loss of half of the visual field in each eye. Cerebral infarction in the occipital lobe is the most common cause of homonymous hemianopsia. Sudden visual field loss should be considered as a cerebral infarction for prompt management.
Case Illustration : Male 43 years old, vision in both eyes appears dark on the left side since 3 months ago, complaints occur suddenly. Patients with a history of hypertension (+) hypercholesterolemia (+). Ophthalmological examination revealed visual acuity in both eyes 6/6 with normal pupillary reflexesand normal fundoscopy in both eyes. Humphrey's visual field perimetry test showed left homonymous hemianopsia. A brain CT scan examination showed multiple cerebral infarctions in the right occipital lobe, cerebellum and basal ganglia bilaterally. The patient was referred to the neurology department for further treatment.
Discussion : The visual field defect pattern is used to predict the location of the lesion in the visual pathway. Neurologic symptoms that may be present in occipital lobe lesions are migraine with aura and visual hallucinations. The patient had left homonymous hemianopsia where the results of brain CT scan showed multiple cerebral infarctions in the right occipital lobe.
Conclusion : Manifestations of homonymous hemianopsia can predict the presence of cerebral infarction so that in the presence of visual field defects it can be used as a predictor of intracranial abnormalities for further evaluation and collaboration with the neurology department.
Terson Syndrome: A Rare, Treatable Visual Loss After Subarachnoid and Intraventricular Hemorrhage
Authors: DITA PERMATASARI  , SYNTIA NUSANTI  , MUHAMMAD SIDIK  , SALMAREZKA DEWIPUTRI  , SITA PARAMITA AYUNINGTYAS  
Published: February 2024

Abstract
Introduction : Intracranial pathologies commonly affect vision through optic neuropathy. However, visual loss could be due to vitreous hemorrhage as in Terson syndrome. This report warns us rare cases of visual loss after intracranial hemorrhage that requires totally different management than more commonly found optic neuropathies.
Case Illustration : Female, 46 years old, had a severe headache and decreased consciousness two days later. CT angiography revealed wide subarachnoid hemorrhage and intraventricular hemorrhage causing hydrocephalus. She received emergency lumbar drainage followed by digital subtraction angiography and flow diverter device. Postoperative she regained consciousness, CT scan showed reduced ventricular size without residual hemorrhage, yet visual acuity of left eye reduced to hand movement and did not improve until one month later. Ophthalmologic examination showed vitreous hemorrhage of the left eye. Right eye was normal. Vitrectomy was planned to clear the vitreous hemorrhage.
Discussion : Terson syndrome is intraocular hemorrhage associated with subarachnoid hemorrhage, cerebral hemorrhage, or traumatic brain injury. The proposed mechanisms were transmission of subarachnoid blood to the optic nerve sheath and rapid effusion of cerebrospinal fluid into the optic nerve sheath due to sudden increase of intracranial pressure. It compresses central retinal vein, causing vascular rupture. The manifestations could be vitreous, subhyaloid, subretinal, or intraretinal hemorrhage. Visual prognosis is good in those resolved spontaneously or receiving vitrectomy in nonresolving cases.
Conclusion : Visual loss from intracranial hemorrhage or trauma could be caused by intraocular hemorrhage. It deserved different management than optic neuropathies. Prompt recognition should improve the management and the prognosis of rare cases such as Terson syndrome.
A Challenging Case of Simple Limbal Epithelial Transplantation (SLET) in Limbal Stem Cell Deficiency Following Chemical Injury: A Case Report
Authors: Amanda Lia , Widyawati Syska , Martha Faraby , Zarwan Jessica 
Published: February 2024

Introduction : Limbal stem cell deficiency (LSCD) often arises following trauma or inflammation that hinders corneal epithelium healing, commonly caused by chemical or thermal injuries. Despite significant advancements, treating LSCD remains challenging. This case highlights a challenging case of simple limbal epithelial transplantation (SLET) in LSCD following chemical injury.
Case Illustration : A 20-year-old male presented with reduced vision in left eye following an alkaline chemical injury (grade III) was diagnosed with unilateral LSCD. Upon examination, conjunctivalization of the peripheral cornea, a central corneal cicatrix, and stromal neovascularization present after previous necrotomy, tenoplasty, and amniotic membrane transplantation (AMT). The patient then underwent SLET, with limbal biopsies from the collateral eye. Four months after surgery the visual acuity improved from 3/60 to 6/15 with spectacles. However, the cornea conjunctivalization still developed despite improved visual acuity.
Discussion : To effectively manage the recurrence of stem cell deficiency, other stem cell transplantation techniques are needed to manage the problem. Combining different limbal stem cell transplantation approaches can be customised to address the problem and achieve lasting results.
Conclusion : Prompt diagnosis and treatment of LSCD is crucial to prevent complications and blindness. SLET is a surgical option for LSCD after chemical injury, but this report highlights a challenging case and the need for the alternatives approaches.
Anatomical and Functional Outcomes of Management Pediatric Retinal Detachment with High Myopia and History of Retinopathy of Prematurity: A Case Report
Authors: Sadikin Irma Suwandi , Yudantha Anggun Rama 
Published: February 2024

Introduction : To report the anatomical and functional outcomes of management of pediatric retinal detachment in children with high myopia and a history of retinopathy of prematurity.
Case Illustration : A 9-year-old boy had a sudden visual loss two months ago. The complaint is accompanied by photopsia and floaters. No history of trauma or infection. He had a history of myopia (S-6.00) and ROP in both eyes. The VA of the right eye was no light perception, and the left eye was 1/60. A retinal detachment with the macula off was discovered in the posterior examination. The axial length was 21 mm. He underwent a scleral buckle with vitrectomy and internal limiting membrane (ILM) peeling for his left eye. After surgery, the visual acuity was 3/60 with the retina attached. Re- detachment was found three weeks after surgery. The patient was scheduled for a second phacoemulsification and vitrectomy surgery. One month later, the best visual acuity reaches 6/48 with S -8.00 D on his left eye. The complication of high intraocular pressure (IOP) after surgery was managed successfully.
Discussion :
Conclusion : Management of retinal detachment cases in children is challenging. Hence, a thorough understanding is crucial in order to achieve anatomical and functional success. Myopia in ROP eyes was mainly lenticular, with an alteration in the anterior chamber that contributed to the patient's refractive status change. We encourage preterm patients to have regular follow-up not only for refractive status but also for structural changes in the anterior segment until adolescence.
Terson Syndrome: what an ophthalmologist should know?
Authors: ANINDITA WICITRA  , Muhammad Firdaus  
Published: February 2024

Abstract
Introduction : Terson syndrome is the occurrence of any intraocular hemorrhage in patients with intracranial hemorrhage or traumatic brain injury. In this article we present a case of patient with Terson Syndrome after craniotomy.
Case Illustration : Forty-six yo female patient consulted from neurosurgery department with chief complain of blurry vision in both eyes since 1 day before. Pain or red eyes were denied. There was no history of visual field defect. She had history of breast cancer and she underwent craniotomy four days before because of her brain metastases. Her Glasgow Coma Scale was 15. In ophthalmology examination, her visual acuity is 6/6 with correction in both eyes with good ocular motility. RAPD was positive in her left eye, and posterior segment showed bilateral optic disc edema with intrapapillary and peripapillary hemorrhage. Humphrey examination revealed enlargement of blind spot in the right eye. Brain CT Scan demonstrated hemorrhagic lesion with pneumoencephal within post operative defect area in right parietal lobe. Laboratory examination showed normal fibrinogen and thrombocyte aggregation with elevation of d-dimer. After two weeks observation, visual acuity still 6/6 in both eyes with decreasing intrapapillary and peripapillary hemorrhage.
Discussion : The exact pathophysiology of Terson Syndrome is still unknown. Even though, it has association with high intracranial pressure. Patient with Terson Syndrome will develop 5 times higher mortality rate compare to subarachnoid hemorrhage without Terson Syndrome.
Conclusion : Terson Syndrome needs to be recognized early since it will bring significant prognostic effect and cause permanent vision loss if left untreated
CHALLENGES IN THE SURGICAL MANAGEMENT OF BILATERAL POSTERIOR LENTIGLOBUS
Authors: RAHMANI SYIFA , Memed Feti Karfiati , Caesarya Sesy , Amiruddin Primawita Oktarima , Irfani Irawati , Kuntorini Mayasari Wahyu 
Published: February 2024

Introduction : Lentiglobus is a lens deformation characterized by spherical bulging of the lens surface. The weakness of the posterior capsule in the lentiglobus makes the surgery challenging. We present a case of bilateral posterior lentiglobus and its management.
Case Illustration : A 5-year-old boy was presented with the chief complaint of gradually blurred vision since 1 year ago. Visual acuity were 0.1 and closed face finger counting in the right and left eyes, respectively. An ophthalmology examination revealed lens opacities with partially reabsorbed lens material and protrusion of the lens surface posteriorly in both eyes (figure 1). The patient was diagnosed with developmental cataracts of the membranous type and posterior lentiglobus in both eyes. The patient underwent a surgical intervention for cataract extraction with aspiration technique. A spontaneous posterior capsule rupture was found with a shape like a lentiglobus. An anterior vitrectomy was performed. An intraocular lens was implanted. At one month after surgery, the best corrected visual acuities were 0.5 in both eyes (figure 2).
Discussion : Several difficulties can be encountered during pediatric cataract surgery with the posterior lentiglobus morphology because of the thin or ruptured capsule. Previous studies have found preoperative and intraoperative posterior capsule rupture in 25% and 3.13% of lentiglobus cases, respectively. Hydrodissection should be avoided due to the weakness of the posterior capsule.
ConclusionAppropriate surgical techniques to anticipate posterior capsule defects in the lentiglobus are required to produce a favorable outcome.
RETINOPATHY OF PREMATURITY IN TERTIARY REFERRAL EYE HOSPITAL IN INDONESIA: CHARACTERISTICS AND MANAGEMENT
Authors: RAISHA PRATIWI INDRAWATI  , Mayasari Wahyu Kuntorini  , Sesy Caesarya  , Primawita O. Amiruddin  , Irawati Irfani  , Feti Karfiati Memed  
Published: February 2024

Abstract
Introduction & Objectives : Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the retina that occurs in premature infants. Incidence of ROP is higher in middle- and lower-income countries, including Indonesia; hence information about the characteristics of the patients is essential to make strategies regarding its management. The aim of this study is to describe the characteristics and managementof patients with retinopathy of prematurity at the National Eye Center, Cicendo Eye Hospital.
Methods : Data were obtained retrospectively from medical records from January 2018 until December 2020 using ICD-10 coding for retinopathy of prematurity. Variables include demographic data, clinical characteristics, and management.
Results : In total, 177 patients (340 eyes) were included in this study. Demographically, 53.7% of the patients were boys; 67.8% came from West Java; 93.2% were referred; and 85.9% were health coverage users. The mean gestational age was 29.9±2.6 weeks and the mean birth weight was 1415.6±393.1 grams. Most of the patients have bilateral conditions and already have stage 5 ROP, regardless of their gestational age and birth weight. Conservative management was given to 95.5% of stage 5 ROP patients. As many as 50% of stage 4 patients underwent pars plana vitrectomy, and 85.4% stage 3 patients were managed by laser photocoagulation. Those in earlier stages were mainly observed first.
Conclusion : Patients with ROP at Cicendo Eye Hospital mostly came in the advanced stage of the disease with conservative management. Early screening, timely referral, and prompt treatment are recommended in order to prevent blindness in premature infants.