bluuebunny/crossref_metadata_2025_split huggingface dataset:
Did the metal object hit the cornea? A case report of penetrating ocular injury with embedded foreign body
Authors: AGUNG NUGROHO  , Dearaini  , Annisa Windyani  , Susantono Diannisa Paramitha , Pangestika Rishka , Laksmita Yulinda Arty , Widyawati Syska , Adriono Gitalisa Andayani 
Published: February 2024

Introduction : Penetrating ocular injury with IOFBs may cause severe ocular damage. We demonstrate the diagnostic and treatment approach in a case of scleral laceration with a large IOFB.
Case Illustration : A-24-year-old male presented with a rusty segment of fence wire, sized 15x11 mm, embedded near the nasal corneal margin of the right eye. Upon initial examination the vision was 6/9 with normal IOP. The object obstructed the view of the entry site, therefore corneal wound was suspected. CT scan showed penetrating metal object without posterior segment involvement. Anti-tetanus injection, topical and oral levofloxacin were given. He underwent exploration, foreign body removal and repair surgery. During surgery, the wound was revealed as a scleral laceration, 4 mm from nasal limbus. One day post-operative, vision was 6/20. A 0.1 mm hypopyon was found, along with fibrin at nasal vitreous. Oral and topical corticosteroids were given, and hypopyon disappeared the next day. One week after surgery, vision improved to 6/7.5, with clear vitreous and normal retina.
Discussion : Ocular injuries with large IOFBs can hinder clinical examination. Corneal entry wound should be ruled out, due to potential permanent damage to visual axis. CT scan was helpful in assessing the depth of object penetration. The object was removed successfully, with no damage to the cornea and retina. Anti-tetanus, antibiotics and corticosteroids were able to control infection and inflammation.
Conclusion : Large IOFBs which do not affect the visual axis, can be managed with successful outcome, by prompt removal and repair of the entry wound, and control of infection and inflammation.
RECONSTRUCTION OF ORBITAL FLOOR FRACTURES USING SILICONE BLOCK IMPLANT
Authors: SYUKRIYAH SOFYAN  
Published: February 2024

Abstract
Introduction & Objectives : It has long been a controversial-both the materials for orbital floor reconstruction and the timing of surgery. Silicone block implant is affordable and readily available especially in developing countries. Due to its complications and the development of other materials, silicone block implant has rarely been used. This study aims to evaluate the outcomes of timing of surgery and the use of silicone block implant in orbital floor fractures reconstruction.
Methods : We conducted a retrospective review of patients who had orbital floor fractures and undergone reconstruction surgery using silicone block implant in Cipto Mangunkusumo Hospital from January 2017 to December 2021. These patients then divided into three groups based on their surgery interval time. Outpatient notes, Computed Tomography (CT) reports, surgical admission notes, records and complications were recorded. Patients with follow-up less than three months were excluded.
Results : Thirty-one patients were included (23 males, 8 females) with age 18-60 years old being dominant. Thirty (96.8%) patients had unilateral fractures, 23 patients (74.2%) came with impure fractures, and fractures mostly caused by traffic accidents (83.9%). Subconjunctival bleeding and eyelid abnormalities were found as the majority of ocular involvement. Symptoms with the greatest improvement were different between three groups based on surgery interval time. Besides, only one extruded implant was found.
Conclusion : Silicone block implant provides good outcomes with minimal complications even after late surgical repair of orbital floor fractures.
The Effect of Limbal Relaxing Incisions on 1-Week Postoperative K1 and K2 Values
Authors: Ilham Prayoga Bakhri  , Wisnu Sudasih  , Rizal Fanany  
Published: February 2024

Abstract
Introduction & Objectives : Limbal Relaxing Incisions (LRI) is a surgical technique used to correct astigmatism during cataract surgery. This technique used to reduce the steepness of the corneal curvature in a particular meridian. LRI can be performed alone or in combination with phacoemulsification.
Methods : This prospective study aimed to investigate the effect of Limbal Relaxing Incisions (LRI) on corneal astigmatism in patients who underwent phacoemulsification cataract surgery. Five patients were included in this study, and preoperative and 1-week postoperative keratometry values (K1 and K2) were measured using the IOL Master. Paired t-test analysis was used to compare the changes in K1 and K2 values before and after LRI
Results : Five eyes of Five patients with the mean age 39.8 years (range : 22 to 76 years) and corneal astigmatism 3.12 D (range : 2.25 to 4.66 D) were underwent LRI and cataract surgery. The mean preoperative K1 and K2 values were 42.12 D and 46.44 D, respectively, while the mean 1-week postoperative K1 and K2 values were 42.60 D and 45.80 D, respectively. Paired t-test analysis showed a statistically significant decrease in K2 values (p = 0.025) but no significant change in K1 values (p = 0.329).
Conclusion : This study showed there were no significant difference between pre and postoperative of K1 and showed a significant decrease in K2 on IOL Master examination. The wide age range of the included patients, may have influenced the effectiveness of LRI in reducing astigmatism. Further study with more subject are required.
OUTCOMES COMPARISON AFTER SMALL INCISION LENTICULE EXTRACTION (SMILE) AND FEMTOSECOND-LASER ASSISTED IN SITU KERATOMILEUSIS (FS-LASIK) IN LOW-MODERATE MYOPIA PATIENTS
Authors: ANDREAS LUKITA HALIM  , Budiman  , Mayang Rini  , Andrew M. H. Knoch  , Emmy Dwi Sugiarti  , Ludwig Melino Tjokrovonco  
Published: February 2024

Abstract
Introduction & Objectives : Uncorrected myopia is the leading cause of visual impairment globally. It can be corrected by refractive surgeries, such as Small Incision Lenticule Extraction (SMILE) and Femtosecond Laser- Assisted In Situ Keratomileusis (FS-LASIK). SMILE technique is less-invasive than FS-LASIK, characterized by all-in-one femtosecond laser and flapless procedure. Correction of low-moderate myopia requires a special concern because even slight decreased in visual quality may be noticed by the patients and affect their satisfaction. The purpose of this study to compare the refractive outcomes after SMILE and FS-LASIK in low-moderate myopia patients.
Methods : This is a prospective analytical observational study that was conducted in a tertiary hospital in Indonesia. Four refractive outcome parameters (predictability, efficacy, safety, and stability) were assessed at 1 day, 1 week, and 1 month postoperatively.
Results : SMILE was performed on 22 eyes with spherical equivalent (SE) -3.60±1.07 D and FS-LASIK on 20 eyes with SE -2.91±1.53 D. At 1 month, the predictability as the proportion of eyes within SE ±0.50 D were 95.5% in SMILE and 80% in FS-LASIK (p=0.174), the efficacy as the proportion of eyes achieving uncorrected distant visual acuity (UDVA) ≥20/20 were 63.6% in SMILE and 35% in FS- LASIK (p= 0.064), the stability as the proportion of eyes experiencing SE change >0.50 D were 4.5% in SMILE and 5% in FS-LASIK (p=1.000). No eyes from both groups had corrected distant visual acuity (CDVA) loss of ≥2 lines (p=1.000).
Conclusion : SMILE and FS-LASIK were both predictable, effective, safe, and stable for low-moderate myopia patients.
Uncover the Hidden Veils: Ophthalmoplegia in Breast Cancer
Authors: SITA PARAMITA AYUNINGTYAS  , Syntia Nusanti  , Salmarezka Dewiputri  , M. Sidik  
Published: February 2024

Abstract
Introduction : Breast cancer can metastasize to many sites, but the orbit is an infrequent location. Orbital metastases represent 1%–13% of all orbital tumors, and the prognosis is rather poor. We reported a case of orbital metastases of breast cancer that led to findings of other sites involvement.
Case Illustration : A 50-year-old female presented with an inward squint and double vision for 9 months before admission. Esotropia, abduction, and elevation deficits in both eyes were observed. The visual acuity of both eyes was 6/6. Orbital MRI revealed an intraconal irregular lesion near the medial rectus muscle, which was hyperintense with contrast and thickened medial rectus muscles of both eyes. She underwent lumpectomy of breast mass two years before admission and no follow-up after surgery. Histopathology showed invasive lobular carcinoma (ILC). We referred her to hematologist- oncologist to have workup on metastases and treatment. Lung and extensive bone metastases were discovered. She was diagnosed with metastatic breast cancer (stage IV) and treated with hormonal therapy and bisphosphonates. On 3-month follow-up, diplopia and gaze limitations persist.
Discussion : Diplopia and motility disturbances are the most common symptoms and signs of orbital metastases, including extraocular muscle involvement. The horizontal rectus muscles are more commonly involved. ILC is more frequent histological subtype involving orbital as the orbits are rich in fat and may attract disseminated ILC cells.
Conclusion : Ocular symptoms in patients with a history of breast cancer should always be investigated for metastatic disease. A multidisciplinary approach is mandatory to achieve the best therapeutic management and long-term surveillance.
CHARACTERISTIC OF PATIENTS WITH ORBITAL MENINGIOMA IN DR. KARIADI GENERAL HOSPITAL SEMARANG
Authors: Joko Satrio  , Trilaksana Nugroho  
Published: February 2024

Abstract
Introduction & Objectives : Meningioma is a neoplasm arising from arachnoid cap cells in the meninges. They can arise in the orbit as primary or secondary orbital meningioma. The characteristic and risk factors of orbital meningioma are essential to acknowledge. The aim of this study is to describe the characteristic and risk factors of patients with orbital meningioma in Dr.Kariadi Hospital.
Methods : A retrospective study was held from the medical record of patients with a diagnosis of meningioma between January 2020-December 2022. The data of 58 patients included age, sex, duration of proptosis, length of proptosis, history of seizure, diplopia, history of contraceptive and trauma, RAPD, fundus examination, and CT-Scan results.
Results : Most of the meningioma patients had female 98,27%, 70,68% in the fourth decade of life. The visual acuity of 25,88% of patients >6/18, and 22,41% were blind. Around 72,41% of proptosis occurred ≥ 1 year, 87,93% had signs of headache, only 1,72% underwent seizure, 8,62% had double vision, and 5,17% had a history of head trauma. Relative afferent pupillary defect occurred in 53,44% of the affected eye with 20,68% atrophic papil and 15,51% edema papil. CT-Scan result of 86,2% had sphenoid meningioma, and only 13,79% had optic sheath meningioma. Most of the patients (72,41%) used 3 months cycle hormonal injection contraceptive.
Conclusion : The characteristic of orbital meningioma patients in DR.Kariadi Hospital were mostly women in the fourth decade of life, had proptosis and headache as primary signs and 3 months of intramuscular hormonal contraceptives were suspected to have a correlation.
Neuromyelitis Optica with Negative AQP-4 Antibody
Authors: Mokolensang Gabriella Olivia  , Stevanus Paliliweu  , Robby Tumewu  
Published: February 2024

Abstract
Introduction : Neuromyelitis Optica (NMO) or neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease of the central nervous system that causes demyelination of the optic nerve and spinal cord. Approximately 75% of cases have antibodies against aquaporin 4 (AQP-4 Antibody).
Case Illustration : A 42 years old male presented with progressing blurred vision in his right eye for 3 weeks. He described there was a black spot in his central vision which gradually enlarged to his peripheral vision, headache for 4 months, and transient tingling sensation and weakness on the left arm for 1 week. Positive RAPD in the right eye and signs of optic neuritis on funduscopy in Opthalmology examination. Campimetry examination revealed generalized depression in the right eye. The visual evoked potential (VEP) was consistent with right optic nerve demyelination. Spine MRI showed extensive transverse myelitis lesions >3 spinal cord hyperintensity on the level of C2-C6. However, the serum AQP-4 antibody was negative. The patient was treated with corticosteroid, and neuroprotector and was also being treated alongside the neurology department.
Discussion : NMO is a rare autoimmune disease. NMO is characterized by segmented demyelination and inflammation of the spinal cord and the optic nerves which gives many ocular signs and symptoms like optic neuritis. A negative test result does not rule out the diagnosis of NMO. Brain and spine MRI plays an important role in diagnosing NMO. Treatment of NMO consists of corticosteroid and plasmapheresis or intravenous immunoglobulin.
Conclusion : This case describes a diagnosis of NMO with a Negative AQP-4 antibody.
Relationship Between Contact Lens Wear and the Risk of Acquired Blepharoptosis
Authors: Febianza Mawaddah Putri  
Published: February 2024

Abstract
Introduction & Objectives : Contact lens wear has been reported to be associated with acquired blepharoptosis. This literature review aims to summarize and evaluate the risk of acquired blepharoptosis in contact lens wearers.
Methods : Literature searching was conducted using three online databases including PubMed, Cochrane Library, and Embase. Search terms such as “contact lens”, “ptosis”, and “blepharoptosis” were included. Reference lists of each study were also assessed for potentially relevant sources. Prospective and retrospective studies as well as meta-analyses and systematic reviews were included.
Results : Using relevant search terms in various databases, a total of five articles were included in this review. Four studies suggested that wearing hard or soft contact lenses was significantly associated with blepharoptosis. One study indicated hard contact lens wearers presented blepharoptosis 17.38 times more frequently than non-wearers (OR, 17.38, 95% CI=3.71–81.29), while soft contact lens wearers had 8.12 times more risk of presenting blepharoptosis than non-wearers (OR, 8.12, 95% CI=2.68–24.87). Furthermore, long-term contact lens wear, which was 20 years or more, seemed to have a significant effect on the incidence of blepharoptosis. There was only one study which stated that hard contact lens wear did not lead to acquired blepharoptosis in this review.
Conclusion : There is evidence of a clear association between hard or soft contact lens wear and an increased risk of blepharoptosis. Patients wearing contact lenses should be informed of the risk of blepharoptosis, and a history of contact lens use should be sought in all patients who have acquired blepharoptosis.
The Effect of Ethambutol Therapy in terms of Visual Evoked Potential, Color Vision Test, and Contrast Sensitivity Test at the Subclinical Level
Authors: ARANDZ RUTTU  , Dr. dr. Yunita, Sp.M(K), M.Kes  , Dr. Nurjannah Lihawa, Sp.P(K)  , Dr. Muh. Firdaus Kasim, M.Sc  , Dr. dr. Noro Waspodo, Sp.M(K)  , Dr. dr. Batari Todja Umar, Sp.M(K)  
Published: February 2024

Abstract
Introduction & Objectives : Ethambutol is one of the first-line drugs in the treatment of tuberculosis and known to induce optic neuropathy. However, there are unknown protocols for detecting subclinical level of toxicity. The aim of this study was to assess the difference in amplitude and latency of visual evoked potential (VEP), color vision, and contrast sensitivity in tuberculosis patients before and after taking ethambutol for 1 and 2 months.
Methods : This was a prospective observational cohort study of 38 eyes of 19 newly diagnosed patients with category-1 tuberculosis being treated with ethambutol. All patients were given ethambutol for 2 months at a dose of 15 - 20 mg/kg body weight/day. The participants underwent complete eye and visual function examination including pattern-reversal VEP, color vision with Farnsworth Munsell D-15 test, and contrast sensitivity with LEA Low Contrast Flip Chart before and after 1 and 2 months of treatment. Wilcoxon test was employed for data analysis.
Results : During the study, no changes in visual acuity was observed. The results showed that the latencies of VEP after 1 month (p = 0.000) and 2 months (p = 0.000) of treatment were significantly delayed. There was a significant difference in contrast sensitivity after 2 months (p = 0.014) of treatment. However, no significant difference was found in color vision and amplitude of VEP.
Conclusion : Latency of VEP and contrast sensitivity test could prove useful in detecting subclinical and hence very useful for monitoring patients under ethambutol therapy for ocular toxicity.
Corneal Collagen Cross-Linking (CXL) in Pediatric Keratoconus: Changes in Visual Acuity and Biomechanical Properties
Authors: Ganjar Sulaksmono  
Published: February 2024

Abstract
Introduction & Objectives : Keratoconus is a progressive disease that changes the mechanical shape of the cornea due to thinning of the stromal layer of the cornea. Therefore, early detection and correct management should be able to slow the progression of the disease. This study aimed to compare changes in visual acuity and biomechanic properties of cornea in patients who underwent Corneal Collagen Cross- Linking (CXL) in Dr. Sardjito General Hospital
Methods : This is a prospective study that included all pediatric keratoconus patients without any underlying disease that underwent CXL between July 2022 to December 2022. Uncorrected Visual Acuity (UCVA), Best Corrected Visual Acuity (BCVA), Central Corneal Thickness (CCT) and Intraocular Pressure (IOP) were evaluated preoperatively, 2 weeks, and 6 weeks following CXL.
Results : Mean age of patients was 11 (range 6-18 y.o). UCVA were 1.00±0.34 logMAR preoperatively, 0.95±0.35 and 0.88±0.37 logMAR at 2 and 6 weeks after CXL (P=0.27 and P=0.02, respectively). BCVA were 0.37±0.28 logMAR preoperatively, 0.46±0.28 and 0.35±0.21 logMAR at 2 and 6 weeks after CXL (P=0.05 and P=0.46, respectively). Mean IOP were 15.21±3.99 preoperatively, 14.45±2.73 and 15.21±3.68 at 2 weeks and 6 weeks after CXL (P=0.33 and P=1.00, respectively). Mean CCT were 503.09±49.43 preoperatively, 508.18±47.68 and 506.82±48.41 at 2 weeks and 6 weeks after CXL (P=0.01 and P=0.11, respectively). No complications occurred during the observation period.
Conclusion : UCVA and BCVA were improved after CXL. Analysis showed no significant change for IOP and CCT after CXL procedure. Overall, CXL was safe and significantly improve UCVA and BCVA in pediatric keratoconus.
COMPARISON OF ANGLE OPENING DISTANCE AND TRABECULAR IRIS SPACE AREA BEFORE AND AFTER LASER PERIPHERAL IRIDOTOMY IN ANGLE CLOSURE DISEASE
Authors: Ramdhani Rizki Fasa , Rifada R. Maula , Irfani Irawati , Gustianty Elsa , Umbara Sonie 
Published: February 2024

Introduction and Objective: Laser peripheral iridotomy (LPI) is the standard first-line therapy in angle closure disease to increase anterior chamber angle width. Spectral Domain Anterior Segment Optical Coherence Tomography (SD AS-OCT) is an instrument that has a quantitative parameter to measure anterior chamber angle. Angle opening distance (AOD) and trabecular iris space area (TISA) are quantitative parameters in SD AS-OCT. The purpose of this study is to compare AOD and TISA before and one week after LPI in angle closure disease.
Methods: This is an analytical prospective study with a cross-sectional study design. Twenty-two eyes with angle closure disease that met inclusion and exclusion criteria underwent LPI and SD AS-OCT before and one week after LPI. Analysis was performed using SD AS-OCT parameters, such as AOD (AOD500, AOD750) and TISA (TISA500, TISA750) in the temporal, nasal quadrants, and average.
Results: Twenty-two eyes with angle closure are divided into nine eyes with primary angle closure suspect, seven eyes with primary angle closure, and six eyes with primary angle closure glaucoma. The mean age of participants was 57.86±7.63 years. There was a significant increase in AOD500, AOD750, TISA500, and TISA750 in the temporal and nasal quadrants, as well as in the average (P=0.0001) based on a paired t test or Wilcoxon as an alternative. Average AOD750 had the highest T-value (T= 6.329) with a mean 0.20±0.096 before LPI and 0.31±0.144 one week after LPI.
Conclusion: There was a significant increase in AOD and TISA after one week LPI in angle closure disease.
TRABECULECTOMY IN CLOSED ANGLE UVEITIS GLAUCOMA A CASE REPORT
Authors: Samosir Alexander Theodore , Natan Priscilla Christina 
Published: February 2024

Introduction : Glaucoma uveitis is caused by increased outflow resistance, which distorts the balance between water production and outflow. Trabeculectomy is better than LPI in controlling IOP in glaucoma uveitis
Case Illustration : Male patient aged 45 years, came to the Eye Polyclinic at Serui Hospital with complaints of very painful right eye since 2 weeks ago, the patient also complained of being unable to see at all, red eyes, headache, stiff neck, nausea and vomiting. Ophthalmological examination reveal right eye vision no light perception (NLP), palpebral edema, spasm, conjunctival hyperemia, corneal edema, shallow anterior chamber angle, iris-corneal contact, negative pupillary reflex, total pupillary block, negative fundus reflex, schiotz IOP 81 mmHg.
Discussion : The patient diagnosed as right eye acute glaucoma and treated with acetazolamide, timolol maleate eye drops, potassium aspar tablets, prednisolone acetate drops, diclofenac sodium drops in the right eye, paracetamol tablets, re-evaluate in 2 hours. The patient chose to be referred to a hospital in Surabaya. The patient came back with the same complaint and was treated the same as before, right eye surgery trabeculectomy + peripheral iridectomy with releaseable suture flap limbal base with controlled IOP results, releaseable suture sutures were removed in 2 weeks. Trabeculectomy of the uveitic eye is generally less successful because of accelerated wound healing by the postoperative fibrinous and cellular response. Antimetabolites such as 5FU and Mitomycin C are used to enhance the success of trabeculectomy in uveitis eyes (5FU, MMC). 95% success (IOP less than 21 mm Hg with 1 or no treatment) was achieved with MMC augmented trabeculectomy.
Conclusion : Increased IOP due to pupillary block causes acute glaucoma with signs of high IOP, middilated pupils, decreased pupillary reflexes, and irregular shape, corneal epithelial edema, episcleral and conjunctival vascular congestion, shallow anterior chamber, small number of flares and cells.