bluuebunny/crossref_metadata_2025_split huggingface dataset:
UNSALVAGEABLE EYE: HOW CAN WE DO MORE?
Authors: Jessica Jovia  , Gladys Kusumowidagdo  , Randy Sarayar  , Hisar Daniel  
Published: February 2024

Introduction : Unsalvageable eye, consisting of total visual loss, orbital wall fracture, and disfigured globe, is devastating for both patients and caretakers. This impairment is a challenge for ophthalmologists to manage. Although visual rehabilitation is impossible, the appropriate management results in outcome that would improve patient’s quality of life (QoL). We aim to report our successful case of orbital reconstruction with satisfactory outcome.
Case Illustration : A 75-year-old male presented to our clinic with total visual loss of right eye (RE) after motorcycle accident three months prior. Examination revealed phthisical RE, partially-healed full-thickness inferior palpebral laceration, and inferomedial blow out fracture (BOF). Electroretinography and visual evoked potential examination showed a decrease of right optic nerve conduction. The patient expressed discontentment with his current physical condition. Simultaneous procedures of orbital floor and medial wall fracture repair using silicone block followed by lid reconstruction, and mucous membrane grafting for ocular surface were performed. An ocular prosthesis was fitted. The patient was pleased with the outcome.
Discussion : Ophthalmologists are often left with little room to aid patients with this condition. More can be done to unsalvageable eye cases. This case shows that improvement of patient’s QoL can be achieved by orbital reconstruction and ocular prosthesis fitting.
Conclusion : The main objective of managing unsalvageable eye is to restore patient’s orbital anatomical features, hence, improving his QoL.
Cataract Progression dan Lens Drop after Pars Plana Vitrectomy and Gas Tamponade : A Case Report
Authors: Suryawijaya Ernes Erlyana , Suryathi Ni Made Ari , Andayani Ari 
Published: February 2024

Introduction : Vitreous Hemorrhage (VH) in proliferative diabetic retinopathy (PDR) is common cause of acute vision loss.If the retina cannot be visualized and the etiology of the VH is unknown, pars plana vitrectomy (PPV) is indicated. 1Intraocular gases like SF6 or C3F8 are one of the most useful adjuncts in vitreoretinal surgery. Exposure to intraocular gases additionally increases retrolental oxygen levels, resulting in development of lens opacities.
Case Illustration : Patient female 52 y.o, came with sudden blurry vision in the left eye since two weeks ago. History of Diabetes Mellitus 10 years with insulin treatment. From the examination left eye visual acuity 1/60, zonulysis, VH, and negative fundus reflect. On ultrasonography found vitreous opacity. The patient was diagnosed with left eye VH ec advanced PDR and scheduled PPV with C3F8 gas tamponade. Patient difficult to maintain prone position after surgery. 2 month after the surgery the patient scheduled with phacoemulsification surgery because progressive lens opacity. While prepare to the second operation, the lens found drop to the vitreous. The second surgery done with lens evacuation and Intraocular lens implantation. Last follow up, best correction visual acuity was 6/18.
Discussion : PPV and Gas tamponade are presdisposing lens opacity progression. Lens opacity after gas tamponade include longer intraocular longevity gas and patients who fail to maintain a prone position. Risk factors for zonulysis in this patient increase the occurrence of lens drop after PPV with gas tamponade.
Conclusion : Regular slit-lamp examination needs to be performed for early detection of cataract after PPV with gas tamponade.
PANUVEITIS AS A MANIFESTATION OF OCULAR SYPHILIS IN PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS : A CASE SERIES
Authors: SITI AISYAH  , Angga Fajriansyah  , Susi Heryati  , Arief Akhdestira Mustaram  , Patrioka Muslima  , Elfa Ali Idrus  
Published: February 2024

Introduction : Syphilis is a sexually transmitted disease caused by the spirochete bacterium Treponema pallidum. Syphilis can result in multiple organ involvement, including the eyes, and demonstrates various clinical findings. Ocular syphilis is an important cause of uveitis in the new era of co-infection with the human immunodeficiency virus (HIV).
Case Illustration : Case 1: A 29-year-old male HIV-positive with 5 months of blurred vision, pain, and redness in left eye (LE) with skin rashes on the palms and foots (Figure 1). The visual acuity was 1/300 in LE, anterior segment showed flare cell (Figure 2). Fundus examination (Figure 3) revealed multiple exudative lesion of right eye (RE) and vitreus opacity of LE due to inflammation. VDRL and TPHA tests were positive. Case 2: 38-year-old male, HIV-positive and tuberculosis-positive, with 2 months of blurred vision,pain and redness in both eyes with skin rashes on the palms and foots (Figure 1). The visual acuity of the RE was 1/60 and 1,5/60 in the LE on the initial visit. Anterior segment eye examination revealed flare and cell (Figure 2). Fundus examination revealed (Figure 3) preretinal hemorrhage and exudate of both eyes. VDRL and TPHA testing were positive, CD4 count showed severe immunodeficiency.
Discussion : This study depicts clinical features and outcomes of two cases of ocular syphilis with HIV co- infection. Poor visual outcome was associated with posterior segment-involving uveitis at presentation.
Conclusion : An accurate diagnosis is crucial, treatment is adjusted according to the clinical stage. Comprehensive education is needed for patients and their families.
CORNEAL INJURY AFTER BEING STRUCK BY A PIECE OF STONE - A CASE REPORT
Authors: Dianata Dewa Ayu Ina , Suniarsih Ni Nyoman 
Published: February 2024

Introduction : Corneal lacerations in oculi trauma are common, any disruption or trauma to the cornea will affect the person's visual acuity.
Case Illustration : 50 years old man came to the eye clinic of Sanjiwani General Hospital Gianyar with pain, blurred vision, and redness in his left eye, The symptom appeared abruptly after a piece of stone struck his left eye where the stone penetration looks deep enough and touched the surface of the iris. Visual acuity of his left eye (VOS) was 6/60, and open globe injury suspicion was removed by seidel test negative. He underwent surgery for corpus alienum removal with local anesthesia. During the procedure, the stone appeared to be even with the corneal surface, making it difficult to pick it up directly, so the removal technique is to pry it from the edge. The wound is closed using the suture. One week after the procedure, the patient came for a re-evaluation examination; visual acuity was improved; VOS: 6/7.5, no sign of infection or complication.
Discussion : The form of the corneal lacerations can vary, with or without globe rupture. To reduce the risk of infection, tissue necrosis, and anterior peripheral synechiae formation, it is suggested that repair should occur within 24 hours after injury. In addition, repairs within this time limit may also aim to provide comfort and reduce the pain that patients may experience.
Conclusion : Immediate recognition and repair procedure of corneal injury in this patient brings good vision results with no complaints of complications.
Management Strategies of Ocular Alkaline Chemical Injury
Authors: Nadia Ayu Destianti  , Patrioka Muslima  , Elfa Ali Idrus  , Arief Akhdestira  , Angga Fajriansyah  
Published: February 2024

Introduction : Ocular chemical burns are true ophthalmic emergencies that can cause permanent corneal and intraocular damage leading to visual impairment or even blindness. When a case of chemical trauma occurs, immediate and appropriate management should be done.
Case Illustration : A 24-year-old man came to Cicendo Eye Hospital with complaints of blurry eyes accompanied by burning and watery eyes after being doused with a bucket of cement mortar two weeks earlier. Ophthalmologic examination obtained visual acuity for the right eye 1/300 and left eye was 1/60. The anterior segment of both eyes showed corneal edema, conjunctivalization, persistent epithelial defects, limbal ischemia, and punctate epithelial erosion. There was an ulcer and thinning of the corneal layer in left eye. He was diagnosed with alkaline chemical injury Dua's classification grade VI on the right eye and grade V on the left eye (Figure 1). The patient then underwent a keratectomy, conjunctival resection, and amniotic membrane transplantation procedure. On the seventh day postoperatively, symptoms and clinical features improved with the visual acuity of both eyes improved to 1/60 (Figure 2).
Discussion : Amniotic membrane graft was performed in late reparative phase which aims to preserve the surface of the corneal epithelium and prevent corneal perforation and inflammation. Conjunctival resection was performed to prevent neovascularization of the amniotic membrane.
Conclusion : Management of ocular burn injury requires an immediate and comprehensive treatment to achieve good result. In this case successful treatment was achieved by improvement of visual acuity and no complication occured.
THE OUTCOME OF INTRAVITREAL BROLUCIZUMAB FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION TREATMENT
Authors: Graziani Gabriella , Ihsan Grimaldi , Widyanatha Made Indra , Virgana Rova , Kartasasmita Arief S. , Iskandar Erwin 
Published: February 2024

Introduction : Age-related macular degeneration (AMD) is a disease that results in irreversible severe loss of central vision in people over 50 years old. Hence, anti-VEGF therapy has become a standard treatment for neovascular AMD. Brolucizumab is a single-chain antibody fragment that inhibits VEGF-A binding to VEGF receptors. It has a higher molar concentration that allows a greater reduction in the central subfield thickness (CST)
Case Illustration : A 59-year-old male with a chief complaint of gradually blurred vision in the left eye for 2 years. BCVA of the left eye was 0.3, OCT showed a hyperreflective band in the sub-neurosensory space with subretinal fluid in the left eye (Figure 1), and OCT-A revealed choroidal neovascularization (Figure 2). The patient was diagnosed with AMD AREDS IV in the left eye. He had undergone three monthly injections of brolucizumab. BCVA of the left eye after injection improved to 1.0 and OCT imaging showed no subretinal fluid, no intraretinal fluid, and no pigment epithelial detachment.
Discussion : Brolucizumab has a greater reduction in CST because of its high molecular concentration. Results of HAWK and HARRIER concluded that brolucizumab was non-inferior towards aflibercept in BCVA change at week 48. According to the HAWK trial, a greater reduction of CST was seen in week 16 among eyes treated with brolucizumab. Brolucizumab was also well tolerated and adverse event rates were similar to aflibercept.
Conclusion : Brolucizumab could be an alternative treatment option considering its efficacy in improving visual acuity and reducing CST.
Management of Streptococcus pyogenes Preseptal Cellulitis in Multisystem Inflammatory Syndrome in Children (MISC)
Authors: ANAK AGUNG DEWI ADNYA SWARI  , N.K. Niti Susila  , I Gusti Ayu Made Juliari  , Ida Ayu Ary Pramita  
Published: February 2024

Introduction : Preseptal cellulitis were more common in children than adults. Preseptal cellulitis was an infection involving the anterior part of the orbita septum. Management of preseptal cellulitis, especially in children, were important to save visual function.
Case Illustration : A boy, 1 year 8 months, was complained by his mother with swollen and redness on both eyes. The patient has a history of Multisystem Inflammatory Syndrome in Children (MISC) and Global Developmental Delay (GDD). Both eyes were edema, hyperemia, excoriation, bleeding, tenderness on eyelid, and conjunctival injection. Blood Culture examination results showed Streptococcus pyogenes bacteria. Patient was receiving therapy of antibiotics cefoperazone-sulbactam, amikacin, methylprednisolone intravena, enoxaparin subcutaneous injection, moxifloxacin and prednisolone asetat eye drops during hospitalization at Prof. Dr. I.G.N.G. Ngoerah General Hospital.
Discussion : A patient with fever and respiratory tract infection was diagnosed with preseptal cellulitis. Preseptal cellulitis is a common infection of the eyelid and periorbita soft tissues characterized by acute eyelid erythema and edema. Antibiotic therapy had been started before blood culture examination. This study discusses toddler with preseptal cellulitis treated with antibiotics showing good results.
ConclusionPreseptal cellulitis due tue multisystem inflammatory syndrome in children was an infection of the soft tissues of the eye that requires a multidisciplinary approach in management therapy. Early detection and adequate therapy have been proven to significantly improve patient survival rates and quality of life.
Autologous Fascia Lata Graft in Scleromalacia Perforans: A Rare Case
Authors: ANCI WINAS  , Petty Purwanita  , Anang Tribowo  
Published: February 2024

Introduction : Scleromalacia perforans, also called anterior necrotizing scleritis without inflammation, is a rare disease with an initial lesion of yellow or greyish nodules that gradually develop into scleral necrosis with perforation and exposure of uvea. It typically occurs in elderly women. Surgical therapy to close the defect may be performed with the sclera, dermis, fascia lata, periosteum, aortic tissue, cartilage, and eventually amniotic membrane as grafts.
Case Illustration : A 59-year-old woman presented with complaint of greyish discoloration of the sclera on the right eye since one years ago. The patient denied the history of arthritis, autoimmune diseases, and other systemic diseases. The patient claimed to have had pterygium surgery ten years ago. Visual acuity was 6/9 with an of IOP 13.1 mmHg. Slit lamp examination revealed thinning of the medial sclera. Posterior segment was within normal limits. Serum antibody screening obtained normal results. The patient was diagnosed with scleromalacia perforans and underwent autologous fascia lata graft surgery. Two weeks postoperatively, scleral of the fascia lata graft gave good results.
Discussion : Scleromalacia perforans is diagnosed based on anamnesis and ophthalmological examination. A history of pterygium surgery is suspected as the trigger for scleral thinning. Surgical therapy was performed to maintain the integrity of the eyeball and prevent further thinning of the sclera. Autologous fascia lata graft is chosen because it is readily available, easy to perform, and has a low rejection rate.
Conclusion : Autologous fascia lata graft is a surgery that provides good prognosis in scleromalacia perforans.
Progressive Bilateral Ptosis in Adduction Deficit: True Internuclear Ophthalmoplegia (INO) or Pseudo-INO?
Authors: MARSHA RAYFA PINTARY  , Salmarezka Dewiputri  , Annisa Nindiana Pertiwi  , Syntia Nusanti  , Sita Paramita Ayuningtyas  , Mohamad Sidik  
Published: February 2024

Abstract
Introduction : Bilateral INO is a rare disease caused by a lesion in the medial longitudinal fasciculus (MLF) in the pons, resulting in adduction deficit. Progression to ptosis is rare and may confuse with pseudo-INO as in ocular myasthenia gravis (OMG). This case aims to report progressive ptosis in bilateral INO that mimics pseudo-INO.
Case Illustration : A 36-year-old woman complained sudden binocular diplopia 4 days before admission. Bilateral adduction deficits (-3 and -2 of right and left eye, respectively) with nystagmus were seen. There was no ptosis. The patient was diagnosed with bilateral INO. One month later, the patient returned with bilateral ptosis. The marginal reflex distance 1 (MRD1) were 0 on both eyes. Post fatigue and ice pack test showed 2mm difference of MRD1. The single fiber electromyography (EMG) result came out negative with jitter <10%. Brain MRI revealed lesions in the posterior pons and periaqueductal on the level of midbrain.
Discussion : The MLF controls 6th and contralateral 3rd cranial nerve nucleus for horizontal gaze. Ptosis in INO can occurred due to central caudal subnucleus involvement in midbrain that innervates levator palpebra. The result of fatigue and ice pack test may be misleading, as those are not pathognomonic for OMG. The single-fiber EMG are valuable modalities to exclude pseudo-INO in this case.
Conclusion : Progressive bilateral ptosis may occur in bilateral INO. Fatigue and ice pack test may give false- positive results leading to confusion with pseudo-INO, rather than true INO. Supporting examinations are needed to confirm the diagnosis.
A Rare Case of Congenital Bilateral Upper Eyelids Ectropion in Down’s Syndrome : Conservative or Operative?
Authors: Mischka Scalvinni Suvero Suyar  , Nazhira Janani  , Ferdian Ramadhan  , Balgis Desy Sulistyowati  
Published: February 2024

Introduction : Congenital upper eyelids ectropion, is a very rare congenital condition characterized by everted upper eyelids associated with Ichthyosis, Blepharophymosis Syndrome, birth trauma and prominently appears in Down’s syndrome. This case aimed to report a rare case of congenital ectropion in an Down’s syndrome with further management considerations, conservative or operative.
Case Illustration : A three-month-old baby with bilateral red upper eyelids swelling since birth with conjunctival swelling followed by yellowish discharge. Born through section caesarean from a mother with history of pre-eclampsia and being incubated for 24 days. Ophthalmic examination revealed bilateral upper eyelids eversion, minimal conjunctival chemosis, epicantal fold. The upper eyelids able to be repositioned in relaxed state and re-everted with forced lid closure. Treatment of the eyelids eversion was conservative, combining antibiotics, topical steroids and lubricants. We referred to the pediatrician for the management of Down’s Syndrome, the further management for the eyelids eversion still debatable.
Discussion : Most infants with congenital ectropion showed excellent anatomic and functional results with conservative treatment if managed timely and promptly. However, infants with Down’s syndrome have a more complicated course due to complex periorbital anatomy and facial anomalies such as flattened face, almond shaped eyes and large nose’s bridge. If congenital ectropion accompanied by lagophthalmos and exposure keratopathy, surgical management should be considered.
Conclusion : Congenital eyelids ectropion can be managed conservatively or surgically depend on the clinical courses. Mild case able to be managed conservatively with excellent results if managed timely but surgical management supposed to be considered in complicated case.
Long-term outcomes of LASIK for myopia
Authors: Mattarungan Monica , Tania  
Published: February 2024

Introduction & Objectives : Myopia is a major healthcare burden worldwide. Refractive surgery is used to correct refractive error for patients who wanted less reliance on glasses and contact lenses. LASIK is one of the most commonly used procedures for correction of myopia. This study aims to evaluate the long-term outcomes of LASIK procedure for myopia.
Methods : A literature search was conducted for the years of 2017 to 2013 from PubMed with the search term "LASIK" AND "myopia" AND ("efficacy" OR "long-term outcomes"). All abstracts were reviewed and evaluated, and articles relevant to the topic was reviewed for this study.
Results : Out of 71 articles from search results, 7 articles were selected for review. At the last follow up from 3-12 years, uncorrected distance visual acuity (UDVA) of -0.03 – 0.39 logMAR was achieved. Around 64% - 90% patients achieved UDVA of 20/20 or better. Myopic progression was found with the mean of 0.63 – 0.97 D. The efficacy index and safety index was at 0.67 - 1.01 MR and 1.02 - 1.09 respectively at the end of follow up.
Conclusion : The data showed that LASIK had an excellent long-term safety and efficacy for treatment of myopia, although small percentage of patients experienced mild myopic progression.
Inverted input method for computing performance enhancement of the ion-gating reservoir
Authors: Yamaguchi Yu , Nishioka Daiki , Namiki Wataru , Tsuchiya Takashi , Imura Masataka , Koide Yasuo , Higuchi Tohru , Terabe Kazuya 
Published: February 2024

Abstract
Physical reservoir computing (PRC) is useful for edge computing, although the challenge is to improve computational performance. In this study, we developed an inverted input method, the inverted input is additionally applied to a physical reservoir together with the original input, to improve the performance of the ion-gating reservoir. The error in the second-order nonlinear equation task was 7.3 × 10−5, the lowest error in reported PRC to date. Improvement of high dimensionality by the method was confirmed to be the origin of the performance enhancement. This inverted input method is versatile enough to enhance the performance of any other PRC.
Management in the tourism industry: Ways to improve the system of management and utilization of cultural and educational objects of Krasnoyarsk Krai
Authors: Tropynin I. V. 
Published: February 2024

Aim. To determine the ways of improving the management system of the objects of cultural and educational activities of the Krasnoyarsk region and their use in the organization of tour- ist and excursion services in the context of cultural and cognitive tourism.Objectives. To identify the peculiarities of development of objects of cultural and educational activity of Krasnoyarsk Krai; to analyze the methods of management of the cultural sphere in Krasnoyarsk Krai, implemented activities and existing problems in the context of regional interdepartmental interaction of cultural and tourism industries; to establish ways to improve the management system of objects of cultural and educational activity of Krasnoyarsk Krai and their use in the organization of tourist and excursion services in the context of cultural and cognitive tourism.Methods. The author used methods of comparison and generalization, tabular method, method of strategic planning (SWOT-analysis).Results. According to the results of the analysis the main recommendations for improving the management system of cultural and educational objects of Krasnoyarsk Krai and their use in the organization of tourist and excursion service are formulated. First of all, a number of proposals for improving the system of financing of cultural institutions and their use of money are presented. In addition to solving financial problems, recommendations related to the solution of systemic problems in the management of cultural and educational activity objects are given.Conclusions. In case of occurrence of signs of realization of the offered recommendations the received results can promote expansion of a circle of visitors of establishments on a paid basis, increase of interest to professional activity in cultural establishments among youth, growth of quality of carrying out of cultural actions, development of interterritorial cooperation and touring activity of collectives, increase of tourist flows.