bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proptosis in Adult Onset of Unilateral High Myopia Patient : A Case Report
Authors: Marcellina  , Yoseph Siahaan  
Published: February 2024

Introduction : Unilateral high myopia is an uncommon refractive condition, because two eyes typically grow bilaterally by the same amount and resulting in symmetric myopia. Proptosis can appeared due to high axial length in myopia.
Case Illustration : A 41-year-old female patient complain protruding eyeball in her left eye, gradually decrease vision, eye discomfort, and headache in her left eye since last year. There was no family history of eye disease, trauma or mass. On examination, her left eye was proptotic 3mm, best corrected visual acquity (BCVA) was 6/21 with -10.00 Sphere, and high intraocular pressure 23 mmhg. Her right eye BCVA 6/6 with -2.75 Sphere, other within normal limits. Her fundus examination showed features of high myopia and B-scan ultrasonographic showed different in axial lengths in both eyes. Orbita computerized tomography non contrast confirmed enlarge globe to posterior and proptotic in left eye.
Discussion : Unilateral high myopia developing in adult onset is a rare case. It appears to be a progressive condition that have a variable age of onset. Amblyopic eye, high intraocular pressure and proptosis demonstrated as the symptoms of unilateral high myopia in this patient. Left eye proptosis confirmed by CT orbita appears secondary due to elongation anteroposterior of the globe / changesin axial components of the eye.
Conclusion : High myopia can be a consideration of proptotic eye beside of mass/ tumor. Several studies to investigate patients with unilateral high myopia should be done to know the etiology and progression of the disease, thus can achieve good treatment and visual outcomes for patient.
UNILATERAL CMV RETINITIS IN HIV/AIDS PATIENT WITH MULTIPLE OPPORTUNISTIC INFECTIONS
Authors: Bening Daya Banyu , Firmansjah Muhammad , Zuhria Ismi , Yustiarini Ima , Widjaja Sauli Ari 
Published: February 2024

Introduction : CMV Retinitis is the most common opportunistic infection in HIV/AIDS patient. Ocular manifestations in HIV/AIDS have similar clinical features though the management therapies are different.
Case Illustration : A 47-year-old man was presented with blurred vision on LE since 4 months. Patient was diagnosed with HIV/AIDS since 2 years. Patient only had light perception on LE, and 5/10 on RE. The LE anterior segment showed flare and cell indicating active anterior uveitis. The LE posterior segment revealed extensive hemorrhage and exudate known as ‘pizza pie’ appearance, and cotton wool spot with multiple ischemic areas on RE. Laboratory tests revealed reactive IgG CMV and very low CD4 count (4 cell/?l). Patient was also diagnosed with Tinea Corporis, Scabies, and Pneumocystis carinii pneumonia. Oral Valganciclovir 900 mg was administered twice a day for 3 weeks, along with anti- retroviral therapy.
Discussion : The anterior uveitis and ‘pizza pie’ appearance with positive CMV IgG indicate CMV Retinitis in fulminant form. Cotton wool spot found in the RE leads to retinal microvasculopathy due to HIV invading the vascular endothelium and causing increased plasma viscosity. This patient only had 4 cell/?l CD4 which indicates severe immune deficiency. If not treated immediately, patients with CD4 count <50 are at higher risk of contralateral eye involvement. Oral Valganciclovir was chosen considering the multiple opportunistic infections the patient had.
Conclusion : It is important to distinguish CMV retinitis with other HIV/AIDS ocular manifestations. The choice of therapy needs be considered with the overall condition of patient.
LONG-TERM FOLLOW-UP ON A RARE CASE OF PERIOPERATIVE POSTERIOR ISCHEMIC OPTIC NEUROPATHY: FINDING HOPE IN THE DARKNESS
Authors: Affannul Hakim  , Lukisiari Agustini  , Gatot Suhartono  
Published: February 2024

Abstract
Introduction : Perioperative posterior ischemic optic neuropathy (PION) following maxillectomy is a rare and devastating condition that leads to permanent vision loss in most reported cases. This case report offers a different perspective through long-term follow-up, providing valuable insights into the prognosis and potential treatments for PION.
Case Illustration : Following a left maxillectomy for ameloblastoma, a 28-year-old female experienced sudden vision loss in her left eye. The visual acuity was 5/60, and an altitudinal inferior visual field defect with a superior extension was present. Ishihara's color vision examination revealed 15/38. The patient was diagnosed with perioperative PION and treated with neurotropic and folic acid. After 16 months, optic atrophy was observed. However, there are complete recovery in visual acuity to 5/5 and Ishihara score to 38/38, along with a significant improvement in the visual field defect.
Discussion : The current management of perioperative PION is focused on prevention, because once vision loss occurs, it is usually severe and irreversible. In our case, the patient exhibited a favorable outcome after a long follow-up period, suggesting that there is still potential for improvement in PION patients. The finding is consistent with previous study, which reported that a small percentage of patients may still experience improved vision during follow-up. The role of neurotropics in improving patient outcomes is further supported by in vitro studies that demonstrate early neurotropic treatment significantly prevents loss of retinal ganglion cells in PION.
Conclusion : Visual improvement is still possible in perioperative PION and early neurotropic administration may be considered in therapy
Reconstruction Management for Neglected Tripod Fracture with Ophthalmic Injuries: A Case report
Authors: Priscillia Tondolambung  , Vera Sumual  , Victor Pamolango  , Freili Akay  
Published: February 2024

Introduction : Tripod fracture or zygomatico-maxillary complex fracture are among the most common injuries to facial structures, which can make reconstruction more difficult. This case highlights the reconstruction of neglected tripod fracture.
Case Illustration : A 17-year-old male was presented with enophthalmos in his right eye. He had an accident three months prior and had received head surgery. After that, the patient came back with a pan-facial fracture. VA on RE was 1/300, limited movement upwards, 4 mm lagophthalmos, negative Bell’s phenomenon, infiltrates and cicatrices on the cornea. CT-scan examination showed tripod fractures. The surgery was performed by the reconstruction division with an oral and maxillofacial surgeon. Nineteen days after surgery, there has been some improvement in the orbital misalignment.
Discussion : Delayed intervention in this case, increased the difficulty of surgical treatment and could lower the success rate of surgery. If the indication is obvious, an immediate intervention will give better results because soft tissue scarring is minimized and fractures are easily reduced. During the procedure, we released the orbital muscle entrapment and repaired the deviated bone and callus with an osteotome to achieve mobility. Therefore, the tripod fracture was fixed with three-point fixation, followed by reconstruction of the maxilla and mandible. The result after surgery showed some improvements in aesthetics but not in vision.
Conclusion : Orbital reconstruction with mini-plate implants in three-point fixation as the management of orbital fractures is effective, but its accuracy is difficult to assess during surgery, especially when coupled with delayed intervention cases. Early reconstruction is recommended for a better cosmetic result.
Cataract Surgery After Keratoplasty: How Should We Prepare?
Authors: Sadikin Irma Suwandi , Widyawati Syska 
Published: February 2024

Introduction : Cataract surgery following corneal transplantation demands special attention to corneal graft stability and optimization to allow for excellent IOL selection, as well as corneal graft preservation since lens removal damages the corneal endothelium. This study aimed to determine how we should prepare for cataract surgery after keratoplasty.
Case Illustration : Case 1: A 34-year-old male has phacoemulsification in his right eye (last eye). He had a history of eye surgery, including, keratoplasty for RE in 2019, and vitrectomy for RE because of endophthalmitis. The pre-operative visual acuity is 0.5/60 with PAS and an irregular pupil. Post-operative VA 3/60 with BCVA 6/40. Last follow-up, the grafted cornea was still clear with normal IOP. Case 2: A 50- year-old female underwent phacoemulsification for both eyes (BE). She had histories of keratoplasty in 1986, 1989, and 1997 for BE. She also had extreme myopia for BE (RE S -17.00, LE S-14.00). Pre- operative VA was 1/60 of BE, and BCVA was 6/20 a month after surgery. During the last check-up, both transplant corneas were clear with normal IOP. Last visit, her both grafts remained clear.
Discussion :
Conclusion : IOL calculations are challenging due to inaccuracy in corneal measurements, astigmatism, or corneal pathology. The best time to perform surgery is at least 2 years after keratoplasty. We suggest using total keratometry in the K-6 formula or Haigis for the IOL formula. Good dispersive viscoelastic, operating away from the corneal endothelium, and employing low phaco-energy/fluids will help to deliver a clear cornea after surgery. Last, steroid treatment will enhance graft survival rate.
Reversible visual recovery in Optic Neuritis patient with No Light Perception VA
Authors: DEVI PUTRI SWADAYANI  , Irwan sanjaya  
Published: February 2024

Abstract
Introduction : Optic neuritis is characterized by an inflammation and demyelination of the optic nerve and is traditionally treated with corticosteroids. The findings of the ONTT, reported in more than 50 publications during the past 20 years, have numerous implications
Case Illustration : A 48-year-old woman presented to the ophthalmology outpatient clinic with a 12-day history of blurred vision. The best-corrected visual acuities and Ishihara colour vision was unilaterally reduced with a non light perception on left eye. There were also relative afferent pupillary defect with slow respons of pupillary reflect. Slit-lamp examination was otherwise normal. Funduscopy was Papillary edema on left eye, with all quadrant blurry edge. Optic neuritis (ON) was presumed as she had suffered with this previously. She was hospitalized and undergone (optic neuritis treatment trial) ONTT . Thereafter, a trial of pulsed methylprednisolone was commenced, resulting in near complete resolution of the Visual acuity that become 6/40 UCVA from NLP.
Discussion : The original ONTT, along with three follow-up studies at five-year intervals, generated more than three dozen papers in scientific journals. Collectively they show what happens to an individual over the course of 15 years following about of optic neuritis.
Conclusion : Prior to the ONTT well-established guidelines for treating optic neuritis did not exist, this case were demonstrates the importance of keep starting ONTT with a point valuable to patient with NLP.
Ophthalmologic findings in Cornelia de Lange syndrome
Authors: Nizma Permaisuari  , Dian Estu Yulia  
Published: February 2024

Introduction : Cornelia de Lange syndrome (CdLS) is a rare disease characterized by multisystem abnormalities, including various ophthalmologic problems. The purpose is to report this kind of rare case and highlight the role of ophthalmologist in visual development optimalization.
Case Illustration : A 2-year-old boy with CdLS showing bilateral microcornea, cataracts with “dot opacities,” and chin lifts induced by ptosis. We also examined brow hypertrichosis, synophrys, and long arcuate eyelashes. High myopia and high astigmatism was found in the patient with spherical equivalent of 9.8 D. He was born with low birth weight, microcephaly, anteverted nostrils, depressed nasal bridge, thin upper lip, micrognathia, low posterior hairline, short neck, and syndactili. He also showed psychological lag and developmental impairment. Glasses was then prescribed to prevent amblyopia.
Discussion : Individuals with CdLS may have multiple treatable ocular conditions. We recommend that patients have an initial ophthalmic examination after diagnosis of CdLS is first made, in order to establish a baseline and to assess for the presence of abnormalities that would benefit from early intervention. Examination under anesthesia may be required in some patients to adequately assess for any abnormalities, and to obtain a good refraction as well as an inspection of the retinal periphery in children with long axial length. Early intervention may greatly improve function and prevent vision loss due to amblyopia.
Conclusion : Initial ophthalmic examination followed by routine annual screening is warranted when a diagnosis of CdLS is made, given that ocular anomalies are present in the majority of patients and may impact vision and daily functioning.
Kissing Nevus of Eyelid: A Rare Case Report
Authors: Dr. Silva Roza  , Dr. dr. Hendriati Sp.M(K)  , Dr. Mardijas Efendi Sp.M  , Dr. dr. Ardizal Rahman Sp.M(K)  
Published: February 2024

Introduction : Kissing nevus, also known as kissing mole, is a rare dermatological condition in the world and characterized by the presence of congenital nevi on both the upper and lower eyelids in symmetrical fashion. Additionally, this report highlights the treatment options available for patients with kissing nevus and discusses the importance of regular monitoring.
Case Illustration : An 11-year-old female patient came with a complaint of a mole on the upper and lower eyelids since birth. The mole was felt to be getting bigger and starting to bother her. The patient feels insecure with the presence of this mole. The patient underwent nevus excision followed by retroauricular graft placement on the superior and inferior eyelidss. Then a biopsy showed benign nevus. After follow-up, it was found that the graft had grown and there was no necrotic tissue.
Discussion : Kissing nevus is a rare skin condition that affects babies and young children. It is characterized by two identical birthmarks that appear on either side of the body, such as on the eyelids. Surgery involves removing the birthmarks surgically. Our patient underwent wide excision and palpebral reconstruction.
Conclusion : Kissing nevuse is a unique skin condition marked by the presence of congenital nevi on both the upper and lower eyelids in a symmetrical pattern. It is worth noting that while treatment may be effective, there is a risk of scarring, infection, and other side effects associated with these procedures.
Efficacy of 0.1 % Sodium Hyaluronate versus 0,5 % Carboxymethylcellulose in Dry Eye Disease : A Meta-Analysis
Authors: ALDILA SAVITRI  , FITRIAN HANIF  
Published: February 2024

Introduction & Objectives : Dry eye is a disorder that involves either insufficient tear production or excessive tear evaporation. Artificial tears are the main treatment for dry eye disease. Sodium Hyaluronate (AH) and Carboxymethylcellulose (CMC) are the two most frequently prescribed and used. To analyze the efficacy of 0,1% sodium hyaluronate compared with 0,5% carboxymethylcellulose toward the symptom score, tear break up time, corneal stain fluorescein in dry eye through a meta-analysis.
Methods : A systematic search was performed using Medline and Cochrane database up to December 2022. Review was performed according to the PRISMA Statement. The eligible studies were RCTs which comparing Sodium hyaluronate with Carboxymethylcellulose.
Results : From 88 retrieved articles, 6 trials involving total 373 patients were included. The median follow-up period of the studies was 6 weeks. Sodium hyaluronate significantly increases tear break up time compared to Carboxymethylcellulose (Mean Difference (MD): 0.46, 95%CI [0.09-0.84], p=0.01, I2=76%), and significantly decrease corneal stain fluorescein (MD: -0.54, 95%CI [-0.86-(-0.23)], p=0.0008, I2=88%). The analysis shows insignificantly decrease in subjective symptom scores (MD: -0.08, 95%CI [-0.40-0.23], p<0.60, I2= 79 %).
Conclusion : In dry eye disease, 0,1% sodium hyaluronate significantly improves tear break up time and significantly decreasing corneal stain fluorescein, while insignificantly decrease subjective symptom scores.
Trabeculectomy Versus Tube Outcome in Neovascular Glaucoma
Authors: Syahiqoh Daisy Syakhsiatusy , Rahmi Fifin Luthfia , Puspasari Denti , Maharani  
Published: February 2024

Introduction & ObjectivesNeovascular glaucoma (NVG) is known to be a refractory form of glaucoma, which frequentlyrequires the integrated use of medical, laser and incisional surgery. Tube-shunt implantation andtrabeculectomy with antifibrotic agent are the two most-popular incisional procedures for managingrefractory glaucoma. This study aims to compare surgical outcome between patients who underwenttrabeculectomy versus tube-shunt implantation for the treatment of NVG.
MethodsA retrospective study was held of NVG patients that underwent trabeculectomy and tube-shuntimplantation between January 2020 - December 2022 at Dr. Kariadi Hospital, Semarang. IOPoutcome and success rate was measured at 3 months post operatively. Statistical analysis was usedto compare the outcome between groups, p<0.05 was considered significant.
ResultsThere were no significant differences in characteristics between groups at baseline. Mean IOPmeasured at 3 months post operatively was 18.58 ± 5.53 and 15.94 ± 10.79 in trabeculectomy andtube group respectively (p=0.04), complete success rate was 18.8% in trabeculectomy and 25% intube group, qualified success rate was 37.5% in trabeculectomy and 56.3% in tube group. Greaterfailure rate was observed in trabeculectomy group (43.8%).
ConclusionCompared to trabeculectomy, tube-shunt implantation has lower IOP at 3 months post operatively inNVG. Greater failure rate was observed in trabeculectomy.
Anterior Segment Dysgenesis in A Child, A Rare Case Report: What Should We Do?
Authors: Permatasari Devi Sarah Intan , Hermawan Dicky , Loebis Rozalina 
Published: February 2024

Introduction : Anterior segment dysgenesis affects a various range of ocular structure, including: cornea, iris, ciliary body, anterior chamber, and lens associated with approximate 50% of glaucoma
Case Illustration : A 20 month-old boy presented with bilateral corneal opacity. VA was 6/480 on both eye. Examination revealed bilateral central corneal opacity with keratolenticular adhesions, anterior lens dislocation and opacification, aniridia, and posterior segment were difficult to evaluate. The IOP were 17.3 mmHg and 14.6 mmHg in the right and left eye respectively. The aforementioned feature contributed to the diagnosis of Type II Peters Anomaly (PA). Lens aspiration combined with adhesiolysis on the LE was performed. Patient was given topical antibiotic, corticosteroid, and anti- glaucoma medication post-operatively. Postoperative course showed no complication and the corneal opacity diminished
Discussion : Lens aspiration in combination with adhesiolysis was performed because the presence of cataract interfered the visual axis and increased the risk of corneal decompensation due to keratolenticular adhesions. We considered to perform the surgery on the LE first because the corneal opacity was milder than the RE. Glaucoma is an almost ineluctable issue and medical therapy are necessary. Further evaluation was required to determine if a similar procedure is needed for the fellow eye and whether the IOL implantation was going to enhance the visual prognosis in the future
Conclusion : The keratolenticular adhesions and corneal opacity in type II PA make the surgical approach more challenging. Cautious manipulation can prevent further corneal decompensation. In addition, parents should receive extensive counseling regarding the complications and prognosis
Post Stroke, Is Perimetry Necessary? A Case Report
Authors: AULIA PURNAMA EFFENDI  , Bobby Ramses Erguna Sitepu  
Published: February 2024

Abstract
Introduction : Stroke are generally associated with peripheral visual field loss. Three out of four stroke patients report some form of disability, one of which is visual impairment. Approximately 16% of these patients have a homonymous visual field defect poststroke. These vision problems can lead to difficulty carrying out a lot of daily tasks and activities, such as driving. This report tries to define the diagnostic flow to determine the exact type and lesion.
Case Illustration : Male, 61 years old, came to Universitas Sumatera Utara Hospital with visual field loss in both eyes. Two months ago, he was diagnosed with ischemic stroke and treated with Aspirin 80 mg, with no limbs disability right now. He also had hypertension and treated with Amlodipine 10 mg. VOD: 6/60 with BCVA S-2.00 6/7,5, VOS: 6/60 with BCVA S-2.00 6/7.5. With confrontation test and perimetry, defect was found in medial visual field OD and lateral visual field OS. Hess screen and Amsler Grid was normal. Head CT-Scan was performed with multiple infarcts, mainly in right occipital lobe. The patient was diagnosed with Incomplete Hemianopia, Left Congruous Homonymous Hemianopia with Macular Sparing, and treated with Citicholine 1000 mg once daily.
Discussion
Conclusion : In stroke patients with homonymous visual field loss, visual field testing with detailed evaluation of visual field defect can determine the lesion location, and neuro-radiological imaging was necessary to assess visual pathway. It’s important for educate the patients, diagnostic and prevent the stroke recurrent.
A peculiar case of idiopathic orbital myositis in adolescence
Authors: NABILA ALJUFRI  , Agung Nugroho  , Sita Paramita  , Salmarezka Dewiputri  , M. Sidik  , Syntia Nusanti  
Published: February 2024

Abstract
Introduction : Idiopathic orbital myositis, an inflammation localized at the extraocular muscles, is rarely reported in pediatrics. Until now, the prevalence and incidence of orbital myositis remain unknown. This paper aims to report a case of idiopathic orbital myositis in a young girl with headache.
Case Illustration : A-16-year-old presented with a droopy eyelid of the left eye (LE) and double vision since 1 week before admission. She also experienced swollen eyelid and cluster headache for 5 months with no neurological abnormalities. Ophthalmic examinations showed exotropia with limited eye movement of LE. Ptosis of LE was noted with margin reflex distance 1 (MRD-1) +2 mm, while MRD-1 +6 mm for the right eye. Other examinations were unremarkable with normal funduscopy and negative RAPD. Non-contrast orbital sinus CT-Scan revealed an enlargement of the superior rectus and lateral rectus muscle. The laboratory result showed slight leucocytosis and normal ESR. High-dose intravenous corticosteroid was administered and tapered with oral steroid. The orbital clinical findings showed improvements, better ocular movements, and diminished headache complaints.
Discussion : As a rare case, the diagnosis of orbital myositis in adolescence can be challenging and requires detailed examination, and proper imaging to exclude other diagnosis such as ophthalmoplegic migraine, infections, malignancies, or congenital lesions (hemangioma). The first-line therapy is a systemic corticosteroid, which well responded in this patient.
Conclusion : In this patient, intravenous corticosteroid represent an effective treatment. Close monitoring of the disease progression is required after switching to oral therapy to prevent relapse.