bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARISON OF HSP90 EXPRESSION IN CONJUNCTIVAL INTRAEPITHELIAL NEOPLASIA AND CONJUNCTIVAL SQUAMOUS CELL CARCINOMA
Authors: TRISSA WULANDA PUTRI  , IBRAHIM  
Published: February 2024

Abstract
Introduction & Objectives : Heat shock protein 90 (HSP90) participates in stabilizing and activating client proteins involved in malignant transformation. This study aims to determine whether there are different values for the expression of HSP90 in Conjunctival Intraepithelial Neoplasia (CIN) and Conjunctival Squamous Cell Carcinoma (CSCC).
Methods : A total of 24 OSSN samples, including 15 cases of CIN and 9 cases of CSCC were evaluated. The immunohistochemical expression of HSP90 was assessed using a scoring system based on the percentage of positive staining of nuclear and cytoplasmic cells, then the intensity of staining was evaluated using the German Immunoreactive Score.
Results : In the study, the average cytoplasmic Immunoreactive Score in CIN was 9.87 and CSCC was 16.89 with a significant result (p=0.007), while the average nuclear Immunoreactive Score in CIN was 11.30 and CSCC was 14.50 with insignificant results (p=0.274). The results of the correlation test showed that the cytoplasmic expression groups with low categories were all in CIN as much as 6 (100%) so they had a ratio of 6:0. and the high category of HSP90 cytoplasmic expression group was only found in CSCC as many as 2 (100%) samples with a ratio of 0:2. The results of the correlation test using the Pearson test obtained a significant correlation value (p=0.006) with a moderate correlation strength (r=0.545).
Conclusion : There are differences in the expression of cytoplasmic and nuclear HSP90 but only the cytoplasmic expression of HSP90 is significantly associated with CIN and CSCC.
OSDI Score Comparison between Sodium Hyaluronate, Carboxymethylcellulose and Polyvinylpirrolidone for Dry Eye in Medical Student during Online Learning
Authors: ARIANI RATRI DEWI  
Published: February 2024

Abstract
Introduction & Objectives : Online learning during COVID pandemic increase medical students’ screen time. Prolonged screen time is known as a risk factor for dry eye. Health problems during online learning such as those induced by dry eye could affect students’ academic performance. This study aim to find the best solution for dry eye in medical student during online learning by comparing three artificial tears eye drops, namely sodium hyaluronate, carboxymethylcellulose and polyvinylpirrolidone.
Methods : This is an experimental study with 48 respondents divided into three treatment groups : sodium hyaluronate (SH), carboxymethylcellulose (CMC) and polyvinylpirrolidone (PVP). Each group consists of 16 respondents. Each respondents use their eyedrops six times daily in both eyes for two weeks. This study use Ocular Surface Disease Index questionnaire to evaluate dry eye. Data were analyzed using SPSS software, with p<0,05 is considered significant.
Results : In SH group, mean OSDI score before treatment were 37,52 and after treatment 13,84 (p=0,001). In CMC group, mean OSDI score before treatment were 35,28 and after treatment 12,54 (p=0,000). In PVP group mean OSDI score before treatment were 38,17 and after treatment 13,15 (p=0,000). No significant differences of OSDI score was found between groups before treatment and after treatment (p=0,237).
Conclusion : Sodium hyaluronate, carboxymethylcellulose and polyvinylpirrolidone eye drops could similiary improve dry eye symptoms significantly as measured by OSDI score in medical students during online learning.
Inhibition of Caspase-3 Provides Neuroprotection for Retina Ganglion Cells againts NMDA-induced Exitotoxicity in Wistar Rats
Authors: Widyarini Andriati Nadhilah , Maharani  , Rahmi Fifin L , Nugroho Trilaksana , Saubig Arnila Novitasari , Istiadi Hermawan 
Published: February 2024

Introduction & ObjectivesGlaucoma is a disorder characterized by the presence of optic neuropathy. Visual impairment inglaucoma is caused by retinal ganglion cell (RGC) apoptosis associated with N-methyl-D-aspartate(NMDA)-mediated excitotoxicity. Excitotoxicity causes an increase in calcium in cells as well asactivation of caspase-3. Glaucoma therapy is currently given to reduce intraocular pressure (IOP),but the damage is still progressing progressively. Hesperidin is known as a neuroprotector that cansuppress calpain overactivation in NMDA-treated retina, thereby reducing the upregulation of TNF-,an inflammatory cytokine, inhibiting calpain activation by suppressing oxidative stress, andattenuating caspase-3 activation. The aim of this study to proving the effect of oral Hesperidin on theexpression of caspase-3 Retinal Ganglion Cell in Wistar rats model of NMDA-induced glaucoma.
MethodsExperimental research with post test design only randomized control trial Wistar rats with NMDAinduction were divided into 2 treatment and control groups. The treatment group was given oralHesperidin at a dose of 100mg/kg/day while the control group was given Na-CMC 182 mg/kg/day for3 weeks. Retinal caspase-3 expression was examined by immunohistochemical staining. Data werecollected and processed and then the Mann- Whitney test was performed. (significant p<0.05)
ResultsThe mean percentage and intensity of RGC caspase-3 expression in the treatment group were 4.29 ±0.49 it was significantly lower than the control group 6.29 ± 0.95 (p value = 0.003).
ConclusionHesperidin provides neuroprotection for RGC againts NMDA- induced exitotoxicity by inhibition ofcaspase-3.
GLAUCOMA SECONDARY TO NONSPECIFIC ORBITAL INFLAMMATION: A DIAGNOSIS NOT TO OVERLOOK
Authors: Prakoeswa Camilla Amanda , Komaratih Evelyn , Fatmariyanti Susy 
Published: February 2024

Introduction : Nonspecific Orbital Inflammation (NSOI) is an inflammatory condition of unknown etiology manifesting as pain, ocular motility disturbances, eyelid edema, chemosis, and increased intraocular pressure (IOP). We illustrate a case of glaucoma secondary to NSOI and the importance of understanding the cause-effect relationship between the two conditions.
Case Illustration : An eighteen-year-old girl presented with severe pain, ptosis, chemosis, ophthalmoplegia, and increased IOP (38 mmHg) despite a leaking trabeculectomy bleb, on the left eye. She was referredwith the diagnosis of primary angle-closure glaucoma (PACG) and a history of twice trabeculectomy surgeries done elsewhere two months before she came to our hospital. She could not move her lefteye nasally five months before the first surgery and felt joint pains for a year. After thorough diagnostics, she was assessed with left eye NSOI and secondary glaucoma with spondyloarthropathy. Oral prednisone 30 mg/day was given to manage the inflammation and the resultant glaucoma. One week follow-up showed an improved condition with decreased IOP (16 mmHg) despite the same anti-glaucoma therapy regimen.
Discussion : NSOI can mimic various diseases, making diagnosis challenging. The raised IOP in NSOI is often caused by extraocular muscles and orbital tissue swelling, which compresses the superior and inferior ophthalmic veins, resulting in choroidal circulation problems. The IOP was quickly reduced once the inflammation was managed. This is a case of secondary glaucoma caused by an overlooked NSOI, aggravated by the immunological process in the orbit after trabeculectomy surgeries.
Conclusion : Secondary glaucoma should be considered as a differential diagnosis of PACG in patients with NSOI.
Searching The New Culprit of Optic Neuritis: The Role of Vitamin D
Authors: ANAK AGUNG MAS PUTRAWATI TRININGRAT  , Made Paramita Wijayati  , Putu Ayu Wulansari  
Published: February 2024

Abstract
Introduction : Low vitamin D status has long been associated in multiple sclerosis patient with higher risk of disease progression and frequent relapses. Vitamin D plays an important role in modulating the immune process responsible for demyelination. To this date, the study on vitamin D deficiency in optic neuritis case is still rare.
Case Illustration : Female, 20 years old, presenting with bilateral sudden visual loss since 1 week prior. The patient looked relatively pale and complained of accompanying headache and myalgia. Visual acuity in both eyes were light perception with dilated pupils and posterior segment showing optic disc swelling. CBC, infection and autoimmune screening came within normal limit and brain MRI further confirmed the presence of optic neuritis. The patient was given high dose intravenous steroid but showed no improvement. Later, she was screened for nutrient deficiency and found sign of low serum 25-hydroxyvitamin D. After one week of oral supplementation and neuroprotective agents, her vision drastically improved to 6/6 in both eyes.
Discussion : Vitamin D deficiency nowadays is getting more prevalent in high risk individuals with low dietary intake and sunlight exposure. Recent study found that mean serum vitamin D level were significantly lower in autoimmune optic neuritis (ON) and were associated with ON attack severity. Vitamin D sufficiency is associated with better inflammatory outcome and long term neurodegenerative measures in demyelinating diseases, as shown by improvement in RNFL thickness after attack.
Conclusion : Screening for vitamin D deficiency is essential to consider in managing patient with atypical optic neuritis.
Epibulbar Choristoma, Dermolipoma
Authors: Maykel Sondak  , Samuel Samatara  
Published: February 2024

Introduction : Choriostoma is a tissue anomalie distinguished by distinct cell types that are not typically present at the affected region. Dermolipoma is one type of choriostoma.
Case Illustration : A twenty three year old woman is presented with epibulbar mass in the left eye since birth. She wished to remove the mass for cosmetic purposes. She denied any underlying medical condition and ocular history. Her visual acuity was 6/6 in both eyes and intraocular pressure was normal. Slit lamp examination revealed a yellowish white lesion of the external canthus of the left eye, no redness, and no discharge. The mass was 5 x 10 mm. Fundus examination was unremarkable. Patient underwent mass excision with cosmetic indication and has a satisfactory result.
Discussion : A dermolipoma is an epibulbar choriostoma made of thick connective tissue and adipose tissue. The benign tumor is rare and makes up 4.2% of all conjunctival lesions. Dermolipoma can be very large, involving the extraocular muscle, lacriminal gland, and orbital tissue. Dermolipoma may be connected to epidermal nevus syndromes, Goldenhar syndrome, or coloboma. The majority of the time, these tumors don't need to be treated unless they are larger or have an unfavorable appearance.
Conclusion : Dermolipoma is not cosmetically acceptable may be treated with excision of the mass.
Platelet Rich Fibrin as a Potential Treatment for Corneal Neovascularization due to Infective Keratitis: An Experimental Study
Authors: NANDANG SUDRAJAT  
Published: February 2024

Abstract
Introduction & Objectives : Platelet-rich fibrin (PRF) as a source of growth factor has been widely used in various therapeutic fields so that it could accelerate the wound healing process. This study investigated the effect of platelet-rich fibrin PRF in inhibiting neovascularization, inhibiting the expression of vascular endothelial growth factor (VEGF) and stimulating pigment epithelial-derived factor (PEDF) in the infective keratitis animal model.
Methods : A total of 12 New Zealand white rabbits (Oryctalogus cuniculus) were subjected to keratitis induction by inoculation of Pseudomonas aeruginosa. The rabbits were divided into two groups, the first group as control was treated antibiotic-only, and the second as treatment group was treated with antibiotic and PRF graft. The corneal neovascularization area was clinically measured before and after treatment. Expression of VEGF and PEDF in the corneal epithelium, stroma, and endothelium were evaluated by immunohistochemical examination on day 10 after keratitis induction.
Results : There were significant differences in VEGF expression between groups in the epithelial layer (p=0.008), but no significant difference in the stromal (p=0.934) and endothelial (p=0.935) layers. PEDF expression showed a significant difference between groups in the epithelial (p = 0.004) and stroma layers (p = 0.029) but no significant difference in the endothelial layer (p = 0.157). However, there was no significant difference in clinical neovascularization between the two groups (p=0.526).
Conclusion : PRF could inhibit VEGF expression and stimulate PEDF expression in the cornea of Pseudomonas aeruginosa keratitis animal model that potentially reduces the corneal neovascularization in the longer observation.
COMPARISON OF VISUAL ACUITY AFTER A COMBINATION OF CITICHOLINE AND METHYLPREDNISOLONE WITH A SINGLE CITICHOLINE TREATMENT IN NON-ARTERITIC ANTERIOR ISCHEMIC OPTIC NEUROPATHY PATIENTS
Authors: NADYA BEATRIX YOHANNA N.  , Antonia Kartika  , Ine Renata Musa  , Rusti Hanindya Sari  , Dianita Veulina Ginting  , Prettyla Yollamanda  
Published: February 2024

Abstract
Introduction & Objectives : Non-arteritic anterior ischemic optic neuropathy (NAION) accounts for 90-95% of optic neuropathy in the elderly with symptoms of decreased visual acuity. Posterior ciliary brevis hypoperfusion results in ischemia, triggers oxidative stress, axonal edema as well as compartment syndrome leading to retinal ganglion cell death via apoptosis. There is no gold standard therapy for NAION. Citicholine as a neuroprotector agent has shown satisfactory results in the acute and chronic phases. Methylprednisolone is also a therapeutic consideration that decreases capillary permeability thereby promoting faster resolution of disc edema. This study aimed to compare visual acuity in NAION patients with combination therapy of citicholine and methylprednisolone with single citicholine therapy.
Methods : An analytical observational study with retrospective data collection at the National Eye Center of Cicendo Hospital for the period January 2021–February 2022. A total of 59 NAION patients who met the inclusion criteria were then divided into 2 groups, namely receiving a combination of citicholine with corticosteroids and single citicholine treatment.
Results : The mean age in the combination group was 52.57±9.035 and the single group was 57.52±10.319. The number of men and women in the combination group were the same while in the single group women was higher. The risk factors obtained were hypertension, diabetes mellitus (DM), dyslipidemia, and smoking. There was a significant mean difference between initial visual acuity and3 months after therapy in the combination therapy group (p=0.0001) and in the single group. (p=0.002)
Conclusion : Visual acuity in NAION patients with combination therapy of citicholine and methylprednisolone is better than citicholine alone.
Optic Neuropathy Secondary to Linezolid for Multidrug-resistant Mycobacterial Tuberculosis
Authors: ARSI NOVIANA SARI  , Ika Nuraita  
Published: February 2024

Abstract
Introduction : Toxic optic neuropathy is well known side effect of medications, including linezolid in patients with MDR-TB. We present 2 cases of patients with linezolid associated ON.
Case Illustration : A 28 year pld man (case 1) and a 50 year old woman complained bilateral progressive visual loss after long term use of linezolid (both 8 months). On initial visit, case 1 presented with 0.1 visual acuity and case 2 presented with counting finger visual acuity. Both have hyperemic optic disc. OCT showed optic disc edema. Both patients showed generalized visual field defect on the Humphrey test. We immediately stopped the linezolid treatment.
Discussion : The exact mechanism of linezolid induced ON is still unclear. It may be caused by impaired mitochondrial function for adenosine triphosphate (ATP) synthesis within retinal nerve fiber layer. Duration of linezolid therapy affects the prognosis for linezolid ON.
Conclusion : Both Ophthalmologist and Physicians must be aware that visual function monitoring and early recognition of toxicity linezolid. Immediate cessation of linezolid has favorable visual recovery
Terson’s Syndrome due to Ependymoma: A Rare Case Report
Authors: Priscillia Tondolambung  , Robby Tumewu  
Published: February 2024

Abstract
Introduction : Terson's syndrome is often associated with subarachnoid hemorrhage. Other reported causes, include trauma, tumors, hypertension, perioperative and postoperative intracranial hemorrhage, or increased intracranial pressure. This case demonstrates a unique pathogenesis of Terson's syndrome.
Case Illustration : A 14-year-old boy presented with the blurred vision on both eyes 3 weeks ago, accompanied with nausea, vomiting, and headache, with normal blood pressure measurement (126/80mmHg). He also had a history of head injury. His visual acuity was 6/20 uncorrected with pinhole on both eyes. Both intraocular pressures within normal limits. The anterior segment showed bilateral mid-dilated reactive pupil. Funduscopy revealed bilateral papilledema with peripapillary hemorrhage, similar to retinal vein occlusion, which is suggestive with Terson’s Syndrome. Magnetic Resonance Imaging (MRI) scan showed an ependymoma mass. We consulted this case with Pediatric Neurosurgeon, who planned for ventriculoperitoneal shunt with craniotomy tumor removal.
Discussion : Terson's syndrome now defined as any intraocular hemorrhage associated with intracranial hemorrhage or elevated intracranial pressures. In this case, the etiology was thought to be increased intracranial pressure, which may be caused by ependymoma. Ependymoma is one of the most common central nervous system tumors in children. Intraocular hemorrhage in Terson’s syndrome is often self-limiting, but ependymoma needs neurosurgical intervention, which has lower survival rates for children with posterior fossa tumors.
Conclusion : There are still controversies regarding the pathogenesis of Terson's syndrome. Not the occlusion, but the compression of the central retinal vein, by the increased pressure of cerebrospinal fluid due to high intracranial pressure, which increases the retinal venous pressure and causes retinal hemorrhage.
LARGE V PATTERN EXOTROPIA WITH BILATERAL INFERIOR OBLIQUE OVERACTION AND ITS CHALLENGING MANAGEMENT
Authors: Rahmah Kartika Amelia , Prastyani Reni 
Published: February 2024

Introduction : V pattern exotropia is a strabismus pattern with greater divergence in upgaze than downgaze. Various surgical treatment options were defined. This report demonstrates the management of largeV pattern exotropia with bilateral inferior oblique overaction (IOOA) by performing multiple surgeries.
Case Illustration : A 20-year-old male came with a chief complaint of squinting eyes outward in both eyes since 9 years old. There was 90 PD exotropia in upgaze, 70 PD in primary gaze, 50 PD in downgaze. Bilateral IOOA grading was +3. Management in this patient was bilateral rectus lateral recession with partial hang back technique 11 mm and inferior oblique anteriorization of both eyes 1 mm posterior to inferior rectus muscle insertion. The IOOA on both eyes was eliminated post-operative, but there was 30 PD residual exotropia. The second step will be bilateral medial rectus resection.
Discussion : A large V pattern with IOOA is challenging for management because it requires surgery of 2 muscles for each eye. The lateral rectus and inferior oblique muscles are close, so it was advantageous to operate simultaneously. Large exotropia requires surgery on many muscles, however operating on more than two muscles in one eye at a time can cause anterior segment ischemia. Therefore, bilateral medial rectus resection for residual exotropia will be done at different times.
Conclusion : Large V pattern exotropia with inferior oblique overaction is a challenging case to manage. Due to its complex nature, it is advantageous to operate adjacent muscles.
Bleb Needling Procedure in Juvenile Open Angle Glaucoma (JOAG) for Failed Bleb in Trabeculectomy
Authors: Putri Rizqi Suryani , Nuradianti Lydia 
Published: February 2024

Introduction : JOAG is less responsive to medications and often requires surgical therapy. The main choice of surgery is trabeculectomy. One of its success rates is determined by the formation of bleb. Failed bleb causes an increase in IOP. To repair the bleb, bleb needling can be performed as a simple procedure.
Case Illustration : A 7-year-old boy came with a chief complaint of pain accompanied by redness of the left eye. The patient was diagnosed with JOAG and had underwent trabeculectomy with mitomycin-C (MMC) 3 months ago on the right eye and 2 months ago on the left eye with complete success surgery. On physical examination, intraocular pressure (IOP) was 12 mmHg / 29 mmHg with flat bleb on the left eye. Visual acuity on the right eye was 3/10 with cc C-2.00 X 0° ? 7/10 while on the left eye was light perception without possible refractive correction. Timolol maleate and latanoprost eye drops were given for 2 weeks but the IOP remained high. Therefore, the patient underwent bleb needling with 5- Fluorouracil (5-FU) on the left eye. Post-operatively, the IOP was 12 mmHg without antiglaucoma medication.
Discussion : Failure of the trabeculectomy bleb can occur due to fibrotic proliferation as part of the wound healing response. Studies stated 5-FU bleb needling provide clinically significant IOP lowering and minimal complication. Reduced IOP post needling and formation of bleb indicate successful needling.
Conclusion : Bleb is an important indicator of a success trabeculectomy surgery. Bleb needling with 5-FU could be considered as effective and safe procedure after trabeculectomy failure.
DIRECT CAROTID CAVERNOSUS FISTULA
Authors: Monica Camilla Chandra  , Stevanus Paliliewu  , Robby Tumewu  , Gilbert Tangkudung  
Published: February 2024

Abstract
Introduction : Carotid cavernous fistula (CCF) is an abnormal communication between the cavernous sinus and the carotid arterial system, most commonly due to head trauma from a basal skull fracture creating a tear in the internal carotid artery (ICA) within the cavernous sinus.
Case Illustration : A 15 years old girl presented with orbital pain, swelling, swishing or buzzing sounds, headache, and vision loss. Five months ago, she had a history of traumatic injury and undergone craniotomy. From physical examination Orbital ultrasound presence with dilated superior ophthalmic vein, which appears as a hollow tubular structure with no internal echo. MRI scan show a mass suggestive carotid cavernosus fistula dextra. DSA result confirmed the diagnose as direct carotid cavernosus fistula dextra as communication between internal carotid artery and sinus cavernosus. The patient was treated with neuroprotective along medication followed by endovascular treatment from the neurointervention department.
Discussion : The classic triad of CCF includes pulsatile exophthalmos, chemosis and orbital bruit. Ophthalmic manifestations of CCFs vary widely depending on underlying aetiology, type, size, location, blood flow rate and drainage route of the CCF. Patient initially undergo noninvasive imaging with orbital ultrasound and magnetic resonance imaging (MRI). Digital subtraction angiography is the gold standard in the diagnosis of CCF and must be performed before any potential intervention.
Conclusion : This case describes a patient who was diagnose with direct carotid cavernous fistula of the right eye.