bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined Pars Plana Vitrectomy with Core Vitrectomy with 3600 Barrage Laser and Iris Claw IOL Implantation in Nuclear Drop Case: Video Presentation
Authors: Adityo Hasiholan Tigor , Tanong Nicholas Dwiki 
Published: February 2024

Introduction : Nuclear drop is one of the numerous complications of phacoemulsification surgery. Today, the incidence of nuclear drop has been declining significantly compared to years before. Eyes with nuclear drop tend to have poorer visual and refractive outcome compared to eyes with existing risk factors but no such complication. This video presentation reports a case of nuclear drop with desirable outcome
Case Illustration : A 46 years old male patient came with blurry vision on his right eye. Patient was undergone eventful phacoemulsification with nuclear drop complication 2 hours ago. Prior to the admission, visual acuity was 1/300, IOP (Intraocular pressure) 24 mmHg, and retinal evaluation showed there is lens nucleus on the retina. Before admission, the patient was given Methylprednisolone 1x 48mg, Ranitidine 2x150 mg, Ciprofloxacin 2x500mg , Asam mefenamat 3x500mg, Cendo LFX ED 6x1 gtt, Cendo Xytrol ed 6x1 gtt. The patient was planned to do the Pars Plana Vitrectomy followed with 360° barrage laser and Retropupil Iris Claw implantation. One day after the surgery, the visual acuity was 0.2, IOL was well implanted, and no sign of retinal detachment. Four weeks after the surgery, the visual acuity was 0.8 with well implanted IOL
Discussion :
Conclusion : The outcome of nuclear drop cases is affected by several factors. Preparations before PPV are important to attain a better visual outcome. Until now the optimum time to perform PPV in nuclear drop cases remains undetermined. Meanwhile, rise in IOP indicating no luxury of waiting for PPV
UNILATERAL CMV RETINITIS IN HIV/AIDS PATIENT WITH MULTIPLE OPPORTUNISTIC INFECTIONS
Authors: Bening Daya Banyu , Firmansjah Muhammad , Zuhria Ismi 
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.
The Comparison of Visual Acuity between Spectacles and Rigid Gas Permeable (RGP) Group in Myopia Patients
Authors: Havilah Zeki Rosa  , Rinda wati  
Published: February 2024

Introduction & Objectives : The prevalence of myopia has approximately doubled in the past three decades, with rates of 70–87% among populations of school children and young adults in Asia. Approaches to treating myopia include spectacles and Rigid Gas Permeable (RGP) contact lenses. RGP has become a new "preference" because it is more comfortable and provides a more aesthetic look. This study aims to determine which method is better for correcting visual acuity in myopia patients.
Methods : This cross-sectional study analyzed the outcomes and exposures measured at the same time. The sample included myopia patients (based on spherical equivalent) who underwent RGP contact lens fitting in the refraction outpatient clinic of M Djamil Hospital from January 2021 to December 2022. The samples were selected based on inclusion and exclusion criteria. The collected data included gender, age, and best-corrected visual acuity using spectacles and RGP.
Results : Forty-three patients were eligible as the sample in this study. Most of the subjects were women (62.8%), and the mean age was 23.58 years old. The median LogMAR for the RGP group was lower than the spectacles group (0.00:0.10 on both eyes). Statistical analyses found a significant visual acuity improvement in the RGP group compared to the spectacles group in both the right and left eyes (p = 0.014 and p = 0.005, respectively (p < 0.05)).
Conclusion : The use of RGP provides significantly better visual acuity in correcting myopia than spectacles. Myopia is more frequently found in young women.
Bilateral Hypocalemic Cataract Post Thyroidectomi : A Case Report
Authors: Lestari Andi Ayu , Ismail Muh. Abrar , Poli Adelina T. , Syamsu Noor 
Published: February 2024

Introduction : Young adult cataracts are negligible, and their prevalence is rarely reported in Indonesia. We reporta rapidly developing cataract in a 25-year-old woman due to secondary hypoparathyroidism. Cataracts in this case, progress remarkably fast compared to primary cataracts.
Case Illustration : A twenty-five-year-old female patient presented bilateral vision loss and a history of a total thyroidectomy caused by diffused toxic goiter 7 years before admission. Postoperative calcium levels were extremely depleted. The uncorrected visual acuity examination measured 1/300 in the right eye and 20/200 in the left. Slit lamp examination revealed cortical opacities in both eyes. We diagnosedit as bilateral hypocalcemia cataracts. Patient has undergone bilateral phacoemulsification and intraocular lens implantation. The day following surgery visual acuity in the right eye was 20/30 and the left eye was 20/30 without correction. After one year of evaluation the visual acuity in RE become RE was 20/20 with a correction of -0.50 D sphere and the LE was 20/20 with a correction of -1.0 D sphere.
Discussion : Patients with hypoparathyroidism risk developing cataracts due to chronic hypocalcemia, which inhibits the lenticular Na/K pump and induces intracellular sodium flux. This high sodium level triggers the osmosis process, followed by swelling of the lens fibers to form dystrophic calcifications. Thyroid surgery procedures suspectedly involving the parathyroid gland may cause hypocalcemia, thus leading to development of cataract.
Conclusion : Clinicians should always consider hypoparathyroidism as the cause of bilateral cataracts in patients with a previous total thyroidectomy.
Retinal Nerve Fiber Layer as The Preferred Objective Measure in Differentiating Pseudopapilledema with True Papilledema: A Systematic Review
Authors: Lourisa Ruth Eldenia  , Rona Ali Badjrai  , Lazuardiah Anandi  , Fierda Ovita Azhari  , Erika Anggraini  , Brigitta Marcia Bidihardja  , Syntia Nusanti  
Published: February 2024

Abstract
Introduction & Objectives : Distinguishing pseudopapilledema from true papilledema may generate confusion for some cases. Regardless of the subjective judgment on clinical examination alone, objective measurement for confirmation of diagnosis might be costly, operator-dependent, invasive, or not readily available. This study aims to evaluate whether retinal nerve fiber layer (RNFL) could be the reliable and efficient objective measure to ascertain the diagnosis.
Methods : Literatures were obtained by comprehensive searching on PubMed, ProQuest, Google Scholar, and Cochrane between 2012 - 2023. Last search was March 26, 2023. Non-english study, animal study, review articles, case studies, and editorial letters were excluded. We included studies with available full-text containing both groups of papilledema and pseudopapilledema. The result was presented according to Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guideline.
Results : A total of 615 participants were included from 8 different studies all comprising a group of papilledema and pseudopapilledema with or without optic disc drusen (ODD). Studies resulted in good accuracy on RNFL in differentiating pseudopapilledema with papilledema as the area under curve ranging from 0,78 to 0,91. However, specificity and sensitivity were varied between 65-100% and 33-91% respectively. Lower accuracy was found when pseudopapilledema only includes patients with ODD or papilledema was narrowed to mild papilledema.
Conclusion : RNFL is a useful objective measure with favorable accuracy in differentiating pseudopapilledema with papilledema especially in acute settings or whenever operator-dependent examination is not obtainable
Recurrent Candida Parapsilopsis Corneal Ulcer cum Hypopion: A Case Report
Authors: Septian Dwi Prabowo  , Ismi Zuhria  
Published: February 2024

Introduction : Candida is common in tropical and subtropical climes estimated for 20-60% of all culture-positive corneal infection. Over the past two-decades, candida parapsilosis has become a common opportunistic fungal pathogen.
Case Illustration : A-60-years-old-man, came with redness and pain in the left eye since one month ago after working at field. In the left eye, visual acuity was hand movement, palpebra was spasm and oedema, conjunctiva was hyperaemia, hazy, feathery edge and fluorescein test were positive in paracentral corneal 6x7 mm and hypopyon in anterior chamber. KOH staining revealed yeast, corneal scrapping revealed candida parapsilopsis, and antifungal sensitive to fluconazole. Fluconazole intravenous 200mg 2-times-a-day, moxifloxacin eyedrop loading dose, fluconazole eyedrop fortified every-one- hour, atropine 1% eyedrop 2-times-a-day, artificial tears eyedrop every-one-hour was administered.In the fifth-day, hypopyon was improved, and patient was discharged. Tenth-days after, patient felt pain and hypopyon raised 4mm. Debridement in the ulcer, and therapy was continued. Two weeks later, hypopyon was less than 1 mm, and pain was relieved.
Discussion : There was clinically improvement using antifungal therapy. Recurrent hypopyon was happen, and mechanical debridement in the ulcer was administered. In four-times within two-weeks, hypopyon was improved. Although, initial treatment was antibiotics until microbiological confirmation, antifungal therapy, combined with mechanical eradication of fungal filaments could be administered for fungal corneal ulcer.
Conclusion : In this case, combination of antifungal therapy with mechanical debridement could be the right choice to treat candida parapsilopsis corneal ulcer. Better outcomes can be achieved and complications can be avoided with appropriate diagnosis and efficient therapy.
Combination Therapy of Amniotic Membrane Transplantation with Conjunctival Peritomy and Autologous Serum for Mooren's Ulcer: A Case Report
Authors: AUFAA SHAFIRA WIDOWATI  , Suhardjo Pawiroranu  , Reny Setyowati  
Published: February 2024

Introduction : A case report of a patient with Mooren’s ulcer who received partial amniotic membrane transplantation and autologous serum eye drops.
Case Illustration : A 44-year-old male patient presented with chief complaint of blurred vision, pain in left eye, and history of eye trauma 6 months prior. Empirical topical antibiotics didn’t improve his condition. VA of left eye was hand movement with good colour/light perception. We diagnosed the patient with marginal ulcer. Partial amniotic membrane transplantation with conjunctival peritomy was planned for this patient along with fortified antibiotic eye drops. Autologous serum eye drops were started at 2 weeks post-surgery. 2 months after surgery, his condition has significantly improved with visual acuity of 6/12 (Snellen), healed corneal defect, and subjective relief of symptoms.
Discussion : Mooren’s ulcer is a severe ulcerative inflammation of the cornea with unclear exact pathogenesis. Many therapies of Mooren’s ulcer are recommended in literatures, including surgical and non- surgical treatment. It was reported that amniotic membrane transplantation and conjunctival peritomy may be chosen as alternative surgical procedure for Mooren’s ulcer, as peritomy displaces the source of inflammation away from the cornea and amniotic membrane helps in corneal reepithelialization. Autologous serum is considered as an effective adjuvant therapy for ocular surface diseases such as dry eye disease, cicatricial pemphigoid, Steven-Johnson syndrome, and Mooren’s ulcer—thus the decision to include the therapy in our regiment.
Conclusion : The combination of amniotic membrane transplantation, conjunctival peritomy, and autologous serum may help in the overall improvement of patients with Mooren’s ulcer.
Rigid Gas Permeable (RGP) as Keratoconus Management After Corneal Collagen Cross-Linking (CXL) Procedure: a Case Report
Authors: Miranti Laras Ayu Sanusi  , Karmelita Satari  , Joan Sherlone Hutabarat  , Ine Renata Musa  , Susanti Natalya Sirait  
Published: February 2024

Introduction : Rigid Gas Permeable (RGP) contact lenses are the mainstay for keratoconus patients and widely used. This case report presents RGP as a management for keratoconus after Corneal Collagen Cross- Linking (CXL) procedure.
Case Illustration : A 22-year-old woman diagnosed with keratoconus since eight months ago, came for vision correction. She had CXL performed on both eyes. Ophthalmologic examination revealed uncorrected visual acuity of 0.63 in the right eye (RE) and 0.08 in the left eye (LE). Her best-corrected visual acuity (BCVA) was 1.0 in the RE with -0.75 D and 0.125 in the LE with -2.00 D. Anterior segment examination of the RE was unremarkable, but the LE has Vogt’s striae and Munson's sign (Figure 1). Corneal topography for the LE showed K1 64.7D/5.2 mm, K2 68.7D/4.9 mm, and Kmean 66.7D/5.1 mm. She was fitted with trial lens of BC 5.40 and the fit was loose. She then fitted with a BC of 5.50 mm showed a good fit result. RGP contact lenses were prescribed with S -8.50, BC 5.50, and 8.6 mm diameter for her LE and combined with spectacle for her RE. Her over-refraction BCVA of the LE was 0.9.
Discussion : The management goals are to improve the patient’s visual acuity and to decrease the progression. The visual acuity of this patient improved after RGP fitting.
Conclusion : The combination of CXL procedure and the use of RGP effective to increase visual acuity, regularity of corneal surface, and patient satisfaction. Keratoconus should be monitored regularly to avoid possible progressivity.
EFFICACY AND SAFETY OF MANUAL SMALL-INCISION CATARACT SURGERY WITH TRABECULECTOMY VERSUS PHACOTRABECULECTOMY IN THE TREATMENT OF GLAUCOMA WITH CATARACT: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Andini El Asha , Avianty Astri , Herman  , Choliq Abdul 
Published: February 2024

Introduction & Objectives : The coexistence of two globally leading causes of blindness, glaucoma and cataract, is frequent, while the consideration of surgical management is complex. Therefore, a systematic review and meta-analysis was conducted to compare the efficacy and safety of two surgical procedures, manual small-incision cataract surgery (MSICS) combined with trabeculectomy and phacotrabeculectomy.
Methods : A comprehensive search was performed in PubMed, Science Direct, and Cochrane Library published up to March 2023. Articles not indexed in those databases were also searched. Pooled odds ratios (OR) and mean differences (MD) with corresponding 95% confidence interval (CI) were also retrieved to compare the outcomes estimating efficacy and safety. Biases in selected studies were assessed.
Results : A total of seven studies consisting of 352 eyes for MSICS with trabeculectomy and 348 eyes for phacotrabeculectomy were included. Postoperative intraocular pressure (IOP) was comparable between the two techniques (MD: -0.45; 95%CI: -1.07 to 0.16; p=0.15). Postoperative Best Corrected Visual Acuity (BCVA) <6/12 (OR: 1.26; 95%CI: 0.62 to 2.53; p=0.52), complete success (OR: 0.92; 95%CI: 0.51 to 1.67; p=0.78), and postoperative complications (OR: 1.27, 95%CI: 0.75 to 2.15, p=0.38) did not differ significantly.
Conclusion : This meta-analysis indicated no significant difference between MSICS with trabeculectomy and phacotrabeculectomy regarding the efficacy and safety profile. Further high-quality studies are required to confirm these findings.
Interferon alpha 2b or Mitomycin-C as Adjuvant Therapy of Pigmented Conjunctival Malignancy : A Literature Review
Authors: Dr. meuthia rana amira primaputri  
Published: February 2024

Abstract
Introduction & Objectives : To compare the efficacy and safety between Mitomycin C (MMC) and Interferon alpha-2b (IFN-α2b) eye drops as adjuvant therapy for conjunctival melanoma.
Methods : Literature searching was conducted using PubMed, ScienceDirect, and Google Scholar. All studies that met the inclusion and exclusion criteria were categorized based on the level of evidence. The data of patients demographics, staging of disease, type of treatments, and outcomes of this review including local control rate, side effect, and recurrence and/or metastases were also reported.
Results : From twelve articles, topical adjuvant chemotherapy with MMC and IFN α-2b showed favourable complete remission rate. Local control (complete remission) of IFN α-2b group is 46%, while in MMC group is 57%. The most side effect of MMC group were severe corneal-conjunctival irritation and corneal defect, while the IFN α-2b group showed mild side effect. Recurrency rate of IFN α-2b group and MMC group both is 35%. Metastases case of IFN α-2b group is 3.8%, while none of cases from MMC group metastases.
Conclusion : Topical adjuvant chemotherapy with MMC and IFN α-2b showed favourable local control rate even though the recurrency rate also relatively high. Both medications showed promising results to reduce residual tumor size after wide excision surgery, preserving eye so reduce the chance of exenteration in various stages. It is important to consider adjuvant therapy following wide excision surgery as the first line treatment.
SCHWARTZ-MATSUO SYNDROME : AN IMPORTANT CAUSE OF SECONDARY GLAUCOMA : RARE CASE
Authors: Perkasa Teguh Ridho , Fidalia  , Sari Prima Maya 
Published: February 2024

Introduction : Schwartz-Matsuo syndrome is a rare ocular condition characterized by rhegmatogenous retinal detachment, elevated intraocular pressure, and open anterior chamber angle with presence of aqueous cells. The prevalence of Schwartz-Matsuo syndrome is quite low and only reported through case studies.
Case Illustration : A 63 years old female complained a visual aquity was no light perception on the left eye (LE) since 2 months ago. The symptoms are gradually getting worse, history of ocular trauma, recent surgery, photopsia, peripheral visual field loss were denied. Patient came to the hospital with IOP elevation on left eye. On Gonioscopy we interpretated as open angle chamber and USG examination we founded retinal detachment, Anti-glaucoma medication were given but no success to lower the IOP.
Discussion : Typically, retinal detachment is associated with low IOP. In Schwartz-Matsuo syndrome the opposite is observed with elevated IOP. Hypothesized that photoreceptor outer segments pass through the retinal break allows for fluid and photoreceptor outer segments to gain access, enter the anterior chamber and block aqueous outflow at the level of the trabecular meshwork. A significant increase in IOP can lead to visual loss and blindness complicated by glaucoma requiring further medical or surgical intervention. Referred to this patient, she came with IOP elevation, open angle anterior chamber and retinal detachment that clinically diagnosed as Schwartz-Matsuo syndrome.
Conclusion : Schwartz-Matsuo syndrome is primarily a clinical diagnosis; Early detection of disease and prompt management of increased IOP and retinal detachment is essential for a good outcome.
A CASE REPORT OF WOODEN STICK IMPALEMENT AND PALPEBRAL RUPTURE : ORBITAL PENETRATION TRAUMA
Authors: NOVIAN ADI SAPUTRA  , MARDIJAS EFENDI  , HENDRIANTI  
Published: February 2024

Introduction : Orbital penetration trauma is a severe injury caused by the penetration of a foreign object into the orbit of the eye. It is a potentially life threatening condition that can cause significant damage to the surrounding structures, including the eye, the optic nerve, and the brain.
Case Illustration : 49 y.o M came with The left eye was impaled by a wooden stick 12 hours before entering the hospital, causing pain, bleeding, and loss of vision.Visual acuity of the left eye was no light perception, extensive palpebral rupture, and left eye movement was limited in all directions. The CT scan of left orbit was orbital floor fracture, hypodense lesion in the left retrobulbar oculi which appeared to obliterate the left optic nerve, and orbital floor fracture.He underwent surgery for the removal of the wood and underwent a wide palpebral reconstruction. .
Discussion : The severity of orbital penetration trauma can vary depending on several factors, including the size and shape of the penetrating object. In some cases, the injury may be relatively minor and only result in minor bruising and swelling around the eye. However, more severe cases can cause significant damage to the eye itself, including rupture of the eyeball or damage to the optic nerve.
Conclusion : Orbital penetration trauma treatments typically involves immediate medical attention to assess the extent of the injury and determine the best course of action. In some cases, surgery may be required to repair the damage and prevent further complications.
Uncommon bilateral orbital lesion in leukemic patient: is it cutis leukemia, celullitis or both?
Authors: ANINDITA WICITRA  , Widiarti S. Soemarno  , Lady P. Sukmawidowati  , Agassi Suseno Sutardjo  , Resti Mulya Sari  , Primasari Deaningtyas  , Grace Shalmont  
Published: February 2024

Introduction : Acute Myeloblastic Leukemia can infiltrate any parts of the body including the orbit and periocular area. This article was aimed to report uncommon sign of cutis leukemia representing as orbital cellulitis.
Case Illustration : Male, 35 yo with chief complained progressive lesion in his bilateral upper and lower eyelid since 4 days before admission. He felt pain and stingy sensation around lesion. There was history of toothache. He was diagnosed with acute myeloblastic leukemia since 2 month before. Ophthalmology examination showed his visual acuity was 6/6 in both eyes with good ocular motility.His bilateral upper and lower eyelid were edematous and spasm with multiple vesicles, papule and pustule. Conjunctival injection was found in both eyes. The reminder of ophthalmology examination was unremarkable. There were other hyperemic nodules in left mandibulae and right mastoid bone. Laboratory examination showed increased leukocyte, procalcitonin and C-Reactive Protein level. Orbital CT scan revealed edema in cutis and subcutis area in both superior and inferior bilateral palpebra. Board spectrum and anaerobe antibiotic along with steroid were administered intravenously. Biopsy was performed. After two weeks medication, lesion around both palpebra was decreased. Unfortunately, because of his poor systemic condition, he was readministered to our hospital and hospitalized in ICU. He was passed away after 8 days of hospitalization.
Discussion : Male patient is more likely to develop orbital infiltration of leukemia, and it necessitates significant morbidity and mortality condition.
Conclusion : Leukemia with orbital invasion should bring more awareness from both ophthalmologist and hematooncologist as it indicates more mortality and morbidity.