bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined Virna Glaucoma Implant (VGI) Implantation and Pars Plana Vitrectomy for Refractory Aphakic Glaucoma
Authors: Herdian Felicia Sesih , Augiani Amani Sakinah , Lumintang Agnesstacia Vania , Iskandar Ferdy , Oktariana Virna Dwi , Djatikusumo Ari 
Published: February 2024

Introduction : Glaucoma drainage devices (GDDs) implantation are frequently indicated for refractory glaucoma. The preferable anterior chamber may be inaccessible for patients with anterior chamber abnormalities.
Case Illustration : A 6-year-old boy presented with high intraocular pressure (IOP) on the right eye (RE) four months before admission. Cataract surgery on both eye was done four years prior, due to congenital cataract. On examination, the visual acuity of the RE was hand movement with IOP 61mmHg with medications. Anterior chamber was shallow, posterior synechiae was found and posterior segment was hard to be evaluated. The fellow eye was nonfunctional with IOP 31mmHg. Pars plana vitrectomy (PPV) was performed followed by implantation of GDD (Virna Glaucoma Implant) with posterior chamber sulcus tube placement without adding a new incision. Post-operatively, IOP was 3mmHg and choroidal detachment was found. With steroid medication, satisfactory IOP control was achieved within three weeks of follow-up. Visual acuity of RE was improved to 0.5/60.
Discussion : In eyes with shallow anterior segments, tube placed in the anterior chamber may increase the risk of corneal endothelial injury. Placement of the silicone tube in the posterior chamber sulcus is an effective alternative technique. Although it is relatively safe in experienced hands, vitrectomy and insertion of the tube into the posterior segment carries significant risks, including choroidal detachment. Careful monitoring and management is needed to control IOP and maintain vision.
Conclusion : Combined GDD implantation and PPV may be considered for refractory aphakic glaucoma, showing favorable outcomes with a relatively safe procedure.
Thyroid Eye Disease and Rare Manifestations of Severe Restrictive Strabismus with Large Hypertropia: A Case Report and Treatment Considerations
Authors: Akla Nurul , Bakri Annisa , Sulistyowati Balgis Desy , Janani Nazhira 
Published: February 2024

Introduction : Restrictive strabismus with large hypertropia is an infrequent manifestation of thyroid eye disease that arises due to severe thickening of the superior rectus muscle. This condition can lead to losing the visual axis in the primary gaze position, and prompt management is essential.
Case Illustration : A Forty-seven-year-old man came to the hospital and presented with misalignment in both eyes, known for five months before admission. Ophthalmology examination revealed visual acuity for both eyes was 0.4—Large hypertropia with 50 prism diopters and exotropia with 20 prism diopters, and down shoot restrictions were found in both eyes. The patient had a history of hyperthyroidism since eight months ago and regularly took PTU medication. CT scan of the orbit showed hypertrophy on the extraocular muscle.
Discussion : Continued fibroblast stimulation results in collagen deposition and subsequent fibrosis, ultimately leading to restrictive strabismus in TED patients. For patients with large hypertropia, the primary surgical approach remains recession of the involved restricted muscles, with or without tendon elongation surgery. Vertical rectus muscle resection is preferred for its low inflammation and restriction risk, while hemi hang-back is another suitable option.
Conclusion : The recession of restricted muscles and tendon elongation, preferably vertical rectus muscle resection, is necessary for patients with rare manifestations of restrictive strabismus and large hypertropia in thyroid eye disease.
Ocular Toxocariasis in The Anterior Chamber of The Eye
Authors: Chandra Monica Camilla , MD Anne Umboh, , Rares, MD Laya 
Published: February 2024

Introduction : Ocular toxocariasis (OT) is a zoonotic infection caused by Toxocara canis and Toxocara cati. Dogs and cats, the definitive hosts of the roundworm, pass unembryonated eggs via their feces into the environment (often into the soil). Transmission to humans occurs through ingestion of soil or contaminated food, or the fecal– oral route.
Case Illustration : A 14 years old male presented with pain and redness in the right eye 2 months prior to the visit. Complaints are redness, itching, and pain especially in the night on the right eye. The patient had habits of eating raw meat and walking around in dirt without any footwear. Ophthalmologic examination showed a toxocara sp. larvae in the anterior chamber of the right eye. This patient treated with surgical removal of the worm, given antihelminth and topical corticosteroid.
Discussion : Toxocariasis results from infection with Toxocara cati (an intestinal parasite of cats) or Toxocara canis (an intestinal parasite of dogs). Children acquire the disease by close association with pets and by eating dirt (pica) contaminated with Toxocara ova. The ingested ova form larvae that penetrate the intestinal mucosa and gain access to the systemic circulation and finally to the eye. Systemic or local corticosteroids should be given when there is evidence of significant intraocular inflammation.
Conclusion : This case described a patient who was diagnosed with a living worm as foreign bodies in the right eye.
Characteristics of Premature Retinopathy Patients who underwent surgery at dr. Kariadi General Hospital Semarang
Authors: CANDA ARDITYA  , Arnila Novitasari Saubig  
Published: February 2024

Abstract
Introduction & Objectives : Introduction: Retinopathy of prematurity (ROP) represents a leading cause of childhood blindness. The management of ROP can be challenging in preterm babies, those with very low birth weight and multiple risk factors. The characteristic and risk factors of ROP is essential to acknowledge. Objective: To describe the characteristic of patients with ROP who underwent surgery in Dr. Kariadi Hospital and to identify the risk factors of the disease
Methods : A retrospective study held from the medical record of patients with diagnosis ROP from January 2020-January 2023 in Dr. Kariadi Hospital, Semarang. The clinical characteristics: sex, gestation age, birth weight, maternal risk factors, neonatal risk factors, and ROP Stage. Type of surgery: laser, intravitreal injection, vitrectomy were also collected.
Results : There were 19 ROP patients with 8 (42.1%) gestational age between 29-30 weeks, 8 (42.1%) birth weight 1000-1500gr, 7 (36.8%) had maternal risk: hypertension, 12 (63), 15%) of patients with ROP stage 3, 8 (42,1%) had a combined management of laser surgery and intravitreal injection. Among all the patients at risk had at least one neonatal risk factor with history of oxygenation being the most common (100%).
Conclusion : Characteristics of ROP patients underwent surgery at Dr. Kariadi General Hospital are mostly patients with gestational age between 29-30 weeks and have the most oxygenation history factors. The most common type of surgical procedure performed is a combination of laser and intravitreal injection.
DIFFERENT APPROACHES IN MANAGING LENS-INDUCED ANGLE CLOSURE GLAUCOMA: A SERIAL CASE
Authors: Wardani Sabrina Indri , Rifada R. Maulana , Prahasta Andhika , Gustianty Elsa , Umbara Sonie 
Published: February 2024

Introduction : Lens-induced angle-closure glaucoma can be caused by phacomorphic lens and ectopia lentis. Several factors affect the disease progression. Early diagnosis and appropriate management are important.
Case Illustration : Case 1. A 67-year-old woman presented with acute redness and blurred vision in her left eye with visual acuity (VA) of 1/300 and intraocular pressure (IOP) of 60 mmHg. Axial length showed 23.66 mm and anterior chamber depth (ACD) was 1.61mm (Figure1). She was diagnosed with phacomorphic glaucoma. Phacoemulsification combined with trabeculectomy was performed (Figure2&3). Her VA was improved to 0.08 and her IOP was reduced to 19mmHg after surgery. Case2. A 67-year-old man came with painful blurred vision in his right eye. His VA was a perception of light with an IOP of 40 mmHg. He had axial length of 22.7 mm and ACD of 2.07 mm (Figure4). The lens was anteriorly subluxated and showed zonular laxity. Intracapsular cataract extraction combined with trabeculectomy was performed (Figure5&6). His VA was unchanged while his IOP was reduced to 18 mmHg after surgery.
Discussion : Age older than 60 years old, female gender, short axial length (<23.7 mm), shallow ACD, and zonular laxity are factors for progressivity of lens-induced glaucoma. Cataract removal was a definitive treatment along with IOP-lowering medications. The choice of lens extraction technique varies among individuals.
Conclusion : Removal of cataractous lens is a definitive treatment in conjunction with intraocular pressure and inflammatory regulations for managing lens-induced angle-closure glaucoma. Comprehensive clinical assessments in patients are necessary for managing the symptoms and preventing complications.
Spontaneous Globe Rupture due to Neglected Glaucoma: How can it be?
Authors: Firdausi Asri Ayu , Kunhermawan Cosmas Hascaryanto , Lestari Chindhia Rima Rochmatika Bunga 
Published: February 2024

IntroductionGlobe rupture is usually associated with spontaneous traumatic processes with the worst prognosis.The occurrence without prior trauma is only reported in small numbers of cases. This paper willdescribe a globe rupture in glaucomatous eye and share our experience with its management.
Case IllustrationA 66-year-old male presented to the emergency department (ED) with reddish and progressive painin the right eye (RE) followed by severe headaches for the last three days. On history taking, thepatient complained of a progressive blurry vision to total blindness of his RE for 1 year. The patientadmitted to having a history of glaucoma on previous primer examination but did not routinelycontrol it. On initial examination, the patient was hypertensive , and suddenly began bleeding within10 minutes upon arrival at ED. The diagnosis of globe rupture was made and he underwentemergency evisceration.
DiscussionSpontaneous globe rupture is very rare, with an incidence of 3 per 100.000 in the United States,while no definite number is found in Indonesia due to the rarity. In glaucoma patients, spontaneousglobe rupture is postulated to occur due to suprachoroidal hemorrhage. Our patients had multiplerisk factors such as advanced age, systemic hypertension, and chronic untreated glaucoma.Evisceration went down to reduce pain, stop bleeding and prevent the spread of infection.Performing surgery within 10 days of the initial injury suggests a lower risk of post-operativeendophthalmitis or sympathetic ophthalmia.
ConclusionSpontaneous globe rupture in neglected chronic glaucoma has a very poor outcome but preventable.
SUCESSFULL MANAGEMENT OF CHILDHOOD BASIC-TYPE ESOTROPIA IN ADULT PATIENT
Authors: VITRIANA ANISA , M. Feti Karfiati , Caesarya Sesy , Amiruddin Primawita O. , Kuntorini Mayasari Wahyu , Irfani Irawati 
Published: February 2024

Introduction : Strabismus in adults may indicate other pathological causes, such as neurological disorders or trauma. Diagnosis of esotropia in adult patients has to be made carefully to determine the right treatment. Management’s goal of strabismus in adult patients is mainly cosmetic by diminishing deviation.
Case Illustration : A 46-year-old woman, complaint of inward deviation of both eyes since childhood. There were no complaints of double vision, headaches, nor trauma history. Visual acuity of right eye was 0.4 with BCVA and left eye was 0.8 with BCVA 0.8. Hirschberg test was 45o (Figure 2A). Prism cover test was 75 PD base out in near and distance. Patient was diagnosed with basic-type esotropia. The patient already given spectacles but the deviation persisted so she underwent bilateral medial rectus recess surgery (Figure 2B). Ocular alignment without spectacles 1 week after surgery showed orthotropia and small esophoria. (Figure 2C).
Discussion : Each esotropia types has a different treatment approach. Basic-type esotropia with large deviation usually needs surgical treatment. Management of childhood onset strabismus in adult patients is challenging because those patients have lesser ability to maintain fusion. Older patients and large deviation are poor prognostic factors to achieve good functional and cosmetics outcome after strabismus surgery.
Conclusion : Establishing a definite diagnosis in adult strabismus patients, including esotropia, is challenging. Careful diagnosis and management decision will determine the outcome of the patient’s condition.
Immediate Bilateral Sequential Cataract Surgery (IBSCS): Special Procedure for Specific Patients
Authors: GEORGE ADE NOVRA SITANAYA  , Ronald Phoniary  
Published: February 2024

Abstract
Introduction & Objectives : Immediate Bilateral Sequential Cataract Surgery (IBSCS) are still controversial topic in Ophthalmology. This paper aims to report the outcome and the efficacy of Immediate Bilateral Sequential Cataract Surgery in writer’s experience.
Methods : This paper collects datas from 150 patients that underwent IBSCS. The procedure was done if patient have one or more from these criteria: live far away from hospital, difficult to mobilize to hospital, extreme urgency to return to work as fast as possible (daily paid worker), and if general anesthesia was used. The exclusion criterias were if there was intraoperative complication during the 1st eye, any posterior segment abnormality, and in complicated cataract cases (bad cornea, glaucoma eyes, small pupil eye, zonular loss / weakness, post uveitic eye). During intraoperative, after the 1st eye was finished all instruments and consumable was changed before proceed to the second eye.
Results : From 150 patients, there were 0 (zero) case of endophthalmitis. At 7th days post op results all patients achieve normal range pressures, quiet anterior chamber, and good visual acuity improvement.
Conclusion : Immediate Bilateral Sequential Cataract Surgery is not less safe than traditional delayed sequential cataract surgery. IBSCS definitely should be considered when encountered with specific patients and specific needs.
EFFECT OF ORAL CURCUMIN ADMINISTRATION ON NMDA RECEPTOR EXPRESSION AND RETINAL GANGLION CELL DENSITY
Authors: SALMAH ALAYDRUS  , RISKI PRIHATNINGTIAS  , ARNILA NOVITASARI  , HERMAWAN ISTIADI  
Published: February 2024

Abstract
Introduction & Objectives : To prove the effect of oral curcumin on NMDA receptor expression and retinal ganglion cell density.
Methods : Wistar rats model of traumatic optic neuropathy were divided into 2 groups. The treatment group was given oral curcumin 150mg/kgBW/24 hours for 14 days 1 hour after trauma. NMDA receptor expression was examined by IHC staining and retinal ganglion cell density was examined by HE staining. Data were collected and analyzed.
Results : NMDA expression was found to be significantly lower in the treatment group compared to the control group (p = 0.046). The mean of ganglion density in the control and treatment group was 12.88 ± 2.44 and 17.92 ± 6.95, respectively. The treatment group had a significantly higher ganglion density (p = 0.043). There was a significant relationship between NMDA receptor expression and retinal ganglion density (p = 0.043, r = -0.591).
Conclusion : Curcumin can suppress the expression of NMDA receptors to maintain retinal ganglion density in rat models of optic neuropathy
Management of Hypotony Maculopathy
Authors: Nanditya Sri Astri , Ayudianingrum Asti , Sulastiwaty Rini 
Published: February 2024

Introduction : Hypotony is a common complicatons after glaucoma filtering surgery. Hypotony maculopathy is a serious condition that related to the significant decrease in visual acuity. This case report is to show the case of hypotony maculopathy and the risk factors.
Case Illustration : A 28 yo female with juvenile glaucoma undergone trabeculectomy on her left eye. One day post surgery show significant inflamation forming fibrin in pupil area. POD 1 IOP decreased to 2 mmHg and remains hypotony after 2 weeks post surgery. Visual acuity decreased significantly even when the anterior chamber inflamation has resolved. Funduscopy showed typical appearance of hypotony maculopathy. Oral steroid of methylprednisolon 1 mg/kg per body weight, and topical prednisolon was administered since POD 1. Visual acuity gained and iop rised to 14 after 3 weeks with theraphy with oral and topical steroid.
Discussion : Sudden drop of intraocular pressure may lead to many complications such as hipotony maculopathy. It was a frightening as it may decreased the visual acuity permanently. Young age and severe post operative inflamation are risk factors found in this patient.
Conclusion : Hypotony after glaucoma filtering surgery may caused hypotony maculopathy. Young age and high inflamation are risk factors for developing hypotony maculopathy. Risk factors considerations and early treatment of hypotony is essential to prevent the sight threatening complications such as hypotony maculopathy.
Development and application of targeted multiplex polymerase chain reaction to help diagnose infectious uveitis
Authors: Rachel Ethelind  
Published: February 2024

Abstract
Introduction & Objectives : Clinical pattern recognition is paramount in uveitis diagnosis. Pathogen detection from ocular fluid samples is often necessary to support infectious uveitis diagnosis, particularly in cases presenting with atypical clinical appearance. This study aims to present the process of developing targeted multiplex PCR and its application in infectious uveitis.
Methods : This was a cross sectional study to evaluate the diagnostic performance of targeted multiplex PCR in infectious uveitis. We obtained ocular fluid samples and reviewed medical records of uveitis patients who underwent ocular fluid analysis at Cipto Mangunkusumo Hospital from February 2022 to March 2023. PCR detection threshold values (DNA copies/mL) were 10.9 for Mycobacterium tuberculosis (Mtb), 672 for Epstein-Barr virus, 4.77 for Cytomegalovirus, 6.37 for Toxoplasma gondii, and 5.53 for Herpes simplex virus. With every two-fold increase of pathogen selection, this method requires a half volume of extracted DNA template from aqueous/vitreous samples than uniplex PCR. The ophthalmologist selected the pathogen combination to be detected, allowing for a tailored examination.
Results : Forty-seven aqueous or vitreous samples were analyzed. The positivity rate was 23.4% (11/47) with Mtb yielded the highest positivity (7/34; 20.6%). With final diagnosis as a reference, targeted multiplex PCR resulted in 32.3% sensitivity, 93.8% specificity, 90.9% positive predictive value and 19.2% negative predictive value.
Conclusion : With its high specificity, targeted multiplex PCR is useful as a confirmatory but not screening tool in uveitis diagnosis. Ocular fluid analysis is an important part of stepwise diagnostic approach in uveitis.
Exploring the Impact of Low-Concentration Atropine Eye Drops on the Progression of Myopia: A Systematic Review
Authors: Stella Nathania  , Gabriella Hafidha Badruddin  , Jovita Jutamulia  
Published: February 2024

Abstract
Introduction & Objectives : Low-concentration atropine eye drops have emerged as a promising therapy for the management of myopia. However, the effectiveness of atropine for myopia has not been widely studied. This paper aims to analyze the efficacy of low-concentration atropine eye drops for progression of myopia.
Methods : A comprehensive literature search was performed on 3 online databases: PubMed, Cochrane, and ProQuest. We used 'Low-concentration atropine eye drops’, ‘Atropine’, ‘Eye Drops’, ‘Myopia’, and their MeSH terms as keywords. All studies included in analysis were available in English and full text format. We analyzed children myopia progression rates from all studies. We used Rayyan, an online-based tool, to conduct the screening process.
Results : Three randomized control trials (RCTs), two cohort studies, and three case report studies with a total of 1389 participants were analyzed. Most studies were done in Asia, except one RCT in Australia. The participants range from 4-12 years old. Atropine eye drops concentrations that had been used were 0,01%, 0,025%, 0,05%, 0,1%, 0,125%, and 0,2%. All studies showed slower progression rate of myopia compared to the control group (-0,31 D vs -0,90 D; -0,05 D vs -1,05 D; -0,27 D vs -0,81 D; -0,28 D vs -0,54 D; -0,18 D vs -0,45 D;−0.31 D vs −0.76 D; -0.91 vs -1.00 D; -0,38D vs -0,55 D) with P < 0,05, except one study P = 0,94.
Conclusion : Low-concentration atropine eye drops have shown promising effects in slowing progression of myopia. However, further research is needed, particularly in non-Asian countries.
REFRACTIVE OUTCOMES COMPARISON IN LIMBAL RELAXING INCISION BASED ON INCISION DEPTH IN MANAGING CORNEAL ASTIGMATISM DURING CATARACT SURGERY
Authors: Alexander Herdyanto  
Published: February 2024

Abstract
Introduction & Objectives : Introduction: Prevalence of clinically significant astigmatism of more than 1D can be found in 20 to 50% population those undergo cataract surgery. During phacoemulsification surgery, astigmatism could be corrected by toric intraocular lens (IOL) or incisional technique such as limbal relaxing incision (LRI). LRI are safe and inexpensive procedures thus results in satisfying outcomes with surgeon’s precise phacoemulsification incision and accurate LRI arc position, which most appropriate treatment choice for surgeons in rural area that has problematic access towards IOL supply. Objectives: To compare refractive outcomes of LRI technique with incision depth of 500um and 600um using diamond knife corresponding with phacoemulsification cataract removal.
Methods : Prospective cumulative interventional case study included 30 eyes of consecutive cataract corneal astigmatic patients power >1.0D those undergoing LRI and phacoemulsification. Length, numbers, and arc position of LRI were calculated on LRI Calc application to obtain best results in minimal astigmatism residual. Uncorrected visual acuity, intraocular pressure, and keratometric cylinder were also analysed before surgery, Day-1, Day-7, and 1-Month post-operation.
Results : Day-1 follow-up keratometry shown that corneal astigmatism was still fluctuated, day-7 follow-up was even better with significant improvement in visual acuity. 1-Month post-operation has reached target correction. Moreover, visual acuity and residual astigmatism was better in 600um incision depth.
Conclusion : When toric IOLs are not available or contraindicated, LRI could be a good option in correcting astigmatism with better refractive outcomes trend in 600um incision depth. LRI results better be evaluated in day-7 and 1-Month post-LRI, which may due to more stable corneal surface.