e-poster - perdami

1E-POSTER

ABSTRACT BOOK PERDAMI Virtual Scientific Meeting 2021 17-26 September 2021

ISBN:

Editor:Syntia Nusanti, MDSita Paramita Ayuningtyas, MDSuci Istiqa Mustafa, MDYulinda Arty Laksmita, MDMade Paramita Wijayati, MDRianti Wulandari Pratiwi, MDAmani Sakinah Augiani, MDAnya Dewi Nastiti, MD

Layout:Johny Zulkarnain

Publisher:Perhimpunan Dokter Spesialis Mata Indonesia (PERDAMI)

Address: Gd. The Baile, Lt. 1 Ruang 101-103, Jl. Kimia No. 4, Menteng, Jakarta Pusat 10320

Published in September 2021

All rights reserved. No part of this publication may be reproduced or transmitted, in any form or by any means, without the permission in writing from the publisher.

Table of Contents

EPOSTER EPOS-INOIIS 02 EPOS-INAVRS 53 EPOS-INASCRS 70 EPOS-INAPOSS 97 EPOS-INACOS 122 EPOS-IGS 123 EPOS- INASOPRS 141 EPOS-INARVOS 190 EPOS-INANOS 198

FREE PAPER FP-IGS 238 FP-INANOS 259 FP-INASOPRS 269 FP-INASCRS 280 FP-INAVRS 297 FP-INARVOS 312 FP-INACOS 328 FP-INAPOSS 345 FP-G-INOIIS 362

E-POSTER

2 E-POSTER

EPOS-G-INOIIS-01Corneal Ulcer Treatments in Rural Area, A Case Report

Abstract TitleCorneal Ulcer Treatments in Rural Area, A Case Report

Abstract Type: Case Report

Abstract Category: E-Poster

Seminat : INOIIS

Competition Category: E-Poster

First Author: Pricilia Olivia Tan

Author Institution: RSUD Tobelo

Co Author: Samuel Samatara (rsud tobelo)

Competition Category: General Practitioner

IntroductionCorneal ulcer is the infection of the eye that is pathologically characterized by an infiltarte that causes discontinuity to Result in tissue death in the cornea. Corneal ulcers are caused by bacteria, fungi, and viruses. The treatment of corneal ulcers must be done immediately to prevent the ulcer spread and causing other complications.Case IllustrationA 71-year-old woman came to the emergency room complaining of severe pain, redness in the right eye, photophobia and decreased of vision 4 days ago. she was exposed to the grass clipping into the right eye. Opthalmic examination of the right eye shown the visual acuity of 1/300, accompanied with ciliary injection and conjungtiva. Deep COA, white infiltration shown in the cornea approximately 4x4mm in size, no synechiae appears in the iris.DiscussionCorneal ulcer’s treatments use the medical and non-medical therapy. Broad-spectrum antibiotics such as ofloxacin and levofloxacin which aim to prevent microorganisms to develop and to damage the cornea. Atropine sulphate is given to prevent acetylcholine from acting to prevent posterior synechiae and to reduce pain.ConclusionCorneal ulcers are type of eye disease that can lead to vision problems and blindness. One of the complications such as corneal perforation to invasion from the associated infection causes a permanent eye damage leading to blindness.KeywordCorneal ulcer, treatment, blindnessLatest UpdateApril 28, 2021, 12:34:52StatusApproved As E-Poster

3E-POSTER

EPOS-R-INOIIS-02Management of Bacterial Corneal Ulcer Perforation Using Amnion Membrane

Transplant and Conjunctival Flap Technique in Thyroid Eye Disease

Abstract TitleManagement of Bacterial Corneal Ulcer Perforation Using Amnion Membrane Transplant and Conjunctival Flap Technique in Thyroid Eye Disease

First Author: Fajar Ahmad Prasetya

Author Institution: Universitas Sriwijaya

Co Author: Petty Purwanita (Universitas Sriwijaya)



Seminat: INOIIS

Competition Category: Resident

IntroductionThyroid Eye Disease (TED) is an autoimmune disorder in the eye and orbit, along with itscomplications. Proptosis, lagophthalmos and reduced blinking led to ulcerative keratitis. Amniotic Membrane Transplant (AMT) combined with conjunctival flap may promote healing, regeneration and maintain ocular surface stability and integrity.Case Illustration16-years-old man presented with white spot in right eye since 1 month ago. Both eyes protruded since a year. He complained pain, redness, blurred vision, and difficulty to open RE. Patient admit his RE exposed to dust, then washed his eye with well water. Both eyes showed proptosis. RE VA 1/300, examination showed cloudy cornea, central defect 5x7 mm with irregular margin, > 2/3 stromal depth, central corneal perforation diameter 2 mm, infiltrate, and fluorescein staining at defect margin. Gram examination: negative-rod-bacteria. Corneal discharge culture: Acinetobacter sp. T3-T4 levels and Orbit CT-Scan suggested TED. Orbital sonography: intact globe, no inflammation. AMT & Conjunctival Flap were undertaken along to maintain eyeball integrity. 2 weeks post procedure, RE VA: 1/300, corneal cicatricial tissue formed and globe integrity maintained.DiscussionTED cause proptosis and exposure keratitis, leading ulceration and perforation. AMT can maintain ocular integrity, prevent corneal ulcer progression and eradicate causative germs. It also accelerates healing, helps epithelial cells migration over corneal defects. Conjunctival flaps also overcome proptosis problem caused by TED, and maintaining eyeball integrity, increasing vascularization thereby speed up tissue recovery and eradicate causative germs.ConclusionThe use of AMT and Conjunctival Flap technique can strengthen, stabilize ocular surface, accelerate corneal epithelialization, and maintain eyeball integrity.KeywordBacterial Corneal Ulcer Perforation, Amnion Membrane Transplant, Conjunctival Flap.Latest UpdateMay 05, 2021StatusApproved As E-PosterFile Download22-EPOS-R-INOIIS-02-Fajar-Ahmad-Prasetya.jpg

4 E-POSTER

EPOS-G-INOIIS-03Enucleation Versus Evisceration to Prevent Sympathetic Ophthalmia: ASystematic Review

Abstract TitleEnucleation Versus Evisceration to Prevent Sympathetic Ophthalmia: A Systematic Review

First Author: Fabiola Supit

Author Institution: Faculty of Medicine, Public Health and Nursing Gadjah Mada University

Co Author: Ardelia Emily (Faculty of Medicine Maranatha Christian University)

Abstract Type: Research


Seminat: INOIIS

Competition Category: General practitioner

Introduction & ObjectivePrevious studies advocated enucleation over evisceration to prevent sympathetic ophthalmia (SO) in severely traumatized eyes, but more recent studies suggested a similar risk of SO between them. A comprehensive study to compare the risk of SO incidence after enucleation versus evisceration in ocular trauma is needed.MethodWe searched eligible English articles published from 2011 to 2021, for people with severe ocular trauma who received enucleation or evisceration. PubMed, Science Direct, SpringerLink, and Google Scholar were explored. We used the combination of Keywords, including ‘ocular trauma’, ‘sympathetic ophthalmia’, ‘enucleation’, and ‘evisceration’. Two independent reviewers systematically screened the articles.ResultA total of 279 titles were retrieved, but only seven studies were selected. There were 351 eyesincluded (158 enucleated and 160 eviscerated). Follow-up duration was varied from one day totwelve years. No SO case in both groups suggested a similar risk between enucleation andevisceration. Evisceration offers a relatively simpler procedure and better cosmetic Result thanenucleation. Further research with extended follow-up time is needed because of the rarity nature of SO and the period between onset and exciting injury.ConclusionWe found no difference between enucleation and evisceration in their risk of SO. Evisceration and enucleation are both viable options. The decision of an eye removal procedure would lie upon each surgeon’s preference and experience.KeywordSympathetic ophthalmia, enucleation, eviscerationLatest UpdateMay 06, 2021StatusApproved As E-PosterFile Download544-PVSM-2021-poster-enuc-vs-evis.jpg

5E-POSTER

EPOS-G-INOIIS-04A Rare Case of Gonococcal Orbital Cellulitis: A Case Report

Abstract TitleA Rare Case of Gonococcal Orbital Cellulitis: A Case Report

First Author: Ardelia Emily

Author Institution: Faculty of Medicine Maranatha Christian University

Co Author: Fabiola Supit (Faculty of Medicine, Public Health, and Nursing Gadjah Mada University)



Seminat: INOIIS


IntroductionThis study reported a rare case of Gonococcal orbital cellulitis. Orbital cellulitis is a serious infection located posterior to the orbital septum. It could cause blindness by optic nerve compression or infarction, or rarely death from septic cavernous sinus thrombosis or intracranial sepsis.Case IllustrationA 31 years old housewife came to the emergency department with swollen eyelids, pain, redness, and a purulent discharge on the right eye for a week. Her vision was gradually blurred. There was pain at ocular movement. Ten days before, she felt a tingling and foreign body sensation in her right eye. Her symptoms worsened after self-treatment with saltwater and betel leaves. Visual acuity in the right eye is 1/300. Superior and inferior eyelid inflamed with axial proptosis. Other ocular findings were within normal limits. Gram staining on conjunctival secretes found intracellular diplococci gram-negative. She was diagnosed with gonococcal orbital cellulitis. Combination of intravenous antibiotics, Gatifloxacin eyedrop, chloramphenicol eye ointment, and hydrocortisone eye ointment was prescribed during hospitalization.DiscussionThe route of transmission of ocular GO infection is auto-infection from genital by contaminatedfinger. Neisseria Gonorrhoeae (NGO) gained access to the orbital tissues by adhering to columnar epithelial cells with fimbriae, which extend several millimeters from the cell surface, penetrate them and multiply on the basement membrane.ConclusionOrbital cellulitis, though rare, is one of the spectrum diseases of gonorrhea. Orbital cellulitis has high-risk complications, which are sight and life-threatening. Medical doctors should recognize how to diagnose orbital cellulitis clinically.KeywordOrbital Cellulitis, gonococcal orbital cellulitis, Neisseria gonorrhoeaeLatest UpdateMay 08, 2021StatusApproved As E-PosterFile Download161-EPOS-G-INOIIS-04.jpg

6 E-POSTER

EPOS-R-INOIIS-05Diagnosis of Neuroretinitis due to Herpes Simplex Virus Infection

Abstract TitleDiagnosis of Neuroretinitis due to Herpes Simplex Virus Infection

First Author: Fatimah Syakirah

Author Institution: Mohammad Hoesin Hospital

Co Author: Anang Tribowo (Mohammad Hoesin Hospital)



Seminat: INOIIS


IntroductionNeuroretinitis is an inflammatory disorder characterized by acute loss of vision associated with optic nerve head edema and star pattern exudates in the macula. The vision loss is painless, and usually unilateral, affecting persons of all ages. Neuroretinitis is a rare clinical entity with definite etiopathogenesis which can be misdiagnosed by the ill-experienced clinician. However, there are certain diagnostic features of neuroretinitis.Case IllustrationA 35-years-old woman presented with sudden blurred vision on the left eye (LE) since two weeks ago, preceded by fever and headache. The LE best corrected visual acuity was 6/30 with positive relative afferent pupillary defect (RAPD), blurred papillary margin, and macular star appearance. There was also dischromatopsia and reduced contrast sensitivity. Humphrey perimetry examination showed cecocentral scotoma. Optical coherence tomography showed retinal layer thickening. The laboratory Result was positive for Herpes Simplex Virus (HSV) 1 IgM. The patient was treated with oral methylprednisolon and acyclovir in tapered dose, showing 6/6 LE visual acuity after 7 weeks of medication and significantly decreased macular star.DiscussionNeuroretinitis may occur due to infectious or noninfectious process. The diagnosis is established by examination Results, namely decreased visual acuity, ipsilateral RAPD, cecocentral scotoma, dischromatopsia, reduced contrast sensitivity, and the funduscopy characteristic appearance of optic disc swelling plus hard exudates on the macula in star arrangement. The laboratory Results revealed HSV as the etiology.ConclusionDiagnosis of neuroretinitis due to HSV infection is made by complete examination: thorough history taking, ophthalmologic examination, laboratory tests, and also can be aided by other additional supportive investigation.KeywordNeuroretinitis, Herpes simplex virus, Macular starLatest UpdateMay 10, 2021StatusApproved As E-PosterFile Download459-EPOS-R-INOIIS-05-Fatimah-Syakirah.jpg

7E-POSTER

EPOS-G-INOIIS-06CASE REPORT : PRESENTATION OF UNUSUAL SHAPE TRANSFORMATIONOF CORNEAL SCAR AFTER CORNEAL ULCER

Abstract TitleCASE REPORT : PRESENTATION OF UNUSUAL SHAPE TRANSFORMATION OF CORNEAL SCAR AFTER CORNEAL ULCER

First Author: Stevie Kresentia L

Author Institution: RSPAL dr. Ramelan, Surabaya

Co Author: Amir Surya (RSPAL dr. Ramelan, Surabaya)



Seminat: INOIIS


IntroductionCorneal ulcers are one of the ocular emergencies causing ocular morbidity. Managing the corneal ulcer accurately can reduce its symptoms and improve patient vision Resulting on better quality of life.Case IllustrationA 19 year-old male came to eye clinic at Navy Hospital, complained about extreme pain on his redleft eye, photophobia, tearing, decrease in vision since a month ago. It was diagnosed with cornealulcer with hypopyon. He was advised for hospitalization. Four weeks later after being dischargedand weekly control, the shape of the corneal ulcer had transformed, thickened in the periphery. Hefelt more discomfort with his eye and blurred vision. To reduce the symptoms, debridement andtopical corticosteroids were performed.DiscussionMeticulous history taking, ocular examination, and laboratory investigation are crucial to decidewhich etiology and treatment used for corneal ulcer. Inflammatory reactions that occur in the deeper layer of the epithelium will cause scar formation, neovascularization and lead to visual disturbance. However, in this case, as the donor limitation and expensive cost, keratoplasty was not the first choice for him.ConclusionCorneal ulcer is quite challenging for ophthalmologists as the case has to be timely handled to avoid worsen vision. Another problem that is often faced is not only about the infection but also about the scars formation after the ulcer.KeywordCorneal ulcer, corneal scar, debridementLatest UpdateMay 10, 2021StatusApproved As E-PosterFile Download47-EPOS-G-INOIIS-06-STEVIE-KRESENTIA-L.jpeg

8 E-POSTER

EPOS-G-INOIIS-07Corneal Perforation Complicated with Acquired Anterior Staphyloma in APatient with Previous History of Conjunctival Flap: A Case Report

Abstract TitleCorneal Perforation Complicated with Acquired Anterior Staphyloma in A Patient with Previous History of Conjunctival Flap: A Case Report

First Author: Rizki Adi Santosa

Author Institution: General Practitioner, East Belitung Regional General Hospital, East Belitung, Bangka

Belitung Islands

Co Author: Yenni Poernama Sari (Ophthalmologist, East Belitung Regional General Hospital, East Belitung,

Bangka Belitung Islands)



Seminat: INOIIS


IntroductionConjunctival flap is one of the options for the treatment of corneal ulcers, particularly in lowresources setting. However, corneal perforation could occur as a complication following thisprocedure or if neglected it can cause acquired anterior staphyloma.Case IllustrationA 77-year old man was diagnosed with a corneal ulcer of the left eye and bilateral involutionalentropion (left eye VA: HM). This patient was advised to be referred to tertiary health center but he refused. Thus, conjunctival flap was decided to be performed. One month following the procedure, the patient complained of watery left eye with evident corneal melting and perforation (VA: LP).The patient was recommended to be referred or underwent evisceration but rejecting both offers.Two months later, the patient complained of excruciating pain and redness in the diseased eye;these clinical findings were in accordance with anterior staphyloma (VA: NLP). Consequently,evisceration, prosthetic implantation, and temporary tarsorrhaphy were inevitably conducted. Onthe seventh day postoperatively, the pain and other symptoms vanished with satisfactory Results.DiscussionCorneal perforation can occur following conjunctival flap procedure due to fragile tectonic strength of the conjunctiva and ongoing inflammation. In this condition, keratoplasty could become a salvage treatment of the eyeball. Nevertheless, evisceration becomes the last resort due to inadequate facility, COVID-19 restriction, and anterior staphyloma causing blind painful eye were present in this case.ConclusionA rarity of corneal perforation as the complication of conjunctival flap should be acknowledgedpromptly to prevent further fallout.Keywordcorneal perforation, anterior staphyloma, conjunctival flapLatest UpdateMay 11, 2021StatusApproved As E-PosterFile Download448-EPOS-G-INOIIS-07-Rizki-Adi-Santosa.jpg

9E-POSTER

EPOS-G-INOIIS-08BILATERAL FUNGAL CORNEAL ULCERS DUE TO NEGLIGENT CONTACTLENS WEAR: A RARE CASE REPORT

Abstract TitleBILATERAL FUNGAL CORNEAL ULCERS DUE TO NEGLIGENT CONTACT LENS WEAR: A RARE CASE REPORT

First Author: Graecia Bungaran

Author Institution: General Practitioner, JEC Eye Hospitals and Clinics, Jakarta, Indonesia

Co Author: Lily Silva Ardiani (Research, JEC Eye Hospitals and Clinics, Jakarta, Indonesia)

Made Susiyanti (Division of Infection and Immunology Medicine, Department of Ophthalmology,

Faculty of Medicine, University of Indonesia, dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia; Infection

and Immunology Service, JEC Eye Hospitals and Clinics, Jakarta, Indonesia)



Seminat: INOIIS


IntroductionFungal keratitis is one of corneal ulcer infections that threatens visual function and eye integrity.Herein, we present a rare and severe case of contact lens (CL)-related fungal corneal ulcer in botheyes (BE) that is successfully treated with medical therapies.Case IllustrationA 15-year-old girl presented with severe pain, redness, photophobia, and blurred vision in the BE two days ago. She had a history of extended CL wear and overnight use the previous night. Visual acuity (VA) could not be performed due to pain, photophobia and blepharospasm. Slit-lamp examination showed bilateral palpebral hyperemia and edema, conjunctival hyperemia, large whitish-grey corneal stromal infiltrates, and hypopyon. Corneal scraping for BE revealed pseudohyphae, long and short hyphae, and spores. Topical and oral antifungal were prescribed. After months of close follow up, the ulcers have healed gradually to corneal scars, and VA has improved to 20/60 on the right eye and 0.5 m CF on the left eye.DiscussionBilateral fungal corneal ulcers due to extended CL use are quite rare. Failure in assessment willlead to inaccurate diagnosis Resulting in unfavorable visual outcome. With delay in treatment or left untreated, bilateral corneal ulcer can be sight-threatening. Therefore, careful examination ismandatory to establish precise diagnosis and treatment.ConclusionBilateral fungal corneal ulcers due to CL is uncommon but is a nightmare. Early diagnosis andappropriate treatment prevent its progression, severe visual loss and maintain the eye integrity.Keywordcontact lens, fungal ulcer, ulcerative keratitisLatest UpdateMay 13, 2021StatusApproved As E-PosterFile Download565-EPOS-G-INOIIS-08-Graecia-Bungaran.jpg

10 E-POSTER

EPOS-G-INOIIS-09MANAGEMENT OF A-9-YEARS-OLD WITH PERIORBITAL CELLULITIS INPERIPHERAL HOSPITAL, SOUTH KALIMANTAN, INDONESIA: A CASE REPORT

Abstract TitleMANAGEMENT OF A-9-YEARS-OLD WITH PERIORBITAL CELLULITIS IN PERIPHERAL HOSPITAL, SOUTH KALIMANTAN, INDONESIA: A CASE REPORT

First Author: Farisa Shauma Fachir

Author Institution: Sari Mulia Hospital Banjarmasin, South Kalimantan

Co Author: Husni Thamrin (Hadji Boejasin Hospital Pelaihari, South Kalimantan)



Seminat: INOIIS


IntroductionPeriorbital cellulitis is an infection of the skin and soft tissue around the eye that is anterior to theorbital septum. Principally occurs by direct inoculation following trauma or spread of infection from adjacent structures including sinuses, upper respiratory, middle ear infections, and local infection in eyes.Case IllustrationA 9-years-old child comes to emergency department with painful hyperaemic swelling in the rightperiorbital region. Two days before admission, there is a sore red bump on the edge of the righteyelid. Visual acuity and motility are unaffected. Relative afferent pupillary defect was absent.Fever and neck lymph node enlargement was present. Patient was admitted to hospital andfollowed the clinical improvement in ward.DiscussionPeriorbital cellulitis is a condition that needs to be able to identify and differentiate from the moreserious, potentially life-threatening orbital cellulitis. After thorough history taking and clinicalassessment, patient was diagnosed with periorbital cellulitis. Complete blood count and watersview had been performed but the Result was normal. Because there is no manifestation pointing toorbital cellulitis from examination of the eyes and limited resources settings, CT Scan was notconducted. Spread of local infection from an acute hordeolum is suspected as etiology. Patientshowed improvement and no complications after four days of treatment.ConclusionPeriorbital cellulitis is relatively common in children but if left untreated, the infection can crossthe septal barrier and spread to the orbit, Resulting in cellulitis that may have life-threateningsequelae, including orbital cellulitis, cavernous sinus thrombosis, and meningitis.Keywordperiorbital, cellulitis, childLatest UpdateMay 14, 2021StatusApproved As E-PosterFile Download512-EPOS-G-INOIIS-09-Farisa-Shauma-Fachir.jpg

11E-POSTER

EPOS-G-INOIIS-10Panuveitis in Thyroid Disease Patient with Exudative Retinal DetachmentComplication: A Case Report

Abstract TitlePanuveitis in Thyroid Disease Patient with Exudative Retinal Detachment Complication: A Case Report

First Author: Fransiska Lavinia Gracella

Author Institution: Rumah Sakit Mata Ramata, Denpasar, Bali

Co Author: Anak Agung Putri Satwika (Rumah Sakit Mata Ramata, Denpasar, Bali)

Ayu Diah Permata Sari (Rumah Sakit Mata Ramata, Denpasar, Bali)

Putu Nanda Tediantini (Rumah Sakit Mata Ramata, Denpasar, Bali)

IGA Made Juliari (Rumah Sakit Mata Ramata, Denpasar, Bali)

Ari Andayani (Rumah Sakit Mata Ramata, Denpasar, Bali)


Abstract Category: E-PosterSeminat: INOIIS

Competition Category: eneral practitioner

IntroductionUveitis is a group of intraocular inflammatory diseases affecting the uvea and surroundingstructures. Retinal detachment in uveitis often causes severe visual impairment. Patients withthyroid disease have a higher risk of developing uveitis.Case IllustrationA female patient, 64 years old, complained about very blurry left eye vision since the past 3 weeks. She had a history of thyroid removal 3 years ago and never returned to control. The visual acuity was light perception on the left eye. Anterior segment examination showed the pupil was irregular, third-degree cell flares, posterior synechiae and lens opacification. On funduscopy and ultrasound examinations, there was retinal detachment. The lab examination showed TSHs was 11.7. The patient was diagnosed with panuveitis and suspected of exudative retinal detachment. The treatments given were anti inflammation eye drop, topical artificial tears, atropine eye drop and also referal to an Endocrinology Specialist. Visual acuity improved to hand movement after one week.DiscussionIn this case the patient is in a hypothyroid state. The chances of developing uveitis in patients withthyroid disorders were 1.7 times and 1.5 times greater, with hypothyroidism was the condition mostcommonly associated with uveitis. Autoimmunity is the mechanism that may explain the association of both conditions and T-cell dependent process exists, specifically involving T-helper 1 and Thelper 17 cells.ConclusionUveitis can be caused by various systemic diseases like hypothyroidism. It takes appropriatecollaboration with related specialties to get maximum therapeutic Results, both for the patient’socular and systemic conditions.KeywordPanuveitis, thyroid disease, retinal detachment.Latest UpdateMay 14, 2021StatusApproved As E-PosterFile Download715-EPOS-G-INOIIS-10-Fransiska-Lavinia-Gracella.jpg

12 E-POSTER

EPOS-R-INOIIS-11A Rare Case of Rapidly Progressive Stenotrophomonas maltophilia Corneal Ulcer after Large Retrobulbar Vascular Malformation Removal: Missed a Caveat?

Abstract TitleA Rare Case of Rapidly Progressive Stenotrophomonas maltophilia Corneal Ulcer after Large Retrobulbar Vascular Malformation Removal: Missed a Caveat?

First Author: Ikhwanuliman Putera

Author Institution: Department of Ophthalmology, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia

Co Author: Mutmainah Mahyuddin (Department of Ophthalmology, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia)

Lukman Edwar (Department of Ophthalmology, Faculty of Medicine Universitas Indonesia – CiptoMangunkusumo Kirana Eye Hospital, Jakarta, Indonesia)



Seminat: INOIIS


IntroductionStenotrophomonas maltophilia is an uncommon cause of keratitis, of which corneal surgery and contact-lens wear are the major risk factors. We aim to describe a rapidly worsening corneal infection due to S. maltophilia after large retrobulbar tumor removal.Case IllustrationFifty-three-year-old female without diabetes presented with acute on chronic proptosis of the right eye. Proptosis grew slowly for ten years but left untreated. Contrast-enhanced computed tomography showed a right extraconal retrobulbar mass. However, during the last four days, the proptosis became rapidly worsened. Preoperatively, lagophthalmos with corneal exposure but without infiltrate was noted. Afterward, uneventful lateral orbitotomy and complete 5 x 4 x 4 cm tumor removal were successfully performed, which later confirmed vascular malformation with lymphatic component. The following day, a full corneal infiltrate was present despite minimal residual lagophthalmos, which was then treated with oral and topical levofloxacin. After one week, a perforated corneal ulcer occurred. The culture Result revealed S. maltophilia, which is sensitive to levofloxacin.DiscussionS. maltophilia corneal infection following retrobulbar vascular malformation removal has neverbeen reported. A spontaneous infection has been previously described in a diabetic patient butseems different from ours. Previous studies supported a good response toward quinolone. However, overestimation of quinolone susceptibility had also reported. Thus, switching to another antibiotic might be preferred if there is no immediate improvement.ConclusionEven though unusual, there is a potency of developing a severe corneal infection after resolution of acute on chronic proptosis. In such a case, an unfavorable outcome could occur due to anuncommon pathogen.KeywordCorneal ulcer, Stenotrophomonas maltophilia, vascular malformationLatest UpdateMay 15, 2021StatusApproved As E-PosterFile Download390-EPOS-R-INOIIS-11-Ikhwanuliman-Putera.jpg

13E-POSTER

EPOS-G-INOIIS-12Uveitic Macular Edema : a Case Report

Abstract TitleUveitic Macular Edema : a Case Report

First Author: Aliya Fatimah

Author Institution: Universitas Airlangga

Co Author: Frisma Sagara (Sagara Eye Care)



Seminat: INOIIS


IntroductionUveitis is an inflammatory disease of the uveal tract with variable etiology. Uveitis may beinfectious, non-infectious, or idiopathic. In non-infectious uveitis, Macular Edema (ME) is the mostcommon complication.Case IllustrationA 31 y.o male with redness in both eyes without pain, blurred vision, and floaters for a week. Redeyes have shown before and treated with eye drops that he bought from a pharmacy. The patientoften had joint pain but only went to a public health center. VOD was 6/7.5, and VOS was 6/12. Theanterior segment showed hyperemia in the conjunctiva, posterior synechia, and irregularities in thepupil. Optic nerves of both eyes appeared swollen,and hyperemic with blurred margins. A weeklater, the patient returned to the clinic with decreased vision, and the visual acuity of both eyes was6/19. OCT revealed fluid accumulation in the intraretinal space.DiscussionUveitic macular edema is a common cause of vision loss in the eyes with uveitis. The overallreported prevalence of visual impairment associated with uveitic macular edema is 33–42 % and isinfluenced by the age, location, severity, and duration of retinal edema. Early detection of cystoidmacular edema is critical for diagnosis and management.ConclusionEarly recognition and prompt treatment of uveitis is recommended to avoid visual impairment. Athorough examination is necessary for uveitis patients, especially with non-infectious etiology.KeywordUveitis, Uveitic Macular Edema, Cystoid Macular EdemaLatest UpdateMay 15, 2021StatusApproved As E-PosterFile Download15-ePoster-Uveitic-Macular-Edema-(Case-Report).jpg

14 E-POSTER

EPOS-R-INOIIS-14Unilateral and Asymmetrical Ocular Involvement Of A Released-From Treatment Lepromatous Leprosy with Erythema Nodosum Leprosum

Abstract TitleUnilateral and Asymmetrical Ocular Involvement Of A Released-From-Treatment Lepromatous Leprosy with Erythema Nodosum Leprosum

First Author: Ni Putu Ayu Reza Dhiyantari

Author Institution: Department of Ophthalmology, Faculty of Medicine Universitas Airlangga – Dr. Soetomo

General Hospital, Surabaya, Indonesia.

Co Author: Ismi Zuhria (Department of Ophthalmology, Faculty of Medicine Universitas Airlangga – Dr.

Soetomo General Hospital, Surabaya, Indonesia.)

Sutjipto (Department of Ophthalmology, Faculty of Medicine Universitas Airlangga – Dr. Soetomo

General Hospital, Surabaya, Indonesia.)



Seminat: INOIISCompetition Category: Resident

IntroductionLeprosy also known as Hansen’s disease, is a chronic infectious granulomatous disease caused byMycobacterium leprae. Indonesia constitutes the third largest share of the global burden of leprosy. Ocular involvement in leprosy is estimated to be 70-75%, manifesting as wide range ofinflammatory and cycatric lession that may need multi disciplinary approach to manage.Case IllustrationWe present a released from treatment case of lepromatous leprosy with erythema nodosumleprosum of a 38 year old man with unilateral and asymmetrical ocular complications. Left eye was diagnosed with chronic uveitis, paralytic ectropion, and laghophtalmos, whereas right eye featured later onset complicated cataract. Best corrected visual acuity (BCVA) was 50 cm counting finger for right eye and 5/10 with correction for left eye. Intra ocular pressure was within normal limit for both eyes. Lagophthalmos and madarosis was found on left eye, along with paralytic ectropion of inferior palpebra and reduced blinking. Iris of the left eye was iradier with anterior synechia and iris atrophy.DiscussionThe case reported herein presented atypical presentation of asymmetric chronic uveitis andunilateral complicated cataract of the fellow eye. A patient considered free from treatment mayhave progressive disability due to leprosy reaction along with relapsing ocular signs and symptoms. Delay in presentation to ophthalmologist contributes to debilitating ocular complications and blindness.ConclusionAll patient diagnosed with leprosy should be encouraged to visit ophthalmologist clinic. Amultidisciplinary approach is to be taken in order to improve quality of life.Keywordocular leprosy, chronic uveitis, lepromatous leprosyLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download:685-EPOS-R-INOIIS-14-Ni-Putu-Ayu-Reza-Dhiyantari.jpg

15E-POSTER

EPOS-R-INOIIS-15AMNIOTIC MEMBRANE TRANSPLANTATION IN DESMETOCELLE RELATEDPERIPHERAL ULCERATIVE KERATITIS WITH PREVIOUS CONJUNCTIVALGRAFT FAILURE : A CASE REPORT

Abstract TitleAMNIOTIC MEMBRANE TRANSPLANTATION IN DESMETOCELLE RELATED PERIPHERAL ULCERATIVE KERATITIS WITH PREVIOUS CONJUNCTIVAL GRAFT FAILURE : A CASE REPORT

First Author: Kautsar Abiyoga

Author Institution: Airlangga

Co Author: dr. Ismi Zuhria, Sp.M (K) (Airlangga)



Seminat: INOIIS


IntroductionPeripheral Ulcerative Keratitis occurs when immune complexes activate the complement systemResulting in chemotaxis of inflammatory cells (neutrophils & macrophages) which contribute to the breakdown of the cornea.Case IllustrationAn 18-year-old woman with a history of descemetocele and conjunctival graft failure was referredfor ophthalmic assessment as she complained of blurring of vision since 1,5 months ago. Atpresentation, her visual acuity was 5/12 in the right eye. In the right eye anterior segmentexamination findings descemetocele, and found 3 stitch and conjunctival graft on the cornea. We’ve done an over-lay 4 layers of Amnion Membrane (AM) transplantation covering the corneal surface. After 4 weeks we found 5/5 on BCVA and neovascular was formed around the AM.DiscussionThe AM is the inner layer of the fetal membranes and consists of 3 different layers: the epithelium,basement membrane, and stroma. Also because of its transparent structure, lack ofimmunogenicity, and the ability to provide an excellent substrate for growth, migration, andadhesion of epithelial corneal and conjunctival cells, it is being used increasingly for ocular surfacereconstruction in a variety of ocular pathologies including corneal disorders associated withautoimmune disease.ConclusionAM transplantation is a very useful armamentarium in the hands of ophthalmic surgeons fortreating a variety of ocular surface disorders. Because of its transparent structure, antiinflammatory, anti-fibrotic and anti-angiogenic properties, and ability to provide a substrate for the growth of corneal and conjunctival epithelial cells form ideal material for ocular surfacereconstruction.KeywordCorneal Ulcer, Peripheral Ulcerative Keratitis, DescemetocelleLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download988-EPOS-R-INOIIS-15-Kautsar-Abiyoga.jpg

16 E-POSTER

EPOS-R-INOIIS-16IDIOPATHIC BILATERAL RECURRENT DIFFUSE ANTERIOR SCLERITIS INHIV-POSITIVE PATIENT

Abstract TitleIDIOPATHIC BILATERAL RECURRENT DIFFUSE ANTERIOR SCLERITIS IN HIV-POSITIVE PATIENT

First Author: Cokorda Istri Winny Prabasari

Author Institution: Udayana University / Sanglah General Hospital, Bali

Co Author: Ida Ayu Ary Pramita (Udayana University / Sanglah General Hospital, Bali)

I Gusti Ayu Made Juliari (Udayana University / Sanglah General Hospital, Bali)

Ni Ketut Niti Susila (Udayana University / Sanglah General Hospital, Bali)

Ni Nyoman Triharpini (Mangusada Badung Hospital, Bali)



Seminat: INOIIS


IntroductionScleritis in HIV-positive patients often considering infections such as syphilis, tuberculosis, ortoxoplasmosis as the classical causes. This is a rare case of bilateral diffuse anterior scleritis in aHIV-positive patient whom presented with none of systemic risk factors.Case IllustrationA 34 years old female came due to ocular pain and redness of right eye (RE). Visual acuity was 1.0with normal IOP on both eyes. RE examination revealed diffuse scleral inflammation and vasculardilatation. Fundus examination within normal limit. No T-sign showed in ultrasound. Fellow eyeexamination was within normal limit. The complaints have relapsing alternately in both eyes since2017 and improved with topical steroid therapy. HIV was diagnosed and HAART was introduced inMarch 2020. Current CD4+ cells count was 186 cell/uL. Extensive laboratory and clinical work-upwas performed such as tuberculin skin test, anti-toxoplasma and anti-CMV immunoglobulin test,VDRL and TPHA, and all Result were negative. Rheumatologic tests such as ANA and IF wasnegative.DiscussionThe only ocular manifestation was anterior scleral inflammation. The patient also experiencedsymptoms while on HAART, but an immune recovery induced scleritis cannot be concluded as thesymptoms began far before HIV was diagnosed. Negative Result systemic work-up tests showedclassical causes was not the lead. Although uncommon, co-existing with autoimmune diseases have been reported, but it was also negative in this case.ConclusionDiffuse anterior scleritis may happen as the only ocular manifestation in HIV positive patientwithout any other opportunistic infection.KeywordDiffuse anterior scleritis, HIV, opportunistic infectionLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download377-EPOS-R-INOIIS-16-Cokorda-Istri-Winny-Prabasari.jpg

17E-POSTER

EPOS-G-INOIIS-17Efficacy of Rebamipide 2% for Treatment of Dry Eye Disease : A SystematicReview

Abstract TitleEfficacy of Rebamipide 2% for Treatment of Dry Eye Disease : A Systematic Review

First Author: Surya AtmajaAuthor Institution: RSUD Prof. Dr. H. M. Chatib QuzwainAbstract Type: ResearchAbstract Category: E-PosterSeminat: INOIISCompetition Category: General practitioner

Introduction & ObjectiveDry eye disease (DED) is a multifactorial and complex disease of the ocular surface, with a highprevalence in adults. Investigations had confirmed that rebamipide increases corneal and conjunctival mucin-like substances along with improving corneal and conjunctival injury. Clinically, rebamipide ophthalmic suspensions can effectively treat tear deficiency and mucin-caused corneal epithelial damage, and can restore the microstructure responsible for tear stability.MethodA thorough literature search of PubMed, Science Direct, CrossReff, Scopus, Cochrane, and GoogleScholar was performed, and studies from published articles reporting Results from RCTs andprospective studies were screened and reviewed. Following the PRISMA guidelines, a systematicreview was used to assess the efficacy of rebamipide 2% compared to other topical ophthalmicdrugs for DED. The clinical outcomes assessed were FCS, TBUT, OSDI, DEQS, and dry eyerelatedandResultFrom the database, 447 studies were searched and screen. Eighty studies were eligible in thesystematic review including studies that comparing of rebamipide 2% with artificial tear,dequafosol 3%, hyaluronate 0,1 %, and cyclosporine 0,1%. Two RCTs comparing rebamipide 2 %with dequafosol 3% found no significant differences of outcomes between those ophthalmic drugs.One study comparing rebamipide 2% with hyaluronate 0,1% found the superiority of rebamipide2%. One study comparing rebamipide 2% with cyclosporine 0,1% found the superiority ofrebamipide 2%. Six studies comparing rebamipide 2% with artificial tear found the superiority ofrebamipide 2%.ConclusionRebamipide 2% was effective in improving the clinical outcome of DED. This review suggested apotential usage of rebamipide 2% as treatment of DED.Keyworddry eye disease, rebamipide, OSDILatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download501-EPOS-G-INOIIS-17-Surya-Atmaja.pdf

18 E-POSTER

EPOS-G-INOIIS-18Acute Toxic Anterior Segment Syndrome After Uncomplicated CataractSugery using Phacoemulsification Technique : A Case Report

Abstract TitleAcute Toxic Anterior Segment Syndrome After Uncomplicated Cataract Sugery usingPhacoemulsification Technique : A Case Report

First Author: Marcellina

Author Institution: Siloam Hospital Lippo Village, Tangerang, Indonesia

Co Author: Yoseph Siahaan (Siloam Hospital Lippo Village, Tangerang, Indonesia)

Cheryll Yudakusuma (Siloam Hospital Lippo Village, Tangerang, Indonesia)

Giovanni Santoso (Siloam Hospital Lippo Village, Tangerang, Indonesia)



Seminat: INOIIS


IntroductionToxic anterior segment syndrome (TASS) is rare sterile postoperative complication that usuallydevelops 12-48 hours after anterior segment surgery. Overall incidence of TASS estimated0.1%-0.22% of anterior segment surgery, and most common in phacoemulsification surgery.This case highlight TASS findings and therapy in patient after uncomplicated cataract surgery.Case IllustrationA 69-year-old man presented with blurry vision and mild discomfort in his right eye from first dayafter phacoemulsification surgery. There was no complication prior the surgery. He had history ofuncontrolled diabetes mellitus and hyperlipidemia. On examination, his BCVA 1/60 OD, noperiocular pain, normal intraocular pressure, mid-dilated and irregular pupil with absent reflex,conjungtiva injection, corneal edema, fibrin formation, and limitation of superior nasal right eyemovement. B-scan ultrasonography demonstrated minimal inflammation. No significantimprovement occurred after 22 days with topical corticosteroid and antibiotic therapy. Weperformed irrigation/aspiration procedure for cortex removal. The patient’s BCVA recovered to 0.8at 1 months after surgery.DiscussionPatient had acute post-operative complication findings that showed TASS characteristic. SometimesTASS and endopthalmitis are hard to differentiated. TASS have multifactorial etiology, in case wefound residual lens cortex and systemic disease as possible factors of anterior segment toxicity.Most TASS cases respond rapidly to topical steroids and antibiotic therapy, but inflammation stillpersisted in patient. Surgical intervention performed to prevent any further ocular damage and giveremarkable outcome.ConclusionTASS can be serious sight-threatening complication that occur acutely following anterior segmentsurgery. A prompt clinical diagnosis and treatment should be done to give good visual outcomes.KeywordToxic anterior segmen syndrome, TASS, cataract surgery complicationLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download419-Eposter-TASS-case---dr.Marcellina.jpg

19E-POSTER

EPOS-O-INOIIS-19Atypical Keratitis Following Corneal Foreign Body Removal

Abstract TitleAtypical Keratitis Following Corneal Foreign Body Removal

First Author: JOSIAH IRMA

Author Institution: FK Universitas Pelita Harapan - Siloam Hospital Lippo Village

Co Author: Valda Garcia (FK Universitas Pelita Harapan - RSU Siloam Lippo Karawaci)



Seminat: INOIIS

Competition Category: Ophthalmologist

IntroductionAtypical keratitis can be caused by trauma, in these two cases were history of corneal foreign bodyremoval.Clinical management are often unsatisfactory due to requirement of prolongedcombination of antibiotics.Case IllustrationA-56 yo man came with corneal ulcer with the history of removal corneal foreign body on righteye.The VA was 1/60,anterior segment examination revealed ciliary injection,corneal ulcer andinfiltrate,hypopion,flare/cells ++/++.He treated with oral ciprofloxacin,topical levofloxacin,artificialtears and tropin for a week.VA became 0.2, topical antibitoc were discontinue and changed totopical steroid.VA was worsened to 1/300 and anterior segment revealed flare up.Topical steriodwas stoped and topical combination antibiotics were given (polymixin,neomycin,gramycin) asintensive therapy.After 1 week combination antibiotics were changed to moxyfloxacin and the VAbecame 0.3 with corneal scar. In another case, a 41-y.o man came with same diagnosis.The VA onright eye is 2/60 and treated with antibiotic combination eyedrop (polymixin, neomycin, gramycin)and artificial tears for two weeks. The VA became 0.05 with descemet buldging and cornealthinning. After 2 weeks the VA became 0.3 and the antibiotic changed into moxifloxacin. After onemonth, the VA became 0.5 with corneal scar.DiscussionThe variable clinical presentations of atypical keratitis, multifocal or a single lesion surrounded bymultiple white lesions.Most atypical keratitis cases showed an intact corneal epithelium at theirinitial presentation.Hypopion is present in poorly managed atypical keratitis cases.The clinicaldiagnosis is often delayed due to the slow growing nature of the organims.ConclusionThis case series showed that prolonged antibiotics and careful application of topical steroid areimportantKeywordAtypical keratitis,corneal ulcerLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download662-EPOS-O-INOIIS-19-Josiah-Irma.jpg

20 E-POSTER

EPOS-R-INOIIS-20Contact Lens-Related Microbial Keratitis due to Poor Personal Hygiene andInadequate Knowledge of Contact Lens Wear in An Urban Adolescent Girl

Abstract TitleContact Lens-Related Microbial Keratitis due to Poor Personal Hygiene and InadequateKnowledge of Contact Lens Wear in An Urban Adolescent Girl

First Author: Fariztah Sukainah Nur Fathimah


Co Author: Ismi Zuhria (Universitas Airlangga)

Evelyn Komaratih (Universitas Airlangga)

Susy Fatmariyanti (Universitas Airlangga)



Seminat: INOIIS


IntroductionCosmetic contact lenses (CCL) are popular among adolescents. Improper use of CL can causenumerous complications. Contact lens-related microbial keratitis (CLMK) is a sight threateningcomplication of CL wear, which causes significant burden on patients.Case IllustrationA 13-year-old girl with history of CCL wear presented with pain, redness, tearing, andblepharospasm in her right eye. She wore CL which purchased from internet without supervision byan ophthalmologist and with poor hygiene practices. Bottled drinking water was used for cleaningthe contact lens. She lived in Surabaya, the second biggest city in Indonesia. The visual acuity washand movement. A 4x3 mm central infiltrate with minimal hypopyon was detected. Direct stainingand culture of corneal scraping were not found germs. Meanwhile, direct staining of contact lensand storage was found gram negative rods bacteria (3+) with the culture Result was Enterobactercloacae. Patient received antibiotic injection and topical, and cycloplegia. After fourteen daystreatment, she had no complaint, the best corrected visual acuity was 6/12 with minimal residualcorneal inflammation and partially formed corneal scar.DiscussionMost of CCL users had insufficient knowledge of CL wear and improper hygiene behavior. Higherrisk of CLMK in CCL users was presumed due to rougher surface areas than corrective lenses.Enterobacter cloacae was unusually found in CLMK with limiting therapeutic options asantimicrobial resistance development.ConclusionCLMK caused significant burden on patient that can lead to permanent scarring and blindness.Interventions to educate adolescents on proper care and risks associated with CCLs are needed toprevent complications.Keywordcontact lens-related microbial keratitis, knowledge, Enterobacter cloacaeLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download469-EPOS-R-INOIIS-20-Fariztah-Sukainah-NF.jpg

21E-POSTER

EPOS-O-INOIIS-21Indications and Outcomes of Penetrating Keratoplasty at Padang Eye CenterHospital

Abstract TitleIndications and Outcomes of Penetrating Keratoplasty at Padang Eye Center Hospital

First Author: RENI ANGRAINI

Author Institution: RSKM Padang Eye Center

Co Author: Havriza Vitresia (RSKM Padang Eye Center)



Seminat: INOIIS

Competition Category:

Introduction & ObjectivePenetrating keratoplasty has become one of the most commonly performed transplant procedureswhere full thickness diseased host corneal tissue is replaced with healthy donor corneal tissue.Aims of penetrating keratoplasty include improvement in visual acuity, removal of infectious load,alleviate pain or even to simply save the anatomy of the eye. Visual improvement and removal ofinfection is the prime objective of majority of corneal grafts. The objective of the study was toevaluate various current indications of penetrating keratoplasty in Padang Eye Center HospitalMethodcross-sectional observational study. Data was collected from medical record of patient who came tokeratoplasty from July 2019 to July 2021. Indication for surgery, investigations demographic profile, pre and post-operative complications, follow-up visits and outcomes were recorded.ResultMean recipient age was 43.85 years. The male: female ratio was 5,7:1. The most common indicationfor penetrating keratoplasty was corneal opacity or scarring (60%), followed by infectious keratitis (20%) and post periosteal graft (20 %). Optic keratoplasty is performed in 80% and tectonickeratoplasty is performed in 20%ConclusionThough corneal diseases and indications for transplant surgery in developing countries aredifferent from those in the western world, penetrating keratoplasty has emerged as one of the mostsuccessful way to reduce corneal blindness and to restore visionKeywordPenetrating keratoplasty, corneal opacity, infectious keratitisLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download90-EPOS-O-INOIIS-21-Reni-Angraini.jpg

22 E-POSTER

EPOS-O-INOIIS-22Treatment Of Perforated Infectious Corneal Ulcers With Corneal Patch Graft

Abstract TitleTreatment Of Perforated Infectious Corneal Ulcers With Corneal Patch Graft

First Author: RENI ANGRAINI

Author Institution: RSKM Padang Eye Center

Co Author:



Seminat: INOIIS


IntroductionInfected corneal ulcer deteriorates to perforated cornea which leads to devastating eye conditionsand lost eyes. Perforated cornea needs emergent surgical and/or nonsurgical modalities oftreatment to save the globe integrity and vision. Cornea patch graft has been advocated as thesurgical procedure to treat it.Case IllustrationThere are three male patient were 51, 41, 40 year old, previously treated for corneal ulcer wasreferred after presenting corneal perforation. Slit lamp examination showed collapsed anteriorchamber and corneal perforation with protruded iris at the peripheral cornea. Hypopion andInfiltration in deep stroma was observed near the perforation. To preserve ocular integrity, thepatient underwent corneal patch graft using residual corneal tissue donor. After surgery, thecorneal patch graft was well attached. Re-epithelialization occurred after 3 days. There was norecurrence of perforation or corneal graft melting. First patient Visual acuity improved to 20/100after 1 month, and visual acuity second patient improved to 20/100 from 1/60. All microbiologicalexamination revealed Aspergillus aureus.DiscussionCorneal patch grafts have a tectonic purpose in corneal perforations. The main goal of thetreatment of a perforated corneal ulceration is to treat it as an ophthalmological emergency, to tryto restore the anatomical integrity of the eye and to minimize the complications as much aspossible.Conclusioncorneal patch graft can be a useful treatment option in large corneal ulcer perforation if freshcorneal donor not availableKeywordcorneal pacth graft, perforated corneal ulcerLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download823-EPOS-O-INOIIS-22-Reni-Angraini.jpg

23E-POSTER

EPOS-R-INOIIS-23DUAL ANTIMICROBIAL INJECTIONS FOR ENDOGENOUSENDOPHTHALMITIS IN PRETERM INFANT WITH CONGENITAL RUBELLASYNDROME : DO WE NEED A MORE AGGRESSIVE TREATMENT ?

Abstract TitleDUAL ANTIMICROBIAL INJECTIONS FOR ENDOGENOUS ENDOPHTHALMITIS INPRETERM INFANT WITH CONGENITAL RUBELLA SYNDROME : DO WE NEED A MOREAGGRESSIVE TREATMENT ?

First Author: Ferdian ramadhan


Co Author: Andityo Sidohutomo (Universitas Airlangga)

Muhammad Firmansjah (Universitas Airlangga)

Ima Yustiarini (Universitas Airlangga)

Ismi Zuhria (Universitas Airlangga)

Rozalina Loebis (Universitas AIrlangga)



Seminat: INOIIS


IntroductionEndogenous endophthalmitis (EE) is an uncommon intraocular infection with potentially devastating visual consequences. An endogenous source is responsible for roughly 2% to 8% of all endophthalmitis. In determining the therapeutic approach, the potential causative organism and the extent of ocular involvement should direct the aggressiveness of therapyCase IllustrationA 2-month-old baby hospitalized with the complaint of lethargy, seizure and fever. 4 days before admission, his left eye was swollen, red and producing purulent discharge. Patient was a preterm baby, due to abormal intrauterine bleeding. Another finding were atrial septal defect, microcephaly, cleft lips palate with positive rubella serology testing. Physical examination from the left eye showed mild proptosis, corneal enlargement, hypopyon in anterior chamber with echogenic lesion in vitreous cavity by utrasonography lead to endophthalmitis. Blood smear was performed with positive Klebsiella pneumonia so the patient treated with intravenous amikacin and intravitreal ceftazidime. 3 Days after antimicrobial admission showed minimal progression so the most possible approach to do is another antimicrobial injection based on microbial sensitivity test.DiscussionEndophthalmitis classified as either endogenous or exogenous. Endogenous endophthalmitis Results from hematogenous spread to the eye secondary to septicemia. The most appropriate treatment for endogenous endophthalmitis is a combination of intravenous vancomycin and third-generation cephalosporin or aminoglycoside.ConclusionHowever some case series had shown a poor visual outcome despite treatment with intravitreal antibiotics. Further close monitoring and workup needed to save the vision and appropriate treatments.KeywordEndogenous, Endophthalmitis, AntimicrobialLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download809-PVSM2021-per-ED2.jpg

24 E-POSTER

EPOS-G-INOIIS-24Gonococcal Ophthalmia Neonatorum : A Case Report

Abstract TitleGonococcal Ophthalmia Neonatorum : A Case Report

First Author: Putu Nanda Tediantini

Author Institution: Rs Ramata

Co Author:

Anak Agung Putri Satwika (Rs Ramata)

I Gusti Ayu Made Juliari (Rs Ramata)



Seminat: INOIIS


IntroductionGonococcal ophthalmia neonatorum also known as gonococcal conjunctivitis is an infection causedby Neisseria gonorrhoeae. In neonates, this transmission often occurs during delivery and exposureto infectious vaginal secretions. This symptom can appear to include swelling eyelids, hyperemicconjunctiva, and the presence of purulent conjunctival secretions. Diagnosis must be doneimmediately with proper management to prevent serious complications.Case Illustration4 days old female infant, both of eyes secreted yellowish discharge like pus for 2 days and made herdifficult to open the eyes. She was born by normal vaginal delivery without complication at thehospital. During the pregnancy, her mother has a history of vaginal discharge before delivery. Fromthe anterior segment, both eyes found eyelids swelling, conjunctiva vascular injection, and copiousmucopurulent discharge. This patient performed KOH, gram stain test, bacteria culture test, andantibiotic sensitivity test. Gram stain of the discharge from both eyes of the patients showed gramnegative diplococci, which were confirmed to be Neisseria gonorrhoeae on culture, and ceftriaxoneor cefotaxime can be considered for the choice of treatment. The patient was diagnosed withgonococcal ophthalmia neonatorum and treated with single-dose ceftriaxone injection, topicalantibiotics, and regular eye toilet. After 3 days of treatment, she showed significant improvement indecreasing eye discharge.DiscussionEarly diagnosis, the combination of treatment, and regular eye toilet provide optimal Results canprevent blindness in children.ConclusionDiagnosis of neonatal ophthalmia must be done immediately so the patient can be treated properly.Early diagnosis and treatment can prevent serious complications.KeywordGonococcal ophthalmia neonatorum, Neisseria gonorrhoeaeLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download769-INOIIS-Putu-Nanda-Tediantini.jpg

25E-POSTER

EPOS-R-INOIIS-25OCULAR SYPHILIS ASSOCIATED WITH HERPES ZOSTER OPHTHALMIC

Abstract TitleOCULAR SYPHILIS ASSOCIATED WITH HERPES ZOSTER OPHTHALMIC

First Author: Pieter JuanartaAuthor Institution: Department of Ophthalmology, Faculty of Medicine, Padjadjaran University, Bandung, IndonesiaCo Author:Susi Heryati (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)Angga Fajriansyah (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)Arief Akhdestira Mustaram (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)Patriotika Muslima (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)Elfa Ali Idrus (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)Abstract Type: Case ReportAbstract Category: E-PosterSeminat: INOIISCompetition Category: Resident

IntroductionOcular Syphilis must be considered in uveitis affecting young male patient with Herpes ZosterOphthalmic (HZO) due to its immunocompromised state. Prompt diagnosis and appropriate antimicrobial therapy can prevent complication and achieve better visual prognosis in patients.Case IllustrationA 27 years old male patient were consulted with HZO Sinistra, Bilateral Intermediate Uveitis, andBilateral Atypical Optic Neuritis. Patient complain of pain-full vesicle eruption on left forehead andeyelid two days ago with gradual, blurred vision on both eyes seven months ago. Physicalexamination showed maculopapular rash on both palms. Vitreous cell and haze were seen in botheyes with bilateral blurred optic disc. Laboratory Results show reactivity in VDRL/RPR and TPHA.Patient was diagnosed with Syphilitic Intermediate Uveitis, HZO Sinistra, and Bilateral AtypicalOptic Neuritis. Patient was given intramuscular Benzathine Penicillin and referred to dermatologyand venereology specialist. Screening for HIV was done, and reactive patients were givenantiretroviral therapy.DiscussionOcular syphilis can be found on any stage of the disease and can be manifested as any form ofuveitis making it the “Great Masquerade”. Clinical manifestation that related toimmunocompromised state may help us identify and conduct serologic laboratory examination.Early treatment with Penicillin may improve visual outcome.ConclusionHZO in young age can be a sign of immunocompromised state. Appropriate examination andlaboratory testing are important in determining the exact cause of uveitis in this patient. Patientwith ocular syphilis will benefits from early course of antibiotic therapy. Misdiagnosis will lead todeterioration of uveitis and affect visual outcome.KeywordUveitis, Ocular Syphilis, Herpes Zoster Ophthalmic.Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download509-EPOS-R-INOIIS-25-Pieter-Juanarta.jpg

26 E-POSTER

EPOS-R-INOIIS-26OUTCOME OF CMV RETINITIS WITH ORAL VALGANCICLOVIR THERAPY

Abstract TitleOUTCOME OF CMV RETINITIS WITH ORAL VALGANCICLOVIR THERAPY

First Author: Astria Rima Rara Yuswir

Author Institution: RSUP Dr M Djamil Padang

Co Author:

Havriza Vitresia (Infection and Immunology sub division Department Ophthalmology Faculty of

Medicine Andalas University / Dr. M. Djamil Hospital Padang West Sumatra)

Getry Sukmawati (Infection and Immunology sub division Department Ophthalmology Faculty of

Medicine Andalas University / Dr. M. Djamil Hospital Padang West Sumatra)



Seminat: INOIIS


IntroductionValganciclovir is drug of choice for treatment CMV retinitis administered systemic and intraocularin induction and maintenance doses. Gold standard is ganciclovir. Discontinuation therapyconsidered; etiotropic and improvement of immune system. CDC recommended CD4+ ≥100cells/μL for longer than 6 months.Case IllustrationDiscussionCase 1, a man, 24 yo complained blurred LE since 1 month ago, followed by RE 1 month later. RVA20/150 and LVA NLP. Funduscopy RE showed whitened retina at 1st zone, hemorrhage, vascularsheating to 2nd zone, looks alike as frosted branch angiitis and LE showed retinal detachment.Patient received HAART with CD4+ 5 cells/μL. Patient was planned for intravitreal and intravenousganciclovir, but refused. Patient got oral valganciclovir induction doses for 3 weeks andmaintenance doses. Patient felt comfortable after 5 days and retinal improvement within 3 weeks,RVA 20/70 and LVA NLP. Case 2, a man, 25 yo complained blurred both eyes since 1 month ago.RVA 20/400 and LVA 20/200. Funduscopy of both eyes showed extensive retinal hemorrhage,whitened retina that look alike as fulminant type. Patient received HAART with CD4+ is 5 cells/μL.Patient got oral valganciclovir induction doses for 3 weeks and maintenance doses. Patient feltcomfortable after 3 days and retinal improvement within 3 weeks, RVA 20/60 and LVA 20/40.ConclusionOn guideline, the cases showed CMV retinitis involving 1st zone and given intravitreal injectiontherapy. Patients were given oral valganciclovir because refused it. Oral valganciclovir providesclinical and visual impairment.KeywordCMV Retinitis, Valganciclovir oral.Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download616-EPOS-R-INOIIS-26-Astria-Rima-Rara-Yuswir.jpg

27E-POSTER

EPOS-G-INOIIS-27Platelet-Rich Plasma for the Treatment of Dry Eye Disease: A SystematicReview

Abstract TitlePlatelet-Rich Plasma for the Treatment of Dry Eye Disease: A Systematic Review

First Author: Lia Amanda

Author Institution: Jakarta Medical Center Hospital, Jakarta, Indonesia

Co Author: Irma Suwandi Sadikin (Kebayoran Lama General Hospital, Jakarta, Indonesia)



Seminat: INOIIS


Introduction & ObjectiveThe use of platelet rich-plasma (PRP) derived eye drops for topical medication appeared to be as analternative therapy for several ocular surface conditions. Beneficial effects of PRP have also beendemonstrated for the treatment of dry eye disease (DED). This study aims to evaluate the effect ofplatelet-rich plasma for the treatment of dry eye disease.MethodA systematic search of the literature was performed in different online databases (Pubmed, theCochrane Library, and Google Scholar) for relevant articles published up to May 2021. The efficacywas assessed based on the ocular surface disease index (OSDI) or improvement of subjectivesymptoms, visual acuity lines, tear break up time (TBUT), Schirmer test, and fluorescein staining ofthe ocular surface.ResultEleven studies involving 624 patients were included in this systematic review. The age of patientsranged from 18 to 89 years old. All studies reported improvement in patients with dry eyesymptoms (80%-93.3%). Seven studies showed improvement at least one line of visual acuity(28%-71.4%). An improvement was also observed in TBUT (46%-86.6%) and Schimer test(40%-66.6%). A reduction in fluorescein staining was also reported (76.1%-89.6%).ConclusionThe topical use of PRP in patients with significant dry eye symptoms has been shown to be safe andeffective treatment in improving the clinical signs and the symptoms of the patients with DED.However, more clinical trials are needed to improve clinical outcomes.Keywordplatelet rich-plasma, dry eye disease, ocular surface diseaseLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download222-EPOS-G-INOIIS-27-Lia-Amanda.jpg

28 E-POSTER

EPOS-R-INOIIS-28Human Ocular Thelaziasis: A Rare Case Report from South Sulawesi, Indonesia

Abstract TitleHuman Ocular Thelaziasis: A Rare Case Report from South Sulawesi, Indonesia

First Author: Liem Meysie Kristi Harlimtom

Author Institution: Department of Ophthalmology, Faculty of Medicine, Hasanuddin University

Co Author:

Andi Muhammad Ichsan (Department of Ophthalmology, Faculty of Medicine, Hasanuddin

University)

Alif Reza (Department of Ophthalmology, Faculty of Medicine, Hasanuddin University)

Junaedi Sirajuddin (Department of Ophthalmology, Faculty of Medicine, Hasanuddin University)

Hasnah B. Eka (Department of Ophthalmology, Faculty of Medicine, Hasanuddin University)

Sitti Wahyuni (Department of Parasitology, Faculty of Medicine, Hasanuddin University)



Seminat: INOIIS


IntroductionThelaziasis is a parasitosis caused by a nematode of genus Thelazia which is uncommon inIndonesia. Definitive hosts for Thelazia include canids, felids, mustelids and other mammals and itsvectors are drosophilid flies. Here, we report a rare case of human ocular thelaziasis in Indonesia.Case IllustrationA 49-year-old man presented in eye clinic with blurred vision, redness and sensation of itch. Visualacuity (VA) in the right eye was 20/20 and 1/60 in the left eye, whilst intraocular pressure wasnormal. Anterior segment examination showed conjunctival hyperaemic, corneal oedema, a movingworm in the anterior chamber and mild opacification of the lens. Removal procedure andidentification of the worm were immediately performed to determine the appropriate antihelminthic therapy. Parasitological examination was conducted and the worm was identified asThelazia callipaeda.DiscussionThis is the first ocular thelaziasis where the worm resides in the anterior chamber in Indonesia. Thepatient’s living environment coincided with the habitat of the causative parasites. The parasite wasidentified as Thelazia callipaeda based on the morphology of the worm. Extraction of the worm isthe definitive treatment, and using levamisole as anti-helminthic therapy has been reported forsimilar infection.ConclusionA rare occurrence of ocular thelaziasis by Thelazia callipaeda in the anterior chamber was found inSouth Sulawesi, Indonesia. This case report also shows the importance of parasitologyidentification to determine the species of the worm and appropriate treatments for the patient.KeywordThelaziasis, callipaeda, IndonesiaLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download751-poster-thelaziasis-fix.pdf

29E-POSTER

EPOS-R-INOIIS-29EPITHELIAL DEFECT IMPROVEMENT IN DIABETES MELLITUS-ASSOCIATEDNEUROTROPHIC KERATOPATHY

Abstract TitleEPITHELIAL DEFECT IMPROVEMENT IN DIABETES MELLITUS-ASSOCIATED NEUROTROPHIC KERATOPATHY

First Author: Raisha Pratiwi Indrawati

Author Institution: Department of Ophthalmology, Faculty of Medicine, Padjadjaran University, Bandung,

Indonesia

Co Author:

Angga Fajriansyah (National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Susi Heryati (National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Arief Akhdestira Mustaram (National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Patriotika Muslima (National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Elfa Ali Idrus (National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)



Seminat: INOIIS

Competition Category: ResidentIntroductionNeurotrophic keratopathy (NK) is one of the important early findings of diabetic neuropathymanifested in the eye. Diabetes mellitus contributed as the 4th cause of bilateral NK. The aim ofthis study is to report the diagnosis and management of bilateral NK in patient with DM.Case IllustrationA 40-year-old male came to Cicendo Eye Hospital, with chief complaint of blurred vision in botheyes for 10 months, accompanied by redness and dryness. Patient has poorly controlled DM for 5years, with high level of blood glucose and HbA1C. Ophthalmological examination showed epithelialdefect and reduced sensibility in both eyes. Patient was diagnosed with stage 2 bilateral NK whichassociated with DM, and treated with lubricants, autologous serum and topical antibiotic, andreferred to internist for systemic regulation. Despite the stagnancy of visual acuity and cornealsensibility, the defect was improved within 3 weeks of treatment.DiscussionNeurotrophic keratopathy is a condition caused by ophthalmic nerve damage, causing cornealhypoesthesia. Persistent epithelial defect is one of the manifestation, that could lead into blindness.Careful examination of cornea and ocular surface is needed in order to correctly confirm thediagnosis and treat diabetic-associated NK. In this stage of NK, autologous serum and lubricantscould be given to treat the condition.ConclusionNeurotrophic keratopathy, especially the bilateral one, needs to be considered in diabetic patientspresenting with epithelial defect. Early diagnosis and prompt treatment, both locally andsystematically, are keys for better structural and visual prognosis of NK.Keywordneurotrophic keratopathy, bilateral keratopathyLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download900-EPOS-R-INOIIS-29-Raisha-Pratiwi-Indrawati.jpg

30 E-POSTER

EPOS-R-INOIIS-30CORNEAL PATCH GRAFT IN PERFORATED CORNEAL ULCER CAUSED BYMETHYCILLIN RESISTANT Staphylococcus haemolyticus (MRSH)

Abstract TitleCORNEAL PATCH GRAFT IN PERFORATED CORNEAL ULCER CAUSED BY METHYCILLINRESISTANT Staphylococcus haemolyticus (MRSH)

First Author: Mia Nursalamah

Author Institution: Department of Ophthalmology, Faculty of Medicine, Padjadjaran University, Bandung

Co Author:

Angga Fajriansyah (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Susi Heryati (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Arief Akhdestira Mustaram (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung,

Indonesia)

Patriotika Muslima (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Elfa Ali Idrus (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)



Seminat: INOIIS


IntroductionBacterial corneal ulcers are common potential causes of vision loss. The clinical appearance was anunreliable factor in determining the pathogen. Special caution must be paid when it caused by amultidrug-resistant bacteria. This case report shows a corneal patch graft as management ofperforated corneal ulcer caused by a methycillin-resistant Staphylococcus haemolyticus (MRSH).Case IllustrationA 78 years old male complained of red and painful eye accompanying whitish plaque in the centerpart of the right eye (RE) since 1 month earlier. The RE got splash of soil water and frequentlyrubbed. He had been treated by prior ophthalmologist but not improving. The visual acuity of REwas light perception and there was a corneal ulcer, a shallow anterior chamber with a 1,3mmhypopion. He was diagnosed as perforated corneal ulcer with hypopion caused by gram positivecoccus, coccobacillae bacteria and gram negative coccus based on corneal scraping and gramstaining Result. He underwent corneal patch graft and culture resistance test revealed MRSH and amultidrug-resistant bacteria. The visual outcome in 3 weeks follow up revealed 1/60.DiscussionBacterial corneal ulcer may be caused by rare organism such as MRSH. Complication can beprevented if culture resistance was done earlier and treated properly. The perforated corneal ulcershould be treated by corneal patch graft.ConclusionAppropriate topical antibiotic and other adjuvants are the mainstay therapy for bacterial cornealulcer. Corneal patch graft reveals a good outcome to manage corneal perforation due to bacterialinfection.Keywordcorneal ulcer, antimicrobial resistant, corneal patch graftLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download553-EPOS-R-INOIIS-30-Mia-Nursalamah-.jpg

31E-POSTER

EPOS-R-INOIIS-32THE PECULIAR PHYSICAL AND HISTOPATHOLOGY FINDINGS OF CORNEALOPACITY TO ESTABLISH SALZMANN NODULAR DEGENERATION

Abstract TitleTHE PECULIAR PHYSICAL AND HISTOPATHOLOGY FINDINGS OF CORNEAL OPACITY TOESTABLISH SALZMANN NODULAR DEGENERATION

First Author: Intan


Indonesia

Co Author:



Arief A Mustaram (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)





Seminat: INOIIS


IntroductionComparative diagnoses of corneal opacity was numerous. By excluding the etiology of infection,,corneal calcification can be considered, such as Salzmann nodular degeneration(SND). The purposeis to show the clinicohistopathology findings in SND.Case IllustrationA-59-year old male came with complain sharp pain, excessive lacrimation, and couldn’t open botheyes. He was treated with prolonged antibiotics, anti-fungal, and treatment of herpes simplex keratitis; but there was no improvement. The RE visual acuity was 0.2 and 0.1 for LE. The examination showed some whitish gray corneal nodules that increased pericentral. He underwent keratectomy and amniotic membrane transplantation. A-month after surgery, he could open both eyes and less eye tear secretion. The Results of pathology evaluation relvealed peripheral keratopathy with increasing in epithelial cells. It was also increased collagen and fibroblast tissue in the stromal layer with a characteristic whorl-like pattern. Six-month later, the RE distance vision was 0.4 and 0.3 for LE.DiscussionSND is a rare case and often overlooked case. The diagnosis of SND may be considered if there israised opacity pericentrally occur over a long period of time and bilaterally after exclude etiology ofinfection. The diagnosis can be confirmed with a histopatologic finding of stromal proliferationwhat squeezes the subepithelial so that it looks thinner. In some cases, there may be a densercalcification with an whorl-like pattern histopatology findings.ConclusionAfter considering the diagnosis of SND from examination, keratectomy and histopathologicalexamination can be performed to confirm the diagnosis.KeywordSalzmann nodular degeneration, cornea, keratectomyLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download321-E-poster-Salzmann.jpg

32 E-POSTER

EPOS-G-INOIIS-33A Case Report and Literature Review of Bilateral Infectious Keratitis afterLaser in Situ Keratomileusis (LASIK)

Abstract TitleA Case Report and Literature Review of Bilateral Infectious Keratitis after Laser in SituKeratomileusis (LASIK)

First Author: Amelia Rahmah Kartika

Author Institution: General Practitioner, Observer Program Undaan Eye Hospital, Surabaya, Indonesia

Co Author:

Septian Dwi Prabowo (General Practitioner, Observer Program Undaan Eye Hospital, Surabaya,

Indonesia)

Camilla Amanda Prakoeswa (General Practitioner, Observer Program Undaan Eye Hospital,

Surabaya, Indonesia)

Dini Dharmawidiarini (Cataract and Refractive Surgery Division Undaan Eye Hospital, Surabaya,

Indonesia)



Seminat: INOIIS


IntroductionLaser in situ keratomileusis (LASIK) is one of the most common ocular surgery nowadays. One ofthe complications is infectious keratitis. This is an extremely rare complication (0.02% to 1%). Inthis case we report bilateral infectious keratitis after LASIK and to explore appropriate preventive,diagnostic, and treatment.Case IllustrationA 18-year-old man was submitted to LASIK in both eyes for myopic astigmatism. The day aftersurgery, clinical examination showed bilateral corneal infiltrates. Corneal scrapings from the edgeof the infiltrate were taken for microscopic examination and inoculation on culture media.DiscussionCulture does not reveal a growth of pathogens. This can be caused by due to the small number ofspecimen or sterile infiltrate. We treated patient with irrigation of flap and stromal bed with 50 mg/mL vancomycin and 50 mg/mL cefazolin. We also give levofloxacin 0.5% every hour. It is recommended to begin systemic treatment with doxycycline, 100 mg twice a day, to inhibit the production of collagenase. This case can be distinguished from diffuse lamellar keratitis because more inflamed and does not respond to steroid therapy. Other clinical manifestations in infection are the presence of sterile peripheral infiltrate and impurities in the interface. Improvement in corneal transparency were obtained 1-month after therapy. Visual acuity improved from 1/300 on both eyes to 7/10 on right eye and 6/10 on left eye at 1-month follow-up.ConclusionWhen keratitis develops, the right approach will help resolve this condition quickly. Increasedawareness, early diagnosis and appropriate treatment can help prevent corneal damage andpreserve vision.KeywordKeratitis, Infectious, LASIKLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download121-EPOS-G-INOIIS-33-AMELIA-RAHMAH-KARTIKA.jpg

33E-POSTER

EPOS-R-INOIIS-35LARGE GRAFT TECTONIC PENETRATING KERATOPLASTY IN A CASE OFAGGRESSIVE MOOREN’S ULCER

Abstract TitleLARGE GRAFT TECTONIC PENETRATING KERATOPLASTY IN A CASE OF AGGRESSIVEMOOREN’S ULCER

First Author: Sri Hudaya WidihasthaAuthor Institution: Department of Ophthalmology,National Eye Center Cicendo Eye Hospital/Universitas

Padjadjaran, Bandung

Co Author:

Susi Heryati (Infection and Immunology Unit, National Eye Center Cicendo Eye Hospital, Bandung)

Angga Fajriansyah (Infection and Immunology Unit, National Eye Center Cicendo Eye Hospital, Bandung)

Arief A. Mustaram (Infection and Immunology Unit, National Eye Center Cicendo Eye Hospital, Bandung)

Patriotika Muslima (Infection and Immunology Unit, National Eye Center Cicendo Eye Hospital, Bandung)

Elfa Ali Idrus (Infection and Immunology Unit, National Eye Center Cicendo Eye Hospital, Bandung)



Seminat: INOIIS


IntroductionMooren’s ulcer is a rare autoimmune disease characterized by progressive stromal ulceration thatbegins peripherally which comprehends immunosuppressive and tectonic surgical management asits treatment. This case report describes surgical management of penetrating keratoplasty in patientwith aggresive Mooren’s ulcer.Case IllustrationA 38-year-old male presented with a chief complaint of pain in his left eye for 2 months and gettingworse one week before. He also complained photophobia on his left eye. He had history of sawdustgot into his left eye 2 months ago. Ophthalmologic examination revealed visual acuity on the righteye was 1.0 and the left eye was 1/300. Anterior chamber examination for the left eye wasblepharospasm, ciliary injection, and peripheral corneal ulcer almost 360 degree with more thanone-half of the cornea thickness. The fluorescein test on the left eye was positive with overhangingedge at its central border with no scleral abnormality. The patient was diagnosed with Mooren’sulcers on his left eye. Tectonic penetrating keratoplasty with conjunctival resection was performed.DiscussionOperative treatment is required in dealing with Mooren ulcer with perforation. In this patient, apenetrating keratoplasty was performed due to extensive ulcer and impending perforation. There isa possibility of graft rejecting in the patient. Routine control and regular use of immunomodulatordrugs are important to avoid disease recurrences.ConclusionLarge graft tectonic penetrating keratoplasty can be performed in Mooren’s ulcer, considering theperforation and the size of the ulcer.KeywordMooren ulcer, tectonic penetrating keratoplasty, large graftLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download865-Large-Graft-Tectonic-Penetrating-Keratoplasty-in-A-Case-of-Aggressive-Type-Mooren-Ulcer-3.jpg

34 E-POSTER

EPOS-R-INOIIS-36MANAGEMENT OF OPEN GLOBE INJURY WITH TRAUMATIC PHACOCELECAUSED BY BLUNT TRAUMA

Abstract TitleMANAGEMENT OF OPEN GLOBE INJURY WITH TRAUMATIC PHACOCELE CAUSED BYBLUNT TRAUMA

First Author: Nasika Celia Dendy


Indonesia

Co Author:



Arief Akhdestira Mustaram (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)





Seminat: INOIIS


IntroductionA ruptured globe is classified as an open globe injury caused by blunt trauma and can Result inindirect scleral rupture. Dislocation of the crystalline lens in the subconjunctival space because ablunt trauma, is a rare case and which is termed as traumatic phacoceleCase IllustrationA-56-year old female came with a chief complain of a lump in the upper left eye since 2 weeks ago.She was hitten by grandson’s head. The left eye vision was rapidly decreasing. No previous traumaand surgery history. From the examination, patient was diagnosed with traumatic phacocele causedby blunt trauma. The surgical step includes exploration and lens mass extraction with primarysutureing of the sclera and conjunctiva. The lens was successfully removed in toto. Patient isplanned for a secondary intraocular implantation after the anterior segment inflammation reducedDiscussionThe impact of blunt trauma Results in a countercoup mechanism, occurring a sudden increase inintraocular pressure Resulting in scleral rupture with dislocation of the crystal lens. The treatmentis a surgical intervention lens extraction with or without intraocular lens implantation.ConclusionOpen globe injury with traumatic phacocele caused by blunt trauma requires good clinicaljudgment also timely medical and surgical intervention in order to achieve a good visual Result.KeywordScleral rupture, Traumatic phacocele, Blunt trauma.Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download291-EPOS-R-INOIIS-36-Nasika-Celia.jpeg

35E-POSTER

EPOS-R-INOIIS-37OUTCOME OF CONCURRENT INTRACAMERAL FLUCONAZOLE INJECTIONWITH AMNIOTIC MEMBRANE TRANSPLANTATION FOR FUNGAL CORNEALULCERS CASES

Abstract TitleOUTCOME OF CONCURRENT INTRACAMERAL FLUCONAZOLE INJECTION WITHAMNIOTIC MEMBRANE TRANSPLANTATION FOR FUNGAL CORNEAL ULCERS CASES

First Author: Ferry Indratno

Author Institution: Andalas University

Co Author:

Havriza Vitresia (Andalas University)

Getry Sukmawati (Andalas University)

Abstract Type: Case ReportAbstract Category: E-Poster

Seminat: INOIIS


IntroductionFungal infections are often difficult to eradicate and require a long treatment. Antifungal can havelower efficacy because of low tissue penetration and indolent nature of infection.Case IllustrationReported four patients with fungal moderate to severe corneal ulcer. All patients were firstlytreated with medications. After no reported progression, all patients were then given intracameralfluconazole injection followed by Amniotic Membrane Transplantation (AMT). Intracameralinjection of fluconazole was administered at a dose of 25 mcg in 0.1 ml, and the AMT wasperformed with multilayered amniotic membranes to fill and cover the defect. A bandage contactlens was placed to protect and keep the AM in place and for comfort. Then, patients were observedfor signs of inflammatory reaction, reduction of hypopyon, and epithelialization.DiscussionConcurrent intracameral Fluconazole injection followed by AMT can be a treatment’s choice incases of refracted fungal corneal ulcer. All patients show clinical improvements of reducedinflammation and hypopyon within 2-4 days post-operation and also epithelialization. MLAMT givesanti-inflammatory and anti-scarring effects and contains growth factors that promote epithelialwound healing on the surface of the eye.ConclusionIntracameral injection of fluconazole followed by AMT can be considered as a treatment forrefracted fungal corneal ulcer as it decreases the rate of inflammation and can be given in adequateconcentration to the anterior chamber.KeywordIntracameral Fluconazole Injection, Amniotic Membranes TransplantationLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download127-EPOS-R-INOIIS-37-Ferry-Indratno.jpg

36 E-POSTER

EPOS-R-INOIIS-38MANAGEMENT OF ACUTE ALKALI CHEMICAL INJURY WITH DEBRIDEMENTAND AMNION MEMBRANE GRAFT; A CASE REPORT

Abstract TitleMANAGEMENT OF ACUTE ALKALI CHEMICAL INJURY WITH DEBRIDEMENT ANDAMNION MEMBRANE GRAFT; A CASE REPORT

First Author: Nadya Beatrix Yohanna Napitupulu

Author Institution: Departement of Ophthalmology, Faculty of Medicine, University of Padjadjaran

Co Author:

Susi Heryati (Indonesia National Eye, Center Cicendo Eye Hospital, Bandung Indonesia)

Angga Fajriansyah (Indonesia National Eye, Center Cicendo Eye Hospital, Bandung Indonesia)

Arief A. Mustaram (Indonesia National Eye, Center Cicendo Eye Hospital, Bandung Indonesia)

Patriotika Muslima (Indonesia National Eye, Center Cicendo Eye Hospital, Bandung Indonesia)

Elfa Ali Idrus (Indonesia National Eye, Center Cicendo Eye Hospital, Bandung Indonesia)



Seminat: INOIIS


IntroductionChemical injury is an ocular emergency leads to surface and anterior segment damage requiresimmediate evaluation and treatment to ensure the best possible outcome for this potentiallyblinding condition.Case IllustrationA 39-year old male presented with pain in left eye and blurry vision after splashed by car shampoo5 days before. Patient was referred by Ophthalmologist after given eye drop medication. Limbalischemia, epithelial defect and conjunctivalisation was found with visual acuity 0.1 and normalintraocular pressure. The patient was diagnosed Alkali Chemical Injury Roper Hall grade III,Suspected Limbal Ischemia and underwent debridement and Amnion Membrane Graft (AMG).DiscussionAMG is effective in promoting re-epithelialization, reducing inflammation, and preventing scarringsequelae. At early stage, AMG would promote ocular surface healing by preventing leucocyticinfiltration, decreasing inflammation severity and duration, and protecting the proliferatingepithelial stem cell. Follow up shows no pain, better visual acuity, intact graft, and no othercomplications.ConclusionAdvances in understanding of the pathophysiology of the injury have led to improvement intreatment as well as surgical treatment. The goal of treatment is restoration of the normal ocularsurface anatomy and lid position and restoration of corneal clarity.KeywordChemical injury, Amnion Membrane GraftLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download945-EPOS-R-INOIIS-38--Nadya-Beatrix-Yohanna-Napitupulu.jpg

37E-POSTER

EPOS-R-INOIIS-39Raising awareness of Demodex folliculorum blepharitis

Abstract TitleRaising awareness of Demodex folliculorum blepharitis

First Author: Muhammad Akbar Wicaksana

Author Institution: Department of Ophthalmology, Faculty of Medicine, Padjajaran University, Bandung

Co Author:

Elfa Ali Idrus (Department of Ophthalmology, Faculty of Medicine, Padjajaran University, Bandung.

Infection and Immunology Unit, Indonesia National Eye Centre, Cicendo Eye Hospital Bandung)

Angga Fajriansyah (Infection and Immunology Unit, Indonesia National Eye Centre, Cicendo Eye

Hospital Bandung)

Arief Akhdestira Mustaram (Infection and Immunology Unit, Indonesia National Eye Centre,

Cicendo Eye Hospital Bandung)

Patriotika Muslima (Infection and Immunology Unit, Indonesia National Eye Centre, Cicendo Eye

Hospital Bandung)



Seminat: INOIIS


IntroductionApproximately 37% Ophthalmologist visit diagnosed by Blepharitis. Early diagnosis remainschallenging because of the lack of awareness and it’s relatively mimics other aetiology.Case IllustrationA 56-year-old female presented in Infection and Immunology Unit, Cicendo Eye Hospital Bandungwith chief complaint of right-sided redness and itching. Patient have history of chemical injury 4years prior to presentation. She reported that she rarely cleans the right eye as she worried torubbing the eye. Ocular examination showed sleeve-cylindrical dandruff. Patient diagnosed withDemodex blepharitis. She was directed to clean the eyelids with eyelid cleanser contains Babassuoil 5%, and artificial tear drop. Treatment continued for 3 weeks to prevent recurrence.DiscussionThis issue makes it important to spotlight and increase capacity to make diagnosis of Demodexblepharitis. Starting the treatment promptly based on symptoms and clinical findings with orwithout laboratory tests.ConclusionCylindrical dandruff seen at the base of eye lashes is considered pathognomonic sign of Demodex.It is crucial for clinician to consider Demodex blepharitis diagnosis with other blepharitis patientswho are non-responsive to standard therapy.KeywordDemodex, blepharitis, eyelashLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download315-E-Poster-PVSM-2021-M-Akbar-Wicaksana.jpg

38 E-POSTER

EPOS-R-INOIIS-40SUTURELESS AMNION GRAFT FOR PERSISTENT EPITHELIAL DEFECT POSTPENETRATING KERATOPLASTY

Abstract TitleSUTURELESS AMNION GRAFT FOR PERSISTENT EPITHELIAL DEFECT POSTPENETRATING KERATOPLASTY

First Author: Amicipta Sanjaya

Author Institution: Udayana University / Sanglah General Hospital, Bali

Co Author:

Cokorda Istri Winny Prabasari (Udayana University / Sanglah General Hospital, Bali)

Siska (Udayana University / Sanglah General Hospital, Bali)

Ida Ayu Ary Pramita (Udayana University / Sanglah General Hospital, Bali)

I Gusti Ayu Made Juliari (Udayana University / Sanglah General Hospital, Bali)



Seminat: INOIIS


IntroductionPersistent corneal epithelial defects (PED) following penetrating keratoplasty (PK) occurs due tofailure of promoting normal corneal re-epithelialization, which may threaten vision, graft survivaland even the eye. PED is defined as epithelial loss resistant to medical therapy within 14 days,where amniotic membrane (AM) graft is considered as alternative therapeutic option.Case IllustrationA 28 years old male came for regular evaluation of PED on left eye (LE) following PK 3 monthsprior. He had history of traumatic corneal ulcer, periosteal graft, and initial PK Resulted in graftfailure. AM were initiated with the purpose of providing support to the ocular surface and aid in thehealing process of PED. The course of treatment in this case includes overlaying sutureless AM andsecure it with bandage contact lens. One week evaluation showed an improvement in the PED.DiscussionAs a replacement for the lost tissue, AM has it ability to integrate into the corneal stroma byforming hemidesmosomes and desmosomes, which provide stability and improve the structuralquality of the tissue. The epithelial side was placed up, while the basement membrane act as asubstrate for epithelial regeneration.ConclusionAM graft can prevent epithelial non-healing and inflammation which become beneficial alternativein case of PED post PK.KeywordPersistent epithelial defect, amnion membrane, penetrating keratoplastyLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download829-EPOS-R-INOIIS-40-AMICIPTA-SANJAYA.jpg

39E-POSTER

EPOS-R-INOIIS-41Azathioprine as Controlling Visual Acuity in Pediatric Behcet’s Disease: aCase Report

Abstract TitleAzathioprine as Controlling Visual Acuity in Pediatric Behcet’s Disease: a Case Report

First Author: Nurul Rezqi Amaliah

Author Institution: Department of Ophthalmology, Faculty of Medicine, Hasanuddin University, Makassar,

Indonesia

Co Author:

Sitti Soraya Taufik (Department of Ophthalmology, Faculty of Medicine, Hasanuddin University,

Makassar, Indonesia)

Hasnah B Eka (Department of Ophthalmology, Faculty of Medicine, Hasanuddin University,

Makassar, Indonesia)



Seminat: INOIIS


IntroductionBehçet’s disease (BD) is a chronic relapsing inflammatory disorder of unknown etiology whichpresents ocular manifestation. Immunosuppressors, including azathioprine, along with corticosteroidsare considered. The aim of the study is to report significant improvement in visual acuity in a patientwith retinal vasculitis due to Bechet’s Disease treated with azathioprine.Case IllustrationA 14-year-old boy presented with blurred vision in both eyes for a year. Visual acuity was 1/60 and½/60 on the right and left eye, respectively. There was a history of sprue in his mouth every twomonths and pain on his legs’ joint for one year. Funduscopy examination indicated retinal vasculitis inboth eyes. He was treated with 1 mg per bodyweight Methylprednisolone daily for a week.Azathioprine was applied after three weeks combined with Methylprednisolone and retinal vasculitiswas reduced. Methylprednisolone was stopped in 3 months, whereas azathioprine was continued.Four months post-treatment, The Best Corrected Visual Acuity (BCVA) improved to 20/40 in both eyes.DiscussionDiagnosis and treatment of BD have underwent new changes in recent years. The goal of the therapyis to accelerate healing process and prevent sequelae, also maintain remission to prevent new lesions.Visual prognosis in BD has improved with the increasing use of immunosuppressive agents such asAzathioprine, as seen in this case.ConclusionAzathioprine should be considered as a therapy of choice for treating Behçet’s disease with ocularinvolvement as it has shown promising effects in improving visual acuity in patients with this disease.KeywordAzathioprine, Behcet’s Disease, Visual AcuityLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download490-INOIIS-Azathioprine-as-Controlling-Visual-Acuity-in-Pediatric-Behcet’s-Disease--a-Case-Report.pdf

40 E-POSTER

EPOS-G-INOIIS-42The Role of Autologous Serum in Moderate to Severe Dry Eye Disease: ASystematic Review

Abstract TitleThe Role of Autologous Serum in Moderate to Severe Dry Eye Disease: A Systematic Review

First Author: Amani Sakinah Augiani

Author Institution: Research Assistant, Ophthalmology Department, Cipto Mangunkusumo Hospital Jakarta

Co Author:

Lazuardiah Anandi (Research Assistant, Ophthalmology Department, Cipto Mangunkusumo

Hospital Jakarta)

Dearaini (Research Assistant, Ophthalmology Department, Cipto Mangunkusumo Hospital Jakarta)

Anya Dewi Nastiti (Research Assistant, Ophthalmology Department, Cipto Mangunkusumo Hospital Jakarta)

Rianti Wulandari Pratiwi (Research Assistant, Ophthalmology Department, Cipto Mangunkusumo

Hospital Jakarta)



Seminat: INOIIS


Introduction & ObjectiveDry eye disease (DED) is a multifactorial tear-film disease, potentially leads to ocular surfacedamage. Although most patients are well-responded to conventional treatment, symptoms maypersist or worsen for some. Autologous serum (AS) is a novel approach of haemoderivative productused to treat ocular surface diseases. Superior to artificial tears, AS contains additionalcomponents and promotes endothelial homeostasis, growth, and migration. Although some studiesproved its efficacy, others established its insignificant superiority. This study aims to understandthe efficacy of AS in treating DED.MethodWe conducted a systematic literature review through three databases (PubMed, Cochrane Library,and Google Scholar). All English, full-text studies of moderate to severe DED patients treated withAS published between 2017 and 2021 were included. We compared both subjective (OSDI, DEQ-5questionnaire) and objective (Schirmer Test and Tear Break-up Time) outcomes before and afterthe intervention.ResultFour studies with a total of 472 participants met our criteria. The patient’s age ranged from 25 to63 years old and dominantly female (77,75%). Few patients were diagnosed with severe DED(15,67%), while the rest 84,32% with moderate-to-severe DED. All AS preparations were obtainedfrom peripheral blood vessels then centrifuged, Resulting in rich platelet plasma. Treatmentduration varied between 2 weeks to 6 months. All studies reported improvement in both subjectiveand objective symptoms with no recorded side effects.ConclusionAS was found effective and safe for the treatment of moderate to severe DED.KeywordDry Eye Disease, Autologous SerumLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download994-EPOS-G-INOIIS-42-Amani-Augiani.jpg

41E-POSTER

EPOS-R-INOIIS-43Tissue Adhesive Glue as a Successful Management of Corneal Perforation

Abstract TitleTissue Adhesive Glue as a Successful Management of Corneal Perforation

First Author: Drasthya ZarishaAuthor Institution: Opthalmology Department, Faculty of Medicine Padjadjaran UniversityCo Author:Angga Fajriansyah (PMN RS Mata Cicendo )Arief A Mustaram ()Patriotika Muslima ()Elfa Ali Idrus ()Abstract Type: Case ReportAbstract Category: E-PosterSeminat: INOIISCompetition Category: ResidentIntroductionCorneal perforation is known as one of ophthalmological emergency that needed to be treatedpromptly. There are many options, both medically and surgically, to manage corneal perforation.One of the intervention options was to apply tissue adhesive glue (TAG) onto the perforations sinceit reduced the need for urgent surgery. The functions of this glue application were to restore theglobe integrity, retard entry of inflammatory cell and decrease the rate of cornea melting. Theobjective of this case report is to describe how TAG can be used as one of the alternativemanagement for small (≤ 3mm) corneal perforation.Case IllustrationTwo consecutive cases of a 42 and a 23 years old women presented in Infection and ImmunologyUnit, Cicendo Eye Hospital diagnosed with Impending Corneal Perforation and Corneal Perforation,respectively. Both of the patients were treated using TAG. The procedure was performed inoutpatient clinic with the patient sitting in the slit lamp, using topical anesthetic and withoutplacement of speculum. A cotton tip applicator was used to dry corneal surface and TAG was gentlyapplied. TAG will polymerize, expand and harden. Afterwards, we checked for any leakage then weput a Bandage Contact Lens.DiscussionTAG can be used in small perforation cases, it reproduced a structural integrity of the corneathrough synthetic compound that rapidly polymerize upon contact with corneal surface.ConclusionTAG can be used as a feasible and practical alternative for the management of corneal perforation.Keywordcorneal perforation, cyanoacrylate glue, tissue adhesive glueLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download25-Poster-EED-PVSM-2021-Fix.jpg

42 E-POSTER

EPOS-R-INOIIS-44Clinical Features Of Severe Corneal Ulcers As Indication For Evisceration InDr.M.Djamil Hospital Padang In 2018-2020

Abstract TitleClinical Features Of Severe Corneal Ulcers As Indication For Evisceration In Dr.M.DjamilHospital Padang In 2018-2020

First Author: Diki Apriwan

Author Institution: Andalas University / Dr.M.Djamil Hospital Padang

Co Author”

Havriza Vitresia (Andalas University / Dr.M.Djamil Hospital Padang)

Getry Sukmawati (Andalas University / Dr.M.Djamil Hospital Padang)



Seminat: INOIIS


Introduction & ObjectiveCorneal Ulcer is an open soreness on the cornea. It’s a serious ocular infection disease that canlead to significant loss of vision or eye, especially in very severe condition. To describe the clinicalfeatures of severe corneal ulcers that underwent evisceration in Dr. M. Djamil Hospital Padang inJanuary 1st, 2018-December 31st, 2020, including ulcer grading (perforated/ impending), history ofoccupation, and etiology of corneal ulcers which underwent evisceration.MethodA retrospective study based on medical record of 22 of severe corneal ulcer cases which requiredevisceration. Data reviewed includes age sex, associate factors, clinical presentation, treatment,visual acuity duration of treatment and indications for evisceration.ResultThere were 22 patients with severe corneal ulcers who underwent evisceration in 2018-2020 in ourhospital. Most are aged above 50 yo (72.7%), equal for both sexes. Most of the patients work as afarmer. All cases are infectious ocular cases, with large perforation in 81,8% of cases. Patients thatunderwent evisceration due to failure of medical therapy are 19 patients (86.36%), with failedAmniotic Membrane Transplant (AMT) in 3 patients (13.63%), absolute glaucoma (4.5%) andendophthalmitis (4.5%).ConclusionManagement for severe cornel ulcer is medicamentosa. However, in worsening cases such as inmedicamentosa failure, widespread infection, endophthalmitis or glaucoma, evisceration needs to be done.Keywordevisceration, severe corneal ulcerLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download958-EPOS-R-INOIIS-44-.pdf

43E-POSTER

EPOS-R-INOIIS-45Improvement of Neurotrophic Keratitis in Diabetic Male with Reactive IgG –IgM to HSV-1

Abstract TitleImprovement of Neurotrophic Keratitis in Diabetic Male with Reactive IgG – IgM to HSV-1

First Author: Ester Grace Sillya Aprinona Gurning

Author Institution: Ophthalmology Department, Faculty of Medicine, Padjadjaran University

Co Author:

Angga Fajriansyah (Infection and Immunology Unit, National Eye Center Cicendo Eye Hospital)

Susi Heryati (Infection and Immunology Unit, National Eye Center Cicendo Eye Hospital)

Arief Akhdestira Mustaram (Infection and Immunology Unit, National Eye Center Cicendo Eye

Hospital)

Patriotika Muslima (Infection and Immunology Unit, National Eye Center Cicendo Eye Hospital)

Elfa Ali Idrus (Infection and Immunology Unit, National Eye Center Cicendo Eye Hospital)



Seminat: INOIIS


IntroductionNeurotrophic keratitis (NK) is a corneal degeneration, Resulting from impaired corneal innervation,which causes epithelium breakdown, healing disorder, and ulceration. Corneal perforation occurs ifleft untreated or inadequately treated. Treatment goals vary according to clinical stages andunderlying causes.Case IllustrationA 55 year-old male complained of painless blurred vision on right eye, glare, recurrent reddisheyes, without teary eyes, which had occured insidiously within the last 3 months. His BCVA was 0.1and 1.0 on right and left eyes, respectively. There were 5-mm paracentral smooth-edged cornealdefect, stromal edema, and reduced corneal sensitivity. He had been diabetic for ± 5 years androutinely treated with metformin. Reactive IgM and IgG to Herpes Simplex Virus (HSV-1) wasconfirmed by laboratory examination. He was diagnosed with stage 2 neurotrophic keratitis andtreated with preservative-free artificial tears, autologous serum, oral acyclovir, and topicalantibiotic. Corneal defect gradually reduced in size and BCVA increased within 2 months.DiscussionReduced corneal sensitivity, the hallmark of NK, will lead to decreased blinking and tearing asprotective mechanism. Patient may feel little to no pain and delay required treatment. This patienthad the clinical characteristics of stage 2 NK, based on Mackie classification. The goal in treatingstage 2 NK is to improve corneal healing and treat underlying causes to prevent perforation. It iscommonly caused by HSV-1 and may occur, rarely, in diabetic patient.ConclusionAcknowledging clinical characteristic is crucial in determining treatment goals and providingadequate treatment. Improvement in NK is achievable.Keywordneurotrophic keratitis, diabetes mellitus, HSV-1.Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download921-EPOS-R-INOIIS-45.jpg

44 E-POSTER

EPOS-G-INOIIS-46Toxic Anterior Segmen Syndrome Post Phacoemulsification With UveitisAnterior

Abstract TitleToxic Anterior Segmen Syndrome Post Phacoemulsification With Uveitis Anterior

First Author: M Fadhil Syafridon

Author Institution: RS Khusus Mata M77

Co Author: Alfin Radhian (Amelia Rizar)



Seminat: INOIIS


IntroductionCataracts are one of the most common complications of many forms of uveitis. Phacoemulsificationwith simultaneous intraocular lens implantation is the standard Method of cataract surgery forpatients with uveitis. TASS is an acute sterile anterior chamber inflammation that develops 12 to 48hours after surgery.Case IllustrationA 48-year-old male had phacoemulsification in the left eye. The patient was diagnosed with matureOD cataract and Mature Cataract + Anterior OS Uveitis. We reported the left eye. VOD 1 / - andVOS 6/60, ODS cloudy lens, an irregular pupil with pupillary membrane + OS, Sinekia posterior OS.On the first post-operative day, edema was seen throughout the cornea and inflammatory reactionin the anterior chamber, fibrin and synechiae in the iris. IOP is 18 mm Hg. On the 7th postoperative day, edema throughout the cornea was less than on the 1st postoperative day.Inflammation of the anterior chamber has decreased. The pain has also decreased. The patient onlycomplained of black spots in his eyes and VOS 6/18DiscussionPhacoemulsification with IOL implantation improved vision in most patients with coexistingcataracts and uveitis. Formation of the posterior synechiae is associated with the thickening of theanterior capsule of the lens and the formation sue called pupillary membrane. TASS is a relativelyrare condition but may cause injury in a wide region of the anterior segmentConclusionThe prognosis of moderate TASS is good but it is exacerbated by the diagnosis of a patient withUveitis, appropriate progressive treatment of antibiotics and steroidsKeywordCataract, Phacoemulsification, TASS.Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download675-IMG_00001.pdf

45E-POSTER

EPOS-G-INOIIS-47TRAUMATIC CORNEAL ULCER

Abstract TitleTRAUMATIC CORNEAL ULCER

First Author: Fitria Adelita

Author Institution: Cibinong General Hospital

Co Author: Kemala Octariny (Cibinong General Hospital)


Abstract Category; E-Poster

Seminat: INOIIS


IntroductionCorneal ulcer is one of the major eye emergencies causing ocular morbidity. Corneal ulcers cancause progressive damage and complications for example, corneal scars, so this condition can leadto corneal blindness. We report a case of a patient with significant vision improvement afterappropriate treatment for corneal ulcer.Case IllustrationAn 18 years-old man presented with complaints of redness, pain, vision impairment for 4 days inthe right eye, and history of right eye trauma-exposed to fishing hooks. Ophthalmological Status ofthe right eye was obtained visual acuity measured 1/60, conjunctival injection, ciliary injection,hyperemia in the fornix conjunctiva and palpebral conjunctiva, subconjunctival hemorrhage, cloudycornea, ulcers in the cornea with gray infiltrates, hypopyon in the anterior chamber. The localtreatment of this patient is the administration of levofloxacin eye drops every hour in the right eye.Systemic therapy, for example, antibiotics including 1 g of cefotaxime for injection every 12 hours,non-steroidal anti-inflammatory 500 mg of mefenamic acid every 8 hours, 250 mg of glausetacontaining acetazolamide every 24 hours to reduce eye pressure.DiscussionComplaining of redness, pain, visual impairment, and history of right eye trauma indicatinginflammation of the right eye refraction device. In addition, ophthalmological examination showedsigns of eye inflammation, corneal ulcer with infiltrates and hypopyon which indicated traumarelated corneal ulcer. Antibiotic is the main treatment for bacterial corneal ulcer.ConclusionPrompt diagnosis and effective management of therapy can Result in significant improvement. Thissignificant improvement prevents progressive damage and permanent visual impairment or evenblindness.KeywordUlcer, cornea, traumaLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download356-EPOS-G-INOIIS-47-FITRIA-ADELITA.jpg

46 E-POSTER

EPOS-G-INOIIS-49LONG TERM ORAL ACYCLOVIR IN PREVENTING RECURRENCE OF HERPESSIMPLEX VIRUS KERATITIS: A META ANALYSIS

Abstract TitleLONG TERM ORAL ACYCLOVIR IN PREVENTING RECURRENCE OF HERPES SIMPLEXVIRUS KERATITIS: A META ANALYSIS

First Author: Regina Ivanovna

Author Institution: RS YPK Mandiri

Co Author :



Seminat: INOIIS


Introduction & ObjectiveHerpes simplex virus (HSV) keratitis possesses high recurrence rate and risk of visual loss.Acyclovir has been used as antiviral agent on HSV keratitis and has been suggested to be used asprophylaxis to prevent recurrence. The aim of this study was to assess the impact of long term oralacyclovir therapy versus no therapy in the recurrence of stromal herpetic keratitis.MethodEligibility criteria: 1) Immunocompetent patient with stromal keratitis; 2) Receive oral acyclovir300-800 mg/day for 6-12 months; 3) Followed up for at least 12 months after therapy; 4)Randomized clinical trial. Literature search were retrieved from PubMed, EMBASE, and CochraneMedical database. The following Keywords were used: (((((((herpetic eye disease) OR (herpessimplex keratitis)) OR (epithelial keratitis)) OR (stromal keratitis)) AND (oral antiviral therapy)) OR(acyclovir))) AND (recurrence prevention). RevMan 5.0 software was used to analyze the literaturesand perform statistical analysis.ResultThree randomized clinical trial were included. A number of 427 patients received oral acyclovir and411 patients received placebo. Pooled analysis were performed, the Results indicated lowerrecurrence rate on oral acyclovir therapy arm compared to placebo arm. The relative risk ofstromal keratitis recurrence was -0.08 [95% CI, -0.13,-0.14], with P0.0003 in fixed effect model.ConclusionThere was statistical difference between long term oral acyclovir therapy in recurrence of stromalkeratitis compared to placebo. Long term prophylactic use of oral acyclovir is beneficial inpreventing recurrence of stromal keratitis. More high-quality trial is needed, especially regardingpotency of acyclovir resistance in long term use.Keywordstromal keratitis, oral acyclovir, recurrenceLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download36-EPOS-G-INOIIS-49-Regina-Ivanovna.jpg

47E-POSTER

EPOS-G-INOIIS-50Combination Therapy for Management of Corneal Ulcer : A Case Report

Abstract TitleCombination Therapy for Management of Corneal Ulcer : A Case Report

First Author: Alifah Syarafina

Author Institution: General Practitioner, Matraman Regional General Hospital, Jakarta

Co Author:

Tengku Putri Junita (Ophthalmologist, Matraman Regional General Hospital, Jakarta)

Christine Yuliana (Ophthalmologist, Matraman Regional General Hospital, Jakarta)

Dhiny Lidinillah (General Practitioner, Simpangan Depok Hospital, Depok )

Irma Suwandi Sadikin (General Practitioner, Kebayoran Lama Regional General Hospital, Jakarta)



Seminat: INOIIS


IntroductionCorneal ulcer is a potentially sight-threatening disease. The purpose of this study was to report acase of corneal ulcer management in Matraman Regional General Hospital.Case IllustrationA 31-year-old man presented to outpatient clinic with pain and blurred vision in the left eye sincetwo weeks ago. Visual acuity at presentation was 1/300. Slit lamp examination showed palpebraledema, hyperemic conjunctiva, corneal ulcer of about 6x6 mm in diameter, ½ anterior stroma,feathery edges, endothelial plaque and infiltrates. Patient was treated with Natamycin eye dropsevery hour, Fluconazole eye drops every hour, Levofloxacin eye drops every hour, Timolol 0.5% eyedrops 2x/day, Atropine sulfat 1% eye drops 3x/day, Polygran eye ointment 1x/day at night,Itraconazole 200 mg 1x/day per oral, Natrium Diclofenac 50 mg 2x/day per oral, Vitamin C 3x/dayper oral. One month after treatment, the left eye showed improvement and there was increasingvisual acuity.DiscussionCorneal ulcer is a defect in the epithelium of cornea that involves the underlying stroma. Mostcorneal ulcers are caused by infections. In this study, the causative agent of corneal ulcer could notbe identified due to lack of diagnostic test facilities in the hospital. Antifungal therapy was givenbased on clinical manifestation of the patient’s eye. Fluconazole eye drops were added to thepatient because natamycin eye drops showed no improvement at the initial management.ConclusionIn this study, fluconazole can be used as an alternative therapy replacing natamycin. Corneal ulcerneeds immediate management because it may lead to visual impairment and even blindness.Keywordcorneal ulcer, management, visual impairmentLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download211-EPOS-G-INOIIS-50-Alifah-Syarafina.jpg

48 E-POSTER

EPOS-G-INOIIS-51Anterior Uveitis in patient with Ankylosing Sphondylitis

Abstract TitleAnterior Uveitis in patient with Ankylosing Sphondylitis

First Author: Yunanda Rizki Amalia Harahap

Author Institution: General Practitioner at Murni Teguh Hospital

Co Author: Dian Wikaningtyas (Department of Ophtalmology, Murni Teguh Hospital)



Seminat: INOIIS


IntroductionAnkylosing Spondylitis (AS) contributes 0.1% to 1.4% in the general population affecting patientsbelow the age 30-40. Anterior Uveitis (AU) is the most common ophthalmologic manifestation of AS.Since clinical features of AS associated with AU, awareness of the ophthalmologic manifestations isimportantCase IllustrationA 34 year-old man, presented with ocular hyperemia in his right eye, pain and lacrimation for thepast 14 days. The visual acuity was 6/60 OD 6/7.5 OS. Anterior segment examination of right eyeshowed keratic precipitates, flare, ciliary injection, iris had posterior synechiae 360˚. IOP wasnormal. USG examination in right eye showed no pathological findings. He reported spinalpain,morning stiffness and affecting his daily activity with limited ROM. There was no history ofautoimmune disease. Laboratory diagnostic tests revealed ESR was 99mm/hour, CRP was 131mg/L,leukocyte was 12.78x103/μl , Hb was 10.5 g/dL, thrombocyte was 752x103/μl. MRI showed bilateralsacroiliitis. Therefore, the diagnosis of AS was confirmed by a rheumatologist. He receivemethotrexate 2.5mg daily. His eye symptoms started to improve by the first week of local treatmentand by the second week, his uveitis was resolved.DiscussionAU is the most common extra-articular manifestation of AS. Uveitis can have serious consequences.AU of prolonged and uncontrollable course is a risk factor for the extension of inflammation to theposterior segment of the eye.ConclusionA proper examination, early diagnois, and treatment are important to prevent serious complicationby ophthalmologist and rheumatologist. Opthalmologist have an important role in consideringuveitis as ocular manifestation of rheumatic disease.KeywordAnkylosing Spondylitis, Anterior UveitisLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download325-EPOS-G-INOIIS-51-Yunanda-Rizki-Amalia-Harahap.jpg

49E-POSTER

EPOS-R-INOIIS-53Accelerated PACK-CXL and Platelet Rich Plasma as Adjuvant Therapies forCorneal Ulcer: A Case Report

Abstract TitleAccelerated PACK-CXL and Platelet Rich Plasma as Adjuvant Therapies for Corneal Ulcer:A Case Report

First Author: Stefani Melisa Karina

Author Institution: Universitas Gadjah Mada

Co Author

Reny Setyowati (Universitas Gadjah Mada)

Agung Nugroho (Universitas Gadjah Mada)

Suhardjo (Universitas Gadjah Mada)



Seminat: INOIIS


IntroductionCorneal ulcer which may lead to visual impairment is an ocular emergency. Photo ActivatedChromophore for Keratitis-Corneal Cross Linking (PACK-CXL) and Platelet Rich Plasma (PRP) areadjuvant therapies in the management of corneal ulcer.Case IllustrationThere were two cases of clinically diagnosed fungal severe corneal ulcer from exposure tovegetative matter. Both presented with chief complaint of blurred vision, pain in the affected eyeand had prior medications. Case 1: A 39 years old woman presented with VAS Score 3, cornealepithelial stromal defect measuring 3.5x3.5mm and 2mm hypopyon. After 5 days of inpatientmanagement, PACK-CXL was done and PRP was given one week later. By day 28, VAS Score is 0and hypopyon resolved and on day 49, we observed corneal leukoma and improvement in visualacuity. Case 2: A 52 years old woman presented with VAS Score 4, epithelial stroma defectmeasuring 3x4.5mm, and 0.5mm hypopyon. PACK-CXL was done immediately and managed as anoutpatient. On day 21, VAS Score was 0, PRP was given. After a week, corneal leukoma wasobserved and hypopyon resolved.DiscussionPACK-CXL and PRP used in conjunction with antimicrobial therapies may speed up healing. PACKCXL works by releasing reactive oxygen species that can directly damage pathogen walls and crosslinking corneal stroma making them more resistant to enzymatic degradation. PRP is rich in growthfactors that helps speed up reepithelization.ConclusionPACK-CXL and PRP may be useful in the treatment of corneal ulcers if used together withantimicrobial therapy.Keywordcorneal ulcer, PACK-CXL, PRPLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download800-EPOS-R-INOIIS-53-Stefani-Melisa-Karina.jpg

50 E-POSTER

EPOS-R-INOIIS-54ACCELERATED PACK-CXL IN CORNEAL ULCER

Abstract TitleACCELERATED PACK-CXL IN CORNEAL ULCER

First Author: Anak Agung Ayu Putri KhrisnawatiAuthor Institution: RSUP dr. SardjitoCo Author:Reny Setyowati (RSUP dr. Sardjito)Agung Nugroho (RSUP dr. Sardjito)Suhardjo (RSUP dr. Sardjito)Abstract Type: Case ReportAbstract Category: E-PosterSeminat: INOIISCompetition Category: Resident

IntroductionCorneal ulcer is an emergency condition. Although antibacterial or antifungal agent mighteliminate the infection, the defect takes a long time to heal. PACK-CXL is one of the emergingadjuvant treatments and said can hasten the healing due to its plenteous merits.Case IllustrationCase 1: A 53-years-old male with clinically bacterial infection corneal ulcer. VAS score was 5 andredness on right eye since 1 month ago. Palpebra was spasm, cornea edema, hypopyon 2 mm,anterior synechia and pin-point perforation in 7 o’clock with visual acuity HM 1/300 G/G. Case 2: A62-years-old man with clinically fungal infection corneal ulcer. VAS score was 3 and redness on lefteye. Palpebra was mild spasm, epithelial stroma defect 2 x 1 mm with edema, infiltrate and visualacuity HM 1/300 G/G We gave subconjungtiva injection of Ceftazidime+Fluconazole, Molcin ED andAccelerated PACK-CXL therapy. VAS score was decreased to 1 since day 1 after therapy andhypopyon was disappeared on day 3. Two weeks later, the visual acuity for both patient was 6/60 ph6/30 with no cornea edema, no palpebra spasm and minimal conjunctiva’s hyperaemia. Leukoma0.5x0,5mm and 2x1mm was formed.DiscussionPACK-CXL is used concomitant with antimicrobial therapy to treat corneal ulcer. Healing rateregarding bacteria was 88% and 78% for fungal infection. It has many properties such asantimicrobial, anti-inflammation and strengthen the cornea’s stroma.ConclusionPACK-CXL can be used as adjuvant treatment to accelerate the healing of cornea defect ininfectious ulceration concomitant with antimicrobial therapy.Keywordcornea, ulcer, PACK-CXLLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download577-EPOS-R-INOIIS-54-Anak-Agung-Ayu-Putri-Khrisnawati.jpg

51E-POSTER

EPOS-R-INOIIS-55PEDICLE CONJUNCTIVAL FLAP FOR PERIFER CORNEAL PERFORATION

Abstract TitlePEDICLE CONJUNCTIVAL FLAP FOR PERIFER CORNEAL PERFORATION

First Author: Anak Agung Ayu Putri Khrisnawati

Author Institution: RSUP dr. Sardjito

Co Author:

Reny Setyowati (RSUP dr. Sardjito)

Agung Nugroho (RSUP dr. Sardjito)

Suhardjo (RSUP dr. Sardjito)



Seminat: INOIIS


IntroductionCorneal perforation is an emergency condition in ophthalmology. It can lead to endophthalmitis andevisceration. Pedicle conjunctival flap can be used to treat perifer, minimal size corneal perforation.Case IllustrationCase 1: A 58 years old woman came to Sardjito Hospital with redness of her right eye, watery andpain. We found a 0,5 x 0,5 mm cornea perforation at 3 o’clock near limbus, shallow anteriorchamber, seidel test (+), visual acuity 6/15. We did pedicle conjunctival flap, 2 weeks later, thedefect was still closed by conjunctival flap, deep anterior chamber, no visual changes. Case 2: A 60years old man referred to Sardjito Hospital with blurred vision, redness and pain on his left eye. Wefound 4 x 2,5 mm descemetocele at 9 o’clock, deep anterior chamber, edema, seidel test (-), visualacuity 0,5/60. We did partial conjunctival flap, 2 weeks later, the defect was still closed byconjunctival flap, deep anterior chamber, visual acuity improved to 2/60.DiscussionConjunctiva is rich with blood vessel and growth factor that could help healing and preventinginfection. Cornea transplantation for tectonic keratoplasty is not always available and not everycentre has fibrin glue or amniotic membrane to cover corneal perforation. Conjunctiva Flap can beused as alternative to cover the perforation or in case of impending perforation.ConclusionPedicle Conjunctival Flap can be used as alternative in small, peripheral perforation in absent ofanother Methods.Keywordcornea, perforation, conjunctival flapLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download572-EPOS-R-INOIIS-55-Anak-Agung-Ayu-Putri-Khrisnawati.jpg

52 E-POSTER

EPOS-G-INOIIS-56Ulcus Cornea Cum Hypopion

Abstract TitleUlcus Cornea Cum Hypopion

First Author: Abdul Jabbar

Author Institution: Rsud ZM

Co Author: Fachreza ()



Seminat: INOIIS


IntroductionThe cornea is a clear membrane of the eye that covers the front eyeball and consists of five layers.Corneal ulcer is a pathological condition characterized by the presence of suppurative infiltratesaccompanied by echoed corneal defects. In corneal ulcers there is a loss of corneal tissue, then itwill be replaced by scar tissue. The scar tissue due to corneal ulceration can lead to decreasedvisus. Corneal ulcers are often accompanied by hypoopion.Case IllustrationA 52-year-old man with red left eye complaints with decreased vision since 1 week ago, there is ahistory of left eye exposed to sand cement, history of treatment with water mixed with herbs. Onophthalmological examination obtained visus oculi dextra (OD) 6/6, visus oculi sinistra (OS) 1/300,hyperemis in the conjunctiva forniks and palpebral, cylindrical injection (+) murky cornea,hypoopion in 1/3 of the anterior ouli camera, found central-echoed corneal defects, depth >2/3stroma.DiscussionThis case is a central corneal ulcer due to bacteria and fungi, administered ceftriaxone injectiontreatment 1 gr/12hours, Levofloxacin eye drops 1 drop per hour oculi sinistra (OS), cendolyteers 1drop per hour OS, cendotropin 1% 1 drop per hour OS, natamycin 5% 1 drop per hour OS, andcarried out Amnion Membrane graft (AMG).ConclusionThe diagnosis and treatment of these patients is appropriate. Amnion membrane transplantationcan be used as a graft to replace damaged stromal surfaces. The treatment given is in accordancewith the cause of the case, namely surgery and medical therapy.Keywordulcer, cornea, hypopionLatest UpdateMay 18, 2021StatusApproved As E-PosterFile Download515-EPOS-G-INOIIS-56-ABDUL-JABBAR.JPG

53E-POSTER

EPOS-O-INAVRS-01VITREOUS HEMORRHAGE AS LONGTERM COMPLICATION IN BRVO PATIENT ( A CASE REPORT )

Abstract TitleVITREOUS HEMORRHAGE AS LONGTERM COMPLICATION IN BRVO PATIENT ( A CASE REPORT )

First Author: NI LUH DIAH PANTJAWATI

Author Institution: Rumah Sakit Mata Bali Mandara

Co Author: dr. I Gusti Agung Ratna Noviantari (RSUP Sanglah)



Seminat: INAVRS


IntroductionBranch Retinal Vein Occlusion (BRVO) is a disease that can cause a decrease in the function ofvision. It is caused by occlusion in the vein branching, and the arterial stiffness that leads to veincompression by the artery.Case IllustrationMale 46 yo came with blurred vision on his right eye since 1 month ago. He had historyhypertension and cardiovascular desease. The visual aquity was hand movement, with lens opacityand vitreous hemorrhage. It was diagnosed with vitreous hemorrhage ec BRVO + imature senilecataract on his right eye. Vitrectomy combined phacoemulsification was done on 6th April 2021.Visual aquity is 6/45 one month after surgery with central macular thickness is 264μm. One yearago patient diagnosed with macular edema ec BRVO with visual aquity is 6/120 with centralmacular thickness is 529μm. Anti VEGF injection was done at 8th November 2019. On 22thFebruari 2020 the visual aquity is 6/6F and central macular thickness is 233μm. After that patientlost to follow up until 1 year.DiscussionAccording American Academy of Ophthalmology 2019-2020 Basic and Clinical Science Course; riskfactors of BRVO was increasing age more than 50 years old, history of hypertension, smoking,glaucoma, and hypercoagulable conditions. Appropriate treatment will prevent furthercomplications such as vitreous hemorrhage. In this case, vitreous hemorrhage complications occurdue to uncontrolled hypertension although anti-VEGF injection was done.ConclusionVitreous hemorrhage is one of the longterm complications that can occur in BRVO patients if therisk factors are not controlled.KeywordRetinal Vein Occlusion, anti-VEGF, Branch Retinal Vein Occlusion.Latest UpdateMay 09, 2021StatusApproved As E-PosterFile Download990-EPOS-O-INAVRS-01-Ni-Luh-Diah-Pantjawati,-Sp.M(K).jpg

54 E-POSTER

EPOS-O-INAVRS-02Bilateral Central Retinal Vein Oclussion In Tetralogy Of Fallot Patient

Abstract TitleBilateral Central Retinal Vein Oclussion In Tetralogy Of Fallot Patient

First Author: MASNIAH

Author Institution: RSUD. BRIGJEN H. HASAN BASRY KANDANGAN

Co Author: Anggun Rama Yudantha (RSUPN Dr. Cipto Mangunkusumo)



Seminat: INAVRS


IntroductionCentral retinal vein occlusion (CRVO) was one of many etiology that caused visual disturbances andblindness. CRVO caused by an occlusion in the lamina cribrosa level and is typically caused bythrombosis. Majority of cases being unilateral, about 10% are bilateral and 32% of bilateral CRVOwas associated with underlying systemic illness. Tetralogy of fallot (TOF) was combination of fourheart defects: ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy andoverriding aorta. The incidence of TOF ranges from 5-10% of the total CHD. Patient with TOFusually had blood hyperviscosity that will lead to venous and arterial thrombosis.Case IllustrationA 14 years old girl with TOF, complained about visual disturbances without pain or eye traumahistory. Patient’s visual acuity was 1/∞ (OD) and 1/300 (OS). Funduscopy Result showed bilateralCRVO. Patient also had high hemoglobin count and hematocrit. The therapy were intravitrealcorticosteroid (OD) and PRP laser (OS). After the therapy, visual acuity became 1/300 (OD) and1/60 (OS).DiscussionSecondary erythropoiesis due to hypoxia caused blood hyperviscosity and it associated with CRVOin TOF. There were several treatments for CRVO such as laser therapy, intravitreal corticosteroidand anti-VEGF injection. Anti-VEGF is not given because some literature said anti-VEGF may causeendothelial dysfunction and thrombosis, so it needs more caution to be given, especially for patientwith cardiovascular disorder.ConclusionPatients with TOF had a greater-risk for CRVO. In this case, PRP Laser and intravitrealcorticosteroid can improve the patient’s visual acuity.KeywordBilateral CRVO, Tetralogy of FallotLatest UpdateMay 11, 2021StatusApproved As E-PosterFile Download785-EPOS-O-INAVRS-02-Masniah.jpg

55E-POSTER

EPOS-R-INAVRS-04Intravitreal Bevacizumab for Choroidal Neovascularization and SubretinalHemorrhage in Punctate Inner Choroidopathy: A Case Report

Abstract TitleIntravitreal Bevacizumab for Choroidal Neovascularization and Subretinal Hemorrhage inPunctate Inner Choroidopathy: A Case Report

First Author: Muhamad Dwi Nugroho

Author Institution: Department of Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas

Gadjah Mada

Co Author: Firman Setya Wardhana (Department of Ophthalmology, Faculty of Medicine Public Health and

Nursing, Universitas Gadjah Mada), Supanji (Department of Ophthalmology, Faculty of Medicine Public

Health and Nursing, Universitas Gadjah Mada), Muhammad Bayu Sasongko (Department of Ophthalmology,

Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada), Angela Nurini Agni (Department

of Ophthalmology, Faculty of Medicine Public Health and Nursing,Universitas Gadjah Mada), Tri Wahyu

Widayanti (Department of Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas

Gadjah Mada)



Seminat: INAVRS


IntroductionPunctate inner choroidopathy (PIC) is a part of white dot syndrome that reveals multifocal yellow-white macular lesions at the level of the RPE. CNV of the macula leads to decrease visual acuity in PIC. Intravitreal anti-VEGF is known as the treatment of CNV in PIC. Although PIC can be self- limited, CNV can worsen and gave permanent visual loss.Case IllustrationIn this case report, a 43 y-o woman complained of acute blurred in her left eye. The visual acuity of the left eye is 1/60. Fundus examination shows multiple, small, yellow-white spots in the posterior pole of each eye. Extensive subretinal hemorrhage was found in the macula area of the left eye. The macular OCT of both eyes shows multiple RPE elevation with ILM-RPE thinning and extensive subretinal fluid in the left eye. This condition leads to the diagnosis of Punctate inner choroidopathy with cnv. Intravitreal bevacizumab was given three times for the left eye with a one-month interval. And once for the right eye. The subretinal hemorrhage resolved at the follow-up. The visual acuity of the left eye improves to 6/60.DiscussionPIC lesion occurs at the level of the inner choroid and RPE. These acute lesions may resolve, leaving atrophic spots with variable pigmentation. More severe visual loss subsequently occurs, primarily due to the development of CNV. In recent years, the advent of intravitreal anti-angiogenic therapies has greatly improved the treatment options for patients who develop CNV.ConclusionIntravitreal bevacizumab alone may significantly improve cnv and subretinal hemorrhage in PIC.KeywordIntravitreal bevaciumab, retina, puctate inner choroidopathyLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download770-EPOS-R-INAVRS-04---Muhamad-Dwi-Nugroho.jpg

56 E-POSTER

EPOS-R-INAVRS-05Branch Retinal Vein Occlusion

Abstract TitleBranch Retinal Vein Occlusion

First Author: David Christian Chandra

Author Institution: Universitas Sam Ratulangi Manado

Co Author: Eugeni Sumanti (Universitas Sam Ratulangi Manado)



Seminat: INAVRS


IntroductionRetinal vein occlusion is the second most common retinal vascular disorder following diabeticretinopathy and is often associated with vision loss. With comprehensive management, we canencourage management of potential risk factors for retinal vein occlusion.Case IllustrationA seventy-year old man, referred to Kandou hospital with suspect hypertension retinopathy. Hischief complaint is blurred vision left eye since 1 month ago. Patient felt no pain. Patient use glassessince 20 years ago to help him reading. No history of smoking. No history of ocular problems, anyother medication and previous eye examination. Hypertension since 5 years ago. His visual acuitieswere 6/9 right eye, and 6/60 left eye, intraocular pressure were 15.1 mmHg right eye, and 14.5mmHg left eye. Right eye was unremarkable. Posterior segment of the left eye revealedhemorrhage on the supero-temporal quadrant. Patient was diagnosed with branch retinal veinocclusion of left eye. Patient was referred to internist to regulate blood pressure and injection ofranibizumab on the left eye performed 1 weeks later. 2 weeks after surgery, VA of left eye is 6/30.Second injection is planned 1 months after the 1st injection.DiscussionBRVO is caused by thrombosis in retinal vein. There is no known certain ethiology until this day.But there are some risk factor that affecting BRVO such as increased age, hypertension, history ofsmoking, glaucoma and hypercoagulable conditions.ConclusionInjection of anti VEGF is still the most rationale treatment for retinal vein occlusion these days.Focal laser treatment can be added to prevent neovascularitation.KeywordRetinal vein occlusion, branch retinal vein occlusion, anti VEGFLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download634-EPOS-R-INAVRS-07-David-Christian-Chandra.jpg

57E-POSTER

EPOS-R-INAVRS-06BILATERAL CENTRAL RETINAL VEIN OCCLUSION IN A 15-YEARS-OLD FEMALE

Abstract TitleBILATERAL CENTRAL RETINAL VEIN OCCLUSION IN A 15-YEARS-OLD FEMALE

First Author: PATRICIA INDRIYANI TIWOW


Co Author:

EUGENI SUMANTI (Universitas Sam Ratulangi Manado)

DYANA WATANIA (Universitas Sam Ratulangi Manado)



Seminat: INAVRS


IntroductionCentral retinal vein occlusion (CRVO) is an uncommon cause of visual loss in young people.Younger individuals who present with a clinical picture of CRVO may have an underlyinghypercoagulable or inflammatory etiologyCase IllustrationA 15 years old female, with the chief complaint of both blurred eyes since 1 month ago. Patient withhistory of menometrorrhagia and anemia gravis. Her visual acuity were 3/60 OD and 1/60 OS.Anterior segment within normal limits, no iris neovascularization. Posterior segment in both eyesrevealed flame shaped hemorrhage, subhyaloid hemorrhage and papilledema. On OCT examination,macular edema was found in both eyes. Patient was consulted to pediatric department to treat theunderlying disease.DiscussionYounger patients are more likely to have predisposing conditions Resulting in thrombotic disease. Inyounger patients, a thorough investigation should be considered, possibly including a workup forthrombophilia. It is important to perform gonioscopy regularly during follow-up to check for angleneovascularization. In the absence of treatment, patients with CRVO should be monitored monthlyduring the first 6 months for evidence of progression and development of anterior segmentneovascularization or neovascular glaucoma.ConclusionBilateral CRVO can occur at young people. Advanced modalities of treatment are available, but inCRVO the most important thing is a complete examination to determine the etiology and treatmentrequired.KeywordBilateral CRVO, CRVO in young people, underlying diseaseLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download176-EPOS-R-INAVRS-06-Patricia-Indriyani-Tiwow.jpg

58 E-POSTER

EPOS-R-INAVRS-07Bilateral Central Retinal Vein Occlusion- A Case Report

Abstract TitleBilateral Central Retinal Vein Occlusion- A Case Report

First Author: Ivonne


Co Author:

Eugeni Sumanti ( Universitas Sam Ratulangi Manado)

Salam Surbakti ( Universitas Sam Ratulangi Manado)



Seminat: INAVRS


IntroductionTo report a case of bilateral central retinal vein occlusion on 34 year old male.Case IllustrationA-34 year old male came to the hospital with chief complaint of blurry eyes since 3 weeks agosuddenly. He has history of uncontrolled diabetes mellitus and hypertension. Blood pressure was170/90 and fasting blood sugar levels was 203. On eye examination his visual acuities were 6/40right eye and 6/9 left eye. Fundus examination showed dilated and venous turtousity, cotton woolspot, exudates and hemorrhages on both eyes. OCT has shown macular edema on right eye.DiscussionCRVO is more prevalent in adults > 65 years and about 10-15% in adults under 40 years.CRVO inyoung adults is multifactorial ,thrombosis of central retinal vein due to mechanical compression byatherosclerotic central retinal artery has been postulated to be an underlying etiology. CRVO maybe bilateral and usually is associated with systemic diseases.Intravitreal anti VEGF injections arecommonly administered to treat macular edema. Control of systemic risk factors must be done.ConclusionBilateral CRVO was a rare case than unilateral CRVO.KeywordCentral retinal vein occlusion,young adultsLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download174-EPOS-R-INAVRS-07-Ivonne.jpg

59E-POSTER

EPOS-R-INAVRS-08EXUDATIVE RETINAL DETACHMENT AS AN OCULAR COMPLICATION INDENGUE FEVER: A CASE REPORT

Abstract TitleEXUDATIVE RETINAL DETACHMENT AS AN OCULAR COMPLICATION IN DENGUEFEVER: A CASE REPORT

First Author: Annisa Ikhsaniah Ariffin

Author Institution: Universitas Hasanuddin

Co Author:

Andi Muhammad Ichsan (Universitas Hasanuddin)

Habibah Setyawati Muhiddin (Universitas Hasanuddin)

Andi Pratiwi (Universitas Hasanuddin)

Risna Halim Mubin (Universitas Hasanuddin)



Seminat: INAVRS


IntroductionThe eye is uncommonly involved in dengue fever (DF). This complication can be a sight- threateningdisease. Pathomechanism still unclear, but usually resolve as the platelet counts increase.Case IllustrationA 17 years old girl came with her right vision suddenly blurred with best-corrected visual acuityusing visual acuity scale (VAS) was 35 and metamorphopsia. The previous history of hospitalizationdue to DF was recorded. Fundus examination showed dark reflex on foveal macula suggestivemacular oedema. Optical coherence tomography (OCT) examination showed the central macularthickness (CMT) was 834 micrometres with subretinal fluid. She was diagnosed with exudativeretinal detachment and referred to an internal physician. Platelet counts was 99,000 cells/μl.Topical steroid and close observation of fluid were used for treatment. After 6 months follow-up,BCVA was 100, but there was persistent central scotoma.DiscussionOcular complication in dengue infection occur with the lowest platelet count which cause bleedingand lowest haematocrit count which cause plasma leakage. If this complication occur, steroidtherapy may be used. The duration of recovery ranges from a few days to a few months. Fullrecovery with residual deficit ranging from persistent mild central scotoma to impaired VA hasbeen observed.ConclusionExudative retinal detachment associated with macular oedema and metamorphopsia may bepresented as ocular complications in dengue viral infection and may lead to sight-threateningdisease. Although the clear pathomechanism and protocol for management still unclear, a topicalsteroid may be used and showed full recovery with a persistent central scotoma.Keyworddengue fever, exudative retinal detachment, macular oedemaLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download279-EPOS-R-INAVRS-08-ANNISA-IKHSANIAH-ARIFFIN.pdf

60 E-POSTER

EPOS-R-INAVRS-09A Problematic Management Of Retained Posterior Segment IntraocularForeign Body With Good Visual Acuity: A Case Report

Abstract TitleA Problematic Management Of Retained Posterior Segment Intraocular Foreign BodyWith Good Visual Acuity: A Case Report

First Author: Mia Rachmawati Kamal

Author Institution: Ophthalmology Resident, Department of Ophthalmology, Faculty of Medicine Universitas

Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Co Author:

Anggun Rama Yudantha (Staff of Vitreoretina Division Department of Ophthalmology, Faculty of

Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia )



Seminat: INAVRS


IntroductionOcular trauma, associated with intraocular foreign body, gave an unpredictable surgical outcome.Unfavourable final surgical outcome might cause visual impairment and socioeconomic life burden.Case IllustrationA 19-year-old male presented with chief complaint of gradual blurred vision of the left eye for 1 months. This complaint appeared while he was pounding a metal object with iron hammer. Best- corrected visual acuity of the left eye was 6/12. Fundus examination of the left eye showed an encapsulated structure superior to the optic nerve head. B-scan ultrasonography and computed tomography scan confirmed metallic IOFB embedded in the retina. Pars plana vitrectomy, extraction of the IOFB, and injection of silicone oil tamponade was done. After the IOFB extraction surgery, the visual acuity was hand movement good projection. Three months after the first surgery, the patient underwent silicon oil removal surgery combined with ILM peeling. One week post-operative, fundus examination revealed retinal detachment. A second vitrectomy was done,with scleral buckle and lensectomy. The last condition revealed failure of retinal reattachment.DiscussionIOFB injury may vary in presentation, visual outcome and prognosis. The location of IOFB is animportant prognostic factor for development of a retinal detachment and worse visual outcome.This case shows that after meticulous clinical evaluation, diagnostic imaging and prompt surgicalintervention, retinal detachment and poor visual outcome still occur.ConclusionEven though IOFB cases were managed properly in the first place, a risk of having unfavourablefinal anatomical nor visual function outcome still remain.KeywordPosterior segment intraocular foreign body, pars plana vitrectomy, retinal detachment.Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download807-EPOS-R-INAVRS-09-Mia-Rachmawati-Kamal.jpg

61E-POSTER

EPOS-R-INAVRS-10MACULAR EDEMA MANAGEMENT IN CENTRAL RETINAL VEIN OCCLUSION (CRVO)

Abstract TitleMACULAR EDEMA MANAGEMENT IN CENTRAL RETINAL VEIN OCCLUSION (CRVO)

First Author: Ratri Prasetya Ningrum N

Author Institution: Sriwijaya University/Dr. Mohammad Hoesin General Hospital Palembang

Co Author: Ramzi Amin (Sriwijaya University, Dr. Mohammad Hoesin General Hospital Palembang)



Seminat: INAVRS


IntroductionCentral retinal vein occlusion (CRVO) is one type of RVO, second leading cause of vision loss due toretinal vascular disease. Most of RVO patient have hypertension or cardiovascular disease. Patientsusually come with unilateral painless sudden loss of vision. Management of CRVO is directed atmanaging secondary complications, such as macular edema (ME) which occur in more than 90%.Anti-vascular endothelial growth factor (VEGF) is main therapy of ME on CRVO.Case IllustrationA 47-year-old man came with sudden blurry left vision of 5 months. No complain of redness, pain ortrauma. Patient had uncontrolled hypertension. Ophthalmologic examination showed swollenbleeding macula with exudates and tortuous retinal vein with dot, blot, flame-shaped bleeding.Patient was treated with ranibizumab injection 0.5 mg for 3 months along with oralantihypertension and showed progressionDiscussionME in CRVO often persists if patient does not receive therapy; only 30% recover spontaneously.Management of CRVO is currently undergoing rapid development with new modalities includinganti-VEGF and corticosteroid implants. Intravitreal injections of ranibizumab rapidly reduce venousdilation and curvature, amount of intraretinal bleeding and severity of ME. Anti-VEGF impact onpermeability. It is hypothesized that thrombosis with ischemia upregulates VEGF locally, which inturn causes endothelial hyperplasia within affected lumen, inflammatory cell endothelial adhesion,and nitric oxide (NO) mediated vasodilation. Anti-VEGF injection can reverse VEGF-inducedvasodilation and blood-retinal barrier damage, Resulting in observable improvements in venousdistention and degree of intraretinal bleedingConclusionAnti-VEFG ranibizumab is safe and effective for ME on long term CRVO case.Keywordcentral retinal vein occlusion (CRVO), macular edema, anti-VEGFLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download896-ratri.pdf

62 E-POSTER

EPOS-O-INAVRS-11Laser Photocoagulation in Secondary Full Thickness Macular Break

Abstract TitleLaser Photocoagulation in Secondary Full Thickness Macular Break

First Author: LIA MEUTHIA ZAINI

Author Institution: FK Univ Syiah Kuala/ RSUD Zainoel Abidin Banda Aceh

Co Author:



Seminat: INAVRS

Competition Category:Ophthalmologist

IntroductionMacular membrane or fibrosis can cause significant anatomical changes to the macula, leading tofunctional deficits including decreased visual acuity and metamorphopsia.Case Illustration75 years-old male patient came with blurred vision in both eyes. Cataract surgery performed in theright eye (3 months ago) and left eye (1 year ago) did not improve visual function. Initialexamination revealed phthisis in the left eye. Pars plana vitrectomy was performed in the right eyewhich had retinal detachment with PVR grade C and very thick sub-macular fibrosis. Duringsurgery, fibrosis in the macula is arduous to remove and retina is unable to attach. After arelentless removal of fibrosis which Resulted in full thickness break at the macula, the retina isattached completely. Photocoagulation laser is performed around the macula break, followed byinjection of silicone oil as a tamponade. Visual acuity was improved from hand movement beforesurgery to 2 meter finger counting 2 weeks after the surgery. Retina is perfectly attached, and thepatient was delightedDiscussionThis case presents a challenge of macular break occurrence while treating the macular fibrosis invitrectomy surgery, which is difficult to handle. Laser photocoagulation in macular area is extremely rare and poorly documented. Two studies, reported by Baba et al. (2011) and Riordan-Eva et al. (1992), performed laser photocoagulation of the macula to avoid re-detachment.ConclusionMacular laser photocoagulation in retinal detachment with a macular break may be consideredsince management of the peripheral retina alone is inadequate to avoid redetachment.KeywordRetinal Detachment, Full Thickness Macular Break, Proliferative VitreoretinopathyLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download686-EPOS-O-INAVRS-11-Lia-Meuthia-Zaini.jpg

63E-POSTER

EPOS-R-INAVRS-12Anterior Segment Intraocular Foreign Body

Abstract TitleAnterior Segment Intraocular Foreign Body

First Author: Muhammad Fadhil Rahmadiansyah


Co Author: Weni Helvinda (Andalas University)



Seminat: INAVRS


IntroductionAnterior segment is the second most frequent location after the posterior Intraocular Foreign Body(IOFB). An anterior segment IOFB should be ruled out in ocular trauma to avoid missed diagnosisand delayed treatment.Case IllustrationMale, 29 years old, came to M. Djamil hospital with red and pain in left eye since 3 weeks ago aftergot hit by iron rod. Patient reported also got hit by iron rod 7 years ago. Left eye (LE) visual acuitywas 1/~ wrong perception. She had ± 3 mm scar at 10-11 o’clock paracentral region of LE corneas.A 3x4 mm whitish foreign body was found at anterior chamber. The lens was cloudy. Intraocularpressure in LE was 8 mmHg and position was 30° Esotropia. Ultrasonography confirmed axiallength was 25 mm RE and 22mm LE. Hertel examination was □((20-15)/115). In Orbital CT-Scanwas found a metallic object in LE anterior chamber. Diagnosis was anterior segment IOFB LE withphthisis bulbi, traumatic cataract, and esotropia. Patient underwent IOFB extraction surgerythrough corneal incision and irrigation/aspiration.DiscussionAnterior segment IOFB in this patient quite confusing since there was no opened lesion at ocularsurface. There was scar in LE cornea that could be port d’ entrée. Orbital CT scan could confirmeda metallic object in anterior segment therefore patient underwent extraction surgery.ConclusionThe extraction surgery was success to remove the anterior segment IOFB of patient. However theoutcome was poor because patient delayed seeing to hospital.Keywordintraocular foreign body, orbital CT scanLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download739-EPOS-R-INAVRS-12-Muhammad-Fadhil-Rahmadiansyah.jpg

64 E-POSTER

EPOS-R-INAVRS-13Late Removal of Retained Posterior Segment Intraocular Foreign Body with Good Visual Outcome

Abstract TitleLate Removal of Retained Posterior Segment Intraocular Foreign Body with Good Visual Outcome

First Author: Tarosa Yodia Urolita

Author Institution: Department of Ophthalmology, Faculty of Medicine Airlangga University/ Dr Soetomo

General Hospital, Surabaya, Indonesia

Co Author:

Ima Yustiarini (Department of Ophthalmology, Faculty of Medicine Airlangga University/ Dr Soetomo General

Hospital, Surabaya, Indonesia), Wimbo Sasono (Department of Ophthalmology, Faculty of Medicine Airlangga

University/ Dr Soetomo General Hospital, Surabaya, Indonesia), Muhammad Firmansjah (Department of

Ophthalmology, Faculty of Medicine Airlangga University/Dr Soetomo General Hospital, Surabaya, Indonesia),

Sauli Ari Widjaja (Department of Ophthalmology, Faculty of Medicine Airlangga University/ Dr Soetomo

General Hospital, Surabaya, Indonesia), Ady Dwi Prakosa (Department of Ophthalmology, Faculty of Medicine

Airlangga University/ Dr Soetomo General Hospital, Surabaya, Indonesia)



Seminat: INAVRS


IntroductionIntraocular Foreign Body (IOFB) is a serious ocular injury which can lead to poor visual outcome. An IOFB can further be complicated by recurrent iridocyclitis, vitreous opacities, vitreous adhesions, retinal degeneration and detachment, and metallosis.Case IllustrationA 35-year-old male came to outpatient clinic with chief complain of decreased visual acuity in his left eye 6 months ago after some unidentified thing came into his eyes while he rode motorcycle, making him could only see hand movements. On presentation, anterior segment examination showed hyperemia conjunctiva, leucoma cornea in 8-o’clock direction, lens particle in anterior chamber, iradier pupil, anterior and posterior capsule rupture in superonasal quadrant, posterior synechia, and opaque lens. Ultrasonography showed vitreous echogenic lesion in the form of particle as high as 100% RCS complex with shadow, which suggests the presence of a foreign body. CT Scan examination showed corpus alienum with metal density of 4,9x52 mm in the left bulbus oculi medioinferior side. We did pars plana vitrectomy and lensectomy then take out the corpus alienum through the cornea. One month after the surgery, his best corrected visual acuity was 5/8.5 with normal examination of anterior and posterior segment.DiscussionThe IOFB composition analysis were ferrous. We found vitreous fibrosis around the corpus alienum leading to no retinal damage. Even though it is a non-inert, it came in high-speed so it may self-sterilize and reduce the risk of endophtalmitis.ConclusionThe late removal of metallic IOFB is necessary even though it is late and caused no significantinflammatory signs.KeywordIntraocular foreign body, posterior segment, metallic foreign bodyLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download738-EPOS-R-INAVRS-13-Tarosa-Yodia-Urolita.jpg

65E-POSTER

EPOS-O-INAVRS-14Internal Limiting Membrane Peeling for Vitreomacular Traction with Full Thicknes Macular Hole

Abstract TitleInternal Limiting Membrane Peeling for Vitreomacular Traction with Full Thicknes Macular Hole

First Author: EWI PRIMADONA,

Author Institution: Regina eye centre padang

Co Author:



Seminat: INAVRS


IntroductionVitreomacular Traction (VMT) is a disease caused by the partial detachment of posterior hyaloidswith persistence of macular adhesion and with tractional forces can be associated with macularhole. Full-thickness macular hole (FTMH) is a foveal lesion with interruption all macular layers.This condition can cause visual disturbances, including photopsia, metamorphopsia, and decreasedvisual acuityCase IllustrationFirstcase (female 51 th yo) came to hospital with blured of right eye since 1 month ago. Visualacuity (VA) 20/200, normal anterior segment, on funduscopy have found macular hole. OpticalCoherence Tomography (OCT) founded FTMH with VMT. Second case (male 61 th yo ) came tohospital with blured of left eye since 3 month ago. VA 20/200, normal anterior segment, onfunduscopy have found macular hole. Optical Coherence Tomography (OCT) founded FTMH withVMT. The patient was diagnose with VMT with FTMH. Patient was treatment with vitrectomy,Internal limiting membrane (ILM) peeling and SF6 .The VA patient first case was 20/50 and secondcase20/30, macular morphology recovery.DiscussionBoth of the patients have VMT with FTMH. The firsth case have macular hole larger diameter thansecond case. Vitrectomy with ILM peeling was done to this patients, injection gas SF6. There isimproving visual acuity and restoring macular morphologyConclusionVitrectomy with ILM peeling was effective for improving visual acuity and restoring macular morphologyKeywordVitreomacular Traction, Full-thickness macular hole,Internal limiting membraneLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download475-EPOS-0-INAVRS-14-Ewi-Primadona.pdf

66 E-POSTER

EPOS-G-INAVRS-15Primary Scleral Buckle in Exudative Retinal Detachment Due to Tuberculous Choroiditis in Immunocompromised Patient : A Case Report

Abstract TitlePrimary Scleral Buckle in Exudative Retinal Detachment Due to Tuberculous Choroiditis in Immunocompromised Patient : A Case Report

First Author: Anak Agung Putri Satwika

Author Institution: Rumah Sakit Mata Ramata

Co Author:

Fransiska Lavinia Gracella (Rumah Sakit Mata Ramata) Putu Nanda Tediantini (Rumah Sakit Mata Ramata)

Ayu Diah Permata Sari (Rumah Sakit Mata Ramata) Ari Andayani (Rumah Sakit Mata Ramata)

I Gusti Ayu Made Juliari (Rumah Sakit Mata Ramata)



Seminat: INAVRS


IntroductionTuberculous choroiditis commonly Results from hematogenous spread of tuberculosis infection. A severe choroiditis can lead to exudative retinal detachment (ERD). Immunocompromised patients have greatest risk of developing ocular tuberculosis.Case IllustrationA 73 years old male presented with blurry vision and metamorphopsia since a week without red eyes or pain. He has history of HIV and is undergoing tuberculosis treatment. It was found that visual acuities (VA) 6/38 for right eye (RE) and 6/7,5 for left eye (LE). RE did not get better by correction. Intraocular pressure and anterior segment both eyes were normal. Evaluation of posterior segment through fundoscopy detected the presence of tubercles, vitreous cells, and retinal detachment with no break. Sub-retinal fluid was found through Optical Coherence Tomography (OCT). This patient was diagnosed with tuberculous choroiditis and exudative retinal detachment in RE. Comprehensive systemic workup also performed, and found low CD4 (360 cells/mm3). Patient was treated by continuing anti-retroviral and anti-tubercular therapy, with additional oral and eyedrop anti-inflammation. However, there was no improvement after 6 months. Thus, scleral buckling procedure was performed. It successfully re-attached his retina, increased VA RE to 6/24 and resolved the metamorphopsia.DiscussionFirst line management of ERD is by treating the underlying diseases. Surgical intervention is considered if no improvement observed through the conventional treatment. Scleral buckle can reestablish the anatomic proximity of separated retina from its underlying tissue.ConclusionScleral buckling procedure can provide anatomical improvement to re-attach retina in ERD but may not provide a significant functional improvement.Keywordscleral buckle, exudative retinal detachment, tuberculous choroiditisLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download91-EPOS-G-INAVRS-15-Anak-Agung-Putri-Satwika.jpg

67E-POSTER

EPOS-R-INAVRS-16IDENTIFYING POLYPOIDAL CHOROIDAL VASCULOPATHY (PCV) : SEVERAL IMPORTANT FEATURES TO RECOGNIZE

Abstract TitleIDENTIFYING POLYPOIDAL CHOROIDAL VASCULOPATHY (PCV) : SEVERAL IMPORTANTFEATURES TO RECOGNIZE

First Author: Andreas Lukita Halim

Author Institution:

Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia

Co Author:

Iwan Sovani (Indonesia National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Arief Sjamsulaksan Kartasasmita (Indonesia National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Erwin Iskandar (Indonesia National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Rova Virgana (Indonesia National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Grimaldi Ihsan (Indonesia National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)



Seminat: INAVRS


IntroductionPolypoidal choroidal vasculopathy (PCV) is considered as a subtype of neovascular age-relatedmacular degeneration (nAMD). Current gold standard for diagnosing PCV requires indocyaninegreen angiography (ICGA), however it is invasive, time-consuming, and may not be available inIndonesia. Here we present a PCV case detected by fundus photography and optical coherencetomography (OCT).Case IllustrationA 60-years-old male experienced sudden blurred vision of his right eye since 1 week ago.Ophthalmologic examination showed VA RE 2/60 and normal anterior segment. Multiple orangenodules and subretinal hemorrhages were found in right macular region, whereas left funduscopywas unremarkable. OCT findings were matched to the PCV criteria. The patient was diagnosed asPCV and planned for intravitreal anti-VEGF injection for his right eye.DiscussionSeveral studies have used various combinations of imaging features other than ICGA and reportedhigh sensitivity and specificity for identifying PCV. The most recent publication by the panel of Asia-Pacific Ocular Imaging Society (APOIS) proposed several non-ICGA features based on fundusphotography and OCT imaging. They suggested combination of 3 major criteria of : sharp-peakedPED, sub-RPE ring-like lesion, and en-face OCT complex RPE elevation to diagnose PCV. Based onthis criteria, the accuracy for diagnosing PCV in our presented case was 82%.ConclusionAcknowledging certain features on fundus photography and OCT could assist ophthalmologists toidentify PCV.Keywordpolypoidal choroidal vasculopathy, fundus photography, optical coherence tomographyLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download934-EPOS-R-INAVRS-16-Andreas-Lukita-Halim.jpg

68 E-POSTER

EPOS-G-INAVRS-17Role of Optical Coherence Tomography Angiography (OCTA) in Patient with Branch Retinal Vein Occlusion, a Case Report

Abstract TitleRole of Optical Coherence Tomography Angiography (OCTA) in Patient with BranchRetinal Vein Occlusion, a Case Report

First Author: Miranti Laras Ayu Sanusi

Author Institution: General Practioner, Ciawi General Hospital, Bogor

Co Author: Nanda Lessi Hafni Eka Putri (Department of Ophtalmology, Ciawi General Hospital, Bogor)



Seminat: INAVRS


IntroductionBranch Retinal Vein Occlusion (BRVO) is a term to describe the occlusion of a branch of a centralretinal vein. One of imaging modalities used for assessment in BRVO is Optical CoherenceTomography Angiography (OCTA), a noninvasive diagnostic test that allows the integration ofabnormalities in vascularity and structural changes.Case IllustrationA 54-year-old man came with a complaint of a blurred right eye for almost 2 months. The symptomis followed by reduced field of view. Best corrected visual acuity (BCVA) of the right eye (OD) was1/60 and left eye (OS) was 1.0 lm. Intraocular pressure was 12,9 mmHg OD and 13,6 mmHg OS.Funduscopy examination showed sclerotic vessels in superior temporal quadrant with intraretinalhemorrhages ODS. OCTA showed IS/OS junction disruption OD and OCTA suggest more than 10-disc areas of retinal capillary nonperfusion ODS. The lab Resulted showed his total cholesterol 217mg/dL and LDL cholesterol 197 mg/dL. The patient was diagnosed with BRVO with ischemic type inboth eyes.DiscussionIn this patient, the visual acuity (VA) in his right eye worse than his left. After OCTA examination,we found the disruption in IS/OS junction OD. Photoreceptor disruption of these outer retinal layersmight be correlate with his lower VA. Beside that, BRVO were evaluated for the presence of retinalcapillary nonperfusion ODS and confirmation by the OCTA.ConclusionOCTA is useful in evaluating capillary nonperfusion, visualize ischemia, capillary drop out and todetermine the next treatment in BRVO patients.KeywordBranch Retinal Vein Occlusion, Optical Coherence Tomography Angiography, IschemicLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download42-EPOS-G-INASCRS-27-Miranti-Laras-Ayu-Sanusi.jpg

69E-POSTER

EPOS-G-INAVRS-18A Case of Proliferative Diabetic Retinopathy with Macular Edema andPosterior Subcapsular Cataract : What to Do?

Abstract TitleA Case of Proliferative Diabetic Retinopathy with Macular Edema and Posterior Subcapsular Cataract : What to Do?

First Author: dewi

Author Institution: Faculty of Medicine, North Sumatera University, Medan

Co Author: Eugeni Jumilia Rachel Sumanti (Ophthalmologist, Department of Ophthalmology, Sam Ratulangi

University, Manado)



Seminat: INAVRS


IntroductionDiabetes is a major risk factor for cataract development and diabetic retinopathy. Diabetic macularedema (DME) and neovascularization are the two main causes of vision impairment.Case IllustrationThe case of a a 58 year old male who had a constant blurred far vision since a month ago. Patient isdiagnosed with proliferative diabetic retinopathy with DME and Posterior Subcapsular Cataractafter examined under slit lamp, indirect funduscopy and OCT. Both eye present the best visualcorrected acuity (BCVA) of 20/200, central macula thickness 425 μm of the right eye and (20/70;600 μm) of the left eye. After treated with panretinal photocoagulation and three times injection ofanti-VEGF factor agent, the patient’s right eye presented a good improvement of BCVA 20/40and a reduction of central macular thickness into 333 μm, while there is only a reduction of centralmacular thickness to 236 μm of the left eye.DiscussionIn PDR treatment, eyes receiving a combination of PRP with anti-VEGF treatment had a more rapidand larger reduction in area of active neovascularization than PRP alone. The PRP laser and thethree times injection of anti-VEGF factor agent Resulted in improvement of the macular edema.After treatment, the macular edema showed a tendency of improvement. Several studies reportedprogression of diabetic retinopathy after cataract surgery. The cataract is treated later because thepatient’s BCVA is still in the tolerable limit.ConclusionWe observed remarkable improvement in patient’s follow up with the cataract remained, andconclude that the treatment protocol is applicable.KeywordProliferative Diabetic Retinopathy, anti-VEGF, Panretinal PhotocoagulationLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download957-EPOS-G-INAVRS-18-Dewi-Maya-Putri-Alam.jpg

70 E-POSTER

EPOS-R-INASCRS-01MANAGEMENT SURGERY OF TRAUMATIC CATARACT WITH CORNEAL LACERATION

Abstract TitleMANAGEMENT SURGERY OF TRAUMATIC CATARACT WITH CORNEAL LACERATION

First Author: Octarina Ervianti

Author Institution: Perdami jatim

Co Author:

indri wahyuni (perdami jatim)

dicky hermawan (perdami jatim)



Seminat: INASCRS


IntroductionTo report the management of cataract surgery with corneal lacerationCase IllustrationA 47-years-old man from Kalimantan came to outpatient clinic with blurred vision, progressivewhitish appearance redness in his right eye. Seven months ago, he got hit by hook when he wentfishing. He used Atropin 0.5% and Artificial Tears eyedrop on right eye. He was referred toSurabaya for repair a cataract formation. VA of right eye was 1/300 with Good projectionIllumination, and left eye 5/5. Intraocular pressure was normal.There was 3 corneal suture at 6o’clock, lecoma at 6-9 o’clock, irradial iris, posterior synechiae, pupil not round, decrease lightreflex with 4mm diameter, iris pigment on the lens and opaque lens.DiscussionTraumatic cataract may occur after either blunt or penetrating ocular trauma that disrupts the lensfibers. Laceration or loss of corneal tissue may be present as Result of the trauma. A sealed anteriorchamber is necessary to avoid fluid leakage during cataract surgery. Corneal wounds should beclosed with suture. This procedure may be done in the same surgical session as the cataractextraction. Although secondary removal can be applied for some patients. The benefits of secondaryremoval are improved visibility and less chance of postoperative complications. A detailed history,careful examination and a clear management plan can simplify these cases and provide the bestpossible visual outcome.ConclusionTraumatic cataract and laceration of corneal tissue is very common sequel of ocular trauma. Thechoice of surgery depends on the surgeons’ experience and the particularity of the case.Keywordcorneal laceration, cataract, surgical treatmentLatest UpdateMay 15, 2021StatusApproved As E-PosterFile Download981-EPOS-R-INASCRS-01-Octarina-Ervianti.jpg

71E-POSTER

EPOS-R-INASCRS-02Subluxated Traumatic Cataract Following 30 Years of Facial Trauma: A CaseReport

Abstract TitleSubluxated Traumatic Cataract Following 30 Years of Facial Trauma: A Case Report

First Author: Herdina Ramadhani

Author Institution: Departemen/KSM Ilmu Kesehatan Mata FK UNAIR - RSUD Dr. Soetomo

Co Author:

Indri Wahyuni (Departemen/KSM Ilmu Kesehatan Mata FK UNAIR - RSUD Dr. Soetomo)

Dicky Hermawan (Departemen/KSM Ilmu Kesehatan Mata FK UNAIR - RSUD Dr. Soetomo)



Seminat: INASCRS


IntroductionOcular trauma is frequently associated with formation of traumatic cataract. Both blunt andpenetrating trauma can cause damage to the lens and lens metabolism disturbance. Damage to thezonules may also occur, causing subluxation or total displacement of lens, which may also requirecataract surgery.Case IllustrationA 45-year-old woman was presented with complained of blurred vision in right eye since got anaccident 30 years ago. Patient did not performed any medical check up and treatment. There waswhitish appearance in right eye since seven months ago and vision became blurry. Visual acuity(VA) was Light Perception. Anterior segment found shallow anterior chamber, irradier iris, pupilnot round with 5 mm diameter, opaque lens, subluxated lens at 4-2 o’clock and phacodonesis.Patient underwent right eye Intracapsular Cataract Extraction (ICCE). The right eye patient wasconsidered to be aphakic. Visual acuity after cataract extraction only slightly progressed to handmovement. Fundal photograph showed optic atrophy in right eye. Meanwhile, left eye withinnormal limit.DiscussionA blunt trauma or nonperforating injury may cause lens opacification either as an acute event or asa late complication. In some cases, blunt trauma causes both dislocation and cataract formation.The patient had late complication of traumatic cataract.ConclusionThe possible factors which may affect the final VA of traumatic cataract were initial VA, injury type,wound location, cataract removal procedure, and the way of IOL implantation. The time intervalbetween trauma and intervention had no significant effect on final visual acuity.Keywordtraumatic cataract, subluxated lens, blunt traumaLatest UpdateMay 15, 2021StatusApproved As E-PosterFile Download90-EPOS-R-INASCRS-02-Herdina-Ramadhani.jpg

72 E-POSTER

EPOS-R-INASCRS-03Challenging Cataract Extraction in Post-LASIK and Phakic IOL eye: A Case Report

Abstract TitleChallenging Cataract Extraction in Post-LASIK and Phakic IOL eye: A Case Report

First Author: Hanifah Rahmani Nursanti

Author Institution: Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital

Co Author: Faraby Martha (Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital)



Seminat: INASCRS


IntroductionEven with advanced surgical instrumentation, cataract extraction after refractive surgery posesmany challenges. The patient usually had high expectations of similar Results to prior refractivesurgery and the intraocular lens (IOL) power calculation was difficult. Here, we discuss achallenging cataract surgery in a patient who had received iris-fixated phakic IOL (pIOL) and laserassisted in situ keratomileusis (LASIK).Case IllustrationA 39-year-old male had received refractive surgery with pIOL implantation and LASIK about tenyears ago. He developed a moderate cataract in his right eye with best-corrected visual acuity(BCVA) of 20/50. Explantation of pIOL, phacoemulsification and in-the-bag IOL implantation weresuggested. The IOL calculation was made using the Barrett True-K no history formula for postmyopic LASIK eye. The refractive target was set at -1.00 D, despite the extremely high axial length.Eight weeks postoperatively, the patient right eye achieved BCVA of 20/28. The refraction was-1.50 -0.50x60.DiscussionCorneal refractive surgery changes the relationship between anterior-posterior corneal curvature.Various Methods introduced for estimating the true corneal power in post-LASIK eyes are includedin various online calculators. However, no single formula has been found to outperform the others.Objective measurement of true corneal power using combined telecentric keratometry and sweptsource OCT-based Method may help in achieving more predictable Results.ConclusionWhile not supported with historical data and had limited access to technology-assisted total cornealpower measurement, using the Barrett True-K no history formula might help to avoid postoperativehyperopic surprise in patients with prior corneal refractive surgery and high axial length.KeywordCataract extraction; post-LASIK; phakic IOL; Barrett True-K no history; intraocular lens powerLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download800-EPOS-R-INASCRS-03-Hanifah-Rahmani-Nursanti.JPG

73E-POSTER

EPOS-G-INASCRS-04A Challenging Case of Complicated Cataract in Juvenile Idiopathic Arthritis(JIA)-associated Uveitis Patient: A Case Report

Abstract TitleA Challenging Case of Complicated Cataract in Juvenile Idiopathic Arthritis (JIA)-associated Uveitis Patient: A Case Report

First Author: Mochamad Tito Aditya Pratama

Author Institution: Bhayangkara Hospital Tulungagung, East Java

Co Author: Frisma Sagara Brilliyanto (Sagara Eye Care, Sampit, Central Kalimantan)



Seminat: INASCRS


IntroductionCataract is a frequent complication of JIA-related uveitis, accounting for almost two thirds ofincident blindness (≤20/200 vision). Intraocular lens (IOL) implantation after cataract surgeryin patients with JIA-associated uveitis is controversial yet challenging choice in pediatrics.Case IllustrationA 16 y.o male presented with pain, redness and blurry vision on both eyes that started 2 weeksprior. Patient had used an OTC eye drops, but the symptoms remained. Patient was diagnosed withJIA by an internist and had undergone therapy. VOD was hand-movement and VOS was 6/12.Examination on both anterior segments showed conjunctival hyperemia, posterior synechia,narrow-irregular pupils, and increased opacity of the lenses. Ultrasound and IOP were normal.Fundus reflex were negative. Pupil expander assisted-simple aspiration and synechiolysis withoutIOL transplantation was done on the right eye. Postoperatively, VOD was 1/60. Systemiccorticosteroids and topical antibiotic-corticosteroid were administered for the iritis. After threemonths, the inflammation subsided and secondary implantation of three pieces IOL with PosteriorCapsulotomy was done. After the surgery, VOD was 6/12, fundoscopy showed cicatrix macula, andothers were within normal limit.DiscussionInflammatory condition such as uveitis become major burden for intraocular procedure. Simpleaspiration was chosen due to nonsolid lens material and pupil expander was used for sticky-narrowpupil due to inflammation. IOL transplantation was postponed until the inflammation subside andduring this period systemic and topical corticosteroid were used.ConclusionWith adequate long-term pre-and-postoperative control of intraocular inflammation, JIA-associateduveitis patient can demonstrate favorable surgical outcomes after cataract surgery.KeywordUveitis, Complicated Cataract, Juvenile Idiopathic ArthritisLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download697-EPOS-G-INASCRS-04-Mochamad-Tito-Aditya-Pratama.JPG

74 E-POSTER

EPOS-R-INASCRS-05A Rare, Devastating Case of Ocular Bee Sting Injury

Abstract TitleA Rare, Devastating Case of Ocular Bee Sting Injury

First Author: Theresia Kania

Author Institution: Department of Ophthalmology, Faculty of Medicine Universitas Indonesia - Cipto

Mangunkusumo Hospital, Jakarta

Co Author: Faraby Martha (Cataract and Refractive Surgery Division, Faculty of Medicine Universitas

Indonesia - Cipto Mangunkusumo Hospital, Jakarta)



Seminat: INASCRS


IntroductionCorneal bee sting rarely occurs and may cause mild to severe inflammation. Its venom may lead toloss of permanent vision and ocular integrity due to corneal melting. We present a rare case ofocular bee sting injury to enlighten ophthalmologists about the seriousness of the disease.Case IllustrationA 53-year-old man was presented with pain and blurry vision on both eyes after being attacked byhundreds of bees (Apis dorsata) while rock-climbing twelve hours previously. His visual acuity washand-motion-good-projection for both eyes and multiple bee stingers were embedded into corneaand sclera. There were infiltrate and corneal erosion around the bee sting. Stinger extraction,anterior chamber wash, and amniotic membrane transplant (AMT) with fibrin glue on both eyeswere immediately performed. He was given intravenous steroid, oral antibiotic, steroid andantibiotic eyedrops. After surgery, the cornea healed completely although visual acuity remainedunimproved.DiscussionThere is no standardized guideline for ocular bee sting injury. The stinger should be removedimmediately to prevent venom spread, especially when severe inflammation occurs. Promptsurgical intervention was done to clear the venom from intraocular and AMT was performed topromote corneal healing. High-dose systemic steroid was given to suppress inflammation Resultingfrom venom. Despite the severe hemolytic effect on the iris, vitreous and retina, corneal meltingwas halted and ocular integrity could be preserved.ConclusionOcular bee sting injuries are rare but may lead to serious complications. Aggressive and timelyinitial management is crucial to prevent venom spread which may lead to loss of ocular integrity.KeywordCorneal melting; Ocular bee stingLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download255-EPOS-R-INASCRS-05-Theresia-Kania.jpg

75E-POSTER

EPOS-G-INASCRS-06Visual Improvement Outcome Percentage After Nd YAG Laser CapsulotomyTreatment In Patients With Posterior Capsule Opacification After IOL Insertion

Abstract TitleVisual Improvement Outcome Percentage After Nd YAG Laser Capsulotomy Treatment InPatients With Posterior Capsule Opacification After IOL Insertion

First Author: Cheryll Yudakusuma

Author Institution: UPH Faculty of Medicine - Siloam Hospital Lippo Village

Co Author:

Yoseph Siahaan (UPH Faculty of Medicine - Siloam Hospital Lippo Village)

Giovanni Adrian (UPH Faculty of Medicine - Siloam Hospital Lippo Village)

Marcellina Hermanto (UPH Faculty of Medicine - Siloam Hospital Lippo Village)



Seminat: INASCRS


Introduction & ObjectivePosterior Capsule Opacification (PCO) is the most common complication that arises in the upcoming2-3 years after cataract surgery. Neodynium doped Yttrium Aluminium Garnet (Nd YAG) laser capsulotomy is a gold standard for eliminating PCO. This study is to evaluate the effect of Nd YAG laser capsulotomy towards visual function outcome percentage in patients with posterior capsule opacification.MethodPatients’ eyes diagnosed with PCO, which previously had cataract surgery with IOL insertion andscheduled for Nd YAG capsulotomy laser, included as subjects. Eyes’ visual acuity improvementafter capsulotomy treatment were evaluated and individually compared with the best visualoutcome obtained after cataract surgery.ResultStudy included 9 eyes from 6 patients (2 men, 4 women; mean age 64 years) presented with PCOgrade 3. Cataract surgery took place 2-3 years priorly before patients report subjective symptoms.Visual acuity improved significantly after Nd YAG laser capsulotomy took place, compared with bestvisual acuity obtained after cataract surgery (P < .05). No subjective symptoms reported in all patients.ConclusionNd YAG laser capsulotomy treatment shows a significant improvement in visual function in patientswith PCO without any posterior impairment of the eye. Further studies referring to capsulotomytechnique needs to be assessed which capsulotomy pattern shows better visual function outcome.KeywordPCO, Nd YAG Laser, Visual Function OutcomeLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download169-EPOS-G-INASCRS-06-Cheryll-Yudakusuma.jpg

76 E-POSTER

EPOS-G-INASCRS-07Congenital Cataract Removal Without Intraocular Lens Replacement

Abstract TitleCongenital Cataract Removal Without Intraocular Lens Replacement

First Author: Gabriel Giacinta Nandha Dwi Utama

Author Institution: Siloam Hospitals Kupang

Co Author: Boyke Kuhurima (Siloam Hospitals Kupang)



Seminat: INASCRS


IntroductionCataracts can happen at any ages, even in children (pediatric cataracts). Pediatric cataracts can becongenital or acquired. It can affect on single or both eyes. The most cases are idiopathic. Ifpediatric cataracts aren’t well-treated immediately, it may cause permanent vision loss even afterthey have their cataracts removed.Case IllustrationA 7-year-old boy went to Eye Department Clinic of Siloam Hospital Kupang with a chief complaintof blurry vision on both eyes, whereas he still can see and recognize people from nearby. He neverhad any eye trauma nor eye infections, never taken any drugs and never suffered at any congenitaldisease. On physical examination, opacities were presented in both lenses and visual acuity Resultswere 1/300. He was diagnosed with bilateral congenital cataract.DiscussionThis patient was afraid and didn’t agree if we removed both cataracts at once, so we onlyperformed phacoemulsification with general anesthesia on his left-eye. We found 80% rupture onposterior capsule, therefore we didn’t perform Intraocular Lens (IOL) placement. The totaloperative time was 30 minutes. After the operation, patient was in a good condition and he was ableto discharge at the same day.ConclusionCongenital cataract can lead to visual disability in children, so the treatment has to be performedas soon as possible to prevent permanent damage. This patient has to do postoperative check-up,do visual acuity test to get vision correction by eyeglasses, and to be scheduled for left-eye anteriorchamber IOL placement. Next further plan is to remove his right-eye cataract.Keywordcongenital cataract, phacoemulsification, aphakiaLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download

77E-POSTER

EPOS-G-INASCRS-08visual acuity improvement after iris claw intraocular surgery in lenssubluxation patient with marfan syndrome

Abstract Titlevisual acuity improvement after iris claw intraocular surgery in lens subluxation patientwith marfan syndrome

First Author: Jauza irbah

Author Institution: West Nusa Tenggara Provincial Eye Hospital

Co Author:

Quri Meihaerani (West Nusa Tenggara Provincial Eye Hospital)

Sriana wulansari (West Nusa Tenggara Provincial Eye Hospital)



Seminat: INASCRS


IntroductionMarfan syndrome is an autosomal dominant inheritance genetic defect that affects connectivetissue. The cause of Marfan syndrome is a gene mutase (FBN1) on chromosome 15 that encodes theconnective tissue protein fibrillin-1. Ectopia lentis or subluxation lens is a criterion ocular major ofMarfan syndromeCase IllustrationA 32-year-old female patient came to the West Nusa Tenggara Provincial Eye Hospital with chiefcomplaints of prolonged blurred vision and worsened in the last one week before admission.Headaches accompany the complaints. The patient had a history of Marfan syndrome. Onophthalmological examination, the right eye visual acuity was 1/60, and the left eye was 2/60. Thepatient was diagnosed with right and left eye lens subluxation due to Marfan syndrome. Surgerywas carried out for lens extraction. One month after surgery, the patient underwent iris-clawsurgery in the right eye. Two weeks after surgery, visual acuity improvement was noticed, whichbecame 6/30DiscussionThe patient has been diagnosed with lens subluxation according to the Ghent criteria of Marfansyndrome. In some cases, lens extraction combined with artificial IOL replacement may beindicated to achieve visual acuity improvement.ConclusionIris-claw intraocular lens implantation is effective surgical management to improve patients’ visualacuity with subluxation lens that suffers from Marfan SyndromeKeywordiris-claw IOL, lens subluxation, Marfan syndromeLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download145-EPOS-G-INASCRS-08-JAUZA-IRBAH.jpg

78 E-POSTER

EPOS-R-INASCRS-09Late Visit for Keratoconus: What can we do?

Abstract TitleLate Visit for Keratoconus: What can we do?

First Author: I Nyoman Cahya Setiabudi

Author Institution: UNUD

Co Author:

Siska (UNUD)

Ida Ayu Ary Pramita (UNUD)

I Gusti Ayu Made Juliari (UNUD)

Ni Ketut Niti Susila (UNUD)



Seminat: INASCRS


IntroductionKeratoconus (KCN)is a disease characterized by progressive thinning, bulging, and distortion of thecornea. Various therapeutic modalities exist, including spectacles, contact lenses, corneal crosslinking, lamellar keratoplasty (LK), penetrating keratoplasty (PKP), and intracorneal rings (ICRS).Case IllustrationA 37 years-old female came with blurry vision of both eyes which became worse with cornealopacification of both eyes since a year. Visual acuity of right eye was 1/300 and left eye was lightperception (pthisis). Corneal scarring, protruded central corneal thinning and neovascularization(CNV) on the right eye. History of cryotherapy of both eyes due to small perforation. Patientdiagnosed with RE KCN with perforation. Patient underwent PKP followed by intrastromalbevacizumab the next 3 weeks due to neovascularization of the graft. After the treatment, VAbecame 3/60 and CNV regressed.DiscussionKCN is eligible for ALK when spectacle and contact lens are inappropriate, due to thin corneas andscar. Unfortunately, in this case the descemet membrane was not intact, and we did PKP as thetreatment. Some issues may occur after PKP include suture and wound-healing problem,progression of the disease, allograft reaction.1 The presence of CNV prior to PKP can induced graftrejection. Several evidence-based studies have shown that anti-VEGF significantly improves longterm graft survival.ConclusionThe time and condition of first visit and the stage progression of KCN play roles in managementand Result. PKP and intrastromal anti-VEGF could give promising Result in this case.KeywordKeratoconus, penetrating keratoplasty, anti-VEGFLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download791-FINAL-E-POSTER-KCN.pdf

79E-POSTER

EPOS-G-INASCRS-10Complicated Catarract Traumatic with Lens-Induced Glaucoma from BluntTrauma: Case Report

Abstract TitleComplicated Catarract Traumatic with Lens-Induced Glaucoma from Blunt Trauma: Case Report

First Author: dr. Faizal Mahfudh Ariandi

Author Institution: RSUD dr murjani sampit

Co Author: dr. Frisma Sagara Brilliyanto (RSUD dr Murjani Sampit)



Seminat: INASCRS


IntroductionTraumatic Cataract occur secondary to Blunt or Penetrating Ocular Trauma. Lens-InducedGlaucoma is secondary Glaucoma in which the Crystalline lens Mechanism of intraocular PreasureIncrease.Case Illustrationa 32 years old Male presented to our out-patient clinic due to ocular pain and blurred vision in hisright eye after blunt trauma. On examination revealed visual acuity consisting hand movement, IOP40 mmhg, cornal edem, hyperemic conjutiva. On anterior chamber examination flare cell (+), pupilmidilatation, lens opacity with rupture anterior capsule. On gonioscopy oped angled. Patient gottreatment with β-adrenergic antagonist, Carbonic anhydrase inhibitor, hyperosmotic agent andCorticosteroid. After that it was continued to cataract surgery with phacoemulsification andimplantation 3-piece IOL and followed by topical anti-inflammatory medication. after cataractsurgery visual acuity has improve 6/12 and IOP within normal limit.DiscussionTear of anterior capsule from non-penetrating ocular trauma maybe torn by direct contusion fromrapid focal indetational of the cornea on the lens (coup injury) or by Fluid-mechanical, anteriorlydirected rebound of vitreous, busting open the anterior capsule (countre coup injury). Leakage lensmaterialto anterior chamber from ruptured of anterior capsule can induced Lens-Particle Glaucomaor more severe Phacoantigenic Glaucoma.ConclusionManagement Cataract Traumatic with Lens-Induced Glaucoma is Extraction of lens or lensfragments followed by topical anti-inflammatory medication.KeywordCataract Traumatic, Lens-induced GlaucomaLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download349-Complicated-Catarract-Traumatic-With-Lens-Induced-Glaucoma-From-Blunt-converted.pdf

80 E-POSTER

EPOS-R-INASCRS-11Challenging Management Post Phakic Intraocular Lens Implant in HighMyopia with Complicated Cataract After Vitrectomy: A Case Report

Abstract TitleChallenging Management Post Phakic Intraocular Lens Implant in High Myopia withComplicated Cataract After Vitrectomy: A Case Report

First Author: Herdanti Rahma Putri

Author Institution: Department of Ophthalmology, Faculty of Medicine Universitas Indonesia

Co Author:

Syska Widyawati (Department of Ophthalmology, Faculty of Medicine Universitas Indonesia)

Virna Dwi Oktariana (Department of Ophthalmology, Faculty of Medicine Universitas Indonesia)



Seminat: INASCRS


IntroductionTreatment for high myopia and its complications remain a challenge. This case report is aimed tohighlight the dilemma in managing complications following multiple intraocular surgeries, in highmyopia patient who previously had refractive surgery.Case IllustrationA 37-year old man with history of high myopia and phakic intraocular lens (PIOL) implantation 12years ago came with inferior retinal detachment in RE with presented visual acuity of HM. Patientunderwent vitrectomy with silicone oil four days after admission. One month after surgery,intraocular pressure (IOP) was increased to 43 mmHg and large lens particle seen in AC. He wasgiven antiglaucoma medication and had lens extraction surgery one month later where we foundsmall rupture in posterior capsule.DiscussionPIOL is a safe and effective technique to correct high myopia. However, it won’t prevent futureocular problems such as RD. RD itself is common in moderate to high myopia, in our case thepatients promptly managed with PPV and silicone oil tamponade. Posterior capsule rupturefollowing vitrectomy is causing impaired capsule integrity that leads to traumatic cataract andretained lens fragment. Furthermore, the fragments may induce secondary glaucoma. Threemonths after lens extraction, rubeosis iridis appeared which may indicate the presence of retinalre-detachment, hence the prognosis is still doubtful.ConclusionHigh myopia can be corrected by refractive surgery but the cost is high and it won’t prevent futureocular problems. Preoperative assessment and closely monitor the patient’s condition aremandatory in order to prevent sight-threatening complications of high myopia.Keywordhigh myopia, retinal detachment, lens-particle glaucomaLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download620-EPOS-R-INASCRS-11-Herdanti-Rahma-Putri.jpg

81E-POSTER

EPOS-R-INASCRS-12Early Resolution of Acute Corneal Hydrops Treated with ConservativeTreatment: A Case Report

Abstract TitleEarly Resolution of Acute Corneal Hydrops Treated with Conservative Treatment: A CaseReport

First Author: Karina Luthfia

Author Institution: Cornea and Refractive Surgery Division, Department of Ophthalmology, Faculty of

Medicine

Universitas Indonesia– Kirana Cipto Mangunkusumo Hospital, Jakarta

Co Author:

Jessica Zarwan (Cornea and Refractive Surgery Division, Department of Ophthalmology, Faculty of

Medicine Universitas Indonesia– Kirana Cipto Mangunkusumo Hospital, Jakarta )



Seminat: INASCRS


IntroductionAcute Corneal Hydrops (ACH) is a condition associated with corneal ectasias, one of which iskeratoconus (KC), characterized by stromal edema due to leakage of aqueous through a tear inDescemet Membrane (DM). Here we present a case of an early resolution of ACH treated withconservative treatment.Case IllustrationA 15 year-old girl presented with discomfort and watery on her left eye after she rubbed her eyes 2weeks prior. From the examinations, the uncorrected visual acuity (UCVA) was 1/300 with highmyopia in both eyes. The cornea was edema, hazy, breaks in DM with subsequent intrastromalfluid. We performed Anterior Segment Optical Coherence Tomography (AS-OCT), and the cornealthickness (CCT) was 1041 nm with intrastromal fluid. We diagnosed the patient with ACH causedby KC of the left eye. We gave bandage contact lens, hypertonic saline eyedrops, eye lubricants,topical corticosteroids and observed if any further management needed. One week later, there weresignificant improvements from subjective and objective measurement as we retook the AS-OCT andthe CCT became 627 nm. We planned to further examine her fellow eye for the possibilities ofbilateral KC but unfortunately, the patient was lost to follow-up.DiscussionCorneal hydrops occurs in 2.6–2.8% of patients with KC, usually self-limiting and resolve after twoto four months with conservative treatment, while in our case the improvement could be seen afterone week. Modalities such as serial AS-OCT can be used for follow-up.ConclusionConservative treatment with topical medication is generally sufficient in early cases of cornealhydrops.Keywordacute corneal hydrops, keratoconus, treatmentLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download541-EPOS-R-INASCRS-12--KARINA-LUTHFIA.jpg

82 E-POSTER

EPOS-G-INASCRS-13PROPHYLAXIS PHARMACOLOGICAL MANAGEMENT FOR PATIENTS WITHINTRAOPERATIVE FLOPPY IRIS SYNDROME RISK DUE TO α1-ADRENERGICRECEPTOR ANTAGONISTS USE: A SYSTEMATIC REVIEW

Abstract TitlePROPHYLAXIS PHARMACOLOGICAL MANAGEMENT FOR PATIENTS WITH INTRAOPERATIVE FLOPPY IRIS SYNDROME RISK DUE TO α1-ADRENERGIC RECEPTOR ANTAGONISTS USE: A SYSTEMATIC REVIEW

First Author: Brigitta Marcia Budihardja, MD

Author Institution: Bajawa Regional General Hospital

Co Author: Ade Ajeng Cempakadewi, MD (Bajawa Regional General Hospital)



Seminat: INASCRS


Introduction & ObjectiveIntraoperative floppy iris syndrome remains a challenge that increases risk of complications inpatients undergoing cataract surgery who use α1-adrenergic receptor antagonists. To date, nodefinite consensus on a preventive strategy for IFIS is available. The aim of this review is to assessvarious pharmacological managements to prevent IFIS in high-risk patients.MethodThis review was based on Preferred Reporting Items for Systematic Reviews and Meta-Analysesguidelines. A systematic search using PubMed, Science Direct, Cochrane Library, and WorldCatdatabase was performed. Quality of each study was evaluated using Cochrane Risk of Bias 2.0 (RoB2.0), Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I), or Newcastle-OttawaScale (NOS).ResultThe search identified 1589 articles of which 7 met the eligibility criteria. Experimental andobservational studies between 2010 and 2018 were included. Pharmacological managementsincluded in this review are administered in varying routes. Phenylephrine, lidocaine, combination oflidocaine and epinephrine are given intracamerally. Other pharmacological managements includedare sub-tenon injection of lidocaine, topical atropine, combination of topical atropine withintracameral epinephrine, combined irrigation solution of phenylephrine and ketorolac, andmydriatic cocktail-soaked wick sponges.ConclusionVarious pharmacological managements for IFIS prophylaxis have shown promising potential.Studies that evaluate efficacy of each agent and comparison between these strategies are stilllimited. Further research is needed to determine the best prophylaxis strategy to reduce incidence of IFIS.Keywordalpha-1 adrenergic receptor antagonists; pharmacological prophylaxis; intraoperative floppy irissyndromeLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download131-EPOS-G-INASCRS-13---Brigitta-Marcia-Budihardja,-MD.jpg

83E-POSTER

EPOS-R-INASCRS-14 Modified Closed-chamber, Double-Armed, Cross-Pupil Technique in ManagingTraumatic Subtotal Iridodialysis : A Case Report

Abstract TitleModified Closed-chamber, Double-Armed, Cross-Pupil Technique in Managing TraumaticSubtotal Iridodialysis : A Case Report

First Author: Ridho Ranovian

Author Institution: RSCM

Co Author:

Tjahjono. D. Godhowiardjo, MD (Cornea Cataract and Refractive Surgery Division Faculty of

Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta)



Seminat: INASCRS


IntroductionTo elaborate the modified closed-chamber, cross-pupil technique in managing traumatic subtotaliridodialysis.Case IllustrationA 55 years old male presented to our clinic with chief complaint of a 5 days history of pain andblurred vision after his left eye was hit by bouncing metal object. His visual acuity was handmovement with high IOP. Ophthalmological status showed the subtotal iridodialysis and traumaticcataract. He underwent iridodialysis repair with ICCE under local anesthesia. The challenges werethe size and shape of the iridodialysis also traumatic cataract formation. The postoperative outcomewas good enough, most of meridian of detached iris had been reattached. The symptoms such asglare and monocular diplopia had been resolved.DiscussionMcCannel technique is the most widely used technique in iridodialysis repair, the scleral groovingis made at the site of the iridodialysis. However, in cross-pupil approach, the grooving site islocated 180 degree away from the iridodialysis. In this modification technique, scleral grooving notperformed, corneal main port was made to enter the anterior chamber and penetrate the doublearmed needle through the iridodialysis perpendicularly, then knotting at the sclera of theiridodialysis site. Direct suturing was also performed in some parts.ConclusionThere are some techniques in iridodialysis repair, but choosing the proper one depends on howlarge the iridodialysis, the operator experiences, and the timing of the surgery. In our case report,the surgeon performed a combination closed chamber - cross pupil and direct suturing techniquewhich made reattachment of subtotal iridodialysis more possible.Keyword: Iridodialysis, iridoplasty, ocular traumaLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download327-EPOS-R-INASCRS-14-Ridho-Ranovian.jpg

84 E-POSTER

EPOS-G-INASCRS-15Management of Corneal Bee Sting with Early Remover of Stinger andSystemic High-Dose Steroid Therapy

Abstract TitleManagement of Corneal Bee Sting with Early Remover of Stinger and Systemic High-DoseSteroid Therapy

First Author: Ni Nyoman Yuniasih

Author Institution: Karangasem Hospital

Co Author: Ni Made Lienderi Wati, MD (Karangasem Hospital)



Seminat: INASCRS


IntroductionBee sting of the cornea is uncommon environmental eye injury. Due to the rarity of this condition,there is no clear guideline for management of affected individuals. Several case presentationsdemonstrated no removal of corneal stingers and no use of systemic steroids in treatment and viceversa, the results show vary.Case IllustrationA 15 year old male got stung by a bee in the right eye. From the examination upper and lowereyelids were swollen, conjunctiva injection and stinger still under threat at cornea, direct removalof stinger was performed and followed by eye irrigation. Follow up show massive corneal edema,descemet fold, injury to corneal stroma, visual acuity is counting finger at one meter. The patientreceived high dose intravenous steroid for three days, steroid eye drops, antibiotic eye drops,artificial tears and oral antihistamin. The last follow-up after three months the visual acuity is 6 /7.5, left a scar in the corneal and good healing.DiscussionThe pathophysiology of bee sting is related to three factors, penetrating injury by sting,immunologic reaction to venom and toxic effects of the bee sting injected through the cornea or thecombination of all mechanisms. To prevent complications, treatment mainly aimed at the control ofthe inflammatory response. Patient underwent direct removal of stinger then irrigation to eliminatethe venom completely. High dose systemic steroid to suppress the active inflammation.ConclusionThis report suggests that early stinger removal combined with systemic high-dose steroid therapymight be an effective treatment option for corneal bee sting.Keywordcorneal bee sting, high-dose steroid systemic, stinger removalLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download72-EPOS-G-INASCRS-15-NI-NYOMAN-YUNIASIH.jpg

85E-POSTER

EPOS-R-INASCRS-16Cornea Graft in Acquired Corneal Staphyloma with Secondary Glaucoma AfterKeratoplasty: A Case Report

Abstract TitleCornea Graft in Acquired Corneal Staphyloma with Secondary Glaucoma AfterKeratoplasty: A Case Report

First Author: Tsania Rachmah Rahayu

Author Institution: Department of Ophthalmology, Faculty of Medicine Universitas Indonesia - Cipto


Co Author:

Syska Widyawati (Department of Ophthalmology, Faculty of Medicine Universitas Indonesia - Cipto

Mangunkusumo Hospital, Jakarta)

Virna Dwi Oktariana (Department of Ophthalmology, Faculty of Medicine Universitas Indonesia -

Cipto Mangunkusumo Hospital, Jakarta)



Seminat: INASCRS


IntroductionCorneal graft survival depends on several factors and pre operative IOP control is one of the mostimportant issue. We report a case of acquired corneal staphyloma that underwent penetratingkeratoplasty (PK) with glaucoma after surgery.Case IllustrationA 16-year-old boy with thinning, cone-shaped leucoma, with neovascularization cornea of his righteye. He has history of blunt trauma complained of opacification. We performed PK and foundalmost all the iris attached to the cicatricial cornea. After the surgery the cornea was clear but theIOP was high at 54 mmHg. With antiglaucoma medication the IOP was still uncontrolled and thegraft rejection started with appearance of cornea defect and neovascularization. The glaucomamanaged with glaucoma device implant but the cornea graft failure can not be saved.DiscussionThe factors that affect graft failure include glaucoma, corneal neovascularization, and ocularsurface disease. In this case, the factors developing higher IOP were the age, pseudophakic, andhistory of perforated corneal with leucoma. Besides, the damage of the ocular surface, in this case,may also increase the risk of graft failure. As the glaucoma medication was not given good result,surgery is needed to prevent further graft damage.ConclusionCorneal graft survival is influenced by eye condition before and after surgery. Glaucoma after PK isimportant factor that affects graft survival. It needs to treat well to prevent graft failure.KeywordAcquired corneal staphyloma, penetrating keratoplasty, secondary glaucomaLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download299-EPOS-R-INASCRS-16-Tsania-Rachmah-Rahayu.jpg

86 E-POSTER

EPOS-O-INASCRS-17Iridocorneal Endothelial Syndrome: A Rare Case Three Years Follow UpReport and Literature Review

Abstract TitleIridocorneal Endothelial Syndrome: A Rare Case Three Years Follow Up Report andLiterature Review

First Author: Septian Dwi Prabowo

Author Institution:

Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital Surabaya

Co Author:

Camilla Amanda Prakoeswa (Faculty of Medicine Universitas Airlangga, Dr. Soetomo General

Academic Hospital Surabaya)

Amelia Rahmah Kartika (Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic

Hospital Surabaya)

Dewi Rosarina (Undaan Eye Hospital)

Dini Dharmawidiarini (Undaan Eye Hospital)



Seminat: INASCRS


IntroductionIridocorneal endothelial (ICE) syndrome is a rare disease characterized by hammered-silver appearance of posterior corneal surface, cornea-endothelial abnormality, peripheral anterior synechiae, iris stromal abnormalities, and secondary glaucoma.Case IllustrationA thirty-eight-year-old woman was referred to Undaan Eye Hospital with Normo-tension glaucoma and blurry vision in the left eye. Anterior segment examination revealed peripheral anterior synechia, corneal edema with microcyst, Descemet membrane opacification, and conjunctival hyperemia. A specular corneal microscope showed ICE cells in the left eye with 1568 cells/mm2 and endothelium with mild polymorphism and pleomorphism with 2459 cells/mm2 in the right eye. OCT Macula showed average CD Ratio of 0.37 and 0.19 in the left and right eye, RNFL thickness 102 □m and 111 □m in the left and right eye.DiscussionPrimary angle-closure was suspected, and iridocorneal endothelial syndrome considered as differential diagnosis. Descemet Stripping Automated Endothelial Keratoplasty was planned, but turns out to be treated by Penetrating Keratoplasty due to Descemet membrane adhesions. One year after follow-up, the IOP was 29 in the left eye, and treated with oral Acetazolamide 250 mg, oral Kalium, oral methylprednisolone 8 mg, and fluorometholone and neomycin eye drops. Phacoemulsification and Glaucoma Drainage Implant was planned in the left eye due to uncontrolled IOP in spite of maximal local treatment.ConclusionThere is clearly no intervention can treat the condition for an entire lifetime, due to the rarity of thesyndrome and the difficulty of ascertain the best strategy to manage. The best treatment isrequiring multiple intervention to control the IOP and corneal clarity.KeywordICE Syndrome, Secondary Glaucoma, KeratoplastyLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download93-EPOS-O-INASCRS-17-SEPTIAN-DWI-PRABOWO.jpg

87E-POSTER

EPOS-R-INASCRS-18HUTCHINSON’S PUPIL IN A PATIENT WITH SEVERE HEAD INJURY : A CASEREPORT

Abstract TitleHUTCHINSON’S PUPIL IN A PATIENT WITH SEVERE HEAD INJURY : A CASE REPORT

First Author: Pikasa Retsyah Dipayana

Author Institution: Airlangga University

Co Author:

Gatot Soehartono ()

Lukisiari Agustini ()



Seminat: INANOS


IntroductionTrauma is the most common cause of death for those under the age of 45. Traumatic brain injuryremains the cause of approximately half of the deaths secondary to trauma. Hutchinson’s pupil ischaracterised by initial ipsilateral miosis followed by dilatation with no light reflex due to raisedintracranial pressure. The purpose of this case report is to report the pupil assessment in a severehead traumaCase IllustrationA 43-years-old man came unconcious after traffic accident 2 days before admission. GCS was 1-X-4.Both eyelids were lagophthalmos. Both eyes showed conjungtival hyperemia, subconjunctivalbleeding in inferotemporal right eye and subconjunctival bleeding in nasal and inferotemporal andchemosis 180 degree inferior on left eye. Pupils were round with diameter 4 and 6 mmrepectively,with pupillary light reflex decreased on left eye. The optic nerve head of left eye showedslightly hyperemic and blurred border at superonasal. CT Scan of head showed biconvexhyperdense lesion of the left frontal with a volume of 39 cc suggests an extradural hematome.Multiple hyperdense lesions. Midline shift to the right 1 cm.DiscussionHutchinson’s pupil should be assessed for its causes, as an early symptoms of compression of theoculomotor nerve as a result of uncal herniation. The parasympathetic fibers which responsible forpupillary constriction pass through the periphery of the oculomotor nerve and hence are the first tobe affected in case of compression of the nerve.ConclusionHutchinson’s pupil is useful in cases of severe head injury as a marker of herniation that requiresimmediate decompression.KeywordHutchinson’s Pupil, herniation,Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download19-EPOS-R-INASCRS-18-Pikasa-Retsyah-Dipayana.jpg

88 E-POSTER

EPOS-G-INASCRS-19MULTILAYERED AMNIOTIC MEMBRANE TRANSPLANTATION INMANAGEMENT OF TRAUMATIC PERFORATED CORNEA: A CASE REPORT

Abstract TitleMULTILAYERED AMNIOTIC MEMBRANE TRANSPLANTATION IN MANAGEMENT OFTRAUMATIC PERFORATED CORNEA: A CASE REPORT

First Author: Cindy Prajna Metta

Author Institution: Research Intern, Department of Ophthalmology, Prima Pekanbaru Hospital, Riau

Co Author: Ressa Yuneta (Ophthalmologist, Department of Ophthalmology, Prima Pekanbaru Hospital, Riau)



Seminat: INASCRS


IntroductionAmniotic membrane (AM) is the innermost layer of fetal membranes. It is comprised of a stromalmatrix, a thick collagen layer, and an overlying basement membrane with a single layer ofepithelium. It has a combination of antiadhesive effects, bacteriostatic properties, and woundprotective abilities, which reduces pain and enhance tissue epithelialization.Case IllustrationA 31-year-old male patient presented with blurred vision, redness, and ocular pain after sustainingan injury to his left eye at work. No eye protection was worn at the time. Initial ophthalmologicevaluation revealed an oval-shaped corneal perforation with iris prolapse on the perilimbal corneaof his left medial canthal area. Left VA 0.4. The patient underwent surgery and repositioned theiris. A folded piece of AM plugged into the perforated cornea. Then a larger piece of AM graft wasapplied over the perforated cornea – epithelial side up, secured with 10-0 nylon sutures. Steroiddrops and antibiotic drops were instilled and bandage lens placement. After 4 weeks of follow-up,sutures were removed, re-evaluated UCVA 0.7, and BCVA 1.0 with S+1.00 C-1.00 x 145corrections.DiscussionAM material contains biological growth factors and anti-inflammatory factors. It does not expressHLA-A, B, or DR antigens thus not host rejected. Since the membrane heals rapidly and becomestransparent in few weeks, vision recovery is sooner. The graft’s relative avascularity also achievesgreater cosmesis in comparison to conjunctival graft’s more opaque appearance.ConclusionAmniotic membrane is a useful adjunct in ocular surface reconstruction. Multi-layered AMT ispreferred in the management of small corneal perforations.KeywordAmniotic membrane, corneal perforationLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download388-EPOS-G-INASCRS-19-Cindy-Prajna-Metta.jpg

89E-POSTER

EPOS-R-INASCRS-20CHARACTERISTICS OF PATIENTS WITH MODERATE TO SEVERE VISUALIMPAIRMENT IN LOW VISION POLYCLINIC NATIONAL EYE CENTER,CICENDO EYE HOSPITAL

Abstract TitleCHARACTERISTICS OF PATIENTS WITH MODERATE TO SEVERE VISUAL IMPAIRMENTIN LOW VISION POLYCLINIC NATIONAL EYE CENTER, CICENDO EYE HOSPITAL

First Author: Magdalena Purnama S

Author Institution: Universitas Padjadjaran - PMN RS. Mata Cicendo

Co Author:

Magdalena Purnama S, Karmelita Satari MD ()

Susanti Natalya Sirait MD ()

Ine Renata Musa MD ()



Seminat: INASCRS


Introduction & ObjectiveVisual impairment and blindness is one of public health problem and Results in decreased quality oflife. Global report estimates there were 36 million people who were blind and 217 million hadmoderate and severe visual impairment. This study aims to describe the characteristics of patientswith moderate and severe visual impairment at Low Vision unit in Indonesia National Eye CentreCicendo Eye Hospital.MethodAll medical records of moderate and severe visual impairment patients in 2017- 2018 wereretrospectively reviewed. Patients’ age, gender, area of origin, employment Status, visualimpairment type, diagnosis,, low vision aid given, and number of visit were obtained.ResultTotal number of patients in this study was 209 patients, 73,2% were moderate and 26,7% weresevere visual impairment. Most patients were males (56.0%), age group of 0-16 years (28,7%), fromWest Java outside of Bandung (41,1%), and had no job (40.6%). Most common diagnosis in agegroup of 5-16 years was amblyopia (5.2%), in 17-33 years age group were amblyopia (5,2%) andretinitis pigmentosa (5.2%), in age group of 34-50 years was retinitis pigmentosa (7,6%), in agegroup > 50 years was macular degeneration (6,7%). low vision optic devices were given for 95,2%patients. 85,1% of patients only visited once.ConclusionPatients’ characteristic of moderate and severe visual impairment at Low vision unit are dominatedby men, age range of 5-16 years, with posterior segment abnormaities, one-time control , onlymostly area of origin from West Java outside Bandung. Low vision optical devices which are mostlygiven areaKeywordModerate vision impairment, severe visual impairment, low vision device.Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download88-poster-magda-1.jpg

90 E-POSTER

EPOS-G-INASCRS-21Efficacy of Corneal Collagen Cross-Linking (CXL) in Treating Keratoconus: ASystematic Review

Abstract TitleEfficacy of Corneal Collagen Cross-Linking (CXL) in Treating Keratoconus: A Systematic Review

First Author: Kiara Nurmathias

Author Institution: Gandaria Hospital, Jakarta, Indonesia

Co Author:

Anya Dewi Nastiti (Trisakti University)

Arlin Chyntia Dewi (IMC Bintaro Hospital, Tangerang Selatan, Indonesia)



Seminat: INASCRS


Introduction & ObjectiveKeratoconus is a non-inflammatory disease characterised by progressive corneal thinning andapical protrusion. It induces irregular astigmatism, myopia, thus leads mild to marked impairmentin the quality of vision. The incidence of keratoconus is approximately 1 per 2,000 in the generalpopulation. Since 2003, Corneal Collagen Cross-Linking (CXL) has become an option to halt KCprogression, help corneal flattening and improve refractive Status of the eye. The purpose of thisbstudy is to evaluate the efficacy of CXL in treating keratoconus.MethodSystematic review was performed using “corneal collagen cross-linking”, “CXL” and “keratoconus”as Keywords to identify published articles between years 2016-2021 on PubMed, ProQuest,Cochrane Library and Google Scholar. Full-text English articles that include keratoconus patientsunderwent CXL as subjects will be reviewed. The primary outcome parameters includeduncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and Kmax measured at 12and 24 months after CXL.ResultFrom two prospective studies and one retrospective study, 155 eyes met the eligibility criteria forthis systematic review. UCVA and BCVA improved significantly in all patients who completed 12and 24 months of follow up (P < 0,05). Meanwhile, Kmax readings were lowered significantly in twostudies (P < 0,05) within 12 and 24 months of follow up while one study shows no significantoutcomes. In these studies, no major complications were found.ConclusionOur review suggested that Corneal Collagen Cross-Linking (CXL) is effective in improving visualacuity and preventing further progression of keratoconus.KeywordCorneal collagen cross-linking; CXL; keratoconus.Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download962-EPOS-G-INASCRS-21-Kiara-Nurmathias.jpg

91E-POSTER

EPOS-R-INASCRS-22MANAGEMENT INTRAOCULAR LENS REPOSITION WITH IRIS SUTUREFIXATED ON DISLOCATED INTRAOCULAR LENS

Abstract TitleMANAGEMENT INTRAOCULAR LENS REPOSITION WITH IRIS SUTURE FIXATED ONDISLOCATED INTRAOCULAR LENS

First Author: Putu Gede Yudi Darma Wijaya suparta

Author Institution: Opthalmology Department, Faculty of Medicine, Udayana University

Co Author:

I Wayan Gede Jayanegara (Opthalmology Department, Faculty of Medicine, Udayana University)

Siska (Opthalmology Department, Faculty of Medicine, Udayana University)



Seminat: INASCRS


IntroductionDislocated Intraocular Lens (IOL) can be Resulted from multiple causes, including trauma,complicated cataract surgery, pathological abnormalities or inadequate capsular support. IOLreposition on inadequate capsular support can be done by anterior chamber support, iris fixatedposterior chamber IOL, scleral fixated posterior chamber IOL.Case IllustrationA 42 year old man complain of blurry vision on right eye since 4 month ago after hit by toys whileplaying with his children. He had cataract surgery on right eye 3 years ago. Ophthalmologyexamination shows Uncorrected Visual Acuity (UCVA) was 1/60 and Best Corrected Visual Acuity(BCVA) was 6/30 on the right eye. Anterior segment examination revealed dislocated IOL toinferomedial on the right eye. Patient was diagnosed with right eye dislocated intraocular lens ec.Blunt trauma. Reposition IOL with Iris Suture Fixated was chosen as a management for this patient.On third month follow up UCVA was 6/30 and BCVA was 6/6.DiscussionDislocated lens with inadequate capsular support, reposition IOL with Iris Suture Fixated can beused. This Method spends shorter time, simple technique, no significant complication than scleral fixation. To implement this procedure, the following factor must present: iris integrity, depth of theanterior chamber ≥ 3 mm, and, preferably, an endothelial cell count ≥ 1,200 cells/mm2ConclusionDiagnosis dislocated intraocular lens based on history, sign and symptom, and completeophthalmologic examination. Reposition IOL with Iris Suture Fixated can be used to improve visualacuity.KeywordIntraocular Lens Dislocation, Iris Suture FixatedLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download338-Poster-PVSM-Yudi-Fix.jpg

92 E-POSTER

EPOS-O-INASCRS-23MANAGEMENT OF IRIS TRAUMA AND INADEQUATE OF CAPSULAR BAG SUPPORT

Abstract TitleMANAGEMENT OF IRIS TRAUMA AND INADEQUATE OF CAPSULAR BAG SUPPORT

First Author: SISKA

Author Institution: Departemen Ilmu Kesehatan Mata FK UNUD/ RSUP Sanglah Denpasar

Co Author:

Cokorda Istri Winny Prabasari (Departemen Ilmu Kesehatan Mata FK UNUD/ RSUP Sanglah Denpasar)

Pande Made Gustiana (Departemen Ilmu Kesehatan Mata FK UNUD/ RSUP Sanglah Denpasar)

Winly (Departemen Ilmu Kesehatan Mata FK UNUD/ RSUP Sanglah Denpasar)

I Wayan Gede Jayanegara (Departemen Ilmu Kesehatan Mata FK UNUD/ RSUP Sanglah Denpasar)



Seminat: INASCRS


IntroductionIris trauma and inadequate of capsular support is challenging situation in lens surgery. This casepresented an aphakic complicated case that underwent a several interventions. We report asuccessful procedure of surgical correction with minimal complication.Case IllustrationA 59 years old male patient was referred with hand movement vision on left eye after history ofphacoemulsification. CTR was found strangulated in false route of ciliary sulcus, where 360-degreeiris atrophy and pupil damage, posterior capsular rupture and vitreous prolapse was revealed.Patient then underwent CTR explantation, secondary implant by modified Yamane intrascleralfixation technique and pupilloplasty until the pupil well-centred and IOL stabilized.DiscussionCapsular tension ring is normally use in weak or defective zonular, but unfortunately in this case ithad been strangulated and made iris trauma with pupil damage, so we removed a displaced CTR, amodified Yamane intrascleral fixation technique was done for the secondary implanted IOL andrepaired the iris with pupilloplasty. As the Result, pupil was well-centred and the IOL was fixatedperfectly stable.ConclusionCombination of CTR explantation, Yamane scleral fixation technique, and pupilloplasty consideredsuccessful for an aphakic complicated case of iris trauma and inadequate of capsular bag support.KeywordIris trauma, Yamane intrascleral fixation technique, pupilloplasty.Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download388-EPOS-O-INASCRS-23-SISKA.jpg

93E-POSTER

EPOS-G-INASCRS-24Complicated Cataract Caused by Uveitis and Pupil Seclusion

Abstract TitleComplicated Cataract Caused by Uveitis and Pupil Seclusion

First Author: NAFILAH AZIZIYAH ZEIN

Author Institution: KLINIK RAWAT INAP RAHMAN MEDIKA SEKARAN, LAMONGAN

Co Author: BUDY SURAKHMAN, dr., Sp.M (RUMAH SAKIT MATA MASYARAKAT JAWA TIMUR)



Seminat: INASCRS


Introductioncataract become the cause of blindness in 51% population in the world. The incidence of cataract inuveitis varies from 57% in pars planitis to 78% in Fuchs heterochromic iridocyclitis. In a study,visual outcome after cataract surgery in complicated cataract is statistically significant (P<0.0001).The purpose of research is to report the management of complicated cataract caused by uveitis andpupil seclusion.Case Illustrationa 56 years old man complain of having red left eye in the last 10 days and blurred vision in the last1 year that progresses over time. Visual acuity in left eye was hand movement. Ophthalmicexamination showed conjunctiva injection, iris atrophy, posterior synechiae, total opacification inthe lens. Ultrasound examination on the left eye showed vitreus echospike 40-50%, retina on placedand vitritis. Pre-operative treatment was tobroson, p-pred and cenfresh eye drops. Patient wasperformed phacoemulsification in the left eye with help of iris retractor and continued with IOLimplant in the capsule.Discussionvisual outcome one week after surgery was 0.2. Intraocular pressure was stable. IOL is placed inthe capsule. No sign of inflammation or hemorrhage after surgery.Conclusionphacoemulsification with iris retractor and IOL implant in the capsule may give good Result forcomplicated cataract caused by uveitis.Keywordcomplicated cataract, uveitisLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download392-Slide1.JPG

94 E-POSTER

EPOS-G-INASCRS-25Marfan syndrome : a rare case report

Abstract TitleMarfan syndrome : a rare case report

First Author: Alfin Radhian

Author Institution: Rs mata m77

Co Author:

Sandi washkito (Rs mata m77)

Fadhil syafridon (Rs mata m77)



Seminat: INASCRS


IntroductionMarfan’s syndrome is a genetic disorder with high morbidity and mortality. About 1 in every 3,000to 5,000 people is affected. People affected by Marfan syndrome carry mutations in one of twocopies of their gene that codes for the connective tissue protein fibrillin-1. Marfan syndrome affectsmost of the organs and tissues, eye features of this syndrome have been reported.Case IllustrationA 23 year old man revealed severe eye complications as ectopia lentis. Physical examinationrevealed a tall and thin patient with long extremities and an elongated face. Eye examinationshowed VOD 6/36 increased to 6/6 with a -1.74 lens and VOS 1/60 cannot increase by pinhole. Slitlamp examination found ectopia lentis in the infero temporal quadrant. The patient will be treatedwith Phacoemulsification and Intra Ocular Lens implantation. Post operative day 1 Result shownthere was an improvement, VOS 6/60 -> 6/36 increase by pinhole, IOP 20 / 18, clear cornea. Postoperative day 2 Result VOS 6/36 False +2,00 x 130 6/10 False there was no increase by pinhole.DiscussionSubluxed lenses with limited zonular support in some cases be managed by phacoemulsificationsurgery, but long-term stability after phacoemulsification has not been consistently reported.ConclusionThere is a need to manage the eye features of Marfan syndrome effectively to prevent amblyopiaand vision loss. There must be a multidisciplinary approach to the management of Marfan’ssyndrome.KeywordMarfan Syndrome, Ectopia Lentis, phacoemulsificationLatest UpdateMay 18, 2021StatusApproved As E-PosterFile Download340-EPOS-G-INASCRS-25-Alfin-Radhian.jpg

95E-POSTER

EPOS-R-INASCRS-26MANAGEMENT IN POSTERIOR POLAR CATARACT WITH POSTERIORLENTICONUS AND SENSORY DEPRIVATION EXOTROPIA: A CASE REPORT

Abstract TitleMANAGEMENT IN POSTERIOR POLAR CATARACT WITH POSTERIOR LENTICONUS ANDSENSORY DEPRIVATION EXOTROPIA: A CASE REPORT

First Author: Intifada

Author Institution: Resident of Ophthalmology, Faculty of Medicine Universitas Airlangga - Dr. Soetomo


Co Author:

Indri Wahyuni (Cataract and Refractive Surgery Division, Department of Ophthalmology, Faculty of

Medicine Universitas Airlangga - Dr. Soetomo General Hospital, Surabaya, Indonesia)



Seminat: INASCRS


IntroductionPolar cataracts are lens opacities that involve the subcapsular cortex and capsule of the anterior orposterior pole of the lens. Lenticonus is a localized, cone-shaped deformation of the anterior orposterior lens surface.Case IllustrationA 30-year-old woman complained of blurred vision, excessive glare, and squint of the right eye fornine years and progressively worsened. The visual acuity was hand movement. Slit-lampexamination revealed a posterior polar cataract and posterior lenticonus. The patient wasdiagnosed with a posterior polar cataract with lenticonus posterior and sensory exotropia based onclinical findings. The patient has undergone cataract extraction, and due to adherent plaque at theposterior capsule and the abnormal shape of the posterior surface, the plaque was left in place andfollowed by Nd-YAG laser posterior capsulotomy. However, the visual acuity was still not improved,and then diagnosed with anisometropic and sensory amblyopia.DiscussionPosterior polar cataract presents a challenge to surgeons because of a predisposition to posteriorcapsular rupture. The management is to clear the visual axis by total cataract extraction; however,if the posterior capsular plaque is firmly adherent to the capsule, the safest option is to leave theplaque for Nd-YAG laser capsulotomy. In this patient, the sensory exotropia develops due to acataract that severely reduces vision or the visual field in one eye.ConclusionTheposteriorpolarcataractmanagementiscataractextraction,andthetreatment for amblyopia andexotropia should be done to improve visual acuity. This case needs multidiscipline management toprovide the best outcome.KeywordPosterior Polar Cataract, Lenticonus, CataractLatest UpdateMay 18, 2021StatusApproved As E-PosterFile Download424-EPOS-R-INASCRS-26-Intifada.jpg

96 E-POSTER

EPOS-R-INASCRS-28OUTCOME OF IRIS-CLAW INTRAOCULAR LENS IMPLANTATION INDROPPED INTRAOCULAR LENS CASES

Abstract TitleOUTCOME OF IRIS-CLAW INTRAOCULAR LENS IMPLANTATION IN DROPPED INTRAOCULAR LENS CASES

First Author: syifa rahmani


Indonesia

Co Author:

Emmy Dwi Sugiarti (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Budiman (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Andrew M.H. Knoch (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)


Abstract Category: Free Paper

Seminat: INASCRS


Introduction & ObjectiveDropped intraocular lens (IOL), though rare, represents serious complication after cataractsurgery. Although several procedures of IOL implantation for inadequate capsular support havebeen described, surgical treatment of aphakia still remains challenging. This study aimed todescribe visual outcome of iris-claw IOL implantation in aphakia caused by dropped IOL after parsplana vitrectomy in Cicendo Eye Hospital from 2018 to 2020.MethodA retrospective descriptive study from medical records of patients with aphakia caused by droppedIOL which underwent iris-claw implantation after pars plana vitrectomy. Iris-claw lens were eitherimplanted in the same procedure along with vitrectomy or later in different procedure. Visualoutcomes and complications were recorded.ResultThe study comprised 20 eyes of 20 patients. The mean uncorrected visual acuity (UDVA) andcorrected distance visual acuity (CDVA) postoperatively was better than preoperatively.Postoperative UDVA was better than preoperative UDVA in 14 (70%) patients. Postoperative UDVAwas better than preoperative CDVA in 11 (55%) patients. The patients had following complications:deformed pupil (35%, n=7), secondary glaucoma (15%, n=3), cystoid macular edema (5%, n=1),and dislocation of IOL (5%, n=1).ConclusionIris-claw IOL implantation gave good visual outcome and low complication in aphakic eyes causedby dropped IOL.KeywordIris-claw, aphakia, dropped IOLLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download335-FP-R-O-INASCRS-17---Syifa-Rahmani.pdf

97E-POSTER

EPOS-O-INAPOSS-01Prevalence of Amblyopia in School-Age Children with Refractive Errors inKlungkung Public Regional Hospital Bali

Abstract TitlePrevalence of Amblyopia in School-Age Children with Refractive Errors in KlungkungPublic Regional Hospital Bali

First Author: NI LUH PILIANTARI MEIGAWATIAuthor Institution: RSUD Kab. Klungkung

Co Author: Davin Edlyn Frizzy (RSUD Kab. Klungkung)



Seminat: INAPOSS


Introduction & ObjectiveAmblyopia is a condition characterized by the reduction in best-corrected visual acuity (BCVA) ofone or both eyes without ocular structural abnormalities. The prevalence of amblyopia observed tobe 0.6 to 6.2% worldwide. It has life-long impacts not only on children’s lives but as well as theirfamilies. Therefore, it is important to do appropriate examinations and interventions. This studyaims to find the prevalence of amblyopia in children between 3-17 years old in Klungkung PublicRegional Hospital.MethodData taken from medical history in eye clinic of Klungkung Public hospital. School-Age childrenbetween 3-17 years old who were diagnosed with refractive errors from January to December 2020were eligible as participants, those with BCVAResultTotal number of participants was 80, all were from Asian origin with the distribution betweenfemale and male were 52 (65%) and 28 (35%) respectively. The participants’ age mean was 13.6(95% CI 10.33-16.87), with BCVA was within range 0.2-1.0. The number classified as amblyopia was29 out of 80 (36.25%) and were observed notably insignificant between genders with 17 (58.62%)being female and 12 (41.38%) were male. The mean age was 13.03 (95% CI 9.55-16.51) with meanof BCVA 0.5.ConclusionThis study found that the prevalence of amblyopia in school-age children between 3-17 years oldwith refractive errors in Klungkung Public Hospital was fairly high compared to other studies.However, the number might not have represented the entire population in region, thereforehopefully there will be future studies.KeywordAmblyopia, Refractive Errors, ChildrenLatest UpdateApril 21, 2021StatusApproved As E-PosterFile Download305-EPOS-O-INAPOSS-01-Ni-Luh-Piliantari-Meigawati.jpg

98 E-POSTER

EPOS-G-INAPOSS-02Pediatric Penetrating Ocular Injury : a Case Report

Abstract TitlePediatric Penetrating Ocular Injury : a Case Report



Co Author:



Seminat: INAPOSS


IntroductionOcular injury is a common cause of unilateral blindness in children and young adults. Children aremore prone to injuries because of their inability to avoid hazards. In general, males are morefrequently reported to have eye injuries compared to females due to their adventurous andaggressive nature. Prompt evaluation and appropriate management of ocular injuries areparamount in the preservation of vision.Case IllustrationA ten years old male was admitted to the hospital after his right eye stabbed by a knife andcomplained of vision loss right away after the incident. On initial right eye examination, foundvisual acuity at hand movement, corneoscleral laceration, iris prolapse, and hyphema in theanterior chamber.DiscussionWe use Pediatric Penetrating Ocular Trauma Score (POTS) as a tool for the prediction of visualoutcomes after ocular trauma. The total score, in this case, is 40, therefore it was classified toGroup 1, of which 73% of cases had the probability of visual outcome NLP. The patient underwentsurgery. Performed globe exploration and iris reposition, corneosclera suture, aspiration irrigationhyphema, and anterior chamber reformation. Improvement visual acuity 5/60 at 5 weeks follow up,which was better than the POTS prognosis.ConclusionThe visual prognosis of ocular injury is associated with various variables including size and locationof the lacerated wound, and also immediate treatment. The best treatment for eye injuries inchildren is prevention, therefore parental supervision is very important. In this case, there weregood wound healing, no secondary infection, and improvement of visual acuity.KeywordPediatric ocular injury, penetrating ocular injury, ocular traumaLatest UpdateMay 06, 2021StatusApproved As E-PosterFile Download306-EPOS-G-INAPOSS-02.jpg

99E-POSTER

EPOS-R-INAPOSS-03CHALLENGING CASES: INCREASING STEREOACUITY IN PATIENT WITHTRUE DIVERGENCE EXCESS AFTER SURGERY

Abstract TitleCHALLENGING CASES: INCREASING STEREOACUITY IN PATIENT WITH TRUEDIVERGENCE EXCESS AFTER SURGERY

First Author: Sandiyanto

Author Institution: Department of Ophthalmology, Andalas University - RSUP DR. M. Djamil Padang

Co Author: Julita (Department Ophthalmology, Andalas University - RSUP DR. M. Djamil Padang)



Seminat: INAPOSS


IntroductionTrue divergence excess is an uncommon pattern of intermittent exotropia in which the distancedeviation is at least 10 PD larger than the near deviation. Operating between the distance and neardeviation produces a compromise. These are very difficult cases and may result in a residualexotropia in the distance and a consecutive esotropia at near. Therefore, the target angle inpatients with true divergence excess should be an average of the distance and near deviation afterthe patch test.Case IllustrationTwo cases of true divergence excess with TNO test >2000 sec/arc. Case 1, male, 25 years old, withthe prism alternate cover test (PACT) deviation showed 60 PD base in (BI) near and >90 PD BIdistance. Case 2, female, 9 years old, with deviation was 30 PD BI near and 90 PD BI distance. Afterpatch test, both cases showed the same deviation. All the cases underwent monocular lateral rectusrecession with hangback recession and medial rectus resection with target angle surgery averageof the distance and near deviation after the patch test.Discussion1 day after surgery, both cases showed orthophoria at distance and near. 5 weeks after surgery,follow up of all the cases showed improvement stereoacuity with no other complication. Case 1,stereoacuity improvement to 60 sec/arc and 120 sec/arc in case 2.ConclusionThe management of true divergence excess is challenging. Surgery should be performed based onthe average of the distance and near deviation after the patch test.KeywordTrue divergence excess, patch test, stereoacuity.Latest UpdateMay 07, 2021StatusApproved As E-PosterFile Download644-EPOS-R-INAPOSS-03-Sandiyanto.jpg

100 E-POSTER

EPOS-G-INAPOSS-04.Coats’ Disease With Intracranial Tumor Of 13-Years-Old Teenager:A Case Report

Abstract TitleCoats’ Disease With Intracranial Tumor Of 13-Years-Old Teenager: A Case Report

First Author: Giovanni Adrian Santoso

Author Institution: Universitas Pelita Harapan

Co Author:

Yoseph Siahaan (Universitas Pelita Harapan)

Cheryll Yudakusuma (Universitas Pelita Harapan)

Marcellina Hermanto (Universitas Pelita Harapan)



Seminat: INAPOSS


IntroductionCoats’ disease was first described in 1908 as unilateral retinal vascular abnormality with exudationby George Coats. This condition affects males more than females with no ethnic or geographiccorrelations. Coats’ disease is rare and often difficult to diagnose, also has some overlappingclinical manifestations with unilateral retinoblastoma, which occurs in the same age group. In thisstudy, we report a case of teenager Coats’ disease to illustrate its clinical findings and thetreatments.Case IllustrationA 13-years-old male teenager, came to the Ophthalmology outpatient department (OPD) with ahistory of pain and progressive reduced vision in the right eye for three months. The patient had nohistory of using eye drops medication, steroid-related medication consumed in a long period, andprevious illness or surgery of the eye. Family history showed that there were no such symptoms inany of family members. The patient had no history of traumatic accident beforeDiscussionMost common complications of Coats’ are secondary to chronic retinal detachment. Patients maypresent with a painful blind eye due to neovascular glaucoma as a result of iris and angleneovascularization and often require primary enucleation. In this patient’s case primaryenucleation has been done to the right eye which correlated to patient’s symptoms.ConclusionGreater understanding about typical features, diagnosing the disease at an early stage andinitiating appropriate treatment like improving surgical techniques for retinal detachment, lasers,and intraocular injections can greatly improve the visual outcomes and reduce the rate ofenucleation in coats’ disease.Keywordteenager coat’s disease, telangiectasia, exudatesLatest UpdateMay 09, 2021StatusApproved As E-PosterFile Download887-Case-Report-(1).jpg

101E-POSTER

EPOS-O-INAPOSS-05Amblyopia in 7-year-old Child with Refractive Errors: A Case Report

Abstract TitleAmblyopia in 7-year-old Child with Refractive Errors: A Case Report

First Author: NI LUH PILIANTARI MEIGAWATI

Author Institution: RSUD Kab. Klungkung

Co Author: DAVIN EDLYN FRIZZY (RSUD Kab. Klungkung)



Seminat: INAPOSS


IntroductionOptimum vision is obtained by the continuous clear images’ stimulation provided by the eyes to thebrain cortex during the visual developmental phase. Interference in the pathways may lead to acondition called amblyopia, which is clinically defined as the reduction of best-corrected visualacuity (BCVA), the leading cause of low vision in children and adults in developed countries withapproximately about 3-6 % or 1.9 million in prevalence worldwide. Studies suggest that earlyrecognition and intervention is necessary for better outcomes, however every child has the right tobe treated regardless of their age.Case IllustrationWe present a case of a 7-year-old boy who first complained about blurred vision that affected hisstudy performance when he visited the eye clinic at Klungkung Public Regional Hospital in 2017.Thorough general and ophthalmic examinations were performed and he was diagnosed withrefractive errors and amblyopic eyes with BCVA for OD and OS 0.7F and 0.8F subsequently. Wefollowed the patient’s progress in the following years with the results for OD and OS as follows,0.8F and 0.8 in 2018; 0.9F and 0.9 F in 2019; 1.0 for both eyes in 2020DiscussionThe improvement of our patient’s BCVA was evident throughout the years we have been followingby optical correction alone. However, his good prognosis should be ascertained with close follow-upuntil visual stability is achieved.ConclusionComprehensive management that includes multisectoral fields is essential for early detection andintervention, for better outcomes in treating refractive errors-related amblyopia.KeywordAmblyopia, Refractive Errors, Visual DevelopmentLatest UpdateMay 09, 2021StatusApproved As E-PosterFile Download839-EPOS-O-INAPOSS-05-Ni-Luh-Piliantari-Meigawati.jpg

102 E-POSTER

EPOS-R-INAPOSS-06PEDIATRIC CATARACT WITH MICROPHTHALMIA, IRIS COLOBOMA,NYSTAGMUS, DEVELOPMENTAL DELAY AND LIMB ABNORMALITY: A CASEOF 5 YEARS OLD CHILDREN

Abstract TitlePEDIATRIC CATARACT WITH MICROPHTHALMIA, IRIS COLOBOMA, NYSTAGMUS,DEVELOPMENTAL DELAY AND LIMB ABNORMALITY: A CASE OF 5 YEARS OLD CHILDREN

First Author: Annisa Karima

Author Institution: airlangga university

Co Author: Luki Indriaswati (airlangga university)



Seminat: INAPOSS


IntroductionPediatric cataract associates with ocular and systemic abnormalities is a rare case and could bepart of syndromesCase IllustrationA 5 years old female patient with blurred vision especially when seeing far objects. The left eye (LE)was smaller than the right eye (RE) with involuntary movement of those eyes and inadequateresponse to the around objects since she was born. Developmental delay was present. Her left legwas shorter than the right leg. Physiotherapy had been performed. Visual acuity of the RE was 6/60and the LE was 1/300. There was microphthalmia on the LE with the axial length was 19,48 mmwhereas the RE was 22.94 mm. Nystagmus, iris coloboma on both eyes and cataract on the REwere present. The intra ocular pressure, keratometry and funduscopic examination was difficult tobe performed. Diagnose of Pediatric Department are gross motor delay and personal social delay.Further diagnostic and gene examination was planned. We gave one drop homatropine every 24hours on the RE then observe periodically. We explained her condition to her family. Physiotherapyfor motor delay should be continued.DiscussionThe differential diagnoses of pediatric cataract associates with microphthalmia, iris coloboma,nystagmus, developmental delay, and limb abnormality were Waardenburg anophthalmiasyndrome, IPO13 mutation, Odgen syndrome, and PAX6 gene mutationConclusionThis case showed pediatric cataract with multiple ocular abnormalities and systemic features thatneed further comprehensive examination and multidiscipline consultation to establish the diagnoseKeywordpediatric cataract, microphthalmia, iris colobomaLatest UpdateMay 15, 2021StatusApproved As E-PosterFile Download944-EPOS-R-INAPOSS-06-annisa-karima.jpeg

103E-POSTER

EPOS-O-INAPOSS-07CONSECUTIVE EXOTROPIA AFTER CONGENITAL ESOTROPIA SURGERY :SURGICAL RESULT

Abstract TitleCONSECUTIVE EXOTROPIA AFTER CONGENITAL ESOTROPIA SURGERY : SURGICAL RESULT

First Author: BALGIS DESI S.

Author Institution: RS Mata SMEC

Co Author: Ferdian Ramadhan (Universitas Airlangga)



Seminat: INAPOSS


IntroductionConsecutive exotropia (XT) is a manifest XT that develops in a formerly esotropic patient eitherspontaneously or after treatment for esotropia (ET). It has been reported in 4–27% of consecutiveXT after all types of corrective ET surgery. Patients with congenital ET, and those with ETassociated with high hypermetropia, amblyopia developmental delay, multiple previous strabismussurgeries and large bimedial recessions, higher the risk to develop consecutive XT after surgery.Case Illustration1 year old girl came with bilateral squint eyes with poor image focus complained by her parents.Ophthalmologic work up found 1.0 dec in 1 meter visual acuity, 70 prism base out prism, withoutposterior segment abnormality. Forced duction test showed bilateral restriction with suspectibleinsertion of oblique superior insertion in media rectus muscle of the left eye. Bimedial 6.5 mmrectus muscles recession + 3 mm left lateral rectus muscle resection were performed. Month aftersurgery showed 35 prism XT. CT scan revealed slipped and thickening of medial rectus muscle.Month after bimedial rectus muscle advancement patient showed orthotropia. 3-year-old visualacuity showed 20/40 visual acuity and orthotropia.DiscussionManagement of consecutive exotropia is rendered difficult due to scarring from previous surgery,lack of well established surgical dose corrections, high incidence of late exodrifts and requirementof multiple surgeries.ConclusionThe Method of surgical treatment varies according to different factors, such as the grade ofprevious medial rectus function that was recessed, the amount of consecutive exotropia deviation,and amblyopia.KeywordEsotropia, exotropia, consecutiveLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download907-PVSM2021-fer2-ed.jpg

104 E-POSTER

EPOS-R-INAPOSS-08BASIC TYPE EXOTROPIA AS ONE OF THE OCULAR MANIFESTATION IN DELA CHAPELLE SYNDROME: A RARE CASE REPORT

Abstract TitleBASIC TYPE EXOTROPIA AS ONE OF THE OCULAR MANIFESTATION IN DE LACHAPELLE SYNDROME: A RARE CASE REPORT

First Author: Puspita Hapsari SItorasmi

Author Institution: Universitas Airlangga/RSUD Dr. Soetomo

Co Author: Rozalina Loebis (Universitas Airlangga/RSUD Dr. Soetomo)



Seminat: INAPOSS


IntroductionDisorder of sex developmental (DSD) is a condition with atypical chromosomal, gonadal orphenotypic sex differences in the development of the urogenital tract and clinical phenotypes. De laChapelle syndrome, which one of DSD, a rare cause of male infertility. This syndrome is oftenfollowed by abnormalities in other parts of the body, one of which is an ocular disorder, includingstrabismus.Case IllustrationA 7-year-old boy presented with squint outward of both eyes since the age of 3 months. Squintappeared while daydreaming. Visual acuity was 6/6 in both eyes. There’s exotropia 30o in near anddistance and krimsky test showed 50 prism dioptre BI in near and distance. From urological Status,there’s a meatus urethral external in the ventral penis and there’s undescended testis. Hormonaltesting showed 0,30 mlu/ml for B HCG and 0.09 ng/ml for testosterone. Chromosomal testingshowed 46-XX and SRY negative.DiscussionNo one knows for sure the cause of DSD which is followed by other congenital diseases, but onestudy found that the GATA4 gene is a gene that is responsible for the transcription factor in theformation of the gonads and the heart. In another study, it was stated that mutases of the FGFR1and STARD3 genes were found in patients with DSD.ConclusionDe la Chapelle is often followed by several other congenital abnormalities, one of which is an oculardisorder. Education for families is important so that children can develop physically and mentallylike other normal children.Keywordbasic type exotropia, De la Chapelle syndrome, congenital abnormalityLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download787-EPOS-R-INAPOSS-08-Puspita-Hapsari-Sitorasmi.jpg

105E-POSTER

EPOS-R-INAPOSS-09THE SIGNIFICANT DIFFERENCE BETWEEN CYCLOPLEGIC AND NONCYCLOPLEGIC REFRACTION USING STREAK RETINOSCOPY IN REFRACTIVEACCOMMODATIVE ESOTROPIA

Abstract TitleTHE SIGNIFICANT DIFFERENCE BETWEEN CYCLOPLEGIC AND NON-CYCLOPLEGICREFRACTION USING STREAK RETINOSCOPY IN REFRACTIVE ACCOMMODATIVE ESOTROPIA

First Author: Rikha Erina

Author Institution: Fakultas kedokteran universitas andalas

Co Author: Julita (Fakultas kedokteran universitas andalas)



Seminat: INAPOSS


IntroductionRefractive accommodative esotropia is a convergent deviation of eyes associated with activation ofaccommodative reflex, caused by uncorrected hyperopia, accommodative convergence, and poorfusional divergence. Because of uncorrected hyperopia, patient must accommodate to focus retinalimage. Assessment of refractive error of eye under cycloplegia is considered to be the standard forrefractive error measurements in children.Case Illustration4 years old patient came to M.Djamil hospital with squint inward since 1 years ago. Visual acuityOD : 20/50, OS : 20/30, normal anterior and posterior segment, Hirschberg test esotropia 300,Prism alternate cover test (PACT) near and distance fixation : 60 dioptric prism base out. Refractivecorrection using streak retinoscopy with non-cycloplegic OD : S+2.75 C-1.25 (180), OS : S+1.75C-0.50 (180), whereas with cycloplegic OD : S+7.00 C-1.00 (180), OS : S+6.00 C-1.00 (180). Thispatient was given spectacles based on full correction with cycloplegic result. After 1 month wearingspectacles, visual acuity was improved, OD: 20/40, OS: 20/25, Hirschberg test became orthophoriain both eye and no deviation with PACT, near and distance fixation.DiscussionInitial treatment of refractive accommodative esotropia is proper spectacles correction. Significanthyperopia refractive error should be corrected by prescribing spectacles based on full cycloplegicrefractive correction. In children, non-cycloplegic refractions are prone to significant errors, largelydue to an active accommodation.ConclusionNon cycloplegic refraction in children can cause high error for hyperopia patient with refractiveaccommodative esotropia. Therefore full correction with cycloplegic remain essential.Keywordcyclopegic, hyperopia, esotropiaLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download964-EPOS-R-INAPOSS-09-RIKHA-ERINA.jpg

106 E-POSTER

EPOS-R-INAPOSS-10Unusual Etiology of Gradual Third Nerve Palsy in Children

Abstract TitleUnusual Etiology of Gradual Third Nerve Palsy in Children

First Author: Fadilah Rezki Said


Co Author:

Marliyanti N. Akib (Hasanuddin University)

Fiona Dean (Coventry and Warwickshire Hospital)

Yunita Mansyur (Hasanuddin University)

Ratih Natasha Maharani (Hasanuddin University)

Rani Yunita Patong (Hasanuddin University)



Seminat: INAPOSS


IntroductionAmong all cases of ocular misalignment from cranial nerve palsies involving the eye, third nervepalsies are important because a subset of these are caused by life threatening aneurysms. The trueincidence of third nerve palsies with its various etiologies is largely unknown but it is uncommon inchildren.Case IllustrationA three years old boy came to eye clinic with a complaint of the left eye gradually shifting to the leftgaze. According to the parents, he sustained a fall from his crib onto his head when he was 8months old. The squint was noticed by his parents when he was 2 years old with ptosis. An MRI ofthe head showed lesion in left ethmoid sinus pressing medial rectus muscle.DiscussionParanasal sinus mucocele is a cystic lesion resulting from the accumulation of mucus secretionsand epithelial desquamation due to chronic obstruction of the sinus osteum. Mucoceles are slowgrowing. Pathophysiology of nerve palsy in the orbit caused by mucoceles is not well-known.Mucoceles probably cause ischemia by compressing the microvascular supply to the nerve.Although it is very rare that a mucocele in the ethmoid sinus induces oculomotor nerve paralysis. Asphenoid or ethmoid mucoceles can compromise the medially located branches of the oculomotornerve to the medial rectus muscle.ConclusionWe report a rare case of child with a third nerve palsy which is probably caused by the mass effectof a mucocele in the ethmoid sinus.KeywordThird nerve palsy, Oculomotor palsy, Ethmoidal mucoceleLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download538-Unusual-Etiology-of-Gradual-Third-Nerve-Palsy-in-Childre.pdf

107E-POSTER

EPOS-R-INAPOSS-11Spontaneous Cataract Absorption in Pediatric Patient with Noonan Syndrome:A Scientifically Explainable Miracle?

Abstract TitleSpontaneous Cataract Absorption in Pediatric Patient with Noonan Syndrome: A Scientifically Explainable Miracle?

First Author: Nur Aisyah Rahmawati

Author Institution: Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto

Mangunkusumo Hospital

Co Author

Rita Sita Sitorus (Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto

Mangunkusumo Hospital)



Seminat: INAPOSS


IntroductionSpontaneous cataract absorption has been infrequently reported in some cases with variousetiologies. We report a rare case of spontaneous cataract absorption in patient with Noonansyndrome.Case IllustrationA 10-year-old boy presented to the Pediatric Ophthalmology Clinic with blurry vision and pain in theright eye (RE) after being hit with soccer ball one day before admission. He had high myopia inboth eyes since 4-years old. Best corrected visual acuity of the RE was finger counting, associatedwith total cataract and traumatic iritis. Topical steroid and cycloplegic were administered andelective cataract extraction was planned. After further assessment with pediatrician, he wasdiagnosed with Noonan syndrome. One month following the first visit, patient came with visualimprovement, aphakic with some cortex remnant and intact lens capsule. Neither nucleus drop norabnormalities in the posterior segment were found. Anterior segment optical coherencetomography showed increased anterior chamber depth and intact thin capsular bag withoutnucleus.DiscussionSudden visual improvement in patient with total cataract may occur, the most common mechanismis lens dislocation, while spontaneous lens absorption is rarely reported. Comprehensiveinvestigation is critical to determine which mechanism is responsible.ConclusionTo our knowledge, this is the first reported case of spontaneous cataract absorption following blunttrauma in pediatric patient with Noonan syndrome. The most possible mechanism is unrecognizablerupture of the lens capsule during the trauma, leading to the nucleus emulsification. Whether thespontaneous absorption is related to Noonan syndrome, as a predisposing factor, remains an issueto elaborate.Keywordspontaneous cataract absorption, trauma, Noonan syndromeLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download207-EPOS-R-INAPOSS-11_Nur-Aisyah-Rahmawati.jpg

108 E-POSTER

EPOS-R-INAPOSS-12A Case Report on Single Horizontal Muscle Transposition in the Managementof Congenital Monocular Elevation Deficiency with Esotropia

Abstract TitleA Case Report on Single Horizontal Muscle Transposition in the Management ofCongenital Monocular Elevation Deficiency with Esotropia

First Author: Evan Regar


Co Author: Anna P Bani (RSCM)



Seminat: INAPOSS


IntroductionThis case report aims to demonstrate a single horizontal muscle transposition procedure in themanagement of congenital monocular elevation deficiency, associated with horizontal strabismus.Case IllustrationA 13-year-old girl presented with ptotic left eye and also turned down since her birth. Bestcorrected visual acuity was 6/40. She demonstrated 30 PD hypotropic and 60 PD esotropia (she didnot fixate with her left eye), with duction test confirmed -4 elevation deficit in all upgaze (abducted,primary, and adducted), with negative bell reflex. There was no problem with her right eye.Intraoperative forced duction test demonstrated inferior rectus muscle restriction. She underwentmaximal inferior muscle recession. Post-operatively, there was a marked improvement (10 PDhypotropia, residual 40 PD esotropia) and 0, -2, -4 elevation deficit. She underwent second-stepsurgery, which was augmented lateral rectus transposition. She demonstrated 15 PD hypotropiaand 15 PD esotropia, with a slight improvement in duction (0, -1, and -3). She was orthophoric indistance.DiscussionInferior rectus recession is done in this case, as FDT is positive, and in accordance with all theories,this should be the procedure of choice. In attempts to address horizontal deviation, singlehorizontal rectus transposition was chosen, also with augmentation sutures that may increase tonicforces, augmenting elevation as well as exerting lateral power to alleviate horizontal strabismus.Lateral rectus should be chosen in esotropic case.ConclusionAugmented single horizontal muscle transposition procedure is a promising alternative in a patientwith monocular elevation deficiency with horizontal strabismus.KeywordAugmented single horizontal muscle transposition, monocular elevation deficiency, esotropiaLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download850-E-Poster.jpg

109E-POSTER

EPOS-R-INAPOSS-13MANAGEMENT OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS(MRSA) IN PRESEPTAL CELLULITIS AMONG CHILDREN: A CASE REPORT

Abstract TitleMANAGEMENT OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) INPRESEPTAL CELLULITIS AMONG CHILDREN: A CASE REPORT

First Author: Monika Ayuningrum

Author Institution: Department of Ophthalmology Faculty of Medicine University of Sumatera Utara

Co Author:

Aryani Atiyatul Amra, MD (Department of Ophthalmology Faculty of Medicine University of

Sumatera Utara)

Fithria Aldy, MD (Department of Ophthalmology Faculty of Medicine University of Sumatera Utara)



Seminat: INAPOSS


IntroductionPreseptal cellulitis is one of the most common infections of the eyelid and periorbital soft tissuesthat is characterized by acute eyelid erythema and edema. This inflammatory disease more commonin young children. Reported a rare case of 12-year-old-girl with preseptal cellulitis following MRSAas primary etiologyCase IllustrationA 12 y.o girl complained edema in the left eye. She had an acne in palpebral 1 week ago. VA was5/60 (bed side) edema, redness, purulent discharge and limited opening the eye (Fig.1A).Ulceration and necrotic tissue on the upper and temporal region (Fig.1B). Laboratory testsuggested leukocytosis. Until infectious agent was identified, the patient was initially treated withbroad-spectrum intravenous (IV) antibiotics Ceftriaxone, IV NSAID, oral steroid, antibiotic eyedropand eye ointment. Bacterial culture and antimicrobial test revealed that there was MRSA whichresistant to Ceftriaxone, it was changed to Clindamycin. Finally, within 7 days, the symptoms hadresolvedDiscussionLocal infection could cause direct infection, allowing hematogenous spread, contributing to thevalveless orbital veins as the antegrade and retrograde direction of bacterial passage. As the veindrain to the cavernosus sinus, which has devoid valves, it can rapidly spread infections to preseptaland postseptal space. Treatment requires coordination multidisciplinary approach under apediatrician’s care, an ophthalmologist, and otorhinolaryngologistConclusionManagement of preseptal cellulitis includes rapid clinical assessment following the bacterialculture and antimicrobial susceptibility test. Hospitalization may be required to administer IVantibiotics to relieve symptoms and prevent further complicationsKeywordChildren, edema, preseptal cellulitisLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download686-PVSM-MONIKA-A.pdf

110 E-POSTER

EPOS-R-INAPOSS-14Management of Retinoblastoma with Enucleation

Abstract TitleManagement of Retinoblastoma with Enucleation

First Author: Lidiawati Manik

Author Institution: Universitas Sumatera Utara

Co Author:

dr. Fithria Aldy, M.Ked(Oph), Sp.M(K) (Universitas Sumatera Utara)

dr. Aryani Atiyatul Amra, M.Ked(Oph), Sp.M(K) (Universitas Sumatera Utara)



Seminat: INAPOSS


IntroductionRetinoblastoma is a malignant disease of the retina layer of the eye. Retinoblastoma can attack anyage, but generally affects children under 3 years. These tumors can be unilateral or bilateral. Themodality of retinoblastoma therapy is based on the grade of the tumor. Retinoblastoma therapymodalities include enucleation, chemotherapy, coagulation photos, cryotherapy, laser radiationtherapy, and bone marrow transplantation. The main goal of retinoblastoma management is to savethe patient’s life, while the return to visual function of the eye is a secondary goal.Case IllustrationA boy 4-years-old, came to the pediatric ophthalmologist, with the main complaint showing that hisleft eye was shining like a cat’s eye for 6 months before being admitted to the hospital. Onophthalmological examination on left eye, BCVA : light response (-), leukocoria (+), shallow COA,cloudy lens, and USG was found mass on the vitreous , the patient was diagnosed with leukocoriaOS ec Retinoblastoma and enucleation was performed.DiscussionWhen the likelihood of salvaging vision is low, primary enucleation of eyes with advanced unilateralretinoblastoma is often performed. To prevent extraocular spread of the tumor, the surgeon shouldminimize manipulation of the globe and obtain a long segment of optic nerve.ConclusionTreatment of enucleation as early as possible can save lives and prevent tumor metastases.KeywordEnucleation, Leukocoria, Retinoblastoma.Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download868-POSTER---LIDIAWATI-MANIK.pdf

111E-POSTER

EPOS-G-INAPOSS-15Gonococcal Opthalmia Neonatorum in 20 days old infant

Abstract TitleGonococcal Opthalmia Neonatorum in 20 days old infant

First Author: Maykel Sondak

Author Institution: Tobelo District Hospital, North Halmahera, North Mollucas

Co Author:

Semuel Samatara (Tobelo District Hospital, North Halmahera, North Mollucas)

Christine A Taneng (Tobelo District Hospital, North Halmahera, North Mollucas)

Raissa M Tanto (Departement of Opthalmology, FAculty of Medicine, Padjajaran University, Bandung)



Seminat: INAPOSS


IntroductionOpthalmia Neonatorum refers to conjungtivitis in occurring at the first month of life. This conditioncan be caused by bacterial, viral, or chemical agents.Case IllustrationA twenty days old female infant is presented with history of bilateral mucopurulent discharge fromthe eyes, redness and pre orbital swelling edematous eyelids. Bloody discharge was also found onthe right eye. The symptoms were first reported when the baby was eighteen days old. The babywas not given any antimicrobial eye ointment at birth. On Gram staining, negative gramdiplococcus intracellular was found. Microbial culture was not performed because of the limitedresources. No symptoms were found after seven days of therapy.DiscussionOpthalmia neonatorum is a sight threatening diseases that manifest within 3 – 4 weeks of life andrequires urgent treatment. Time incubation and onset of disease are important factors indetermining the etiology of diseases. Neisseria gonorrhea incubation period is typically 3 days to 3weeks but many literature reviews that symptoms present mostly on 2nd day to 5th day. Neisseriagonorrhea is one of the few bacteria that can penetrate intact corneal epithelium causing cornealulceration, corneal perforation, and blindness at the worst case scenario.ConclusionGonococcal Opthalmia Neonatorum is a serious infection in newborn. It requires prompt treatmentto avoid worsening condition. This case reviews that it is possible for symptoms to present after fivedays of life. Gonococcal Opthalmia neonatorum needs to be considered as the differential diagnosisfor infants under 3 weeks.KeywordGonococcal, Optahlmia Neonatorum,Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download151-EPOS-G-INAPOSS-15-Maykel-Sondak.jpg

112 E-POSTER

EPOS-R-INAPOSS-17Management of Congenital Glaucoma in Neonates

Abstract TitleManagement of Congenital Glaucoma in Neonates

First Author: Mia NursalamahAuthor Institution: Department of Ophthalmology, Faculty of Medicine, Padjadjaran University, Bandung

Co Author:

Maya Sari Wahyu K (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Feti Karfiati Memed (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Irawati Irfani (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Primawita O. Aminuddin (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Sesy Caesaria (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)



Seminat: INAPOSS


IntroductionPrimary congenital glaucoma is the most common form of childhood glaucoma. The most severeform of congenital glaucoma is the newborn onset. This case report shows a case of congenitalglaucoma in neonatal onset with trabeculotomy-trabeculectomy surgery as the operativemanagement.Case IllustrationA baby boy, aged 8 days was complained of cloudiness in both eyes of since birth by his mother.Photophobia, epiphora and blepharospasm were also complained. The examination underanaesthesia was revealed that the cornea was hazy and enlarged in both eyes. Fundus reflexes wasnegative. The intraocular pressure was 28 mmHg in the right eye and 32 mmHg in the left eye withPerkins tonometer. The trabeculotomy-trabeculectomy was performed in both eyes, and the cornealcloudiness became clearer in 1 month later and fundus reflex was brighter. Serum IgG rubella wasreactive and IgM rubella was negative. He was referred to paediatrician for further investigation.DiscussionCongenital glaucoma in neonates can be diagnosed by the hallmark signs such as cloudiness ofcornea, buphthalmos and increased intraocular pressure. Other systemic condition should beinvestigated in congenital glaucoma. The angle and filtering surgery give good response in neonatalonset of congenital glaucoma. Investigation of other systemic condition is a mandatory for acomprehensive management.ConclusionEarly diagnosis is the most important thing in congenital glaucoma management. Early operativemanagement of congenital glaucoma in neonates reveals a good outcome. Trabeculotomytrabeculectomy is best performed in case of poor visualization caused by corneal haziness.Keywordcongenital glaucoma, buphthalmos, trabeculotomy-trabeculectomyLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download978-EPOS-R-INAPOSS-17-Mia-Nursalamah.jpg

113E-POSTER

EPOS-R-INAPOSS-18Staphylococcus Lugdunensis in Recurrent Periorbital Cellulitis with a Historyof Reconstruction of Maxillofacial Fracture - A Case Report

Abstract TitleStaphylococcus Lugdunensis in Recurrent Periorbital Cellulitis with a History ofReconstruction of Maxillofacial Fracture - A Case Report

First Author: Sri Rejeki Sinaga


Co Author:

dr. Fithria Aldy, M.Ked(Oph), SpM(K) (Universitas Sumatera Utara)

dr. Aryani Atiyatul Amra, M.Ked(Oph), SpM(K) (Universitas Sumatera Utara)



Seminat: INAPOSS


IntroductionPeriorbital cellulitis is an inflammatory process of the eyelids and periocular soft tissues anterior tothe orbital septum.Case IllustrationA 16-year-old boy complained of swelling in the left eye (LE) for a week and difficulty opening theLE (Fig. 1). Visual acuity:5/60 (bedside), redness, purulent discharge, ulcerated tissue on the lowereyelid, fever and swelling like this one month ago. History of maxillofacial fracture six months agoand performed reconstruction and miniplate installation by plastic surgery department. Laboratoryshowed leukocytosis. Orbital CT scan showed periorbital cellulitis and there is a surgical chain inthe ethmoid sinus wall which is inflamed. The patient was diagnosed with recurrent periorbitalcellulitis LE and referred to otorhinolaryngology and plastic surgery for further evaluation.Treatment was given 3rd generation cephalosporin i.v, NSAIDs, antibiotic eye drops, and ointment.Bacterial culture and antimicrobial test showed s.lugdunensis with resistance to levofloxacin andoxacillin. The patient was treated for 5 days and advised by the plastic surgery department for theremoval of mini plates.DiscussionRecurrent periorbital cellulitis is rare entity. Current literature is limited but it could be caused byanatomy abnormality for disease recurrence. A long abnormal uncinated process, fused uncinatedprocess to the ethmoid bulla, and dehiscence between lateral nasal wall and lamina papyracea weresuggested as possible etiologies. The management was based on the underlying causalmicroorganism, clinical reassessment, and appropriate medical or surgical therapy.ConclusionThe evaluation and treatment of recurrent periorbital cellulitis requires an interprofessional teamapproach to its management.Keywordstaphylococcus lugdunensis, recurrent, periorbital cellulitisLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download718-POSTER---SRI-REJEKI-SINAGA.pdf

114 E-POSTER

EPOS-O-INAPOSS-19KERATOCONUS FINDING AFTER YEARS OF BILATERAL CONGENITALCATARACT SURGERY

Abstract TitleKERATOCONUS FINDING AFTER YEARS OF BILATERAL CONGENITAL CATARACT SURGERY

First Author: IRMA PRAMINIARTI

Author Institution: RS Mata Undaan Surabaya

Co Author: DINI DHARMAWIDIARINI (RS Mata Undaan Surabaya)



Seminat: INAPOSS


IntroductionKeratoconus (KC) is a bilateral asymmetric noninflammatory disorder characterized by progressivethinning and cone-shaped protrusion of the cornea. Exact etiology of KC remains unclear, evidencehas indicated multifactorial, multigenic disorder and ectasia might not be activated or reactivatedunless an additional stressful event triggers the disease (“two-hit” hypothesis). Triggering factorsare sources of reactive oxidative stress, mechanical trauma (vigorous eye rubbing, poorly fitcontact lenses), exposure to ultraviolet light, and atopy/allergies.Case Illustration7 month old girl came with chief complaint of whitish in both eyes 2 months after birth withoutpreviously known history of systemic disease. She underwent cataract surgery followed by IOLimplantation for both eyes with +33.00 D foldable IOL in 1 month separation for fellow eye surgery.Within 5 years, the patient visual acuity just reach 3 meters finger count for both eyes with hugedifference in keratometry findings; + 2.25 in RE and + 0.50 in LE and get worsen along the time.Pachymetry shows thin central corneal thickness for both eyes and corneal topography showscorneal thinning with keratoconus pattern.DiscussionConclusionCataract extraction previously known induce corneal mechanical stress due to corneal incisions,primarily during IOL implantation and destabilize tear film promoting ocular surface disease.Possibly, in our patient, cataract surgery-induced stress acted as the triggering factor thatdestabilized the cornea. An amblyopia therapy needs to be done in this case while waiting what willwe do with the KC.KeywordCongenital Cataract, Keratoconus, Amblyopia TherapyLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download138-PVSM-E-POSTER-dr.IR-4.jpg

115E-POSTER

EPOS-R-INAPOSS-20THE COMBINATION OF TRIMETHROPRIM/SULFAMETHOXAZOLE ANDMETHYLPREDNISOLONE FOR UNILATERAL NEURORETINITIS THERAPY INA 10 YEARS OLD BOY WITH SUSPECTED CAT SCRATCH DISEASE

Abstract TitleTHE COMBINATION OF TRIMETHROPRIM/SULFAMETHOXAZOLE ANDMETHYLPREDNISOLONE FOR UNILATERAL NEURORETINITIS THERAPY IN A 10 YEARSOLD BOY WITH SUSPECTED CAT SCRATCH DISEASE

First Author: Rikha Erina

Author Institution: Fakultas kedokteran universitas andalas

Co Author: Kemala Sayuti (Fakultas kedokteran universitas andalas)



Seminat: INAPOSS


IntroductionNeuroretinitis is an inflammatory disorder characterized by acute visual loss, optic disc edema andmacular star, associated with mild vitritis. Cat-scratch disease caused by Bartonella henselae is themost common cause of neuroretinitis due to infection, transmitted to humans by scratches, licks,and bites of cats.Case IllustrationBoy, 10 y.o came to M.Djamil hospital present with acute blurred vision and glare in right eye since4 days before admitted hospital. Fever, myalgias, and headaches occured 2 weeks earlier. Pasienthad history of cat-scratch on the right hand. Visual acuity OD 1/60, OS 20/20, RAPD (+) on OD,funduscopy : disc swelling with hyperemic papil, blurred boundaries, splinter hemorrhage, flameshape hemorrhage, and macular star. Pasient had dyschromatopsia (OD : 10/24 ishihara plates) andvisual field defect (central scotoma and enlargement blind spot). Erythrocyte sedimentation rateincreased, Mantoux test (-) and IgM IgG anti-toxoplasmosis (-). Oral Trimethroprim80mg/sulfamethoxazole 400mg is prescribed twice daily (6 weeks) and after 1 weeks oralmethylprednisolone 1x24mg was started (6 weeks). After 6 weeks therapy, visual acuity of ODimproved: 20/50, RAPD(-), disappearance disc swelling, decreased hard exudates in macula, andnormal colour visionDiscussionTreatment is recommended for neuroretinitis patient due to infection with severe visual loss,significant optic disc edema, and high degree of intraocular inflammation. A combinationtrimethroprim/sulfamethoxazole and methylprednisolone for 6 weeks can provide a better visualoutcome.ConclusionAdministration of antibiotics and corticosteroids immediately can improve visual outcome ofpatients with neuroretinitis caused by cat-scratch disease.KeywordNeuroretinitis, optic disc edema, macular starLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download51-EPOS-R-INAPOSS-20-RIKHA-ERINA.jpg

116 E-POSTER

EPOS-R-INAPOSS-21Successful Management of Hypertropia Related Thyroid Eye Disease

Abstract TitleSuccessful Management of Hypertropia Related Thyroid Eye Disease

First Author: Maria Debora Niken Larasati

Author Institution: Department of Ophthalmology, Universitas Airlangga, Dr. Soetomo Academic General

Hospital, Surabaya

Co Author:

Luki Indriaswati (Pediatric Ophthalmology and Strabismus Consultant in Department of

Ophthalmology, Universitas Airlangga, Dr. Soetomo Academic General Hospital, Surabaya)

Delfitri Lutfi (Orbita and Oncology Consultant in Department of Ophthalmology, Universitas

Airlangga, Dr. Soetomo Academic General Hospital, Surabaya)



Seminat: INAPOSS


IntroductionHypertropia in thyroid eye disease (TED) is uncommon which may cause visual and aestheticalproblem with quality of life disturbance.Case IllustrationA 44-year-old woman presented with a squint on the right eye with bilateral diplopia for 18 months.She had history of hyperthyroidism 2 years prior and was treated with thiamazole and propanololfor 1 year and methylprednisolone for 6 months. Visual acuity of both eyes was 20/20 with no signof active inflammation and optic neuropathy. Ocular motility showed restriction in lateral anddowngaze. Inferior restriction was found in forced duction test. Hypertropia was remarkably seenwith 40 prism BD in Krimsky test. After euthyroid state for 6 months without treatment and noescalation of Clinical Activity Score (CAS 2), strabismus surgery was planned. During surgery wefound hypertrophy and fibrous tissue of superior rectus muscle. Superior rectus recession for 6 mmwith additional semi-hang back procedure for 2 mm was performed. The following day we foundresidual hypertropia of 15 prism BD with significant improvement of diplopia. Ocular motilityexercise was suggested to reach binocular vision.DiscussionHypertropia in TED was caused by extraocular muscle fibrosis due to inflammation and lymphocyticinfiltration. Strabismus surgery was aimed at correcting diplopia in primary position. Surgicalprocedure, extra ocular muscles in which surgery must be done and its surgical dosage should beconsidered carefullyConclusionThis case showed restrictive hypertropia in TED with distressing symptoms and challengingmanagement. Careful examination, measurement, and surgical decision were performed carefullyto improve the outcome.Keywordhypertropia, strabismus surgery, thyroid eye diseaseLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download620-EPOS-R-INAPOSS-21-Maria-Debora-Niken-Larasati.jpg

117E-POSTER

EPOS-R-INAPOSS-22Ocular Manifestations in Alagille Syndrome

Abstract TitleOcular Manifestations in Alagille Syndrome

First Author: Drasthya Zarisha

Author Institution: Opthalmology Department, Faculty of Medicine Padjadjaran University

Co Author:

Sesy Caesarya (PMN RS Mata Cicendo )

Feti Karfiati Memed ()

Mayasari Wahyu K ()

Irawati Irfani ()

Primawita O. Amiruddin ()



Seminat: INAPOSS


IntroductionAlagille syndrome is a rare genetic disorder that manifest in several organ systems, including theeyes. It is an autosomal dominant inherited disease with several pathology such as cholestaticjaundice, butterfly vertebrae, unusual facial appearance, posterior embryotoxon that occurred inthe anterior chamber of the eye, anomalous optic disc appearance and choroidal hypopigmentationwere mostly seen. The objective of this case report is to describe the ocular manifestations found ina child with Alagille Syndrome.Case IllustrationA 17 months old child came to the Pediatric Ophthalmology Unit on November 2020 to be screenedfor specific ophthalmological findings as he was suspected to suffer from Alagille Syndrome.Posterior embryotoxon in anterior chamber and anomalous optic disc appearance were identified inboth eyes. The other manifestations that was found in this patient were typical facial appearance(broad forehead, deep set eyes, prominent ears) and jaundice.DiscussionAlagille syndrome is a multiorgan disorder, in this case the patient had posterior embrytoxon inanterior chamber, and anomalous optic disc and retinal vasculature appearance in funduscopicexamination. Some of the clinical characteristics of this patient met with Classic Criteria of AlagilleSyndrome which help uphold the diagnosis and aid further management of the patient.ConclusionPosterior embryotoxon and anomalous optic disc appearance were found in this patient as theocular manifestations found to help establish the diagnosis of Alagille Syndrome.Keywordalagille syndrome, autosomal dominant, posterior embryotoxonLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download754-Poster-PVSM-PO.jpg

118 E-POSTER

EPOS-R-INAPOSS-23ACUTE DACRYOCYSTITIS IN INFANT

Abstract TitleACUTE DACRYOCYSTITIS IN INFANT

First Author: ELAN SATRIA

Author Institution: Co Author

KEMALA SAYUTI (Universitas Andalas)



Seminat: INAPOSS


IntroductionAcute dacryocystitis consists of inflammation of lacrimal sac, it caused by infection, which resultsfrom an obstruction of nasolacrimal duct and stasis of tears in lacrimal drainage system. Acutedacryocystitis is not very common in pediatric groups and occurs mostly as congenital nasolacrimalduct obstruction (CNLDO) complication. It is reported 1,6% among CNLDO patients. It alsoassociates with dacryocele. A report shows mean age are from 1 week-3.5 years.Case IllustrationA female 1,5 months infant with swollen redness at left eye/LE nasal canthal at 3 weeks of age, Nocold cough history. Swelling enlarged when crying. Patient was given Ulcori eye drop andperformed lacrimal sac massage. Swelling was getting bigger as big as quail eggs. Incision wasperformed, yellowish clear discharged. Staphylococcus was found in cultured sensitivity test,resistant to ciprofloxacin and oflovacin. Orbital computed tomography/CT Scan showed LEhemangioma. Medications changed with Polygran, Tobrosone eye drops, Cendomycetin eyeointment and intravenous Ceftriaxone. Massage was performed 5 times a day, whitish fluiddischarged in small amount. Swelling deflated and no enlargement. Magnetic Resonanceimaging/MRI is performed and showed LE dacryostenosis.DiscussionAcute dacryocystitis in infant needs immediate treatment, initially treated with lacrimal sacmassage and topical antibiotic. Careful evaluations are necessary especially in antibiotic resistancycases. Microbiological examination is very useful for subsequent treatment. Radiology could beperformed for differential diagnosis.ConclusionAcute dacryocystitis is not very common in pediatric groups. It related to CNLDO and dacryocele.Microbiological examination is important. Managements are lacrimal sac massage andtopical/systemic antibiotics.KeywordAcute dacryocystitis, Infant, Microbiological examination.Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download2-Acute-Dacryocystitis-In-Infant_dr.-Elan-Satria_FK-Unand_RSUP-M-Djamil-Padang-(1).jpeg

119E-POSTER

EPOS-R-INAPOSS-24ANTERIOR SEGMENT DISGENESIS IN CHILDREN: CASE REPORT

Abstract TitleANTERIOR SEGMENT DISGENESIS IN CHILDREN: CASE REPORT

First Author: Muhammad Arief Munandar

Author Institution: Pusat Mata Nasional RS Mata Cicendo

Co Author:

Feti karfiati MD (Pediatric Ophtalmology Unit, Cicendo Eye Hospital Bandung, Padjajaran University)

Maya Sari Wahyu MD (Pediatric Ophtalmology Unit, Cicendo Eye Hospital Bandung, Padjajaran University)

Irawati Irfani MD (Pediatric Ophtalmology Unit, Cicendo Eye Hospital Bandung, Padjajaran University)

Primawita O.Amiruddin MD (Pediatric Ophtalmology Unit, Cicendo Eye Hospital Bandung, Padjajaran

University)

Sesy Caesarya MD (Pediatric Ophtalmology Unit, Cicendo Eye Hospital Bandung, Padjajaran University)



Seminat: INAPOSS


IntroductionAnterior segment dysgenesis is a congenital disorder that occurs in the anterior segment involvingthe cornea, iris, the angle of the anterior chamber, and the lensCase IllustrationA 5 years old child, came to pediatrict Ophtalmology Clinic, Cicendo National Eye Hospital with achief complaint of blur vision on both eye of 2 years duration. Ophthalmology examination revealedthe intraocular pressure of the right eye was 21 mmHg and the left eye was 16 mmHg (on Timololmaleate 0.5% 2x1 drops of the right and left eye). The anterior segments of the right and left eyesshowed corneal opacification, Van Herick’s grade I-II, the pupil found corectopia, the iris foundanterior synechiae, the lens found clear and subluxation to the superior, the posterior segmentfound a round papilla with a firm border with a Cup Disc Ratio 0.4, no cupping. The patient wasdiagnosed with anterior segment dysgenesis with Microspherophakia with ocular hypertension onright and left eyes.Discussionresult: The patient was given Timolol maleate 0.5% 2 x 1 drops of the right and left eye and underwent ICCE with synekiolysis with anterior vitrectomy and given bifocal glassesConclusionAnterior segment dysgenesis may increase the risk of glaucoma, cataracts and corneal opacitie.ICCE is the management of patients with lens subluxation accompanied by increased intraocularpressureKeywordAnterior segment dysgenesis, Microspherophakia, ICCELatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download542-EPOS-R-INAPOSS-24-Muhammad-Arief-Munandar.jpeg

120 E-POSTER

EPOS-R-INAPOSS-25MONOCULAR RECESS INFERIOR RECTUS AND RESECT SUPERIOR RECTUSIN ACQUIRED HYPOTROPIA IN PARTIAL SUPERIOR RECTUS PALSY

Abstract TitleMONOCULAR RECESS INFERIOR RECTUS AND RESECT SUPERIOR RECTUS INACQUIRED HYPOTROPIA IN PARTIAL SUPERIOR RECTUS PALSY

First Author: Gama Agusto Lonanda

Author Institution: M Djamil hospital- FK Unand

Co Author: Julita (M Djamil hospital- FK Unand)



Seminat: INAPOSS


IntroductionSuperior rectus palsy characterised by hypotropia and limitation in elevation. Chief complaint ishypotropia and diplopia. Surgery indicated for the patient when diplopia and anomalous headposture is present.Case Illustration64th years old male came to hospital with double vision, anomalous head posture (chin up and lefthead tilt), and left eye downward deviation since 1 year ago and has been observed for 1 year. Bestcorrected visual acuity of both eyes is 20/40, normal anterior segment, normal pupil reflex,immature cataract in both eyes. Left eye hypotropia with PACT 30 prism dioptri base up in the lefteye. Eye movement limitation in superior(-1) and superior left gaze(-1). The three step test result isweakness of superior rectus muscle. Brain CT Scan shows no disorder. The patient was diagnosedwith hyportropia acquired OS et causa partial superior rectus palsy. Patient treated with monocularrecess inferior rectus (5mm), and resect superior rectus (5mm), in the left eye. One day postoperation, the result is orthophoria, no diplopia in primary positionDiscussionDiplopia and anomalous head posture is the principal indication to choose surgery treatment for thepatient. It’s advisable to wait 6-12 month before proceeding with surgical correction. Selection ofthe surgical procedure is dictated by the number of involved muscles. In a case of incompleteparalysis, recession-resection of the rectus muscles is effective.ConclusionMonocular recess resect is an effective procedure for hypotropia e.c partial superior rectus palsywith diplopia and anomalous head postureKeywordpartial, superior, rectusLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download772-EPOS-R-INAPOSS-25-gama-agusto.jpg

121E-POSTER

EPOS-R-INAPOSS-26Resolution of Refractory Orbital Cellulitis in a Non-Immunocompromised Child

Abstract TitleResolution of Refractory Orbital Cellulitis in a Non-Immunocompromised Child

First Author Sahar Salim Saleh Alatas

Author Institution: Department of Ophthalmology, Faculty of Medicine Universitas Indonesia – Cipto

Mangunkusumo Hospital, Jakarta.

Co Author:

Dian Estu Yulia (Department of Ophthalmology, Faculty of Medicine Universitas Indonesia – Cipto

Mangunkusumo Hospital, Jakarta.)

Hinky Hindra Irawan (Department of Pediatrics, Faculty of Medicine Universitas Indonesia – Cipto

Mangunkusumo Hospital, Jakarta.)

Retno Sulistyo Wardani (Department of Otorhinolaryngology Head Neck Surgery, Faculty of

Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta.)



Seminat: INAPOSS


IntroductionOrbital cellulitis in pediatric which still have immature immune system is a potentially fatal emergency that can develop rapidly, leading to refractory condition, cause severe visual loss and life-threatening complications. Prompt treatment and early diagnosis of orbital cellulitis in children is important.Case Illustration16-month-old unconscious girl presented to the emergency department with a 4-day history ofswollen right eyelid. CT scan revealed soft tissue swelling at the superior and inferior palpebralregion with bilateral maxillary sinusitis. She had a severe septic condition and was given intravenous antibiotics. After her general condition improved, she underwent surgical drainage in conjunction with mini-FESS (Functional Endoscopic Sinus Surgery)-the culture of purulent material from which Staphylococcus Aureus was isolated. After a few days, she had Hospital-Acquired Pneumonia (HAP), and an abscess in her right eyelid reformed. The immunoglobulin test and lymphocyte subset test showed normal. The patient underwent re-surgical drainage and experienced a complete resolution of refractory orbital cellulitis.DiscussionTreatment of orbital cellulitis includes intravenous antibiotic and other supportive therapies. Thepresence of well-defined abscess, no clinical improvement despite appropriate antibiotic therapy,significant visual impairment and/or complete ophthalmoplegia are indications for surgicaldrainage. More indolent infections causing refractory orbital cellulitis are associated withunderlying ocular disease, nosocomial infections, and immunocompromised Status.ConclusionClose monitoring in orbital cellulitis case is essential that any sign of progression warrants promptsurgical drainage. Septic condition in the patient might likely complicate the progression ofrefractory orbital cellulitis.Keywordrefractory orbital cellulitis, orbital infection, pediatric orbital cellulitisLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download997-EPOS-R-INAPOSS-26-Sahar-Salim-Saleh-Alatas.jpg

122 E-POSTER

EPOS-R-INACOS-01A CHALLENGING EMERGENCY SURGICAL APPROACH OF INTRACAMERALFOREIGN BODY EXTRACTION IN A CONFIRMED COVID-19 PATIENTAbstract TitleA CHALLENGING EMERGENCY SURGICAL APPROACH OF INTRACAMERAL FOREIGNBODY EXTRACTION IN A CONFIRMED COVID-19 PATIENT

First Author: dr. Muhammad Fariz

Author Institution: Department of Ophthalmology, Faculty of Medicine Universitas Airlangga

– Dr. Soetomo General Hospital

Co Author:

Lukisiari Agustini (Department of Ophthalmology, Faculty of Medicine Universitas Airlangga

– Dr. Soetomo General Hospital )

Nandang Sudrajat (Department of Ophthalmology, Faculty of Medicine Universitas Airlangga




Seminat: INACOS


IntroductionIntracameral foreign body is a case in which emergency extraction is needed. In such cases with aconfirmed COVID-19 patient, the surgical approach might become more challenging.Case IllustrationA 38-year-old man with a confirmed COVID-19 infection came with a complaint of a foreign bodysensation after a hook wire hit his left eye while he was honing. Visual acuity on his left eye was6/12, and anterior segment revealed a conjunctival hyperemia and a wire hook on the anteriorchamber with its edge stuck in the corneal lining of his left eye. Fluorescein test was positive with anegative result of Seidel test. Emergency foreign body removal was performed in a negativepressure operating room and monitoring in a negative-pressure isolation ward, using level-1personal protective equipment (PPE) and limited ophthalmic tools available.DiscussionReducing the risk of COVID-19 viral transmission has become a challenge for healthcareprofessionals, including ophthalmologists. With difficulties of examining the ocular inspection, extraattention is also needed to perform ophthalmic surgery and post-operative monitoring. This patientrequired an emergency removal of intracameral foreign body before any complications might occur.But due to additional preparations, a delay of surgery time and adjusted standard of examinationsmust be done.ConclusionCOVID-19 pandemic has forced healthcare workers to modify the standard of providing services.Though it is more demanding, any complications due to trauma and the delay of surgery should bereduced to a minimum, without compromisng the safety of either the patient and operators.KeywordIntracameral foreign body, COVID-19Latest UpdateMay 17, 2021StatusSubmittedFile Download

123E-POSTER

EPOS-R-IGS-01 Management of Increased Intraocular Pressure et causa Use of SystemicSteroids in Systemic Lupus Erythematosus : A Case Report

Abstract TitleManagement of Increased Intraocular Pressure et causa Use of Systemic Steroids inSystemic Lupus Erythematosus : A Case Report

First Author: Mohammad Aulia Molid Ogest Putra CalisanieAuthor Institution: Sriwijaya University / Dr. Mohammad Hoesin Hospital PalembangCo Author: Prima Maya Sari (Sriwijaya University / Dr. Mohammad Hoesin Hospital Palembang)

Abstract Type: Case ReportAbstract Category: E-PosterSeminat: IGSCompetition Category: Resident

IntroductionSystemic Lupus Erythematosus (SLE) is an autoimmune disease characterized by widespreadinflammation affecting any organ or system in the body. Patients with systemic lupuserythematosus use corticosteroid drugs as the main treatment. Steroid-induced increase inintraocular pressure and glaucoma may occur following the use of systemic steroids.Case IllustrationA 19-year-old woman complained that her left eye vision was suddenly blurred, accompanied by redeyes, glare, and headaches. Examination of intraocular pressure in the left eye found 29.3 mmHg.The patient has been diagnosed with SLE for the past 2 years and is regularly taking high doses ofmethylprednisolone. The results of the examination of the anterior and posterior segments of botheyes were within normal limits. We prescribed the eye drops Timolol Maleate and the oral drugAcetazolamide in the first 3 days of treatment. This regimen showed a significant decrease inintraocular pressure to 19.3 mmHg in the left eye on the first day of treatment.DiscussionWhen glaucoma or steroid-induced elevated intraocular pressure is diagnosed, the causative drugshould be discontinued or dose reduced. If steroid cannot be stopped, antiglaucoma consists oftopical beta-blockers, alpha antagonists, carbonic anhydrase inhibitors and prostaglandinanalogues are required.ConclusionIncreased intraocular pressure requires regular monitoring of intraocular pressure to preventglaucoma. With excellent follow-up coupled with a combination of anti-glaucoma drugs, theincreased intraocular pressure did not lead to primary open-angle glaucoma.KeywordSystemic Lupus Erythematosus, Systemic Steroids, Intra Ocular PressureLatest UpdateMay 04, 2021StatusSubmittedFile Download

124 E-POSTER

EPOS-R-IGS-02TRABECULECTOMY AND 5-FLUOROURACIL AS SELECTED THERAPY FORPRIMARY OPEN-ANGLE GLAUCOMA

Abstract TitleTRABECULECTOMY AND 5-FLUOROURACIL AS SELECTED THERAPY FOR PRIMARYOPEN-ANGLE GLAUCOMA

First Author: Dita Mintardi

Author Institution: Sriwijaya University / Dr. Mohammad Hoesin Hospital Palembang

Co Author: Prima Maya Sari (Sriwijaya University / Dr. Mohammad Hoesin Hospital Palembang)



Seminat: IGS


IntroductionPrimary open angle glaucoma is a chronic, slow progressive optic neuropathy disease, withsymptoms of optic nerve damage and loss of visual field. The more severe optic nerve damage, thelower target intraocular pressure must be achieved, in order to reduce the risk of blindness. A lowtarget intraocular pressure only can be achieved with surgery.Case IllustrationA man, 58 years old, complained his right eye vision had become blurry since three months.Ophthalmological examination found an increase of intraocular pressure. Anterior chamberexamination found an interpretation of Van Herrick Grade 4. Gonioscopy examination showed anopen angle glaucoma. This confirmed primary open angle glaucoma diagnosis. During one month,the intraocular pressure was controlled within normal with timolol maleate, latanoprost, andbrinzolamide. Progessively, there had been wide visual field defect and enlargement of C/D ratio ofthe right eye.DiscussionSevere primary open angle glaucoma can be confirmed by a visual field defect (more than 10o) andan abnormality of the optic nerve. In patients with severe primary open-angle glaucoma,trabeculectomy with 5-FU was performed. The goal of trabeculectomy is establishing a permanentflow from the anterior ocular camera to the subconjunctival space. The use of 5-FU is reducing theproliferation of subconjunctival fibroblasts and increasing the success rate of trabeculectomy.ConclusionTrabeculectomy with 5-Fluorouracil was performed in severe primary open-angle glaucoma, inobjective to make a good filtration bleb which will lower the intraocular pressure.Keywordprimary open angle glaucoma, trabeculectomy, 5-fluorouracilLatest UpdateMay 06, 2021StatusSubmittedFile Download

125E-POSTER

EPOS-G-IGS-03Diabetes Mellitus as a Risk Factor for Open Angle Glaucoma: Meta-Analysis ofLarge Observational Studies

Abstract TitleDiabetes Mellitus as a Risk Factor for Open Angle Glaucoma: Meta-Analysis of LargeObservational Studies

First Author: Himawan Widyatmiko

Author Institution: Universitas Kristen Indonesia

Co Author:

Faulina Yosia Panjaitan (Universitas Kristen Indonesia)

Dave Abraham Kambey (Universitas Kristen Indonesia)

Joue Abraham Trixie (Universitas Kristen Indonesia)



Seminat: IGS


Introduction & ObjectiveGlaucoma is one of the leading causes of blindness. Primary open-angle glaucoma (POAG) is themost common type. Diabetes had been deemed as a risk factor for POAG by some reports, however,epidemiologic studies of the relationship between diabetes and POAG are still controversial. Theaim of this study is to determine the association between diabetes mellitus (DM) and primary openangle glaucoma (POAG).MethodLiterature searches use medical search engines such as Pubmed and medical scientific journal suchas American Jounal of Ophthalmology (AJO), Ophthalmology Glaucoma. The literature used untilApril 30th 2021. The main data extraction was diabetes mellitus with meta-analysis performedusing the random-effects model to produce an odds ratio (OR) with 95% confidence interval (CI).Data analysis using the RevMan 5.4 application.ResultEighteen studies (seven cohort, four case-control, and seven cross-sectional) were analyzedcomprising 2,508,917 participants. The pooled OR of the association between DM and POAG basedon the risk estimates of the seven cohort studies was 1.75 (95% CI, 1.42–2.15), four case-controlstudies was 2.03 (95% CI, 2.97-4.25) and seven cross-sectional studies was 1.91 (95%, CI,1.60-2.28). There was considerable heterogeneity among the case-control and cohort studies (PConclusionPeople with DM have an increased risk of developing POAG.Keyworddiabetes mellitus; meta-analysis; primary open-angle glaucomaLatest UpdateMay 13, 2021StatusSubmittedFile Download

126 E-POSTER

EPOS-G-IGS-04Mindfulness Meditation as an Adjuvant Therapy in Ocular Hypertension

Abstract TitleMindfulness Meditation as an Adjuvant Therapy in Ocular Hypertension

First Author: Klarissa Chrishalim

Author Institution: Faculty of Medicine, Atma Jaya Catholic University of Indonesia

Co Author: Airina Stefanie (Department of Ophthalmology, Atma Jaya Catholic University of Indonesia)



Seminat: IGS

Competition Category: General practitione

IntroductionPatients with ocular hypertension have greater risk of developing glaucoma. Early treatment ofocular hypertension patients may reduce the 5-year incidence of glaucoma. A new study suggeststhat mindfulness meditation may help lower eye pressure in glaucoma patients by lowering stresshormones.Case IllustrationA 24-years-old male presented with elevated intraocular pressure (IOP). IOP on the right eye (RE)was 28 mmHg and 26 mmHg on the left eye (LE). BCVA on both eyes was 6/6. CD ratio was 0.4 onboth eyes. AC depth of Van Herick’s grade 4, CCT 580 μm on both eyes. OCT and perimetryshowing normal results on both eyes. The patient decided to try meditation mindfulness once dailyto lower his IOP. Follow up on 30 days showing IOP on RE was 22 mmHg and LE 21 mmHg. Thepatient continued meditation mindfulness for 60 days showing IOP on RE 21 mmHg and LE 21mmHg.DiscussionEarly treatment of ocular hypertension patients may reduce the 5-year incidence of POAG by 60%.OHTS suggests that clinicians and patients should decide the risk and benefit of early treatment forlow and intermediate risk ocular hypertension. New studies suggest mindfulness meditationsignificantly lowers IOP but long-term studies are limited. Therefore, follow-up for this patientshould be continued to maintain the IOP, visual function, and prevent the progression to glaucoma.ConclusionMindfulness meditation may help lower eye pressure in low and intermediate risk ocularhypertension, which can be used as adjuvant treatment and help prevent glaucoma due to highocular pressure.KeywordOcular hypertension, mindfulness meditation

127E-POSTER

EPOS-R-IGS-05UNCOMMON CASE OF EARLY POST-OPERATIVE COMPLICATION WITH AIRBUBBLE INDUCED ACUTE ELEVATED IOP AFTER UNCOMPLICATEDPHACOEMULSIFICATION PROCEDURE

Abstract TitleUNCOMMON CASE OF EARLY POST-OPERATIVE COMPLICATION WITH AIR BUBBLEINDUCED ACUTE ELEVATED IOP AFTER UNCOMPLICATED PHACOEMULSIFICATIONPROCEDURE

First Author: Clarisa Finanda

Author Institution: Resident of Ophthalmology, Faculty of Medicine Universitas Airlangga – Dr. Soetomo


Co Author:

Evelyn Komaratih (Glaucoma Division, Department of Ophthalmology, Faculty of Medicine

Universitas Airlangga – Dr. Soetomo General Hospital, Surabaya, Indonesia)

Himawati Nirmalasari (Tritya Eye Clinic Surabaya, Indonesia)



Seminat: IGS


IntroductionNowadays, air bubble induced hypertension oculi usually observed at lamellar keratoplasty as acomplication to the sticking technique.Case IllustrationA 62-years-old male patient came with sudden pain in the right eye four hours before admission.The chief complaint was accompanied by redness, tearing, glare, difficulty opening the right eye,severe headache, nausea, and vomiting more than ten times. Eight hours ago, the patient hadcataract surgery. The patient did not administer the medication after the phacoemulsification.Controlled hypertension oculi history was obtained from the interview. Examinations showed bloodpressure 160/90, visual acuity OD 1/300 good projection and OS 3/60, IOP OD 81,7 mmHg and OS17.3 mmHg, and anterior segment OD full air bubble with deep anterior chamber. Six days later,the air bubble was diminished with improvement on the complaints and objectives with VODS 4/60PHNI and IOP 16,5 mmHg on therapy. Posterior segment examination after the complaints resolvedshowed ODS Neovascular AMD and ODS optic nerve head oedema.DiscussionElevated IOP post phacoemulsification is usually mild and self-limited. Mostly, OVD is responsiblefor this complication. Pain is the chief complaint with symptoms mimicking acute angle-closureglaucoma. This phenomenon is observed in lamellar keratoplasty with air-bubble technique to stickdonor-host tissue. Injecting less than 80% air is advisable. The air bubble diminished entirely onday 6. ODS Neovascular AMD and ODS optic nerve head oedema were signs of an uncontrolledsystemic condition.ConclusionA surgeon can avoid this complication with less than 80% air injection, therefore gives some spacefor aqueous flowKeywordAir bubble induced hypertension oculi, air bubble pupillary block, lamellar keratoplasty

128 E-POSTER

EPOS-R-IGS-06GLAUCOMA DRAINAGE DEVICE (GDD) IMPLANTATION IN FAILEDTRABECULECTOMY

Abstract TitleGLAUCOMA DRAINAGE DEVICE (GDD) IMPLANTATION IN FAILED TRABECULECTOMY

First Author: Ida Ayu Prama Yanthi

Author Institution: Resident, Ophthalmology Department, Faculty of Medicine, Udayana University, Bali

Co Author:

I Gusti Ayu Ratna Suryaningrum (Ophthalmologist of Glaucoma Division, Ophthalmology

Department, Faculty of Medicine, Udayana University/ Sanglah Public Hospital, Bali)

Ni Kompyang Rahayu (Ophthalmologist of Glaucoma Division, Ophthalmology Department, Faculty

of Medicine, Udayana University/ Bali Mandara Eye Hospital, Bali)

I Made Agus Kusumadjaja (Ophthalmologist of Glaucoma Division, Ophthalmology Department,

Faculty of Medicine, Udayana University/ Sanglah Public Hospital, Bali)



Seminat: IGS


IntroductionSurgical implant glaucoma drainage device (GDD) is a procedure designed to divert the aqueousflow of humor from the anterior chamber to an external reservoir where fibrous capsule will formafter 4-6 weeks after surgery. The indication for GDD implant is in the condition of glaucoma whichis not resolved despite previous trabeculectomy.Case IllustrationA 58-year-old male patient came with complaint of blurred vision since two years ago. Patient didnot complain of sore and red eyes. He was given 2 x 250 mg of Acetazolamide, 2 x 1 tab of Aspar K,2 x 1 ODS of Latanoprost, and 2 x 1 ODS of Betaxolol HCl. The patient had glaucoma since 10 yearsago and had undergone surgery in 2002 on the right eye and left eye surgery in 2004. His rightintraocular pressure was 38 mmHg with conjungtival bleb (+) flat (+) minimal vascularity (+)horizontal extent 1-2 clock hours. Patient then underwent a GDD implant surgery of the right eye.Three months after surgery, patient complained of blurred vision again. On examination, it wasfound that his cornea was cloudy. Therefore, he then underwent a phacoemulsion surgery. After thesurgery, patient’s intraocular pressure was stable with better eyesight.DiscussionThe advantage of the GDD implant is that it performs a permanent sclerostomy to insert the GDDtube and plate which functions as a bleb and aqueous humor flow which fills the subconjunctivalspace.ConclusionIn trabeculectomy failure, implantation of the GDD is the safest and most effective option in eyesKeywordTrabeculectomy, Glaucoma Drainage Device, Glaucoma

129E-POSTER

EPOS-R-IGS-07Post Penetrating Keratolasty Glaucoma : Managing the Ups and Downs

Abstract TitlePost Penetrating Keratolasty Glaucoma : Managing the Ups and Downs

First Author: Ghina Fedora

Author Institution: Resident of the Departement of Ophthalmology, Faculty of Medicine Universitas

Indonesia - Cipto Mangunkusumo Hospital, Jakarta

Co Author: dr. Astrianda N. Suryono, SpM(K) (Glaucoma Divison, Departement of Ophthalmology, Faculty of

Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta)



Seminat: IGS


IntroductionOver 1 billion people have vision loss due to corneal opacities. Penetrating Keratoplasty (PK) offerssolution with post-op challenges such as post PK glaucoma (PPKG).Case Illustration19-year-old woman came with sudden blurriness of right eye due to acute hydrops keratoconus andcorneal scar. Patient then underwent PK procedure. Twenty-three weeks post-op, there was IOPelevation. Anti-glaucoma medications were given with no success. Patient then underwent GDDsurgery using Virna Glaucoma Implant (VGI®). Post-operatively IOP was 2 mmHg and intracameralviscoelastic was done which increased it to 14 mmHg subsequently. Nine weeks post-op, IOP was25 mmHg and shallow AC with iris-lens touch and cataract. Phacoemulsification and tube flushingwere done. Five weeks after, the IOP was 6 mmHg with deep AC and diffused bleb.DiscussionPPKG is one of the most frequent complications from PK. It’s marked as ocular hypertension >21mmHg, which needed treatments to reduce the IOP. Known preoperative risk factors were noted inthis patient including bullous keratopathy, corneal perforation, history of PK and young age. Noknown intraoperative risk factors were present. Post-op cause for IOP rise are structural changesdue to inflammation, including pupillary blockage and synechiae that were present in this patient.Other post-op issues such as tightness of GDD-tube ligation and steroid usage were also possible.ConclusionPPKG is challenging and could cause permanent impairment. Possible complications following GDDimplantation in PPKG needs to be recognized and addressed accordingly.KeywordPost-penetrating keratoplasty glaucoma, secondary glaucoma, glaucoma drainage device implant

130 E-POSTER

EPOS-R-IGS-08MANAGEMENT ANGLE-CLOSURE GLAUCOMA IN NANOPHTHALMOSPATIENT : A CASE REPORT

Abstract TitleMANAGEMENT ANGLE-CLOSURE GLAUCOMA IN NANOPHTHALMOS PATIENT : A CASE REPORT

First Author: Rizki Fasa RamdhaniAuthor Institution: Department of Ophthalmology, Faculty of Medicine, University of Padjadjaran,

Cicendo Eye National Eye CenterDepartment of Ophthalmology, Faculty of Medicine, University of

Padjadjaran, Cicendo Eye National Eye Center

Co Author:

Andika Prahasta ,Elsa Gustianty, R. Maula Rifada ,Sonie Umbara

(Department of Ophthalmology, Faculty of Medicine, University of Padjadjaran, Cicendo Eye National Eye

Center)



Seminat: IGS


IntroductionAngle-closure glaucoma in nanophthalmos had persistent high intraocular pressure (IOP) that cannot be controlled with medication and require surgery. Nanophthalmos patients are at higher risk for having intraoperative and postoperative complications.Case IllustrationA Forty-one years old man underwent trabeculectomy in his right eye with IOP before surgery was 44 mmHg and received two antiglaucoma medications that lowered IOP by 30 mmHg. On ocular examination, both eyes were small with well-formed bleb and patent peripheral iridectomy in the right eye. An anterior chamber depth/axial length were 2.17/15.74 mm in the right eye and 2.05/15.47 in the left eye. After two month, patient underwent anterior vitrectomy through pars plana and phacoemulsification was performed with foldable single-piece IOL inserted in the capsular bag. After one month surgery, the IOP was controlled at 15 mmHg, BCVA was 0.125 and anterior chamber depth was 3.38 mm in the right eye.DiscussionAcute angle-closure in nanophthalmos was results from thickening of the lens that pushes the iris towards anterior chamber. A sudden decompression of the globe in nanophthalmos patients may trigger the development of massive uveal effusion. Filtration surgery before cataract surgery can reduce the IOP gradually. Combining vitrectomy with phacoemulsification can reduce the intraoperative risks. The removal anterior vitreous facilitates the posterior displacement of the lens, deepens the anterior chamber, and decreases the IOP by decreasing the positive vitreous pressure and relieve the ciliary block.ConclusionCataract extraction with anterior vitrectomy surgery provided an effective results for controlled theIOP, reduce intraoperative risk and postoperative complications in nanophthalmos.KeywordNanophthalmos, Angle-closure glaucoma, Anterior vitrectomyLatest UpdateMay 17, 2021StatusSubmittedFile Download

131E-POSTER

EPOS-R-IGS-09WHAT TO DO IN SECONDARY GLAUCOMA WITH ANIRIDIA– A CASE SERIES

Abstract TitleWHAT TO DO IN SECONDARY GLAUCOMA WITH ANIRIDIA– A CASE SERIES

First Author: Intan


Indonesia

Co Author:

Elsa Gustianty (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Andika Prahasta (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

R. Maula Rifada (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Sonie Umbara (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)



Seminat: IGS


IntroductionAniridia is bilateral congenital anomaly what profound hypoplasia of the iris. Around 50-75% ofaniridics develop glaucoma. The surgical treatment should be performed to prevent progressivity ofoptic neuropathy.Case IllustrationCase 1:A-male-29-years-old came with high IOP (46mmHg and 36mmHg). The examination revealedinferior rudimentary iris. Cup/disk-ratio were 0.4 and 0.4. Trabeculectomy in right-eye was chosen.Three-months after surgery, the IOP was 14mmHg. Case 2:A-boy-1-year-old came with high IOP(46mmHg and 50mmHg). The examination revealed rudimentary iris and aphakia. Cup/disk-ratiowere 0.6 and 0.5. He underwent GDD-implantation for both eyes in 6months interval. The IOP after3months surgical were 18mmHg and 15mmHg. Case 3:A-girl-5-years-old came with high IOP(36mmHg and 44mmHg). The examination revealed minimal rudimentary iris and aphakia.Cup/disk-ratio were 0.8 and 0.7. She underwent trabeculectomy for right eye. The IOP wasachieved, but continuously increased after 6-months of surgery. She underwent GDD implantationfor her both eyes. The IOP after 3months surgical were 16mmHg and 9mmHg.DiscussionTreating glaucoma aniridia was challenging, the rudimentary iris stump will roll and getting aheadthen block the angle. The surgical options can be determined using stages glaucoma classificationby evaluating optic nerve head conditions. After trabeculectomy (case 1-mild glaucoma), IOPachieved the target. Severe glaucoma (case 3), the IOP was failed to be mantained so that GDDimplantation was next option.ConclusionGDD-implantation is the best surgical treatment for aniridic glaucoma patient, Trabeculectomycould be considered for mild glaucoma patients with aniridia as a first line surgical treatment. Incases of failed, GDD-implantation has been used.Keywordglaucoma, aniridia, angle closure glaucomaLatest UpdateMay 17, 2021StatusSubmittedFile Download

132 E-POSTER

EPOS-G-IGS-10Comparison between Latanoprost 0,004% vs Bimatropost 0,03% in LoweringIntra Ocular Pressure for Long Term Use (3-6 months) in Primary Open AngleGlaucoma: A Meta-Analysis

Abstract Title:Comparison between Latanoprost 0,004% vs Bimatropost 0,03% in Lowering Intra OcularPressure for Long Term Use (3-6 months) in Primary Open Angle Glaucoma: A MetaAnalysis

First Author: Irma Suwandi Sadikin

Author Institution: Kebayoran Lama General Hospital, Jakarta, Indonesia

Co Author: Alifah Syarafina (Matraman General Hospital, Jakarta, Indonesia)

Dhiny Lidinillah (Simpangan Depok Hospital, Depok, Indonesia)



Seminat: IGS


Introduction & ObjectiveProstaglandin Analogue has been used as the most potent ocular hypotensive medication used inthe treatment of Primary Open Angle Glaucoma (POAG) and Ocular Hypertension (OHT). This studyaims to compare the effect of latanoprost 0,004% versus Bimatropost 0,03% on Intra OcularPressure Reduction (IOPR) for long term use (3-6 Months)MethodAn electronic literature search was performed in PubMed, Cochrane Library, and Google Scholarfor relevant articles from 2005 to 2021. The efficacy estimates were measured by their meandifference (MD) to calculate the intraocular pressure reduction (IOPR) from baseline to endpointand by Odds ratio (OR) to determine conjunctival hyperemia as the most common adverse effect.ResultA total of 780 patients were included in 8 trials. The age of the patients ranged from 54 to 68 yearsand the mean follow-up time ranged from 3 months to 6 months. There were significant differencesin IOPR between Latanoprost 0,004% and Bimatropost 0,03% in the third months and sixth monthsusage (3 Months (MD): -0.12 [95% CI, (-0.20) - (-0.04)] p=0.003, I2=85%) and (6 months (MD): 1.53[95% CI, (1.29-1.78] p=<0.00001, I2=91%). However, bimatropost led to a higher proportion ofconjunctival hyperemia (OR: 0.28 [95% CI, (0.14 – 0.57] p=<0.0004, I2=0%).ConclusionBimatoprost 0.03% tends to be more beneficial in reducing IOP for long-term use (3 and 6 months).Nevertheless, latanoprost has lower incidence of conjunctival hyperemia. Therefore, theophthalmologist’s decision in determining treatment must be tailored to the characteristics of thepatient and the patient’s tolerance to the treatment given.KeywordBimatoprost, latanoprost, Primary Open Angle Glaucoma (POAG)Latest UpdateMay 17, 2021StatusSubmittedFile Download

133E-POSTER

EPOS-R-IGS-11GOOD OUTCOMES OF INITIAL BLEB NEEDLING IN FILTRATION FAILUREAFTER TRABECULECTOMY IN SECONDARY OPEN ANGLE GLAUCOMA

Abstract TitleGOOD OUTCOMES OF INITIAL BLEB NEEDLING IN FILTRATION FAILURE AFTERTRABECULECTOMY IN SECONDARY OPEN ANGLE GLAUCOMA

First Author: Rahayu Widhyasti


Indonesia

Co Author:







Seminat: IGS


IntroductionFiltration failure is one of complication after trabeculectomy procedure. Scar tissue formed aroundthe bleb during conjunctival wound healing is cause of filtration failure. Combination bleb needlingwith anti fibrotic had become a widely accepted approach for trabeculectomy failure.Case IllustrationA 50 years old man presented in Glaucoma Unit complaining pain on the right eye for the past amonth. He had trabeculectomy in his right eye about two months ago. Visual acuity was 1/60,intraocular pressure (IOP) was 38 mmHg and slit lamp examination of the right eye showedencapsulated bleb noted in the superior area and vascularized with deep anterior chamber.Gonioscopy examination showed patent ostium internum of sclerostomy. Bleb needling withsubconjunctival injection of 5-fluorouracil (5-FU) was done in the operating room. Needle wasinserted subconjunctiva at some distance from bleb, the motions were done to disrupt any fibrotictissue, and then 0.1 ml of 5 mg/ml 5-FU was injected subconjunctiva periphery. The IOP 1 day, 7days, 1 month, and 3 months after surgery was 15, 12, 11, and 18 mmHg respectively. Antiglaucoma medications were continued.DiscussionAn ideal functioning bleb should be achieved after trabeculectomy procedure. Bleb needling isgenerally considered when the IOP is higher than target pressure. Mechanism of bleb needling isreestablishing the aquoeus humor pathway so the target IOP achieved.ConclusionBleb needling with antimetabolic agent has advantage of minimal surgery and could preventproliferation of fibroblasts in the subconjunctival space and tenon capsule after trabeculectomyfailure.KeywordBleb needling, glaucoma, failing filteringLatest UpdateMay 17, 2021StatusSubmittedFile Download

134 E-POSTER

EPOS-R-IGS-12TRABECULECTOMY + 5-FLUOROURACIL AND PANRETINALPHOTOCOAGULATION AS THE TREATMENT OF NEOVASCULAR GLAUCOMA

Abstract TitleTRABECULECTOMY + 5-FLUOROURACIL AND PANRETINAL PHOTOCOAGULATION ASTHE TREATMENT OF NEOVASCULAR GLAUCOMA

First Author: MUHAMMAD MAULANAAuthor Institution:

Department of Ophthalmology, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia

Co Author:







Seminat: IGS


IntroductionNeovascular glaucoma (NVG) is defined as an iris and or anterior chamber angle neovascularizationassociated with increased intraocular pressure (IOP). NVG is secondary glaucoma determined by asevere retinal ischemia; most common is diabetic retinopathy. There are several procedure optionsas the treatment of NVG.Case Illustrationa 50 years old female came to Glaucoma unit of National Eye Center Cicendo Eye Hospital with chief complain of sight lost of the right eye. Throughout examinations, IOP of the right eye was 68 mmHg and Iris neovascularization was found. The patient was diagnosed Neovascular Glaucoma OD + Proliferative Diabetic Retinopathy ODS. Patient planned to undergo trabeculectomy with a combination of anti-vascular endothelial growth factor (anti-VEGF). Due to unavailability of antiVEGF, patient then underwent surgical procedure Trabeculectomy + 5- Fluorouracil (5-Fu) followed by Panretinal Photocoagulation (PRP) 2 weeks post operative. Both procedure shown successful outcome by showing IOP 18 mmHg 1 month post operatively.DiscussionTrabeculectomy is one of the surgical treatment chosen for NVG, with the adjunct use of antimetabolites has improved the success rate of the surgery for controlling IOP, PRP works by reducing posterior segment ischemia and controlling active neovascular growth in cases of NVG.ConclusionManagement of NVG primarily consists of controlling the high IOP by medical and or surgicaltreatment, Trabeculectomy + 5-Fu and PRP were given successful outcome by decreasing IOP tothe patient.KeywordNeovascular Glaucoma, Trabeculectomy 5-Fluorouracil, Panretinal Photocoagulation.Latest UpdateMay 17, 2021StatusSubmittedFile Download

135E-POSTER

EPOS-G-IGS-13IMPORTANCE OF EARLY DETECTION OF ACUTE ANGLE CLOSUREGLAUCOMA: A CASE REPORT

Abstract TitleIMPORTANCE OF EARLY DETECTION OF ACUTE ANGLE CLOSURE GLAUCOMA: A CASEREPORT

First Author: Sarah Yasmin Ramadhanti

Author Institution: General Practitioner, Jakarta Eye Center Hospital

Co Author:

Lazuardiah Anandi (Research Assistant, Ophthalmology Department, Cipto Mangunkusumo Hospital)

Muhammad Yoserizal (Ophthalmologist, Jakarta Eye Center Hospital)



Seminat: IGS


IntroductionGlaucoma is one of the highest causes of blindness in the world. Visual losses caused by glaucomais irreversible so that early detection with the right diagnosis by general practitioner orophthalmologist is vital to minimize the risk of permanent damage. We report the case of a patientwho gained significant improvement after glaucoma surgery immediately after diagnosed withacute angle closure glaucoma in the ER.Case IllustrationA 53-year old female was presented with a chief complaint of throbbing pain and redness on botheyes (left eye (LE) at first, followed by right eye (RE)) for 3 days. She also had blurred vision,headache, and was unable to sleep due to the pain. Her presenting visual acuity (VA) was 20/80 inthe RE and hand movements in the LE, with measured intraocular pressure (IOP) was 65 mmHg inthe RE and 63 mmHg in the LE.DiscussionAfter diagnosed with acute angle closure glaucoma and senile nuclear cataract on both eyes, aseries of peripheral iridotomy laser followed with trabeculectomy was performed. Four weeks afterthe surgery, her VA is improved to 6/6 with corrected refraction and IOP is successfully lowered to10mmHg on both eyes. Slit-lamp examination also showed an improvement of anterior chamberdepth now that it is deep.ConclusionRisk of further damage and visual loss caused by glaucoma can be minimized with early detectionand right diagnosis followed with the right treatment and surgery. It is important for generalpractitioner to fully understand the sign and symptoms of glaucoma.KeywordAcute Glaucoma, TrabeculectomyLatest UpdateMay 17, 2021StatusSubmittedFile Download

136 E-POSTER

EPOS-R-IGS-14Management of Steroid Induced Glaucoma

Abstract TitleManagement of Steroid Induced Glaucoma

First Author: Muhammad Apriliandy Shariff


Co Author:

Fidalia (Universitas Sriwijaya)

Prima Mayasari (Universitas Sriwijaya)



Seminat: IGS


IntroductionSecondary corticosteroid-induced glaucoma is open-angle glaucoma caused by prolonged use ofcorticosteroids. 4%-6% of the population are considered high corticosteroid responders and have anIOP increase after exposure to corticosteroids.Case IllustrationA 43-year-old woman complained that vision was blurry 7 months ago and the left eye felt moreblurry with tunnel vision. History of uncontrolled Systemic Lupus Erythematosus for 20 years.History of methylprednisolone use without consultation. History of cataract extraction surgery 1year ago. Increased IOP with higher IOP in the left eye and decreased pupillary reflex. Gonioscopywith open-angle impression. Fundoscopy with the tigroid appearance in both eyes. Trabeculectomy+ 5-fluorouracil OD was performed for a patient in this case.DiscussionSteroid-induced increases in IOP may occur following the use of systemic, ocular, or inhaledsteroids which result in optic nerve damage. Medication for IOP control is initial treatment beforedefinitive therapy is done. Although it is an iatrogenic condition, it may not be preventable becausestopping corticosteroids is not possible. Doctors should confirm the response of steroids to the eyebefore irreversible damage to the optic nerve occurs.ConclusionCorticosteroid-induced glaucoma can develop within weeks, months, or years of drug use; thus, IOPshould be monitored regularly in patients receiving this drugKeywordsecondary glaucoma, steroidLatest UpdateMay 17, 2021StatusSubmittedFile Download

137E-POSTER

EPOS-G-IGS-15Glaucoma Drainage Device Implantation for Sturge-Weber Syndrome in aPediatric Patient with Secondary Glaucoma: A Case Report

Abstract TitleGlaucoma Drainage Device Implantation for Sturge-Weber Syndrome in a PediatricPatient with Secondary Glaucoma: A Case Report

First Author: Camilla Amanda Prakoeswa

Author Institution: Faculty of Medicine Airlangga University, Dr. Soetomo General Academic Hospital,

Surabaya, Indonesia

Co Author:

Amelia Rahmah Kartika (Faculty of Medicine Airlangga University, Dr. Soetomo General Academic

Hospital, Surabaya, Indonesia)

Septian Dwi Prabowo (Faculty of Medicine Airlangga University, Dr. Soetomo General Academic

Hospital, Surabaya, Indonesia)

Dewi Rosarina (Glaucoma Division, Undaan Eye Hospital, Surabaya, Indonesia)



Seminat: IGS


IntroductionSturge-Weber syndrome (SWS) is a rare non-inherited congenital disorder marked by facial venouscapillary malformation (port-wine stain), leptomeningeal angiomas, and ocular abnormalities. Themost common complication is glaucoma due to elevated episcleral venous pressure, anteriorchamber abnormalities, and abnormal ocular hemodynamics.Case IllustrationAn eight-year-old girl was accompanied by her mother to the hospital with complaints of migrainesand pain in the left eye since two years ago that worsened recently. The patient had port-wine stains on the left side of her face since birth that involved the forehead, nose, and eyelids. She had poor compliance with the medications in the past year (timolol 0.25% eye drop, tobramycin & dexamethasone eye drop, and oral acetazolamide). She had no light perception in the left eye and the intraocular pressure (IOP) was 51 mmHg. There were conjunctival injections, hazy cornea, shallow anterior chamber, iris neovascularization, and cloudy lens. The patient was planned to undergo Glaucoma Drainage Device (GDD) implantation surgery.DiscussionThis patient was treated with AADI (Aurolab aqueous drainage implant, Aurolabs, Madurai, India),a non-valved GDD, with the intention to control IOP in the long term and reduce pain instead ofimproving the visual acuity. Studies proved that GDD is effective in treating glaucoma where previous medications or filtration surgery fail. One month post-surgery, the IOP was 25 mmHg with timolol 0.25% eye drop and oral acetazolamide, no corneal oedema, and no complaints of pain in the left eye.ConclusionGDD implantation showed a favorable outcome in managing secondary glaucoma in a pediatricSWS patient.KeywordSturge-Weber Syndrome, Secondary Glaucoma, Glaucoma Drainage DeviceLatest UpdateMay 17, 2021StatusSubmittedFile Download

138 E-POSTER

EPOS-R-IGS-16Long-Term Intraocular Pressure Reduction Achieved by Glaucoma DrainageDevice Implantation in Silicone-Filled Eye After Vitreoretinal Surgeries

Abstract TitleLong-Term Intraocular Pressure Reduction Achieved by Glaucoma Drainage DeviceImplantation in Silicone-Filled Eye After Vitreoretinal Surgeries

First Author: Ester Grace Sillya Aprinona Gurning

Author Institution: Ophthalmology Department, Faculty of Medicine, Padjadjaran University

Co Author:

R. Maula Rifada (Glaucoma Unit, National Eye Center Cicendo Eye Hospital)

Andika Prahasta (Glaucoma Unit, National Eye Center Cicendo Eye Hospital)

Elsa Gustianty (Glaucoma Unit, National Eye Center Cicendo Eye Hospital)

Sonie Umbara (Glaucoma Unit, National Eye Center Cicendo Eye Hospital)



Seminat: IGS


IntroductionSecondary open angle glaucoma commonly presents after pars plana vitrectomy (PPV) with siliconeoil insertion. Silicone oil evacuation is the most common management to lower intraocular pressure(IOP). This report aims to describe effective glaucoma drainage device (GDD) implantation inpatient requiring sustained silicone oil.Case IllustrationA 31 year-old female complained of painful left eye. She had 3 previous vitreoretinal surgeries, thelatest was silicone oil insertion due to retinal redetachment. Her BCVA was 1/60 and IOP was 43mmHg, despite regular use of β-blocker eye drop and oral acetazolamide. There was no abnormalities found from gonioscopy, anterior and posterior segment examination. She was diagnosed with secondary open angle glaucoma and GDD implantation was performed, the tube was placed superiorly. Normal cornea and effective IOP reduction, to 16 mmHg, were still achieved after 1 year.DiscussionThis patient had multiple vitreoretinal surgeries due to previous retinal redetachment, thus siliconeoil evacuation was not an option. Multiple vitreoretinal surgeries changed conjunctival structure,and GDD was chosen over trabeculectomy. The tube should be placed inferiorly, in patients withhistory of silicone oil insertion, to prevent tube clogging by silicone oil. This patient had GDD tubesuperiorly placed, but the long-term IOP reduction is still effective. Regular evaluation is needed tomonitor IOP and any endothelial damage caused by GDD tube.ConclusionImplantation of GDD with superior placement of the tube is still effective in managing secondaryopen angle glaucoma with history of silicone oil insertion. Regular evaluation is needed to monitoreffects and any complications.Keywordsilicone oil, glaucoma drainage device implantation, vitreoretinal surgeries.Latest UpdateMay 17, 2021StatusSubmittedFile Download

139E-POSTER

EPOS-R-IGS-17Trabeculectomy augmented with 5-Fluorouracil on Acute Phase ofPhacomorphic Glaucoma

Abstract TitleTrabeculectomy augmented with 5-Fluorouracil on Acute Phase of Phacomorphic Glaucoma

First Author: Ryan Aquario


Co Author:

Fidalia (Universitas Sriwijaya)

Prima Mayasari (Universitas Sriwijaya)



Seminat: IGS


IntroductionGlaucoma is the leading cause of irreversible blindness in the world with an incidence rate of 12.3%of total blindness cases. Glaucoma can occur primary or secondary and one of the most commoncauses of secondary glaucoma is phacomorphic glaucoma. Patient of phacomorphic glaucomausually come to us in the late phase with a sign of acute glaucoma making management moredifficult.Case IllustrationA 62-year-old man complained that his right eye vision was blurry accompanied by cloudy visionsince 2 weeks ago. History of past illness was remarkable. There was a decreased vision in botheyes and the right eye IOP was 42.0 mmHg with 1 anti glaucoma drugs, corneal edema, irregulariris with synechiae, mid-dilation pupil, and cloudy lens with iris pigment. Gonioscopy with closedangle impression and posterior segment hard to asses. Trabeculectomy + 5-fluorouracil OD wasperformed for patient in this case.DiscussionThe principle of management of phacomorphic glaucoma is cataract extraction surgery, but the IOPreduction in patients is done first. The patient performed trabeculectomy + 5-Fluorouracil with agood response which has been seen from controlled IOP but the prognosis of the right eye was poorbecause of optic nerve damage which was known from the funduscopy examination, Humphreyexamination and OCT.ConclusionSecondary cases of acute angle-closure glaucoma such as phacomorphic glaucoma are initiatedwith IOP reduction first before it’s definitive therapeutic.KeywordPhacomorphic Glaucoma, trabeculectomyLatest UpdateMay 17, 2021StatusSubmittedFile Download

140 E-POSTER

EPOS-G-IGS-18Secondary Angle Closure Glaucoma with a Rare Case of Recently DiagnosedAphakia at Mid 40s

Abstract TitleSecondary Angle Closure Glaucoma with a Rare Case of Recently Diagnosed Aphakia at Mid 40s

First Author: dr. Ni Putu Sitha Medha Paramitha Sumantra

Author Institution: RS Bhayangkara Denpasar

Co Author: dr. Anak Agung Ngurah Putra Asryana, Sp.M (RS Bhayangkara Denpasar)



Seminat: IGS


IntroductionGlaucoma is a group of diseases affected by optic neuropathy with remodelling of connective tissuefrom the head of optic nerve and accompanied by loss of nerve tissue associated with visualdysfunctionCase IllustrationA 44 yo woman came to local police hospital with complaints of blurry and sudden painful eyes. Shehad a history of motorbike accidents in childhood age and wears glasses since 6 yo. On physicalexamination, ODS visual acuity was 6/20, refractometer of OD: S +3.25 C -0.75 x 60 and OS: S+6.00 C -1.50 x 80, ODS front chambers were shallow, OD eyeball pressure was 23.1 mmHg andOS was 31.8 mmHg. Slit lamp showed aphakia and tremulous iris. She was diagnosed withSecondary Angle Closure Glaucoma e.c Aphakia. The patient were given timolol 0.5%, 250 mgacetazolamide, artificial tears, KCl tablets and referred to local eye hospitalDiscussionLens dislocation, that caused absence of the lens (aphakia), is one of several lens-induced factorsthat may cause an acute elevation of IOP and lead to secondary glaucoma. Ocular lens dislocationcommonly caused by ocular trauma. Blunt trauma may cause sudden compressive deformation ofthe globe causing transient shortening of the eye in the antero-posterior, stretching and destroyingthe zonula which hold the lens. Lens dislocation complications include secondary glaucoma, retinaldetachment, cataracts, and vision lossConclusionRaised IOP in glaucoma may damage optic nerve and leads to visual dysfunction. Glaucoma mayalso be affected by the absence of lens (aphakia). Proper management is needed to prevent furthercomplicationsKeywordaphakia; lens dislocation; secondary angle closure glaucomaLatest UpdateMay 17, 2021StatusSubmittedFile Download

141E-POSTER

EPOS-G-INASOPRS-01Ocular Barotrauma

Abstract TitleOcular Barotrauma

First Author: Jeffry Alamsjah

Author Institution: RSPI Puri Indah

Co Author: Eduard Jordi Luminta (RS Cipto Mangunkusumo)



Seminat: INASOPRS


IntroductionIndonesia, as one of the leading tourism county and also one of the world’s favorite diving spot. Assuch, injuries related to diving is not uncommonly found and can range from minor cuts and bruisesto life threatening decompression sickness. We present you a case of ocular barotrauma caused bygoggle squeeze.Case IllustrationA 43 years old male came to emergency department of RSUD dr. H. Marsidi Judono with chiefcomplaint of pain in both eyes. The patient was a fisherman who regularly dives to set fish trap onthe seabed approximately 10 meters below sea level. During the dive, the tubing connecting thediver mouthpiece and compressor was tugged loose and the divers’ goggle is pushing his face dueto the pressure difference causing orbital and facial trauma.DiscussionOcular barotrauma, colloquially known as ‘mask squeeze’, happens when diver cannot stabilize thepressure inside their goggle during their dive. Some of the common mask squeeze injury includessubconjunctival hemorrhage and palpebral edema/ecchymosis.. Routine ocular examination need tobe performed to make sure that no complications go unnoticed.ConclusionOcular barotrauma is a common trauma amongst diver, and as a physician in archipelagic countrywe should familiarize ourselves with the complication that entails. We should also be familiar withprevention of squeeze barotrauma, namely using the appropriate gear and equalizing the pressureinside the mask or gogle whenever possible.Keywordocular, barotrauma, mask squeezeLatest UpdateApril 18, 2021StatusApproved As E-PosterFile Download407-EPOS-G-INASOPRS-01-Jeffry-Alamsjah.jpg

142 E-POSTER

EPOS-G-INASOPRS-02Orbital Blowout Fracture: A Case Report

Abstract TitleOrbital Blowout Fracture: A Case Report

First Author: Ferdy Iskandar

Author Institution: General Practitioner, Pondok Indah - Puri Indah Hospital, Jakarta, Indonesia

Co Author:

Rianti Wulandari Pratiwi (Research Assistant, Department of Ophthalmology, Cipto Mangunkusumo

General Hospital, Jakarta, Indonesia)

Dearaini (Research Assistant, Department of Ophthalmology, Cipto Mangunkusumo General

Hospital, Jakarta, Indonesia)

Firman Hendrik (Neurologist, Pondok Indah - Puri Indah Hospital, Jakarta, Indonesia)

Siti Fatimah Sah Rahmadhani (Ophthalmologist, Pondok Indah - Puri Indah Hospital, Jakarta,

Indonesia)

Hisar Daniel (Ophthalmologist, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia)



Seminat: INASOPRS


IntroductionOrbital blowout fracture is caused by an external force on the orbit, causing the pressure to passalong the orbital margin to the orbital wall. Orbital floor fracture occurs more frequently than otherorbital wall fractures.Case IllustrationA 14-year-old boy came to the emergency ward with a painful, swollen left eye with apparentecchymosis. He was in the backseat with supine position when the car crashed. Nausea andvomiting were reported, while double vision, numbness on the face, and loss of visual acuity weredenied. Patient’s ABCs were clear. Both eyes have normal visual acuity, despite difficulty in openinghis left eye. We found subconjunctival hemorrhage in his left eye, with pain while elevating his lefteye. Other ocular examinations were normal. Laboratory studies were unremarkable, while CTHead revealed multiple fractures involving left orbital floor with prolapse of intraorbital fat intomaxillary sinus, left superior orbital wall, midline nasal bone, and anterior and lateral wall of leftmaxillary sinus. Enlargement of the left optic nerve and multiple extraocular muscles were alsofound. The patient was treated conservatively, with mannitol and methylprednisolone initiatedpromptly. Cold pack, topical antibiotic along with topical steroids was applied to his left eye. Onone week follow up, the patient showed improvement in pain, swelling, and ocular motility.DiscussionWe treated the patient conservatively since the patient is stable, and no significant orbital tissue isherniated into the paranasal sinuses.ConclusionThis case suggests orbital blowout fracture which shows improvement with conservative approach.Keywordorbital, blowout, fractureLatest UpdateMay 01, 2021StatusApproved As E-PosterFile Download310-EPOS-G-INASOPRS-02-Ferdy-Iskandar.pdf

143E-POSTER

EPOS-O-INASOPRS-035 y.o Child With Malposition of The Upper Eyelid After Trauma - Is It Possibeto Repair?

Abstract Title5 y.o Child With Malposition of The Upper Eyelid After Trauma - Is It Possibe to Repair?

First Author: JOSIAH IRMA

Author Institution: FK Universitas Pelita Harapan - Siloam Hospital Lippo Village

Co Author:

Cheryll Yudakusuma (FK Universitas Pelita Harapan - RSU Siloam Lippo Village)

Fatrin Patrycia Salim (FK Universitas Pelita Harapan - RSU Siloam Lippo Village)

Valentinus Ferdian Cipta (FK Universitas Pelita Harapan )



Seminat: INASOPRS


IntroductionReconstruction of the eyelid are one of many operation that very challenging in oculoplasticsurgery.The reason why this procedure is so challenging because the eyelids function for protectionof the eyeball from trauma,excess light,and maintaining the tear film.Case IllustrationA 5 year old boy presented with lagophthalmos and exposure of the upper eyelid tarsus afterprevios surgery due to trauma.The surgery were performed 2 weeks prior to his currentvisit.Ophthalmology examination revealed visual acuity of both eyes were 20/20 and the hischbergtest were orthophoria. Cornea of both eyes were clear and posterior segments were within normallimit.Lagofthalmos of left eye were 2 mm, but there was no corneal exposure.DiscussionWe did exploration berfore dicided which technique would be taken. Eyelid defect ini this case wereabout 50 to 75% of lid length.There are three options to repair the defect.There are cutlerbeard,tenzel flap or Z-Plasty.We found that the tarsus of the upper eyelid were intact, but therewere malposition of the margin.We dicided to remade the margin area,cut the fibrotic tissue andresuture margin to each side of its grey line.Due to high tension of the upper eyelid skin,we did Zplasty from eyebrow area to reduce the tension.ConclusionThe eye is one of the human organs that have visual system functions, so that reconstruction of theeyelid should be done shortly to avoid further complications such as conjungtivitis and the worst iscorneal damage.Careful examination and proper management will bring to better outcomeespecially its function.Keywordeyelid defect,z-plasty,lagofthalmosLatest UpdateMay 02, 2021StatusApproved As E-PosterFile Download476-EPOS-O-INASOPRS-03.jpg

144 E-POSTER

EPOS-R-INASOPRS-04Management of Congenital Upper Eyelid Coloboma in Goldenhar Syndromeusing Direct Closure Technique

Abstract TitleManagement of Congenital Upper Eyelid Coloboma in Goldenhar Syndrome using DirectClosure Technique

First Author: Willdania Yolanda

Author Institution: Sriwijaya University, Dr. Mohammad Hoesin Hospital Palembang

Co Author: Elza Iskandar (Sriwijaya University, Dr. Mohammad Hoesin Hospital Palembang)



Seminat: INASOPRS


IntroductionEyelid colobomas are congenital abnormalities caused by incomplete cell migration inembryogenesis. It may be isolated or associated by other ocular or systemic abnormalities. Uppereyelid coloboma is commonly associated with Goldenhar Syndrome. Surgical treatment of eyelidcoloboma is mandatory to preserve the cornea and visual function.Case IllustrationA 1 year old boy patient came with chief complaint of upper eyelid defect since birth on his righteye. On ophthalmological examination of the right eye revealed full-thickness defect on 1/3 medialof upper eyelid, limbal dermoid, leukoma in cornea, and lipodermoid in conjunctival. There wereother malformation such as asymmetrical nose and preauricular tags. There was no abnormalpregnancy nor delivery from her mother and no similar anomaly found in his relatives. He wasdiagnosed as Congenital Upper Eyelid Coloboma in Goldenhar Syndrome and was planned toundergo an eyelid reconstruction surgery by using direct closure technique.DiscussionThe eyelid reconstruction technique is chosen based on the size of the defect. In this case, therewas a defect on 1/3 medial of upper eyelid. This kind of defects is usually repaired by direct closuretechnique. A pentagonal excision is performed at the direct closure of the defect in the uppereyelid. The approximation of eyelid margin was good after surgery and adequate closure of theeyelid.ConclusionProper and adequate management of palpebral coloboma can improve the anatomical structure,providing adequate eyelid function to protect the globe.KeywordGoldenhar Syndrome, coloboma, direct closureLatest UpdateMay 04, 2021StatusApproved As E-PosterFile Download466-willdania.pdf

145E-POSTER

EPOS-R-INASOPRS-05DIAGNOSIS AND MANAGEMENT OF SEVERE PTOSIS WITH FRONTALISSLING PROCEDURE

Abstract TitleDIAGNOSIS AND MANAGEMENT OF SEVERE PTOSIS WITH FRONTALIS SLING PROCEDURE

First Author: Dita Mintardi

Author Institution: Sriwijaya University / Dr. Mohammad Hoesin Hospital Palembang

Co Author: Elza Iskandar (Sriwijaya University / Dr. Mohammad Hoesin Hospital Palembang)



Seminat: INASOPRS


IntroductionPtosis is a condition when the superior palpebra dropped which the lid position is below 2 mm fromthe edge of the upper limbus and the inferior palpebra is on the edge of the lower limbus. The typeof surgery for ptosis management is determined based on assessment of the ptosis, especially thefunction of levator muscles.Case IllustrationA male, 30 years old, complained of drooping left upper eyelid since 10 years ago. On examinationof left eye Margin to Reflex Distance1: -3 mm, Margin to Reflex Distance2: 0 mm, Palpebral Fissure2 mm, Levator Function 0 mm. Follow-up in this patient gave good results where the width andsymmetry of the palpebrae were normal, the contours of the eyelids were good, and the degree oflagophthalmos was normal.DiscussionIn severe ptosis, surgery performed for shortening of the weak levator muscle and its aponeurosisor hanging the palpebrae on the frontal muscles. Patients with poor or no levator function need analternative source of lift. This patient managed with frontalis sling procedure.ConclusionSurgery is the main choice for ptosis management. In this patient with 0 mm levator function,frontalis sling procedure was chosen. This procedure is expected to give good results and minimalcomplications.Keywordptosis, severe ptosis, frontalis sling procedureLatest UpdateMay 06, 2021StatusApproved As E-PosterFile Download79-ptosis.jpg

146 E-POSTER

EPOS-R-INASOPRS-06Management Of Cicatricial Ectropion Using Lateral Tarsal Strip And DermisFat Graft

Abstract TitleManagement Of Cicatricial Ectropion Using Lateral Tarsal Strip And Dermis Fat Graft

First Author: M Dani Hamid Arma

Author Institution: Universitas sriwijaya

Co Author: Elza Iskandar (Universitas sriwijaya)



Seminat: INASOPRS


IntroductionCicatricial ectropion is the condition of the lid margin pulled away from the globe by a shortage ofskin, which can be due to a variety of causes. Both eyelids may be involved and the shortage of skinmay be local general. The treatment for cicatricial ectropion is by incising and removing thecicatricial tissue on the palpebra and replacing it with a transplant or graft skin.Case IllustrationA 08-months-old baby presented with the lower right eyelid has been rolling outward since 3months ago. The patient was said to have had a pimple like lump since 7 months ago. One weeklater, a lump appeared near the lower left eyelid, as big as green bean seed, red in color, filled withyellowish liquid, the lump then burst and became inflamed and often recur. Visual Acuity of LE wasfixation of objects 4 m. There were inferior margo palpebral rotating outward, granuloma, with size15x5 mm, red color, chewy consistency, and immobile.DiscussionTreatment is based on correcting the underlying etiology. In this patient is to dissect and freecicatrix formation to release the lower eyelid to allow it to go back into proper position. The lateraltarsal strip procedure is done to increase horizontal lid tension and adjusting the level of the lateralcanthus. And than Its necessary to replace the skin by using a full-thickness skin graft.ConclusionThe ectropion cicatricial is best managed by combined surgery therapy depend on the condition ofthe patient.KeywordEctropion, lateral tarsal strip, dermis fat graft.Latest UpdateMay 08, 2021StatusApproved As E-PosterFile Download314-EPOS-R-INASOPRS-06-M.-Dani-Hamid-Arma.jpg

147E-POSTER

EPOS-G-INASOPRS-07Spontaneous Globe Rupture With Uveal Protrusion: A Case Report

Abstract TitleSpontaneous Globe Rupture With Uveal Protrusion: A Case Report

First Author: Fabiola Supit

Author Institution: Faculty of Medicine, Public Health, and Nursing Gadjah Mada University

Co Author:

Y. Anton Suryowibowo (Dept. Ophthalmology Panti Rapih Hospital, Dept. Ophthalmology Panti Rini

Hospital)

Yoselyn Gunawan (Faculty of Medicine, Public Health, and Nursing Gadjah Mada University)



Seminat: INASOPRS


IntroductionThis study reported a rare case of geriatric with globe rupture without preceding trauma.Case IllustrationAn 83 years old woman had bleeding and pain in her left eye, which happened spontaneously at 3am. Before the presentation, there was a bulging in the left eye and she had a headache. She hadnever had her eyes examined by an ophthalmologist. There was no history of fall down, left eyetrauma, and surgery. She had uncontrolled high blood pressure (BP). Ocular examination of the lefteye revealed a visual acuity of no light perception, inflamed upper and lower palpebra, conjunctivalinjection, scleral laceration approximately 4mm below limbus with choroid expulsion, and activebleeding. There was a corneal defect, corneal edema, and a hyphema. The patient was clinicallydiagnosed with spontaneous eyeball rupture with choroidal expulsion. Vision restoration was notattainable therefore an evisceration took place to prevent sympathetic ophthalmia.DiscussionSuprachoroidal hemorrhage was reported triggering spontaneous eyewall rupture in aglaucomatous patient. The patient has several possible risk factors of glaucoma, including old age,chronic uncontrolled high BP, a history of headache, and early morning incident. The highest IOPpeak usually during sleep in the early morning hours. People with glaucoma have a higherfluctuation of IOP. A history of eye-bulging and corneal defect before rupture suggested a thineyewall or possible corneoscleral abnormality.ConclusionA suprachoroidal hemorrhage, related to a sudden increase in IOP, and a corneoscleral fragilitymight be the mechanism of spontaneous globe rupture.Keywordspontaneous globe rupture, uveal protrusion, suprachoroidal hemorrhageLatest UpdateMay 09, 2021StatusApproved As E-PosterFile Download808-poster-rupture.jpg

148 E-POSTER

EPOS-R-INASOPRS-08BLUNT TRAUMA WITH OCULAR MUSCLE LOSS AND RUPTURE, ANDTRAUMATIC PTOSIS SEQUELAE

Abstract TitleBLUNT TRAUMA WITH OCULAR MUSCLE LOSS AND RUPTURE, AND TRAUMATIC PTOSIS SEQUELAE

First Author: Putu Daivi Prakriti

Author Institution: Udayana University

Co Author:

dr. A. A. A. Sukartini Djelantik, Sp.M(K) (Department of Ophthalmology, Faculty of Medicine,

Udayana University / Sanglah Hospital Bali)

Dr. dr. Putu Yuliawati, Sp.M(K) (Department of Ophthalmology, Faculty of Medicine, Udayana

University / Sanglah Hospital Bali)

dr. Ni Made Laksmi Utari, M.Biomed, Sp.M(K) (Department of Ophthalmology, Faculty of Medicine,

Udayana University / Sanglah Hospital Bali)

dr. Ni Made Ayu Surasmiati, M.Biomed, Sp.M(K) (Department of Ophthalmology, Faculty of

Medicine, Udayana University / Sanglah Hospital Bali Indonesia)



Seminat: INASOPRS


IntroductionBlunt ocular trauma is more common than sharp injury, with various outcome. Complicatingsequelae requiring further treatment is not uncommon. One of the sequelae is traumatic ptosis. It isgenerally self-limited, but in some cases may require surgery.Case IllustrationA 46-year-old male was referred to our hospital with RE blunt trauma complicated with palpebralmargin rupture and suspected medial rectus muscle rupture. ER examination found VA 6/60 PH NIon RE, ruptures on superior palpebral margin and conjunctiva, and limited RE adduction. Uponexploration, we discovered right medial rectus loss, and superior oblique rupture. Repair of ruptures and vertical muscle transposition was done. 2 weeks after, symblepharon developed, with middilatation, 150 exotropia and ptosis (MRD1 +1, LA 9 mm). After a 6-month period of observation, symblepharon release with amnion grafting was done, however, the ptosis persisted. Levator Resection was then done, and after nearly 2 months, condition improved with MRD1 +3, LA 10 mm, orthophoria and still middilated but BCVA 6/6.DiscussionTraumatic ptosis accounts for 11.2% of blepharoptosis cases. Its management depends on the underlying mechanism. In traumatic cases, ptosis repair is secondary and usually done after 6 months. In this case, traumatic ptosis occurred as sequelae of a blunt injury, which improved after symblepharon release with amnion graft and subsequent levator resection.ConclusionBlunt ocular trauma may have various outcome and sequelae. Traumatic ptosis is one of thesequelae that may need surgical treatment, depending on its underlying mechanism.Keywordocular blunt trauma, traumatic ptosis, levator resectionLatest UpdateMay 12, 2021StatusApproved As E-PosterFile Download36-EPOS-R-INASOPRS-08-Putu-Daivi-Prakriti.jpg

149E-POSTER

EPOS-R-INASOPRS-09Management of Involutional Ectropion with Lateral Tarsal Strip Procedure

Abstract TitleManagement of Involutional Ectropion with Lateral Tarsal Strip Procedure

First Author: dr. Putri Dwi Kartini

Author Institution: Sriwijaya University, Dr. Mohammad Hoesin Hospital Palembang

Co Author: Elza Iskandar (Sriwijaya University, Dr. Mohammad Hoesin Hospital Palembang)



Seminat: INASOPRS


IntroductionInvolutional ectropion is an outward turning of the eyelid margin due to horizontal eyelid laxity inthe medial or lateral canthal tendons or both and usually occurs in the lower eyelid because of theeffects of gravity on a horizontally lax lower eyelid. Untreated, this condition leads to loss of eyelidapposition to the globe and eversion of the eyelid margin.Case Illustration77-year-old man with a complaint of his right lower eyelid rolled outward. On examination of theright eye revealed horizontal lid laxity with prominently slowing in snap back test > 2 seconds andover 8 mm in distraction test. There was scleral show sign on the right eye. The MRD 2 distancewas 9 mm with no eversion at lacrimal punctum. The patient was then diagnosed with involutionalectropion and repaired with lateral tarsal strip procedure. Two weeks after surgery, the MRD 2distance improved to 5 mm with no scleral show apparent nor other complications.DiscussionHorizontal lid laxity can be corrected surgically by a number of procedures. With lateral tarsal stripprocedure, the lid is shortened and a new lateral canthal tendon is created out of the lateral tarsalplate. The small lateral canthal incision make the lateral tarsal strip a minimally invasive procedurethat contributes to the easy post-operative management. This procedure is very simple and can beperformed quickly.ConclusionLateral tarsal strip is one of surgical procedure that suitable for involutional ectropion.KeywordInvolutional ectropion, eyelid laxity, lateral tarsal stripLatest UpdateMay 13, 2021StatusApproved As E-PosterFile Download658-EPOS-R-INASOPRS-09.jpg

150 E-POSTER

EPOS-R-INASOPRS-10Successful Treatment of Neglected Orbital Lymphoma: A Case Report

Abstract TitleSuccessful Treatment of Neglected Orbital Lymphoma: A Case Report

First Author: Rif’at NurfahriAuthor Institution: FK UnairCo AuthorHendrian Dwikoloso Soebagjo (FK Unair)Susy Fatmariyanti (FK Unair)Delfitri Lutfi (FK Unair)Abstract Type: Case ReportAbstract Category: E-PosterSeminat: INASOPRSCompetition Category: Resident

IntroductionOcular adnexal lymphoma (OAL) is a rare tumor with an incidence of 0.2 per 1,00,000 individuals.OAL can involve conjunctiva, eyelid, lacrimal gland, and orbital soft tissues. This is a case report ofneglected orbital lymphoma with a good outcome with chemotherapy.Case IllustrationA 46 years old man, complained of severe pain and blindness in the right eye for one week. Therewas a white appearance in the right eye and discharge since 2 months ago and protruded since 7months ago. There was a mass in his right cheek diagnosed as TB gland elsewhere since 7 yearsago and had been treated for 1-year long medication without significant result. RE examinationrevealed VA no light perception with pain and corneal perforated. Head CT examination showed asolid tumor on the right parotid extending to the right superotemporal orbital cavity. The patientunderwent a right parotid open biopsy and the results showed Non-Hodgkin Lymphoma with adifferential diagnosis of follicular lymphoma. We performed right eye evisceration, debulkingorbital tumor, and incisional biopsy. HPE and IHC resulted in high-grade Non-Hodgkin LymphomaB Cell Type with CD20 Positif.DiscussionTreatments for OAL including surgical excision, chemotherapy, or combination therapy have goodoutcomes. Patient treated with chemotherapy combination of Vincristine (1,6 gram), Doxorubicin(96,6 gram), and Cyclophosphamide (1208,25 gram) for seven cycles. Tumor in the right eye andright cheek show complete resolution after chemotherapy.ConclusionCT or MRI followed by biopsy-proven histological verification is an important diagnostic tool ofLymphoma. Chemotherapy shows a good outcome.KeywordOcular Adnexal Lymphoma, Perforated Corneal UlcerLatest UpdateMay 14, 2021StatusApproved As E-PosterFile Download812-EPOS-R-INASOPRS-10-Rifat-Nurfahri.jpg

151E-POSTER

EPOS-R-INASOPRS-11The Challenging Management of Severely Irradiated ContractedAnophthalmic Socket with Tunneled Island Suprabrow Flap in an EnucleatedEye: A Case Report

Abstract TitleThe Challenging Management of Severely Irradiated Contracted Anophthalmic Socketwith Tunneled Island Suprabrow Flap in an Enucleated Eye: A Case Report

First Author: Yuri Dwi MayasariAuthor Institution: Ophthalmology Resident, Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, IndonesiaCo Author: Yunia Irawati (Head of Plastic and Reconstructive Surgery Division, Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia)Abstract Type: Case ReportAbstract Category: E-PosterSeminat: INASOPRSCompetition Category: Resident

IntroductionA contracted socket is a complication of anophthalmic socket which results in the inability tosupport a prosthesis. Reconstruction of a contracted socket is aimed to solve this problem.Case IllustrationAn 11-year-old boy presented with a severely contracted left eye socket and a history of unattachedprosthesis one year ago. His left eye was enucleated due to retinoblastoma six years ago and it wasreplaced by a dermis fat graft implant. Radiation therapy had been given to his left eye socket 25times. On examination, the left socket was dry with severe surface and volume contracture. Thepatient had performed surgery with tunneled island suprabrow flap, oral mucosa graft implant,tarsal fracture, anterior lamellar reposition, and fornixplasty. A prosthesis for socket maintenancewas inserted postoperatively. The patient was given both oral and topical antibiotics. One weekpostoperative, the left eyelid was on blepharoraphy without any inflammation signs.DiscussionContracted anophthalmic socket can be caused by mechanical trauma, thermal and chemical burn,as well as irradiation and chronic inflammation. At an advanced stage, more than one procedure isoften necessary to solve the problem. Tunneled island suprabrow flap is a satisfactory choice forreconstructing wide volume and line deficiency in a single-stage procedure. This flap has the abilityto camouflage the scar on the donor area and preserve the symmetry plane of faces.ConclusionSocket surgery is a principled choice to reconstruct the disfigurement of a severely contractedsocket. The choice of surgical technique is tailored to the severity and causes of each individual.Keywordseverely contracted anophthalmic socket, tunneled island suprabrow flap, post irradiationcontracted anophthalmic socketLatest UpdateMay 14, 2021StatusApproved As E-PosterFile Download335-IMG-20210709-WA0012.jpg

152 E-POSTER

EPOS-O-INASOPRS-12Periocular reconstruction after radiotherapy in wide excision of Basal CellCarcinoma with Buccal Mucosal Graft and Anterolateral Thigh Free flap: A Case Report

Abstract TitlePeriocular reconstruction after radiotherapy in wide excision of Basal Cell Carcinoma withBuccal Mucosal Graft and Anterolateral Thigh Free flap : A Case Report

First Author: FREILI AKAYAuthor Institution: RSUD Noongan, Minahasa, Sulawesi Utara

Co Author:

Yunia Irawati (Plastic Reconstructive Surgery Division, Department of Ophthalmology, Faculty of

Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia)

Parintosa Atmodiwirjo (Reconstructive Microsurgery Division, Department of Plastic Surgery,

Faculty of Medicine Universitas Indonesia, Dr. Cipto MangunkusumoHospital, Jakarta, Indonesia)



Seminat: INASOPRS


IntroductionEyelids reconstruction after tumor removal remains one of the most challenging tasks inreconstructive surgery, mainly after radiotherapy.Case IllustrationA 55-year-old female presented with history of wide excision and aggresive radiotherapy due toextensive basal cell carsinoma (BCC) of the right eye a year earlier. The appropriate managementof extensive BCC to periorbital and fornix is exenteration, but the patient was reluctant. Aftercompleted radiotherapy, we found complete ankyloblepharon and lateral upper eyelid defect withepithelized tissues on the temporal side. After releasing ankyloblepharon, corneal necrosis withexposed iris was found, the globe then covered with periosteal graft, the posterior lamella wasreplaced with buccal mucosal graft (BMG) and the anterior lamella reconstrucion using forearmradial free flap was performed by the Plastic Surgeon. Unfortunately, the free flap was ischemic 1day postoperative and was immediately replaced with anterolateral thigh free flap.DiscussionThe extent of skin defect and aggresive radiotherapy history increased the management difficulty ofthis case. Multidisciplinary approach must be taken. Combining a nonvascularized graft with avascularized flap should be the rule. Therefore, this case was managed with BMG to replace theposterior lamella and free flap with pedicle of vascularisation for anterior lamella reconstruction.Close monitoring of the flap was necessary, because acute irradiation may predispose tomicrovascular thrombosis, leading to flap congestion and necrosis.ConclusionThe use of forearm free flap in post-radiotherapy patients showed insufficient vascularization, thus,we need larger blood vessels supply taken from anterolateral thigh free flap.KeywordPeriocular reconstruction, eyelid defect, free flapLatest UpdateMay 14, 2021StatusApproved As E-PosterFile Download29-EPOS-O-INASOPRS-12-Freili-Akay.jpg

153E-POSTER

EPOS-O-INASOPRS-13Surgical Approaches and Amniotic Membrane Transplantation ForManagement of Large Corneal-Limbal Dermoids in Children: A Case report

Abstract TitleSurgical Approaches and Amniotic Membrane Transplantation For Management of LargeCorneal-Limbal Dermoids in Children: A Case report

First Author: NI MADE LIENDERI WATI

Author Institution: RSUD KARANGASEM

Co Author



Seminat: INASOPRS


IntroductionLimbal dermoids are the most common choristomas, which are known as congenital benign tumorsthat are found in abnormal locations. Despite the benign nature, enlarging limbal dermoids maycause visual abnormalities by the gradual development of corneal astigmatism and encroachmentin the visual axis.Case Illustration A 9 years-old girl with a limbal-corneal tumor on the right eye was visited policlinic ofophthalmology of Karangasem Hospital. On ophthalmological examination revealed a solid, withishyellow and ovoid mass, approximately 20 mm x 20 mm in size, with central keratinized epitheliumover the lateral limbus and expand to the two third of the corneal surface. Visual acuity of the righteye was light perception and left eye was 6/6. No associated regional or systemic abnormality werefound. She was diagnosed as large corneal limbal dermoid, and underwent excision of the tumorfollowed by multilayer amniotic membrane transplantation. Histopathological result was suggestiveof dermoid cyst with hair follicle appearance, fibrotic connective tissue and limfosit.DiscussionAnatomically, limbal dermoids can be classified into 3 grades. Possible surgical approaches forgrade II and III limbal dermoids include excision, lamellar or penetrating keratoplasty, andamniotic membrane or limbal stem cell transplantation. In this case, the patient was treated bysurgical intervention followed by multilayer amniotic membrane transplantation. Patient wentthrough a well healing process with rapid corneal reepithelizationConclusionExcision and amniotic membrane transplantation may be considered as a treatment for large limbalcorneal dermoids cases.KeywordLarge corneal-limbal dermoids, excision, amniotic membrane transplantationLatest UpdateMay 15, 2021StatusApproved As E-PosterFile Download35-Poster-limbal-dermoid-PVSM-2021-JPEG-resize.JPG_4.JPG

154 E-POSTER

EPOS-R-INASOPRS-14ENLARGEMENT EYELID HEMATOME FOLLOWING BLUNT TRAUMAASSOCIATED WITH BLOOD ABNORMALITIES IN HEPATIC DISEASE

Abstract TitleENLARGEMENT EYELID HEMATOME FOLLOWING BLUNT TRAUMA ASSOCIATED WITHBLOOD ABNORMALITIES IN HEPATIC DISEASE

First Author: dr. Bimanda Rizki NurhidayatAuthor Institution: Ilmu Kesehatan Mata FK Unair

Co Author: Sutjipto (Ilmu Kesehatan Mata FK Unair )



Seminat: INASOPRS


IntroductionTo report a management of blunt trauma induce enlargement eyelid hematome associated withblood abnormalities in hepatic disease.Case IllustrationA 6-month-old baby was presented to Soetomo Hospital with eyelid swelling of right eye since 1week previously after his head stumbled and hit by a cellphone on the floor in his right eye. Theeyelid swelling was getting bigger accompanied with red eye and difficult to open eyelid. The visualacuity (VA) of right eye was difficult to evaluated, palpebra hematome, and chemosis of right eye.His weight belongs to severely underweight category. The ancillary test result prolongation ofhemostasis, increase of liver function test, leukocytosis, and thrombosis. The CT scan result cysticmixed semisolid lesion with hematome at right upper eyelid. The patient was treated together withpediatrician to treating cholestasis, stabilize systemic conditions and improve nutritional status.DiscussionIncision and drainage was performed and follow-up was monitored at day-1 until day-30 postoperatively. At day-1, follow-up the drain was in good position and minimal bleeding. The patientwas treated with chloramphenicol eye oinment. At day-7 post operatively, the palpebra hematomedecrease. At day-30 post operatively, the eyelid hematome getting better, systemic condition isstable, and his weight increases.ConclusionThe decision to perform incision and drainage surgery should first rule out the underlying systemicabnormality, which might aggravate without considering it. Quick medical diagnosis should be doneto prevent the late complication.Keywordblunt trauma, eyelid hematome, blood abnormalities.Latest UpdateMay 15, 2021StatusApproved As E-PosterFile Download787-EPOS-R-INASOPRS-14-Bimanda-Rizki-Nurhidayat.jpg

155E-POSTER

EPOS-R-INASOPRS-15Challenging Management of Ocular Complication after Calcium CarbideExplosion Injury

Abstract TitleChallenging Management of Ocular Complication after Calcium Carbide Explosion Injury

First Author: Agung FujiyonoAuthor Institution: RSCM

Co Author: Yunia Irawati (RSCM)



Seminat: INASOPRS


IntroductionWe describe a case of ocular complication from a chemical injury caused by calcium carbideexplosion.Case IllustrationA 45-year-old man presented to our plastic and reconstruction clinic with worsening of redness andpain on the left eye. One month prior, his eyes was struck by a calcium carbide explosion. Heimmediately flushed both of his eyes with running tap water for about 30 minutes. He soughttreatment at the emergency department, where an initial examination was conducted. He wasimmediately treated with irrigation, debridement, and medications. However, his left ocular surfacewas deteriorating. On examination at our clinic, he was diagnosed with cicatricial entropion on thesuperior left eye-lid, and symblepharon of the left eye. Also, there was a sign of lagophthalmos withcorneal exposure of the left eye due to the symblepharon. The patient underwent surgery of releasesymblepharon followed by amnion membrane transplantation and anterior lamellar repositionafterwards.DiscussionAlkali injuries to the eye can induce an extensive damage to the ocular surface, leading to visualimpairment and disfigurement. Lid malposition may be present due to symblepharon formation,yielding a cicatricial entropion or ectropion. The goal of treatment is restoration of the normalocular surface anatomy and lid position.ConclusionCalcium carbide explosion, as an alkali injury, can lead to a poor prognosis of the eyes. Furthermanagement of the complications are needed to maintain an ocular surface stability. Releasesymblepharon, amnion membrane transplantation, and anterior lamellar reposition were the keys ofmanaging the presented case.KeywordCalcium carbide, explosion, ocular surface complicationLatest UpdateMay 15, 2021StatusApproved As E-PosterFile Download276-EPOS-R-INASOPRS-15---Agung-Fujiyono.jpg

156 E-POSTER

EPOS-R-INASOPRS-16AN UNUSUAL PRESENTATION HIGH GRADE ADENOID CYSTIC CARCINOMAOF THE LACRIMAL GLAND IN AN ADOLESCENCE

Abstract TitleAN UNUSUAL PRESENTATION HIGH GRADE ADENOID CYSTIC CARCINOMA OF THELACRIMAL GLAND IN AN ADOLESCENCE

First Author: Clarisa Finanda

Author Institution: Resident of Ophthalmology, Faculty of Medicine Universitas Airlangga – Dr. Soetomo


Co Author:

Grace Ariani (Department of Pathology Anatomy, Faculty of Medicine Universitas Airlangga – Dr.

Soetomo General Hospital, Surabaya, Indonesia)

Susy Fatmariyanti (Orbit and Oncology Division, Department of Ophthalmology, Faculty of

Medicine Universitas Airlangga – Dr. Soetomo General Hospital, Surabaya, Indonesia)

Hendrian Dwikoloso Soebagjo (Orbit and Oncology Division, Department of Ophthalmology, Faculty

of Medicine Universitas Airlangga – Dr. Soetomo General Hospital, Surabaya, Indonesia)

Delfitri Lutfi (Orbit and Oncology Division, Department of Ophthalmology, Faculty of Medicine

Universitas Airlangga – Dr. Soetomo General Hospital, Surabaya, Indonesia)



Seminat: INASOPRS


IntroductionAdenoid cystic carcinoma (ACC) lacrimal gland only constitutes 1.6% of all orbital tumours, evenless in pediatric, making it an unusual presentation in clinical settings.Case IllustrationA 15-years-old male patient with protruding and inferolateral right globe displacement for nine years had a history of visits several times to our outpatient clinic but lost to follow up. Right eye examination revealed no light perception visual acuity, and solid fixed mass was palpated orbital superior up to the frontal area. MRI and CT scan showed indistinct intra and extraconal mass with heterogenous contrast-enhancing infiltrated adjacent paranasal sinuses and pushed duramater of cavernous sinus from foramen opticum. Arteriography showed vascularization of the lesion from branches of ophthalmic artery (ICA) and internal maxillary artery (ECA). Multi-disciplinary Discussion decided to perform extended exenteration with prior embolization.DiscussionACC has bimodal prevalence with a mean age of diagnosis at 30 – 40 years old and adolescence.Young age usually presents low-grade ACC, which correlates with a better prognosis. But ourpatient exhibits high-grade ACC (grade III basaloid pattern) and invasion to adjacent structures(pT4cN1M0). Embolization was done before the surgery to minimize the bleeding. The patient willundergo radiotherapy after the exenteration to prevent further metastasis.ConclusionHigh-grade ACC is an unusual presentation in the adolescent age group. As in our knowledge, thereis no case report with a similar presentation.KeywordAdenoid cystic carcinoma of the lacrimal gland, adolescence, basaloid patternLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download349-EPOS-R-INASOPRS-16-Clarisa-Finanda.jpg

157E-POSTER

EPOS-R-INASOPRS-17Surgical Management of A Large Upper Eyelid Coloboma in GoldenharSyndrome Patient

Abstract TitleSurgical Management of A Large Upper Eyelid Coloboma in Goldenhar Syndrome Patient

First Author: Muhammad Dio S


Co Author: Yunia Irawati (Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital)



Seminat: INASOPRS


IntroductionGoldenhar syndrome is a rare congenital disease with multifactorial etiopathogenesis. Managementof eyelid coloboma as one of the classical triad is crucial. The surgical management will bepresented in this report.Case IllustrationAn 11 day-old boy presented to the plastic reconstruction clinic with a complaint of a large defect ofhis left upper eyelid from birth. He was born of nonconsanguineous marriage with no maternalhistory of any illness or drug intake during pregnancy. Ophthalmological examination revealedcoloboma involving the medial two-thirds of the left superior palpebra with 12 mm oflagophthalmos and full corneal exposure. A 9 mm diameter temporal limbal dermoid and cornealdefect (2 mm x 1 mm) at the central were observed in the left eye. Telecanthus and bilateralpreauricular appendage were noted, with no facial hypoplasia. Based on clinical findings, superiorpalpebral coloboma suspected of Goldenhar syndrome was made. The patient underwent leftsuperior palpebral reconstruction with cantholysis, direct closure, semicircular flap, and glabellarflap. Despite significant improvement at five months follow-up, lagophthalmos and ectropion wereslightly present. Therefore sufficient ocular surface treatment was given.DiscussionCongenital eyelid coloboma may be isolated or associated with other ocular or systemic anomalies.The timing and surgical technique depending on the size of the defect. Corneal protection isessential to prevent visual loss and risk of amblyopia.ConclusionSurgical treatment of large eyelid coloboma is a challenge due to functional and cosmetic resultswill be difficult to attain. Post-operative care and close monitoring of visual development are required.KeywordEyelid coloboma, Goldenhar syndrome, palpebral reconstructionLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download886-EPOS-R-INASOPRS-17---M.-Dio-Syaputra.jpg

158 E-POSTER

EPOS-R-INASOPRS-19Lower Eyelid Reconstruction with Mustarde Rotational Flap and Oral MucosaGraft for Large Defect after Basal Cell Carcinoma Removal

Abstract TitleLower Eyelid Reconstruction with Mustarde Rotational Flap and Oral Mucosa Graft forLarge Defect after Basal Cell Carcinoma Removal

First Author: Mega Hayyu Isfiati

Author Institution: Department of Ophthalmology, Faculty of Medicine, University of Indonesia, Dr. Cipto


Co Author: Yunia Irawati (Head of Plastic and Reconstructive Surgery Division, Department of

Ophthalmology, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital)



Seminat: INASOPRS


IntroductionTumors larger than two-thirds of the lower eyelid require surgical reconstruction that preservesanatomy of the eyelid. The aim of this case report is to present reconstruction of large lower eyeliddefect following tumor removal with Mustarde rotational flap and oral mucosa graft.Case IllustrationA 74-year-old male was admitted to our hospital with basal cell carcinoma of the right lower eyelid.Wide excision of 24 x 15 mm tumor was performed, leaving full thickness eyelid defect with morethan 15 mm vertical defect. The anterior lamella was reconstructed using Mustarde rotational flapand posterior lamella was reconstructed using oral mucosa graft. Postoperatively, patient did notpresent any distortion of anatomy or ectropion.DiscussionSurgery in basal cell carcinoma aims to excise the entire tumor with > 3 mm margin outside thetumor and to reestablish eyelid function and esthetics. In case of large defect of the lower eyelid,exceptional care must be taken to prevent ectropion. Mustarde rotational flap is especially usefulfor vertically deep defect as described in this case. Conjunctival and tarsal loss are bestreconstructed with oral mucosa graft since it provides a good vascularisation to the wound bed andhas long-term stability.ConclusionReconstruction of large eyelid defect following tumor removal surgery requires special attention topreserve anatomy of the eyelid. Mustarde rotational flap and oral mucosa graft have been proven tobe successful and reliable techniques for repairing large defect of the lower eyelid.KeywordMustarde rotational flap, basal cell carcinoma, lower eyelid reconstructionLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download562-EPOS-R-INASOPRS-19-Mega-Hayyu-Isfiati.jpg

159E-POSTER

EPOS-R-INASOPRS-20Significant Regression of Conjunctival Papilloma Using Oral Cimetidine

Abstract TitleSignificant Regression of Conjunctival Papilloma Using Oral Cimetidine

First Author: Oggy Satriya Putra


Co Author:

Susy Fatmariyanti (Airlangga University)

Hendrian D Soebagjo (Airlangga University)

Delfitri Lutfi (Airlangga University)



Seminat: INASOPRS


IntroductionConjunctival papilloma is an acquired benign tumor that arises from the stratified squamousepithelium of the conjunctiva. Our purpose to report significant regression of conjunctivalpapilloma treated by oral cimetidine.Case IllustrationA 21-years-old man presented with a progressive mass on the right eye for 2 months. The reddishmass was located on the inside of the eyelid. He suffered from a foreign body sensation whenblinked and no history of red eye. Visual acuity was 6/6 for both eyes. The anterior segmentexamination on the right eye revealed a pedunculated red lesion on temporal conjunctival palpebrasuperior, 10x8 mm in size, fixed, tender, sharp margin, and irregular surface. Cytology Impressionrevealed conjunctival papilloma and the HPV test was negative. We treated the patient oralcimetidine 200 mg three times daily for two months. There was a significant decrease in tumor sizeeven not complete resolution. For the complete resolution, excisional surgery was done, adjunctwith double-freeze-thaw cryotherapy for reducing recurrence.DiscussionCimetidine is an H2 receptor antagonist which at high doses has cellular immunomodulatory effectsthat are elicited by inhibiting the H2 receptors on suppressor T-Cells and augmenting delayed-typehypersensitivity responses. In this case, oral cimetidine was given as an adjunctive treatmentbefore the surgery and give significant regression of the lesion.ConclusionDespite the benign nature of the tumor, treatment conjunctival papilloma may be challenging. Oralcimetidine can be used as primary or adjuvant treatment for treating conjunctival papilloma.Successful outcomes may require combined management of both medications such as cimetidine,surgery, and cryotherapy for complete resolution and low recurrence rate.Keywordconjunctival papilloma, oral cimetidine, squamous papillomaLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download772-EPOS-R-INASOPRS-20-Oggy-Satriya.jpg

160 E-POSTER

EPOS-R-INASOPRS-22Unusual Presentation Non-Teratoid Medulloepitelioma MimickingRetinoblastoma In 8-Months-Old Boy: A Case Report

Abstract TitleUnusual Presentation Non-Teratoid Medulloepitelioma Mimicking Retinoblastoma In 8-Months-Old Boy: A Case Report

First Author: ANINDITA JUWITA PRASTIANTI

Author Institution: RS, DR. SOETOMO

Co Author:

Susy Fatmariyanti (RS, DR. SOETOMO)

Hendrian D. Soebagjo (RS, DR. SOETOMO)

Dyah Fauziah (RS, DR. SOETOMO)

Delfitri Lutfi (RS, DR. SOETOMO)



Seminat: INASOPRS


IntroductionMedulloepithelioma is a neuroepithelial tumor arising from primitive medullary epithelium, clinically evident in children aged 4-12 years. Most commonly appears as a white or yellow-colored ciliary body tumor and is frequently misdiagnosed as retinoblastoma.Case IllustrationA-8-months old boy with leukocoria in the left eye since 3 months age. The anterior segmentshowed a shallow anterior chamber, irradier iris, synechia posterior, and cataract. From ultrasonography, there was a diffuse mass with intra-tumoral multiple cysts in the vitreous cavity. Orbital CT showed intraocular hyperdense lesions 90% in the left eye without calcification. We diagnosed him with Retinoblastoma Introculi Group E treated with enucleation. Histopathologynrevealed a multi-layer rosette consisting of elongated neuroepithelial cells with round nuclei. Therenwas no pleomorphism, mitosis, necrosis, and heteroplastic components suggesting a Non-Teratoid Medulloepithelioma.DiscussionMedulloepithelioma and retinoblastoma were difficult to distinguish on clinical appearance. Basedon age, medulloepithelioma tends to be older than 2 years. The hallmark from ultrasonography inmedulloepithelioma showed clear cyst within the mass and areas of cartilage within the tumor canproduce dense echoes that mimic calcification in retinoblastoma, especially in teratoid subtypes.Definitive diagnosis made by histopathological which the characteristic combination of theprimitive neuroepithelium and hypocellular stroma make up most of the medulloepithelioma.ConclusionThe unusual presentation of medulloepithelioma at a very young age makes it challenging toestablish a diagnosis. Histopathology is mandatory to rule out retinoblastoma. Based on ourknowledge, this is the youngest case of meduloepithelioma was reported.KeywordMedulloepithelioma, Retinoblastoma Intraoculi, LeukocoriaLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download655-EPOS-R-INASOPRS-22-Anindita-Juwita.jpg

161E-POSTER

EPOS-R-INASOPRS-23Surgical Management and Eyelid Reconstruction in a Large FornicealConjunctival Melanoma – a Case Report

Abstract TitleSurgical Management and Eyelid Reconstruction in a Large Forniceal ConjunctivalMelanoma – a Case Report

First Author: Marsha Alyssa Razief Fitri

Author Institution: Ophthalmology Department, Faculty of Medicine Universitas Indonesia, Dr. Cipto

Mangunkusumo National Hospital, Jakarta, Indonesia

Co Author: Mutmainah (Ophthalmology Department, Faculty of Medicine Universitas Indonesia, Dr. Cipto

Mangunkusumo National Hospital, Jakarta, Indonesia )



Seminat: INASOPRS


IntroductionTo describe management of large conjunctival melanoma of the lower fornix reconstructed withoral mucosa graft and advancement flaps.Case IllustrationA 67-years old male patient presented to the clinic with a bulging mass on his lower fornix of theleft eye. The tumor has grown bigger for the last 6 months and induced foreign body sensation andwatery eyes. Examination revealed hyperpigmented mass along the entire tarsal and fornicealconjunctiva of the lower eyelid. Wide excision of the tumor and oral mucosa graft was performedalong with skin advancement flaps to reconstruct the lower eyelid. Histopathological analysisconfirmed the diagnosis of malignant conjunctival melanoma with perineural invasion. He wasconsulted to the Radiotherapy Department for further treatment. No local recurrence found oneyear after the surgery.DiscussionConjunctival melanoma is a rare type of cancer that comprise about 2% of all ocular cancer and0.25% of all melanoma. Fornix is a less frequent site of conjunctival melanoma and associated withworse prognosis. Main surgical principle in this disease is wide excision with the “no-touch technique” to avoid tumor seeding. The absence of posterior lamella of lower lid could be reconstructed with oral mucosa graft fixated to the skin after being reconstruct with advancement flaps.ConclusionMalignant conjunctival melanoma is a serious condition that requires meticulous treatment.Complete removal of the tumor, local, and systemic evaluation must be done due to the high risk ofmortality. Oral mucosa graft was an excellent option to reconstruct posterior lamella following wideexcision in conjunctival melanoma.KeywordConjunctival melanoma, oral mucosa graft, eyelid reconstructionLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download215-EPOS-R-INASOPRS-23-Marsha-Alyssa-RF.jpg

162 E-POSTER

EPOS-R-INASOPRS-24ADJUNCT TOPICAL CHEMOTHERAPY OF MITOMYCIN-C SUCCESSFULLYREDUCE GIANT SQUAMOUS CELL CARCINOMA CONJUNCTIVA: A CASEREPORT

Abstract TitleADJUNCT TOPICAL CHEMOTHERAPY OF MITOMYCIN-C SUCCESSFULLY REDUCE GIANTSQUAMOUS CELL CARCINOMA CONJUNCTIVA: A CASE REPORT

First Author Citra Dewi Maharani

Author Institution Department of Ophthalmology, Faculty of Medicine Universitas Airlangga – Dr. Soetomo


Co Author: Susy Fatmariyanti (Department of Ophthalmology, Faculty of Medicine Universitas Airlangga –

Dr. Soetomo General Hospital, Surabaya, Indonesia)

Hendrian Dwikoloso Subagyo (Department of Ophthalmology, Faculty of Medicine Universitas

Airlangga – Dr. Soetomo General Hospital, Surabaya, Indonesia)

Delfitri Lutfi (Department of Ophthalmology, Faculty of Medicine Universitas Airlangga – Dr.




Seminat: INASOPRS


IntroductionOne of the adjunctive treatments for chemo reduction of the ocular surface tumor is topical Mitomycin C (MMC). We reported a case of giant Squamous Cell Carcinoma (SCC) Conjunctiva that was successfully reduced with topical MMC.Case IllustrationA 60-years-old woman came with a complaint of slowly growing mass in the right eye for three months. Examination revealed papillomatous elevated lesion from 1 to 8 o’clock direction. The tumor involved >180 degrees of the limbus, and biopsy showed SCC, making it compatible with the diagnosis of giant SCC conjunctiva. This patient was admitted with topical MMC 0,04% qid, 4-daysa-week for four weeks with two weeks off-treatment free interval. Clinical evaluation and OCT anterior after six weeks presenting with significant resolution. Surgery and cryotherapy were done to altogether remove the tumor.DiscussionGiant SCC widespread to cornea and conjunctiva with a higher risk of recurrence makes treatment more challenging. The surgical approach is often complicated because the margins are not clearly demarcated. Extensive tissue removal can induce scarring with damage to the ocular surface. Topical chemotherapy becomes favorable due to its advantage to reduce the size of the tumor and risk of recurrence. MMC is one of the topical chemotherapy agents that widely accepted as adjunctive chemotherapy. Complete removal of the tumor in several cases still needs surgical excision.ConclusionMMC topical can be used as adjunct chemotherapy to treat giant SCC on the ocular surface, whichprovides chemo reduction of the tumor so that surgical excision can reach the free margin of the lesion.Keywordconjunctival tumor, ocular surface squamous neoplasia, MMCLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download299-EPOS-R-INASOPRS-24-Citra-Dewi-Maharani.jpg

163E-POSTER

EPOS-R-INASOPRS-25MANAGEMENT OF CYSTIC ANOPHTHALMIC SOCKET

Abstract TitleMANAGEMENT OF CYSTIC ANOPHTHALMIC SOCKET

First Author: dr.Nitia Amanda

Author Institution: Department of Opthalmology Andalas university RSUP dr.M.Djamil Padang

Co Author: Hendriati (Recontruction Oncology and Oculoplasty Subdivision Department of Opthalmology

Andalas university RSUP dr.M.Djamil Padang)



Seminat: INASOPRS


IntroductionAbnormalities of anophthalmic socket has a variety form. Complications associated with theanophthalmic socket are possible with evisceration surgery. One of the abnormality of ophthalmicsocket is Anophthalmic socket cysts. Its rare but challenging to remove and incomplete excision hasbeen shown to increase the risk of recurrence. The are some possible mechanisms for thedevelopment of cystic anophthalmic such as inadvertent implantation of a free fragment ofconjunctiva within Tenon’s capsule during surgery,incarcerartion of tongue of conjunctiva thataccidentally inverted in wound closure through Tenon’s capsule or epithelial downgrowth by wounddehiscence.Case IllustrationA 34 years old women admitted to clinic M. Djamil Hospital in April 12nd 2021 with compliance theprosthesis does not fit since 4 month ago. Patient has been repair anophthalmic socket withcontracture socket on January 2020 with Dermis Fat Graft with fornixplasty, and the patient thenreceived an ocular prosthesis but prosthesis only fit for 11 month. From Previous history in 32years ago patient had evisceration for ocular dextra.DiscussionWe report the case of 34 years old women had history evisceration when patient 2 years old andhas been repair the anophthalmic socket about one year ago and compliance the prosthesis only fitabout 11 month from repaired. The patient was managed with doing the incision to the socket toevacuate the discharge and do partial thickness incision closed with the direct closure to thepalpebral inferior and fornixplasty.ConclusionCystic anophthalmic socket following evisceration is a rare case but serious complication.KeywordSocket, anophthalmic, cystLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download819-169-Nitia.jpg

164 E-POSTER

EPOS-R-INASOPRS-26Primary Orbital Neuroblastoma in 2 years-old female children: A Case Report

Abstract TitlePrimary Orbital Neuroblastoma in 2 years-old female children: A Case Report

First Author: dr. Muhammad Indra Mahardika Iridika Humeri

Author Institution: Resident of Department of Ophthalmology, Faculty of Medicine Universitas Airlangga –

Dr. Soetomo General Hospital, Surabaya, Indonesia

Co Author

Susy Fatmariyanti (Department of Ophthalmology, Faculty of Medicine Universitas Airlangga – Dr.


Hendrian Dwikoloso Soebagjo (Department of Ophthalmology, Faculty of Medicine Universitas

Airlangga – Dr. Soetomo General Hospital, Surabaya, Indonesia)

Delfitri Lutfi (Department of Ophthalmology, Faculty of Medicine Universitas Airlangga – Dr.




Seminat: INASOPRS


IntroductionNeuroblastoma is a type of cancerous tumor most commonly affects children. We report a case ofprimary orbital neuroblastoma with a good response to chemotherapy.Case IllustrationA 2-year-old child was referred to us with painful proptosis on the left eye. Visual acuity in botheyes is fixed and follows. Left eye examination showed inferonasal globe displacement, slightconjunctival hyperemia, and eyelid swelling. No mass was found in another part of the body such asthe abdomen. Bone marrow aspiration shows neuroblastoma with bone marrow metastasis. Biopsyrevealed neuroblastoma or lymphoma malignant. Orbital CT showed lymphoma malignant ormetastasis neuroblastoma. We assessed the patient with orbital neuroblastoma and treated herwith 8 cycles of chemotherapy. She was evaluated and there was a remaining orbital tumor. Thenshe had additional 4 cycles of chemotherapy and showed good resolution of the tumor. Three weeksafter chemotherapy, she had a lesion in her right femur and having seizures. She passed away dueto this metastasis.DiscussionPrimary orbital neuroblastoma might be refractory to chemotherapy but this case showed a goodresolution in orbital tumor with chemotherapy. Even with a good result after chemotherapy, thepatient didn’t survive due to intracranial metastasis.ConclusionOrbital neuroblastoma in children commonly occurs due to metastasis with primary in theabdomen. Primary orbital neuroblastoma is very rare constitutes 8% of cases. Metastasis to boneand intracranial is associated with poor prognosis in neuroblastoma and is present in most children.Keywordprimary orbital neuroblastoma, metastasis orbital neuroblastoma, chemotherapyLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download27-EPOS-R-INASOPRS-26-dr.-Muhammad-Indra-Mahardika-Iridika-Humeri.jpg

165E-POSTER

EPOS-R-INASOPRS-27LATERAL TARSAL STRIP PROCEDURE FOR CORRECTION OFINVOLUTIONAL ENTROPION: A Case Report

Abstract TitleLATERAL TARSAL STRIP PROCEDURE FOR CORRECTION OF INVOLUTIONALENTROPION: A Case Report

First Author: Rika Ramadhani Sinambela

Author Institution: Department of Ophthalmology, Faculty of Medicine University of Sumatera Utara

Universitas Sumatera Utara General Hospital, Medan, Indonesia

Co Author: Rodiah Rahmawaty Lubis (Department of Ophthalmology, Faculty of Medicine University of

Sumatera Utara Universitas Sumatera Utara General Hospital, Medan, Indonesia)



Seminat: INASOPRS


IntroductionInvolutional entropion occurs in the lower eyelids and caused by horizontal laxity, disinsertion ofeyelid retractors, and overriding of preseptal orbicularis oculi.Case IllustrationA 86-year-old man with main complaint of red eye and epiphora. Examination showed inversion ofthe right eyelid. Snap back test showed the lower eyelid does not return to normal position, liddistraction 10mm, medial-lateral canthal tendon laxity more than 2mm, and positive squeeze test.This patient was planned for lateral tarsal strip procedure. Post-operative examination showed thatthere was no more entropion and provide a good anatomical position, functional and cosmetic result.DiscussionInvolutional entropion in this patient caused by horizontal laxity, that results from senescence, withstretching of the eyelid and canthal tendons. Disinsertion of eyelid retractors in conjunction withpreseptal orbicularis override, allows the inferior border of the tarsus to roll forward andsuperiorly, resulting in inward rotation of the margin. Lateral tarsal strip procedure performed bysuturing the tarsus to the lateral orbital edge periosteum, strengthening the eyelid retractor, andlimited orbicularis myectomy to correct of all etiologic factors.ConclusionProcedure to repair involutional entropion consists of several techniques, such as temporizingmeasures, horizontal tightening, and retractor repair. Combined procedures are usually requiredbased on severity to improve the anatomical function of the eyelids.KeywordEyelid, involutional entropion, lateral tarsal strip.Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download771-EPOS-R-INASOPRS-27-Rika-Ramadhani-Sinambela.jpg

166 E-POSTER

EPOS-R-INASOPRS-28CUTLER-BEARD PROCEDURE FOR MILD (SIMPLE) AND COMPLICATED(SYNDROMIC) CONGENITAL COLOBOMA AND ITS SURGICAL OUTCOMES: ACASE SERIES

Abstract TitleCUTLER-BEARD PROCEDURE FOR MILD (SIMPLE) AND COMPLICATED (SYNDROMIC)CONGENITAL COLOBOMA AND ITS SURGICAL OUTCOMES: A CASE SERIES

First Author: Ahdini Zulfiana Abidin

Author Institution: University of Hasanuddin

Co Author:

Halimah Pagarra (University of Hasanuddin)

Suliati P. Amir (University of Hasanuddin)

Andi Pratiwi (University of Hasanuddin)

Marliyanti N. Akib (University of Hasanuddin)



Seminat: INASOPRS


IntroductionCongenital malformation such as coloboma may be simple or syndromic and unilateral or bilateraland most commonly accompanied with CHARGE syndrome. Cutler-Beard is one of many proceduresuse to repair the upper eyelid defect with large size and can be applied to coloboma. This type ofsurgery was expected to be a treatment for large upper eyelid defect in babies.Case IllustrationThree patients with coloboma (one syndromic and two simple) underwent Cutler-Beard procedurefor eyelid repair. Patient 1 with syndromic coloboma presented with bilateral upper eyelid defectwith microcephalic, bifid nose, growth retardation and developmental delay, patient 2 onlypresented with unilateral eyelid defect, whereas patient 3 with bilateral defect presented withlanugos, bifid nose, and mix developmental delay and nutritional marasmus. Retinoscopy evaluationwere performed with 1 patient could not be evaluated due to corneal haze and 1 patient only on hisleft eye due to corneal scar. Release time for the procedure were two and five months, one month,and two and two months, for right and left eyelid respectively.DiscussionCongenital lid colobomas can be treated by many kinds of surgery depends on the severity of thedefect in the eyelid and the condition of corneal surface that usually reflects the location and size ofthe deformity.ConclusionSimple and syndromic coloboma may be considered to be repaired by Cutler-Beard procedure withpromising results. Although one of our patients had longer release time, it did not become a risk ofamblyopia.Keywordcoloboma; eyelid coloboma; CHARGE syndrome; Cutler-BeardLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download21-EPOS-R-INASOPRS-28-Ahdini-Zulfiana-Abidin.jpg

167E-POSTER

EPOS-R-INASOPRS-29Presumed Orbital Metastases from Breast Cancer ; A Report of Two Cases

Abstract TitlePresumed Orbital Metastases from Breast Cancer ; A Report of Two Cases

First Author: Sartika Stiefany Putri


Co Author:

Halimah Pagarra (Universitas Hasanuddin)

Suliati P. Amir (Universitas Hasanuddin)

Andi Pratiwi (Universitas Hasanuddin)

William Hamdani (Universitas Hasanuddin)



Seminat: INASOPRS


IntroductionBreast cancer (BC) is the most common primary source of orbital metastases in women. Some casesoccurs in the uvea with choroid as main ocular site. Orbital metastases may also found in orbitalfat, bones and extraocular muscle (EOM).Case IllustrationTwo patients with a history of breast cancer came with ocular complain. Patient 1 presented withdiplopia, difficulty of moving the eye to the left and pain in the eye. MRI showed a thickening of themedial rectus of the left eye. Immunohistochemical (IHC) tests showed NegativeEstrogen/Progesterone Receptor (ER/PR) and Positive Human Epidermal growth factor Receptor-2(HER-2). Patient 2 presented with blurred vision in right eye accompanied with flashes of lightsensation. Funduscopic examination revealed an elevated in the inferotemporal with dome shapedappearance and adjacent subretinal fluid and also associated with irregularity of the RPE andbruch’s membrane on OCT. In IHC test ER/PR were Negative/Positive and HER-2 was positive.Discussionwe reported two cases of breast cancer that presumed to metastasized to the orbit, one in EOM andthe other in the choroid. Pathophysiology of metastases to the EOM is remain unknown but forintraocular metastases is believed to be hematogenous spreading. Patient with choroidalmetastases tend to have positive ER/PR. A definite diagnosis required a biopsy of suspectedmetastases lesion.ConclusionOrbital metastases in BC may varies, include EOM and choroidal metastases. Thus patient with BCshould raise suspicion and further ophthalmology examination is required. IHC is an importantexamination for treatment and prognosis.KeywordBreast cancer, Choroid metastases, Extraocular muscle metastases.Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download539-EPOS-R-INASOPRS-29-Sartika-Stiefany-Putri.jpg

168 E-POSTER

EPOS-R-INASOPRS-30CHALLENGES IN THE MANAGEMENT OF CICATRICIAL ECTROPION WITHOCCLUDED EYE CAUSED BY BURN INJURY

Abstract TitleCHALLENGES IN THE MANAGEMENT OF CICATRICIAL ECTROPION WITH OCCLUDEDEYE CAUSED BY BURN INJURY

First Author: SUCYEKA SYAFUTRI

Author Institution: Department of Ophthalmology, Andalas University, M.Djamil Hospital

Co Author: HENDRIATI (Department of Ophthalmology, Andalas University, M.Djamil Hospital)



Seminat: INASOPRS


IntroductionEyelid reconstruction in cicatricial ectropion caused by burn injury represents a surgical challangedue to difficulties to obtain proper healthy skin graft, tissue ischemia, and necrosis.Case IllustrationA 7 years-old boy came with right upper and lower eyelids attached (occluded eye) with cicatricialright lower eyelid ectropion after getting burn injury 6 months ago. Patient can still see through slitof attached eyelid, although it is difficult, with visual acuity 20/30. Right eye was occluded byvertical cicatric and ectropion in lower eyelid. Reconstruction was made with release of verticalcicatric to open occluded eye and advancement flap was used to close the temporal defect.Placement of postauricular skin graft was done 3 months later because we found pus when releasing cicatric in the first operation. Post operative visual acuity was 20/20. The follow up was done in 5 days and 3 months after first operation; and 5 days, 1 month, and 1 year after second operation.DiscussionMajor issues in management of cicatricial ectropion caused by burn injury are releasing cicatric,consideration of using skin flap or skin graft, right donor site selection, consideration of graft sizeto support contraction and full eyelid closure. For further plan, consultation to Plastic Surgery wasmade to manage other cicatricial tissue in another part of the face.ConclusionReconstruction of cicatricial ectropion by releasing cicatric and using combination of skin flap andskin graft can achieve better functional and aesthetic outcomes. Surgical correction in cicatricialectropion with occluded eye was needed to prevent amblyopia.KeywordCicatricial Ectropion, Eyelid Reconstruction, Skin GraftLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download971-EPOS-R-INASOPRS-30-Sucyeka-Syafutri.jpg

169E-POSTER

EPOS-R-INASOPRS-31DIRECT CLOSURE TECHNIQUE FOR SUPERIOR PALPEBRA DEFECT INSEBACEOUS GLAND CARCINOMA PALPEBRA

Abstract TitleDIRECT CLOSURE TECHNIQUE FOR SUPERIOR PALPEBRA DEFECT IN SEBACEOUSGLAND CARCINOMA PALPEBRA

First Author: Kelvin Mandela


Co Author:

HENDRIATI (Andalas University)

MARDIJAS EFENDI (Andalas University)



Seminat: INASOPRS


IntroductionSebaceous Gland Carcinoma (SGC) palpebra is a malignancy tumor on the palpebra whichoriginates from the sebaceous gland. These tumors can spread peripherally throgh intraepithelialor pagetoid growths. The main management is surgery and the defect reconstruction performedaccording to the size and area of the defect.Case IllustrationA 53th year-old female patient came with mass on upper eyelid of the right eye since 1 year, whichprogressively growing in size, sticks to the eyelid, no bleeding, and no pain. History of treatmenthas not provided an adequate response for last 1 year. Visual acuity was 6/12 in both eye, a masswas found approximately 8x8 mm in size, nodular, fixed and accompanied by madarosis. Thehistopathological examination showed a palpebral sebaceous gland carcinoma. There was noenlargement of submandibular or parotid lymph nodes. Patient underwent wide excision of theupper eyelid lesion. Then, defect was reconstructed by direct closure technique. Patient has beencontrolled 4 weeks of follow-up. The functional and cosmetic outcome were satisfiedDiscussionA full-thickness defect after excision of the palpebra tumor requires reconstruction to maintain theanatomical and physiological integrity of the palpebra. A full-thickness palpebra defect involvingthe margins with a size of less than one-third of the total palpebra can be reconstructed with directclosure techniques.ConclusionAfter a month of follow up, no recurrence occurred. Reconstruction with direct closure techniquehas a good results in terms of anatomy, functional and cosmetics.KeywordDirect closure, Sebaceous gland carcinoma, Palpebral reconstructionLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download954-EPOS-R-INASOPRS-31-Kelvin-Mandela.jpg

170 E-POSTER

EPOS-O-INASOPRS-32ANKYLOBLEPHARON FILIFORME ADNATUM WITH CLEFT LIP AND PALATE: A CASE REPORT

Abstract TitleANKYLOBLEPHARON FILIFORME ADNATUM WITH CLEFT LIP AND PALATE : A CASE REPORT

First Author: TEGUH ANAMANI

Author Institution: FK Universitas Jenderal Soedirman/RSUD Margono Soekardjo Purwokerto

Co Author:



Seminat: INASOPRS


IntroductionIntroduction : Ankyloblepharon filiforme adnatum (AFA) is a rare congenital abnormality of theeyelids which has been reported as an isolated anomaly, but may also be associated with otheranomalies or as a part of well-defined syndromes. The aim of this work was to present a case of AFAassociated with cleft lip and palate.Case IllustrationCase Illustration : A full-term female newborn ( 40weeks’ GA, BM 2700g) had bilateral partiallyfused eyelids at birth, associated with a cleft lip and palate. The surgical treatment was performedat the age of 2,5 month. The surgical treatment of the cleft lip and palate was performed later.DiscussionDiscussion : AFA was divided into 4 sub groups by Rosenman et al. According to which group I andII are sporadically inherited, and the remaining groups, group III and IV have autosomal dominantinheritance pattern. Group I have no associated abnormalities, group II is associated with cardiacor central nervous system abnormalities, group III is associated with ectodermal syndrome whilegroup IV is associated with cleft lip or cleft palate. In our case, the child was having a group IV AFAand had a satisfactory outcome with surgery.ConclusionConclusion : AFA if not treated, can cause amblyopia. The management of AFA is simple and had asatisfactory outcome with surgery. A cleft lip and palate in our patient require a surgical treatment,oral and dental rehabilitation, as well as a need for more intensive care and regular follow-ups bymultidisciplinary teams.KeywordKeywords : newborn; eyelids; congenital abnormality; cleft lip and palateLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download252-EPOS-O-INASOPRS-32-TEGUH-ANAMANI.jpg

171E-POSTER

EPOS-R-INASOPRS-33Management of Upper Eyelid Epidermoid Cyst in Elderly Patient withSystemic Disease: A Case Report

Abstract TitleManagement of Upper Eyelid Epidermoid Cyst in Elderly Patient with Systemic Disease: ACase Report

First Author: Dwi Atikah Sari

Author Institution: Department of Ophthalmology, Faculty of Medicine University of Sumatera Utara,

Universitas Sumatera Utara General Hospital, Medan, Indonesia

Co Author: Rodiah Rahmawaty Lubis (Department of Ophthalmology, Faculty of Medicine University of

Sumatera Utara, Universitas Sumatera Utara General Hospital, Medan, Indonesia)



Seminat: INASOPRS


IntroductionEpidermoid cyst is benign tumor that develop slowly from the proliferation of epidermal cells.Usually asymptomatic, solitary, elevated, round, freely mobile subcutaneous mass with smoothoverlying skin. Epidermoid cysts are lined with keratinized stratified squamous epithelium andcontains keratin.Case IllustrationA 66-year-old woman came to the hospital complaining a painless mass on her right upper eyelidsince 1 year ago. The mass gradually increase in size. Pain, itchy and blurred vision was denied.History of hypertension was found, blood pressure 170/90 mmHg. Visual acuity on both eyes 6/6.On ophthalmology examination found pseudoptosis of the right upper eyelid, a round mass, suppleconsistency and mobile from the surrounding tissue, painless, size 14x14 mm. The anterior segmentof the left eye was within normal limits. Histopathological examination found C2 (benign smear)impression of Epidermal Cyst. The patient was diagnosed with Epidermoid Cyst on the Right UpperEyelid. The mass excision was performed under general anesthesia.DiscussionEpidermoid cysts are caused by occlusion of the pilosebaceous follicle or surface epidermis, mostcommonly 15-35 years. The definitive diagnosis for establishing epidermoid cyst ishistopathological examination. In this case, it can be treated with general anesthesia. Butcontrasted without systemic disease, it can be treated with local anesthesia. The prognosis of suchcases tends to be poor if it is not managed properly.ConclusionEpidermoid cyst is benign tumor that can be treated with surgical excision. In case of elderlypatient with systemic disease, general anesthesia may be considered.Keywordepidermoid cyst, excision, upper eyelid.Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download532-EPOS-R-INASOPRS-33-Dwi-Atikah-Sari.jpg

172 E-POSTER

EPOS-G-INASOPRS-34TRICHOFOLLICULOMA, A RARE TUMOR OF THE EYELID: A CASE REPORT

Abstract TitleTRICHOFOLLICULOMA, A RARE TUMOR OF THE EYELID: A CASE REPORT

First Author: Cindy Prajna Metta

Author Institution: Intern of Ophthalmology Department, Klungkung Regional General Hospital, Bali

Co Author: Ni Luh Piliantari Meigawati (Ophthalmologist, Department of Ophthalmology, Klungkung

Regional General Hospital, Bali)



Seminat: INASOPRS


IntroductionTrichofolliculoma is a rare benign tumor of the skin, occurring on the face, scalp, or neck,excessively rare affecting the eyelid. It is visible as a nodule with occasional central pore and mayhave protruding thread-like hairs. Because of the rare literature for eyelid trichofolliculoma, theyare frequently mistaken for other lesions.Case IllustrationA 25-year-old female patient presented with a 2-year history of gradually enlarged exophytic noduleover the inner third of her right upper eyelid. The patient only felt discomfort during blinking.Ophthalmology examination showed a solitary skin-colored nodule measuring 10 mm in diameter,with hair follicles emerge from a central orifice. This patient underwent excision. Thehistopathological finding showed a dilated follicle orifice with keratin and immature hair follicleshaft fragments on its surrounding, suggest Trichofolliculoma. Follow-up examination up to 2 yearsrevealed no sign of recurrence.DiscussionTrichofolliculoma is a rare benign adnexal hamartoma of the skin, presents as a pink-to-fleshcolored, dome-shaped nodule with well-defined margins. Telangiectatic vessels may be apparent onthe surface. Actively trichogenic lesions have tiny tufts of white hairs protruding from the centralcore – a highly diagnostic clinical feature. In the absence of such hairs, these lesions appear morelike a nodular Basal Cell Carcinoma or nevus. The histological features exhibit variable degrees offollicle maturation. Surgical excision remains the mainstay of treatment. In the present case, thepatient had all features reported in the literature.ConclusionTrichofolliculomas are uncommon adnexal tumors that can sometimes mimic a malignancy.Excisional biopsy remains the gold standard.KeywordTrichofolliculoma, tumor, hair follicleLatest UpdateMay 17, 2021StatusSubmittedFile Download

173E-POSTER

EPOS-R-INASOPRS-35INVOLUTIONAL ENTROPION REPAIR WITH ANTERIOR LAMELARREPOSITIONING TECHNIQUE

Abstract TitleINVOLUTIONAL ENTROPION REPAIR WITH ANTERIOR LAMELAR REPOSITIONING TECHNIQUE

First Author: Lina Shabrina Qorib S.

Author Institution: Departement of Ophthalmology, Faculty of Medicine University of Padjadjaran

Co Author:

M. Rinaldi Dahlan (National Eye Center Cicendo Eye Hospital)

Angga Kartiwa (National Eye Center Cicendo Eye Hospital)

Shanti F Boesoirie (National Eye Center Cicendo Eye Hospital)

Niluh Putu Ayu (National Eye Center Cicendo Eye Hospital)



Seminat: INASOPRS


IntroductionEntropion is the inversion of the eyelid margins. Based on the cause, entropion can be classified ascongenital, involutional, acute spastic, and cicatrical. Involutional entropion is the most common.Several method of treatment are available for the management of involusional entropion. To describes the treatment of involutional entropion using Anterior Lamellar Repositioning (ALR) technique.Case IllustrationAn 80-year-old woman came with complaints of her upper left lashes turn inwards and causedforeign body sensation, redness and tearing. History of recurrent redness in the patient’s left eye isfound. No history of trauma nor surgery. Anterior segment examination revealed entropion in theupper left eye with corneal abrasion and dermatochalasis associated with cloudy lenses on botheyes. Patient diagnosed as Involutional Entropion with corneal abrasion on the left eye anddermatochalasis with immature cataract on both eyes. Patient had undergone surgery to repair theentropion using ALR Technique on left eye. Postoperative ophthalmological examination showedgood anatomical position and relieved the symptoms.DiscussionThe treatment of entropion depends on the severity of the entropion. The most common surgicalmanagement are the ALR technique and tarsotomy. Choice of surgical method depends on thesurgeons preference.ConclusionAnterior Lamellar Repositioning (ALR) is a simple yet effective treatment for involutional entropion.KeywordEntropion, involutional, ALRLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download817-EPOS-R-INASOPRS-35_Lina-Shabrina.jpg

174 E-POSTER

EPOS-R-INASOPRS-36VISUAL IMPROVEMENT FOLLOWING REMOVAL OF CHRONIC ORBITALCAVERNOUS HEMANGIOMA

Abstract TitleVISUAL IMPROVEMENT FOLLOWING REMOVAL OF CHRONIC ORBITAL CAVERNOUSHEMANGIOMA

First Author: Raisha Pratiwi Indrawati


Indonesia

Co Author:

M. Rinaldi Dahlan (National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

R. Angga Kartiwa (National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Shanti F. Boesoirie (National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Niluh Putu Ayu Dewi (National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)



Seminat: INASOPRS


IntroductionOrbital cavernous hemangioma is a benign, well-defined vascular lesion, located mainly in theintraconal space. Surgical treatment is indicated in symptomatic cases, such as proptosis or visualdisturbance. The aim of this study is to report the visual improvement of the successfully-managedchronic orbital cavernous hemangioma.Case IllustrationA 51-year-old man came to Cicendo Eye Hospital with chief complaint of protrusion of the right eyefor seventeen years, accompanied by blurred vision two years earlier. Ophthalmologicalexamination revealed decreased visual acuity, together with ocular movement restriction andrelative afferent pupillary defect. Computed-tomography (CT) scan showed a retrobulbar mass,attached to the lateral and medial rectus muscle, and shifting the optic nerve superiorly. The tumorwas removed through inferior anterior orbitotomy with transconjunctival incision, and thehistopathological finding revealed a cavernous hemangioma. Follow-up examination showedimprovement of the patient’s condition, measured by no protrusion remained and the achievementof best-corrected visual acuity (BCVA) of 1.0.DiscussionIn the case of benign intraorbital tumor, orbitotomy approach should be best selected based on itsanatomical location and involvement of adjacent structure. Despite the size of the tumor, chronicduration, and disturbing manifestation, improvement of visual acuity and structural appearance could be achieved if the tumor is removed correctly and adjacent structure has not been severely damaged.ConclusionCavernous hemangioma is a benign lesion in which surgical treatment is indicated in symptomatic cases. The right approach of orbitotomy is needed in order to give a good outcome anatomically and functionally.Keywordcavernous hemangioma, anterior orbitotomyLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download620-EPOS-R-INASOPRS-36-Raisha-Pratiwi-Indrawati.jpg

175E-POSTER

EPOS-R-INASOPRS-37MANAGEMENT OF NASOLACRIMAL DUCT OBSTRUCTION WITH LOBSTERCLAW SYNDROME

Abstract TitleMANAGEMENT OF NASOLACRIMAL DUCT OBSTRUCTION WITH LOBSTER CLAW SYNDROME

First Author: Indriyani


Indonesia

Co Author:

Angga Kartiwa (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

M. Rinaldi Dahlan (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Shanti F. Boesoirie (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Niluh Putu Ayu (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)



Seminat: INASOPRS


IntroductionNasolacrimal duct obstruction (NLDO) is main risk factor of dacryocystitis. NLDO have beenreported in 12-23% of Lobster Claw Syndrome cases. Dacryocystorhinostomy is a surgicalmanagement option for pediatric nasolacrimal duct obstruction with recurrent dacryocystitis.Objective of this study to report a management of nasolacrimal duct obstruction in patient withLobster Claw syndromeCase IllustrationA 5 years old boy came to policlinic with chief complaint epifora on both eyes since birth,companied by intermittent redness and mucoid secret on both eyes. Patient came 1,5 year ago andhad underwent probing and syringing that revealed obstruction in nasolacrimal duct on both eyes.Physical examination found ectrodactily in fingers and toes. Ocular examination revealed visualacuity 0.5 on the right eye and 0.4 on the left eye, epifora with mucoid secret, minimal conjungtivalinjection, intact superior and inferior punctum with positive reflux, and absent of nodule ortenderness on both eyes. The patient underwent external dacryocystorhinostomy with silicone tube.DiscussionEtiology of NLDO in pediatric could be congenital or acquired. Stepwise approach of surgicalmanagement including probing, intubation, balloon catheter dilatation, and dacryocystorhinostomy.Dacrycystorhinostomy is an option of nasolacrimal duct obstruction with recurrent dacryocystitisand congenital malformation such as Lobster Claw syndrome. Challenge of dacryocystorhinostomyin the children’s lacrimal system is narrower than in adult, especially in congenital malformation.ConclusionNasolacrimal duct obstruction can also be one of clinical manifestation of Lobster Claw syndrome.External or endonasal dacryocystorhinotomy is a choice of surgical management in pediatricnasolacrimal obstruction with recurrent dacryocystitis with Lobster Claw syndrome.Keywordnasolacrimal duct obstruction, lobster-claw syndrome, dacryocystorhinostomyLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download507-Management-of-Nasolacrimal-Duct-Obstruction-With-Lobster-Claw-Syndrome.jpg

176 E-POSTER

EPOS-R-INASOPRS-38Malignant Round Cell Tumor Coexisting with Trilateral Retinoblastoma: ARare and Poor Prognostic Case

Abstract TitleMalignant Round Cell Tumor Coexisting with Trilateral Retinoblastoma: A Rare and Poor Prognostic Case

First Author: Ni Luh Made Novi Ratnasari


Co Author: Putu Yuliawati , I Wayan Eka Sutyawan, A A A Sukartini Djelantik, Ni Made Ayu Surasmiati, Ni

Made Laksmi Utari

(Ophthalmology Department, Faculty of Medicine, Udayana University,Sanglah Hospital)



Seminat: INASOPRS


IntroductionTrilateral retinoblastoma (TRB) is a syndrome consisting of unilateral or bilateral retinoblastomaassociated with intracranial neuroblastic tumor in the suprasellar or parasellar regions. These areconsidered both as an independent primary site or metastatic from the eye.Case IllustrationA 1-year-old boy, with leukocoria on his left eye since he was 3,5-month-old. The patient then being referred to Sanglah Hospital with glaucoma, but couldn’t come immediately because the pandemic situation. The patient then getting Seizure and unconscious for 21 days and treated by Neurosurgery Department Sanglah Hospital. He diagnosed with intra-axial tumor ec medulloblastoma dd/ neuroblastoma. Patient then examined in Eye Polyclinic. It found left eye suspected RB Stage III Group E and patient planned for chemotherapy. CT-Scan at next showed endophytic solid heterogenous with calcification at left oculi extended to intraconal and orbital cavity suprasellar to left orbital apex. Histologic feature found as malignant round cell tumor with Hommer Wright Rossete ec retinoblastoma dd/ extended medulloblastoma and high mitotic index.DiscussionThe association of retinoblastoma with intracranial tumors is an uncommon syndrome. In this case, the presentation of suprasellar tumor and retinal mass were found at the same time considered as independent primary foci. Children with risk of developing TRB, commonly carried the germline mutation of the RB1 gene. TRB is a rare case and has poor prognosis. Once lesion in the pineal or sellar region is diagnosed, the average survival is 9.7 months even treated adequately.ConclusionTRB is a poor prognostic disease. Appropriate management at earlier stage and multimodalitytreatment are needed.KeywordTrilateral Retinoblastoma, Malignant round cell Tumor, suprasellarLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download350-Poster-Ilmiah-Mata-NV-03.pdf

177E-POSTER

EPOS-R-INASOPRS-39UVEAL MELANOMA WITH EXTRASCLERAL EXTENSION : A CASE REPORTWITH PATHOLOGIC EXAMINATION

Abstract TitleUVEAL MELANOMA WITH EXTRASCLERAL EXTENSION : A CASE REPORT WITHPATHOLOGIC EXAMINATION

First Author: Dhanang Hadi Pradipta, dr


Co Author:

Susy Fatmariyanti (Universitas Airlangga)

Grace Ariani (Universitas Airlangga)

Delfitri Lutfi (Universitas Airlangga)

Hendrian Dwikoloso Subagjo (Universitas Airlangga)



Seminat: INASOPRS


IntroductionMelanoma is common malignant intraocular tumour of the adult eye. Most of these (85%) weredevelop in the uveal tract. In this case, we describe a uveal melanoma with extrascleral extension.Case IllustrationA 40-years-old woman complained black mass and blurred vision in her left eye since 2 years ago.Blurred vision was began after mass appeared. Eyes initially feel sandy. She was a farmer. Onophthalmological examination, her visual acuity was NLP. Left eyelid was edema and pseudoptosis.On slit lamp biomicroscope we found hyperpigmentation mass on ocular surface partially coveredlimbus and cornea at 10-degree left eye conjunctiva, size 2.5 x 1.5 x 2 cm, slippery surface, firmborder, and feeder vessel. CT Scan of head support uveal malignant melanoma and invisibleexpansion to the conjunctiva. We performed vries coup first and result was anaplastic cells withpleomorphic nuclei, hyperchromatic, narrow cytoplasm,and hyperpigmented color. We continued toexplore and found ruptured sclera, so we performed exenteration. Paraffin coupe was mixedepithelioid and spindle cell uveal melanoma infiltrate corpus albicans, penetrate sclera 2 mm, anddistal optic nerve. Mitotic index was 8/10 high power field and the diagnosis was Uveal Melanomawith Scleral Extension.DiscussionClinical diagnosis of uveal melanoma was difficult. We should evaluate melanoma with nuclear tocytoplasmic ratios > 1 and mitotic ratios > 2/10 high power field were considered malignant.ConclusionUveal melanoma with scleral extension needs to be distinguished by melanoma on ocular surfaceclinically and pathology. Malignancy on this tumor need aggressive treatment to save free margin.KeywordUveal melanoma, extrascleral extension, pathologic examinationLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download835-EPOS-R-INASOPRS-39-Dhanang-Hadi-Pradipta.jpg

178 E-POSTER

EPOS-R-INASOPRS-40Dermatofat Graft to Repair Frontal Sinus Fistula after Mucocele Removal: anEndoscopic-Guided Approach

Abstract TitleDermatofat Graft to Repair Frontal Sinus Fistula after Mucocele Removal: an EndoscopicGuided Approach

First Author: Alia Nessa

Author Institution: Ophthalmology Resident, Department of Ophthalmology, Faculty of Medicine, University

of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Co Author: Yunia Irawati (Head of Plastic and Reconstructive Surgery division, Department of

Ophthalmology, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta,

Indonesia)



Seminat: INASOPRS


IntroductionThis case is aimed to show the successful case of dermatofat graft implantation to reconstructfrontal sinus fistula.Case IllustrationFemale, 37 years old, came with complaints of continuous serous secret production around the skindefect above the left eye. Two years prior, patient had complained of left eye proptosis, suspectedto be frontal sinus mucocele. The patient had undergone functional endoscopic sinus surgery(FESS) to remove the tumor. Two years after the surgery, orbital CT-Scan showed expansile lyticlesion of left frontal bone with defect in left maxilla sinus ostium. Therefore, the patient wasdiagnosed with left superior palpebral defect due to frontal sinus fistula. Procedure to reconstructthe defect was planned using dermatofat graft, guided with naso-endoscopy. During the procedure,polypoid mucosa was excised and surgeon closed the defect using dermatofat graft taken from theabdomen. Eight months postoperatively, defect was successfully repaired and no discharge wasseen from the palpebral fistula.DiscussionMucocele is an accumulation of mucoid secretion and desquamated epithelium within the sinus,with frontal sinus as the most frequently involved location. There have been many attempts toreconstruct sinus walls after fistula formation post-mucocele repair. Transfistula endoscopicclosure is considered as the most recommended procedure. We combined this idea with theinsertion of dermatofat graft to mimic previous sinus wall construction. The result was satisfyingwith no leakage eight months after the procedure.ConclusionDermatofat graft is a sufficient procedure with favorable result to repair fistula extending toparanasal sinuses. Naso-endoscopy approach is important to ensure the success.KeywordDermatofat graft, frontal sinus fistula, FESSLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download514-REVISI-E-POSTER-NESSA-FINAL.pdf

179E-POSTER

EPOS-R-INASOPRS-41SPONTANEOUS SUBCONJUNCTIVAL BLEEDING AND HYPHEMA IN ANAPLASTIC ANEMIA PATIENT: A CASE REPORT

Abstract TitleSPONTANEOUS SUBCONJUNCTIVAL BLEEDING AND HYPHEMA IN AN APLASTICANEMIA PATIENT: A CASE REPORT

First Author: dr. Muhammad Fariz


Co Author:

Ismi Zuhria (Department of Ophthalmology, Faculty of Medicine Universitas Airlangga


Ady Dwi Prakosa (Department of Ophthalmology, Faculty of Medicine Universitas Airlangga


Delfitri Lutfi (Department of Ophthalmology, Faculty of Medicine Universitas Airlangga




Seminat: INASOPRS


IntroductionAplastic anemia (AA) is a serious disease of bone marrow failure, with few reports on its ophthalmicmanifestations. Some anterior segment manifestations are well-documented but among the rarecomplications of AA.Case IllustrationA 64-year-old woman came with a complaint of spontaneous bleeding from both of her eyes for oneday, preceded by swelling and hematoma on both eyes 2 weeks prior. She had a history of aplasticanemia, with a routine blood transfusion. Her visual acuity was 2/60 and light perception on theright and left eye, respectively. Anterior segment examination revealed eyelid hematoma and swelling, subconjunctival bleeding and conjunctival chemosis on both eyes, and full hyphema on her left eye. Her left eye showed a positive fluorescein test. Blood examinations reveal a low red blood cell, low white blood cell level, and a very low thrombocyte count. We managed this patient together with the hematologist to treat the underlying systemic cause.DiscussionConservative treatment for the anterior segment complications with an application of antibiotic eyeointment was given for this patient while observing the bleeding, with thrombocyte concentratestransfusions administered by the hematologist. Throughout the therapy, the anterior segmentocular manifestations were subsided.ConclusionPatients with these life-threatening hematological disorders can be present initially to ophthalmologists because this bone marrow failure syndrome can primarily manifest with ocular problems. Clinicians should be aware of the presence of the various ocular findings during the physical inspection of AA patients.Keywordaplastic anemia, subconjunctival bleeding, hyphemaLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download347-EPOS-R-INASOPRS-41-Muhammad-Fariz.jpg

180 E-POSTER

EPOS-R-INASOPRS-42Asian Upper Eyelid Blepharoplasty As a Management of Dermatochalasis

Abstract TitleAsian Upper Eyelid Blepharoplasty As a Management of Dermatochalasis

First Author: Adessa Rachma


Indonesia

Co Author:

M. Rinaldi Dahlan (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

R. Angga Kartiwa (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Shanti F. Boesoirie (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Niluh Putu Ayu Dewi (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)



Seminat: INASOPRS


IntroductionDermatochalasis is an involutional periorbital skin changes characterized by redundant skin whichcould affect both upper and lower eyelid. The purpose of this study is to report the management ofupper eyelid dermatochalasis patient with a certain technique.Case IllustrationA-69-year old woman came to Reconstruction, Oculoplasty and Oncology Unit of National EyeCenter Cicendo Eye Hospital with chief complain drooping of the upper eyelid since eight yearsprior to presentation. Patient also complain heavy feeling on both superior eyelid and intermittentvisual disturbance. There were no history of swelling, redness or itchy sensation of the eyelid, eyesurgery, nor systemic disease. Ophthalmological examination revealed dermatochalasis on bothupper eyelid, distichiasis of left upper eyelid, and corneal abrasion of the left eye. Surgery wasperformed, and follow-up examination showed an improvement of the patient’s condition, measuredby no excess skin remained and no irritation of the left eye.DiscussionThe indication of surgery for upper dermatochalasis are disturbance of visual axis, restriction ofsuperior visual field, or as simply as heavy feeling on the eyelid. Blepharoplasty is the procedure totreat the case, the adjustment to the Asian eye was developed into Asian blepharoplasty technique.Skin marking and resection are the crucial steps, which would define the newly formed eyelidcrease that desired 5-7 mm in Asian blepharoplasty.ConclusionSurgical treatment is indicated in dermatochalasis case. The Asian blepharoplasty is suitable optionfor this patient which results in a good functional and cosmetical result.Keyworddermatochalasis, upper eyelid blepharoplasty, Asian blepharoplasty.Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download611-Asian-upper-eyelid-blepharoplasty-as-a-management-of-dermatochalasis-Adessa-Rachma.jpg

181E-POSTER

EPOS-G-INASOPRS-43Conjunctival foreign body: Fire Ant (solenopsis invicta)

Abstract TitleConjunctival foreign body: Fire Ant (solenopsis invicta)

First Author: G.A Dian Listyanti Utami

Author Institution: RS Bhayangkara Denpasar

Co Author: dr Anak Agung Ngurah Putra Asryana, Sp.M (ophthalmologist, RS Bhayangkara Denpasar)



Seminat: INASOPRS


IntroductionThe literature that discusses ant bites on the conjunctiva is rare, even though in tropical countries,especially Indonesia, fire ants are an insect that we often encounter.Case IllustrationA 71 yo woman complained burning, watery, and itching in her RE. Patient with a history ofglaucoma in both eyes. There was moderate hyperemia in conjunctiva RE, VA was 6/6 RE, IOP was17.3 mmHg RE. Slitlamp examination showed intact fire ant bodies in the bulbar conjunctival RE,extracted using Cillia Forceps under a slitlamp, with previously given 2% pantocaine ED in the REwithout any residue. A fluoresin test was performed on the patient’s RE with no abrasion resultsfound in all regions of the cornea and conjunctiva. The symptom disappeared after 48 hours.Patients were given Tobramycin/Dexamethason ED 3x1, Timolol ED 2x1, and artificial tears ED 3x1DiscussionCases of foreign bodies in the eye caused by insects generally cause acute mild symptom. Particularconcern in this case are the venom can contain alkaloids which can cause chemical injury to the eyewhich can lead to corneal ulcer. Fluoresin stain test can be done to ensure there is no cornealabrasion.ConclusionAlthough cases of foreign bodies in the eye caused by ants are still rarely reported and generallyresolve on their own without further treatment. However, it is important to know the specialhandling of this case, considering that in Indonesia we still encounter fire ants very often.Keywordconjunctival foreign body, fire ant, ocular traumaLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download423-EPOS-G-INASOPRS-43-G.A.DianListyantiUtami.jpg

182 E-POSTER

EPOS-R-INASOPRS-44Management of Cicatricial Ectropion After Multiple Excisions on Basal CellCarcinoma

Abstract TitleManagement of Cicatricial Ectropion After Multiple Excisions on Basal Cell Carcinoma

First Author: Nia Amerina

Author Institution: FKUI-RSCM Kirana

Co Author: Hisar Daniel (FKUI-RSCM Kirana)



Seminat: INASOPRS


IntroductionCicatricial ectropion following multiple excisions of skin malignancy of the eyelid can bechallenging yet frustrating for ophthalmologists. The aim of this case report is to present asuccessful management of severe cicatricial ectropion by combining medical and surgicalinterventionsCase IllustrationOur patient was a 67-years-old male, who first came to our hospital in 2017 with continuous tearingof the right eye. A month before, the patient was diagnosed with right lower eyelid basal cellcarcinoma (BCC) at previous hospital and underwent tumor removal with wide excision. In the firstexamination, we found hyperpigmentation lesion at right medial canthus indicating recurrent BCCand we did second excision. The severe cicatricial ectropion was later managed by intralesionalinjection of 5-fluorouracil and triamcinolone (1 ml, 3:1 composition) 2 times, followed by surgery ofcanthopexy, canthoplasty, Z-plasty, and skin graft.DiscussionMultiple excisions of BCC in our case lead to severe scarring of the lower lid. Intralesional injectionof 5-fluorouracil and triamcinolone is superior to triamcinolone alone in terms of reduction in initialheight of such scar. In our case, the normal anatomical structures at the medial area werediminished due to multiple excisions. Z-plasty is beneficial in reconstructing the medial area toresemble the normal appearance. Skin grafts should also be considered in large scarConclusionCombination of medical and surgical interventions is beneficial in managing cicatricial ectropionafter multiple excisions of skin malignancy. Intraoperative assessment is important in determiningthe reconstructive strategy. Adjusted and personalized treatment is the most suitable managementof cicatricial ectropion.Keywordcicatricial ectropion, intralesional injection, eyelid reconstructionLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download445-EPOS-R-INASOPRS-44-Nia-Amerina.jpg

183E-POSTER

EPOS-R-INASOPRS-45DEFECT AFTER EXCISION KISSING NEVUS, HOW TO MANAGE ?

Abstract TitleDEFECT AFTER EXCISION KISSING NEVUS, HOW TO MANAGE ?

First Author: Arnov Lahira Eriskan

Author Institution: Departement of Ophthalmology Faculty of Medicine Padjadjaran University, Bandung

Co Author:

Shanti F. Boesoirie (Indonesia National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

M. Rinaldi Dahlan (Indonesia National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Angga Kartiwa (Indonesia National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Niluh Putu Ayu (Indonesia National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)



Seminat: INASOPRS


IntroductionKissing nevus is a rare congenital nevi occurs on areas of the upper and lower eyelids unilaterally,such that both nevus lesion appose becoming one large lesion when the eyelids are closed Kissingnevus can have cosmetic and functional disorder for the patient.Case IllustrationA 33 years old woman came to Cicendo Eye Hospital with chief complaint mass on her right eyelidsince she was born. Ophthalmologic examination showed black round hairy mass sized 4 cm x 2 cmon upper eyelid and sized 5 cm x 1 cm on lower eyelid. Patient diagnosed as kissing nevus andunderwent excision followed by full thickness skin graft. Graft was taken from supraclavicular area,and placed over the wound. Examination on the first day after surgery, showed graft and suturewere intact with pale color. Tenth day post operation, graft and suture were intact and had similarcolor with surrounding skin. Histology examination revealed intradermal nevus.DiscussionKissing nevus forms during the embryological period as a single lesion, when the eyelids are stillfused. At 24 weeks gestation, eyelid will split into upper and lower eyelid, as well as to the nevus.Initially patient has no complaints, subsequently will loses her confidence cosmetically. Therefore,we need appropriate technique to repair kissing nevus.ConclusionEyelid defect after excision kissing nevus can be managed with full thickness skin graft.Reconstructions for the defect after excision depend on clinical manifestation, skills and experienceof the surgeon.KeywordKissing nevus; Eyelid Mass; Skin Graft; Intradermal nevus; ReconstructionLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download213-EPOS-R-INASOPRS-45-Arnov-Lahira-Eriskan.jpg

184 E-POSTER

EPOS-O-INASOPRS-46NEOADJUVANT SYSTEMIC CHEMOTHERAPY SUCCESSFULLY REDUCEEXTENSIVE EYELID SEBACEOUS GLAND CARCINOMA: A CASE REPORT

Abstract TitleNEOADJUVANT SYSTEMIC CHEMOTHERAPY SUCCESSFULLY REDUCE EXTENSIVEEYELID SEBACEOUS GLAND CARCINOMA: A CASE REPORT

First Author: DELFITRI LUTFI

Author Institution: Department of Ophthalmology Universitas Airlangga

Co Author:

MERLYNA SAVITRI (Department of Internal Medicine Universitas Airlangga)

ALPHANIA RAHNIAYU (Department of Pathology Anatomy Universitas Airlangga)

SUSY FATMARIYANTI (Department of Ophthalmology Universitas Airlangga)

HENDRIAN D. SOEBAGJO (Department of Ophthalmology Universitas Airlangga)



Seminat: INASOPRS


IntroductionTo report the efficacy of neoadjuvant systemic chemotherapy in the management of extensive eyelidsebaceous gland carcinoma (SGC) to avoid invasive surgery.Case IllustrationA 71-year-old woman came with a complaint of progressive edematous tumor in the right uppereyelid for four months. Right eye examination found diffuse eyelid thickening tumor extended fromupper eyelid to anterior orbital superior. On examination, no palpable lymph nodes were found.Incisional biopsy histopathology revealed sebaceous gland carcinoma. We consulted the patientwith a hematologist and gave her two cycles of neoadjuvant chemotherapy with paclitaxel andcarboplatin for three weeks interval. After two cycles of chemotherapy, the tumor gave a goodresponse and was limited in 2/3 lateral of the right upper eyelid. We performed wide eyelid excisionbiopsy under frozen section control and Cuttler-Beard reconstruction procedure for better cosmesis.DiscussionIn the beginning, the complete treatment for this patient required extensive surgery which is orbital exenteration or more than 75% loss of eyelid tissue which can cause a cosmetic issue. Neoadjuvant chemotherapy gives a good response with more than 75% reduction in tumor size so we can perform tumor-free margin excision surgery with reconstruction to achieve better function of the eye.ConclusionNeoadjuvant chemotherapy is a promising and safe treatment strategy for patients with locally advanced eyelid SGC providing adequate tumor volume reduction with the additional benefit of regional tumor control during surgery. This combination treatment can give significant benefits of organ preservation and patient cosmesis also downstages the disease and lower the risk of distant metastasis.Keywordsebaceous gland carcinoma, neoadjuvant chemotherapy, eyelid tumorLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download627-PVSM2021-dr-delfitri.jpg

185E-POSTER

EPOS-R-INASOPRS-47Management of Post-Operation External Dacryocystorhinostomy Complicationwith 5-fluorouracil

Abstract TitleManagement of Post-Operation External Dacryocystorhinostomy Complication with 5- fluorouracil

First Author: Cecilia Anggraini

Author Institution: Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto


Co Author: Yunia Irawati (Oculoplastic and reconstructive surgery division, Faculty of Medicine, Universitas

Indonesia, Cipto Mangunkusumo Hospital, Jakarta)



Seminat: INASOPRS


IntroductionExternal dacryocystorhinostomy (Ex-DCR) was the most frequently performed ophthalmic surgicalprocedure. It was regarded as the gold standard of treatment for nasal lacrimal duct obstructionand chronic dacryocystitis. This approach has a varying success rate. There is still a failure rate interms of recurrence of patients’ epiphora.Case IllustrationA 66-year-old woman was presented with epiphora and a swollen left eye that extended to themaxilla. The patient was diagnosed with nasolacrimal duct obstruction (NLDO). Externaldacryocystorhinostomy with silicone tube implantation was performed on the patient. Epiphorapersists following surgery. She was referred to Rhinology division in Ear, Nose, and Throat (ENT)department for further evaluation and treatment. After five months, nasoendoscopy revealed thatthe ostium remained blocked due to excessive granulation. Then, busination and a 3-minute soak in5-fluorouracil (5-FU) were performed. After a month of that treatment, the epiphora was obliteratedand patient satisfaction increased.Discussion5-Fluorouracil inhibits DNA replication and proliferation of fibroblasts. Antimetabolites such as 5-FU, may improve functional and anatomic success. The primary reason for failure in ex-DCR was most likely totally inadequate ostium formation.Conclusion5-Fluoracil may be one of the solutions to the post-operative Ex-DCR complication of ostiumblockage by inhibiting the development of fibrosis. Collaboration with a ENT department enablescomprehensive approach to the patient.KeywordExternal dacryocystorhinostomy; fluorouracil; nasolacrimal duct obstructionLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download235-EPOS-R-INASOPRS-47-Cecilia-Anggraini.pdf

186 E-POSTER

EPOS-R-INASOPRS-48V-Advancement flap and Buccal Mucosal Graft in Recovering TraumaticCicatricial Lower Eyelid Ectropion with symblepharon

Abstract TitleV-Advancement flap and Buccal Mucosal Graft in Recovering Traumatic Cicatricial LowerEyelid Ectropion with symblepharon


Author Institution: Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto


Co Author: Yunia Irawati (Oculoplastic and reconstructive surgery division, Faculty of Medicine, Universitas

Indonesia, Cipto Mangunkusumo Hospital, Jakarta)



Seminat: INASOPRS


IntroductionReconstruction of bilamellar eyelid structure needs the right technique to prevent complications.Skin flaps and autogenous grafts were used for outcome effectiveness. Numerous autogenousgrafts have been used to reconstruct posterior lamellar defects, but the most effective material forposterior lamellar repair is unknown.Case IllustrationA 45-year-old woman had primary repair on her left lower eyelid at the nearest hospital due to amotorcycle accident three months ago. Now, she felt pain from cicatricial tissue tension and wateryeye. Symblepharon, ectropion, lagophthalmos, and cicatricial tissue on the lower eyelid werepresented. Three times triamcinolone injection on cicatricial lesion to decrease the tension. Shethen had a release symblepharon, lower eyelid restoration, with a buccal mucosal graft as aposterior lamellar graft and a v-advancement flap as an anterior lamellar graft on her left eye.DiscussionFull-thickness defects of the width of the eyelid cannot be closed directly, resulting in thecomplication of ectropion due to incorrect technique. Size, location, and elasticity of thesurrounding tissues determine the technique. The V-advancement flap is a simple, faster healingand forces color and texture into the adjacent skin. A high success rate was achieved when a buccalmucosal graft was used as a lamellar posterior. The graft should be interlocked and anchored to theperiosteum to prevent shrinkage and dislocation.ConclusionV-advancement flap simplify the restoration of anterior lamellar. Buccal membrane-grafting is aneasy, anatomically effective procedure as a lamellar posterior. Keywords: Eyelid reconstruction; VAdvancement flap; Buccal mucosal graftKeywordEyelid reconstruction; V-Advancement flap; Buccal mucosal graftLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download651-EPOS-R-INASOPRS-48-Cecilia-Anggraini.pdf

187E-POSTER

EPOS-O-INASOPRS-49Unusual Presentation of Retrobulbar Orbital Kaposi Sarcoma

Abstract TitleUnusual Presentation of Retrobulbar Orbital Kaposi Sarcoma

First Author: NENI ANGGRAINI

Author Institution: Ophthalmologist, Ophthalmology Department, Cipto Mangunkusumo Hospital Jakarta

Co Author:

Mutmainah Mahyuddin (Ophthalmologist, Ophthalmology Department, Cipto Mangunkusumo

Hospital Jakarta), Amani Sakinah Augiani (Research Assistant, Ophthalmology Department, Cipto

Mangunkusumo Hospital Jakarta), Nurjati Chairani Siregar (Anatomical Pathology Department, Cipto

Mangunkusumo Hospital Jakarta), Evy Yunihastuti ( Internal Medicine Department, Cipto Mangunkusumo

Hospital Jakarta)

bstract Type: Case Report


Seminat: INASOPRS


IntroductionAn increased risk of ocular disease was noticed in HIV-positive individuals, including a malignantvascular tumor, Kaposi sarcoma (KS). Although it could affect any vascular endothelium, orbital KSis rare. The most common site known for orbital KS was the eyelid, lacrimal gland, and conjunctiva,but in this case, it was located at the unusual site, which is at retrobulbar region.Case IllustrationWe present a case of a 26-year-old HIV-positive male patient with a massive, slowly growingproptosis of his right eye (RE) and total visual loss. Other than HIV, he has confirmed forpulmonary tuberculosis, and hepatitis C. Imaging studies suggested a retrobulbar abscess, buthistopathology study later revealed plump nuclei endothelial lining and atypical spindle cells stoma,concluded as early-stage KS. Due to massive retrobulbar mass, after he reached an optimal CD4and controlled by anti-retroviral therapy (ART), he was obliged to undergo an orbital exenteration.DiscussionKaposi sarcoma is a malignant vascular tumor known to be the most common AIDS-associatedneoplasia. Although there still no definitive cure for this condition, KS could be effectively managedby immunological status improvement and adequate ART, particularly in its early stage. The clinicalmanifestation is varied widely; both clinical and histopathological diagnosis is challenging.However, we expect this case to raise awareness among ophthalmologists to prevent radicalmanagement of KS patients through early detection.ConclusionOphthalmologists should consider KS as a differential diagnosis for HIV-positive patients presentedwith any sign of proptosis or ocular mass.KeywordKaposi Sarcoma, Human Immunodeficiency Virus, Orbital ExenterationLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download998-EPOS-O-INASOPRS-49-Neni-Anggraini.jpg

188 E-POSTER

EPOS-O-INASOPRS-50Successful systemic propranolol treatment for periocular capillaryhemangioma in indonesian infant girls: a series of six cases

Abstract TitleSuccessful systemic propranolol treatment for periocular capillary hemangioma inindonesian infant girls: a series of six cases

First Author: NENI ANGGRAINI

Author Institution: Ophthalmologist, Ophthalmology Department, Cipto Mangunkusumo Hospital Jakarta

Co Author: Mutmainah Mahyuddin (Ophthalmologist, Ophthalmology Department, Cipto Mangunkusumo

Hospital Jakarta), Arcci Pradessatama (Resident, Ophthalmology Department, Cipto Mangunkusumo

Hospital Jakarta), Amani Sakinah Augiani (Research Assistant, Ophthalmology Department, Cipto

Mangunkusumo Hospital Jakarta)

A

bstract Type: Case Report


Seminat: INASOPRS


IntroductionAs the most prevalent benign tumor in children with a self-limiting feature, spontaneous involutionis usually expected from capillary hemangioma (CH). Approximately only 10% of all CH patientsrequire treatment. Studies showed an excellent role of propranolol compared to the prior standardtreatment of CH, corticosteroids. This study aims to present cases of periocular capillaryhemangioma (PCH) successfully treated with systemic propranolol.Case IllustrationWe present six infant girls treated with systemic propranolol for PCH. Patients’ age was rangingfrom 5-days and 11-months-old. The orbital type was the most prevalent. Except for the superficialform, all cases were assessed by orbital imaging to explore the tumor extension. Oral propranololwas given at 0.5 mg/kg body weight (mg/kg BW) starting dose for two weeks. If well-tolerated, thenthe dose was increased gradually to 2.0 mg/kg BW with a treatment duration of 7-18 months. Allpatients showed sufficient responses (mass reduction and color change) within 2-12 weeks. Nocomplications and adverse effects were observed.DiscussionPeriocular CH is a benign vascular endothelial cell tumor. It is classified into three main types,including superficial, subcutaneous, and orbital types. To date, the role of systemic propranolol onhemangioma is still unclear. Hypothetically, several mechanisms are proposed: angiogenesissuppression, vasoconstriction of the capillaries, and apoptosis induction. Our finding was supportedby several studies, which showed up to a 90% response rate.ConclusionThe regimen of 2.0 mg/kg BW systemic propranolol treatment is considered safe and effective forPCH.KeywordCapillary hemangioma; infantile hemangioma, propranololLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download639-EPOS-O-INASOPRS-50-Neni-Anggraini.jpg

189E-POSTER

EPOS-G-INASOPRS-51Pyogenic Granuloma at the Harvest Site: an Unusual Complication FollowingConjunctival-Limbal Graft in Pterygium Surgery

Abstract TitlePyogenic Granuloma at the Harvest Site: an Unusual Complication Following Conjunctival-Limbal Graft in Pterygium Surgery

First Author: CARENNIA PARAMITA

Author Institution: Arga Makmur Regional Hospital, Bengkulu, Indonesia

Co Author: TRI REJEKI HERDIANA (Oculoplastic Service, JEC Eye Hospitals and Clinics, Jakarta, Indonesia)



Seminat: INASOPRS


IntroductionThe use of conjunctival-limbal graft (CLG) in pterygium surgery is favourable to reduce recurrenceand surgical complications. Despite that, a rare occurrence of granuloma can still be a nuisancebecause CLG may induce an intense wound healing response post-surgery. To describe the clinical,surgical, postoperative and histologic aspects of pyogenic granuloma or Tenon’s granuloma at theharvest site as a rare complication is the merit of this report.Case IllustrationA 43-year-old male complained of a red mass on the left superior conjunctiva that made himuncomfortable. The mass occurred one month after he underwent an unremarkable pterygiumsurgery using CLG. Biomicroscopic examination revealed a mass measuring 6.00 x 8.00 mm, redcoloured, slightly raised lesion with well-defined border at the harvested site of the left superior bulbar conjunctiva, accompanied by vascularization from the nearest blood vessels. The CLG sealed by autologous blood at the recipient site healed completely. The rest of the ocular examination was normal.DiscussionOne month after pterygium surgery, patient’s chief complain of a red mass on the superiorconjunctiva led us to observe the extremely rare granuloma at the harvested site. Excision andcauterization were performed and eventually followed by further histopathology examination. Thisgranuloma, however, describes an inflammatory nonsuppurative reaction that may followuneventful pterygium surgery in susceptible individuals.ConclusionPyogenic granuloma may plausibly occur at the harvest site as an unusual complication followingpterygium excision. It may be prudent to counsel patients about a variety of adverse risks ofsurgery, in addition to recurrence of the pterygium itself.Keywordpyogenic granuloma, conjunctival-limbal graft, pterygiumLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download311-EPOS-G-INASOPRS-51-Carennia-Paramita.pdf

190 E-POSTER

EPOS-R-INARVOS-01Long-Term Effect of RGP Contact Lens in High Myopia with Anisometropia

Abstract TitleLong-Term Effect of RGP Contact Lens in High Myopia with Anisometropia

First Author: NLP Wistya Eka mahadewi

Author Institution: Resident of Medical Faculty Udayana University

Co Author: Ariesanti Tri Handayani (Refraction, Contact Lens and Low Vision Ophthalmologist of Medical

Faculty Udayana University)



Seminat: INARVOS


IntroductionUncorrrected refractive errors are a leading cause visual impairment and myopia is the mostcommon refractive error. RGP attempt to reshape the cornea to reduce refractive error. RGP lensesare considered more beneficial than glasses in high myopia cases due to provide wider field of viewand shorter vertex distances for better vision quality. To evaluate long-term effects of RGP lenseson high myopia and anisometropia.Case IllustrationA seventeen-year-old complained of blurred vision in both eyes and uncomfortable feeling whileusing RGP lenses. He had used RGP lenses since he was 7 years old. There were keratitis, dry eyesyndrome and scratched was founded on the RGP. Right eye (RE) visual acuity (VA) was 0.6 and theleft eye (LE) was 0.9 with the old RGP lenses. The Refraction on the first visit (10 years ago) on theRE was S-6.00 C-1.25 x1800 and LE was S-11.00 C-1.50 x00. The current refraction of RE wasS-7.50 C-1.00 x 100 and LE was S-12.00 C-1.00 x1600. Topography examination of the showed aregular cornea. The new RGP lenses were prescribed on the RE with S-6.50, BC 7.60, diameter9.60mm and LE with S-12.50, BC 7.60, diameter 9.60mm. After 10 years used of RGP lenses, theprogression of myopia on the RE was 1.50 D and the LE was 0.50 D.DiscussionRGP lenses one of choice to treat myopia and anisometropia in children. In this patients the longterm use of RGP lenses could effectively reduced myopia progression, even though not so effectivecompared to ortho-K and atropine in several studies. Some complication such as corneal erosion ordry eye could happened but in this patient these condition could be treated by medication.ConclusionRGP contact lenses are one of the therapeutic modalities of myopia refractive disorders that canprovide good visual acuity and reduce the progressiveness of myopia.KeywordRigid gas permeable contact lens, high myopia, anisometropiaLatest UpdateMay 12, 2021StatusApproved As E-PosterFile Download721-poster-refraksi.pdf

191E-POSTER

EPOS-G-INARVOS-03Relationship between Axial Length and Intraocular Pressure in Myopia Eyes

Abstract TitleRelationship between Axial Length and Intraocular Pressure in Myopia Eyes

First Author: Agustin virajati negoro

Author Institution: Klinik sentral medika

Co Author: Yulia Wardany (Departement of Ophthalmology, RSUD Arifin Achmad - FK UNRI)



Seminat: INARVOS


Introduction & ObjectivePrevious studies reported that myopia especially high myopia has long axial length. This conditionshowed with higher intraocular pressure (IOP) and become one of the risk factor of primary openangle glaucoma. This study aims to determine whether there is a relationship between the axiallength of the eyeball with intraocular pressure at RSUD Arifin Achmad, Pekanbaru. This studybegan on November 2020 to April 2021.MethodThis research method was analytic research with cross sectional design. The number of samples inthis study were 184 eyes from 92 respondents. Intraocular pressures were measured by using anon-contact tonometer. Axial lengths were measured by using a contact biometry. Analyzes wereperformed with the Spearman Correlation test.ResultThe result showed that most of the respondents in this study were 21-30 years old (75.0%), thelargest gender was female (77.2%), the mean IOP was 15.96 ± 1.405 mmHg and the mean axiallength was 24.868 ± 1.269 mm. There is a positive correlation between the mean axial length of theeyeball with intraocular pressure (p = 0.020 r = 0.171 with the Spearman Correlation test).ConclusionThere is a significant relationship between the mean axial length of the eyeball with intraocularpressure where the correlation strength value shows a very weak positive correlation.KeywordAxial Length, Intraocular Pressure, MyopiaLatest UpdateMay 15, 2021StatusApproved As E-PosterFile Download816-EPOS-G-INARVOS-03-AGUSTIN-VIRAJATI-NEGORO.jpg

192 E-POSTER

EPOS-G-INARVOS-04Optical Management In Chronic Diplopia Adolecent Patient With UncorrectedAstigmatism

Abstract TitleOptical Management In Chronic Diplopia Adolecent Patient With Uncorrected Astigmatism

First Author: Windya Tri Hapsari

Author Institution: Universitas Airlangga-Ilmu Kesehatan Mata dr Soetomo Surabaya

Co Author: Christina Aritonang (Universitas Airlangga-Ilmu Kesehatan Mata dr Soetomo Surabaya)



Seminat: INARVOS


IntroductionUncorrected refractive error is the most common cause of visual impairment. One of cause isastigmatism. A large-scale study of a multiethnic Asian population over 10000 adults found 58.8%had astigmatism and one of optical management is RGPCase IllustrationA 16 y.o boy was refer with diplopia in both eyes since 3 years ago. Event one eye was closed, hefelt diplopia. He went to optic and got spectacle for 3 years but still felt diplopia. Notrauma/operation in eyes. RLE spectacle S-1.75 C-0.75 A 0 For VA RE 6/18f cc S-1.25 C-1.50 A1706/6 and LE 6/30 cc S-1.50 C-1.75 A180 6/6,IOP,anterior,posterior segment,ocularmotility,schimmer,WFDT,pachymetri were normal.ARK RE S-1.25 C–1.75 A174 with K1 8.12 K27.46 and LE S-1.50 C-1.75 A180 with K1 8.18 K2 7.59 and he was prescribed spherical RGP RE BC7.9mm/P -2.00 D/D 9.2mm and LE BC 8.0mm/P -2.00 D/D 9.2mmDiscussionThe cause of diplopia in this case is uncorrected astigmatism. Astigmatism can produce a moredistinct doubling of a bright line in some axis between two image and may represent a differentphenomenon altogether. One of the management is spherical RGP lens that can reduceeyestrain,diplopia,improve binocularity,and prevent the development of myopia astigmatism. RGP isdesign from hydrophobic material that can correct refractive error and astigmatism caused byirregular astigmatism,reduce aberration,and provide good visual quality.ConclusionDiplopia because of uncorrected astigmatism can use spherical RGP and it can improvebinocularity, prevent the development of myopia astigmatism, and reduce eyestrain so can providegood visual qualityKeywordDiplopia,Astigmatism, RGP Contact LensLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download526-EPOS-R-INARVOS-04-Windya-Tri-Hapsari.JPG

193E-POSTER

EPOS-R-INARVOS-05The Role of Rigid Gas Permeable Contact Lens in Infantile Nystagmus– A Case Report

Abstract TitleThe Role of Rigid Gas Permeable Contact Lens in Infantile Nystagmus – A Case Report

First Author: Indah Saraswati


Co Author: Tri Rahayu (RSCM)



Seminat: INARVOS


IntroductionInfantile nystagmus may impair visual function including in gaze fixation and stereopsis. We reportan improvement of infantile nystagmus intensity while using a rigid gas permeable contact lens(RGPCL).Case IllustrationA 13-years old female presented with a chief complaint of headache and double vision upon wearingspectacles. The patient has been diagnosed with infantile nystagmus, aphakia of the left eye, andhigh myopia of the right eye leading to anisometropia. The patient had a history of rhegmatogenousretinal detachment on the left eye 2 years prior and underwent scleral buckle, vitrectomy,endolaser, lensectomy, and insertion of silicon oil. A year after the vitreoretinal surgery, sheunderwent corneal scrapping and evacuation of silicone oil due to secondary glaucoma and bandkeratopathy. The patient was treated by RGPCL to overcome the anisometropia and showed animprovement in visual acuity and nystagmus intensity.DiscussionThe nystagmus intensity of both eyes was examined with/without using RGPCL. The movement ofnystagmus was more stable in RGPCL while fixating at the central position. The reduction ofnystagmus amplitude might be due to the improvement of foveation.ConclusionRGPCL may improve personal symptoms and decrease the intensity of infantile nystagmus.Keywordinfantile nystagmus, rigid gas permeable contact lensLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download16-EPOS-R-INARVOS-05-Indah-Saraswati.jpg

194 E-POSTER

EPOS-R-INARVOS-06Accomodative spasm management in RSUP Sardjito Yogyakarta: A case report

Abstract TitleAccomodative spasm management in RSUP Sardjito Yogyakarta: A case report

First Author: Pramudya Budi Kusumawardhana

Author Institution: Ilmu Kesehatan Mata FKKMK UGM

Co Author:

Datu Respatika (Ilmu Kesehatan Mata FKKMK UGM)

Sagung Gede Indrawati (Ilmu Kesehatan Mata FKKMK UGM)



Seminat: INARVOS


IntroductionAccomodative spasm (AS) is a rare condition where there is greater accommodative response thanthe accommodative stimulus. The etiology has not been precisely determined, but the mostprobable etiology is psychogenic factors.Case IllustrationCase 1. A 16-year-old female presented 1/60 visual acuity and variable myopic refractive error. Shehad unstable refractive error on both eyes S-4.75 SE - S-6.00 in one week. S-0.25 SE on right eyeand S+0.25 SE on left eye on cyclopentolate. Case 2. A 24-year-old female presented 3/60 visualacuity and high myopic refractive error. She had unstable refractive error on both eyes S-2.50 -S-5.00 in 9 months, on examination with cyclopentolate became S-0.75 on both eyes.DiscussionAS can occurred in children and young aldoscents. It can show variable refractive error. Wediagnose AS when there is a shift of refraction after cycloplegia instilation.ConclusionRepeated ophthalmology examination and the used of cyclopegic agents are mandatory to establishthe diagnosis of AS. Referring patients to another department is recommended to search the etiology.KeywordAccomodative spasm, pseudomyopia, cyloplegicLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download854-EPOS-R-INARVOS-06--PRAMUDYA-BUDI-KUSUMAWARDHANA.jpg

195E-POSTER

EPOS-R-INARVOS-07Management of Low Vision Problem at Bilateral Aphakic and Myopic MacularDegeneration Patient to Achieve the Best Visual Outcome

Abstract TitleManagement of Low Vision Problem at Bilateral Aphakic and Myopic MacularDegeneration Patient to Achieve the Best Visual Outcome

First Author: Andi Putra Jayanegara


Co Author: Tri Rahayu (Department of Ophthalmology, Faculty of Medicine Universitas Indonesia)



Seminat: INARVOS


IntroductionLow vision results in decreased quality of life (QoL) and loss of independence. We aim to report asuccessful case of low vision management in bilateral aphakic patient with posterior capsuleopacification (PCO) and myopic macular degeneration of both eyes (BE).Case IllustrationFemale, 57 years old, came with blurred vision of BE. Patient underwent cataract extractionwithout intraocular lens implantation on BE during childhood. Uncorrected visual acuity (UCVA)was 3/60 on the right eye (RE) with best-corrected visual acuity (BCVA) was 6/60 of the right eyeusing S+3.25 C-1.50 x 700 and no light perception on the left eye (LE). Aphakia with PCO was alsofound along with myopic macular degeneration on BE. Patient underwent Nd:YAG LaserCapsulotomy for RE. After Nd:YAG Laser Capsulotomy, BCVA of RE was 6/48 with S+4.50 C-0.50 x1000 due to myopic macular degeneration. Telescope of 20 D and 3x magnification increased herbest distance VA to 6/15. Handheld Magnifier with power of 20 D resulted in near VA 0,6 M in achart at a distance of 25cm.DiscussionComprehensive examination is required for proper management in low vision. Appropriate lowvision aids for corresponding VA such as telescopes and magnifier may aid in improving patient vision.ConclusionAchieving optimal rehabilitation plan is essential in low vision management. A successful approachcould enhance patient QoL and independence.KeywordLow vision, telescope, magnifierLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download643-EPOS-R-INARVOS-07-Andi-Putra-Jayanegara.jpg

196 E-POSTER

EPOS-R-INARVOS-08ACCOMODATIVE INSUFFICIENCY RELATED TO ANTIEPILEPTIC DRUGS:A CASE REPORT

Abstract TitleACCOMODATIVE INSUFFICIENCY RELATED TO ANTIEPILEPTIC DRUGS: A CASE REPORT

First Author: Sri Hudaya Widihastha

Author Institution: Department of Ophthalmology,National Eye Center Cicendo Eye Hospital/Universitas


Co Author: Susanti Natalya Sirait (Refraction, Contact Lens, and Low Vision Unit, National Eye Center

Cicendo Eye Hospital, Bandung), Karmelita Satari (Refraction, Contact Lens, and Low Vision Unit, National

Eye Center Cicendo Eye Hospital, Bandung), Ine Renata Musa (Refraction, Contact Lens, and Low Vision

Unit, National Eye Center Cicendo Eye Hospital, Bandung)



Seminat: INARVOS


IntroductionAccommodative insufficiency is a type of accommodative dysfunction in which the amplitude ofaccommodation is lower than the age-expected norm. This case report describes an accommodativeinsufficiency due to the use of anti-epileptic drug treatment.Case IllustrationA 24-year-old woman came with chief complaint of blurry vision at near in the last 4 months. Shehas had history of epilepsy for six years and had been in treatment of several antiepileptic drugs,including Carbamazepine, Sodium Valproate, Levetiracetam and Lamotrigine. Ophthalmologicexamination revealed that visual acuity on the right eye was 0.63 pinhole 1.0 and the left eye was0.63 pinhole 1.0. The best corrected visual acuity after giving cyclopentolate 1% was 1.0 withcorrection S-0.50 on both eyes. Amplitude accommodation was 1.17 D. Anterior and posteriorsegment were within normal limit. The patient was diagnosed with myopia and accommodativeinsufficiency due to anti-epileptic drug. The patient was given a prescription of S-0.50 with additionof S+2.50 in progressive lens and advised for orthoptic exercise therapy.DiscussionAccommodative insufficiency may lead to various vision-related symptoms and significantly affectindividual’s performance during near visual activities. Antiepileptic drugs which are prescribed toreduce and control seizure activity, has been reported to have side effect of blurred vision due to itsmuscarinic effects. The possibility of adverse visual side effects in epilepsy patients should be keptin mind by ophthalmologist, so the correct management can be given.ConclusionAccommodative insufficiency may occur due to anti-epileptic drug.KeywordAccommodation, Accommodative insufficiency, antiepileptic drugLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download537-Poster-Ref.jpg

197E-POSTER

EPOS-R-INARVOS-09Rigid Gas Permeable Contact Lens in the Management of AdvancedKeratoconus - A Case Report

Abstract TitleRigid Gas Permeable Contact Lens in the Management of Advanced Keratoconus - A Case Report

First Author: Herin Arini Natalia


Co Author: Nursyamsi (Universitas Hasanuddin)

Muhammad Irfan (Universitas Hasanuddin)

Purnamanita Syawal (Universitas Hasanuddin)

Adelina T. Poli (Universitas Hasanuddin)



Seminat: INARVOS


IntroductionKeratoconus is a non-inflammatory, progressive thinning of the cornea that is usually bilateral andinvolves the central two-thirds of the cornea. The etiology is unknown and most likelymultifactorial. This case report aims to describe the use of rigid gas permeable contact lens (RGPCL) as a treatment modality in advanced keratoconus.Case IllustrationAn eighteen-year-old young man was referred to hospital due to uncorrected visual acuity andkeratoconus presentation in both eyes. Patient has complained of blurred vision and diplopia since4 years ago along with history of allergies and eye rubbing. Ophthalmology examination revealeduncorrected visual acuity (UCVA) of counting fingers in both eyes which improved by subjectiverefraction into 0.16 (BCVA) using Snellen chart in both eyes. Following extensive examination, botheyes showed advanced keratoconus. Patient was prescribed RGP-CL and visual acuity became 0.40on the right eye and 0.50 on the left eye. Patient remain comfortable after 6 months of usage.DiscussionThere are several treatment options available, depending on the stage of keratoconus. RGP-CL offerbetter vision than soft lenses in more advanced cases but are often associated with discomfort andforeign body sensation. Recent studies reported scleral contact lenses have advantages for patientswith advanced keratoconus by provide excellent comfort, centration and stability. RGP-CL offerimprovement in visual acuity and as another choice in limited modality.ConclusionRGP-CL is one of the non-surgical management for visual improvement in treating keratoconus andits refractive error with improved visual acuity outcome and comfort.Keywordkeratoconus, rigid gas permeable contact lens, advanced keratoconusLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download424-Poster-edit-.pdf

198 E-POSTER

EPOS-G-INANOS-01Homonymous Hemianopia in Occipital Ischemic Stroke: A Case Report

Abstract TitleHomonymous Hemianopia in Occipital Ischemic Stroke: A Case Report

First Author: Ferdy Iskandar

Author Institution: Pondok Indah - Puri Indah Hospital, Jakarta, Indonesia

Co Author:

Rianti Wulandari Pratiwi (Research Assistant, Department of Ophthalmology, Cipto Mangunkusumo

General Hospital, Jakarta, Indonesia), Dearaini (Research Assistant, Department of Ophthalmology, Cipto

Mangunkusumo General Hospital, Jakarta, Indonesia), Marcus Adityawan Bahroen (Neurologist, Rumah Sakit

Pondok Indah - Puri Indah, Jakarta, Indonesia), Lukman Edwar (Ophthalmologist, Pondok Indah – Pondok

Indah Hospital, Jakarta, Indonesia), Alia Arianti (Ophthalmologist, Jakarta Eye Center Hospitals and Clinics,

Jakarta, Indonesia)



Seminat: INANOS


IntroductionHomonymous hemianopia (HH) is hemianopic visual field loss on the same side of both eyes.Case IllustrationA 62-year-old male patient complained about his first episode of sudden narrowing visual field inboth of his eyes. He is a heavy smoker with dyslipidemia as his clinical history. His right visual fieldin both eyes is narrowed, with normal pupillary reflex, normal funduscopy, and normal IOP. Wefound right HH in his Humphrey test. Acute infarct lesions in the left occipital lobe, left parietallobe, and left temporal superior lobe in the left lateral periventricular region which could match theterritory of the left posterior cerebral artery (PCA) and its watershed area were found during MRIMRA. Aspirin, cilostazol, and statin were immediately given. His visual field gradually improved andhe has maintained the treatment for more than 3 months without recurrent symptoms.DiscussionThere is still no standardized treatment for visual deficits in the acute period after a stroke. HHusually improves spontaneously within the first months of injury with the aid of vision training andrehabilitation. However, we gave him cilostazol combination treatments to prevent further ischemicdamage and reduce the risk of recurrent attack.ConclusionThis case suggests right HH as the first sign of left occipital ischemic stroke, with promising resultsusing cilostazol combination treatments.Keywordhomonymous hemianopia, strokeLatest UpdateApril 19, 2021StatusSubmittedFile Download

199E-POSTER

EPOS-R-INANOS-02A CASE REPORT OF INFECTIOUS NEURORETINITIS : IS THIS CAUSED BYCAT SCRATCH DISEASE?

Abstract TitleA CASE REPORT OF INFECTIOUS NEURORETINITIS : IS THIS CAUSED BY CAT SCRATCHDISEASE?

First Author: Henu Hadiyantama

Author Institution: UNAIR

Co Author: Lukisiari Agustini (UNAIR)



Seminat: INANOS


IntroductionNeuroretinitis is an inflammatory disorder characterized by acute loss of vision, papil edema andmacular star. The most common etiology of neuroretinitis is cat scratch disease.Case IllustrationA 24-year-old man complain sudden blurred vision on both eye and headache since July 2020. Hehas four cats. Visual acuity (VA) of right eye is 5/60 PHNI, left eye 1/300 good PI. Anterior segmentis normal. Posterior segment of both eyes showed papil edema and macular star. HFA of right eye,defect of visual field in superonasal and inferotemporal region. The left eye, visual field defect in allregion. OCT showed increase of RNFL thickness on both eyes. TORCH and ANA test is negative. Nolaboratory test of bartonella in our center. Diagnosis of cat scratch disease neuroretinitis wasmade. Treatment with methylprednisolone 32 mg every 12 hours. Four months follow up, resultimproved VA of both eyes and reduced edema of ONH and macular star.DiscussionNeuroretinitis is self limiting disease characterized by clinical triad of vision loss, optic disc edemaand macular star.1 Cat-scratch disease caused by Bartonella henselae, a gramnegative bacteriumis the most common cause of neuroretinitis. The vector is an infected kitten.1,2,3 Most cases can betreated with high-dose steroids.4 The prognosis is generally excellent.5ConclusionCat scratch disease was the most common cause of neuroretinitis. Prompt examination andancillary test should be done to diagnose accurately. Effective therapy would give a good outcomes.KeywordNeuroretinitis, Bartonella henselae, Macular starLatest UpdateMay 11, 2021StatusSubmittedFile Download

200 E-POSTER

EPOS-G-INANOS-03Methanol-Associated Optic Neuropathy Treated with Corticosteroid: Asystematic Review

Abstract TitleMethanol-Associated Optic Neuropathy Treated with Corticosteroid: A systematic Review

First Author: Agung Anugerah

Author Institution: Universitas Jember

Co Author: Ekvan Danang Setya Pramudito (Universitas Jember)



Seminat: INANOS


Introduction & ObjectiveMethanol-Associated optic neuropathy is prevalent in countries where adulterated ethanolconsumption are common. In the absence of clinical guideline, corticosteroid arises as a treatmentchoice for its accessability and affordability although its therapeutic effect remain controversial.Therefore, we conduct a systematic review to summarize existing evidences.MethodLiterature search was conducted throughout PubMed and Google Scholar. Keywords were(corticosteroid OR prednisone OR methylprednisolone) AND (methanol) AND (optic OR opticneuropathy OR neuropathy). Review articles were excluded.ResultWe retrieve 13 articles accounting for 80 patients. Visual acuity outcome are different acrossarticles, some even conflicting. Improvement in visual acuity upon discharge are demonstrated inmost reports, though deterioration in long term follow up was reported by Zhao, et al. (2015).Reported cases exhibiting visual improvement by Abrishami (2011) and Koehrer (2011), receive acommentary afterwards, suggesting that even without corticosteroid therapy, hemodialysis alonealso exhibit various outcome that are not different with corticosteroid group. To date, there is nostudy comparing visual outcome among corticosteroid and hemodialysis group in a long term followup. Instead, two studies comparing erythropoietin and corticosteroid are available but exhibitingconflicting result. In other side, duration between methanol exposure and hospital admittance wasshown to exhibit significant correlation towards visual prognosis as reported by Zamani, et al.(2017) (p= 0.04) and duration of methanol exposure itself as reported by Ma, et al. (2019).ConclusionCorticosteroids’ efficacy and its additional benefit in treating methanol-associated optic neuropathyremain unclear and demand further studies.Keywordcorticosteroid, methanol, optic neuropathyLatest UpdateMay 12, 2021StatusSubmittedFile Download

201E-POSTER

EPOS-G-INANOS-04Optic Nerve Sheath Meningioma: A Case Report

Abstract TitleOptic Nerve Sheath Meningioma: A Case Report



Co Author: Fabiola Supit (Faculty of Medicine, Public Health, and Nursing Gadjah Mada University)



Seminat: INANOS


IntroductionOptic nerve sheath meningioma (ONSM) is a rare intraorbital benign neoplasm originating frommeningoepithelial cells lining the sheath of the intraorbital or intracanalicular optic nerve. ONSMusually causes vision loss gradually and painlessly, therefore patients might come when symptomsare prominent. A good pre-treatment visual acuity (VA) has been linked to a better visual outcomein post-radiation treatment.Case IllustrationA 46 years old housewife went to the eye clinic complaining of left eye protrusion and progressivelyblurred vision for one year. There was no headache, nausea, vomit, history of eye diseases, orinterventions. VA of the left eye was 6/60, raised IOP, and positive relative afferent pupillary defect.Contrast-enhanced CT scan shown left optic nerve sheath meningioma. The patient was treatedwith Timolol maleate eye drop and oral methylprednisolone and then referred for furthermanagement.DiscussionThe classic triad of ONSM is visual loss, optic atrophy, and optociliary shunt vessel although rarelycompletely found. The patient may be asymptomatic or shows signs vary from vision loss, visualfield defect, proptosis, restrictive ocular movement, strabismus, optic disc abnormality, orbitalcompartment syndrome, pain, and headache. MRI is preferred because useful in defining tumorsize and intracranial expansion. CT scan is better in detecting calcification and evaluating lesionconfiguration and relation to bony anatomy. Treatment options include observation, radiotherapy,and surgery. The mortality and systemic morbidity rate in ONSM are extremely low.ConclusionONSM is a rare, significant, benign neoplasm, which could cause blindness. Early detection ofONSM may lead to a better outcome.KeywordOrbital meningioma, optic nerve sheath meningioma, orbital tumorLatest UpdateMay 12, 2021StatusSubmittedFile Download

202 E-POSTER

EPOS-R-INANOS-05Neuroretinitis as The First Sign of Systemic Lupus Erythematosus:A Case Report

Abstract TitleNeuroretinitis as The First Sign of Systemic Lupus Erythematosus: A Case Report

First Author: Harris Kristanto Gunawan


Co Author: Lukisiari Agustini (Universitas Airlangga)



Seminat: INANOS


IntroductionNeuroretinitis is a type of optic neuropathy characterized by an acute unilateral visual loss in thesetting of optic disc swelling accompanied by hard exudates characteristically arranged in a starshape around the fovea. Neuroretinitis can be caused by autoimmune, infection, or idiopathic.Case IllustrationA 35 years old man with chief complaint of blurred vision of left eye with dark area of visual fieldfor three weeks. Visual acuity was 5/20 difficult to correct on left eye, no abnormality on anteriorsegment, posterior segment showed ONH with blurred margins (inferior and temporal), hyperemia,CDR 0.2, with partial macular star at inferonasal. There was also superotemporal central scotomaby HFA examination. The patient also had positive ANA test (155,9) and the diagnosis is confirmedby internist as SLE. After administration of Methylprednisolone 250mg every 6 hours intravenousfor 5 days, visual acuity became 5/5 OU, and there was improvement of ONH (temporal marginbecame sharp and CDR increase to 0.3). There was improvement of the visual field defect.DiscussionPositive ANA test in patient with neuroretinitis without history of autoimmune disease showed thatthe neuroretinitis is the first sign of SLE and collaboration with internist is needed to check forother signs/symptoms and to give treatment to prevent future attacks. Steroid can be used to treatneuroretinitis that is caused by SLE.ConclusionA lot of ethiology can cause neuroretinitis. A thorough physical examination and ancillary test areneeded to know the ethiology, so the patient can be treated appropriately.KeywordNeuroretinitis, SLE, SteroidLatest UpdateMay 12, 2021StatusSubmittedFile Download

203E-POSTER

EPOS-R-INANOS-06Remarkable Ophthalmic Improvement Following Early Diagnosis andTreatment of Prolactinoma-Compressing Optic Chiasm: A Case Report

Abstract TitleRemarkable Ophthalmic Improvement Following Early Diagnosis and Treatment ofProlactinoma-Compressing Optic Chiasm: A Case Report

First Author: Muhamad Dwi Nugroho

Author Institution: Department of Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas

Gadjah Mada

Co Author:

Indra Tri Mahayana (Department of Ophthalmology, Faculty of Medicine Public Health and

Nursing, Universitas Gadjah Mada), Tatang Taka Gani (Department of Ophthalmology, Faculty of Medicine

Public Health and Nursing, Universitas Gadjah Mada), Widyandana (Department of Ophthalmology,

Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada), Hartono (Dr. Yap Eye Hospital,

Yogyakarta)



Seminat: INANOS


IntroductionProlactinoma frequently manifests as a visual field defect and often undetected due to its slowlygradual progression. Chronic optic nerve compression will result in irreversible diffuse nerveatrophy and associated with permanent severe vision and field loss.Case IllustrationThis is a case report of a 12 y-o boy with an acute visual loss, right eye ptosis, decreased visualacuity (VA). Band atrophy at the optic disc and bitemporal hemianopia were found. MRI revealed ahomogenic solid lesion intrasellar to supersellar region suggested macroadenoma pituitary.Laboratory examination showing increase prolactin hormone (33.6 ng/ml) and decrease boththyroid hormone (FT4 0.68 mg/dL and TSH 0.07 mg/dL) and testosterone (DiscussionCompressing optic chiasm resulting in decrease VA, ptosis, and bitemporal hemianopia. Aftersurgical, hormonal and, radiotherapy, the clinical conditions were improved significantly.Treatment goals in children with prolactinoma are to shrink the pituitary mass, attain normalgonadal function and normal pubertal development, achieve adequate peak bone mass, and ensurefuture fertility. Dopaminergic agonists are the initial therapy of prolactinoma. Inmacroprolactinoma, surgery should be reserved for medically intractable tumors or neurosurgicalemergencies. If it is not immediately diagnosed, macroprolactinomas might have a tendency togrow over time. Chronic nerve compression by a pituitary mass results with permanent severevision and field loss.ConclusionEarly diagnosis and treatment of prolactinomas might give a good clinical outcome for the patient.Keywordmacroadenoma pituitary, prolactinoma, neuro-ophthalmologyLatest UpdateMay 13, 2021StatusSubmittedFile Download

204 E-POSTER

EPOS-R-INANOS-07Subclinical Linezolid Toxic Optic Neuropathy in a Patient with TB XDR : ACase Report

Abstract TitleSubclinical Linezolid Toxic Optic Neuropathy in a Patient with TB XDR : A Case Report

First Author: Niska Ayu Anjaswari

Author Institution: RSUD Dr. Soetomo

Co Author: Gatot Suhartono (RSUD Dr. Soetomo ), Lukisiari Agustini (RSUD Dr. Soetomo )



Seminat: INANOS


IntroductionTo report a case of subclinical linezolid toxic optic neuropathy in a patient with TB XDR.Case IllustrationA 47-year-old man complaint of blurred vision in both eyes since 4 months ago. The blurred visionwas getting worsen during several hours after taking TB medicine. Visual acuity was 6/6 andishihara test was 38/38 in both eyes. Both pupil were 3 mm rounded pupil and no relative afferentpupillary defect. Confrontation test was normal. There was no limitation and pain on ocularmotility. The optic disc showed slightly hyperemia, swollen and blurred margin. OCT revealed anincrease of RNFL thickness on both eyes. Humphrey result test were normal for both eyes.Treatment was initiated with stopping Linezolid.DiscussionSubclinical Toxic Optic Neuropathy is an unusual condition that should be assessed for the causes.Papilledema was the manifestation of subclinical toxic optic neuropathy in XDR-TB patient withLinezolid therapy. Multidisciplinary approach is essential for management of this case.ConclusionLinezolid consumption on XDR-TB patient is common cause of toxic optic neuropathy in TB patient.Awareness of the specific causes of toxic optic neuropathy might enable a prompt clinical diagnosis.Appropriate and effective therapy would give a good result.KeywordSubclinical Toxic Optic Neuropathy, Linezolid, XDR-TBLatest UpdateMay 14, 2021StatusSubmittedFile Download

205E-POSTER

EPOS-R-INANOS-08Unharming the Unfortunate: Recognizing and Holding Off Megadose Steroidin A Boy with Optic Nerve Avulsion

Abstract TitleUnharming the Unfortunate: Recognizing and Holding Off Megadose Steroid in A Boy withOptic Nerve Avulsion



Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia

Co Author:

Syntia Nusanti, Nur Aisyah Rahmawati, Annisa Nindiana Pertiwi, Mario Marbungaran Hutapea

(Department of Ophthalmology, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Kirana

Eye Hospital, Jakarta, Indonesia)



Seminat: INANOS


IntroductionOptic nerve avulsion (ONA) is rare yet severe of blunt trauma complication. We aim to describedetailed presentation of ONA in which megadose steroid would give no advantage.Case IllustrationA five-year-old boy came with a unilateral sudden visual loss after incidentally falling with his left eye struck to a handlebar of a parked bicycle. His left eye became no light perception, ophthalmoplegia, and showing 4+ relative afferent pupillary defect. Dilated fundus examination using a 20D lens showed blood emanating from the optic canal with a hallmark pit and pale retina without break. B-scan ocular ultrasound displayed retinal step sign, vitreous hemorrhage in front of the optic canal, lamina cribrosa defect, edematous retina, and retracted optic nerve. Orbital computed tomography scan confirmed a comminuted fracture of the superior orbital wall with a 5- mm impression to intracranial, ruptured superior rectus muscle, and disruption of the optic nerveglobe junction. Steroid infusion was decided not to be given. At one week, extensive vitreous hemorrhage occurred with still no light perception.DiscussionRetrodisplacement of the optic nerve might occur after a sudden incline of intraocular pressure or rotation of the globe following blunt trauma, which is accounted for much less than 0.5% of all head traumas. No light perception, hallmark fundus appearances, ruptured extraocular muscle, and pathognomonic imaging characteristics could ascertain ONA. Immediate diagnosis can avoid unnecessary steroid that may otherwise harm systemically.ConclusionNot all cases of traumatic optic nerve injury required steroid such as in ONA, which signs should beaware of following blunt trauma.KeywordBlunt trauma, optic nerve avulsion, retinal step signLatest UpdateMay 15, 2021StatusSubmittedFile Download

206 E-POSTER

EPOS-R-INANOS-09Blindness due to Methanol Induced Toxic Optic Neuropathy in a Young Male :A Case Report

Abstract TitleBlindness due to Methanol Induced Toxic Optic Neuropathy in a Young Male : A Case Report

First Author: Dian Mayangsari

Author Institution: 1Department of Ophthalmology, Faculty of Medicine Universitas Airlangga – Dr. Soetomo


Co Author: Lukisiari Agustini (1Department of Ophthalmology, Faculty of Medicine Universitas Airlangga – Dr.




Seminat: INANOS


IntroductionMethanol-induced toxic optic neuropathy (TON) is defined as a visual impairment due to optic nervedamage by toxic methanol poisoning.Case IllustrationA 40-year-old man complained sudden painless vision loss in both of his eyes since one month agoafter he drunk one day before. The visual acuity of the right and left eyes was no light perception.The light reflex decreased in both eyes, RAPD was not present in both eyes, and found isocoricpupil with diameter 5 mm on both eyes. Optic nerve head appeared sharp margin and pallor colorwere found on both eye. OCT revealed a decrease of RNFL thickness on both eyes. Laboratoryresults showed within normal limits. Diagnosis of right and left eye toxic optic neuropathy wasmade. Treatment was initiated with methyl prednisolone, citicholine, neurotropic and folic acidDiscussionToxic optic neuropathy due to methanol intoxication is an unusual condition that should be assessedfor the causes. This case presented classic manifestation of methanol intoxication with blindness inboth eyes. Blindness is the common symptom and permanent. Elimination of methanol and itsmetabolites is required to preventing the formation of toxic metabolites.ConclusionMethanol intoxication is still a common problem in many parts of the developing world. Blindness isthe common symptom in methanol intoxication. Acute methanol poisoning is a potentially fatalpublic health problem in developing countries. This disease is often underdiagnosed or oftendiagnosed at a stage when recover of vision is not possible.KeywordToxic Optic Neuropathy, Methanol Intoxication, Methanol Optic NeuropathyLatest UpdateMay 15, 2021StatusSubmittedFile Download

207E-POSTER

EPOS-R-INANOS-10SIXTH NERVE PALSY AND PERIPHERAL SEVENTH NERVE PALSY IN ASIXTEEN YEARS-OLD BOY : A CASE REPORT

Abstract TitleSIXTH NERVE PALSY AND PERIPHERAL SEVENTH NERVE PALSY IN A SIXTEEN YEARSOLD BOY : A CASE REPORT

First Author: Made Dessy Gangga Ayu Cinthiadewi


Co Author:



Seminat: INANOS


IntroductionIn pediatric population, isolated sixth nerve palsy is the most common cranial nerve palsy. Pediatricfacial nerve palsy can be either congenital or acquired case. It becomes more significant because offunctional and aesthetic outcomes.Case IllustrationA 16-years-old male patient was consulted from pediatric department with Brain Edema andMeningoencephalities. Patient experienced headache since 1 week before admission, double visionand seizure since 2 days before admission. Visual acuity was 5/5 on both eyes with normalintraocular pressure. There was painless restriction on the right eye extraocular movement.Anterior segment was within normal limit. Funduscopy was also within normal limit. Cranial nerveexamination showed N. VI and N. VII palsy. From MRI brain with contrast examination showed ahistory of vasculitis.DiscussionIn sixth nerve palsy of childhood, a recovery is expected. A thorough history and physicalexamination to evaluate for any other neurological symptoms or signs, followed by a brain MRimaging, are recommended. For the peripheral seventh nerve palsy, to assess the prognosis of canbe difficult, especially in children, even if the possibility of a complete functional recovery is greaterin pediatric cases than in adult ones.ConclusionAn observation is needed in children with sixth nerve palsy as there is possibilities it become arecurrent case. Seventh nerve palsy, is the most frequent form of facial paralysis in children. Acareful diagnostic workout and differential diagnosis are always recommended.KeywordSixth nerve palsy, peripheral seventh nerve palsyLatest UpdateMay 15, 2021StatusApproved As E-PosterFile Download850-EPOS-R-INANOS-10-Made-Dessy-Gangga-Ayu-Cinthiadewi.JPG

208 E-POSTER

EPOS-R-INANOS-11A TRAUMATIC UNILATERAL THIRD NERVE PALSY ON A CHILD AT EMERGENCY DEPARTMENT: A CASE REPORT

Abstract TitleA TRAUMATIC UNILATERAL THIRD NERVE PALSY ON A CHILD AT EMERGENCY DEPARTMENT: A CASE REPORT

First Author: Putri Anya Universade

Author Institution: FK UNAIR

Co Author: Dr. dr. Lukisiari Agustini Sp.M(K) (FK UNAIR)

dr. Gatot Suhartono Sp.M(K) (FK UNAIR)



Seminat: INANOS


IntroductionTo provide clinically relevant information regarding evaluation of traumatic unilateral third nervepalsy of a child after a motorbike accident.Case IllustrationAn 11 years old boy was brought to the Emergency Department after experiencing a trafficaccident. The peek acuity 6/6 for both eyes. Diplopia was not detected. The right upper eyelidshowed edema, bleeding from the lacerations, mydriatic pupil, and restricted inferior eyemovement. Pilocarpine 1% eyedrops were given to exclude between traumatic iridoplegia or thirdnerve palsy. The head CT scan without contrast revealed an orbital floor fracture and intracranialhemorrhage. The Neurosurgeon evacuated the intracranial hemorrhage. The Ophthalmologistsutured the palpebra lacerations. The post-operation conditions follow-up were visual acuity,inflammation signs, and ocular motility. Tarsoraphy was considered if lagophthalmos persisted.DiscussionTrauma accounts for 12% of all third nerve palsies. The injury may be direct or indirect.Oculomotor nerve palsy generally causes mydriasis, impairment of eye adduction, upward anddownward gaze palsy, and eyelid drop in the affected eye. Pilocarpine 1% eyedrops were given toexclude the differential diagnosis of third nerve palsy. Features of traumatic optic neuropathyshould not be missed. A head CT scan is essential for trauma cases. In general, patients withtraumatic third nerve palsies have a poor prognosis therefore it needs good rehabilitation.ConclusionTraumatic nerve palsy is one of the major complications of orbital trauma. Careful assessment helpsto distinguish the prognosis and recovery time.KeywordTraumatic Third Nerve Palsy, Orbital Floor Fracture, Head InjuryLatest UpdateMay 15, 2021StatusApproved As E-PosterFile Download120-EPOS-R-INANOS-11-Putri-Anya-Universade.jpg

209E-POSTER

EPOS-R-INANOS-12Fortunate Case of Bilateral Toxic Optic Neuropathy

Abstract TitleFortunate Case of Bilateral Toxic Optic Neuropathy

First Author: Claudia Hartomuljono

Author Institution: RSCM Kirana - FKUI

Co Author: Syntia Nusanti (RSCM Kirana - FKUI)



Seminat: INANOS


IntroductionThe current lifestyle that is not balanced with knowledge has a negative impact as in the case ofToxic Optic Neuropathy (TON). The aim of this case is to present an unusual case of methanolpoisoning which caused bilateral blindness but was very fortunate the visual acuity (VA) in the righteye returned to 20/20 after 9 months.Case IllustrationA 17-year-old male presented with sudden and unpainful bilateral blurred vision. He consumed sixglasses of alcohol mixed with ExtraJoss® two days before. On examination, his VA was no lightperception (NLP) in both eyes with fully dilated pupil and no light reflex. Posterior segment showedbilateral hyperemic optic disc with distinct edge. We started therapy with high dose intravenousmethylprednisolone (IVMP) for 3 days. Visual evoked potential (VEP) showed reduced in amplitude.We reduced the dosage of MP gradually and after 2 months, the VA OD increased to 20/50 and VAOS 20/1200. Nine months after, the VA OD was 20/20 with optic disc atrophy.DiscussionMethanol toxicity is believed to cause irreversible blindness but in this case the damage was notpermanent at the beginning after prompt therapy was given. Methylprednisolone acts as acompetitive inhibitor of alcoholic dehydrogenase and also to reduce inflammation since the toxicityof methanol is mostly inflammatory. Administration of high doses IVMP followed by oral MP hasshown improvement in vision.ConclusionIntravenous methylprednisolone therapy reduced gradually has the potential in salvaging vision.However, initial systemic therapy in cases of methanol poisoning should not be missed.KeywordToxic Optic Neuropathy, Methanol, Bilateral Visual LossLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download362-EPOS-R-INANOS-12-Claudia-Hartomuljono.jpg

210 E-POSTER

EPOS-R-INANOS-13Optic perineuritis with sixth cranial nerve involvement in acute emergency setting: A Case Report

Abstract TitleOptic perineuritis with sixth cranial nerve involvement in acute emergency setting: A Case Report

First Author: Ferdinand Inno Luminta


Co Author:

Salmarezka Dewiputri (Neuroophthalmology Division, Department of Ophthalmology, Faculty of

Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta)

Theresia Kania (Department of Ophthalmology, Faculty of Medicine Universitas Indonesia)

Izza Zukhrufia (Department of Ophthalmology, Faculty of Medicine Universitas Indonesia)



Seminat: INANOS


IntroductionOptic perineuritis is an uncommon variety of orbital inflammatory disease that is distinct fromdemyelinating optic neuritis. We describe a case of bilateral optic perineuritis with right sixthcranial nerve (CN) involvement in emergency setting.Case IllustrationA 36-year-old female came to emergency room (ER) with diplopia, painful blurry vision on botheyes, and headache for three days. She had history of flu-like symptoms in the last one week. Bestcorrected visual acuity (BCVA) were 6/30 and 6/45 for the right and left eye, respectively. Therewas 7° esotropia and restricted right eye abduction. Funduscopy revealed hyperemic both opticdisc. Brain Computed Tomography (CT) Scan was performed with normal result. Laboratory resultshowed positive Anti-Nuclear Antibody (ANA). Patient was diagnosed with suspected opticperineuritis with sixth CN palsy of the right eye and received intravenous methylprednisolone forthree days, then planned to undergo brain MRI. At final follow-up, BCVA were 6/6 and 6/7.5 andocular movement were good.DiscussionOptic neuritis or optic perineuritis is a clinical diagnosis. It is important to accurately distinguishbetween these two because of their different prognosis and treatment consideration. The ER settingmay lack the appropriate diagnostic tools for diagnosis. Mild motility disturbance, due toextraocular muscle inflammation is occasionally a helpful feature of optic perineuritis. This is nottypical features of optic neuritis unless there is associated brainstem involvement due to multifocaldemyelinating disease.ConclusionA good clinical judgement is needed to address proper treatment of optic perineuritis to achievegood visual outcome in ER setting.Keywordoptic perineuritis; cranial nerve involvement; imaging; intravenous methylprednisolone.Latest UpdateMay 16, 2021StatusApproved As E-PosterFile Download113-EPOS-R-INANOS-13-Ferdinand-Inno-Luminta.jpg

211E-POSTER

EPOS-G-INANOS-14Parenteral Glucocorticoid in Sight-Threatening Graves’ Ophthalmopathy: ACase Report

Abstract TitleParenteral Glucocorticoid in Sight-Threatening Graves’ Ophthalmopathy: A Case Report

First Author: Rania Ayu Permata Putri Kornia

Author Institution: Intern Doctor of Ophthalmology Department at Tabanan General Hospital, Bali

Co Author:

I Putu Rustama Putra (Ophthalmologist at Tabanan General Hospital, Bali)

Ni Wayan Sedani (Ophthalmologist at Tabanan General Hospital, Bali)

Cynthia Dewi M (Ophthalmologist at Tabanan General Hospital, Bali)



Seminat: INANOS


IntroductionGraves’ ophthalmopathy (GO) is an autoimmune inflammation of the orbital tissues and the most common extra-thyroid symptom of Graves’ disease. Management of GO is depends on the activity and severity of GO. Parenteral high-dose glucocorticoid (GC) are the first line treatment for sightthreatening GO.Case IllustrationA 55-year-old man came with complaints of redness, protruding, feeling stiff, pain, and blurredvision in both eyes since 3 days ago. Two months ago his both eyes started to get swollen,protruding, and wasn’t able to close completely. He had history of hyperthyroid. His visual acuitywas 6/60 on right eye and 1/300 on left eye, both palpebras were edematous, hyperemic,lagophthalmos, and exophthalmos. Both conjunctivas had chemosis and CVI, both corneas haderosions in inferior area, and there was restriction on both eye movements in all directions. OrbitalCT scan showed bilateral exophthalmos and enlargement of extraocular muscles. The patient washospitalized and got treatment of IV methylprednisolone 250 mg 4 times/day for 3 daysconsecutively. After 3 days, his visual acuity had improved to 6/20 on right eye and 6/60 on left eye,protrusion of eyes seems disappear gradually, there was minimal lagophthalmos still remaining,and both eye movements had improved in all gaze.DiscussionAdministration of parenteral GC showed improvements for treating sight-threatening GO in thiscase. Patient still on followed up to see whether the response was good and remains stable or thereare signs that orbital decompression is needed.ConclusionParenteral GC has a beneficial effect in the treatment of sight-threatening GO.KeywordGraves’ Ophthalmopathy, Sight-Threatening, Parenteral GlucocorticoidLatest UpdateMay 16, 2021StatusApproved As E-PosterFile Download304-EPOS-G-INANOS-14-Rania-Ayu-Permata-Putri-Kornia.jpg

212 E-POSTER

EPOS-R-INANOS-15BILATERAL PAPILLEDEMA AND PROGRESSIVE VISUAL LOSS IN A YOUNGOBESITY WOMAN MIMICKING IDIOPHATIC INTRACRANIAL HYPERTENSION: A CASE REPORT

Abstract TitleBILATERAL PAPILLEDEMA AND PROGRESSIVE VISUAL LOSS IN A YOUNG OBESITYWOMAN MIMICKING IDIOPHATIC INTRACRANIAL HYPERTENSION: A CASE REPORT

First Author: Farahdila Adline, dr

Author Institution: RSUD dr. Soetomo Surabaya - FK UNAIR Surabaya

Co Author:



Seminat: INANOS


IntroductionPapilledema defined as optic disc edema secondary to high intracranial pressure (ICP). Papilledemacannot exist in the absence of high ICP. The etiology for the high ICP or intracranial hypertensionmay be known (e.g., brain tumor, meningitis) or idiopathic.Case IllustrationA 21-year-old woman, BMI 31,25, had a sudden blurred vision on her eyes, narrowing the visualfield 2-months ago and complained of back pain, headache, nausea, and vomiting. VOD 6/6, VOS6/20 ph 6/8,5. RAPD +/+. Both posterior segments showed swollen optic disc with elevationhyperemic-blurred margin. OCT showed both eyes increase in RNFL thickness at inferior-superiornasal and increased macula thickness at nasal region. MRI found possibility high-gradeastrocytoma/glioblastoma at intraaxial supratentorial. Treatment was initiated withneuroprotection, steroid and operation were scheduledDiscussionChronically high ICP that caused papilledema can lead to permanent drop out of the nerve fiberlayer, resulting in progressive visual field loss and loss of central visual acuity. The main goals ofpapilledema treatment are alleviation of symptoms and preservation of vision. Pseudopapilledemamistaken for papilledema is a common reason for IIH misdiagnosis. Acute fulminant papilledemaand visual loss usually require urgent surgical intervention to prevent further irreversible outcome.The most common intra-axial glial tumor is glioblastoma, the most common and lethal primarycerebral neoplasm, typically affecting young and middle-aged.ConclusionAncillary test such as MRI is needed to exclude disease. We have to be more cautious, so we don’tmisdiagnose. The proper treatment is essential to achieve a better prognosis. Medical and surgicalmodalities provide options for treatment.Keywordpapilledema, idiophatic intracranial hypertension intraaxial tumorLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download665-EPOS-R-INANOS-15-Farahdila-Adline.jpg

213E-POSTER

EPOS-R-INANOS-16“A CHALLENGING DIAGNOSTIC IN DECREASED VISION: CAUSED BY OPTIC NEURITIS POST VACCINATION AND TOXIC OPTIC NEUROPATHY INDUCED BY ANTI-TUBERCULOSIS”

Abstract Title : “A CHALLENGING DIAGNOSTIC IN DECREASED VISION: CAUSED BY OPTIC NEURITIS POST VACCINATION AND TOXIC OPTIC NEUROPATHY INDUCED BY ANTI-TUBERCULOSIS”

Abstract Type : Case Report

Abstract Category : E-Poster

Seminat : INANOS

Competition Category : Resident

First Author : Astry Ayunda

Author Institution : Department of Ophthalmology, Faculty of Medicine Universitas Airlangga - Dr. Soetomo

General Hospital, Surabaya, Indonesia. Institution

Co Author :

Dr.dr.Lukisiari Agustini,.Sp.M(K) (Department of Ophthalmology, Faculty of Medicine Universitas Airlangga -

Dr. Soetomo General Hospital, Surabaya, Indonesia.)

Dr. dr, Wimbo Sasono, SpM(KVR) (Department of Ophthalmology, Faculty of Medicine Universitas Airlangga

- Dr. Soetomo General Hospital, Surabaya, Indonesia.) dr. Ima Yustiarini, SpM (Department of Ophthalmology,

Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Hospital, Surabaya, Indonesia.)

IntroductionOptic neuritis (ON) and toxic optic neuropathy (TON) have similar early symptoms. Commonly TON caused by anti-TB drugs, while ON in several cases are caused by post-vaccination. These conditions turn out to be a new case. CaseA 27-years-old male patient had blurry vision on both eyes since 1.5 months ago, it happened 2 days after got second dosage of vaccine (in Illustration Pandemic Era). He could not see an object from near/far and got headache, periocular pain. He had got cough for>4 months and diagnosed with TB. He consumed Isoniazid, Rifamicin, Ethambuthol, and Pirazinamid. After 2 months, he stopped consuming Ethambutol and Pirazinamid, but still consuming Isoniazid and Rifamicin. The result of sputum test is inactive. Spectacles history: RE S-2.00 and LE S-1.50, visual acuity: RE 1/60 PHNI and LE 2/60 PHNI. Anterior segment: isocor pupil RLE 3 mm, good light reflex, and negative RAPD. Posterior segment:fundus reflex positive with papil N II of blurry margin in superior, inferior, and nasal on RE, while in superior and inferior on LE. Hyperemia color and retinal hemorrhage on RLE. DiscussionOptic Neuritis post-vaccination in most cases are bilateral, with acute visual loss, periocular pain, visual field defects, the recovery of visual loss in several months and these symptoms are commonly the closest diagnostic in this case. ConclusionThe closest diagnostic in this case was optic neuritis post-vaccination. This new case needs further studies to support this disease, get the appropriate treatment and best outcome. KeywordBlurry Vision, Optic Neuritis, Toxic Optic Neuropathy

214 E-POSTER

EPOS-R-INANOS-17Diplopia As A Sign Of Oculomotor Nerve Palsy Due to Intracranial Aneurysma

Abstract TitleDiplopia As A Sign Of Oculomotor Nerve Palsy Due to Intracranial Aneurysma

First Author: RESTIANA HILDA ISLAMI

Author Institution: Departemen/KSM Ilmu Kesehatan Mata FK UNAIR-RSUD Dr. Soetomo

Co Author:

Lukisiari Agustini (Departemen/KSM Ilmu Kesehatan Mata FK UNAIR-RSUD Dr. Soetomo)

Gatot Suhartono (Departemen/KSM Ilmu Kesehatan Mata FK UNAIR-RSUD Dr. Soetomo)



Seminat: INANOS


IntroductionOculomotor nerve palsy is a rare neurological disorder associated with numerous underlyingpathologies. Aneurysm of the posterior communicating artery has been identified due to the closeassociation with the third cranial nerveCase IllustrationA 58-year-old woman came to the outpatient clinic complaining of sudden diplopia and ptosis since2 months ago. Ptosis and mydriasis was observed in her right eye.Patient also got headache in theright side. History revealed that she has aneurysm disease just found out 2 months ago. Visualacuity of the right eye was 6/20 pinhole no improvement and the left eye was 6/20 with pinholebecame 5/12. An ophthalmic examination revealed right mid-dilated 6 mm pupil did not react todirect light stimulus. From WFDT found suppression of right eye. Limited right ocular movement inall direction without lateral. MRI and MRA show aneurysm from the right posterior communicatingartery. Patient was given mecobalamin 2x500mg and manage to exercise her right eye.DiscussionOculomotor nerve palsy with pupillary involvement can result from a wide variety of factors. Themost common and life-threatening cause is intracranial. This case presented classic manifestationof oculomotor nerve palsy caused by aneurysm which manifests are diplopia with ptosis result incompression by an intracranial aneurysmConclusionAmong cranial nerve palsies,oculomotor nerve palsy is important. Despite all the causes,the mostcommon and life-threatening cause is an intracranial aneurysm. Appropriate and effective therapygives good result.KeywordOculomotor Nerve Palsy, Diplopia, AneurysmLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download79-EPOS-R-INANOS-17-Restiana-Hilda-Islami.JPG

215E-POSTER

EPOS-O-INANOS-18A Rare Case of Pediatric Optic Neuritis, is it Neuromyelitis Optica SpectrumDisorder or Multiple Sclerosis?

Abstract TitleA Rare Case of Pediatric Optic Neuritis, is it Neuromyelitis Optica Spectrum Disorder or Multiple Sclerosis?

First Author: ANINDITA WICITRA

Author Institution: FKUI - RSCM Kirana

Co Author: Syntia Nusanti (FKUI - RSCM Kirana)



Seminat: INANOS


IntroductionNeuromyelitis Optica Spectrum Disorder (NMOSD) is an inflammatory demyelinating diseaseaffecting the optic nerves, spinal cord, and other CNS regions. The purpose of this article is toreport a rare case of pediatric optic neuritis related to NMOSD or Multiple SclerosisCase IllustrationA 11y.o girl with complaint of blurry vision in the last 3 weeks before admission. Before it occurred,she felt weakness in her lower limb. She was also reported of having squint eyes, fever, episodes ofseizure, and history of unconsciousness. In physical examination, GCS was 15. Motor strength weredecreased in all extremities, with decreased physiological reflex and negative pathologic reflex. Inophthalmology examination, visual acuity in both eyes were NLP and ocular movement wererestricted. Both optics were atrophic. She was given high dose methylprednisolone but hercomplain did not resolved. Brain MRI showed white matter changes in both frontoparietal lobe,both lateral periventricular region, and left occipital lobe with suspected of demyelinating process.Cerebrospinal analysis showed normal result. Aquaporin-4 antibody and ANA examination alsorevealed negative result. She was diagnosed with NMOSD seronegative and planed to receiveplasmapharesis from pediatric department.DiscussionNMOSD is infrequent in children and characterized by recurrent episodes of optic neuritis,transverse myelitis, and brainstem syndrome. NMOSD was diagnose with core clinicalcharacteristic, MRI, and aquaporin4-IgG examination. Because NMOSD and anti-myelinoligodendrocyte glycoprotein (anti-MOG) syndrome have similar clinical manifestations andcharacteristic relapsing progression, they are commonly confounded with MSConclusionEarly diagnosis and adequate treatment of NMOSD may prevent disabilities, ecspecially in pediatricpatientKeywordNMOSD, optic atrophy, aquaporin-4Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download636-EPOS-O-INANOS-18--Anindita-Wicitra.jpg

216 E-POSTER

EPOS-R-INANOS-19Multiple cranial nerve paresis due to nasopharyngeal tumor

Abstract TitleMultiple cranial nerve paresis due to nasopharyngeal tumor

First Author: Ghulam Ahmad Mubaraq


Co Author:

Yunita Mansyur ()

Batari Todja Umar ()

Rani Yunita Patong ()



Seminat: INANOS


IntroductionOne of the presenting characteristics of benign or malignant tumors of the head and neck may becranial nerve paresis. The presence of multiple cranial nerves may be sequential or discrete,unilateral or bilateral. We present case of an underlying neoplasm which effect multiple cranialnerve Paresis.Case IllustrationA 58 year old male patient presented to the Hospital with symptoms of diplopia due to esotropia forthe six months, asymmetrical face, hypersalivation, numbness on the left side of the face, and Epistaksis that occurred nearly twice a week for one year, and weight loss. This patient’s MRI brain show a Nasopharyngeal mass extending into the intracranial space, mastoiditis, and nasal septaldeviation.Discussionlateral rectus muscle paralysis that produces diplopia and abduction deficit of the involved eye.While paralysis of the fifth nerve can lead to hypoesthesia of the portions of the face depended tothe location of involvement. Interestingly, our patient developed sixth nerve palsy, as an usuallyneuro-ophthalmic presentation for this tumor. In this case there are also symptoms that indicatedamage to Nerve X: motor disorders dysphagia and sensory disturbances.ConclusionMultiple nerve palsy caused by a nasopharyngeal tumor with clinical findings of paresis nerves III,VI, and X in this case report is highly dependent on the tumor’s position and anatomical pathwaysthat cause the patient’s symptoms. The use of a neuro imaging scan will help assess the location ofa lesion, as well as medical Status and treatment options.KeywordAnatomical nerve pathways, Multicranial nerve palsy, Nasopharyngeal tumors.Latest UpdateMay 17, 2021StatusApproved As E-PosterFile Download775-EPOS-R-INANOS-19--Ghulam-Ahmad-Mubaraq.jpg

217E-POSTER

EPOS-R-INANOS-20Internuclear Ophthalmoplegia Due to Lacunar Pontine Infarction

Abstract TitleInternuclear Ophthalmoplegia Due to Lacunar Pontine Infarction

First Author: Sarah Eisya Putri

Author Institution: University of Hasanuddin

Co Author: Yunita Mansyur (), Batari Todja Umar ()



Seminat: INANOS


IntroductionInternuclear Ophthalmoplegia (INO) is a horizontal gaze disorder that refers to a lesion in themedial longitudinal fasciculus (MLF). There is impaired adduction of the eye on the lesion’s side ofMLF with dissociated nystagmus of the contralateral abducting eye.Case IllustrationA 46-year-old man had acute onset of double vision five days prior with coexisting dizziness andvertigo two days before. Visual acuity was 20/20. The left eye had an adduction limitation, whereasthe fellow eye showed nystagmus when abducting. A Brain MRI showed a lacunar lesion in theposterior of the pons. He was observed and given a neuroprotection drug, then reported animprovement after two weeks. Diplopia was resolved within a month.DiscussionDisruption of the MLF on the left side of the mid-pontine causes discrete adduction in the left eye.The abduction fellow eye showed dissociated horizontal nystagmus as a compensatory response dueto the law of equal innervation of Herring’s Law. The patient had convergent dissociation thatdistinguished from third nerve palsy. Excessive innervation of the left medial rectus and itssynchronized muscle of the right lateral rectus caused intermittent exotropia, leading to diplopia ascomplained by the patient. In this case, INO was proved by a lacunar lesion in the posterior of thepons. The prognosis depends on the etiological causes.ConclusionInternuclear Ophthalmoplegia is a rare case. Pontine infarction is one of the most caused. There isno specific treatment for this disease. Neuroprotection drug may provide benefits for pontineinfarctionKeywordDiplopia, Internuclear Ophthalmoplegia, Lacunar Pontine InfarctionLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download291-Internuclear-Ophthalmoplegia-Due-to-Lacunar-Pontine-Infarction.pdf

218 E-POSTER

EPOS-R-INANOS-21Oral Steroid in Thyroid Eye Disease, The Effective Management in Covid Era

Abstract TitleOral Steroid in Thyroid Eye Disease, The Effective Management in Covid Era

First Author: Ade Marlina

Author Institution: USU

Co Author: Bobby Ramses Erguna Sitepu (USU)



Seminat: INANOS


IntroductionThyroid eye disease is a complex autoimmune disease characterized by inflammation of the orbital.Low immunity makes it easier to be exposed to covid-19. We report the management of thyroid eyedisease on the left eye by administering oral corticosteroids and maintaining follow-up records.Case IllustrationA 46 year old woman complaining about protruding of the left eye since 5 months, blurred vision,pain, red and watery eyes. She has had the history of thyroid disease for 10 years and it was undercontrol for the last 5 months. There was a decrease vision of 6/21, edema, proptosis, retraction ofthe superior palpebra, and limited left eye movement. During covid-19, the patient refused to behospitalized, was given oral corticosteroid therapy, and was regularly followed up. After 6 monthsof treatment, the complaints of blurred vision decreased, followed by better eyeball movement,reduced redness and swelling of the eye; decreased diplopia, but the proptosis still existed.DiscussionManagement of thyroid eye disease requires multidisciplinary approaches. Patient adherence playsan important role in increasing the effectiveness of thyroid eye disease treatment. The maintreatment goals are supportive and pharmacological. In active TED, whether mild or moderate tosevere, management including the use of corticosteroid which is known to have an inhibitory effecton the inflammatory response. The use of oral steroids during the Covid-19 pandemic was quiteeffective in active TED patients.ConclusionThe use of oral steroids in COVID-19 patients with active TED had effective outcome.KeywordThyroid eye disease, Oral steroid, Maintenance follow upLatest UpdateMay 17, 2021StatusSubmittedFile Download

219E-POSTER

EPOS-R-INANOS-22Right Gaze Palsy in Multiple Brainstem Lesion due to Metastatic Carcinoma

Abstract TitleRight Gaze Palsy in Multiple Brainstem Lesion due to Metastatic Carcinoma

First Author: Aswira Aslam


Co Author:

Yunita Mansyur (Universitas Hasanuddin)

Batari Todja Umar (Universitas Hasanuddin)



Seminat: INANOS


IntroductionGaze palsy infers to paresis of the abduction of the ipsilateral eye, simultaneously with theconjugate paresis of the adduction of the contralateral eye. Only a few cases reported of gaze palsyassociated with pontine metastasis.Case IllustrationA thirty-seven-year-old female with both eyes suddenly fixated to the left. Horizontal diplopia atnear and distance. Relative afferent pupillary defect was present on the right eye with primaryoptic disc atrophy. The brain magnetic resonance imaging revealed multiple nodular lesions invarious size followed by perifocal edema scattered over the cerebri, cerebellum through the ponsand medulla oblongata presumed as metastatic lesions.DiscussionA condition which both eyes isolated to the left caused by the lesion possibly in the rightparamedian pontine reticular formation (PPRF) through the right abduscens nucleus thatinterconnected to the contralateral oculomotor nucleus via the medial longitudinal fassiculus(MLF). Magnetic resonance imaging (MRI) permits high abstraction resolution and signal intensitydistinction. Multiple of more than three hypointense lesions specifically due to metastatic lesions.ConclusionGaze palsy may result in multiple brainstem lesion due to metastatic carcinoma. Tonically isolatedto the left gaze related to the lesion on the brainstem which specifically disturb the signal from theright PPRF that cause the contralateral oculomotor nucleus unable to work. The neuroimaging hadbecome the most valuable examination to locate the lesion. Multidisciplinary management isneeded to these such case.Keywordabducens nerve, brainstem metastatic lesions, gaze palsyLatest UpdateMay 17, 2021StatusSubmittedFile Download

220 E-POSTER

EPOS-R-INANOS-23Cytomegalovirus (CMV) Atypical Optic Neuritis in a Patient with HumanImmunodeficiency Virus/Acquired Immunodeficiency Syndrome (AIDS)

Abstract TitleCytomegalovirus (CMV) Atypical Optic Neuritis in a Patient with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (AIDS)

First Author: Tiara Bunga Indiarsih


Co Author: Devi Azri Wahyuni (Universitas Sriwijaya)



Seminat: INANOS


IntroductionOptic neuritis (ON) is an inflammation of the optic nerve with multifactorial causes and varies inclinical presentation, treatment, and prognosis. In typical ON, patients usually present with acutepain and unilateral vision loss with a good visual prognosis. Meanwhile, atypical ON leads to worseprognosis if not treated in a timely manner. Thus, early diagnosis and treatment of atypical ON areimportant. In this paper, we report a case of Cytomegalovirus (CMV) atypical neuritis optic in apatient with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS)Case IllustrationA 22-year-old male presented with sudden vision diminution and floaters in the left eye two weeksbefore admission, preceded by fever three weeks before admission. The patient has recurrent oralulcers for the last six months, along with frequent diarrhea and weight loss since the past year. Thepatient was diagnosed with HIV/AIDS and has been treated with antiretroviral therapy (ARV) sincethe past year. Ophthalmologic examination revealed visual acuity of 6/60(OD) and 2/60(OS),papilledema with undefined margins, peripapillary tortuous veins, and visual field defect on the lefteye. CMV IgG was reactive. A diagnosis of CMV atypical optic neuritis was made. The patient wastreated with high-dose oral methylprednisolone and oral valganciclovirDiscussionAtypical ON is usually associated with systemic diseases and commonly occurs in immunodeficientpatients. Treatment with high-dose methylprednisolone and valganciclovir aims to improve visualacuity and reduce the optic nerve inflammationConclusionEarly diagnosis, treatment, and follow-up are essential to improve the prognosis of atypical ONKeywordCytomegalovirus, HIV, Optic neuritisLatest UpdateMay 17, 2021StatusSubmittedFile Download

221E-POSTER

EPOS-R-INANOS-24Atypical Optic Neuritis with Third Cranial Nerve Involvement: A Case Report

Abstract TitleAtypical Optic Neuritis with Third Cranial Nerve Involvement: A Case Report

First Author: Meuthia Rana Amira P.


Co Author: dr. Syntia Nusanti SpM(K) (RSCM )



Seminat: INANOS


IntroductionAtypical optic neuritis with cranial nerve involvement is a rare form of optic neuritis. Managementof optic neuritis impacts clinical outcome. Here in, we report a rare case of recurrent atypical opticneuritis patient with cranial nerve involvement.Case IllustrationA 25-year-old female presented with sudden blurry vision and orbital pain of the right eye since 3days. Right eye were ptosis, slight exotropia, and diplopia with restricted eye movements, and bestcorrected visual acuity 6/6. Right optic disc was hyperemia with indistinct margin. Similar event ofthe left eye one year before. CT Scan result was diffuse thickening of right optic nerve, mild perineural fat stranding. Brain MRI shown hyperintense T2 lesion on left optic nerve with smallerdiameter compared to right optic nerve and normal brain. Intravenous methylprednisolone 1000mg for three days shown improvement and good recovery. We plan to evaluate Aquaporin-4antibody level.DiscussionWe presumed atypical optic neuritis due to optic disc edema, third cranial nerve involvement andrecurrent. Etiological factor might be associated Myelin Oligodendrocyte Glycoprotein Antibody(Anti-MOG), as female with optic disc edema, cranial nerve involvement, recurrence and goodvisual recovery. Other possible etiolgy is Neuromyelitis Optica Spectrum Disorder (NMOSD),because she had nausea and recurrency. However, she had ocular muscle weakness that could becoincidence of NMOSD and Myasthenia Gravis (MG). Treatment of acute atypical optic neuritis ishigh dose intravenous methylprednisolone.ConclusionComprehensive management and determining etiological factor are important in atypical opticneuritis. Acute treatment with high dose steroid intravenous obtained good outcome.KeywordAtypical optic neuritis; cranial nerve involvement; oculomotor palsyLatest UpdateMay 17, 2021StatusSubmittedFile Download

222 E-POSTER

EPOS-R-INANOS-25Recurrent Migraine with Binocular Amaurosis Fugax Associated with AcuteHemorrhagic Stroke Attack : A Case Report

Abstract TitleRecurrent Migraine with Binocular Amaurosis Fugax Associated with Acute HemorrhagicStroke Attack : A Case Report

First Author: Nabita Aulia

Author Institution: PERDAMI Sulawesi Selatan

Co Author:

Yunita Mansyur (Department of Ophthalmology, Faculty of Medicine, Hasanuddin University)

Batari Todja Umar (Department of Ophthalmology, Faculty of Medicine, Hasanuddin University)

Anastasia Vanny Launardo (Department of Ophthalmology, Faculty of Medicine, Hasanuddin University)



Seminat: INANOS


IntroductionWe report a very rare case of recurrent migraine with binocular amaurosis fugax followed by acutehemorrhagic stroke attackCase IllustrationA 45-year-old male with uncontrolled hypertension and diabetes mellitus presented to the eye clinicwith acute episodic binocular vision loss with spontaneous complete recovery in about 5-10 minutesthree days ago. He also had headaches, nausea, and vomiting. Initially, he was diagnosed withrecurrent migraine attacks until he had a vision loss attack once for 5 minutes. He was immediatelyreferred to the hospital for an MRI-Scan and laboratory workup. While waiting for the results, hehad a seizure and went unconscious. His MRI showed encephalomalacia post hemorrhagic in theright internal capsule and minimal subarachnoid hemorrhage. Laboratory results revealed a veryhigh blood sugar level. Funduscopy examination indicated signs of hypertensive retinopathy. Thepatient was diagnosed with bilateral amaurosis fugax due to hemorrhagic stroke and hypertensiveretinopathy. He was treated by neurologist and 3 days after discharge, he came to the eye clinicwith visual acuity of 20/25 in both eyes and tunnel vision on the left eyeDiscussionAmaurosis fugax usually associate with ischemic stroke, rather than hemorrhagic stroke.Concomitant occluded or narrowed proximal internal carotid artery which is caused byuncontrolled hypertension and diabetes mellitus may increase the risk of subsequent stroke in thispatientConclusionRecurrent migraine with binocular transient vision loss can develop into acute hemorrhagic strokeattacks. Urgent evaluation can be an eye saving for this patientKeywordAmaurosis fugax, migraine, strokeLatest UpdateMay 17, 2021StatusSubmittedFile Download

223E-POSTER

EPOS-G-INANOS-26Fellow Eye Involvement in Hypercoagulable State Patient with Non-ArteriticIschemic Optic Neuropathy : A Case Report

Abstract TitleFellow Eye Involvement in Hypercoagulable State Patient with Non-Arteritic IschemicOptic Neuropathy : A Case Report

First Author: Rasyidia Laksmita Putri

Author Institution: Research Assistant, Ophthalmology Department, RSCM Kirana, Jakarta

Co Author:

Dearaini (Research Assistant, Ophthalmology Department, RSCM Kirana, Jakarta)

Rianti Wulandari Pratiwi (Research Assistant, Ophthalmology Department, RSCM Kirana, Jakarta)

Dhiny Lidhinillah (Research Assistant, Ophthalmology Department, RSCM Kirana, Jakarta)

Syntia Nusanti (Ophthalmologist, Neuro-ophthalmology Department, RSCM Kirana, Jakarta)



Seminat: INANOS


IntroductionThe incidence of fellow eye involvement in non-arteritic anterior ischemic optic neuropathy(NAION) is 15% at 5 years after initial onset, although risk factors have not been identified.Case IllustrationA 72 year-old male presented with painless vision loss in left eye for 3 months. He didn’t havesmoking habit. BCVA on left eye (LE) was 3/60 and RAPD was present. Funduscopic examinationshowed optic disc atrophy on LE. Humphrey test revealed altitudinal pattern on LE with visual fieldindex (VFI) 63%. OCT and OCTA showed significant retinal nerve fiber layer thinning and poorcapillary perfusion on LE. Right eye (RE) was normal. Laboratory examination indicated diabetesmellitus, dyslipidaemia, and hypercoagulable state. He was prescribed antidiabetic medication,antithrombotic therapy, and statin. After a month, patient showed improvement in both ocular andlaboratory examinations. He was advised to continue treatment until the next visit, but he didn’tcomply. Two months later, patient was presented with painless vision loss, edematous optic disc,and altitudinal visual field defect in RE. Laboratory examination also revealed unsatisfactoryresults.DiscussionPrior studies discovered that hypercoagulable states potentially contribute to NAION, presumablydue to altered blood viscosity, which further leads to vascular occlusion. Our case showcasedhypercoagulable state patient with increased d-Dimer and fibrinogen level. Antithrombotic therapywas found beneficial to improve patient’s symptoms. However, he didn’t comply to therapy, thusvision loss of the fellow eye occurred.ConclusionManaging risk factors and patient’s compliance are crucial to halt disease severity and to preventNAION involvement in fellow eye.KeywordNAION, ischemic optic neuropathy, fellow eye NAIONLatest UpdateMay 17, 2021StatusSubmittedFile Download

224 E-POSTER

EPOS-R-INANOS-27COMPLETE UNILATERAL OCULOMOTOR NERVE PALSY WITH PUPILLARYINVOLVEMENT AS MANIFESTATION OF CRANIAL BASED MENINGIOMA

Abstract TitleCOMPLETE UNILATERAL OCULOMOTOR NERVE PALSY WITH PUPILLARYINVOLVEMENT AS MANIFESTATION OF CRANIAL BASED MENINGIOMA

First Author: Lina Shabrina Qorib S.


Co Author:

Rusti H. Sari (National Eye Center Cicendo Eye Hospital)

Antonia Kartika (National Eye Center Cicendo Eye Hospital)

Dianita V. Ginting (National Eye Center Cicendo Eye Hospital)



Seminat: INANOS


IntroductionOculomotor nerve palsy is a pathology resulting from damage to the third cranial nerve and mightbe complete or partial, with or without pupillary involvement. The involvement of the pupillaryfunction might indicate the presence of a life-threatening condition. This case report is aimed todescribe the best approach to find the associated etiology of unilateral complete oculomotor nervepalsy with pupillary involvement.Case IllustrationA 26-year-old man came with a chief complaint of drooping of the right eyelid for six days.Abnormal position and double vision of the eye were present in the past two weeks. No history oftrauma nor systemic conditions. The visual acuity of both eyes was 1.0 with the primary position of7 degree of exotropia. Right ocular motility showed a reduction of motion to superior, inferior andmedial with no pain accompanied with upper eyelid ptosis. CT of head and orbits showed a30x30x15 mm solid mass suspected a cranial based meningioma around sella turcica, rightparasellar,suprasellar, and clivus. CT angiography (CTA) was within normal limits.DiscussionLesion in the subarachnoid space may produce complete or partial palsy with or without pupillaryinvolvement. Complete oculomotor nerve palsy with pupillary involvement has the highest risk of acompressive lesion as its etiology thus best assessed through magnetic resonance imaging (MRI)and magnetic resonance angiography (MRA)/CTA.ConclusionDeep anamnesis, complete ocular evaluation along with appropriate imaging examination isessential to find the etiological factor of oculomotor nerve palsy.Keywordoculomotor palsy, pupillary involvement, CT angiographyLatest UpdateMay 17, 2021StatusSubmittedFile Download

225E-POSTER

EPOS-O-INANOS-29 Recurrent Optic Neuritis in Suspected Multiple Sclerosis Patient

Abstract TitleRecurrent Optic Neuritis in Suspected Multiple Sclerosis Patient



Co Author: M. Sidik (FKUI - RSCM Kirana)



Seminat: INANOS


IntroductionMultiple sclerosis is a chronic inflammatory neurological disorder of the central nervous system. The aim of this article is to report about recurrence optic neuritis in suspected multiple sclerosis patientCase IllustrationA 42 y.o. female came with complain of blurry vision in her LE since 1 month. History of fever andflu like symptoms were denied. She underwent same complain 2.5 years ago where she got blurryvision in her RE. ANA result was positive 1/1000 at that time. She got methylprednisolone andmethotrexate, then her complaint was getting better. In ophthalmology examination, her VA in LEwas 2/60 and 6/9 in RE. RAPD was positive in her LE. Slit lamp examination showed normofundusin both eyes. Humprey examination showed paracentral scotoma. Pelli-Robson contast sensitivitywas 1.65 (OD), 1.35 (OS), and 1.65 (BE). Ishihara test was 28/38 plate in RE and LE. Brain MRIshowed white matter changes in periventricular, centrum semiovale, and subcortical area. Patientthen consulted to Neurology Department to evaluate the possibility of Multiple Sclerosis andAquaporin-4 IgG examination. She was given methylprednisolone in immunosuppression dose. Intwo weeks follow up, the visual acuity improved into 6/12 in RE and 6/18 in LE. Ishihara andcontrast sensitivity examination also showed improving result.DiscussionOptic neuritis is an acute inflammatory demyelinating disease of the optic nerve. It typically canoccur in association with multiple sclerosisConclusionDiagnosis of recurrent optic neuritis can be challenging. Treatment of multiple sclerosis should bemade by experts from a multidisciplinary teamKeywordOptic neuritis, Reccurent, Multiple SclerosisLatest UpdateMay 17, 2021StatusSubmittedFile Download

226 E-POSTER

EPOS-R-INANOS-30Successful External Manual Carotid Compression in Direct Carotid Cavernous Fistula

Abstract TitleSuccessful External Manual Carotid Compression in Direct Carotid Cavernous Fistula

First Author: Mia Nursalamah


Co Author:

Antonia Kartika (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Rusti Hanindya Sari (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Dianita Veulina Ginting (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)



Seminat: INANOS


IntroductionCarotid Cavernous Fistula (CCF) arises from abnormal connections between the carotid artery andthe cavernous sinus. Besides trauma, direct CCF may be caused by rupture of Internal CarotidArtery (ICA) aneurysm within the cavernous sinus. The rate of spontaneous closure in direct CCFwas reported about 1.2–4%. This case report shows a clinically improvement of direct CCF byexternal manual carotid compression (EMCC).Case IllustrationA 38-year-old female complained double vision, redness and swelling of her right eye (RE),headache, and heard of whooshing sound since 2 months before. The visual acuity was 0.32. Therewere episcleral injection, ophthalmoplegia, bruit, upper right face hypaesthesia and raisedintraocular pressure on RE. She had medication for hypertension and diabetes mellitus, no historyof trauma. The Computed Tomography Angiography revealed Type A CCF according to BarrowClassification. She received medication and instructed to perform EMCC while waiting for DigitalSubstraction Angiography + Coiling and Ballooning by Neurosurgery Department. She admittedsubjective decreased in eyelid swelling, improvement of lateral ophthalmoplegia and visual acuitybecame 0.8 in 2 weeks.DiscussionOphthalmologist can be the first who diagnose CCF by ophthalmological signs and symptoms, andthen gives initial treatment related. EMCC is one of the supporting management in direct CCF thatmight reduce some clinical symptoms. It should be performed carefully and under supervision.ConclusionThe mainstay treatment for direct CCF is endovascular treatment because the spontaneouslyresolved is rare, but EMCC can be considered carefully while waiting for further intervention.Keywordcarotid cavernous fistula, direct, external manual carotid compressionLatest UpdateMay 17, 2021StatusSubmittedFile Download

227E-POSTER

EPOS-G-INANOS-31Five Years Descriptive Study of Optic Atrophy Among Patients Admitted inTertiary Care Hospital

Abstract TitleFive Years Descriptive Study of Optic Atrophy Among Patients Admitted in Tertiary Care Hospital

First Author: Budi Santoso Nong Ulir

Author Institution: Faculty of Medicine Mulawarman University

Co Author: Nur Khoma Fatmawati (Departement of Ophtalmology, Faculty of Medicine Mulawarman

University) Nataniel Tandirogang (Departement of Microbiology, Faculty of Medicine Mulawarman

University)



Seminat: INANOS


Introduction & ObjectiveOptic atrophy is the end process of a disease that causes degeneration of axons along the pathwayto the lateral retinogeniculate bodies. Previous studies regarding the optic atrophy have haddifferent results. This study was conducted to describe of optic atrophy patients at Abdul WahabSjahranie Hospital Samarinda in 2015-2020.MethodThis retrospective descriptive study was conducted in February 2021. Data were obtained from 64patients who admitted to Abdul Wahab Sjahranie Hospital, Samarinda.ResultThis study found that the most common types of optic atrophy were secondary optic atrophy with20 patients (83,3%). The highest age group of patients with optic atrophy was the 45-55 yearsgroup with 17 patients (26.6%). The most prevalent gender was male as many as 37 patients(57.8%). Eyes affected by optic atrophy were bilateral with 34 patients (53,1%). Most of thepatients with optic atrophy had visual acuity below 3/60 or experienced blindness with 52 eyes(57,8%). Eye disease was the most comorbid group with a total of 29 patients (37,2%). The mostcomorbidities were retrobulbar neuritis with 11 patients (14,1%).ConclusionOptic atrophy patients at Abdul Wahab Sjaharanie Hospital from 2015-2020 found that secondarytype, bilateral, male, 45-55 years old age group, blind vision and comorbid retrobulbar neuritiswere the most frequent occurrencesKeywordoptic atrophy, neuritis retrobulbarLatest UpdateMay 17, 2021StatusSubmittedFile Download

228 E-POSTER

EPOS-R-INANOS-32A PECULIAR CASE: UNILATERAL OCULAR ISCHEMIC SYNDROME

Abstract TitleA PECULIAR CASE: UNILATERAL OCULAR ISCHEMIC SYNDROME

First Author: Whisnu Bambang Jatmiko

Author Institution: FKUI-RSCM Kirana

Co Author: Syntia Nusanti (FKUI-RSCM Kirana)



Seminat: INANOS


IntroductionThe variety of clinical findings make it difficult to diagnose eye involving vascular disorders, whichis a challenge in patients with the ocular ischemic syndrome (OIS).Case IllustrationMale, 57 years old, with proptosis and sudden blurry vision of the right eye since four days. Thepatient had a history of cardiac stent insertion and is currently on systemic medication. Right eyevisual acuity was no light perception with intra-ocular pressure 17 mmHg, ptosis, limited eyemovement to all directions, chemotic, large corneal epithelial defect without decreased sensibility,full hyphema, and the posterior segment was difficult to assess. Left eye was within normal limit.Cerebral CT-angiography and Doppler ultrasound revealed stenosis of the right anterior cerebralartery and caliber narrowing of the right internal carotid and vertebral artery compared with theleft. Patient also underwent irrigation and aspiration of hyphema.DiscussionOIS is a hypoperfusion disorder to the eye due to atherosclerosis of the internal carotid arteriesthrough central retinal, posterior and anterior ciliary arteries, which may cause anterior and/orposterior segment ischemia, iris neovascularization, and optic nerve damage. Collaborativemanagement between departments is crucial because untreated condition can lead to higher rate ofmulti-organ morbidity and mortality, systemic therapy such as anti-hypertension, anticoagulant,antithrombotic must be given to prevent further damage and support the success of therapy.ConclusionVascular stenosis, which often causes ischemia, can be observed at the early onset of signs throughthe eye. With good knowledge and multi-department collaboration, mortality can be prevented.KeywordOcular ischemic syndrome; OIS; ocular hypoperfusionLatest UpdateMay 17, 2021StatusSubmittedFile Download

229E-POSTER

EPOS-R-INANOS-33A PRESENTATION OF PSEUDO-FOSTER KENNEDY SYNDROME INUNDIAGNOSED DIABETES MELLITUS AND DYSLIPIDEMIA

Abstract TitleA PRESENTATION OF PSEUDO-FOSTER KENNEDY SYNDROME IN UNDIAGNOSEDDIABETES MELLITUS AND DYSLIPIDEMIA

First Author: Sri Hudaya Widihastha

Author Institution: Department of Ophthalmology, National Eye Center Cicendo Eye Hospital/Universitas


Co Author:

Rusti Hanindya Sari (Neuro-ophthalmology Unit, National Eye Center Cicendo Eye Hospital,

Bandung), Antonia Kartika (Neuro-ophthalmology Unit, National Eye Center Cicendo Eye Hospital,

Bandung), Dianita Veulina (Neuro-ophthalmology Unit, National Eye Center Cicendo Eye Hospital, Bandung)



Seminat: INANOS


IntroductionPseudo-Foster Kennedy Syndrome is described as unilateral optic disc swelling with contralateraloptic atrophy in the absence of an intracranial mass. We report a case of Pseudo-Foster Kennedysyndrome in patient with untreated diabetes mellitus (DM) and dyslipidemia.Case IllustrationA 54-year-old male came with a chief complaint of painless blurred vision in the left eye (LE)started one week ago and in the right eye (RE) started two months ago. He has had history oftreated hypertension since 10 years ago. Visual acuity of the RE was 2/60 and LE was 0.63. Relativeafferent pupillary defect was observed on the RE. The funduscopy examination revealed optic discpallor on the RE and optic disc swelling with peripapillary hemorrhage on the LE. Opticalcoherence tomography (OCT) showed retinal nerve fiber layer (RNFL) thinning on the RE andthickening on the LE. Laboratory examination showed fasting and two hours post prandial bloodsugar level of 290 mg/dl and 440 mg/dl, respectively. Total cholesterol were 310 mg/dl. Magneticresonance imaging showed there was no signs of cerebral infarct or space occupying lesion. Patientwas diagnosed with Pseudo-Foster Kennedy Syndrome caused by ischemic optic neuropathy.Further management was systemic regulation and neuroprotective agent.DiscussionPseudo-Foster Kennedy Syndrome typically occur due to bilateral sequential non-arteritic anteriorischemic optic neuropathy (NAION). Identification of risk factors associated with NAION such asDM and dyslipidemia is mandatory. The most important management in NAION is modification ofsystemic risk factors.ConclusionPseudo-foster Kennedy Syndrome may occur due to uncontrolled systemic disease.KeywordPseudo-foster Kennedy Syndrome, diabetes mellitus, non-arteritic anterior ischemic opticneuropathyLatest UpdateMay 17, 2021StatusSubmittedFile Download

230 E-POSTER

EPOS-R-INANOS-34RADIATION-INDUCED OPTIC NEUROPATHY (RION) : A POSSIBLE OPTICNEUROPATHY FINDING ENCOUNTERED IN PATIENT WITHNASOPHARYNGEAL CARCINOMA

Abstract TitleRADIATION-INDUCED OPTIC NEUROPATHY (RION) : A POSSIBLE OPTIC NEUROPATHYFINDING ENCOUNTERED IN PATIENT WITH NASOPHARYNGEAL CARCINOMA

First Author: Andreas Lukita Halim

Author Institution: Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung,

Indonesia

Co Author:

Antonia Kartika (Indonesia National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Rusti Hanindya Sari (Indonesia National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Dianita Veulina Ginting (Indonesia National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)



Seminat: INANOS


IntroductionRadiotherapy is the classic treatment for nasopharyngeal carcinoma (NPC). However, due to thetumor anatomical location, cumulative radiation doses may cause harm to the eyes. Here wedescribe a case report of possible radiation-induced optic neuropathy (RION) in NPC patient whohave completed the radiotherapy regiment.Case IllustrationA 26-years-old male came with bilateral, gradual, painless blurred vision with history of NPC (stageT4N3Mx). He had completed radiotherapy and chemotherapy, 10 months and 1 month before thesymptoms respectively. Ophthalmologic examination showed VA RE 1/60, LE 0.125, decreased bothpupillary reflexes, decreased colour and contrast sensitivity, and bilateral optic disc swelling fromfunduscopy. No tumor metastasis from the imaging.DiscussionRION is a rare side effect of radiotherapy, but quite common occurred in NPC patients. It usuallypresents after a latency period of months to years after the radiation. The pathophysiology of RIONis still explored in depth, but the proposed mechanism is related to radiation necrosis that damagethe vascular endothelium and neuroglial progenitor cells. The vascular injury causes ischemia andretinal exudative vasculopathy, whereas the neuroglial injury leads to demyelination andsubsequent optic nerve degeneration. Diagnosis of RION is challenging, but it is usually made byexclusion of tumor infiltration to the optic nerve.ConclusionRION should be considered as a possible cause of ophthalmic symptoms in all NPC patients whounderwent radiotherapy. With advances in NPC management today, patients’ survival rate may beprolonged, therefore early ophthalmologic investigation is an essential thing.Keywordradiation-induced optic neuropathy, nasopharyngeal carcinoma, radiotherapyLatest UpdateMay 17, 2021StatusSubmittedFile Download

231E-POSTER

EPOS-R-INANOS-35ORBITAL APEX SYNDROME WITH CAROTID CAVERNOUS FISTULA ANDBELL’S PALSY: AN UNUSUAL MANIFESTATION OF HERPES ZOSTER OPHTHALMICUS

Abstract TitleORBITAL APEX SYNDROME WITH CAROTID CAVERNOUS FISTULA AND BELL’S PALSY:AN UNUSUAL MANIFESTATION OF HERPES ZOSTER OPHTHALMICUS

First Author: Tommy Tri Atmaja

Author Institution: 1Departement of Ophthalmology, National Eye Center Cicendo Eye Hospital/ Universitas


Co Author:

Antonia Kartika (Neuro-ophthalmology Unit, National Eye Center Cicendo Eye Hospital, Bandung)

Rusti Hanindya Sari (Neuro-ophthalmology Unit, National Eye Center Cicendo Eye Hospital,

Bandung)

Dianita Veulina (Neuro-ophthalmology Unit, National Eye Center Cicendo Eye Hospital, Bandung)



Seminat: INANOS


IntroductionThe neurological complication associated with Herpes Zoster Ophthalmicus (HZO) has beenreported widely. It may include encephalitis, cranial nerve palsy, partial or completeophthalmoplegia, and vascular disease. We present a case of HZO complication with unusualmanifestation that include orbital apex syndrome, carotid-cavernous fistula (CCF), and bell’s palsy.Case IllustrationA 40-year-old male came with a chief complaint of droopy right eyelid, accompanied by blurred,double vision, and wheezing sound on the right eye for 3 month ago. Twelve weeks prior of hissymptom, the patient was diagnosed with HZO by an ophthalmologist. The patient has no history oftrauma and hypertension disease. The visual acuity and intraocular pressure in the right eye were20/50 and 24 mmhg, respectively, and within normal limit in the left eye. Examination on the righteye showed proptosis with corkscrew appearance, ophthalmoplegia, optic disc swelling, andperipheral facial nerve palsy on the right side. We gave corticosteroid therapy of 64 mg orally oncea day and it showed clinical improvement within 3 weeks.DiscussionExtensive inflammation around ciliary nerves and vessels in HZO, can causes orbital apex syndromedue to compression of orbital fat edema, vessels fistula due to vasculopathy, and facial nerve palsydue to affection of petrosal nerve. Systemic corticosteroid still the mainstay treatment ofophthalmoplegia in HZO.ConclusionThe appropriate diagnose of neurological complication in HZO is important and require furtherinvestigation.KeywordOrbital apex syndrome, Bell’s palsy, carotid-cavernous fistulaLatest UpdateMay 17, 2021StatusSubmittedFile Download

232 E-POSTER

EPOS-R-INANOS-36Multidisciplinary Approach for Sight-Threatening Graves’ Ophthalmopathy ina Multimorbid Patient : A Case Report

Abstract TitleMultidisciplinary Approach for Sight-Threatening Graves’ Ophthalmopathy in a Multimorbid Patient : A Case Report

First Author: Firdha M. Fauzia

Author Institution: Department of Ophthalmology, Faculty of Medicine University of Indonesia, Dr. Cipto

Mangunkusumo Hospital, Jakarta, Indonesia

Co Author: Syntia Nusanti (Division of Neuro-Ophthalmology, Department of Ophthalmology, Faculty of

Medicine University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia )

Yunia Irawati (Division of Plastic and Reconstructive Surgery, Department of Ophthalmology, Faculty

of Medicine University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia), Salmarezka

Dewiputri (Division of Neuro-Ophthalmology, Department of Ophthalmology, Faculty of Medicine University

of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia ), Dicky L. Tahapary (Division of

Endocrine and Metabolism, Department of Internal Medicine, Faculty of Medicine University of Indonesia, Dr.

Cipto Mangunkusumo Hospital, Jakarta, Indonesia), Irwan Ramli (Department of Radiation Oncology, Faculty

of Medicine University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia)



Seminat: INANOS


IntroductionSight-threatening Graves’ Ophthalmopathy (GO) is an emergency condition that needs immediate: treatment. This report aims to describe the management of sight-threatening GO in a multimorbid: patient.Case IllustrationA 56-year-old male presented with pain and protruded left eye (LE). He was diagnosed with GO and had been already treated with intravenous methylprednisolone (IVMP) from the previous hospital. The patient has a history of hypertension, diabetes, cardiac disease, and second-hand smoke. He was diagnosed with active sight-threatening GO due to severe corneal defect and Graves’ disease. Orbital scan showed bilateral thickening of recti muscles with proptosis of the LE, while laboratory showed hypothyroid. He was admitted to receive 500 mg of IVMP for 3 days, meanwhile, medication and anchoring suture of LE was done to protect the cornea. Subsequently, he underwent orbital decompression of the LE and blepharotomy for both eyes. Despite the excellent results, his condition relapsed one month later. He was re-admitted for 12 cycles of IVMP followed by orbital radiotherapy with a total dose of 20 Gy/10-fraction. The condition was improved after completion of radiotherapy cycles along with oral methylprednisolone.DiscussionRestoration of euthyroidism and avoid smoke exposure are imperative in the presence of GO. Firstline management of sight-threatening GO is high-dose intravenous glucocorticoid with immediate orbital decompression. Due to steroid partial response, orbital radiotherapy combined with oral glucocorticoid was chosen as a second-line treatment according to multidiscipline consideration.ConclusionIn managing a case of sight-threatening GO, collaboration of ophthalmologists, endocrinologists,and radiation oncologists is compulsory to achieve satisfying results.KeywordSight-threatening Graves’ ophthalmopathy, orbital decompression, orbital radiotherapyLatest UpdateMay 17, 2021StatusApproved As E-PosterFile Download553-EPOS-R-INANOS-36-Firdha-M.-Fauzia.jpg

233E-POSTER

EPOS-R-INANOS-37Management of Atypical Optic Neuritis in Children with History of Traumaand Tuberculosis Disease

Abstract TitleManagement of Atypical Optic Neuritis in Children with History of Trauma and Tuberculosis Disease

First Author: Amanda Riza


Co Author: Bobby Ramses Erguna Sitepu (Universitas Sumatera Utara)



Seminat: INANOS


IntroductionOptic Neuritis (ON) is an acquired disorder of the optic nerve due to inflammation anddemyelination which presented with acute onset unilateral/bilateral visual loss. An-ON-conditionusually presented feature of multiple sclerosis, eventhough other etiology can be an underlyingcondition. In children, optic neuritis tend to occur bilaterally.Case IllustrationA 9 year old girl came to the hospital with sudden visual loss in both eyes as chief complaint. Thevisual loss suffered one week before with orbital pain and headache. History of trauma was found.History of tuberculosis disease was found. From the examination, visual acuity in both eyes 1/300.The eyes position was orthotropia, but pain in eye movement. The anterior segment was withinnormal limit except light reflex with RAPD (+) in both eyes. The posterior segment was found ahyperemic and swollen optic disc from fundus photography examination. Color vision test withFarnsworth-Munsell test was found dyschromatopsia in the yellow-blue axis. Laboratory and chestx-ray examination within normal limits.DiscussionOptic neuritis (ON) is an acquired disorder of the optic nerve due to inflammation anddemyelination which presented with acute onset unilateral/bilateral visual loss and associated withocular pain and dyschromatopsia. Optic neuritis in children is often seen after infection. Bacterialinfection can also produce optic neuritis. After intravenous and oral corticosteroids treatment, thevisual acuity became 6/7.5 and color perception became normal in both eyes in 5 months.ConclusionIntravenous and oral corticosteroids therapy in children with atypical optic neuritis is effective torecover visual acuity and color perception.KeywordOptic neuritis, RAPD, CorticosteroidsLatest UpdateMay 17, 2021StatusSubmittedFile Download

234 E-POSTER

EPOS-O-INANOS-38A Case of Pediatric Pineal Region Tumor Manifest as a Parinaud Syndrome

Abstract TitleA Case of Pediatric Pineal Region Tumor Manifest as a Parinaud Syndrome



Co Author: Salmarezka Dewiputri (FKUI - RSCM Kirana)



Seminat: INANOS


IntroductionParinaud syndrome (PS) consist of supra-nuclear vertical gaze palsy caused by damaged of theposterior commissure of the dorsal midbrain by any pathological lesion. The purpose of this articleis to report about clinical symptoms of PS in patient with pineal region tumor.Case IllustrationA 9 y.o boy came to our policlinic with complain of difficulties to look upward. Patient with historyof double vision, headache, vomiting, and seizure for 2 months before admission. He went topediatric doctor and underwent brain MRI, and the result was heterogen mass with solid and cystcomponent size 2.0 x 2.5 x 2.4cm, with calcification and hemorrhage within pineal region. Therewas also enlargement of both lateral and third ventricles with the periventricular edema. Then hewas consulted to the neurosurgery and oncology hematology from pediatric department. Onophthalmology examination, visual acuity with correction was 6/6 in RE and 6/12 in LE. Theposition was orthophoria. His eye movement were restricted to superior, superonasal andsuperotemporal. Convergence nystagmus and light near dissociation were positive. Anterior andposterior segment were good in both eyes, but light reflexes were negative and RAPD was hard tobe evaluated. Humprey examination showed unilateral blind spot enlargement in his LE.DiscussionParinoud syndrome is characterized by difficulties of conjugate up gaze, convergence-retractionnystagmus, and light-near dissociation of pupils. The most common symptoms were blurry vision,visual field defect, and diplopiaConclusionComprehensive examinations are needed to confirm the diagnosis of PS. The treatment isprincipally focused to the primary cause.KeywordParinoud syndrome, pineal region tumor, pediatricLatest UpdateMay 17, 2021StatusSubmittedFile Download

235E-POSTER

EPOS-O-INANOS-39CAVERNOUS SINUS THROMBOSIS (CST) : A CASE REPORT

Abstract TitleCAVERNOUS SINUS THROMBOSIS (CST) : A CASE REPORT

First Author: FRANCISCUS ASSISI TIMMY BUDI YUDHANTARA

Author Institution: RS St. Carolus

Co Author:

Fadima Fitri Larasati (RS St. Carolus)

Adrian Bamby Sutrisno (RS St. Carolus)

Silvester Christanto (RS St. Carolus)



Seminat: INANOS


IntroductionSeptic cavernous sinus thrombosis (CST) is a rare but serious complication of infection of thecavernous sinuses. The source of infection, the likely causative organism(s) and therefore the mostappropriate choice of antibiotics, underlying medical condition(s), and the need for surgicaltreatment are important to be considered when managing these patients. Potential therapy includesantibiotics, corticosteroids, anticoagulation, and surgical intervention for source control of theinfection.Case IllustrationMale, 43 y.o, was referred to our hospital with a history of swelling in his RE, decreased vision,fever, and headache. No history of systemic disease. A history of alcohol consumption and hasreceived treatments form previous hospital. Examination shows VOD NLP, VOS 20/30. Proptosis,blepharoptosis, impaired eye movement, pale papil, and RAPD were found on RE, with numbness inthe temporal area of the RE. The LE was normal. Laboratory examination, CT-Angiography, andhead CT-Scan were performed on this patient.DiscussionThe cavernous sinus is located posterior to the optic canal and superior to the orbital fissure,adjacent to the internal carotid artery and CN III, IV, V, VI. Infection or thrombosis in this area canproduce symptoms of ptosis, ophthalmoplegia, diplopia, paresthesia of the orbital region of theaffected side, and impaired drainage of the inferior ophthalmic vein which can lead to proptosis.Administration of antibiotics, anticoagulants have a positive effect.ConclusionCST is a fatal condition because it threatens life and vision. Antibiotic and anticoagulant therapyprovides benefits, supported by a fast and accurate diagnosis.Keywordcavernous sinus thrombosisLatest UpdateMay 17, 2021StatusSubmittedFile Download

236 E-POSTER

EPOS-G-INANOS-40An Optic Nerve Avulsion Due to A Gun Shot Injury: A Case Report

Abstract TitleAn Optic Nerve Avulsion Due to A Gun Shot Injury: A Case Report

First Author: IlmahAuthor Institution: Emergency Department RSPAD Gatot Soebroto

Co Author:

Ariawan Priguna (Ophthalmology Department RSPAD Gatot Soebroto)

Puranto Budi Susetyo (Ophthalmology Department RSPAD Gatot Soebroto)



Seminat: INANOS


IntroductionTo present a rare case of optic nerve avulsion due to gun shot injury.Case IllustrationA 30-year-old man presented with sudden visual loss on the Right Eye (RE) after a gun shot on hisleft frontal bone. Hematoma, edema periorbital were presented on both eyes. There’s conjunctivalchemosis on the RE. RE visual acuity was NLP, pupil was dilated and nonreactive to light. Left eye’svisual acuity was 1.0, other examinations was normal. B-scan USG of the RE showed hyperechoicimage on the retinal projection in front of the optic nerve. CT-scan showed multiple metal densityfractions in the subcortical cortical left frontal lobe and right retrobulbar. On funduscopicexamination, there’s bleeding in the inferior vitreous originating from the optic nerve papilae.Craniotomy, debridement, and corpus alienum extraction was done by neurosurgeon and plasticsurgeon. High dose steroid was given. After a week of therapy, there’s no improvement of his REvisual acuity.DiscussionTraumatic optic neuropathy (TON) occurs due to direct or indirect injury. In this case, the fractionsof the bullet caused direct injury to the optic nerve resulting in optic nerve avulsion. Optic nerveavulsion is a severe TON, the optic nerve is forcibly disinserted from the retina, choroid and thelamina cribrosa.1 The majority of affected patients are young adult males (79-85%) in their early30s.2 The management of TON is controversial, between medical therapy of steroids, surgery, orboth3ConclusionOptic nerve avulsion is a rare case with devastating results because there’s still no definite therapyto improve the outcome.Keywordoptic nerve avulsion, traumatic optic neuropathy, optic nerve injuryLatest UpdateMay 17, 2021StatusSubmittedFile Download

FREEPAPER

238 FREE PAPER

FP-R-E-IGS-01 THE EFFECT OF SUBCONJUNCTIVAL ASIATIC ACID ON CONJUNCTIVALFIBROBLATS POST TRABECULECTOMY: EXPERIMENTAL STUDY NEWZEALAND RABBITS

Abstract TitleTHE EFFECT OF SUBCONJUNCTIVAL ASIATIC ACID ON CONJUNCTIVAL FIBROBLATSPOST TRABECULECTOMY: EXPERIMENTAL STUDY NEW ZEALAND RABBITS

First Author: Dedeh Kurniasih

Author Institution: Undip

Co Author:

Maharani (Undip)

Riski Prihatningtias (Undip)

Arief Wildan (Undip)

Sri Inakawati (Undip)

Novan Adi (UNS)



Seminat: IGS


Introduction & ObjectiveIntroduction: Excessive formation of scar tissue in the conjunctival bleb is a major cause of failureof trabeculectomy. The use of antifibrotic agents, such as 5-fluorouracil (5-FU) or mitomicin C(MMC), is an attempt to improve trabeculectomy Results but has some adverse side effects. Asiaticacid (AA) is a pentacyclic triterpenoid derived from the tropical medicinal plant Centella asiatica AAhas a broad spectrum of biological activities including anti-fibrosis Objective: to determine theeffect of subconjunctival AA on conjunctival fibroblast New Zealand rabbit post trabeculectomy.MethodMethods: A total of 14 New Zealand white rabbits were divided into 2 groups, control andtreatment group. Treatment group was given subconjunctival AA 0.4mg / 0.5 ml aftertrabeculectomy. The number of fibroblasts measured by Hematoxyline & eosin staining. Differencesbetween two groups was analysed statistically used Independent t-test. ResultResult: The mean of fibroblast in treatment group was 73,00 ± 9,06 and control group was 89,29 ± 11,32. Statistically significant difference in TNF-α expressions between two groups (p=0,015). The results of the Independent t-test showed a significant difference between the two groups p = 0.012.ConclusionConclusion: Subconjunctival administration of AA after trabeculectomy significantly reduced thenumber of conjunctival fibroblasts in New Zealand rabbits.KeywordAsiatic acid, Fibroblast, TrabeculectomyLatest UpdateMay 12, 2021StatusSubmittedFile Download

239FREE PAPER

FP-R-E-IGS-02ORAL MIRTOGENOL EFFECT ON INTRAOCULAR PRESSURE ANDAPOPTOSIS INDEX OF GANGLION RETINA CELLS IN WISTAR GLAUKOMA MODEL

Abstract TitleORAL MIRTOGENOL EFFECT ON INTRAOCULAR PRESSURE AND APOPTOSIS INDEX OFGANGLION RETINA CELLS IN WISTAR GLAUKOMA MODEL

First Author: YUSTIADENTA WIDYA ANDIKA

Author Institution: Resident, Ophthalmology Department Diponegoro University

Co Author:

Arief Wildan (Staff, Ophthalmology Department, Medical Faculty Diponegoro University / Dr.

Kariadi Hospital Semarang), Winarto (Staff, Ophthalmology Department, Medical Faculty Diponegoro

University / Dr. Kariadi Hospital Semarang), Fifin L. Rahmi (Staff, Glaucoma Division, Ophthalmology

Department, Medical Faculty Diponegoro University /Dr. Kariadi Hospital Semarang), Maharani (Staff,

Glaucoma Division, Ophthalmology Department, Medical Faculty Diponegoro University /Dr. Kariadi Hospital

Semarang)



Seminat: IGS


Introduction & ObjectiveGlaucoma is the second leading cause of blindness after cataracts and characterized by RetinalGanglion Cell (RGC) death with typical visual field defect. High intraocular pressure (IOP) is amodified risk factor that can be controlled using pharmacotherapy or surgery. Mirtogenol exertbeneficial effect in ophthalmology. The aim of this study was to observe mirtogenol effect on IOPand RGC apoptosis index of Wistar glaucoma models.MethodAn experimental study with pre-post test and post-test only randomized controlled group designwas conducted at Experimental Animal Laboratory Faculty of Medicine, Diponegoro University,Semarang during March-May 2019. Twelve Wistar glaucoma models that met our study criteriawere divided into two groups. Mirtogenol 12.3 mg two times daily for 2 weeks were administered totreatment group while control group received placebo with similar administration manner. IOPexamination was performed before and after intervention, and apoptotic index was examined afterinterventionResultRGC apoptosis index was significantly lower in treatment groups compared to control group (pConclusionOral mirtogenol supplementation can significantly reduce the IOP and RCG Apoptosis Index. Wealso found a significant and strong correlation between IOP and RGC apoptosis index.Keywordapoptosis index, retinal ganglion cell, mirtogenolLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download544-FP-R-E-IGS-02-Yustiadenta.pdf

240 FREE PAPER

FP-R-E-IGS-03ORAL MIRTOGENOL EFFECT ON INTRAOCULAR PRESSURE ANDTRABECULAR MESHWORK APOPTOSIS INDEX IN WISTAR GLAUCOMA MODEL

Abstract TitleORAL MIRTOGENOL EFFECT ON INTRAOCULAR PRESSURE AND TRABECULARMESHWORK APOPTOSIS INDEX IN WISTAR GLAUCOMA MODEL

First Author: INTAN SAMIRA

Author Institution: Resident, Ophthalmology Department Diponegoro, Medical Faculty University / Dr.

Kariadi Hospital Semarang

Co Author:

Sri Inakawati (Ophthalmology Department, Medical Faculty Diponegoro University / Dr. Kariadi Hospital

Semarang), Trilaksana Nugroho (Ophthalmology Department, Medical Faculty Diponegoro University /

Dr. Kariadi Hospital Semarang), Maharani (Staff, Glaucoma Division, Ophthalmology Department, Medical

Faculty Diponegoro University / Dr. Kariadi Hospital Semarang), Fifin L. Rahmi (Staff, Glaucoma Division,

Ophthalmology Department, Medical Faculty Diponegoro University / Dr. Kariadi Hospital Semarang)



Seminat: IGS


Introduction & ObjectiveGlaucoma is a syndrome consist of an optic nerve damage is accompanied by a typical visual deficitand the second most common cause of permanent blindness worldwide. Glaucoma highly correlatedwith high IOP due to aqueous humour resistance flow through the trabecular meshwork (TM).Mirtogenol can be used to prevent glaucoma by reducing IOP and improving ocular blood flow. Theaim of this study was to observe mirtogenol effect on intraocular pressure and TM apoptosis indexof Wistar glaucoma models.MethodAn experimental study with pre-post test controlled group design and post-test only randomized controlled group design was conducted at Experimental Animal Laboratory Faculty of Medicine, Diponegoro University, Semarang during March-May 2019. Twelve Wistar glaucoma models that met our study criteria were divided into two groups. Mirtogenol 12.3 mg/kg two times daily for 2 weeks were administered to treatment group while control group received placebo with similar administration manner. IOP examination was performed before and after intervention, and TM apoptotic index was examined after intervention.ResultIOP decreased significantly in treatment group compared to controls group (mean difference: -12.48 ± 3.59 mmHg vs -0.88 ± 4.45 mmHg, respectively, p = 0.001). TM apoptosis index was significantly lower in treatment groups compared to control group (pConclusionOral mirtogenol supplementation can significantly reduce the IOP and TM Apoptosis Index. We alsofound a significant and strong correlation between IOP and TM apoptosis index.Keywordapoptosis index, trabecular meshwork, mirtogenolLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download670-FP-R-E-IGS-03-Intan-Samira.pdf

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FP-R-O-IGS-04PUPIL CYCLE TIME IN NORMAL AND GLAUCOMA PATIENTS AT KARIADI HOSPITAL

Abstract TitlePUPIL CYCLE TIME IN NORMAL AND GLAUCOMA PATIENTS AT KARIADI HOSPITAL

First Author: Ezra Margareth

Author Institution: Resident of Ophthalmology Department of Diponegoro University, Kariadi Hospital,

Semarang, Central Java

Co Author

Maharani Cahyono (Staff of Glaucoma, Ophthalmology Department of Diponegoro University,

Kariadi Hospital, Semarang, Central Java), Fifin L. Rahmi (Staff of Glaucoma, Ophthalmology Department

of Diponegoro University, Kariadi Hospital, Semarang, Central Java), Denti Puspasari (Staff of Glaucoma,

Ophthalmology Department of Diponegoro University, Kariadi Hospital, Semarang, Central Java)



Seminat: IGS


Introduction & ObjectiveGlaucoma is a group of progressive optic neuropathies that caused the afferent pathway of thepupillary reflex arc was disturbed. Pupil cycle time (PCT) is a fast, simple, and reliable clinic test ofoptic nerve function. Prolongation of the PCT may Result in the impairment of the afferent orefferent pathways of the pupillary light reflex by some diseases including glaucoma. The aim of thisstudy was to evaluate the PCT value in patients with glaucoma compared to normal patients.MethodIt was a cross sectional study, 40 eyes having primary glaucoma and 37 eyes of normal subjectswere enrolled in this study. All patients underwent complete ophthalmologic examinations and PCTmeasurement. The pupil cycle time counted 5 times in 30 seconds. Comparisons between bothgroups were then analyzed. There were statistically significant in p valueResultThe mean PCT of normal subjects was 718,22 ± 31,02 ms and glaucoma was 887,32 ± 141,54 ms.There were statistically significant difference PCT value on glaucoma compared to normal subjects (pConclusionPCT measurement showed significant prolonged in Glaucoma in our study. Further studies areneeded to evaluate the PCT value in every stage glaucoma patients.KeywordPupil Cycle Time, Glaucoma, Glaucomatous Optic NeuropathyLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download956-FP-R-O-IGS-04-Ezra-Margareth.pdf

242 FREE PAPER

FP-R-E-IGS-05Effect of Moringa oleifera Leaves Extract Oral on Interleukin-6 Expression inTrabecular Meshwork of Wistar Glaucoma Model

Abstract TitleEffect of Moringa oleifera Leaves Extract Oral on Interleukin-6 Expression in TrabecularMeshwork of Wistar Glaucoma Model

First Author: Dexa Rivandi

Author Institution: Ophthalmology Resident of Medical Faculty, Diponegoro University / Dr. Kariadi Hospital

Semarang

Co Author: Maharani Cahyono (Lecturer of Ophthalmology Departement, Medical Faculty, Diponegoro

University / Dr. Kariadi Hospital Semarang), Winarto (Lecturer of Ophthalmology Departement, Medical

Faculty, Diponegoro University / Dr. Kariadi Hospital Semarang), Sri Inakawati (Lecturer of Ophthalmology

Departement, Medical Faculty, Diponegoro University /Dr. Kariadi Hospital Semarang)

Riski Prihatningtias (Lecturer of Ophthalmology Departement, Medical Faculty, Diponegoro

University / Dr. Kariadi Hospital Semarang), Vega Karlowee, Hermawan Istiadi (Lecturer of Pathology

Anatomy Departement, Medical Faculty, Diponegoro University / Dr. Kariadi Hospital Semarang)



Seminat: IGS


Introduction & ObjectiveElevated intraocular pressure (IOP) in glaucoma induces inflammation in trabecular meshwork(TM) through production of pro-inflammatory cytokines such as Interleukin (IL)-6 by activating NFkB. Inflammation can cause mechanical stress, changes in expression of metalloproteinase andextracellular matrix, and aquos humor outflow resistance. Flavonoid as active component ofMoringa oleifera (MO) leaves extract known as anti-inflammatory and antioxidant agent that inhibitNF-kB activation. Purpose of this study to analyze the effect of MO leaves extract on IL-6expressions in TM of Wistar glaucoma model.MethodWistar model of glaucoma were divided into 2 groups, treatment and control group. Treatmentgroup was given MO leaves extract 300 mg/kgBW/day oral for 4 weeks. IL-6 expressions weremeasured by immunohistochemistry staining. Differences between two groups was analyzedstatistically using Mann-Whitney test. Significantly different if p < 0,05.ResultMean of Allred score of IL-6 expressions in treatment group was 4,57 ± 0,54 and control group was6,29 ± 4,88. There was significantly difference in IL-6 expressions between two groups (p=0,001).ConclusionMO leaves extract per oral can decrease IL-6 expression in TM of Wistar glaucoma model. Studiesin humans are still needed to assess the effect of MO leaves extract on the activity or expression ofinflammatory mediators that are increased in glaucoma.KeywordMO, IL-6, TMLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download414-3-FP-R-E-IGS-05-Dexa-Rivandi.pdf

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FP-G-IGS-06Intraocular Pressure Reduction and Success Rate Outcomes between Selective Laser Trabeculoplasty versus Medication in Open-Angle Glaucoma: A systematic Review and Meta-analysis

Abstract TitleIntraocular Pressure Reduction and Success Rate Outcomes between Selective Laser Trabeculoplasty versus Medication in Open-Angle Glaucoma: A systematic Review and Meta-analysis

First Author: Irma Suwandi Sadikin

Author Institution: Kebayoran Lama General Hospital, Jakarta, Indonesia

Co Author: Lia Amanda (Jakarta Medical Center Hospital, Jakarta, Indonesia)



Seminat: IGS


Introduction & ObjectiveSelective laser trabeculoplasty (SLT) has been used as an alternative therapy in reducingintraocular pressure (IOP) for the management of open-angle glaucoma (OAG). This study aims tocompare the efficacy of SLT versus topical medication in the treatment of OAG.MethodAn electronic literature search was performed in Pubmed, Cochrane Library, and Google Scholarfor relevant articles up to May 2021. The efficacy estimates were measured by their meandifference to calculate the intraocular pressure reduction (IOPR) from baseline to endpoint and byrisk ratio (RR) to determine success rates.ResultA total of 2218 patients were enrolled in 13 trials. Overall, there were no significant differences inIOPR between SLT and medication (mean difference (MD): 0.39 [95% CI, -1.12-0.34] p=0.29,I2=81%) and IOP control’s success rate (RR: 0.96 [95% CI 0.86-1.07] p=0.42, I2=50%). Evaluationof IOPR showed significant difference between SLT as an adjuvant for medication vs medicationonly (MD): 1.78 [95% CI, 0.38-3.19] p=0.01, I2=58%). Due to the limited data availability, adverseevents, quality of life, and the number of medications were also collected as qualitative data.ConclusionSLT was considered to be a safe and effective procedure for OAG, with a lower incidence of ocularside effects. However, cost-effectiveness and patients’ characteristics should be considered beforedetermining the therapeutic options. Nonetheless, further research is needed to investigate SLTperformance predictors and post-SLT management.KeywordSelective Laser Trabeculoplasty, Glaucoma Medication, Open Angle GlaucomaLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download749-FP-G-IGS-06-Irma-Suwandi-Sadikin.pdf

244 FREE PAPER

FP-R-E-IGS-07THE EFFECT OF LEAF EXTRACT MORINGA OLEIFERA ORAL AT RETINA OF WISTAR GLAUCOMA MODEL

First Author: NOVIKA PRISTIWATI

Author Institution: RSU dr. Kariadi Semarang

Co Author:

DR.dr.Fifin L.Rahmi, MS, Sp.M(K) (RSU dr. Kariadi Semarang)

dr. Maharani Cahyono, Sp.M(K) (RSU dr. Kariadi Semarang)

dr. Fatimah Dyah NA, MARS, Sp.M(K) (RSU dr. Kariadi Semarang)

DR.drTrilaksana N,M.Kes,FISCM,Sp.M(K) (RSU dr. Kariadi Semarang)



Seminat: IGS


ABSTRACTIntroduction :High intraocular pressure in glaucoma could precipitate retinal neuroinflammation. Chronic neuroinflammation can cause retinal ganglion cell death. TNF-α is one of inflammatorry mediators that involved in this process. Moringa oleifera leaf extract known for its antiinflammation effect through its inhibition of NFkB, transcription factor of inflammatory mediator, in retinal glial cell.Purpose :to know the effect of Moringa oleifera leaf extract on TNF-α expression at retina of Wistar glaucoma model..Methods :Wistar rat model of glaucoma were divided into 2 groups. Control group and treatment group. The treatment group was given leaf extract of Moringa oleifera leaf 300mg/BW oral a day for 4 weeks. Using imunohistochemistry stain, TNF-α expression between groups were assessed and compared statistically. Significant if p < 0.005.Result : Mean of TNF-α Allred score in control group was 5,57 ± 0,79 and mean of treatment group was 5,43 ± 0,54. The difference between two groups was assessed using Mann-Whitney test, and the Result was not significant different. ( p > 0,005 )Conclusion : Leaf extract of Moringa oleifera oral can decrease the expression of TNF-α in retina of Wistar glaucoma model eventhough it was not significant.Keywords:Moringa oleifera, glaucoma, TNF-αLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download537-FP-R-E-IGS-07--NOVIKA-PRISTIWATI.pd

245FREE PAPER

FP-R-E-IGS-08THE IMPACT OF CORNEAL ENDOTHELIAL CELL FOLLOWING TRABECULECTOMY, PHACOEMULSIFICATION AND COMBINED PHACOTRABECULECTOMY AT EARLY PHASE

Abstract TitleTHE IMPACT OF CORNEAL ENDOTHELIAL CELL FOLLOWING TRABECULECTOMY,PHACOEMULSIFICATION AND COMBINED PHACOTRABECULECTOMY AT EARLY PHASE

First Author: Nadira Putri Arlanbi

Author Institution: Resident of Ophtalmology Department of Diponegoro University, Kariadi General

Hospital, Semarang

Co Author:

Maharani Cahyono (Staff of Glaucoma Subdivision, Ophthalmology Department of Diponegoro

University, Kariadi General Hospital, Semarang), Wisnu Sadasih (Staff of Cataract and Refractive Surgery

Subdivision, Ophthalmology Department of Diponegoro University, Kariadi General Hospital, Semarang)



Seminat: IGS


Introduction & ObjectiveThe corneal endothelial cell is essential for preserving corneal optical clarity by keeping the corneadehydrated. Glaucoma can cause corneal endothelial cell damage as a Result of both the diseaseprocess and the treatment, which includes surgical procedures. This study aimed to investigate theearly impact of trabeculectomy, phacoemulsification, and phacotrabeculectomy on the cornealendothelial cell in all types of glaucoma patients.MethodIn this prospective study, three groups were identified group I trabeculectomy (n=17), group IIphacoemulsification (n=14), and group III phacotrabeculectomy (n= 23). A non-contact specularmicroscope (Nidek CEM-530) was used to measure corneal endothelial cell density (CECD),coefficient of variation (CV) (polymegathism), hexagonality (HEX) (pleomorphism), and centralcorneal thickness (CCT) in the pre, postoperative day 1, and postoperative day 7.ResultThe CECD of each group decreased significantly (p<0.001) postoperative day 1 and day 7 (-81.59;-89.18 cell/mm2 in trabeculectomy group, -137.64; -146.86 cell/mm2 in phacoemulsification group,and -175.60; -200.20 cell/mm2 in phacotrabeculectomy group). Each group’s CV and CCT valueincreased significantly (p<0.001) after surgery. The HEX value of each group decreased significantly (p=0.014 in the trabeculectomy group and p<0.001 in the rest) after surgery. There was no significant difference in CECD and HEX values between the phacoemulsification and phacotrabeculectomy groups.ConclusionThe CECD and HEX values were decreased significantly in all groups, while the CV and CCT valueswere increased significantly in all groups. There was no significant difference in corneal endothelialcell loss and morphological changes between phacoemulsification and phacotrabeculectomy groups.KeywordTrabeculectomy; Phacoemulsification; Combined Phacotrabeculectomy; Corneal Endothelial CellLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download199-FP-R-O-IGS-08-Nadira-Putri-Arlanbi.pdf

246 FREE PAPER

FP-R-O-IGS-09CENTRAL CORNEAL THICKNESS IN PATIENTS WITH OCULAR HYPERTENSION, GLAUCOMA SUSPECT, NORMAL TENSION GLAUCOMAAND PRIMARY OPEN ANGLE GLAUCOMA AT DR. M. DJAMIL HOSPITALPADANG

Abstract TitleCENTRAL CORNEAL THICKNESS IN PATIENTS WITH OCULAR HYPERTENSION,GLAUCOMA SUSPECT, NORMAL TENSION GLAUCOMA AND PRIMARY OPEN ANGLEGLAUCOMA AT DR. M. DJAMIL HOSPITAL PADANG

First Author: Harliady Dany Prabowo


Co Author: Andrini Ariesti (Department of Ophthalmology, Andalas University, M.Djamil Hospital)



Seminat: IGS


Introduction & ObjectiveGlaucoma is the leading cause of irreversible blindness globally, with open angle glaucoma beingthe most common type of glaucoma. Central corneal thickness (CCT) is an important parameter ofglaucoma. The relationship between CCT and intraocular pressure (IOP) measured was clinicallysignificant and could be a prognostic factor for development of glaucoma. To determine the variation of CCT in patients attending the glaucoma clinic at Dr. M. Djamil Hospital during January 2019 until December 2020.MethodA retrospective study using the data taken from medical records of glaucoma patients duringJanuary 2019 until December 2020. Data of CCT values in this study was taken from measurementsusing the Anterior Segment Optical Coherence Tomography.ResultA total of 106 subjects within 11-77 years were used for this study. There were more females (61.32%) than males (38.68%). Most of diagnosis in this study was glaucoma suspect, found in 59 cases (55.66%), Primary Open Angle Glaucoma (POAG) in 23 cases (21.70%), ocular hypertension in 14 cases (13.20%) and normal tension glaucoma (NTG) in 10 cases (9.43%). The mean CCT value in ocular hipertension was 566.31 μm, glaucoma suspect was 533.41 μm, NTG was 532.90 μm and POAG was 523.52 μm.ConclusionThis study confirms that ocular hipertension’s group have the highest CCT value among the other groups. CCT value in POAG’s group is the lowest among the other groups. This Result is different from several previous studies that obtained CCT value in NTG has tendency to be thinner than the other groups.KeywordCCT, ocular hipertension, POAGLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download721-FP-R-O-IGS-09-HARLIADY-DANY-PRABOWO.pdf

247FREE PAPER

FP-R-O-IGS-10THE DIFFERENCE OF LENS THICKNESS IN ACUTE AND CHRONIC PRIMARYANGLE CLOSURE GLAUCOMA

Abstract TitleTHE DIFFERENCE OF LENS THICKNESS IN ACUTE AND CHRONIC PRIMARY ANGLECLOSURE GLAUCOMA

First Author: SUCYEKA SYAFUTRI


Co Author: FITRATUL ILAHI (Department of Ophthalmology, Andalas University, M.Djamil Hospital)



Seminat: IGS


Introduction & ObjectiveLens thickness is one of the factors that influence the mechanism of acute primary angle closureglaucoma (PACG). The thicker lens usually Results in shallower anterior chamber angle (ACA) andthe gradual and progressive increase in lens thickness with age Results in exaggerated shallowingof the ACA. Because lens thickness has important role in acute PACG mechanism, prophylactictreatment like lens extraction might prevent PACG in early stages. The objective of this study wasto describe the difference of lens thickness in acute and chronic PACG.MethodThe research was a cross-sectional study with samples conducted in M. Djamil Hospital Padangfrom September-Desember 2019. The number of eyes that fulfills inclusion criteria were 50 eyesfrom 50 patients consisting of 25 eyes with acute PACG and 25 eyes with chronic PACG. Subjectswere examined with ocular biometry using A-scan biometry to evaluate lens thickness. Data wasprocessed and analyzed using computer program with chi-square test.ResultMean of lens thickness in acute PACG is 5.02 ± 0.45, while in chronic PACG is 4.86 ± 0.40. Thedifference of lens thickness in acute and chronic PACG was statistically significant (p = 0,037).ConclusionLens thickness is thicker in acute PACG than chronic PACG. It is concluded that the mechanism ofacute PACG can be affected by lens thickness that can make shallow ACA.KeywordLens Thickness, PACG, Shallow ACALatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download980-FP-R-O-IGS-10-Sucyeka-Syafutri.pdf

248 FREE PAPER

FP-R-O-IGS-11CLINICAL CHARACTERISTICS OF STEROID-INDUCED GLAUCOMA PATIENTSAT GLAUCOMA UNIT OF INDONESIA NATIONAL EYE CENTRE CICENDO EYEHOSPITAL BANDUNG

Abstract TitleCLINICAL CHARACTERISTICS OF STEROID-INDUCED GLAUCOMA PATIENTS AT GLAUCOMA UNIT OF INDONESIA NATIONAL EYE CENTRE CICENDO EYE HOSPITAL BANDUNG

First Author: Marsita Lita

Author Institution: PMN RS Mata Cicendo - Universitas Padjadjaran

Co Author:

R. Maula Rifada (Unit Glaukoma PMN RS Mata Cicendo - Universitas Padjadjaran)

Elsa Gustianty (Unit Glaukoma PMN RS Mata Cicendo - Universitas Padjadjaran)

Andika Prahasta (Unit Glaukoma PMN RS Mata Cicendo - Universitas Padjadjaran)



Seminat: IGS


Introduction & ObjectiveSteroid induced glaucoma (SIG) is a secondary glaucoma caused by unmonitored used of steroid.Steroids induce resistance aqueous humour flow in trabecular meshwork (TM) increase intraocularpressure (IOP). To describe the clinical characteristics of SIG patient, treatment and the Result atGlaucoma unit of Indonesia National Eye Center Cicendo Eye HospitalMethodSteroid induced glaucoma between January 2017 until December 2019 were retrospectivelyreviewed. The patient’s age, gender, level of education, type and duration of steroids, completeophthalmology examination, and treatment were reviewed.ResultThere were 61 patients (111 eyes) with SIG were included in this study. 57.4% were female withmean age was 34.8 ± 13.87 years and 82% were bilateral. 90.2% of patients in this study usedtopical steroids. Mean initial IOP was 33.5 ± 15.4 mmHg at the first visit. 33,3% were severe stage.The majority of patients were severe visual impairment to blind. The success of treatment in thisstudy were 70 eyes (63%).ConclusionSteroid induced glaucoma is most commonly caused by topical steroids. Chronic use of steroidscauses TM damage, hypotonic agent and surgery were needed to reduce IOP.Keywordsteroid induced glaucoma, steroidLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download454-Free-Paper---Marsita-Lita---KARAKTERISTIK-KLINIS-PASIEN-GLAUKOMA-AKIBAT-STEROID.pdf

249FREE PAPER

FP-R-O-IGS-12Structure-function Correlation of Macular Cube OCT Angiography (OCT-A)and Visual Field Automated Perimeter in Glaucoma

Abstract TitleStructure-function Correlation of Macular Cube OCT Angiography (OCT-A) and VisualField Automated Perimeter in Glaucoma

First Author: Endah Prasetyowati

Author Institution: Dr. Sardjito General Hospital /Faculty of Medicine, Public Health, and Nursing, Universitas

Gadjah Mada

Co Author:

Retno Ekantini (Dr. Sardjito General Hospital /Faculty of Medicine, Public Health, and Nursing,

Universitas Gadjah Mada), Tatang Talka Gani (Dr. Sardjito General Hospital /Faculty of Medicine, Public

Health, and Nursing, Universitas Gadjah Mada), Krisna Dwi Purnomo Jati (Dr. Sardjito General Hospital /

Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada)



Seminat: IGS


Introduction & ObjectiveGlaucoma is characterized with progressive loss of retinal ganglion cells and axons of peripapillaryretinal nerve fiber layer with alterations on optic nerve head and visual field. This study is todetermine the structure-function correlation between macular microvascular damage and visualfield alterations in glaucoma.MethodA cross sectional study, sample was recruited by consecutive sampling. OCT-A was used to measureretinal vascular microcirculation of the macula (Vessel Density), SD-OCT was used to measureGCIPL Thickness, using Cirrus HD-OCT 5000 (Carl Zeiss Meditec Inc.). Visual field (Visual FieldIndex and Mean Deviation) was tested using automated perimeter Humphrey Field Analyzer 3 (CarlZeiss Meditec Inc.).ResultFifty-five eyes were included in this study. Total gender was female and male, 34 (61,8%) and 21(38.2%) respectively. The mean age was 35.15 ± 2.097 years (range: 17-73 y). There are significantcorrelation between VFI and GCIPL Thickness (r = 0.409 p = 0.002), Central Vessel Density (r =0.324 p = 0.016), Outer Vessel Density (r = 0.411 p = 0.002), Full Vessel Density (r = 0.360 p =0.007). Significant correlation between MD and GCIPL Thickness (r = 0.282 p = 0.037), CentralVessel Density (r = 0.274 p = 0.043), Outer Vessel Density (r = 0.296 p = 0.028).ConclusionGCIPL Thickness and Outer VD correlate moderately with VFI. Central VD and Full VD have lowcorrelation with VFI. HFA Mean Deviation has low correlation with GCIPL Thickness and macularvascular density (Central and Outer VD).KeywordMacular OCT-Angiography, Visual Field Index, GCIPL ThicknessLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download880-FP-R-O-IGS-12-Endah-Prasetyowati.pdf

250 FREE PAPER

FP-R-E-IGS-13The Effect Of Duration Discontinuation Topical Prednisolone On ExtracellularMatrix Trabecular Meshwork In Wistar Rat

Abstract TitleThe Effect Of Duration Discontinuation Topical Prednisolone On Extracellular MatrixTrabecular Meshwork In Wistar Rat

First Author: Sekar Kumalasari

Author Institution: Universitas Diponegoro

Co Author:

Fifin Luthfia Rahmi (Universitas Diponegoro)

Arnila Novitasari Saubig (Universitas Diponegoro)

Hermawan Istiadi (Universitas Diponegoro)

Arief Wildan (Universitas Diponegoro)

Liana Ekowati (Universitas Diponegoro)



Seminat: IGS


Introduction & ObjectiveInstillation of glucocorticoids such as prednisolone is known to Result in elevation of IOP.Corticosteroid causes ECM activity decrease and leads to ECM accumulation in TM and eventuallyincreasing of IOP. Increase of IOP will leads to ECM turnover. This reversibility is known asmaintenance remodeling of ECM TM. To analyze the reversibility of ECM TM in Wistar rat afterdiscontinuation of instillation prednisolone topical 1% at different duration (14 days and 28 days)MethodThis was an experimental study with post test only controlled group design. Total samples of 28rats were divided into 4 groups: Treatment 1 was given prednisolone topical for 28 days anddiscontinued for 14 days. Treatment 2 was given prednisolone topical for 28 days and discontinuedfor 28 days. Control 1 was given prednisolone topical in 28 days, and control 2 was given salinetopical for 28 days. Pathology anatomy of ECM TM evaluated using histopahological score grading.Differences between 2 group were analyzed statistically using Mann-Whitney test and differencesbetween all group were analyzed using Kruskal-Wallis testResultCronbach Alpha test obtained the kappa value is 0.935. Deposition of ECM in TM were nostatistically difference in treatment 1 and treatment 2 group (p>0.05). Deposition of ECM in TMwere statistically difference in treatment 2 and control 1 group (p<0.05). Comparative test in allgroup showed p<0.05ConclusionECM TM was thinner in the experimental animals with a longer duration of discontinuation ofprednisolone topical that shows maintenance remodeling of ECM does happenKeywordECM prednisolone remodellingLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download203-FP-R-E-IGS-13-Sekar-Kumalasari.pdf

251FREE PAPER

FP-R-O-IGS-14CORRELATION OF STRUCTURE AND FUNCTIONAL DEFECT WITH QUALITYOF LIFE IN PATIENT WITH GLAUCOMA

Abstract TitleCORRELATION OF STRUCTURE AND FUNCTIONAL DEFECT WITH QUALITY OF LIFE INPATIENT WITH GLAUCOMA

First Author: Meta Rahma An Nazzila

Author Institution: Dr. Sardjito General Hospital/Faculty of Medicine, Public Health, and Nursing, Universitas

Gadjah Mada

Co Author:

Retno Ekantini (Dr. Sardjito General Hospital/Faculty of Medicine, Public Health, and Nursing,

Universitas Gadjah Mada), Tatang Talka Gani (Dr. Sardjito General Hospital/Faculty of Medicine, Public

Health, and Nursing, Universitas Gadjah Mada),Krisna Dwi Purnomo Jati (Dr. Sardjito General Hospital/

Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada)



Seminat: IGS


Introduction & ObjectiveGlaucoma damage generally produces a characteristic change in the morphology of the optic nerve, runs progressively and permanently that cause visual changes, decreased vision, and blindness. Blindness will affect one’s dependence to get help in their daily activities. This paper investigate the correlation between VFI, BCVA, MD and RNFL thickness with the quality of life of people with glaucoma using Glaucoma Quality of Life-15 (GQL-15).MethodA cross-sectional study conducted at the Sardjito Eye Center in April 2021. Purposive samplingused to recruit glaucoma patients who had BCVA, Visual Field examination (Humphrey FieldAnalyzer (HFA) 3 Carl Zeiss Meditec Inc.), and OCT ONH (Cirrus HD-OCT 5000, Carl Zeiss).Glaucoma Quality of Life-15 (GQL-15) questionnaire were used to interview the patients.ResultEight (32%) normotension glaucoma and 17 (68%) open angle glaucoma patients were included. Fifteen (60%) patients aged 17-40 y.o, 7 (28%) aged 41-60 y.o and 3 (12%) aged > 60 y.o were included. Majority of the samples 6 of them were unemployed (24%), 5 entrepreneurs 5 (20%) and 5 students (20%). GQL-15 score was significantly correlated with respondent’s BCVA r= -0.39 (p=0.05). However, there was no correlation between GQL-15 with RNFL r= 0.01 (p=0.94), VFI r=-0.21 (p= 0.29) and MD with r=0.09 (p= 0.66) respectively. It showed that VFI and GQL-15 has negative correlation with a correlation coefficient of -0.21 (p=0.29).ConclusionGQL-15 score has a weak negative correlation with BCVA and MD. There was no correlationbetween GQL-15 with VFI and RNFL.KeywordGlaucoma Quality of Life-15, OCT, Visual Field IndexLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download193-FP-R-O-IGS-14-Meta-Rahma-An-Nazzila.pdf

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FP-O-IGS-15THE EFFECT OF PHACOEMULSIFICATION on GLAUCOMA PATIENTS at DR.SAIFUL ANWAR GENERAL HOSPITAL MALANG

Abstract TitleTHE EFFECT OF PHACOEMULSIFICATION on GLAUCOMA PATIENTS at DR. SAIFULANWAR GENERAL HOSPITAL MALANG

First Author: Tania Rahmania M.

Author Institution: RSSA Malang

Co Author: dr. Aulia Abdul Hamid Sp.M (K) (RSSA Malang)



Seminat: IGS


Introduction & ObjectiveTo evaluate outcome of phacoemulsification surgeries in patients with glaucoma at departement ofophtalmology, Dr. Saiful Anwar General Hospital, Malang.MethodThis was a retrospective analysis of the medical records of open angle glaucoma (Group A), angleclosure glaucoma (Group B), and Phacomorphic glaucoma (Group C) patients who underwentphacoemulsification surgery at Dr. Saiful Anwar General Hospital with follow up within 6 monthsperiod. The variables noted were age, gender, visual acuity (LogMAR), intraocular pressure, and ACD depth.ResultTotal of 39 eyes with OAG-group A (12 eyes), ACG-group B (10 eyes), and phacomorphic glaucomagroup C (17 eyes) underwent phacoemulsification surgery. The mean IOP in group A,B and C wasdecreased to more than 30% at one day postoperatively in all group. VA was increase up untill 4lines on Snellen chart in group C, 3 lines in group A and 1 line in group B. There was a difference inACD between the three groups prior to surgery, but following surgery the ACDs of the three groupswere not significantly different.ConclusionThis study revealed that there was a significant decrease in IOP, increase in VA and ACD depthafter phacoemulsification surgery in OAG and Phacomorphic glaucoma patients. Patients with OAGand Phacomorphic glaucoma may benefit from phacoemulsification surgery.KeywordPhacoemulsification, Glaucoma, Cataract surgeryLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download435-Jurnal-deskriptif-pvsm.pdf

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FP-R-O-IGS-16Optical Coherence Tomography (OCT) Structural Pattern among GlaucomaPatients in Sardjito General Hospital Yogyakarta

Abstract TitleOptical Coherence Tomography (OCT) Structural Pattern among Glaucoma Patients inSardjito General Hospital Yogyakarta

First Author: Putri Claudya Octaviani

Author Institution: Dr. Sardjito General Hospital/ Faculty of Medicine, Public Health and Nursing, Universitas

Gadjah Mada

Co Author: Retno Ekantini (Dr. Sardjito General Hospital/Faculty of Medicine, Public Health and Nursing,

Universitas Gadjah Mada), Tatang Talka Gani (Dr. Sardjito General Hospital/Faculty of Medicine, Public Health

and Nursing, Universitas Gadjah Mada), Krisna Dwi Purnomo Jati (Dr. Sardjito General Hospital/Faculty of

Medicine, Public Health and Nursing, Universitas Gadjah Mada)



Seminat: IGS


Introduction & ObjectiveEarly detection of glaucoma disease progression is an important and challenging component.Optical Coherence Tomography (OCT) has been proven as an objective Method to assessglaucomatous damage before visual field defect worsen. Aim of this study was to compare the ONH,RNFL, and macular structure using Cirrus-OCT between demographic groups of glaucoma patientsin Sardjito General Hospital.MethodThis was a cross-sectional study. Consecutive sampling Method was used to recruit the samples.Glaucoma patients who visited Sardjito Hospital in April 2021, and had Cirrus HD-OCT 5000 Zeissexamination, consisted of RNFL thickness, ONH parameters, GCIPL thickness, macular and ONHOCTA perfusion and density, with 8 as the minimum signal strength, were included.ResultTwenty seven glaucoma patients were included. The mean±SD (range) age of the subjects was 38.67±16.14 (18-71) y.o, consisted of 14(51.9%) ≤35 y.o, 5(18.5%) 36-50 y.o, and 8(29.6%) >50 y.o. Mean±SD vertical CD ratio for subjects ≤35 y.o, 36-50 y.o, and >50 y.o were 0.63±0.09, 0.64±0.17, 0.65±0.2 respectively (p=0.94). Mean±SD RNFL thickness were 103±10um, 96.4±8.5um, and 84.4±5.5um for those age groups respectively (p=0.02). Mean±SD ONH OCTA vessel perfusion for those age group were 46.1±1.8%, 43.5±2.8%, and 42.2±3.2% (p=0.02) and mean±SD flux index were 0.45±0.03, 0.42±0.07, and 0.39±0.06 respectively (p=0.62). Mean±SD macular OCTA vessel density were 44.07±2.67%, 37.8±11.6%, and 38.4±7.5% respectively for full region (p=0.86). Mean±SD GCIPL thickness were 82.64±4.3um, 78±15.6um, and 72.4±12.5umrespectively (p=0.10).ConclusionThere is a significantly higher ONH OCTA vessel perfussion and also thicker RNFL thickness inyoungest group among glaucoma patient in this study.KeywordGlaucoma, OCT Angiography, GCIPL ThicknessLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download267-FP-R-O-IGS-16-Putri-Claudya-Octaviani.pdf

254 FREE PAPER

FP-R-O-IGS-17COMPARISON OF ONH, MACULA STRUCTURE AND HFA PATTERN IN HIGHMYOPIA AND EMETROP EYES WITH/WITHOUT GLAUCOMA

Abstract TitleCOMPARISON OF ONH, MACULA STRUCTURE AND HFA PATTERN IN HIGH MYOPIAAND EMETROP EYES WITH/WITHOUT GLAUCOMA

First Author: IDHAYU ANGGIT WIDHASARI

Author Institution: UGM

Co Author: Retno Ekantini ()

Tatang Talka Gani ()

Krisna Dwi Purnomo Jati ()



Seminat: IGS


Introduction & ObjectiveAxial length elongation contributes a challenge in myopia eyes due to morphological and visual fieldabnormalities. OCT instruments do not embed a normative database from high myopia. The study isaimed to compare Cirrus OCT and HFA parameters on high myopia and emetrop with/withoutglaucoma.MethodThis cross-sectional, prospective study was conducted at Sardjito General Hospital from 1st April 2021 to 11th May 2021. Patients with high myopia was enrolled with Spherical Equivalent (SE) ≥ -6D, 20 – 55 years of age. All participants underwent a complete ophthalmologic examination. Inclusion criteria: BCVA 20/40 or better, reliable visual field Results.ResultFrom 22 eyes, there were no significant difference of age between high myopia withglaucoma/HMG (n=5), high myopia/HM (n=6), emetrop with glaucoma/EG (n=5), emetrop/E (n=6)with mean age was 36±3.2 y.o and 60% were male with SE -8.5±1.03D. Among ONH parameters,there were no differences between groups. In HMG, HM, EG, E group, median avgRNFL was 85um,96.5um, 105um, 110um respectively. Thus, median vertical CD is 0.48, 0.40, 0.58, 0.55 in HMG,HM, EG, E group respectively. Whilst, median GCIPL and visual index were 75um, 78.5um, 85um,89.5um in HMG, HM, EG, E group respectively and had significantly different 0.012 (p<0.05)between groups. Median visual field index was 92%, 97%, 98% in HMG, HM, EG group respectivelywith significantly different 0.04 (p<0.05).ConclusionThe GCIPL and visual field index are significantly different between eyes with high myopia andemetrop with/without glaucoma.KeywordGlaucoma, myopia, OCTLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download753-371FP-R-O-IGS-17-Idhayu-Anggit-W.pdf

255FREE PAPER

FP-R-O-IGS-18Visual Function of New Glaucoma Patient in Sardjito 2021

Abstract TitleVisual Function of New Glaucoma Patient in Sardjito 2021

First Author: Amelia Devy Indriasari

Author Institution: Departement of Ophthalmology, Faculty of Medicine, Public Health, and Nursing, Gadjah

Mada University

Co Author:

Retno Ekantini (Departement of Ophthalmology, Faculty of Medicine, Public Health, and Nursing,

Gadjah Mada University)

Tatang Talka Gani (Departement of Ophthalmology, Faculty of Medicine, Public Health, and

Nursing, Gadjah Mada University)

Krisna Dwi Purnomo Jati (Departement of Ophthalmology, Faculty of Medicine, Public Health, and

Nursing, Gadjah Mada University)



Seminat: IGS


Introduction & ObjectiveGlaucoma is a potentially blinding condition, which is caused by many factors, including latediagnosis and limited health facilities in remote areas. This study will assess the visual function ofnew patients living with glaucoma in order to improve health care.MethodA descriptive cross-sectional study of primary and secondary glaucoma patients in Sardjito EyeCenter, selected through consecutive sampling on April 2021. The outcomes included basicdemographic data (age, gender, and residence) and clinical characteristics based on eyeexamination, best corrected visual acuity (BCVA), and Humphrey Field Analysis (HFA 24-2 SITAStandard).ResultOf the 27 patients participated in the study, 22 patients (81%) had primary glaucoma, 5 patients (19%) had secondary glaucoma. Glaucoma cases were observed in 52%(aged less than 35), 18%(36-50 years), and 30%(over than 50 years) (mean age= 39.14±17.02 years). The male: female ratio was 3:5 with 37% were men and 63% were women. The average distance of residence was 42km (range 6-166km). Glaucoma cases by stage of disease were mild glaucoma 59%, moderate glaucoma 15%, advanced glaucoma 4% and late stage glaucoma 22%. The average Visual Field Index (VFI) was 72.8±39.05%. The Results of BCVA parameters of patients were as follows: 17(63%) had no visual impairment, 6(22%) had a mild visual impairment, and 4(15%) had blindness.ConclusionGlaucoma occurs mostly in young adults and middle age groups with women had a higher risk thanmen. Overall, the average distance to the tertiary hospital was 42 kilometers. Twenty percent ofcases arrive in late stage and 15% had blindness.KeywordGlaucoma, visual function, best corrected visual acuity (BCVA)Latest UpdateMay 17, 2021StatusApproved As Free PaperFile Download385-FP-R-O-IGS-18-Amelia-Devy-Indriasari.pdf

256 FREE PAPER

FP-R-E-IGS-19Duration Effect of Topical Dexamethasone Withdrawal on The Thickness ofTrabecular MeshworkExtracellular Matrix (Experimental Study on Wistar Rats)

Abstract TitleDuration Effect of Topical Dexamethasone Withdrawal on The Thickness of TrabecularMeshworkExtracellular Matrix (Experimental Study on Wistar Rats)

First Author: DYAH AYU ELIZA LESTARI

Author Institution: Resident of Ophthalmology Departement of Diponegoro University/dr.Kariadi Hospital

Semarang

Co Author: Fifin Lutfia Rahmi (Lecturer of Ophthalmology Department, Diponegoro University/dr.Kariadi

Hospital Semarang), Arief Wildan (Lecturer of Ophthalmology Department, Diponegoro University/dr.Kariadi

Hospital Semarang), Maharani Cahyono (Lecturer of Ophthalmology Department, Diponegoro University/

dr.Kariadi Hospital Semarang) A Kentar Arimadyo (Lecturer of Ophthalmology Department, Diponegoro

University/dr.Kariadi Hospital Semarang), Hermawan Istiadi (Lecturer of Pathology Anatomy Department,

Diponegoro University/dr.Kariadi Hospital Semarang)



Seminat: IGS


Introduction & ObjectiveIntroduction: The extracellular matrix within the trabecular meshwork has important role in regulation aqueous humor, remodeling of the extracellular matrix affects the aqueous humor outflow. Long term administration of corticosteroids causes increased IOP effect due to the accumulation of extracellular matrix material within trabecular meshwork, influencing factors including steroid potency, duration, length of withdrawal, route, doses. Withdrawal of dexamethasone treatment in some period can decrease TIO as returns to baseline. Objective: Analyzing differences in thickness of the trabecular meshwork extracellular matrix after 14 and 28 days of topical dexamethasone withdrawal.MethodMethode: An experimental study with a posttest only controlled group design. Total samples of 28 rats were divided into 4 groups, consisting of control, treatment groups 1 (stopped for 0 days), treatment groups 2 (stopped for 14 days) and 3 (stopped for 28 days). Pathology anatomy of the trabecular meshwork extracellular matrix using histopathological score grading.This study used the KruskalWallis and Mann Whitney test (significancy p<0,05).ResultResult: The comparative test of the control group, groups 1, 2 and 3 showed p<0,001 that there was a change in thickness of the extracellular matrix after withdrawal of dexamethasone for 28 days. The comparative test of the treatment group 1 and treatment groups 2 showed p=0,317. The comparative test of treatment groups 2 and 3 showed p=0,002. The Cronbach Alpha test obtained the kappa(k)value is 0,924.ConclusionConclusion: The thickness of the trabecular meshwork extracellular matrix was thinner in theexperimental animals with longer steroid withdrawal.KeywordKeywords: Extracellular Matrix, Trabecular Meshwork, DexamethasoneLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download519-FP-R-E-IGS-19-DyahAyuElizaLestari.pdf

257FREE PAPER

FP-R-O-IGS-20CORRELATION BETWEEN OPTIC NERVE HEAD OPTICAL COHERENCETOMOGRAPHY ANGIOGRAPHY AND VISUAL FIELD INDEX IN GLAUCOMA

Abstract TitleCORRELATION BETWEEN OPTIC NERVE HEAD OPTICAL COHERENCE TOMOGRAPHYANGIOGRAPHY AND VISUAL FIELD INDEX IN GLAUCOMA

First Author: Aloysius Angga Wibowo


Co Author: Retno Ekantini (UGM), Tatang Talka Gani (UGM), Krisna Dwi Purnomo Jati (UGM)



Seminat: IGS


Introduction & ObjectiveIncreased intraocular pressure is glaucoma major risk factor, but decreased vascular perfusion alsoplays an important role in the glaucoma pathogenesis. Previous studies have reported finding fillingdefects in intrapapillary and peripapillary capillary fluorescein accompanied by RNFL defects,generating discussion whether these defects associated with loss of visual fields. Optical CoherenceTomography Angiography (OCT-A) is a non-invasive technique to delineate optic nerve head (ONH)vascularization. This study investigating the correlation between Flux Index and Perfusion in ONHOCT-A Results with Visual Field Index (VFI) in HFA Results in glaucoma patients.MethodA cross-sectional study at RSUP Dr. Sardjito Yogyakarta. Purposive, non-random sampling techniques were used to recruit participants. This study enrolled glaucoma patients with ONH OCTA (Cirrus HD-OCT 5000, Carl Zeiss Meditec, Dublin, CA) and Visual Field examination (Humphrey Field Analyzer (HFA) 3, Carl Zeiss Meditec, Dublin, CA) Results.ResultThis study collected 49 eyes datasets from 28 subjects. Six (12.2%) secondary glaucoma, 14 (28.6%) normal tension glaucoma, and 29 (59.2%) open angle glaucoma eyes were included. Of the 28 subjects (aged 18-73 years old), 17 was female (60.7%) and 11 was male (39.3%), with mean age of 37.77 years old (SD=16.4). Correlation coefficient between flux index with VFI was 0.735 (p<0.0001) and perfusion with VFI was 0.771 (p<0.0001).ConclusionFlux index and perfusion were significantly correlated with VFI. The lower percentage of flux indexand perfusion of ONH OCT-A, the lower VFI of eye would be. Flux index and perfusion using ONHOCT-A showed promising Result to predict VFI using HFA.KeywordONH OCT-A, Flux Index, Visual Field Index (VFI).Latest UpdateMay 17, 2021StatusApproved As Free PaperFile Download450-FP-R-O-IGS-20-Aloysius-Angga-Wibowo.pdf

258 FREE PAPER

FP-R-E-IGS-21 Effect of Moringa oleifera Leaves Extract on Tumor Necrosis Factor Alpha:Experimental Study in Trabecular Meshwork of Wistar Glaucoma Model

Abstract TitleEffect of Moringa oleifera Leaves Extract on Tumor Necrosis Factor Alpha: ExperimentalStudy in Trabecular Meshwork of Wistar Glaucoma Model

First Author: Ratih Kusuma Astuti

Author Institution: RSI PKU Muhammadiyah Tegal

Co Author:

Maharani Cahyono (RSUP dr.Kariadi Semarang)

Riski Prihatningtias (RSUP dr.Kariadi Semarang)

Winarto Reki (RSUP dr.Kariadi Semarang)

Afrisal Hari Kurniawan (RSUP dr.Kariadi Semarang)

Hermawan Istiadi (RSUP dr.Kariadi Semarang )



Seminat: IGS


Introduction & ObjectiveElevated intraocular pressure induces inflammation in trabecular meshwork (TM) throughincreases of TNF-α expressions by activating NF-kB. Inflammation can cause extracelullar matrixremodelling and increase aquous humor outflow resistance. Quercetin as active component ofMoringa oleifera (MO) leaves extract known as antiinflammatory agent that inhibit NF-kBactivation. Purpose: to analyze the effect of MO leaves extract on TNF-α expressions in TM ofWistar glaucoma model.MethodWistar model of glaucoma were divided into 2 groups, treatment and control group. Treatmentgroup was given MO leaves extract 300mg/kgBW/day oral for 4 weeks. TNF-α expressions weremeasured by immnuhistochemistry staining. Differences between two groups was analyzedstatistically using Mann-Whitney U test, significant if p<0,05.ResultMean of TNF-α expressions in treatment group was 4,29 + 0,76 and control group was 5,29 + 0,49.There was significantly different in TNF-α expressions between two groups (p=0,015).ConclusionMO leaves extract per oral can decrease TNF-α expression in TM Wistar glaucoma model. Studiesin human are still needed to assess the effect of MO leaves extract on inflammatory mediatorsexpression that are increased in glaucoma.KeywordMoringa oleifera, TNF-α, glaucomaLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download446-FP-R-E-IGS-21-Ratih-Kusuma-Astuti.pd

259FREE PAPER

FP-R-O-INANOS-01INCIDENCE AND CLINICAL FEATURES OF ETHAMBUTOL-INDUCED OPTICNEUROPATHY IN DR KARIADI HOSPITAL, SEMARANG

Abstract TitleINCIDENCE AND CLINICAL FEATURES OF ETHAMBUTOL-INDUCED OPTICNEUROPATHY IN DR KARIADI HOSPITAL, SEMARANG

First Author: Prianka Bayu Putra

Author Institution: Ilmu Kesehatan Mata FK Undip

Co Author: Riski Prihatningtias (Ilmu Kesehatan Mata FK Undip)



Seminat: INANOS


Introduction & ObjectiveIntroduction: The incidence, clinical manifestations, and contributory factors in ethambutol-inducedoptic neuropathy (EON) have not been widely studied. Objective: To evaluate the incidence andclinical manifestations of EON in the Dr Kariadi Hospital and to identify the development factors ofside effects.MethodA retrospective chart review of 368 patients who took ethambutol for treatment of tuberculosisidentified 13 patients who complained of decreased vision after initiation of treatment and weretherefore referred to the ophthalmology clinic of Dr Kariadi Hospital, Semarang, between January2017 and December 2019. Information was extracted in regard to systemic illnesses, duration anddose of ethambutol therapy, visual acuity, color vision, ophthalmoscopic examination, and visualfields.ResultEON was diagnosed in 13 (3.5%) patients during a follow-up period of 12.15 ± 9.39 months. Theaverage dose of ethambutol was 16.35 ± 2.37 g/kg/day, and the duration of therapy was 9.38 ±10.12 months. Ophthalmic findings included decreased visual acuity (57.7%), abnormal visual fields(57.7%), abnormal color vision (65.4%), or optic disc pallor (46.2%). Slightly less than one third ofpatients showed improvement in visual function after discontinuing ethambutol. The latency forrecovery was 5.29 ± 1.29 months.ConclusionBased on this study, the incidence of ON in Dr Kariadi Hospital is estimated to beKeywordEthambutol, optic neuropathy, visual acuityLatest UpdateMay 15, 2021StatusApproved As Free PaperFile Download433-FP-R-O-INANOS-01-Prianka-Bayu-Putra.pdf

260 FREE PAPER

FP-R-O-INANOS-02THE ALTERATION OF VISUAL FUNCTION BEFORE AND AFTERCRANIOTOMY IN COMPRESSIVE OPTIC NEUROPATHY PATIENTS ATKARIADI HOSPITAL SEMARANG

Abstract TitleTHE ALTERATION OF VISUAL FUNCTION BEFORE AND AFTER CRANIOTOMY INCOMPRESSIVE OPTIC NEUROPATHY PATIENTS AT KARIADI HOSPITAL SEMARANG

First Author: John Elfran Sihombing

Author Institution: FK UNDIP/RSUP dr. Kariadi Semarang

Co Author: Riski Prihatningtias (FK UNDIP/RSUP dr. Kariadi Semarang)



Seminat: INANOS


Introduction & ObjectiveCompressive optic neuropathy (CON) can be caused by intrinsic or extrinsic compression anywherealong the optic nerve. The common cause is intracranial tumors. Any change inside skull isreflected through ocular signs and symptoms. One of managements CON caused intracranialtumors is craniotomy. The aim of this study was to evaluate the alteration of visual function beforeand after craniotomy in CON patients at Kariadi Hospital SemarangMethodThis research is a retrospective study. The patients from January 2019 until December 2020 whoinclude inclusion criteria were taken their visual function data before and after craniotomy from themedical record, 14 (28 eyes) CON patients were enrolled in this study. The visual function datataken were visual acuity, contrast sensitivity, color vision, and visual field. Comparison betweenbefore and after visual function data were then analyzed with paired T test.ResultThe mean visual acuity before and after were RE 0,21 and 0,19 (p value 0,588), LE 0,26 and 0,24 (pvalue 0,593). The mean contrast sensitivity before and after were RE 5,50 and 5,50, LE 9,50 and9,50. The mean color vision before and after were RE 0,64 and 0,53 (p value 0,399), LE 0,13 and0,13. The mean visual field before and after were RE 0,64 and 0,53 (p value 0,399), LE 0,13 and0,13ConclusionThe visual function before and after craniotomy was not significant in CON patients at KariadiHospital SemarangKeywordCompressive optic neuropathy, craniotomy, visual functionLatest UpdateMay 15, 2021StatusApproved As Free PaperFile Download401-Abstract-Code-First-Author-FP-R-O-INANOS-02-John-Elfran-Sihombing.pdf

261FREE PAPER

FP-R-O-INANOS-03VISUAL OUTCOME OF TRAUMATIC OPTIC NEUROPATHY AFTER STEROIDTREATMENT IN KARIADI HOSPITAL

Abstract TitleVISUAL OUTCOME OF TRAUMATIC OPTIC NEUROPATHY AFTER STEROID TREATMENTIN KARIADI HOSPITAL

First Author: Isnia Rahmi Roosdhantia

Author Institution: FK Undip/ RSUP dr. Kariadi Semarang

Co Author: Riski Prihatningtias (FK Undip/ RSUP dr. Kariadi Semarang)



Seminat: INANOS


Introduction & ObjectiveThe occurrence of Traumatic Optic Neuropathy (TON) often occurs in the form of head injuriesResulting from traffic accidents. TON is an important cause of impaired visual function which maybe improved with steroid therapy. To determine the visual outcome in patients with TON treatedwith steroids in Kariadi Hospital, SemarangMethodThis research was a retrospective study. Thirty patients (20 males and 10 females) with TON inophthalmology clinic of Kariadi Hospital Semarang between Januari 2019 and December 2020.Visual acuity, contrast sensitivity and color blindness test was included in the data from medicalrecord. Steroid therapy was divided into 3 groups. Steroid intravena injection alone, steroidintravena followed with oral steroid, and oral steroid alone. The Wilcoxon Test and Kruskall WallisTest were used as the statistical test for visual outcome.ResultThere were 5 cases that received steroid intravena injection alone, 18 cases received steroidintravena followed with oral steroid, and 7 cases received oral steroid alone. The visual outcomeafter using 3 Methods steroid therapy showed statistically significant (p-value < 0.05). The averageof visual acuity (8.286) and contrast sensitivity (0.0566) with steroid intravena followed with oralsteroid had the best outcome. The average of color blindness test (1.000) with oral steroid alonehad the best outcome.ConclusionPatients with TON had better visual outcome after treated with steroid intravena followed with oralsteroidKeywordTraumatic Optic Neuropathy, Steroids, Visual OutcomeLatest UpdateMay 15, 2021StatusApproved As Free PaperFile Download33-FP-R-O-INANOS-03-Isnia-Rahmi-Roosdhantia.pdf

262 FREE PAPER

FP-R-O-INANOS-04UPDATES ON CLINICAL AND ETIOLOGIC FEATURES OFOPHTHALMOPLEGIA CASES : TWO-YEARS RETROSPECTIVE STUDY

Abstract TitleUPDATES ON CLINICAL AND ETIOLOGIC FEATURES OF OPHTHALMOPLEGIA CASES :TWO-YEARS RETROSPECTIVE STUDY

First Author: Sesaria Rizky

Author Institution: Department of Ophthalmology Cipto Mangunkusumo Hospital Jakarta

Co Author: M. Sidik (Neuro-ophthalmology Division Cipto Mangunkusumo Hospital Jakarta)



Seminat: INANOS


Introduction & ObjectiveAbnormalities in eye movement can be characterized by various clinical and etiologic factors. Thesefactors differ in many studies, including some previous studies in Cipto Mangunkusumo Hospital.The variation depends on its clinical settings, time period, and geographical location. This studyaims to determine recent characteristics of clinical and etiologic features of ophthalmoplegia cases.MethodDescriptive retrospective study is conducted on patients’ medical records from Neuroophthalmology clinic. Selected medical records between 2017 and 2018 are reviewed.Demographic, clinical characteristics, and etiology data are documented. Further analysis is thenperformed to calculate the recent distribution of each variable.ResultData collected from 145 patients’ medical records is analyzed. Total affected eyes are 179. Most ofthe cases (78.6%) show eye malposition with diplopia as the common symptoms (31.7%). Clinicalmanifestations are mostlty unilateral in 111 patients (76.6%). The most frequent type ofophthalmoplegia is neurogenic origin (77.7%) with the highest number in palsy of multiple cranialnerves (39.7%) followed by palsy of sixth cranial nerve (16.2%). Vascular (32.4%) and neoplasm(31.7%) are found as the most frequent etiologic factor of ophthalmoplegia. Vascular- ischemicdisease is seen in numerous cases of vascular origin while nasopharyngeal cancer represents themajority of neoplasm cases.ConclusionOphthalmoplegia has many different clinical and etiologic features. Compared to the previousstudies, the distribution of some factors is changing. Predominant manifestation is neurogenicorigin with vascular and neoplasm as the most common etiologic factors. Prompt diagnosis ofetiology using additional laboratory work-up and imaging modalities are important in some cases.Keywordophthalmoplegia, ocular motor nerve palsy, etiologyLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download636-FP-R-O-INANOS-04-Sesaria-Rizky-Kumalasari.pdf

263FREE PAPER

FP-O-INANOS-05Risk Factors for Ophthalmoplegia in Diabetes Mellitus

Abstract TitleRisk Factors for Ophthalmoplegia in Diabetes Mellitus

First Author: GANESA WARDANAAuthor Institution: Department of Ophthalmology Universitas Hasanuddin

Co Author:

BATARI TODJA UMAR (Department of Ophthalmology Universitas Hasanuddin)

HABIBAH S. MUHIDDIN (Department of Ophthalmology Universitas Hasanuddin)



Seminat: INANOS


Introduction & ObjectiveThis study was aimed to evaluate the risk factors associated with ophthalmoplegia in patients withDiabetes mellitus.Methodthe Cross Sectional study was conducted at the Teaching Hospital of Hasanuddin University duringJuly - September 2019. The sample were 55 people who met the inclusion criteria, 43 people withDiabetes Mellitus patients without ophthalmoplegia and 12 patients with ophthalmoplegia, with anaverage age of 52 years. Subject age, sex, type of diabetes mellitus, duration of illness,accompanying diseases are hypertension, dyslipidemia, coronary heart disease and diabeticretinopathy were recorded. All data is recorded and processed using the SPSS statistical analysisprogram using descriptive and frequency univariate analysis, and bivariate analysis Chi square test(χ2) to compare correlations between categories, after which all risk factors are assessed using aunivariate logistic regression model.ResultThe Results showed the most important and very significant risk factor (p = 0.003) forophthalmoplegia in diabetes was age ≥ 45 years. While risk factors for sex, type of diabetes,duration of disease, and the presence or absence of concomitant diseases did not show a significantrelationship to ophthalmoplegia in patients with diabetes mellitus.ConclusionThe risk factor for age ≥ 45 years was the most statistically significant associated with theoccurrence of ophthalmoplegia in diabetes, with a 4-fold higher risk of developing ophthalmoplegiacompared to younger age in diabetes mellitus patients.KeywordOphthalmoplegia, risk factors, diabetes mellitusLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download545-FP-O-INANOS-05-Ganesa-Wardana.pdf

264 FREE PAPER

FP-R-O-INANOS-06Visual Evoked Potential as a Routine Diagnostic Procedure to DifferentiateTypical and Atypical Optic Neuritis

Abstract TitleVisual Evoked Potential as a Routine Diagnostic Procedure to Differentiate Typical andAtypical Optic Neuritis

First Author: Gandhi Anandika Febryanto

Author Institution: Universitas Gadjah Mada

Co Author: dr. Indra Tri Mahayana, Ph.D., Sp.M (Universitas Gadjah Mada)



Seminat: INANOS


Introduction & ObjectiveVEP is used to evaluate the visual pathway functions starting from the retina up to the visualcortex. It detects any abnormality of visual pathways such as optic neuritis or demyelination of theoptic nerve in Multiple Sclerosis. This study aims to analyze VEP outcomes in suspected opticneuritis eyes compared to normal eyes.MethodThis was a cross-sectional study in patients with suspected optic neuritis from April 2021 until May2021 in Sardjito General Hospital Yogyakarta. The P100 latencies were recorded from VEPexaminations of suspected optic neuritis patients with 10-50 years of age, had acute vision loss inone or both eyes, and visual field examinations supportive towards optic neuritis. Patients with ahistory of other ophthalmologic disease or neurologic disease other than multiple sclerosis wereexcluded. The P100 latencies were analyzed using SPSS Independent T-Test.ResultEleven patients were included in the study; 3 (27.3%) male and 8 (72.7%) female. From the VEP Results of 22 eyes; 18 (81.8%) were suspected to had optic neuritis; 4 (18.2%) were normal; 12 (54.5%) had prolonged P100 latency; 9 (40.9%) were suspected Multiple Sclerosis; 10 (45.4%) had normal P100 latency; 11 (50%) were assessed to had demyelinating optic nerves. The mean latency of normal and neuritis optic eyes were 95.6ms and 114.3ms, respectively (p= 0.659).ConclusionAmong 11 patients with suspected neuritis optic, 7 patients had VEP Results of demyelinating optic nerves. VEP is a useful examination to diagnose demyelinating optic nerve conditions. Otherpatients with atypical optic neuritis require other diagnostic procedures.KeywordVisual Evoked Potentials (VEP), Optic Neuritis, Multiple SclerosisLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download240-FP-R-O-INANOS-06-Gandhi-Anandika-Febryanto.pdf

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FP-R-O-INANOS-07NEURO-OPHTHALMOLOGY PRACTICE DURING COVID-19 PANDEMIC

Abstract TitleNEURO-OPHTHALMOLOGY PRACTICE DURING COVID-19 PANDEMIC

First Author: Yuri Dwi Mayasari

Author Institution: Department of Ophthalmology Faculty of Medicine Universitas Indonesia, Dr. Cipto

Mangunkusumo Hospital Jakarta, Indonesia

Co Author: Syntia Nusanti (Department of Ophthalmology Faculty of Medicine Universitas Indonesia, Dr.

Cipto Mangunkusumo Hospital Jakarta, Indonesia)



Seminat: INANOS


Introduction & ObjectiveOphthalmology practice including neuro-ophthalmology adopted the American Academy ofOphthalmology recommendation to provide only urgent or emergent care during the COVID-19pandemic. This report aimed to present demographical and attendance data regarding outpatientcharacteristics in neuro-ophthalmology clinics and to evaluate the patients’ flow regulation andpriority mitigation according to PERDAMI guidelines during the COVID-19 pandemic.MethodRetrospective study using medical record data of neuro-ophthalmology outpatients at Dr. CiptoMangunkusumo Hospital from April-June in 2019 and 2020.ResultThere was 207 attendance from 160 patients during the pandemic which was 33.9% attendancecompared to attendance before pandemic. Most patients were referred from internal referral(54.5%). The external referral of new patients mostly came more than 2 weeks since the onset(40.6%). During pandemic, most patients were diagnosed with NAION (12.6%), toxic opticneuropathy (8.7%), and paretic eye movement disorder (7.7%) which were similar to patientdiagnosis before pandemic. The diagnosis was later classified further into patient flow guidelines inneuro-ophthalmology clinic and PERDAMI guideline, divided based on diagnosis andteleophthalmology, with the highest category were non-priority patients (34.8%), 3B-level priority(26.5%), and first-level priority, respectively.ConclusionA major difference characteristic of neuro-ophthalmology outpatients during pandemic was thenumber of patients attendance. New patients mostly came from internal and local (Jabodetabek)referrals which can be caused by mobility limitation, patients flow regulation, and patients’ concernabout COVID-19. Priority mitigation in this study found non-priority patients were the majority whovisited the clinic during the COVID-19 pandemic which needs further evaluation on referral andtriage systems.KeywordNeuro-ophthalmology practice during COVID-19 pandemic, COVID-19, OutpatientsLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download786-FP-R-O-INANOS-07-YURI-DWI-MAYASARI.pdf

266 FREE PAPER

FP-O-INANOS-08Common Signs and Symptoms of Brain Tumor in NeuroophthalmologyPatients: A serial cases in Sardjito National Hospital

Abstract TitleCommon Signs and Symptoms of Brain Tumor in Neuroophthalmology Patients: A serial cases in Sardjito National Hospital

First Author: WIDYANDANA

Author Institution: RSUP Dr. Sardjito Yogyakarta - Department of Ophthalmology, Faculty of Medicine, Public

Health, and

Co Author: Indra Tri Mahayana (RSUP Dr. Sardjito Yogyakarta - Department of Ophthalmology, Faculty of

Medicine, Public Health and) Hartono (RSUP Dr. Sardjito Yogyakarta - Department of Ophthalmology,

Faculty of Medicine, Public Health, and )



Seminat: INANOS


Introduction & ObjectiveOphthalmologists, neuroophthalmologists in particular, frequently come across patients with visualimpairments caused by brain tumors that require an MRI scan with contrast to confirm thediagnosis. Unfortunately, MRI is considered expensive and not available in most of the peripheralareas. This circumstance forced ophthalmologists to strengthen their clinical skills to diagnosepatients using only simple diagnostic tools. The objective of this study was to specify the mostcommon signs and symptoms that appeared in patients with brain tumors.MethodThe study was conducted in Sardjito Hospital in 2020. We randomly selected 12 adult patients withbrain tumors who had an MRI scan done to confirm the diagnosis and came to ourneuroophthalmology subdivision clinic. Qualitative descriptive analysis was carried out by 2 codersto verify the signs and symptoms that occurred most frequently in the subjects.ResultThe majority of subjects were young adults (age 20-64 y.o., mean=36.66), with a progressiveblurring of vision, headache, and visual field disorder. Almost all patients had no history ofcomorbid chronic diseases such as diabetes mellitus and hypertension.ConclusionThe most common signs and symptoms in young healthy patients without a history of chronicdisease with brain tumors are decreased visual acuity, headaches, and visual field disorders.KeywordBrain tumor, neuro-ophthalmology patients, most common signs and symptomsLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download728-FP-O-INANOS-08-Widyandana.pdf

267FREE PAPER

FP-O-INANOS-09Clinical Characteristics and Outcome of Neuromyelitis Optica SpectrumDisorder (NMOSD) Compared with Typical Optic Neuritis (ON) in a TertiaryCare Eye Hospital in Jakarta

Abstract TitleClinical Characteristics and Outcome of Neuromyelitis Optica Spectrum Disorder (NMOSD)Compared with Typical Optic Neuritis (ON) in a Tertiary Care Eye Hospital in Jakarta

First Author: Valenchia

Author Institution: JEC Eye Hospitals and Clinics, Jakarta, Indonesia

Co Author:

Alia Arianti (JEC Eye Hospitals and Clinics, Jakarta, Indonesia)

Amira Widyasari (JEC Eye Hospitals and Clinics, Jakarta, Indonesia)

Lily Silva Ardiani (JEC Eye Hospitals and Clinics, Jakarta, Indonesia)



Seminat: INANOS


Introduction & ObjectiveTo investigate the characteristics and treatment outcome of NMOSD compared with typical ON atJEC@Kedoya and JEC@Menteng from 2017 to 2021MethodA retrospective, descriptive study was conducted using medical records from patients treated withhigh-dose intravenous methylprednisolone in JEC Eye Hospitals. The diagnosis was based on OpticNeuritis Treatment Trial (ONTT) and the 2015 International Consensus NMOSD diagnostic criteria.Demographical, clinical, radiological features, best-corrected visual acuity (BCVA), visual fielddefects, optic disc retinal nerve fiber layer (RNFL), and macular ganglion cell complex (GCC)thickness were evaluated and compared before and after treatment.ResultSixty-seven patients (82 eyes) were analyzed; 60 patients (71 eyes) with typical ON and 7 patients(11 eyes) with NMOSD. Most were female with sudden onset of blurred vision and retrobulbarinvolvement. Bilaterality and recurrence were significant for NMOSD. Long segment optic nerveinvolvements in contrast-enhanced MRI were found in 7 NMOSD patients and 81.8% showed nadirBCVA < 0,1. Initially, the NMOSD group had thinner inferior (107,63 vs 198,58 μm; p 0,002) andnasal (75 vs 115,16 μm; p 0,007) RNFL thickness compared to the typical ON group. Both groupsshowed improved BCVA and visual field, with thinning of RNFL and GCC after treatment but nosignificant differences between the two groups (p >0.05).ConclusionBilateral involvement, recurrence, and long segment optic nerve involvement were distinctivefeatures of NMOSD in this study. However, no significant differences were found between the twogroups after treatment for BCVA, visual field, RNFL, and GCC changes.Keywordneuromyelitis optica; optic neuritisLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download353-FP-O-INANOS-09-Valenchia.pdf

268 FREE PAPER

FP-R-O-INANOS-11Diminishing the learning effect of Humphrey Field Analyzer performanceafter third examination session

Abstract TitleDiminishing the learning effect of Humphrey Field Analyzer performance after third examination session

First Author: Bayu Primahatmaja


Co Author: Indra Tri Mahayana (Neuro Ophthalmology Division, Department Ophthalmology Faculty of

Medicine Universitas Gadjah Mada), Krisna Dwi Purnomo Jati (Glaucoma Division, Department

Ophthalmology Faculty of Medicine Universitas Gadjah Mada)



Seminat: INANOS


Introduction & ObjectiveLearning effect is important factor in many psychophysical test. This study aim is to examine thelearning effects of HFA in patients with glaucoma.MethodThis was a crosssectional study. Twelve patients (20 eyes: 80% Open Angle Glaukoma, 10% AngleClosure Glaukoma and 10% Secondary Glaukoma) were submitted to Humphrey perimetry for threedifferent sessions of examinations. Inclusion criteria was patient with glaucoma that enrolled threeexaminations, exclusion criteria was the dropped out patients. We analyzed the Results by using ANOVA and post hoc test by using Tukey. Main outcomes were reliability, global indices andthreshold sensitivity between three sessions. Secondary outcomes were intereye differencebetween first eye and second eye in the same session.ResultDuration of test was statistically decrease after third session (p=0,017). Fixation loss wasstatistically decrease (p=0,001). False negative was improved after third seassion (p=0,00). Thereis no statistically difference in false positive, MD, PSD and VFI between three sessions. ComparingResult of first eye and second eye in the same session, the second eye was consumed longer time (p=0,00), had fewer fixation loss (p=0,001), experienced decreasing of false positive (p=0,00) butincreasing of false negative (p=0,026). There is no statistically difference in MD, PSD and VFIbetween first eye and second eye.ConclusionThe effects of increasing test experience of Humphrey Field Analyser were large especially inreliability indices while no statistically change in global indice. Experience has clinically importanteffects on perimetry Results. To avoid false Conclusions, we should take learning effect into judgement.Keyword: Learning effect, Humphrey Field Analyser, GlaucomaLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download265-FP-R-O-INANOS-11-Bayu-Primahatmaja.pdf

269FREE PAPER

FP-R-O-INASOPRS-01ORBITAL LYMPHOMA: CLINICAL PROFILE, AT DR. M. DJAMIL HOSPITALPADANG, INDONESIA

Abstract TitleORBITAL LYMPHOMA: CLINICAL PROFILE, AT DR. M. DJAMIL HOSPITAL PADANG, INDONESIA

First Author: Meironi Waimir

Author Institution: Department of Ophthalmology, Faculty of Medicine, Andalas University, M Djamil Hospital

Padang

Co Author: Ardizal Rahman ( Department of Ophthalmology, Faculty of Medicine, Andalas University,

M Djamil Hospital Padang)



Seminat: INASOPRS


Introduction & ObjectiveTo explore the baseline clinical profile of orbital lymphoma, at Dr. M. Djamil Hospital Padang, Indonesia.MethodAs part of routine delivery service, we evaluated data from January 2015 to December 2020 of theorbital lymphoma patients included in the study. Initially they are confirmed by histopathologicalstudy reports. Their clinical charactetistics were evaluated.ResultA total of 17 patients were evaluated. The majority of the patients being male, with a mean agerange of 60 years. The most clinical manifestations were proptosis (58.82%) followed by palpebralmass (41.18%) and most cases were unilateral. Most of the patients were non Hodgin lymphomawith small lymphocytic type. The management performed were chemotherapy in 16 patients and 1patient performed anterior orbitotomy and refused chemotherapy.ConclusiionOrbital lymphoma is a disease of the elderly. It tends to be localized to the orbit at the time ofdiagnosis. Systemic chemotherapy is one of the effective therapies for orbital lymphoma.KeywordOrbital lymphoma, proptosis, chemotherapyLatest UpdateMay 06, 2021StatusApproved As Free PaperFile Download329-FP-R-O-INASOPRS-01-Meironi-Waimir.pdf

270 FREE PAPER

FP-R-O-INASOPRS-02Clinical Characteristic and Surgical Outcome of Blepharoptosis: Five-years Retrospective Study

Abstract TitleClinical Characteristic and Surgical Outcome of Blepharoptosis: Five-years RetrospectiveStudy

First Author: Putri Anggia Bunga

Author Institution: Departement of Ophthalmology, Faculty of Medicine, Universitas Indonesia Cipto

Mangunkusumo Hospital, Jakarta, Indonesia

Co Author

Yunia Irawati (Departement of Ophthalmology, Faculty of Medicine, Universitas Indonesia Cipto

Mangunkusumo Hospital, Jakarta, Indonesia)



Seminat: INASOPRS


Introduction & ObjectiveIntroduction: Blepharoptosis is a common upper eyelid problem which can affect children andadult. It can cause amblyopia in younger patients and reduce visual field in older patients henceprompt treatment is required. Objective: To determine the prevalence and clinical characteristic ofblepharoptosis and to evaluate surgical outcome of eyelid ptosis in a tertiary ophthalmologyreferral hospital in Jakarta.MethodMethod: Retrospective study was conducted in 2020. Medical records patient underwentblepharoptosis surgery between January 2014-December 2018 were analysed. Prevalence rates,patient’s demographic, clinical characteristic, type of surgery, successful rate and complication ofblepharoptosis surgery were evaluated.ResultResult: The prevalence of blepharoptosis in this study was 104 patients and were almost equal 1.2:1ratio in women and men. Mean aged in this study was ±31.9 years old. The blepharoptosis waspredominantly unilateral 84.6%. Blepharoptosis was severe in 90% cases and myogenic ptosis wasthe most common etiology of ptosis in this study. Levator resection is the most prevalent type ofsurgery. The success rate of blepharoptosis surgery was 83.1%. The most common complication islagophthalmos without corneal exposure.ConclusiionConclusiion: The success rate of ptosis surgery in this study was high and lagophthalmos was themost common complication of blepharoptosis surgery.KeywordBlepharoptosis, successful rate, ptosis surgeryLatest UpdateMay 14, 2021StatusApproved As Free PaperFile Download37-FP-R-O-INASOPRS-02---Putri-Anggia-Bunga.pdf

271FREE PAPER

FP-R-O-INASOPRS-03Correlation Between Signal Regulatory Protein Alpha Expression with theGrading of Retinoblastoma

Abstract TitleCorrelation Between Signal Regulatory Protein Alpha Expression with the Grading ofRetinoblastoma

First Author: Reza AuliaAuthor Institution: UGMCo Author: Datu Respatika (UGM), Agus Supartoto (UGM), Purjanto Tepo Utomo (UGM), Banu Aji Dibyasakti (UGM)Irene Titin Darajati (UGM)

Abstract Type: ResearchAbstract Category: Free PaperSeminat: INASOPRSCompetition Category: Resident

Introduction & ObjectiveAlmost all of solid tumor can bypass immune checkpoint system. Signal Regulatory Protein Alpha(SIRPα) is one of immune checkpoint system that express in several solid tumor. SIRPα has beendescribe as anti-phagocytic signal on tumor cell. Retinoblastoma is one of solid tumor thatoriginates from retinocytes, which is has been reported to express SIRPα. Therefore, SIRPα mightbecome one of the targeted therapies that can be designated for Retinoblastoma. This study aims toinvestigate the correlation of SIRPα expression and the grading of Retinoblastoma.MethodThis was a retrospective analytic cross-sectional study that conducted using histopathologic samplefrom Retinoblastoma patients at Sardjito General Hospital Yogyakarta. The eye was primarilyenucleated between 2014 until 2017. All of the patient Retinoblastoma was classified usingInternational Retinoblastoma Staging System (IRSS). The expression SIRPα mRNA was quantifyusing Reverse Transcriptase Polymerase Chain Reaction.ResultAmong total of 24 subjects from 13 males and 11 females. According to IRSS 1 children was stage0, 8 children were stage 1, 2 children were stage 3, 13 children were stage 4. There was noassociation between SIRPα expression with IRSS (p=0.251).ConclusiionHistopathologic evidence of SIRPα expression do no correlate with the IRSS. Thus, the targetedtherapy for Retinoblastoma by suppressing the SIRPα, could be performed in all Retinoblastomapatients.KeywordRetinoblastoma, International Retinoblastoma Staging System (IRSS), Signal Regulatory Protein(SIRPα).Latest UpdateMay 16, 2021StatusApproved As Free PaperFile Download457-FP-R-O-INASOPRS-03-Reza-Aulia.pdf

272 FREE PAPER

FP-R-O-INASOPRS-04Association between Expression of Signal Regulatory Protein Alpha with theLaterality in Retinoblastoma

Abstract TitleAssociation between Expression of Signal Regulatory Protein Alpha with the Laterality inRetinoblastoma

First Author: Sarah Rizqia Indrayanti

Author Institution: RSUP Dr. Sardjito Yogyakarta - Department of Ophthalmology, Faculty of Medicine, Public

Health, and Nursing, Universitas Gadjah Mada

Co Author:

Datu Respatika, Irene Titin D, Banu Aji Dibyasakti, Purjanto Tepo Utomo, Agus Supartoto

(RSUP Dr. Sardjito Yogyakarta - Department of Ophthalmology, Faculty of Medicine, Public Health, and

Nursing, Universitas Gadjah Mada)



Seminat: INASOPRS


Introduction & ObjectiveSeveral solid tumors “escaped” from body immune response by activating immune checkpoint. Immunotherapy targeting on immune checkpoint has been a promising strategy to cure cancers SIRPα(Signal Regulatory Protein Alpha) is a transmembrane protein that play important roles in immune checkpoint and is expressed on several solid tumor cells. Retinoblastoma, a solid tumor originated from retinocytes, were shown to express SIRPα. Therefore, targeting SIRPα for future Retinoblastoma immunotherapy might Result in favorable outcome. This study aims to evaluate the relationship between the expression of SIRPα and Retinoblastoma laterality.MethodThis was a retrospective cross-sectional study enrolling histopathological tissue from primary enucleated Retinoblastoma patients from year 2014 until 2017 in Sardjito General Hospital Yogyakarta. The expression SIRPα mRNA was examined with qPCR and the relationship between SIRPα expression and Retinoblastoma laterality were analyzed.ResultTwenty-four subjects were included; 13 (54.2%) was male, with presenting visual acuity of Snellen (5; 20.8%), LP (11; 45.8%), and NLP (8;33.3%). Retinoblastoma staging was performed with ICRB, with 22 (91.7%) was ICRB-E, and the rest was ICRB-B. SIRPα expression was low in 6 (25.0%) and high in 18 (75%) patients. Laterality of RB was analyzed, 20 (83.3%) of them had unilateral RB and its relationship with SIRPα was not significant (p=0.293).ConclusiionThe lack of relationships between SIRPα and Retinoblastoma laterality might indicate that, regardless of laterality Status, future immunotherapy targeting on SIRPα could be performed in all Retinoblastoma patients.KeywordRetinoblastoma, Signal Regulatory Protein (SIRPα), lateralityLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download830-FP-R-O-INASOPRS-04-Sarah-Rizqia-Indrayanti.pdf

273FREE PAPER

FP-R-O-INASOPRS-05Signal Regulatory Protein Alpha Expression in Retinoblastoma: A NewEmerging Aspect for Retinoblastoma Immunotherapy

Abstract TitleSignal Regulatory Protein Alpha Expression in Retinoblastoma: A New Emerging Aspectfor Retinoblastoma Immunotherapy

First Author: Dimas Nugroho Kurniawan


Co Author:

Datu Respatika (Ilmu Kesehatan Mata FKKMK UGM)

Irene Titin D (Ilmu Kesehatan Mata FKKMK UGM)

Banu Aji Dibyasakti (Ilmu Kesehatan Mata FKKMK UGM)

Purjanto Tepo Utomo (Ilmu Kesehatan Mata FKKMK UGM)

Agus Supartoto (Ilmu Kesehatan Mata FKKMK UGM)



Seminat: INASOPRS


Introduction & ObjectiveSignal Regulatory Protein Alpha (SIRPα) has been described as an important anti-phagocytic signalexpressed on tumor cells in immune checkpoint system. In solid tumors, a moderate increase inSIRPα expression has been detected compared with normal tissues. Retinoblastoma (RB) isoriginated from retinocytes that were shown express SIRPα. Targeting SIRPα for RBimmunotherapy might be the future option. This study aims to evaluate the relationship betweenthe expression of SIRPα and the clinical manifestation in RB patient.MethodThis was retrospective cross-sectional study conducted in Sardjito General Hospital. Twenty-fourhistopathological samples from primary enucleated retinoblastoma patients from 2014 until 2017were obtained. The expression of SIRPα mRNA was examined with qPCR.ResultAmong 24 patients, 13 (54.2%) were male and 11 (45.8%) were female, with presenting visualacuity of Snellen 5 (20.8%), LP 11 (45.8%), and NLP 8 (33.3%). Ptosis was reported 6 (25.0%)patient, 5 (20.8%) hyperemia, 2 (8.3%) chemosis. Among all clinical manifestations, there were norelations found with SIRPα expression.ConclusiionThe expression of SIRPα were shown independent to the clinical manifestations of RB. TargetingSIRPα for RB immunotherapy may be used regardless the clinical manifestations of the RB patients.KeywordSignaling Regulatory Protein Alpha (SIRPα), Retinoblastoma, Clinical SignLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download417-FP-R-O-INASOPRS-05-DIMAS-NUGROHO-KURNIAWAN.pdf

274 FREE PAPER

FP-R-O-INASOPRS-06THE PROFILE OF SINONASAL TUMORS WITH ORBITAL INVOLVEMENT INDR. M. DJAMIL HOSPITAL PADANG : 10 YEARS REVIEW

Abstract TitleTHE PROFILE OF SINONASAL TUMORS WITH ORBITAL INVOLVEMENT IN DR. M.DJAMIL HOSPITAL PADANG : 10 YEARS REVIEW

First Author: Dwi Lestari PohanAuthor Institution: PPDS Ophthalmology FK Universitas AndalasCo Author:Ardizal Rahman (Reconstruction, Oculoplasty, and Oncology Subdivision Department ofOphthalmology – Faculty of Medicine Andalas University/ Dr. M. Djamil Hospital)Mardijas Efendi (Reconstruction, Oculoplasty, and Oncology Subdivision Department ofOphthalmology – Faculty of Medicine Andalas University/ Dr. M. Djamil Hospital)


Introduction & ObjectiveSinonasal tumors are rare tumors either malignant or benign that vary greatly based on the originand primary tumor location in sinonasal tract. The close anatomical relationship between sinonasaltract and orbital cavity makes orbital involvement very common (50%-80%) in sinonasal tumors andthis indicates negative prognostic factor in sinonasal malignancy. The purpose of this study is todemonstrate the profile of sinonasal tumors with orbital involvement in our center.MethodRetrospective study from oncology subdivision files and medical records from January 2011 –December 2020. Collected data including age, sex, clinical presentation of orbital involvement,primary location, histopathology, and management of sinonasal tumors.ResultThere were 35 patients examined by the oncology subdivision either directly came or consultedfrom ENT department, consist of 18 (51.4%) males and 17 (48.6%) females. The age of patientsranged from 11 to 83 y.o with the most common age group were 41-50 and 51-60 (25.7% in eachage group). Majority of the patients (77.1%) had presented with proptosis. Maxilary sinus was themost common (45.7%) primary site of tumors and squamous cell carcinoma was the most common(51.4%) histopathology found. Most of the patients (37.1%) were treated with combination ofchemotherapy and radiotherapy.ConclusiionOrbital involvement was commonly occurred in malignant sinonasal tumors with proptosis as amajor clinical presentation. Combination of chemotherapy and radiotherapy was the most commonpracticed management because at the time of presentation the tumors were unresectable.Keywordsinonasal tumors, orbital involvement, proptosisLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download421-FP-R-O-INASOPRS-06-Dwi-Lestari-Pohan.pdf

275FREE PAPER

FP-R-O-INASOPRS-07A Desceptrive Study on Ocular Surface Squamous Neoplasia in CiptoMangunkusumo Hospittal : 5 Years Observation

Abstract TitleA Desceptrive Study on Ocular Surface Squamous Neoplasia in Cipto MangunkusumoHospittal : 5 Years Observation



Co Author: Neni Anggraini ()



Seminat: INASOPRS


Introduction & ObjectiveOcular squamous surface neoplasia (OSSN) is the most common malignant conjunctival tumour,with high recurrence rate. After the use of cryotherapy and chemotherapeutic agents significantlyreduce the percentage of recurrences. The study aims to find data on sociodemographic, clinicalcharacteristics, type of management, and the percentage of OSSN recurrences in CiptoMangunkusumo Hospital (RSCM).MethodRetrospective descriptive study design based on secondary data from medical record of OSSNpatient in Ocular Oncology Division from January 2015 - December 2020.ResultFrom 61 patients included in the study, 75.5% were male, working as merchants, with a mean ageof 54.8 ± 2.4 years. The clinical characteristics were four months of mean onset with mean followup duration of 5 (1 — 66) months, undergoing direct light exposure (68.4%). Meanwhile, the clinicalappearance commonly presented with reddish masses on the conjunctiva (44.3%), unilateral(98.4%) and papilliform (57.5%). The bulbi conjunctiva, limbus, and cornea were the mostcommonly involved eye structures (47,5%), with size in clock hours 1-3 o’clock (41%).Histopathological findings mostly were CIN (45.6%) and SCC (43.9%). The recurrence rate was14% with a 12-month remission period.ConclusiionThe majority of the patients were male, with mean age above the fourth decade, middle education,and predominantly having direct sunlight exposure as the risk factor exposure. The most commonhistopathological findings were CIN, with wide excision as the most frequent surgery, followed byin short-term recurrence rate.KeywordOcular surface squamous neoplasia; recurrence; excision; cryotherapy; MMCLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download954-FP-R-O-INASOPRS-07-Cecilia-Anggraini.pdf

276 FREE PAPER

FP-R-O-INASOPRS-08THE PROFILE OF EYELID BASAL CELL CARCINOMA IN DR. M. DJAMILHOSPITAL PADANG : 5 YEARS REVIEW

Abstract TitleTHE PROFILE OF EYELID BASAL CELL CARCINOMA IN DR. M. DJAMIL HOSPITALPADANG : 5 YEARS REVIEW

First Author: Rikha ErinaAuthor Institution: Fakultas kedokteran universitas andalasCo Author:Ardizal Rahman (Fakultas kedokteran universitas andalas)Mardijas Efendi (Fakultas kedokteran universitas andalas)


Introduction & ObjectiveBasal cell carcinomas (BCCs) is the most common eyelid malignancy, accounts for approximately90% - 95% of malignant eyelid tumors. BCCs originate from the stratum basale, or stratumgerminativum of epidermis and outer root sheath of hair follicle and occur only in hair-bearingtissue. The purpose of this study is to demonstrate profile of eyelid basal cell carcinoma in ourcenter.MethodRetrospective study from oncology subdivision files and medical records from January 2016 -December 2020. Collected data including age, sex, occupation, laterality, tumor predilection, tumorinvasion, and management of BCCs.ResultThere were 36 patients who examined and managed, consist of 19 males (52,78%) and 17 females(47,22%). The patient ages ranged from 16 to 83 y.o with the most common age group were 61-70y.o (44,44%). Most of patients worked as farmers (61,11%). Majority of BCCs in eyelid occurredunilateral (91,67%) and lower eyelid was the most common site of occurence (63,64%). Theinvasion of BCCs involved ocular/orbital (36,11%), paranasal sinus (16,67%) and nasal cavity(16,67%). All of the patient were treated with surgical management, consist of combination therapysuch as wide exicion and palpebra reconstruction (77,77%), exentration and radiotherapy (27,78%).ConclusiionMajority BCCs of eyelid occurred in elderly people, and more common in man than women. Inferiorpalpebra is the most common predilection of BCCs. Early detection and timely managementmitigates the extensive destructive ocular/orbital damage. Surgery is the treatment of choice for alleyelid basal cell carcinomas.KeywordBasal cell carcinoma, eyelid, malignancyLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download466-FP-R-O-INASOPRS-08-RIKHA-ERINA.pdf

277FREE PAPER

FP-R-E-INASOPRS-09Comparison of Complete Conjunctival Epithelialization After CryopreservedAmniotic Membrane Transplantation Versus Freeze-dried in Symblepharon.

Abstract TitleComparison of Complete Conjunctival Epithelialization After Cryopreserved AmnioticMembrane Transplantation Versus Freeze-dried in Symblepharon.

First Author: FITRI MUSLIMAuthor Institution: Universitas IndonesiaCo Author: Yunia Irawati (Universitas Indonesia)Tjahjono D. Gondhowiardjo (Universitas Indonesia)Lisnawati (Universitas Indonesia)Joedo Prihartono (Universitas Indonesia)


Introduction & ObjectiveSymblepharon is an attachment of conjunctival bulbi to conjunctival tarsal due to chronicinflammation. Amnion membrane (AM) transplantation is a surgical treatment for symblepharon.There are two types of amniotic membranes namely cryopreserved and freeze-dried which havedifferent preservative processes. Our aim was to compare AM cryopreserved and freeze-dried incomplete conjunctival epithelization to reduce the inflammation and restored goblet cells.MethodIn 14 eyes of symblepharon, symblepharon release with AM transplantation was performed. 7 eyeswith AM cryopreserved, 7 eyes with AM freeze-dried. The post-operative evaluation was doneweekly in all subjects until 4 weeks after surgery include photographic documentation to evaluateconjunctival epithelization and grading inflammation. In the last week subjects underwent cytologyimpression and Ferning test (mucin production) to be compared with Results that have been donepre-operatively.ResultEyes with AM cryopreserved showed epithelization in 2,14 ± 1,07 weeks, while AM freeze-driedwas 3,29 ± 1,25 weeks. Severe inflammation (4/7) was found in eyes with freeze-dried, goblet cellsand mucin production were higher in eyes with AM cryopreserved.ConclusiionClinically AM cryopreserved showed better Results in completing conjunctival epithelization, reduceinflammation, and restored goblet cells compared with AM freeze-driedKeywordAmnion membrane transplantation, symblepharonLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download793-Publish-Format-pvsm-Fitri-Muslim.pdf

278 FREE PAPER

FP-R-O-INASOPRS-10THE PROFILE OF OCULAR FIBROUS HISTIOCYTOMA TUMORS AT DR. M.DJAMIL HOSPITAL PADANG: 2016-2020 REVIEW

Abstract TitleTHE PROFILE OF OCULAR FIBROUS HISTIOCYTOMA TUMORS AT DR. M. DJAMILHOSPITAL PADANG: 2016-2020 REVIEW

First Author: EKA ALPASRA

Author Institution: Recontruction Oculoplasty and Oncology Subdivision, Department of Ophthalmology,

Faculty of: Medicine Andalas University/ Dr. M. Djamil Hospital

Co Author:

MARDIJAS EFENDI ()

ARDIZAL RAHMAN ()



Seminat: INASOPRS


Introduction & ObjectiveOcular fibrous histiocytoma tumors are derived from histiocytic cells or primitive mesenkim cells.Fibrous histiocytoma is basically composed of a mixture of fibroblastic cells, histiocytic cells, bloodvessels and collagen in various proportions. This study is as first time study that purpose forknowing the profile ocular fibrous histiocytoma tumors at RSUP Dr.M. Djamil Padang from thecharacteristics of patients based on age, gender, clinical manifestations, history of diseases, onset,size, location, lateralization, histopathological and its treatment.MethodA cross sectional descriptive study based on medical record with ocular fibrous histiocytomatumors who had biopsy and histopathological examination between January 2016 until Desember 2020.ResultIn this study the subjects were 3 male subjects (37.5%) and 8 female subjects (62.5%), the most agerange was 51-60 years (50%). The most clinical manifestations were mass (87.5%), with a history ofunknown diseases (75.0%), the most onset was <6 months (50.0%), tumor size was between 1-5 cm(50%), the most location in orbita (50%) and the most lateralization was at oculi sinistra (50%). Themost histological were xanthelesma (37.5%) and dermatofibroma (37.5%). Its management wereexcision (75%), exenteration with radiotherapy (12.5%) and craniotomy (12.5%) cause meningioma.ConclusiionMost type of fibrous histiocytoma tumors at RSUP Dr. M Djamil Hospital were benign and locallyaggressive type and there was no malignant type.KeywordOcular fibrous histiocytoma, fibroblastic cells, histiocytic cells.Latest UpdateMay 17, 2021StatusApproved As Free PaperFile Download84-FP-R-O-INASOPRS-10-EKA-ALPASRA.pdf

279FREE PAPER

FP-R-O-INASOPRS-11 Normal Values of Hertel Exophthalmometry in a Javanese Population fromSouthern Java Region

Abstract TitleNormal Values of Hertel Exophthalmometry in a Javanese Population from Southern Java Region

First Author: ANDI ASHADY FITRAH PAWALLANGI

Author Institution: FKKMK UGM - RSUP dr Sardjito

Co Author:

Irene Titin Darajati (FKKMK UGM - RSUP dr Sardjito)

Banu Aji Dibyasakti (FKKMK UGM - RSUP dr Sardjito)

Purjanto Tepo Utomo (FKKMK UGM - RSUP dr Sardjito)

Agus Supartoto (FKKMK UGM - RSUP dr Sardjito)



Seminat: INASOPRS


Introduction & ObjectiveMany orbital diseases can cause proptosis, including thyroid-associated orbitopathy, tumors,inflammation, head and orbital trauma, and craniofacial abnormalities. Therefore, when evaluatingthe Results of measurements, the normal exophthalmometry value range in a specific populationmust be taken into consideration. Aims of this study were to determine the normal range ofabsolute and relative Hertel exophthalmometric values (EVs) in a Javanese populationMethodThis population-based cross-sectional study consisted of 300 healthy Javanese (154 females and 146males) aged between 18–62 years living in Southern Java Region. The data taken in SardjitoGeneral Hospital Yogyakarta. A Hertel exophthalmometer was used by the one physician for themeasurement of EV and inter-orbital distance (IOD).ResultFor the entire study population, the Hertel EVs ranged from 16 mm to 19 mm; the mean EVs for theleft eye (OS) and right eye (OD) were 17.0 ± 1.4 mm and 17.0 ± 1.5 mm, respectively; the uppernormal limits of the EVs (mean + 2 SD) for OS and OD were 18.8 mm and 19.0 mm, respectively;the mean relative EV was 0.20 ± 0.43 mmConclusiionWe concluded that our study provides normative ophthalmic data in a Javanese population. Thenormal EVs, asymmetry and IOD values have been established for clinical reference.KeywordHertel, Exophthalmometry, Javanese PopulationLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download551-PVSM-Fulltext---AA---UGM-fix.pdf

280 FREE PAPER

FP-O-INASCRS-01Catechin Regulates Reticulum Endoplasmic Stress in Rats Cataract Model

Abstract TitleCatechin Regulates Reticulum Endoplasmic Stress in Rats Cataract Model

First Author: NUGRAHA WAHYU CAHYANA

Author Institution: Universitas Jember

Co Author



Seminat: INASCRS


Introduction & ObjectiveThe pathogenesis of cataracts is still not widely known. One theory is that the cause of cataracts isstress of the endoplasmic reticulum. This study is to prove whether catechins can improveendoplasmic reticulum stress by regulating GRP78.Method19 μmol/kg of sodium selenite was injection by intraperitoneal to ten day-old Wistar rats. The ratswere separated randomly in five groups (n = 5 in each group): a control group, and four cataractinduction groups, treated with 0, 50, 100, 200 mg / kg catechin isolates. GMB4 Clone of Green Tea.By slit-lamp bio microscopic we performed degree of lens opacity and analysis of GRP78 byEnzyme-linked immunosorbent assay (ELISA).ResultBoth eyes of all rats in Group 1 no cataract formation. 20% of group 2 were found grade 3 cataractsand the remaining four of five (80%) developed grade 4 cataracts. Cataract in the lens of all ratsbetween group 2 and any eyes from groups 3 or 4 and 5 showed a significant difference (P = 0.022,0.001, 0.001). The degree of cataract formation in groups 3, 4 and 5 decreased. GRP78 in Group I,Group III, Group IV and Group V were significantly higher than the mean lens in Group II (PConclusionReticulum endoplasmic stress in the lens that increased following cataract formation in rats wassuppressed by catechin Isolate From GMB4 Clone Green Tea.KeywordCataract, GRP78, Catechin IsolateLatest UpdateApril 16, 2021StatusApproved As Free PaperFile Download725-FP-O-INASCRS-01-Nugraha-Wahyu-Cahyana.pdf

281FREE PAPER

FP-O-INASCRS-02Accuracy and Predictability of Toric Intraocular Lens Implantation afterPhacoemulsification Surgery (Comparison of 2 Toric IOL Design in JEC EyeHospital)

Abstract TitleAccuracy and Predictability of Toric Intraocular Lens Implantation after Phacoemulsification Surgery (Comparison of 2 Toric IOL Design in JEC Eye Hospital)

First Author: LARAS WIDAYANTI

Author Institution: JEC Candi Semarang

Co Author:

Vidyapati Mangunkusumo (Jakarta Eye Center)

Setiyo Budi Riyanto (Jakarta Eye Center)

Johan A Hutauruk (Jakarta Eye Center)

Ucok P Pasaribu (Jakarta Eye Center)

Abstract Type: ResearchAbstract Category: Free PaperSeminat: INASCRSCompetition Category: Ophthalmologist

Introduction & ObjectiveAstigmatism is refractive error with high prevalence in all ethnic groups. There are several surgicaloptions to treat astigmatism at the time of cataract surgery, and toric intraocular (IOL) implantation has proven to be a safe and effective Method to correct preexisting astigmatism in cataract patient. This study was performed to compare accuracy and predictability of 2 toric IOL designs,AT-Torbi plate haptic toric IOL (Carl Zeiss Meditec AG,Jena,Germany) and AcrySof loop haptic toric IOL (Alcon Laboratories, Inc.,FortWorth,TX,USA) forcorrecting astigmatism in cataract patientMethodThis is a retrospective case series study. Data was taken consecutively from medical records of patient undergoing phacoemulsification surgery with At -Torbi Toric IOL and AcrySof toric IOL implantation using Image Guided System (Callisto Eye™) from July 2018 –July 2019. Data was analyzed using Alpin’s Vector Analysis to describe the change in refractive astigmatism before and after surgeryResultThere was no statistically significant difference between mean residual astigmatism in 2 groups (pvalue 0,717). Patients who achieved residual astigmatism ≤ 0,50 D was 76% in AcrySof group and73% in AT-Torbi group. Axis shifting in AT-Torbi group is larger than AcrySof group, but notstatistically significant (p value 0,855). The magnitude error in AcrySof group was larger than ATTorbi group, and this Result statistically significant (p value 0,010).Both groups have good measurement in both relative and absolute success,and there was no statistically significant difference between 2 groupsConclusionImplantation of both types of toric IOL is a predictable and effective tool in cataract surgery withpre-existing astigmatismKeywordAstigmatism, Toric IOL, phacoemulsificationLatest UpdateMay 06, 2021StatusApproved As Free PaperFile Download784-Accuracy-and-Predictability-of-Toric-Intraocular-Lens-Implantation-after-Phacoemulsification-Surgery.pdf

282 FREE PAPER

FP-R-O-INASCRS-03Comparison of Residual Refractive between SRK/T Formula and Barrett IIUniversal Formula in RSUP Dr. Kariadi Semarang

Abstract TitleComparison of Residual Refractive between SRK/T Formula and Barrett II UniversalFormula in RSUP Dr. Kariadi Semarang

First Author: TRIA KUSUMA MAHARANI



Co Author: dr. Wisnu Sadasih, Sp. M(K) (Subdivision of Cataract and Refractive Surgery, Ophthalmology

Department of Diponegoro University, Kariadi Hospital, Semarang, Central Java)



Seminat: INASCRS


Introduction & ObjectiveMeasurement, IOL calculation formula, IOL insertion, and lens constant’s errors are the mainsources of postoperative refractive errors. SRK/T formula is currently still the most used formulafor intraocular lens (IOL) power calculation, while Barrett Universal II formula provided a higherpredictability than the SRK/T formula. However, controversy about the accuracy remains. Thisstudy was performed to compare residual refractive using SRK/T and Barrett Universal II formula.MethodWe performed observational analytic, with cohort approach, in 41 eyes that divided into 2 groups(Barrett Universal II and SRK/T groups). Axial length (AL), flat/steep (K1/K2), and anterior chamberdepth (ACD) were measured. We compared the residual refractive, using two formula, and alsovisual acuity pre and post phacoemulsification with hydrophilic and hydrophobic IOL. Visual acuitywas converted to visual acuity decimal (VAdec).ResultMean value of K1, K2, ACD, visual acuity decimal one day after phacoemulsification with IOLrespectively, was 43.51 ± 2.15 mm, 44.69 ± 2.23 mm, 3.32 ± 0.45 mm, and 0.42 ± 0.26. They wereno residual refractive difference between using SRK/T and using Barrett Universal II formula(Mann-Whitney U test, p >0.05). Visual acuity in one day after surgery and one weeks after surgerybetween hydrophobic and hydrophilic IOL had no differences (p >0.05).ConclusionThe Barrett Universal II formula have no difference with SRK/T formula for measure residualrefractive. Using hydrophobic or hydrophilic IOL have no difference in visual acuity outcome.Further research is needed.KeywordSRK/T formula, Barrett II universal formula, residual refractiveLatest UpdateMay 12, 2021StatusApproved As Free PaperFile Download976-FP-R-O-INASCRS-03-Tria-Kusuma-Maharani.pdf

283FREE PAPER

FP-R-O-INASCRS-04Effect of Total Power Nd:YAG Laser Posterior Capsulotomy on CornealEndothelial Cell At dr.Kariadi General Hospital

Abstract TitleEffect of Total Power Nd:YAG Laser Posterior Capsulotomy on Corneal Endothelial Cell Atdr. Kariadi General Hospital

First Author: Yhastra Hayu PrabhaswariAuthor Institution: Resident of Ophthalmology Department of Diponegoro University, dr.Kariadi General Hospital, SemarangCo Author: Wisnu Sadasih ( Staff of Cataract and Refractive Surgery Subdivision, Ophthalmology Department of Diponegoro University, dr.Kariadi General Hospital, Semarang)Rizal Fanany (Staff of Cataract and Refractive Surgery Subdivision, Ophthalmology Department ofDiponegoro University, dr.Kariadi General Hospital, Semarang)



Seminat: INASCRS


Introduction & ObjectiveIntroduction: Posterior capsule opacification (PCO) is the most common postoperative complicationof cataract extraction. PCO can cause significant visual symptoms, particularly when it involves thecentral visual axis. Neodymium: yttrium-aluminium garnet (Nd:YAG) laser posterior capsulotomyhas been proven to be a valuable treatment modality of PCO. Although Nd:YAG laser posteriorcapsulotomy procedure presents an effective Method to treat PCO, corneal endothelium may bedamaged. Objective: To compare corneal endothelial cell before and 1 week after the Nd:YAG laserposterior capsulotomy in patients with PCO at dr.Kariadi General Hospital.MethodThis study is a cross-sectional research conducted at dr.Kariadi General Hospital. Samples weretaken from medical records patients with PCO who had Nd:YAG laser posterior capsulotomytreatment in January 2, 2021 – May 5, 2021. A data of corneal endothelial cell before and 1 weekafter Nd:YAG laser posterior capsulotomy from 22 patient were taken. Data analysis was performedby comparing the corneal endothelial cell before and 1 week after Nd:YAG laser posteriorcapsulotomy. Data was analyzed using paired t-test and spearman’s correlation.ResultThe correlation between pre and post laser corneal endothelial cell density (EDC) was found to bestatistically significant (p=0.033) in patient with PCO. There was no significant value betweenincrease of co-efficient of variation of area cell (CV) (p = 0.551) and decrease of hexagonallyshaped cells (HEX) (p=0.407) before and 1 week after laser in patient with PCO.ConclusionWe found significant correlation of total power Nd:YAG laser posterior capsulotomy in decreasingECD before and 1 week after Nd:YAG laser posterior capsulotomy.KeywordPosterior capsule opacification, Nd:YAG laser posterior capsulotomy, Corneal endothelial cellLatest UpdateMay 15, 2021StatusApproved As Free PaperFile Download650-FP-R-O-INASCRS-04-Yhastra-Hayu-Prabhaswari.pdf

284 FREE PAPER

FP-O-INASCRS-05Evaluation of the Alteration in the Corneal Endothelial Count, CentralCorneal Thickness a nd Anterior Chamber Depth in Patients With PosteriorCapsular Opacity Post Nd: Yag Laser

Abstract TitleEvaluation of the Alteration in the Corneal Endothelial Count, Central Corneal Thicknessa nd Anterior Chamber Depth in Patients With Posterior Capsular Opacity Post Nd: Yag Laser

First Author: NATALIA STEVANIE

Author Institution: Rs Ali Sibroh Malisi

Co Author:

dr. Hamzah, Sp.M(K) (RSP.Unhas), dr. Junaedi Sirajuddin, Sp.M(K) (RSP.Unhas), Dr. dr. Ilhamjaya Pattelongi,

M.Kes (RSP. Unhas)



Seminat: INASCRS


Introduction & ObjectivePosterior capsular opacity(PCO)in pseudofakia patients can be therapy using the Nd:YAG Laser,butthe Nd:YAG laser can affect the corneal endothelial count,central corneal thickness,and anteriorchamber depth.MethodA cross-sectional study was conducted to compare the alteration in the corneal endothelial count, central corneal thickness, and anterior chamber depth in patients with PCO post Nd:YAG Laser.This research was conducted in Celebes Eye Center Orbita Makassar from August 2019 to October 2019.Obtained a sample from 16 patients with pseudophakia with PCO.This study analyzed various factors such as age and sex,capsulotomy diameter,intraocular pressure,and the total dose of Nd:YAG laser.Chi Square tests,descriptive statistic,paired T-test, and Spearman non parametric were employed for data analysisResultThere was a significant reduction of endothelial cell density(P=0.000),the central corneal thicknesswas increased significantly(P=0.000),and anterior chamber depth becomes significantlyshallower(P=0.004).Central corneal thickness was found to have a significant relationship withanterior chamber depth(P=0.023),but central corneal thickness decreased 1 week after Nd:YAGlaser(P=0.276).No significant relationship was found between the total dose of Nd:YAG lasercapsulotomy in the type of PCO fibrosis type with the central corneal thickness(P=0.060)andcorneal endothelial count (P=0.228).An insignificant relationship was also found between the totaldose of Nd:YAG laser capsulotomy in the type of PCO Elschnig’s Pearl type with the thickness of thecentral cornea(P=0.191)and the endothelial cell count(P=0.191).ConclusionNd:YAG Laser affects the corneal endothelial count,central corneal thickness,and anterior chamberdepth at 1 hour after Nd:YAG Laser and lasts for 1 week.There was insignificant relationship doseof Nd:YAG Laser with central corneal thickness and anterior chamber depth.KeywordCorneal endothelial count, central corneal thickness, anterior chamber depthLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download410-FP-O-INASCRS-05-Natalia-Stevanie.pdf

285FREE PAPER

FP-R-O-INASCRS-06A Prospective Comparative Study on Endothelial Corneal Cell After CataractSurgery Using Torsional vs Longitudinal Phacoemulsification

Abstract TitleA Prospective Comparative Study on Endothelial Corneal Cell After Cataract SurgeryUsing Torsional vs Longitudinal Phacoemulsification

First Author: Precisza Fanny Faranita

Author Institution: Resident of Ophthalmology Department of Diponegoro University, Kariadi General

Hospital, Semarang

Co Author:

dr Wisnu Sadasih, SpM (K) (Staff of Cataract and Refractive Surgery Subdivision, Ophthalmology

Department of Diponegoro University, Kariadi General Hospital, Semarang)

dr Rizal Fanany, SpM (K) (Staff of Cataract and Refractive Surgery Subdivision, Ophthalmology

Department of Diponegoro University, Kariadi General Hospital, Semarang)

dr. Maharani Cahyono, SpM (K) (Staff of Glaucoma Subdivision, Ophthalmology Department of

Diponegoro University, Kariadi General Hospital, Semarang)



Seminat: INASCRS


Introduction & ObjectiveEndothelial cells losses remain as undesirable side effect of cataract surgery. Torsional phacoemulsification offer less repulsion and heat energy than Longitudinal phacoemulsification. The purpose of this study was to compare endothelial corneal cell changes after cataract surgery performed with Torsional and Longitudinal phacoemulsification in patient with senile cataract.MethodIn this prospective study, the patients were divided into two groups, 24 eyes had underwent cataract surgery using Torsional (OZil Infiniti Vision System, Alcon) and 23 eyes using Longitudinal phacoemulsification (Stelaris, Bausch & Lomb). Preoperative, 1 day, and 1 week post-operative examinations on endothelial corneal cells were performed using specular microscopy. Cataracts were subdivided according to the LOCS III grading of nucleus. Intraoperative parameters using phacoemulsification time were evaluated.ResultOn the Results of CCT at 1 day and 1 week post-operative, there were significant changes in group Torsional and Longitudinal 601±68.67; 562.22±45.48 (p=0.033) and 561,71±36,37; 519.52±79.93 (p = 0.015). However, there were no significant changes of CD, CV, HEX 1 day and 1 week post operatively between two groups. The phacoemulsification time was lower in group Torsional 17.11±15.86 seconds than group Longitudinal 18.53±15.46 seconds (p=0.595) but not significantly different.ConclusionTorsional phacoemulsification outperforms the Longitudinal with a lower phacoemulsification time on soft and medium cataracts, but the differences were not significant. Torsional caused more corneal edema at 1 day and 1 week postoperative significantly and more endothelial cell losses but insignificantly.KeywordCorneal endothelial cell, Longitudinal phacoemulsification, Torsional phacoemulsificationLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download444-FP-R-O-INASCRS-06-Precisza-Fanny-Faranita.pdf

286 FREE PAPER

FP-R-O-INASCRS-07COMPARISON OF CENTRAL CORNEAL THICKNESS MEASUREMENTBETWEEN OPTICAL TECHNIQUE PACHYMETER AND SCHEIMPFLUGPRINCIPLE BASED PACHYMETER

Abstract TitleCOMPARISON OF CENTRAL CORNEAL THICKNESS MEASUREMENT BETWEEN OPTICALTECHNIQUE PACHYMETER AND SCHEIMPFLUG PRINCIPLE BASED PACHYMETER

First Author: Feni Sulastry

Author Institution: Faculty of Medicine Diponegoro University

Co Author:

Wisnu Sadasih (Faculty of Medicine Diponegoro University )

Rizal Fanany (Faculty of Medicine Diponegoro University )



Seminat: INASCRS


Introduction & ObjectiveMeasurement of central corneal thickness (CCT) is necessary for assessing the endothelial cellsfunction, screening and planning refractive surgery, and obtaining true intraocular pressure value.Optical corneal pachymetry is widely used and had Results close to the ultrasound pachymetry asgold standard. The new emerged Scheimpflug-based pachymetry can automatically correct IOPbased on the CCT data obtained. The objectives of this study are to compare CCT values andreliability in the normal cornea between Nidek CEM-530 non-contact specular microscope (opticaltechnique) and Nidek NT-530P non-contact pachymeter (scheimpflug principle)MethodCross-sectional study conducted at Dr. Kariadi Hospital, Semarang from April to May 2021. TheCCT was measured in one hundred eyes of 100 healthy subjects with optical technique andscheimpflug principle alternately in both eyes by the same investigator. Mean CCT was comparedamong the instruments and the level of reliability was assessed using Cronbach’s AlphaResultMean CCT with optical technique and scheimpflug principle was 547,91±46,97 (right eye: RE),548,73±47,73 (RE), 549,71 ± 40,50 (left eye; LE) and 546,18±36,15 (LE), respectively. There wasno statistically significant difference between optical technique and scheimpflug principle (p =0.105; RE, p= 0.392: LE). Reliability of the central corneal measurements was equally high with allof the instruments (Cronbach alpha _ 0.90; RE, _0.85; LE).ConclusionCentral corneal thickness measurements both with optical technique and scheimpflug principlewere reliable and interchangeableKeywordCentral Corneal Thickness, Optical Technique , Scheimpflug PrincipleLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download865-FP-R-O-INASCRS-07-Feni-Sulastry.pdf

287FREE PAPER

FP-R-O-INASCRS-08Effects of Ionizing Radiation Exposure on Cataract among Radiation Workersof Interventional Cardiology in Indonesia

Abstract TitleEffects of Ionizing Radiation Exposure on Cataract among Radiation Workers ofInterventional Cardiology in Indonesia

First Author: WIDA SETIAWATI

Author Institution: Ophthalmology Department, Faculty of Medicine, Universitas Indonesia, Cipto


Co Author:

Syska Widyawati (Ophthalmology Department, Faculty of Medicine, Universitas Indonesia, Cipto


Benny Zulkarnaien (Radiology Department, Faculty of Medicine, Universitas Indonesia, Cipto


Siska Suridanda Danny (Cardiology and Vascular Medicine Department, Faculty of Medicine,

Universitas Indonesia, National Cardiovascular Center Harapan Kita Hospital)

Gitalisa Andayani (Ophthalmology Department, Faculty of Medicine, Universitas Indonesia, Cipto


Joedo Prihartono (Community Medicine Department, Faculty of Medicine, Universitas Indonesia,

Cipto Mangunkusumo Hospital)



Seminat: INASCRS


Introduction & ObjectiveTo determine the prevalence of radiation-induced cataract and correlate with radiation exposuredose and radiation protection equipment usage among radiation workers of interventional cardiology.MethodA cross-sectional and retrospective case-control study. One hundred and eighty subjects were included. Prevalence of radiation-induced cataract was assessed using Scheimpflug analysis on the Pentacam-Oculus device. Individual cumulative radiation exposure dose and radiation protection equipment usage of subjects were identified from questionnaire and personal dosimeter.ResultThe prevalence of radiation induced cataract was 16.7%. Median cumulative radiation dose was 0.8 (0.1-35.6) Gy. A positive correlation was found between cumulative radiation dose and lens density (R Spearman = 0.64). This study showed that 83.9% of subjects used ceiling-suspended shield in 71-100% of their working period, however the majority of subjects (40.6%) did not wear protective eyewear. Statistically significant increasing risk of radiation-induced cataract was found along with unresponsive use of radiation protection equipment. The subjects using ceiling-suspended shield in 31-50% of their working period were increasing their cataract risk by 10.80 times (95% CI 1.05-111.49, p=0.044). Meanwhile, the subjects using protective eyewear in 51-70% of their working period were increasing their cataract risk by 8.64 times (p=0.001). Subjects who did not wear protective eyewear had an OR 164.3 (95% CI 19.81-1363) compared to those who wore protective eyewear.ConclusionRadiation-induced cataract among radiation workers of interventional cardiology were depend onthe dose of radiation exposure dose and the use of radiation protection equipment. Therefore, therewas urgent need to improved their compliance to follow the radiation safety recommendation.

288 FREE PAPER

Keywordinterventional cardiology, radiation-induced cataract, radiation protection equipmentLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download343-FP-R-O-INASCRS-08---WIDA-SETIAWATI.pdf

289FREE PAPER

FP-R-O-INASCRS-09CHARACTERISTIC OF RETINOMETRY Result AND VISUAL IMPROVEMENTIN SENILE CATARACT AFTER PHACOEMULSIFICATION AT SAIIFUL ANWARGENERAL HOSPITAL

Abstract TitleCHARACTERISTIC OF RETINOMETRY Result AND VISUAL IMPROVEMENT IN SENILECATARACT AFTER PHACOEMULSIFICATION AT SAIIFUL ANWAR GENERAL HOSPITAL

First Author: siti chadijah

Author Institution: universitas brawijaya

Co Author: dr. Triana Budi Sulistya, Sp.M(K) (universitas brawijaya)



Seminat: INASCRS


Introduction & ObjectivePrediction of postoperative visual acuity is very important to provide information to sufferers andtheir families about the prognosis of visual acuity after surgery. interference-frings Methods(retinometry) is a routine procedure carried out at the ophthalmology department dr. Saiful AnwarGeneral Hospital, Malang in patients who will undergo cataract surgery to assess the prognosis ofpostoperative vision. This study aims to describe the characteristic of retinometry Result and visualimprovement after phacoemulsification performed at RSUD dr.Saiful Anwar MalangMethodThis is a retrospective study. Inclusion criteria : all senile cataract patients who will undergophacoemulsification in period of July 2016 - February 2020ResultSamples in this study were 141 eyes from 116 patients consisting of 61 male patients (52.59%) and55 women (47.41%) with an average patient age of 61.0 ± 9,264. The Results showed that 68 eyes(48.,%) had normal vision, 38 eyes (26,9%) had mild visual disturbances, 34 eyes (24,11%) hadmoderate visual disturbances and 1 eyes (0,70%) had severe visual impairment. All numbers onBest corrected viasual acuity (BCVA) one month after phacoemulsification had significant visualadvancement , 128 eyes had normal vision, 7 eyes had mild visual disturbances and only six eyeshad moderate visual disturbancesConclusionMost cases of senille cataract occured in male and the age range was 61.0 ± 9,264. the mostcomorbidities are Diabetes Melitus and hypertension. The average retinomeric Result in this studywere 0.4 LogMar and > 90% participant had normal vision for BCVA one month afterphacoemulsification.KeywordRetinometry, Cataract, Prognosis Visual OutcomeLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download663-FP-R-O-INASCRS-09-Siti-Chadijah.pd

290 FREE PAPER

FP-R-O-INASCRS-10Prevalence and Characteristics of Age Related Cataract in an AdultPopulation in Mendalanwangi, Sidorahayu and Cepokomulyo Village inMalang Districts East Java

Abstract TitlePrevalence and Characteristics of Age Related Cataract in an Adult Population inMendalanwangi, Sidorahayu and Cepokomulyo Village in Malang Districts East Java

First Author: Hendrian Dyatmiko

Author Institution: Universitas Brawijaya

Co Author: Dr. dr. Nina Handayani, Sp.M(K) (Universitas Brawijaya)



Seminat: INASCRS


Introduction & ObjectiveTo study the prevalence and characteristics of age related cataract in an adult population inMalang East JavaMethodA population based, cross sectional study of 692 adults (aged > 50 years) were selected fromSeptember until December 2019 from Smarthealth Database. The presence of lens opacity wasexamined by slit lamp biomicroscopy and evaluated according to Lens Opacity ClassificationSystem III. The subtype of cataract present, including nuclear, cortical, and posterior subcapsular,were identified from univariate and 95% confidence interval (CI) for association of each specifictype of cataract with age, health examination and medical history.ResultA total of 692 patients with aged > 50 years old were included in this study. The prevalence ofcataract was 48,7% in participants over 50 years old. From 337 respondents were in the age range50-70 years, as many as 240 people (71,22%) patients were female, as many as 206 people(61,13%) patients with primary school education, and 151 people (44,8%) patients work ashousewife. The standardized prevalences of clinically significant nuclear, cortical, and posteriorsubcapsular cataract (PSC) were 7,42%, 7.72%, and 5.34% in an adult population inMendalanwangi, Sidorahayu and Cepokomulyo village in Malang districs.ConclusionThe prevalence of nuclear, cortical and posterior subcapsular cataract increased high prevalence ofage related cataract in the adult population remains a severe public health problem.Keywordage related cataract, prevalence, population basedLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download428-Prevalensi-dan-Karakteristik-Penderita-Katarak-Senilis-di-Kabupaten-Malang.pdf

291FREE PAPER

FP-R-O-INASCRS-11 Re-epithelization rate in chemical eye injury : a 3-year retrospective study

Abstract TitleRe-epithelization rate in chemical eye injury : a 3-year retrospective study

First Author: Annisa Citra Permadi

Author Institution: Ophthalmology Resident, Department of Ophthalmology, Faculty of Medicine, Universitas

Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Co Author:

Syska Widyawati (Division of Cornea and Refractive Surgery, Department of Ophthalmology,

Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia)

Yunia Irawati (Division of Plastic and Reconstructive Surgery, Department of Ophthalmology,

Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia)



Seminat: INASCRS


Introduction & ObjectiveCorneal re-epithelization is one of the biggest challenges in management of chemical eye injury(CEI). This study aims to review the rate of re-epithelization, management, complications and visualrehabilitations in the setting of CEI.MethodRetrospective cohort study on CEI was seen over a 3-year period (January 2018 – December 2020).Only cases with epithelial defect were included.ResultA total of 55 eyes from 47 patients were identified. Alkali injury was placed as the majority of thecases (81.8%) and 23.6% were classified into grade IV severity. More than half (52.2%) grade IVhad persistent epithelial defect (PED). PED and limbal stem cell deficiency were found 41.8% and38.2% in all cases respectively. Bandage contact lens, autologous-serum 100% eye-drop and earlysurgical interventions were endeavoured to promote re-epithelization. Median time to heal was 13(1–150) days, yet re-epithelization rate in higher grades was hard to achieve despite early surgicalintervention (HR 2.3,CI95% 1.15–4.89). Symblepharon (60.9%) were found higher in PED patients.Linear regression of between time to heal and grade was significantly correlated (p < 0.001).Corneal ulcers (5.5%), descemetoceles (5.5%), and perforations (9.1%) were seen amongst gradeIII-IV. Final best corrected visual acuity (BCVA) was 0.3 (0–2.9) logMar with grade IV was 2.3(0.7–2.9) logMar . Strong positive correlation between initial and final BCVA was found (r=0.7).ConclusionRe-epithelization rate was significantly correlated with grade CEI rather than size of epithelialdefect.. Refined management to enhance re-epithelization is mandatory, especially in severe CEI.KeywordCorneal re-epithelization; chemical eye injury; autologous serumLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download264-FP-R-O-INASCRS-11_Annisa-Citra-Permadi.pdf

292 FREE PAPER

FP-R-O-INASCRS-12VISUAL OUTCOME AND SURGICAL COMPLICATIONS OF RESIDENTPERFORMED SICS (SMALL INCISION CATARACT SURGERY) IN CICENDO NATIONAL EYE HOSPITAL FROM JANUARY-DECEMBER 2019

Abstract TitleVISUAL OUTCOME AND SURGICAL COMPLICATIONS OF RESIDENT-PERFORMED SICS(SMALL INCISION CATARACT SURGERY) IN CICENDO NATIONAL EYE HOSPITAL FROMJANUARY-DECEMBER 2019

First Author: Pauline Meilisa Sihite

Author Institution: Cataract and Refractive Surgery Division, Department of Ophthalmology, Faculty of

Medicine Padjadjaran University, Indonesia National Eye Center, Cicendo Eye Hospital Bandung

Co Author:

Susanti Natalya Sirait (Cataract and Refractive Surgery Division, Department of Ophthalmology,

Faculty of Medicine Padjadjaran University, Indonesia National Eye Center, Cicendo Eye Hospital Bandung)



Seminat: INASCRS


Introduction & ObjectiveCataract is among the leading cause of severe visual impairment. Cataract extraction is one of the most frequent day-case ocular procedures performed worldwide annually. This steadily increasing need for cataract surgery leads to subsequent need for qualified, proficient ophthalmic surgeons. To accomodate this situation, effective and surgical training programs are required to ensure that residents in training achieve greater levels of competence in cataract surgery. This study is conduct to assess the visual outcome and surgical complication of resident-performed small incision cataract surgery in Cicendo National Eye Hospital.MethodThis is a descriptive study. Data were collected from resident’s logbooks and medical recordswithin the period of January 2019 – December 2019 in Cicendo National Eye Hospital and reviewedretrospectively. Subjects in this study are all cataract patients who underwent cataract surgeryperformed by residents. The outcomes included visual acuity on the fourth week after surgery andthe complications found during cataract surgery.ResultThis study assessed 93 eyes from 89 patients, with subject were predominantly female (55%) andmean age was 63,31 ± 10,57 years old. Visual outcome were found good in 78 eyes (83,87%).Complications during surgery were found in 19 eyes (20,43%), which predominantly were posteriorcapsular rupture and vitreous prolapse.ConclusionResident-performed SICS was found to be safe and efficacious for cataract management in CicendoNational Eye Hospital. In our study, cataract surgery performed by residents achieved good visualoutcome in most cases and the complication rate was relatively low.Keywordcataract surgery, resident, visual outcomeLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download324-FP-R-O-INASCRS-12-Pauline-Meilisa-Sihite.pd

293FREE PAPER

FP-R-O-INASCRS-13Correlation between Corneal Stromal Ablation Depth and the Magnitude of High Order Aberrations (HOA) Changes after Femtosecond Laser-Assisted Laser in situ Keratomileusis (FS-LASIK)

Abstract TitleCorrelation between Corneal Stromal Ablation Depth and the Magnitude of High OrderAberrations (HOA) Changes after Femtosecond Laser-Assisted Laser in situ Keratomileusis (FS-LASIK)

First Author: TRI WAHYU

Author Institution: Cicendo National Eye Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung

Co Author: M RINALDI DAHLAN (Cicendo National Eye Hospital, Faculty of Medicine, Universitas

Padjadjaran, Bandung), R MAULA RIFADA (Cicendo National Eye Hospital, Faculty of Medicine, Universitas

Padjadjaran, Bandung), ANDIKA PRAHASTA (Cicendo National Eye Hospital, Faculty of Medicine, Universitas

Padjadjaran, Bandung), SUSI HERYATI (Cicendo National Eye Hospital, Faculty of Medicine, Universitas

Padjadjaran, Bandung), ANDREW MH KNOCH (Cicendo National Eye Hospital, Faculty of Medicine,

Universitas Padjadjaran, Bandung)



Seminat: INASCRS


Introduction & ObjectiveKeratorefractive surgery can Result in increased high order aberrations (HOA), which can affect postoperative optical quality in patients. One of many factors play role in induced HOA after FSLASIK is the depth of ablation, which depends on the severity of refractive error. Theoretically, the severe the refractive error, the deeper the ablation, thus the greater the HOA. The aim of this study is to analyze correlation between corneal stromal ablation depth and the magnitude of HOA changes after FS-LASIK.MethodThis is an analytical observational retrospective study including myopic and myopic astigmatism patients who underwent FS-LASIK procedure. All of the subjects were divided into three groups of ablation depth (shallow, intermediate, deep). High order examination was performed in one and three months postoperatively. Spearman test was used to analyze the correlation between ablation depth and magnitude of HOA changes.ResultA total of 37 patients (67 eyes) met inclusion criteria in this study. Preoperative root mean square (RMS) HOA and Zernike coefficients among three groups were not different statistically (p>0.05). Magnitude of RMS HOA (Δ) and Δcoma in one and three months postoperatively were significantly different among groups (p<0.01), while ΔSA (spherical aberration) and Δsecondary-astigmatism were significantly different among group in one month postoperatively only (p<0.05). Correlation between ablation depth and magnitude of HOA changes was significantly and positively moderate in three months postoperatively (r=0.545; p=0.0001).ConclusionCorneal stromal ablation depth could affect magnitude of HOA changes after FS-LASIK in threemonths postoperatively.Keywordfemtosecond laser, laser in situ keratomileusis, ablation depth levelLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download653-FP-R-O-INASCRS-13-Tri-Wahyu.pdf

294 FREE PAPER

FP-G-INASCRS-14 Visual outcomes and complications of iris-claw intraocular lens implantationin aphakic eyes with inadequate capsular support

Abstract TitleVisual outcomes and complications of iris-claw intraocular lens implantation in aphakiceyes with inadequate capsular support

First Author: Faiz Nurboston Fauzi

Author Institution: Undaan Eye Hospital

Co Author:

Dini Dharmawidiarini (Undaan Eye Hospital)

Gammaditya Adhibarata ()



Seminat: INASCRS


Introduction & ObjectiveTo evaluate the various indications, visual outcomes and complications of iris claw intraocular lensin aphakic eyes.MethodThis retrospective case study was conducted in Undaan Eye Hospital, Surabaya, collecting datafrom medical records with a total of 188 eyes of 186 patients between May 2017 and April 2020,that were rehabilitated with prepupillary and retropupillary fixation of an iris claw lens. Patientswere followed-up to 9 months for visual acuity and complications.ResultThe most common cause of aphakia was subluxation of lens (spontaneous, trauma or congenital) in90 of the 188 eyes (47.3%). The mean follow-up was 3 months (range :1-9 month). Most patient hadthe best preoperative BCVA (0-0.50 logMAR) 63%, ranging 0-2.47 logMAR with a mean of 0.72logMAR. At final follow up, of the total patients, 72.9 % had the BCVA of 0-0.5 logMAR, with a meanof 0.37 logMAR. Complication included secondary glaucoma 2.12%, uveitis 1.06 %, iridodyalisis1.06 % and bullous keratopathy 1.06%.Conclusioniris claw IOL implantation is a safe and effective method of rehabilitating aphakic eye withinadequate capsular support.KeywordAphakia, Iris-claw, Visual outcomeLatest Update:May 17, 2021Status:Approved As Free PaperFile Download:353-FP-G-INASCRS-14_Faiz-Nurboston-Fauzi.pd

295FREE PAPER

FP-G-INASCRS-15KERATOPLASTY IN RUMAH SAKIT MATA UNDAAN SURABAYA: A 4-YEAREXPERIENCE

Abstract TitleKERATOPLASTY IN RUMAH SAKIT MATA UNDAAN SURABAYA: A 4-YEAR EXPERIENCE

First Author: Dedy Aria Aditia

Author Institution: RUMAH SAKIT MATA UNDAAN SURABAYA

Co Author: Dini Dharmawidiarini (RUMAH SAKIT MATA UNDAAN SURABAYA)



Seminat: INASCRS


Introduction & ObjectiveCorneal disorders had been one of the major causes of blindness in the world. Keratoplasty was atreatment of choice to restore vision of corneal disorders, and had improved remarkably from fullthickness penetrating keratoplasty (PK) to lamellar keratoplasty. This study aims to reportdemographical and clinical characteristics, surgical techniques, indications, complications and graftsurvival of keratoplasty in Rumah Sakit Mata Undaan Surabaya between 2017 and 2020.MethodMedical records of patients undergoing keratoplasty between 2017 and 2020 were reviewed.Demographical characteristics, together with pre-operative clinical characteristics (diabetesmellitus and glaucoma), indications of surgery, surgical technique, post-operative glaucoma andendophthalmitis, as well as graft survival were analyzed.ResultAmong 79 eyes, pseudophakic bullous keratopathy (PBK) and corneal scar were the most commonindications for keratoplasty (21.5%; 19.0%; respectively). Penetrating keratoplasty was the mostfrequent surgical technique performed (32.9%), followed by DSAEK (26.6%). Post-operativeglaucoma occurred in 23 eyes (29.1%) and only one endophthalmitis occurred (1.3%). No rejectionoccurred in 60 eyes (75.9%), graft rejection and failure occurred in 6 eyes (7.6%) and 5 eyes (6.3%)respectively.ConclusionKeratoplasty had shown an increasing number during 2017 to 2019 and decreased in 2020, ofwhich the leading indications was PBK. Lamellar keratoplasty contributed more than PK among allcorneal surgery. Most eyes showed no rejection.KeywordKeratoplasty, Indications, TechniquesLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download999-FP-G-INASCRS-15-Dedy-Aria-Aditia.pdf

296 FREE PAPER

FP-G-INASCRS-16Complication and Visual Outcome After Cataract Surgery : A Retrospective Study

Abstract TitleComplication and Visual Outcome After Cataract Surgery : A Retrospective Study

First Author: Fariza Rahma Safira

Author Institution: General Practitioner, Hasta Husada Hospital Kepanjen

Co Author:

Chairunisa Ferdiana ( General Ophthalmologist, Hasta Husada Hospital Kepanjen)

Lina Julianty (General Ophthalmologist, Hasta Husada Hospital Kepanjen)

Aryani Vindhya Putri (General Ophthalmologist, Hasta Husada Hospital Kepanjen)



Seminat: INASCRS


Introduction & ObjectiveCataract is known as the leading cause of blindness worldwide, accounting for 51% of totalblindness. According to WHO, following surgery, at least 80% of the operated eyes should have apresenting visual acuity of 6/6-6/18. This study aims to evaluate the complication and visualoutcome of cataract surgery in senile cataract patient.MethodThis is an observational study. Data were collected from medical records in Hasta Husada HospitalKepanjen within period of June 2020 – March 2021 and reviewed retrospectively. Subject includedwere patients with senile cataract underwent cataract surgery, including ECCE, SICS, andphacoemulsification done by 3 surgeons. Age, gender, comorbidity, staging, involved eyes, type ofsurgery, pre-operative visual acuity, complication, visual acuity at first-day, seventh-day, and onemonth after surgery were studied.ResultThere were 24 eyes of 23 patients included in this study. Patients’ mean age were 61.9 years old.Majority of patients were female (56.5%). Pre-operatively, 23 eyes (98.5%) were blind (<3/60) and1 (4.2%) had severe visual impairment (<6/60 – 3/60). At 1 month after surgery, 6 eyes (25%)achieved good visual acuity (6/6 – 6/18), 12 (50%) had borderline visual acuity (<6/18 - 6/60), andthe remaining 6 (25%) had poor visual acuity (<6/60). Intra-operative complications were irisprolapse (4.2%) and iridodialysis (4.2%). There were corneal edema (25%), striae (25%),subconjunctival haemorrhage (12.5%), aphakia (4.2%), coagulum (4.2%) and hyphema (8.3%) foundas post-operative complications.ConclusionIn our study, complications of cataract surgery were found to be minimal. Non-corrected visualacuity following cataract surgery were mostly borderline category.Keywordcataract surgery, complication, visual outcomeLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download471-FP-G-INASCRS-16-Fariza-Rahma-Safira.pdf

297FREE PAPER

FP-R-E-INAVRS-01The Effect of Anti RAGE (Receptor Advanced Glycated End Product) AntibodyAdministration on ICAM-1 (Intercellular Cell Adhesion Molecule-1)Expression On Model White Rats Diabetic Retinopathy

Abstract TitleThe Effect of Anti RAGE (Receptor Advanced Glycated End Product) AntibodyAdministration on ICAM-1 (Intercellular Cell Adhesion Molecule-1) Expression On ModelWhite Rats Diabetic Retinopathy

First Author: Lilianty Fauzi

Author Institution: FK Unsri-RSMH palembang

Co Author: Ramzi Amin (FK Unsri-RSMH palembang)

Abstract Type:Research

Abstract Category:Free Paper

Seminat: INAVRS


Introduction & ObjectiveDiabetic retinopathy is a microvascular complication disease, chronic progressive disease thatthreatens vision. Advanced Glycation End Product (AGE) is the cause of activation of theinflammatory process and damage to the structure and function of the retinal tissue that triggeredby hyperglycemia. ICAM-1 is a biomarker of primary adhesion molecules for leukostasis in theinflammatory process and an early sign of diabetic retinopathy. Inhibiting the Receptor forAdvanced Glycation End-products (RAGE) can reduce the occurrence of the inflammatory processin early diabetic retinopathy. This research aims to determine the effect of anti RAGE antibody onICAM-1 expression in white rat retinal tissue in a diabetic retinopathy modelMethodExperimental research with a post test only approach with control group design. 30 rats inducedwith Alloxan monohydrate, divided into 5 groups: normal, negative control, groups administrationanti RAGE antibody 1 ng/mL, 10 ng/mL, and 100 ng/mL. Then quantification of ICAM-1 expressionusing ImageJ software applicationResultAdministration of anti-RAGE antibody can inhibit ICAM-1 expression with increasing dose. The doseof 100ng/mL compared to the negative control (distilled water) was more effective in reducing theexpression of ICAM-1 then the dose of 10 ng/mL and the dose of 1 ng/mLConclusionAnti-RAGE antibody can inhibit the expression of ICAM-1 on model white rat diabetic retinopathyKeywordAnti RAGE antibody, ICAM-1, AGE

298 FREE PAPER

FP-R-O-INAVRS-02The difference of quality of life and cognitive function between patients withand without Age-Related Macula Degeneration(AMD)

Abstract TitleThe difference of quality of life and cognitive function between patients with and withoutAge-Related Macula Degeneration(AMD)

First Author: BOBBY KRISTIANTO


Co Author:

Anak Agung Ayu Sukartini Djelantik (Udayana University )

Ari Andayani (Udayana University )

I Gde Raka Widiana (Udayana University )

Anak Agung Mas Putrawati Triningrat (Udayana University )

I Gusti Ayu Made Juliari (Udayana University )



Seminat: INAVRS


Introduction & ObjectiveAMD is an eye disease degeneration which becomes the cause of blindness in the world today.Currently, patients with AMD showed signs of neurological disorders such as stress and alsotriggered by a decrease in the quality of life and also cognitive function in these patients.This studyaims to determine the difference in the quality of life and cognitive function in patients with andwithout AMD.MethodThis research is an observational analytic study (cross sectional) in the polyclinic of RSUP Sanglah,Denpasar. Study samples’s total are 66 people selected by consecutive sampling and divided into 2groups.ResultThe Results of the study showed the average age of the group with AMD 68 years and the groupwithout AMD 67 years old. Most of the male sex and residence in denpasar in both groups. MostAMD with the wet type by 60.6 %. On the measurement of quality of life, it showed decreasing in allsubscale in the group with AMD compared to the group without AMD and also decreasing incognitive function measured by MMSE in the group of AMD compared to the group of non - AMD,even though the MMSE score of the groups are within normal limits. All these things statedsignificant differences (pConclusionThis Study concluded that Group with AMD are less in quality of life and also Cognitive Functionthan group without AMD. So, with this study, we learned that we as eye doctor must examine andcollaborate with another specialist doctor.KeywordAge-Related Macula Degeneration, Vitreo-Retina,Macula

299FREE PAPER

FP-R-O-INAVRS-03ASSOCIATION BETWEEN GLYCATED ALBUMIN AND OSTEOPONTIN PLASMAWITH DIABETIC RETINOPATHY STAGING IN TYPE 2 DIABETES MELLITUS

Abstract TitleASSOCIATION BETWEEN GLYCATED ALBUMIN AND OSTEOPONTIN PLASMA WITHDIABETIC RETINOPATHY STAGING IN TYPE 2 DIABETES MELLITUS

First Author: Devina Permatasari

Author Institution: Ophthalmology Resident, Faculty of Medicine Diponegoro University, Semarang

Co Author:

Arief Wildan (Consultant in Ophthalmology Department, Faculty of Medicine Diponegoro

University, Semarang), Maharani (Consultant in Ophthalmology Department, Faculty of Medicine Diponegoro

University, Semarang), Riski Prihatningtias (Consultant in Ophthalmology Department, Faculty of Medicine

Diponegoro University, Semarang), Edward KSL (Consultant in Clinical Pathology Department, Faculty of

Medicine Diponegoro University, Semarang)



Seminat: INAVRS


Introduction & ObjectiveDiabetic Retinopathy (DR) is a common microvascular complication of diabetes mellitus and a leading cause of severe vision loss and blindness in the working-age population. Besides HbA1c, glycated albumin has recently been used as another clinical indicator of glycemic control. Meanwhile, osteopontin is a proinflammatory cytokine with diverse functions. The aim of this study was to evaluate the association of glycated albumin and osteopontin plasma with DR in type 2 diabetes mellitus.MethodThis cross-sectional study was conducted in Semarang on July 2020. Sixty eight type 2 diabetespatients were categorized based on DR staging; No Diabetic Retinopathy (No DR), Non ProliferativeDiabetic Retinopathy (NPDR), and Proliferative Diabetic Retinopathy (PDR). Each patient wasperformed glycated albumin and osteopontin plasma examination. Analysis both variables betweengroups was performed by Kruskal Wallis and Pearson for correlation between both variables in every group.ResultSixty eight patients were examined and divided into groups: 40 No DR (58.8%), 23 NPDR (33.8%), 5 PDR (7.4%). This study showed p=0.015 for glycated albumin, with mean of glycated albumin in each groups: 29.10% (No DR), 44.11% (NPDR), 33.50% (PDR) and p=0.216 for osteopontin, with mean of osteopontin in each groups: 37.64ng/ml (No DR), 28.65ng/ml (NPDR), 36.30ng/ml (PDR). There were also no correlation between glycated albumin and osteopontin in each stage of DR: No DR (p=0.782), NPDR (p=0.462), PDR (p=0.957).ConclusionGlycated albumin associates with staging of DR in patient with type 2 diabetes, while osteopontinplasma doesn’t associate. They also do not correlate in each stage of DR.KeywordGlycated Albumin, Osteopontin, Diabetic RetinopathyLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download 569-FP-R-O-INAVRS-03-Devina-Permatasari.pdf

300 FREE PAPER

FP-R-O-INAVRS-04THE CORRELATION OF VITAMIN D LEVEL AND GLYCATED ALBUMINSERUM IN VARIOUS DEGREES OF DIABETIC RETINOPATHY IN TYPE 2DIABETES MELLITUS

Abstract TitleTHE CORRELATION OF VITAMIN D LEVEL AND GLYCATED ALBUMIN SERUM INVARIOUS DEGREES OF DIABETIC RETINOPATHY IN TYPE 2 DIABETES MELLITUS

First Author: Cahya Suspimantari

Author Institution: UNDIP

Co Author: Arief Wildan (UNDIP),Edward KSL (UNDIP),Riski Prihatningtias (UNDIP), Maharani (UNDIP)



Seminat: INAVRS


Introduction & ObjectiveDiabetic retinopathy (DR) is one of the leading causes of blindness worldwide. Many markers havebeen found to develop diabetes mellitus or complication of the disease. Vitamin D and Glycatedalbumin were often associated with markers of diabetic complication. To determine the correlationbetween vitamin D level and glycated albumin serum with DR in type 2 diabetes mellitus.MethodIt was a cross-sectional study with type 2 diabetes mellitus in Semarang on July 2020. The subjectswere categorized based on DR staging (Non Diabetic Retinopathy (No DR), Non-ProliferativeDiabetic Retinopathy (NPDR), and Proliferative Diabetic Retinopathy (PDR)). Analysis of vitamin Dlevel and glycated albumin serum with stage of DR used Kruskal Wallis and Spearman forcorrelation of them in each stage of DR.ResultSixty-eight patients were examined and divided into groups of No DR (58,8%), NPDR (33,8%), andPDR (7,4%). The study showed mean of vitamin D level in each groups were 33,18 ng/ml (No DR),28,87 ng/ml (NPDR), 19,98 ng/ml (PDR) and glycated albumin were 20,68% (No DR), 26,06%(NPDR), 21,90% (PDR). Vitamin D level (p = 0,011) and glycated albumin (p = 0,015) had significant differences in various stage of DR, but there were not correlation between level of vitamin D and glycated albumin serum in groups of No DR (p = 0,335), NPDR (p = 0,408) and PDR (p=0,873).ConclusionVitamin D level and glycated albumin serum have significant correlation with the staging of DR, butthey do not correlate in each stage of DR.KeywordGlycated Albumin, Vitamin D, Diabetic RetinopathyLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download238-FP-R-O-INAVRS-04-Cahya-Suspimantari.pdf

301FREE PAPER

FP-R-O-INAVRS-05VISUAL OUTCOME AND CENTRAL RETINAL THICKNESS COMPARISONAFTER RANIBIZUMAB INTRAVITREAL INJECTIONS LOADING DOSES INEXUDATIVE AGE RELATED MACULAR DEGENERATION

Abstract TitleVISUAL OUTCOME AND CENTRAL RETINAL THICKNESS COMPARISON AFTERRANIBIZUMAB INTRAVITREAL INJECTIONS LOADING DOSES IN EXUDATIVE AGERELATED MACULAR DEGENERATION

First Author: Ferdian ramadhan


Co Author: Muhammad Firmansjah (Universitas Airlangga), Ima Yustiarini (Universitas Airlangga)



Seminat: INAVRS


Introduction & ObjectiveAge Related Macular Degeneration (AMD) currently one of the highest irreversible blindness inabove 50. AMD classified in non exudative and exudative, with VEGF as the main factor that inducethe neovascularization in macula leads to exudative AMD. The aim of this study is to compare thevisual outcome based on BCVA and central thickness retina (CRT) as the highly impacted target ofdisease after ranibizumab 0.5 mg loading doses intravitreal injection loading doses in 3 months.MethodThis research is a cross sectional study with retrospective data based on OCT & medical record.The data is collected before and after 3 months injection of ranibizumab in previously diagnosedexudative AMD. Comparison between central retinal thickess and visual outcome before and afterinjection of ranibizumab analyzed by using paired t-test and the correlation between parametersanalyzed by Pearson. All statistics analyzed with SPSS 26.0, p< 0.05 statistically significantResultVA improved compared with baseline at 0 to 3 months in 20 samples, no improvement in 10samples and remain stables in 12 patients (P < 0.005). CRT measured with Cirrus OCT decreased(P < 0.001) at last time points analysed in 30 samples and slightly changes in 12 patients. Nocorrelation found between VA and CRT (P > 0.05) in the statistic Results found.ConclusionBetter VA outcomes and CRT were found in most of patients exudative wet AMD after 3 consecutivemonths ranibizumab intravitreal loading doses injections. No correlation between parameterssuggesting CRT not the single factor for visual outcomes.KeywordAMD, Visual Outcome, Central Retinal ThicknessLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download372-manuscript-pvsm-ferdian-ramadhan.pdf

302 FREE PAPER

FP-R-O-INAVRS-06COMPARISON OF VITREOUS GALECTIN 3 LEVEL BETWEEN TRACTIONALRETINAL DETACHMENT AND RHEGMATOGEN RETINAL DETACHMENT

Abstract TitleCOMPARISON OF VITREOUS GALECTIN 3 LEVEL BETWEEN TRACTIONAL RETINALDETACHMENT AND RHEGMATOGEN RETINAL DETACHMENT

First Author: DEDI PURNOMO

Author Institution: Diponegoro University

Co Author:

Winarto (Staff, Ophthalmology Department)

Arief Wildan (Staff, Ophthalmology Department)



Seminat: INAVRS


Introduction & ObjectiveRetinal detachment describe a situation which cone and rod cells separated from the epitheliallining of retinal pigment that can cause permanent blindness. Vitreoretinal fibrosis due to diabetesis the main pathogenesis of tractional retinal detachment (TRD), whereas rhegmatogenous retinaldetachment (RRD) pathogenesis mainly associated with age-related-degeneration processesMethodDescriptive statistical analysis was used to analyze patient demographic profile. Inter-groupsgalectin-3 differences were analyzed using independent t-test or Mann-Whitney. Correlationbetween variables were analyzed using Pearson or Spearman test.ResultTwenty-two patients were enrolled; 54.5% are women and 45.5% are men. The mean age washigher in TRD than RRD group (47.27±5.73 vs. 42.00±12.55 years, p=0.399). Mean galectin-3levels were significantly higher in the TRD compared to RRD group (4.09±2.81 vs 0.26±0.14, p<0.001). A positive, insignificant correlation was found between galectin-3 levels, age and sex,while negative significant correlation was found between galectin-3 levels and diagnosis.ConclusionVitreous galectin-3 levels were significantly higher in TRD patients than RRD patients, possibly dueto fibrosis process similar to other organs in previous studies, thus anti-galectin-3 may be beneficialfor TRD treatmentKeywordretinal detachment, Galectin-3, traction retinal detachmentLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download924-FP-R-O-INAVRS-06-DEDIPURNOMO.pdf

303FREE PAPER

FP-R-O-INAVRS-07PUPIL CYCLE TIME IN RETINOPATHY DIABETIC PATIENTS BASED ONGLYCATED HEMOGLOBIN

Abstract TitlePUPIL CYCLE TIME IN RETINOPATHY DIABETIC PATIENTS BASED ON GLYCATED HEMOGLOBIN

First Author: Andriati Widyarini

Author Institution: Resident Ophthalmology of Diponegoro University

Co Author:

Arief Wildan (Staff of Ophthalmology Department of Diponegoro University)

Maharani (Staff of Ophthalmology Department of Diponegoro University)

Afrisal Hari Kurniawan (Staff of Ophthalmology Department of Diponegoro University)

Andhika Guna Dharma (Staff of Ophthalmology Department of Diponegoro University)

Satya Hutama Pragnanda (Staff of Ophthalmology Department of Diponegoro University)



Seminat: INAVRS


Introduction & ObjectiveThe length of Pupil Cycle Time (PCT) indicated that the complication of autonomous diabeticneuropathy in Diabetes Melitus (DM), either accompanied by diabetic retinopathy (DR) or withoutdiabetic retinopathy. The aim of this study was to measured and to evaluate the PCT of patientsDiabetes Mellitus Type 2 (DMT2) base on glycated hemoglobin value.MethodCross sectional study from 49 eyes of patients that having DR, 35 eye of patients DMT2 withoutretinopathy and 37 eyes of healthy subject were participated. Data recorded from the patients suchas visual acuity, slit-lamp biomicroscopy, funduscopy, laboratorium for blood glucose and glycatedhemoglobin (HbA1C), and PCT measurement (5 times in 30 seconds). All two groups werecompared then analyzed base on HbA1c and statistically significant Result in p value <0,05.ResultThe mean PCT of HbA1c >7% group was (925 + 138,10 ms) and HbA1c <7% group was (831 +53,25 ms) (p < 0,001). The mean PCT in diabetic retinopathy patiens (965,67 ± 134,22 ms)compared to non diabetic retinopathy patients (813,06 ± 48,60 ms) was (p = 0,000).ConclusionThere was significant difference mean PCT between Hba1c >7% compared <7% determing theseverity of DM and prolonged PCT determining the severity of DR.KeywordPupil cycle time, Diabetic retinopathy, HbA1cLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download869-FP-R-O-INAVRS-07-Andriati-Nadhilah.pdf

304 FREE PAPER

FP-R-E-INAVRS-08The effect of Intravitreal Bevacizumab injection with or withoutdexamethasone for retinal sensitivity in moderate to severe diabetic macularedema: a comparative study

Abstract TitleThe effect of Intravitreal Bevacizumab injection with or without dexamethasone for retinalsensitivity in moderate to severe diabetic macular edema: a comparative study



Co Author:

Anggun Rama Yudhanta (FKUI - RSCM Kirana), Ari Djatikusumo (FKUI - RSCM Kirana)

Virna Dwi Octariana (FKUI - RSCM Kirana), Joedo Prihartono (Community Medicine Department, FKUI)



Seminat: INAVRS


Introduction & Objectiveintroduction: Bevacizumab intravitreal injection therapy in patients with diabetic macular edema(DME) especially with a central macular thickness more than 400μm is considered ineffective.Corticosteroid addition to the standard therapy can help prevent the inflammation that happens inthe progression of diabetic macular edema Objective: to compare the Result of combination ofbevacizumab and dexamethasone intravitreal injection with bevacizumab monotherapy in patientwith moderate to severe DMEMethodrandomized controlled trial in two parallel group. Group A received bevacizumab intravitreal1.25mg in 0.05cc, group B received bevacizumab 1.25mg and dexamethasone 0.5mg. Retinalsensitivity, central macular thickness (CMT) and visual acuity (VA) are evaluated in first and fourthweek after injectionResult22 patients from each group were evaluated. Median of age was 53,1+ 8,4 in group A and 55,1 + 8in group B. Improvement of retinal sensitivity was 2.1dB and 2.03dB in group A and B respectively(p=0,673). There was reduction in CMT about 217μm in group A and 249μm in group B (p=0,992).Visual acuity outcomes showed little difference between groups; +8.5 letter and +7.5 letter ingroup A and group B respectively. Intragroup analysis shows significant differentiation in eachoutcome in both groupsConclusioncombination of intravitreal bevacizumab and dexamethasone clinically improved retinal sensitivity,CMT and VA in patient with DME. There was no statistical difference between in retinal sensitivity,CMT and VA after therapy in both groups. Positive trend was showed especially in patient with cystappearance in Spectrum Domain Optical Coherence Tomography (OCT) and Non-proliferativeDiabetic Retinopathy (NPDR) patient.Keyworddiabetic macular edema, dexamethasone, retinal sensitivityLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download603-FP-R-E-INAVRS-08---Anindita-Wicitra.pdf

305FREE PAPER

FP-O-INAVRS-09Intravitreal Anti-VEGF for Myopic Choroidal Neovascularization : Result ofReal Clinic Experience

Abstract TitleIntravitreal Anti-VEGF for Myopic Choroidal Neovascularization : Result of Real Clinic Experience

First Author: MELITA SUWAN DJAJA

Author Institution: JEC Eye Hospitals and Clinics

Co Author:

Elvioza (JEC Eye Hospitals and Clinics)

Soefiandi Soedarman (JEC Eye Hospitals and Clinics)



Seminat: INAVRS


Introduction & ObjectivePathologic Myopia (PM) and Myopic Choroidal Neovascularization (myopic CNV) are the majorcause of blindness in productive age. This condition treated with intravitreal anti-VEGF showedimprovement in visual outcome in some controlled trials. Our study aimed to describe thecharacteristic of patients with pathologic myopia and the Result of intravitreal anti-VEGF treatmentfor myopic CNV in real world setting.MethodA restrospective study involving patients with pathologic myopia in JEC Eye Hospitals and Clinicsbetween 2015 to 2019. Data regarding characteristic of patients with PM, myopic CNV, number ofintravitreal anti-VEGF injections, and BCVA were retrieved. Main outcome measurements are thenumber of injections and change in BCVA during 12 month follow upResultMyopic CNV was found in 74 eyes from the total of 227 patients diagnosed with PM. Anti-VEGF wasgiven in one loading dose followed by monthly observation and pro re nata additional injections.Mean number of injection was 1,33 (ranged 1 to 3), median was 1. There was a significantimprovement of mean BCVA after anti-VEGF injection in month 1 and month 6 (p = 0.018 andp=0,011 respectively) compared to pre-injection. At 12 month follow up, the improvement was nolonger significant (p= 0.739). No serious adverse event was recorded.ConclusionMyopic CNV was found in 32,59% of pathologic myopia patients in our clinic. Intravitreal anti-VEGFgiven in one loading dose followed by pro re nata injection improved BCVA in patients with myopicCNV significantly and was maintained until 6 month.KeywordMyopic Choroidal Neovascularization, Pathologic Myopia, anti-VEGFLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download76-FP-O-INAVRS-09-Melita-Suwan-Djaja.pdf

306 FREE PAPER

FP-R-O-INAVRS-10Novel Retinal Findings in β-Thalassemia Major: Older Age and Higher FerritinLevel as the Risk Factors

Abstract TitleNovel Retinal Findings in β-Thalassemia Major: Older Age and Higher Ferritin Level as the Risk Factors

First Author: KING HANS KURNIA

Author Institution: Department of Ophthalmology, Faculty of Medicine Universitas Indonesia - Dr. Cipto

Mangunkusumo National General Hospital, Jakarta, Indonesia

Co Author:

ELVIOZA , M. SIDIK, RITA S. SITORUS (Department of Ophthalmology, Faculty of Medicine Universitas

Indonesia - Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia ), TENY TJITRA SARI

(Department of Child Health, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo National

General Hospital, Jakarta, Indonesia), JOEDO PRIHARTONO (Department of Community Medicine, Faculty

of Medicine Universitas Indonesia, Jakarta, Indonesia)



Seminat: INAVRS


Introduction & Objectiveβ-thalassemia major is a monogenic disorder with high prevalence in the Southeast Asia. Retinal involvement

in β-thalassemia major have been reported; however, data from Southeast Asian patients are lacking. It is unknown whether β-thalassemia major patients in Indonesia exhibit the same pattern of retinal changes compared to patients in other regions of the world. This study aims to investigate retinal changes in

β-thalassemia major patients and identify their association with systemic risk factors.MethodIn this prospective study, 120 β-thalassemia major patients received complete ophthalmic examinations (visual acuity, contrast sensitivity, color vision and indirect ophthalmoscopy) and retinal imaging using color fundus photography and fundus autofluorescence imaging. Patients were grouped according to the presence of thalassemia-related retinal changes. The association between systemic risk factors (age, type and duration of iron chelator use, history of splenectomy, hemoglobin level and ferritin level) and thalassemia-related retinal changes was investigated using logistic regression analysis.ResultThalassemia-related retinal changes were identified in 36.7% of patients. Novel retinal changes were observed, including retinal refractile bodies in 10% of patients and retinal hemorrhage in 5.8% of patients. Fundus autofluorescence imaging showed abnormal patterns in 36.3% of patients with thalassemia-related retinal changes and 18.4% of patients without thalassemia-related retinal changes. Age (odds ratio [OR] = 1.10, 95% confidence interval [CI] 1.03–1.18) and ferritin level (OR 1.16, 95% CI 1.01–1.33) were associated with thalassemia-related retinal changes.ConclusionNovel retinal changes were observed in Indonesian β-thalassemia major patients. This studyidentified older age and higher ferritin level as risk factors for thalassemia-related retinal changes.Keywordβ-thalassemia major; ferritin; fundus autofluorescence imaging; iron chelator; retinal changes.Latest UpdateMay 17, 2021StatusApproved As Free PaperFile Download975-FP-R-O-INAVRS-10-King-Hans-Kurnia.pdf

307FREE PAPER

FP-G-INAVRS-11Retinal Impairment Associated with Long-term Use of Ritonavir among HIVPatients: A Systematic Review for Primary Eye Care Practice

Abstract TitleRetinal Impairment Associated with Long-term Use of Ritonavir among HIV Patients: ASystematic Review for Primary Eye Care Practice

First Author: dr. Zakirunallah KaruniaAuthor Institution: RS Pelabuhan JakartaCo Author:dr. Ivana Beatrice Alberta (RS Bhayangkara Pusdik Brimob Pasuruan)dr. Salsha Alyfa Rahmani (RSUD Kemayoran Jakarta)

Abstract Type: ResearchAbstract Category: Free PaperSeminat: INAVRSCompetition Category: General practitioner

Introduction & ObjectiveRitonavir as part of Highly Active Antiretroviral Therapy (HAART) is a potent inhibitor of HIVprotease that have been reported causing retinal impairment in the long term use. Primary eye care(PEC) is an integral part of primary health care that provides an early screening for drug inducedretinal toxicity, by using a funduscopy examination. This study proposed to review and analyzesome case reports conducted on long-term use of ritonavir that affects retinal impairment amongHIV patients, in primary eye care practice.MethodPubMed and Google Scholar were used to perform a systematic review of retinal impairmentassociated with long-term use of ritonavir among HIV patients. Using PRISMA 2020 Guidelines,nine case reports and one case series were included in the review.ResultFunduscopy mainly showed bilateral Retinal Pigment Epithelium (RPE) atrophy with hypertrophy ormottling. Two cases found bilateral crystalline deposits with pigment disruption. One case showedrounded hypopigmented lesion. Bilateral subtle annular pattern of RPE was found in one case.Bilateral retinitis pigmentosa-like appearance found in one case while another found unilateralhyperemic lesion at the left fovea.ConclusionRetinal impairment detected on funduscopy occurred in HIV patients on long-term use of ritonavir.KeywordRitonavir, Retinal Impairment, HIVLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download816-FP-G-INAVRS-11-Zakirunallah-Karunia.pdf

308 FREE PAPER

FP-R-O-INAVRS-12The Outcome of Panretinal Photocogulation on Diabetic Retinopathy Patients

Abstract TitleThe Outcome of Panretinal Photocogulation on Diabetic Retinopathy Patients

First Author: YENI RAHMANAuthor Institution: Department Ophthalmology Faculty of Medicine Universitas BrawijayaCo Author:SAFARUDDIN REFA (Department Ophthalmology Faculty of Medicine Universitas Brawijaya)NADIA ARTHA DEWI (Department Ophthalmology Faculty of Medicine Universitas Brawijaya)

Abstract Type: ResearchAbstract Category: Free PaperSeminat: INAVRSCompetition Category: Resident

Introduction & ObjectivePanretinal photocoagulation (PRP) is a standard treatment for severe non-proliferative diabeticretinopathy (NPDR) and proliferative diabetic retinopathy (PDR) cases. It reduces severe visual loss(SVL), progression of retinopathy, and the need for vitrectomy. This study aims to analyze theoutcome of PRP on diabetic retinopathy (DR) patients.Methodmedical record of all diabetic retinopathy patients who underwent PRP between January 2016 andDecember 2017 at Dr. Saiful Anwar General Hospital Malang were reviewed. The demographics,visual acuity, clinical findings, PRP procedures, and disease progression were evaluated atbaseline, 2-month, 6-month, and 1-year.Result103 patients (136 eyes) were evaluated. Severe NPDR was diagnosed in 41 eyes (30.1 %) and PDRwas diagnosed in 95 eyes (69.9%). The mean of BCVA at baseline, 2 months, 6 months, and 1 yearafter PRP were 0.57 ± 0.64; 0.80 ± 0.46; 0.77 ± 0.38; and 1.20 ± 0.70 respectively. There was nochange in visual acuity between the baseline and 2 and 6 months after PRP. There was a significantdifference between the baseline and 1 year after PRP (p-value of 0.042). SVL occurred in 7.8%patients after 1 year and 8.1% patients need additional surgery.ConclusionThis study proves that PRP can reduce the risk of SVL by more than 50% after 1 year. Thus, PRP isstill highly relevant as the modality of therapy.Keywordpanretinal photocoagulation, diabetic retinopathy, severe visual loss.Latest UpdateMay 17, 2021StatusApproved As Free PaperFile Download80-The-Outcome-of-PRP-on-DR-patients-Yeni-Rahman.pdf

309FREE PAPER

FP-R-O-INAVRS-13THE CORRELATION BETWEEN ANGIOPOIETIN-2 SERUM AND DIABETICMACULAR EDEMA (DME) MORPHOLOGY IN DIABETIC RETINOPATHY(STUDY USING OPTICAL COHERENCE TOMOGRAPHY (OCT))

Abstract TitleTHE CORRELATION BETWEEN ANGIOPOIETIN-2 SERUM AND DIABETIC MACULAR EDEMA (DME) MORPHOLOGY IN DIABETIC RETINOPATHY (STUDY USING OPTICAL COHERENCE TOMOGRAPHY (OCT))

First Author: Friska Desianna H

Author Institution: FKUB

Co Author:

Nadia Artha Dewi (Medical Faculty of Universitas Brawijaya)

Mirza Metita (Medical Faculty of Universitas Brawijaya )



Seminat: INAVRS


Introduction & ObjectiveAngiopoietin-2 (Ang-2) pathway plays a role in vascular destabilization in diabetic retinopathy (DR))especially diabetic macular edema (DME). The aim of this study is to find the correlation betweenserum Ang-2 with the severity and morphology of DMEMethodThis was a cross-sectional study involving 32 DR patients with severe non-proliferative diabeticretinopathy (NPDR) and proliferative diabetic retinopathy (PDR classification), consisted of 28 eyeswith DME and 4 eyes without DME. Data were collected using consecutive sampling. Blood serumwere taken for examination of Ang-2 level. OCT examination to assess morphology of DMEResultThere were 5 types of DME, 14 eyes with diffuse, 3 eyes cystoid, 3 eyes vitreomacular traction(VMT), 2 eyes sub-retinal fluid (SRF) and 6 eyes mixed. Mixed type was defined when one eye hadmore than one type of diffuse, cystoid, SRF or VMT. Serum levels of Ang-2 in diffuse type was1162.72±557.73, cystoids was 1350.00±590.28, VMT was 1001.16±476.46, SRF was2465.63±103.23 and mixed was 1634.02±855. The highest serum Ang-2 levels were found in SRFtype. However, there is an insignificant difference in Ang-2 serum level among all DME type(p=0.217). There is significance different in serum Ang-2 level between SRF type compared toanother type (p=0.015)ConclusionThis study found that the serum levels of Ang-2 DR with and without DME were not different. Eventhough there were no significance different among the serum levels Ang-2, but there weresignificance difference of Ang-2 serum level between SRF with another type of DMEKeywordmorphology of DME, Optical Coherence Tomography, Angiopoietin-2Latest UpdateMay 17, 2021StatusApproved As Free PaperFile Download194-FP-R-O-INAVRS-13-Friska-Desianna-H.pdf

310 FREE PAPER

FP-O-INAVRS-14Effectiveness of OCT-based Measurements in Predicting the SurgicalOutcome of Idiopathic Macular Hole

Abstract TitleEffectiveness of OCT-based Measurements in Predicting the Surgical Outcome ofIdiopathic Macular Hole

First Author: JOSHUA PARTOGI FERDINAND LUMBANTOBING

Author Institution: JEC Eye Hospitals and Clinics

Co Author

Elvioza (JEC Eye Hospitals and Clinics)

Waldensius Girsang (JEC Eye Hospitals and Clinics)

Soedarman Sjamsoe (JEC Eye Hospitals and Clinics)

Referano Agustiawan (JEC Eye Hospitals and Clinics)

Soefiandi Soedarman (JEC Eye Hospitals and Clinics)



Seminat: INAVRS


Introduction & ObjectiveTo evaluate the demographics of idiopathic macular hole cases as well as to analyze the value of theoptical coherence tomography (OCT) parameters in predicting the functional and anatomicalsurgical outcomes.MethodData of all patients with idiopathic macular hole underwent vitrectomy surgery by vitreoretinalsurgeons from 2014 until 2018 were retrospectively reviewed. Baseline OCT parameters wereevaluated. Base diameter, minimum hole diameter, right/left arm length, and height of the macularhole were manually measured by one ophthalmologist using the measurement software to calculatethe macular hole index (MHI), tractional hole index (THI), and hole form factor (HFF).ResultFifty-eight eyes of 58 patients were evaluated. Most patients have MHI ≥ 0.5 (93.1%) and THI ≥1.4 (77.6%). Mean Snellen chart best-corrected visual acuity (BCVA) was increased from 0.18 ±0.16 pre-operatively to 0.55 ± 0.29 on 6 months of postoperative follow-up (p=0.04). Anatomicalsuccess was recorded in 90% of cases with HHF > 0.9.ConclusionMacular hole index (MHI), tractional hole index (THI), and hole form factor (HFF) could be used asstrong predictive OCT-based parameters of postoperative functional and anatomical success inmacular hole surgery.KeywordMacular hole index; tractional hole index; hole form factor.Latest UpdateMay 17, 2021StatusApproved As Free PaperFile Download949-FP-O-INAVRS-14-Joshua.pdf

311FREE PAPER

FP-R-O-INAVRS-15Metabolic Risk Factors Profile and The Relation of Neutrophil/LymphocyteRatio with Bevacizumab Treatment Outcome in Retinal Vein Occlusion: A Retrospective Study from A Tertiary Eye Hospital in Indonesia

Abstract TitleMetabolic Risk Factors Profile and The Relation of Neutrophil/Lymphocyte Ratio withBevacizumab Treatment Outcome in Retinal Vein Occlusion: A Retrospective Study from ATertiary Eye Hospital in Indonesia



Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia

Co Author: Elvioza (Department of Ophthalmology, Faculty of Medicine Universitas Indonesia – Cipto

Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia)



Seminat: INAVRS


Introduction & ObjectiveThe prevalence of retinal vein occlusion (RVO) has been increasing, estimated more than 28 millioncases worldwide in 2015, along with increased identified metabolic risk factors. Anti-vascularendothelial growth factor (VEGF) is the mainstay treatment for macular edema due to RVO. We aimto describe the metabolic risk factors profile and the relation of neutrophil/lymphocyte ratio (NLR)as a marker for nonspecific inflammation toward bevacizumab treatment response in RVO.MethodMedical records of new RVO patients attending RSCM Kirana from January 1st to December 31st,2018, were retrospectively reviewed. The number of metabolic risk factors, bevacizumab injections,and serial central macular thickness (CMT) values were noted. NLR was calculated from thecomplete blood count before the first injection.ResultNinety patients (94 eyes: 59 CRVO and 35 BRVO) were analyzed, of which 23.3% had > 2 riskfactors with hypertension as the leading factor. NLR increased as more risk factors were identified(no risk factor: 2.0 (1.18-3.95); 1-2: 2.25 (0.92-8.41); and >2: 2.38 (0.97-3.76). During one year ofmonitoring, the median number of bevacizumab injections was 2 (1-7). Patients with < 2 riskfactors and ≤ 50 years had a better CMT reduction trend. In linear regression analysis, initial CMTand NLR were associated with CMT reduction in one (β: -0,580 pConclusionAlmost a quarter of RVO patients had > 2 metabolic risk factors. Initial CMT and NLR wereassociated with bevacizumab treatment response.KeywordBevacizumab, neutrophil/lymphocyte ratio, retinal vein occlusionLatest UpdateMay 15, 2021StatusApproved As Free PaperFile Download3-FP-R-O-INAVRS-15-Ikhwanuliman-Putera.pdf

312 FREE PAPER

FP-O-INARVOS-01CORRELATION OF MYOPIA WITH IQ SCORES IN JUNIOR HIGH SCHOOL STUDENTS

Abstract TitleCORRELATION OF MYOPIA WITH IQ SCORES IN JUNIOR HIGH SCHOOL STUDENTS

First Author: MUHAMMAD SYAUQIE


Co Author



Seminat: INARVOS


Introduction & ObjectiveMyopia become one of the most common refractive errors. Myopia supposed to had a relationshipwith IQ (Intelligence Quotient) where some studies shown that myopic students achieved betteracademic Results in school. Previous study found that person with higher myopia get a higher IQscores. This study aims to determine the correlation between myopia and IQ scores in junior highschool students in Padang.MethodThis research is a case control study at SMP Negeri 1 Kota Padang. The sample consisted of 44students consists of 22 myopic students and 22 emetropic students. Refractive error measurementdone for both group with autorefractometer with myopia defined as spherical equivalent less than0,5 Diopter. Both group then undergo IQ test with Culture Fair Intelligence Test.ResultThe mean IQ scores in myopic students were 117 ± 17.5 while in emetropic students were 121.68 ±16.3 (p=0,384). Linear regression analysis also shown very weak correlation (R square = 0,098)between the degree of myopia and the IQ score.ConclusionNo significant correlation between myopia and the IQ scores found in this study as the student withmyopia did not achieve higher IQ scores compare with emetropic students. Students with higherdegree of myopia also did not achieve higher IQ scores compare with the lower degree.KeywordMyopia, Intelligence Quotient, Junior High School StudentLatest UpdateMay 06, 2021StatusApproved As Free PaperFile Download252-CORRELATION-OF-MYOPIA-WITH-IQ-SCORES-IN-JUNIOR-HIGH-SCHOOL-STUDENTS.pdf

313FREE PAPER

FP-O-INARVOS-02THE ACCURACY OF VISUAL ACUITY EXAMINATION USING PEEK ACUITY BYNURSE TO ETDRS BY DOCTOR

Abstract TitleTHE ACCURACY OF VISUAL ACUITY EXAMINATION USING PEEK ACUITY BY NURSE TOETDRS BY DOCTOR

First Author: Nindya Suryani PrasetyoAuthor Institution: Ophthalmology Department, Faculty of Medicine Udayana University, Sanglah Hospital

Bali

Co Author:

IWG Jayanegara (Ophthalmology Department, Faculty of Medicine Udayana University, Sanglah

Hospital Bali)

Ariesanti Tri Handayani (Ophthalmology Department, Faculty of Medicine Udayana University,

Sanglah Hospital Bali)



Seminat: INARVOS


Introduction & ObjectiveVisual acuity examination is an important eye examination that is routinely performed. Theincreased use of smartphones, including in the remote areas, may be a bridge in efforts to improvethe quality of health services. The use of Portable Eye Examination Kit (PEEK) Acuity application bynurses will help the ophthalmologists to detect any visual acuity problems earlier and preventblindness. This study aims to determine the accuracy level of the PEEK Acuity examination by nurses.MethodThis is a diagnostic test study that finding the sensitivity and specificity of PEEK Acuity performedby nurse, and the Early Treatment Diabetic Retinopathy Study (ETDRS) examination as the goldstandard for examining visual acuity.ResultThe mean difference between PEEK Acuity examination performed by nurse and ETDRS by doctorwas 0.03 logMAR (95% CI -0.01-0.07) on the right eye and 0.02 logMAR (95% CI -0.02 - 0.06) onthe left eye. The cut-off value of PEEK acuity examination for the right and left eyes was > 0.3logMAR with the sensitivity and specificity of PEEK acuity for the right eye was 91.67% and93.18%, and for the left eye was 87.80% and 92.31%, respectively.ConclusionThe PEEK Acuity examination performed by nurse has a good level of accuracy, along with goodsensitivity and specificity.Keywordvisual acuity, PEEK Acuity, nursesLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download109-FP-O-INARVOS-02-Nindya-Suryani-Prasetyo.pdf

314 FREE PAPER

FP-R-O-INARVOS-03Differences in Near Point of Convergence and Amplitude Accommodation inMedical Faculty Students with and without Computer Vision Syndrome

Abstract TitleDifferences in Near Point of Convergence and Amplitude Accommodation in MedicalFaculty Students with and without Computer Vision Syndrome

First Author: JOHANES ARIE SETIAWAN

Author Institution: Perdami Sumsel

Co Author:

Cok Istri Dewiyani Pemayun (Perdami Bali)

Ari Andayani (Perdami Bali)



Seminat: INARVOS


Introduction & ObjectiveComputer Vision Syndrome (CVS) is a collection of symptoms caused by the use of Visual DisplayTerminal (VDT) for a long time. Globally it is estimated that up to 60 million people experiencingCVS. Medical faculty students with an independent learning system Result in increased use of VDT.The eye feels tense and tired, blurred eyes, double vision, and headaches are symptoms caused bythe use of accommodation and convergence continuously. This disturbance can be measuredthrough examination of Near Point of Convergence (NPC) and Amplitude Accommodation (AA). Thisstudy aims to find the differences between NPC and AA in medical students with and without CVS.MethodThis study was an observational cross-sectional study located at the Faculty of Medicine of UdayanaUniversity with Cluster Sampling technique, and obtained 212 samples that met the inclusion andexclusion criteria. The data obtained were analyzed by bivariate and multivariate analysis with age,sex, and duration of VDT use.ResultThe Results showed 56.6% of medical students with CVS and average age of 20.09 ± 0.506 years.Male was more frequent than women, 89.6% of students have used VDT for ≥5 years, the total useof VDT for a day ≥4 hours is done by 58.5% of students and most (59.4%) students use VDT at adistance of <50 cm.ConclusionThere is significant differences in NPC break, right eye AA, left eye AA, and binocular AA instudents with and without CVS, whereas for NPC recovery didn’t show any differenceKeywordConvergence insufficiency, Accommodative insufficiency, Computer Vision SyndromeLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download999-FP-R-O-INARVOS-03-Johanes-Arie-Setiawan.pdf

315FREE PAPER

FP-R-O-INARVOS-04The Difference of Angio OCT ONH Flux Index in Myopia and Emetrop Patients

Abstract TitleThe Difference of Angio OCT ONH Flux Index in Myopia and Emetrop Patients

First Author: Jehan Fauzi Rakhmandani

Author Institution: Departement of Ophthalmology, Faculty of Medicine, Public Health and Nursing,

Universitas Gadjah Mada

Co Author:

Sagung Gede Indrawati (Departement of Ophthalmology, Faculty of Medicine, Public Health and


Krisna Dwi Purnomo Jati (Departement of Ophthalmology, Faculty of Medicine, Public Health and




Seminat: INARVOS


Introduction & ObjectiveMyopia is a refractive error, where the increasing axial length plays rule of the pathologi. This canResult in changes in retinal and Optic nerve had perfusion. Vascular flow density in pathologicalmyopia revealed reduced choroidal and retinal blood flow. Purpose To describe the flux indexchanges in OCT ONH Angio in patients with emetrop and myopiaMethodThis was a cross-sectional prospective descriptive study with purposive sampling. This studyenrolled 29 outpatients service of Sardjito General Hospital had cirrus – OCT 5000 Ver11.0.0.29946 examination between 1st April 2021 and 10th May 2021 .ResultWe evaluated 29 glaucoma patients who visited Sardjito Hospital, consisted of 13(44%) emetrop,10(34%) low Myopia,1(3%) moderete myopia and 5(17%) high myopia. The mean of the subjectswas 38,41, consisted of 20 (68,9%) woman and 9 (31 %) man. Mean OCTA flux index were 0,46emetrop, 0,43 low myopia, 0,44 moderate myopia and 0,44 high myopia. Perfussion were 45,7% onemetrop, 45,2% low myopia, 45,85% moderete myopia and 46,1% high myopia.ConclusionThere were difference mean OCT ONH Angio in the flux index in patients with 0,46 on Emetrop and0,43 on myopia. Capilary Perfusion 45,7% on emetrop and myopia patients.KeywordOptical coherence tomography (OCT-A), Flux Index, MyopiaLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download869-FP-R-O-INARVOS-04-Jehan-Fauzi-Rakhmandani.pdf

316 FREE PAPER

FP-R-E-INARVOS-05The Effect of Oral Citicholine on Transforming Growth Factor Expression β1(TGF- β1) on Scleral Tissue of Rattus Novergicus (In Vivo Study of MyopiaPathogenesa)Abstract TitleThe Effect of Oral Citicholine on Transforming Growth Factor Expression β1 (TGF- β1) onScleral Tissue of Rattus Novergicus (In Vivo Study of Myopia Pathogenesa)

First Author: DIMAS ANANDITA W


Co Author:

Nanda Wahyu Anandita (Universitas Brawijaya)

Hidayat Sujuti (Universitas Brawijaya)



Seminat: INARVOS


Introduction & ObjectiveRefractive disorders in the world are estimated to reach 800 million to 2.3 billion with the mostrefractive abnormalities being myopia. Citicoline is thought to be involved in dopaminergicpathways and is thought to play a role as one of the agents in controlling myopia. This study aims tofind out the effect of citicoline on the elongation of the eyeball axis of mice and the expression ofTGF-β1 on the anterior and posterior sclera tissue of mice.MethodThis study is an experimental in vivo study in male mice aged 4 weeks (n = 25). Mice were dividedinto negative controls, the Lense Induced Myopia (LIM) group without citicoline as a positivecontrol, and the LIM group with oral citicoline 100, 200 and 300 mg/kgBB/day administered once aday for a week in the third week. We evaluated Axial Length and expression levels of TGF-β1 inpercentage units using immunohistochemical painting Methods.ResultThe dose of citicoline 300 mg/KgBB/Day significantly increased the expression rate of TGF-β1 by 0.030% in the anterior sclera and 0.022% in the posterior sclera of mice and lowered the Axial Length by 0.002 mm.ConclusionCiticoline was able to increase the expression of TGF-β1 in the mouse sclera and control AxialLength in LIM model mice.Keywordciticoline, Axial Length, TGF-β1Latest UpdateMay 17, 2021StatusApproved As Free PaperFile Download982-(Proofread)-paper-pvsm.pdf

317FREE PAPER

FP-R-O-INARVOS-06REFRACTIVE ERROR PREVALENCE ASSESSED FROM LEVEL OF EDUCATIONAMONG RURAL POPULATION IN MALANG DISTRICTS

Abstract TitleREFRACTIVE ERROR PREVALENCE ASSESSED FROM LEVEL OF EDUCATION AMONGRURAL POPULATION IN MALANG DISTRICTS

First Author: Ferdian Yanuar


Co Author: dr. Anny Sulistyowati, Sp.M (K) (Universitas Brawijaya)



Seminat: INARVOS


Introduction & ObjectiveThe incidence of refractive errors is increasing every year around the world. The prevalence ofrefractive error in Sumatra in 2002 was obtained by myopia 26.1%, hyperopia 9.2% andastigmatism 18.5%. The purpose of this study is to describe the number of refractive errorprevalence assessed from level of education among rural population in Malang districs.MethodA descriptive study was carried out in 2019 in three villages in Malang districs. A detailed ocularexamination was conducted of all participants who attending a research facility and that includedvisual acuity testing, slit lamp examination and. We defined clinically important refractive error asfollows: hyperopia, SphEq value of 0.25 diopters (D) or greater; myopia, SphEq value of −0.25 D orless; and astigmatism, cylinder of 0.25 D or greater in either eye.ResultOf 953 participants who completed the examine, refractive error data were obtained for 375(39.34%). Level of education in refractive error participants dominate by primary school with 210perticipants (56%). Prevalences of hyperopia, myopia, and astigmatism were 38.4%, 36.8%, and22.4%. Myopia more prevalent in junior high school and college (47.62% and 52.38%) than primaryschool and senior high school (34.29% and 30.65%).ConclusionPrevalence of refractive error in Malang districts just 39.35% with level education dominate byprimary school. Myopia and Hyperopia were associated with educations.KeywordRefractive Error, Education, DistrictsLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download972-FP-R-O-INARVOS-06-FERDIAN-YANUAR.pdf

318 FREE PAPER

FP-R-O-INARVOS-07REFRACTIVE STATUS AND REFRACTIVE ERROR PREVALENCE IN CLINICALCLERCKSHIP STUDENTS OF OPHTHALMOLOGY DEPARTMENT MEDICALFACULTY OF ANDALAS UNIVERSITY MAY-JULY 2017 IN RSUP. DR. M.DJAMIL PADANG

Abstract TitleREFRACTIVE STATUS AND REFRACTIVE ERROR PREVALENCE IN CLINICAL CLERCKSHIP STUDENTS OF OPHTHALMOLOGY DEPARTMENT MEDICAL FACULTY OF ANDALAS UNIVERSITY MAY-JULY 2017 IN RSUP. DR. M. DJAMIL PADANG

First Author: Puji Indah Lestari

Author Institution: Universitas Andalas

Co Author: Rinda Wati (Universitas Andalas)



Seminat: INARVOS


Introduction & ObjectiveRefraction error occur because the image is not focused on the retina so that visual objects seemsblurred. Uncorrected refraction error is one of the causes of decreased visual acuity. In the Vision2020 program there are four main principles, are eye health promotion, prevention of eye diseases,curative intervention, and rehabilitation. To achieve these objectives screening activities is neededas a first step in solving the blindness problem globally.MethodThe research sample consisted of 81 clinical clerkship students at the Andalas University medicalfaculty in the Eye department of RSUP Dr. M. Djlamil Padang from May - July 2017. All sampleswere examined for both eyes. In eyes whose vision does not reach 20/20, a maximum correction isperformed until the best corrected visual acuity is obtained. Refractive error are then classifiedaccording to the required correction lensResultThe most common age for refraction is 25 years. More than 60% of the eyes of respondents withmyopia refractive disorders, where more than half suffer from mild degree myopia (52% in the righteye and 60.4% in the left eye). Astigmatism refraction abnormalities are also quite high, 38.3%right eye and 37.3% left eye.ConclusionConclusion: Majority of the refraction error of clerkship student of the Andalas University medicalfaculty in the Eye Department are myopia, especially mild degree myopia and astigmatism.KeywordRefractive disorders, myopia, astigmatism.Latest UpdateMay 17, 2021StatusApproved As Free PaperFile Download100-FP-R-O-INARVOS-07-Puji-Indah-Lestari.pdf

319FREE PAPER

FP-R-O-INARVOS-08CORRELATION BETWEEN METABOLIC SYNDROME COMPONENTS WITHLENS THICKNESS AND REFRACTIVE STATUS: POPULATIONAL STUDY INMALANG DISTRICT

Abstract TitleCORRELATION BETWEEN METABOLIC SYNDROME COMPONENTS WITH LENSTHICKNESS AND REFRACTIVE STATUS: POPULATIONAL STUDY IN MALANG DISTRICT

First Author: Heronita Purnamasari


Co Author:

dr. Anny Sulistiyowati, SpM(K) (Universitas Brawijaya)

dr. Seskoati Prayitnaningsih, SpM(K) (Universitas Brawijaya)

dr. Rulli Rosandi, SpPD-KEMD (Universitas Brawijaya)

dr. Holipah, PhD (Universitas Brawijaya)



Seminat: INARVOS


Introduction & ObjectiveMetabolic syndrome (MS) might induce escalation of oxidative stress, inflammation, and endothelialdysfunction which might impair the refractive system and irritate the visual acuity. This study wasmerely intended to investigate the components of the metabolic syndrome (body mass index, bloodpressure, diabetes mellitus, and dyslipidemia) that primarily impact the lens thickness and refractive Status.MethodThis is an analytic observational study with a cross-sectional design. The sample was citizens fromMalang district, Indonesia, with risk factors for suffering from MS (n=271). The variables measuredinclude body mass index (BMI), systolic blood pressure (systole), diastolic blood pressure (diastole),fasting blood sugar (FBS), HDL cholesterol (HDL), triglycerides (TG), lens thickness, and refractiveStatus were grouped into emmetropia, myopia, hyperopia, and astigmatism.Result116 participants identified as MS and 155 as non-MS. Lens thickness was affected significantly bysystole (coefficient 4.30, SE 1.61, p<0.05) and FBS (coefficient 1.36, SE 0.59, p<0.05), howeverage >60 years also significantly influence it (coefficient 229.11, SE 76.34, p<0.05). FBS and age50-59 years acted as risk factors for myopia (FBS: OR 1.01 with 95% CI 1.00-1.01; age 50-59: OR0.38 with 95% CI 0.17-0.87; p<0.05), whereas HDL acted as risk factors for hyperopia (OR 1.04with 96% CI 1.00-1.07).ConclusionSystole and FBS were the components of MS that have a considerable effect on the lens thickness,as well as age >60 years was also proved to affect it significantly. Myopia was affected by FBS andage (50-59 years), whereas hyperopia was affected by HDL.Keywordlens thickness, hypertension, metabolic syndromeLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download213-FR-R-O-INARVOS-08-Heronita-Purnamasari.pdf

320 FREE PAPER

FP-O-INARVOS-09Correlation Between Intelligence Quotient (IQ) Test Results With RefractiveError in Autistic Children at Special Education Elementary School In Malang

Abstract TitleCorrelation Between Intelligence Quotient (IQ) Test Results With Refractive Error inAutistic Children at Special Education Elementary School In Malang

First Author: DECHRIST YOHANES EDDY WIBOWO

Author Institution: FK UNIVERSITAS BRAWIJAYA

Co Author:

NANDA WAHYU ANANDITA (FK UNIVERSITAS BRAWIJAYA)

ANNY SULISTIYOWATI (FK UNIVERSITAS BRAWIJAYA)

LELY RETNO WULANDARI (FK UNIVERSITAS BRAWIJAYA)



Seminat: INARVOS


Introduction & ObjectiveThis study aims to determine the relationship between the type of refractive error and the level ofautism and the relationship between refractive errors and Intelligence Quotient test Results inchildren with autism.MethodThis cross-sectional study was conducted from September 2019 to February 2020, involving 27 ofthe 32 respondents of autistic special school students in Malang. The data taken in this study weredemographic data, visual acuity, types of refractive errors, autism level, and the value ofIntelligence Quotient (IQ).ResultThere was a significant relationship between the type of refractive error and the level of autism.There was a significant, inversely proportional relationship between refractive errors and IQ testResult, milder the refractive error and the level of autism, the higher the IQ score; conversely, themore severe the refractive error and the level of autism, the lower the IQ score. There was asignificant correlation between the level of autism and IQ with a negative correlation, between thelevel of autism and visual acuity with a positive correlation, and between refractive errors and IQ inautistic children with a negative correlation.ConclusionThere was a significant relationship between the level of autism and refractive errors and betweenrefractive errors and IQ in autistic students at Special Education Elementary SchoolKeywordRefractive error, Autistic students, Intelligence Quotient (IQ)Latest UpdateMay 17, 2021StatusApproved As Free PaperFile Download764-FP-O-INARVOS-09-DECHRIST-YOHANES-EDDY-WIBOWO.pdf

321FREE PAPER

FP-R-O-INARVOS-10Clinical Characteristics of Patients with Retinitis Pigmentosa at Low VisionUnit in National Eye Center Cicendo Eye Hospital

Abstract TitleClinical Characteristics of Patients with Retinitis Pigmentosa at Low Vision Unit incNational Eye Center Cicendo Eye Hospital

First Author: Nuzul Rianti


Co Author:

Ine Renata Musa (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Susanti Natalya Sirait (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)

Karmelita Satari (Indonesia National Eye Centre, Cicendo Eye Hospital, Bandung, Indonesia)



Seminat: INARVOS


Introduction & ObjectiveRetinitis pigmentosa (RP) is a part of visual impairment that could be due to genetic factors.Globally, the prevalence of RP is about 1 in 4000 persons. Retinitis pigmentosa were the leadingcause of visual disability and blindness in individuals aged 20-60 years. To describe the clinicalcharacteristics of patients with RP at low vision unit in Cicendo Eye Hospital.MethodMedical records were reviewed for all new patients with RP between January 2017 throughDecember 2019. Data taken include age, gender, symptoms, visual acuity, colour vision, contrastsensitivity, fundus examination, visual field testing, and electroretinogram examination. The bestcorrected visual acuity was classified based on World Health Organization’s category of vision.ResultA total of 88 patients RP with mean age of 38.5 years were included in this study. Fifty patients(56.8%) were male and 38 patients (43.2%) were female. Loss of vision (50.0%) was the leadingsymptom. Sixteen patients (18.2%) had a positive family history. Retinitis pigmentosa was typical in84 patients (95.5%). Visual impairment (26.1%) and blindness (53.4%) prevalence rates atpresentation are quite high.ConclusionRetinitis pigmentosa occurred mostly in men and range age of 26-45 years old. The Result of theexamination accompanied by decreased colour vision, contrast sensitivity, and visual field defect.Bone spicule is the most commonly found in funduscopic examination. The majority of patients weretypical RP and came in category of blindness at first visit.KeywordRetinitis pigmentosa, visual impairment, blindnessLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download877-FP-R-O-INARVOS-10-Nuzul-Rianti.pdf

322 FREE PAPER

FP-R-O-INARVOS-11CORRELATION OF REFRACTIVE CHANGES TO RELATIVE ACCOMMODATIONIN CHILDREN

Abstract TitleCORRELATION OF REFRACTIVE CHANGES TO RELATIVE ACCOMMODATION IN CHILDREN

First Author: ARYATI S


Co Author:

dr. Nanda Wahyu Anandita, Sp.M (K) (Universitas Brawijaya)

dr. Lely Retno Wulandari, Sp.M (K) (Universitas Brawijaya)

dr. Anny Sulistiyowati, Sp.M (K) (Universitas Brawijaya)



Seminat: INARVOS


Introduction & Objective: School age is a period where near work vision is mostly used during school activities.In ruralareas, school-age children often do not get routine ophthalmology examination. This research isheld to evaluate the correlation of refractive change progressivity to relative accommodation ofschool-age children in rural-urban areaMethod114 students, aged 8-13 years old, participated in this prospective cohort. Refractive Status wasdivided into emmetropic and ametropic. Relative accommodation was measured with binocularspherical lenses. Follow-up was taken 3 monthlies for 6 months.ResultLowest Negative Relative Accommodation (NRA) score was found in emmetropic group withabnormal NRA-PRA, while highest Positive Relative Accommodation (PRA) was found in ametropicgroup with abnormal NRA-PRA. PRA was higher in female respondents. No significant progressivityduring 6 months period. There is significant correlation between right eye refractive Status andbaseline PRA, but no significant correlation afterwards. NRA-PRA changes in ametropic groupshows normal NRA-PRA distribution.ConclusionIn general, there is no significant correlation between refractive Status changes and relativeaccommodative changes in shool-age children in urban-rural area.KeywordREFRACTIVE, ACCOMMODATION, CHILDRENLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download436-jurnal-accomodation-PVSM-aryati-english-270621.pdf

323FREE PAPER

FP-R-O-INARVOS-12COMPARISON OF VISUAL ACUITY EXAMINATION METHODS IN CHILDRENWITH DEVELOPMENTAL DISABILITIES ON SPECIAL NEEDS ELEMENTARYSCHOOL IN MALANG

Abstract TitleCOMPARISON OF VISUAL ACUITY EXAMINATION METHODS IN CHILDREN WITH DEVELOPMENTAL DISABILITIES ON SPECIAL NEEDS ELEMENTARY SCHOOL IN MALANG

First Author: HARDIAN WICAKSONO

Author Institution: FK Universitas Brawijaya RSUD dr Saiful Anwar Malang

Co Author:

NANDA WAHYU ANANDITA (FK Universitas Brawijaya RSUD dr Saiful Anwar Malang)

ANNY SULISTIYOWATI (FK Universitas Brawijaya RSUD dr Saiful Anwar Malang)

LELY RETNO WULANDARI (FK Universitas Brawijaya RSUD dr Saiful Anwar Malang)



Seminat: INARVOS


Introduction & ObjectiveIt is important to perform eye health examinations on children with developmental disabilities (DD).Visual acuity is one of important thing that have to be examine. This study aims to compare visualacuity examination Methods using: Snellen chart, ETDRS chart, and LEA chart in children with DDin special needs elementary school in Malang.MethodThis analytical study uses cross sectional approach measuring the uncorrected and best correctedvisual acuity in 231 students in special needs elementary school with all three Methods and thencompares them statistically. In addition, the success rate of each Method of visual acuityexamination in each group is compared.ResultOut of 231 students, 90 are able to be examined by all three Methods. Significant differences arefounded on visual acuity Results when using the LEA chart Method (p ≤ 0.05), 0.191 ± 0.391compared with 0.284 ± 0.438 Snellen and 0.277 ± 0.452 ETDRS chart. The superiority of LEA chartthan two other Methods are significant in all test groups except in the uncorrected visual acuity agegroup ≥ 13 years old. Examination success rate with LEA chart is highest in total respondents(67.81% compared to Snellen 46.35% and ETDRS chart 45.92%), < 13 years group, learningdisability group and autism-ADHD groups compared to the other two Methods.ConclusionVisual acuity Results of LEA chart (symbol and number) Methods are better in almost all test groupswith higher success rates due to less detection difficulties in children with DD and more familiaroptotype character.Keywordvisual acuity examination Method, developmental disabilities, special needs school.Latest UpdateMay 17, 2021StatusApproved As Free PaperFile Download97-FP-R-O-INARVOS-12-Hardian-Wicaksono.pdf

324 FREE PAPER

FP-R-O-INARVOS-13The Near Vision Related Quality of Life in Corrected and UncorrectedPresbyopia in Cicendo Eye Hospital Employees

Abstract TitleThe Near Vision Related Quality of Life in Corrected and Uncorrected Presbyopia inCicendo Eye Hospital Employees

First Author: ANISA FEBY ARIFANI

Author Institution: PMN RS Mata Cicendo

Co Author:

Susanty Natalya, MD (National Eye Center Cicendo Eye Hospital)

Aldiana Halim, MD (National Eye Center Cicendo Eye Hospital)



Seminat: INARVOS


Introduction & ObjectiveBackground: Quality of life influenced by visual systems and visual functions. The Results of visualacuity could be the prediction for the vision related quality of life. Presbyopia is one of the mostcommon causes of near vision impairment, especially uncorrected presbyopia. Uncorrectedpresbyopia will provide a poor quality of life in daily activitiy. Purpose: To comparing the nearvision quality of life in corrected presbyopia and uncorrected presbyopiaMethodThis cross-sectional study was conducted on 253 employees at the National Eye Center Cicendo EyeHospital with aged ≥35 years. The assessment of the near vision quality of life was assessed byNear Activity Visual Questionnaire (NAVQ) which was filled directly by each subjectResultPrevalence on this study was 85.8% (95% CI :81,2%-90,4%). There were 194 persons hadpresbyopia. The group of corrected presbyopia were 124 persons (64%) and uncorrectedpresbyopia were 70 persons (36%). The age for corrected presbyopia group was from 41-45 yearsold and the age for uncorrected presbyopia was from 51-55 years old. The proportion of gender infemale is higher than men. The median score NAVQ of the corrected presbyopia was 10.72 (IQR0.00-23.07) lower than the uncorrected presbyopia group with median score of 30.30 (IQR0.00-48.32) with p value <0.001ConclusionThe group of uncorrected presbyopia had a poor near vision quality of life than the group ofcorrected presbyopiaKeywordNear vision quality of life, uncorrected presbyopia, Near acquity visual questionnaire (NAVQ)Latest UpdateMay 17, 2021StatusApproved As Free PaperFile Download789-FP-R-O-INARVOS-13--Anisa-Feby-Arifani-(Manuscript).pdf

325FREE PAPER

FP-R-O-INARVOS-14Association Between Myopia and Indoor Activity among Teenager

Abstract TitleAssociation Between Myopia and Indoor Activity among Teenager

First Author: ANGGUN DEWI RENGGINASTI

Author Institution: medical faculty UB RSSA

Co Author: Anny Sulistiyowati (medical faculty UB RSSA)



Seminat: INARVOS


Introduction & ObjectiveUncorrected refractive error is a common cause of visual impairment among school-age children.Many studies have shown that myopia is influenced by both genetic and environmentalmechanisms, including near work activity. We investigated the relationship between indoor activityand myopia among students of SMPN 27 MalangMethodA cross-sectional study of 137 samples from ninth-grade students of SMPN 27 Malang was selectedusing a purposive sampling design. Students had a comprehensive eye examination, including noncycloplegic refraction and completed indoor activity questionnaires.ResultA significant association was found between using gadget (p=0.000) ,playing PlayStation(p=0.003),watching television (p=0.000), near work activity reading (p= 0.000) with the incident ofmyopia. The statistical analysis for the relationship between myopia and duration of readingshowed p value= 0.165. This study showed no significant relationship between the duration ofreading activities and myopia progression.ConclusionFrom this study, it can be concluded that indoor activity have a higher risk to become myopia. Asignificant association between indoor activity and myopia was found in this studyKeywordMyopia, Indoor activity, Refractive StatusLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download356-free-papper-PVSM-dr.Anggun-Sp.M.pdf

326 FREE PAPER

FP-R-O-INARVOS-15REFRACTION ANOMALY IN CHILDREN WITH DEVELOPMENTAL DISABILITIES IN SPECIAL NEEDS SCHOOL IN MALANG

Abstract TitleREFRACTION ANOMALY IN CHILDREN WITH DEVELOPMENTAL DISABILITIES IN SPECIAL NEEDS SCHOOL IN MALANG

First Author: Dian Rosalia

Author Institution: universitas brawijaya

Co Author:

Anny Sulistiyowati (universitas brawijaya)

Nanda Wahyu Anandita (universitas brawijaya)

Lely Retno Wulandari (universitas brawijaya)



Seminat: INARVOS


Introduction Children with disabilities are at a higher risk of visual impairment compared to normal population. Unfortunately, eye examination for such children is neglected. This study is reporting refraction anomaly in children with developmental disabilies in special needs school in Malang.MethodThis consecutive cross-sectional study involved 231 students with developmental disabilities in all special needs schools in Malang. The age range is between 7 and 14 years old. All students underwent some eyes examination after approval and infomed consent from school and parents obtained. Visual acuity examined using Snellen Chart, LVRC Logarithmic Visual Acuity Chart, and LEA symbols.ResultBest-corrected visual acuity test was successfully performed with Snellen chart in 98 students (54,1%), LVRC in 94 students (51,9%) and LEA symbols in 141 students (77,9%). Refraction anomaly was found in 35 eyes (12,3%), consisting of 11 myopia (31,4%), 1 hypermetropia (2,9%) and 23 astigmatism (65,7%). Amblyopia was found in 12 eyes (34,3%) with refraction anomaly and 66,6% of eyes with amblyopia from >9 years old age group.ConclusionLEA symbols was the most successful visual acuity test tool used in special needs students compared to Snellen chart and LVRC. Refraction anomaly was found in 12,3% students and the most common anomaly was astigmatism. Early detection of refractive anomaly is very important to assist their development.Keyworddevelopmental disabilities, refractive error, special needs children

327FREE PAPER

FP-R-O-INARVOS-16INCIDENCE AND PROGRESSION OF MYOPIA IN URBAN RURAL AREA SCHOOL CHILDREN

Abstract TitleINCIDENCE AND PROGRESSION OF MYOPIA IN URBAN RURAL AREA SCHOOL CHILDREN

First Author: ARYATI S


Co Author: dr. Nanda Wahyu Anandita, Sp.M (K) (Universitas Brawijaya)



Seminat: INARVOS


Introduction & ObjectiveTo evaluate the incidence and progression of myopia in school-aged children at SDN 1 AtapLesanpuro.MethodProspective longitudinal study was done to 104 school children aged 5 to 11 years old screenedwithin 2 years in 1-year interval. Subjects of this study were students from urbanrural regionelementary school. Data was analyzed using Paired Sample T-Test and chisquare test.Result104 of the 124 children were qualified for the 2 years examination. The incidence of myopiaincreased from year to year by 22.1%-35.5% with an age interval of 5 to 11 years at the time ofinitial data collection. Most of the subjects experiencing myopia are within age 7-9 interval. Theoverall incidence of progressive myopia was 51% with 0.4 D progression in the first year and 0.37 Din the second year. The greatest progression was found at age group of 8-10 with 0.6 D progressionin the first year and 0.41 D in the second year. Myopia progression was more significant in womenthan in men (p <0.05), but was insignificant with age (p> 0.05).ConclusionThe incidence of myopia in school-aged children in urban rural area increases every year. Itsprogression is still unclear whether it is a physiological condition. Further research is needed inother areas to determine the distribution of myopia in school-aged children in Indonesia. It isnecessary to evaluate the influencing factors.KeywordINCIDENCE, PROGRESSION, MYOPIALatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download582-jurnal-deskriptif-PVSM-aryati-english-23062021.pdf

328 FREE PAPER

FP-G-INACOS-01THE DOWNTREND IN HOSPITAL VISIT FOR VISUAL IMPAIRMENT DURINGCOVID-19 PANDEMIC IN TABANAN, BALI, INDONESIA

Abstract TitleTHE DOWNTREND IN HOSPITAL VISIT FOR VISUAL IMPAIRMENT DURING COVID-19PANDEMIC IN TABANAN, BALI, INDONESIA

First Author: Ni Putu Dharmi Lestari

Author Institution: Intern Doctor of Ophthalmology Department, Tabanan General Hospital, Tabanan, Bali,

Indonesia

Co Author: Gede Benny Setia Wirawan (Center for Public Health Innovation, Faculty of Medicine,

Udayana University, Denpasar, Bali, Indonesia), I Putu Rustama Putra (Ophthalmologist of Ophthalmology

Department, Tabanan General Hospital, Tabanan, Bali, Indonesia), Ni Wayan Sedani (Ophthalmologist

of Ophthalmology Department, Tabanan General Hospital, Tabanan, Bali, Indonesia), Cynthia Dewi M

(Ophthalmologist of Ophthalmology Department, Tabanan General Hospital, Tabanan, Bali, Indonesia)



Seminat: INACOS


Introduction & ObjectiveWHO, and the Indonesian government, have agreed to a plan to eradicate preventable blindness by2020 in VISION 2020. However, the COVID-19 pandemic has caused a strain on the healthcaresystem. It is difficult to assess the impact of the pandemic toward preventable blindness. Here weapproach the issue by evaluating hospital visits for visual impairments in one regency in Bali, Indonesia.MethodWe collected outpatient visit records from three hospitals providing ophthalmologic clinics inTabanan, Bali, Indonesia, a regency of 445 thousand people. We then conducted a descriptiveanalysis of the general changes in outpatient visits to these clinics and changes observed indifferent diagnoses identified as causes for preventable blindness.ResultThe Result showed a 35% downtrend of outpatient visits to the ophthalmologic clinic throughout theprovinces. A more pronounced downtrend (45.22%) was observed for one public hospital that alsoserves as a COVID-19 referral hospital compared to private hospitals (around 30% each). By diagnoses, visits for cataracts were shown with a less severe downtrend compared to glaucoma, pterygium, and refractive disorders.ConclusionOur study found a downtrend for outpatient visits for visual impairment in ophthalmologic clinics,which may be attributed to COVID-19 preventive measures by the hospital as well as patient reluctance due to fear of COVID-19 transmission. Public health communication needs to address this fear to recover patient confidence while maintaining vigilance in practicing COVID-19 preventive behavior.Keywordoutpatient visit, VISION 2020, COVID-19Latest UpdateApril 17, 2021StatusSubmittedFile Download

329FREE PAPER

FP-R-O-INACOS-02Situational Analysis of Eye Care In Bali

Abstract TitleSituational Analysis of Eye Care In Bali

First Author: dr. Anak Agung Ayu Githasari Dewi

Author Institution: Udayana

Co Author

dr. Ni Made Ari Suryathi, M.Biomed, Sp.M(K) (Udayana)

dr. Ni Made Suryanadi, Sp.M(K) (Udayana)

Dr. dr. I Wayan Eka Sutyawan, Sp.M(K) (Udayana)

Dr. dr. AA Mas Putrawati Triningrat, Sp.M(K) (Udayana)

Dr. dr. I Wayan Gede Jayanegara, Sp.M(K) (Udayana)



Seminat: INACOS


Introduction & ObjectiveThe prevalence of blindness in Bali based on Rapid Assessment of Avoidable Blindness (RAAB)survey in 2015 was 2%. This prevalence rate is still high according to WHO guidelines. Bali haschallenges in providing eye care services. The aim of this study was to report situational analysis ofthe eye care in Bali.MethodThis is a descriptive study with quantitative and qualitative approach. Data collection was carriedout through interviews and questionnaires targeting respective stakeholders involved in the eyecare services in Bali.ResultBali consists of 9 districts with total 4,337 million people. Eye care in Bali consist of 43 hospitals,120 primary health care (Puskesmas), 73 general ophthalmologist and subspecialists, 18 trainedopthalmic nurses,and 12 refractionist. Bali has mobile eye care unit covering remotes area and aNon-Government Organization (NGO) actively contributing in community eye care service. Totalnumber of cataract surgery in 2019 was 7.267 eyes with cataract surgical rate (CSR) was 1.675.Komite Mata Daerah (Komatda) dan health insurance for eye service and eye surgery is a form ofsupport from the government.ConclusionThe implementation of eye care services in Bali is yet under evaluation. Things needed to considerto improve eye care services including providing better distribution of ophthalmologist to districts,and empowering voluntary local manpower as village health workers / cadres through regularlyorganized training. Education on blindness and preventable visual disturbances also must becarried out regularly.KeywordBaliLatest UpdateMay 10, 2021StatusSubmittedFile Download

330 FREE PAPER

FP-R-O-INACOS-03Refractive Error Characteristic On Junior High School 4 Kuta SelatanStudents with Ready Made Spectacle

Abstract TitleRefractive Error Characteristic On Junior High School 4 Kuta Selatan Students with ReadyMade Spectacle

First Author: MADE DELTA DWIHARTAMI

Author Institution: Sanglah General Hospital

Co Author: Ni Made Ari Suryathi (SMP.N 4 Kuta Selatan, Bali)

Ariesanti Tri Handayani ()



Seminat: INACOS


Introduction & ObjectiveUncorected refractive erros (URE) is the leading cause of eye problem worldwide and the secondcause of correctable blindness in the world after cataract. Amblyopia are the most cause of URE inschool age at 3 – 15 years old that detected from school eye health screening program in manycountry. Ready Made Spectacles (RMS) is alternative that had been used in many country toanticipated the massive refractive error because the simplest and cheapest solution than CustomMade Spectacle (CMS). While CMS remain the ideal solution to refractive error, RMS represent areasonable alternative which can provide a more rapid response to this problem. This study aim isto evaluate of refractive error changes of student vision and amblyopia after Ready Made Spectacleused during the 1 year follow up period.MethodThis study is descriptif cohort study, with 1 year follow up period for investigate Best CorrectedVisual Acuity (BCVA) change. This study was conducted in SMP.N 4 Kuta Selatan on 1 January2019 to 31 January 2020. Data was collected through questionnaires and basic eye examination.ResultStudent who participated in this study were 164 students and 302 eye with Refractive error.Characteristic of the subject consist of 175 girls’ eye and 127 boys’ eye. Mostly of them were 13years old , and are Balinese.ConclusionOne year follow up period after RMS used that produce decrease Visual Impairment statisticallysignificant with p < 0,05 ( 95%CI) . Two hundred and sixteen from 222 having good ambliopiacorrection.KeywordStudent Refractive Error Screening Program, Refractive error, Ready Made SpectacleLatest UpdateMay 12, 2021StatusSubmittedFile Download

331FREE PAPER

FP-R-O-INACOS-04THE CORRELATION BETWEEN DISTANCE AND POSITION OF COMPUTERUSAGE WITH COMPUTER VISION SYNDROME IN ACADEMICS CIVITASFACULTY OF MEDICINE DIPONEGORO UNIVERSITY

Abstract TitleTHE CORRELATION BETWEEN DISTANCE AND POSITION OF COMPUTER USAGE WITHCOMPUTER VISION SYNDROME IN ACADEMICS CIVITAS FACULTY OF MEDICINEDIPONEGORO UNIVERSITY

First Author: Manista AstriyaniAuthor Institution: Faculty of Medicine Diponegoro University, Kariadi Hospital, Semarang, Central JavaCo Author:dr. Andhika Guna Dharma, Sp.M (K) (Subdivision Staff of Ophthalmology Community,Ophthalmology Department of Diponegoro University, Kariadi Hospital, Semarang, Central Java)DR. dr. Trilaksana Nugroho, M.Kes, FISCM, Sp.M(K) (Subdivision Staff of OphthalmologyCommunity, Ophthalmology Department of Diponegoro University, Kariadi Hospital, Semarang,Central Java)

Abstract Type: ResearchAbstract Category: Free PaperSeminat: INACOSCompetition Category: Resident

Introduction & ObjectiveComputer Vision Syndrome (CVS) is a health problem caused by computer usage. The symptomsinclude eyestrain, headache, blurred vision, dry eye, neck and shoulder pain. One of the factors thatcause CVS is the improper distance between the eye and the computer and sitting position. Thisstudy aims to determine the correlation between distance and position of computer usage withComputer Vision Syndrome in academics civitas Faculty of Medicine Diponegoro University.MethodThis study is an analytical observational study with a cross-sectional design. This study wasconducted by using a questionnaire given to the 30 participants who met the inclusion criteria.Statistical analysis was done by using the Chi-square test to determine the most related variables.ResultThe distance between the eye and the computer (p=0,491; OR=1,67 ; 95% CI=0,39-7,15), spaciousworking space (p=0,605 ; OR=1,18 ; 95% CI=0,20-7,08), sitting in a chair (p=0,467 ; OR= - ; 95%CI= -), upright sitting position (p=0,150 ; OR=3,25 ; 95% CI=0,63-16,79), and the position of thehead parallel to the monitor (p=0,389 ; OR=0,51 ; 95% CI=0,11-2,36) were not significantlycorrelated with CVS.ConclusionIn this study, each of the variables had a p-value of >0.05. Therefore, it can be concluded that therewas no dominant variable related to CVS.KeywordComputer Vision Syndrome, distance, positionLatest UpdateMay 14, 2021StatusSubmittedFile Download

332 FREE PAPER

FP-R-O-INACOS-05LEVEL OF KNOWLEDGE, PERCEPTIONS, AND PREDISPOSITIONS ABOUTTELEMEDICINE HEALTH SERVICE IN RURAL AREA SEMARANGAbstract Title

LEVEL OF KNOWLEDGE, PERCEPTIONS, AND PREDISPOSITIONS ABOUT TELEMEDICINE HEALTH SERVICE IN RURAL AREA SEMARANG

First Author: Yosef Aji Gatra Krisantono

Author Institution: Faculty of Medicine Diponegoro University / Dr Kariadi Hospital, Semarang

Co Author:

Trilaksana Nugroho (Subdivision of Ophthalmology Community, Faculty of Medicine Diponegoro

University / Dr Kariadi Hospital, Semarang)

Andhika Guna Dharma (Subdivision of Ophthalmology Community, Faculty of Medicine Diponegoro

University / Dr Kariadi Hospital, Semarang)



Seminat: INACOS


Introduction & ObjectiveIntroduction: Telemedicine have great potential to address some of the challenges faced bydeveloping countries in providing accessible and cost-effective health care services. The emergenceof the COVID-19 outbreak is increasing the momentum for the use of telemedicine in providinghealth care to avoid the risk of disease transmission. Objective: To determine general knowledge,perceptions, and predispositions about telemedicine health service in rural area SemarangMethodThis research is a descriptive study with in depth interview. The sample of this research wasobtained from respondents who came to Primary Care Center in Gunungpati Semarang. The datacollected by questionnaire about knowledge, perceptions, and predispositions about telemedicinehealth serviceResultThere were 36 respondents, with the majority of respondents (75%) didn’t know abouttelemedicine. Almost all agreed that telemedicine could contribute to reducing health care systemcosts (91.7%), improve access and provide better quality to health care services (86.1%). Theprimary concern about telemedicine is the absence of direct contact with healthcare providers(83.3%). If telemedicine services is available in their area, 72.2% would be willing to receive aremote medical diagnosis, and 77.8% willing to receive a remote medical intervention or treatment.ConclusionThe Results of these studies indicate that the general knowledge about telemedicine is poor in ruralarea, but they have good perceptions and predispositions about telemedicine, even though the levelof concern is high. Therefore, planning is necessary to increase public knowledge about the benefitof telemedicine health service especially in remote area.Keywordtelemedicine, knowledge, rural areaLatest UpdateMay 14, 2021StatusSubmittedFile Download

333FREE PAPER

FP-R-O-INACOS-06THE CORRELATION BETWEEN DURATION OF COMPUTER USAGE WITHCOMPUTER VISION SYNDROME IN ACADEMICS CIVITAS FACULTY OFMEDICINE DIPONEGORO UNIVERSITY

Abstract TitleTHE CORRELATION BETWEEN DURATION OF COMPUTER USAGE WITH COMPUTERVISION SYNDROME IN ACADEMICS CIVITAS FACULTY OF MEDICINE DIPONEGORO UNIVERSITY

First Author: Devi Putri Widyavera Hukom

Author Institution: Faculty of Medicine, Diponegoro University

Co Author

dr. Andhika Guna Dharma, Sp.M (K) (Staff of Ophthalmology Community Subdivision,

Opthalmology Department of Diponegoro University, Kariadi Hospital, Semarang, Central Java)

DR.dr. Trilaksana Nugroho, M.Kes, FISCM, Sp.M (K) (Staff of Ophthalmology Community

Subdivision, Opthalmology Department of Diponegoro University, Kariadi Hospital, Semarang,

Central Java)



Seminat: INACOS


Introduction & ObjectiveComputers are being used by large number of people nowadays. This could lead to ocular and nonocular problems related to computer use called Computer Vision Syndrome (CVS) such as tension and fatigue in the eyes, burning sensation, irritation, redness, haze, dry eyes, and so on. One of the factors that cause CVS is duration of computer usage. This study aimed to analyse correlation between duration of computer usage and computer vision syndrome on academics civitas of Medicine Faculty at Diponegoro University, Semarang, Central Java.MethodThe study was an observational analytic study using cross sectional design, which was held in RSUPdr. Kariadi. The samples taken were 30 respondents who were chosen by some certain criteria. Thesampling technique used was consecutive sampling. This study was accomplished by directinterview based on questionnaire. Statistical analysis was done by using Chi Square test. Odds ratio(OR) was used to know the risk estimation for each variables.ResultDuration of working with computer (p=0,352; OR=3,00; 95% CI=0,28 – 32,75), duration of focusingin front of computer (p=0,296; OR=2,20; 95% CI=0,50 – 9,75), duration of working with computerwithin a day (p=0,765; OR=0,80; 95% CI=0,19 – 3,46) duration of taking break after usingcomputer (p=0,419; OR=1,73 ; 95% CI=0,31 – 9,57) were not related to computer vision syndrome.ConclusionIn this study, there was no significant relation between the working duration on computer andcomputer vision syndrome (p-value >0.05).KeywordDuration, computer vision syndromeLatest UpdateMay 14, 2021StatusSubmittedFile Download

334 FREE PAPER

FP-R-O-INACOS-07VISUAL IMPAIRMENT AND BLINDNESS SCREENING IN SEMARANG RURAL AREA

Abstract TitleVISUAL IMPAIRMENT AND BLINDNESS SCREENING IN SEMARANG RURAL AREA

First Author: Nungki Rusydiana Purnaningrum

Author Institution: Universitas Diponegoro

Co Author:

Trilaksana Nugroho (Universitas Diponegoro)

Andhika Guna Dharma (Universitas Diponegoro)



Seminat: INACOS


Introduction & ObjectiveIdentification of community problem is the first step to arrange strategies to overcome visionimpairment and blindness. Rapid Assessment of Avoidable Blindness showed that blindnessprevalence in Indonesia is 3.0%. The leading cause of blindness and visual impairment arecataracts, posterior segment disorders and uncorrected refractive errors. This study aims todescribe about visual impairment and blindness in Semarang rural areaMethodThis research is a descriptive study. The data was collected by in-depth interview usingquestionnaire and through ophthalmology examination. The sample of this research was obtainedfrom subjects who came to Social Service at Sekatul Village.ResultThere were 33 subjects, 33% are male and 67% are female with age ranging from 34-75 years old.Most of the responders education level were elementary school. There was 1 patient who haddisability on daily activities. Only 9% respondents had gone to the ophthalmologist before. Therewas 5 eyes from 3 patients that categorized into blindness, meanwhile 13% eyes experiencedsevere visual impairment and 22% eyes experienced moderate visual impairment. Both cataract anduncorrected refractive errors diagnosed in 23 eyes. The rest of diagnosis that we obtained werediabetic retinopathy, dry eyes, strabismus, pterygium, papil atrophy and suspect of episcleritis.ConclusionCataracts and uncorrected refractive errors are still the main concern for eye problem incommunity. Early detection and raise of awareness can be part of strategies for a better eye healthKeywordvisual impairment, blindness, screeningLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download375-FP-R-O-INACOS-07---Nungki-Rusydiana-Purnaningrum.pdf

335FREE PAPER

FP-R-O-INACOS-08Mother’s Knowledge and Awareness on Eye Examination in Children atGunungpati Primary Health Care

Abstract TitleMother’s Knowledge and Awareness on Eye Examination in Children at GunungpatiPrimary Health Care

First Author: dr Salmah Alaydrus

Author Institution: Diponegoro University

Co Author:

dr Trilaksana Nugroho Sp. M (K) (Diponegoro University)

dr Andhika Guna Dharma, Sp. M (K) (Diponegoro University)



Seminat: INACOS


Introduction & ObjectiveThe early years of life is very significant in the development of the eyes and vision. A majorcontributing factor to childhood blindness is a lack of awareness about promotive and preventativeeye care measures among parents, this makes the knowledge and awarness of mothers play animportant role. This study conducted to observed level of mother’s knowledge and awareness oftheir children’s eye examination at Primary Health Care in Gunung Pati, Semarang, Central Java.MethodThis study was observational with cross sectional approach using questionnaire about mothers’sknowledge and awareness toward eye examination of their children. Inclusion criteria consisted ofmother who had children under 18 years old and who examined their eyes’s children in primaryhealth centre, Gunungpati.ResultAll respondents in this study were female (100%) aged 26-35 years (65%) at most, and lastgraduate from junior high school (37.5%). Many respondents had poor knowledge (55%) andmoderate awareness (45%).ConclusionLevel of mother’s knowledge about their child’s eye examination is poor, while their awareness ismoderate. Needs to be held a routine health promotion to enhance their knowledge and theirawareness about child’s eye examination.Keywordknowledge, awareness, children’s eye examinationLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download500-FP-R-O-INACOS-08-dr.-Salmah-Alaydrus.pdf

336 FREE PAPER

FP-R-O-INACOS-09The Role of The Prolanis Program in Early Detection of Eye Disorders in TheWorking Area of The Gunungpati Community Health Center

Abstract TitleThe Role of The Prolanis Program in Early Detection of Eye Disorders in The WorkingArea of The Gunungpati Community Health Center

First Author: Nurul Febriani



Co Author:

Trilaksana Nugroho (Staff of Division Community of Ophthalmology, Opthalmology Department of

Diponegoro University, Kariadi Hospital, Semarang, Central Java)

Andhika Guna Dharma (Staff of Division Community of Ophthalmology, Opthalmology Department

of Diponegoro University, Kariadi Hospital, Semarang, Central Java)



Seminat: INACOS


Introduction & ObjectiveEarly detection of eye disorders is needed to detect eye disorders as early as possible to avoidblindness, can be done at a young age or in the elderly. Prolanis is a health service system and aproactive approach that is implemented in an integrated manner that involves participants, HealthFacilities, and BPJS Kesehatan in the framework of health services for BPJS Kesehatan participantswho suffer from chronic diseases to achieve an optimal quality of life at a cost-effective manner.and efficient health services.MethodThis type of research is descriptive with a case study approach, conducted starting April 2021.Samples were taken from Prolanis patients at Gunungpati Public Health Center. The research datainstrument through history taking and physical examination.ResultOur respondents are prolanis patients in the area of Gunungpati Public Health Center. The Resultsshowed that 55.6% of women and the most elderly group were 51.1%. There are 100% of patientsliving in the Gunungpati area. In the history, there were 75.6% of blurred eye complaints and ahistory of diabetes as much as 71.1%. On visual acuity examination, it was found that 51.1% lowvision and 88.9% were diagnosed with immature senile cataract.ConclusionIn the eye detection at Prolanis program in the Gunungpati Health Center, it was found that most ofthem experienced eye complaints and disorders. Prolanis has a role in early detection of eyedisorders in the elderly.KeywordEarly detection, eye disorder, ProlanisLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download486-FP-R-O-INACOS-09-Nurul-Febriani.pdf

337FREE PAPER

FP-G-INACOS-10Prevalence of Dry Eye Syndrome Associated to Face Mask Among TabananGeneral Hospital Health Workers in 2021

Abstract TitlePrevalence of Dry Eye Syndrome Associated to Face Mask Among Tabanan GeneralHospital Health Workers in 2021

First Author: Rania Ayu Permata Putri Kornia

Author Institution: Intern Doctor of Ophthalmology Department at Tabanan General Hospital, Bali

Co Author:

I Putu Rustama Putra (Ophthalmologist at Tabanan General Hospital, Bali)

Ni Wayan Sedani (Ophthalmologist at Tabanan General Hospital, Bali)

Cynthia Dewi M (Ophthalmologist at Tabanan General Hospital, Bali)



Seminat: INACOS


Introduction & ObjectiveThe continuous development of COVID-19 has made face masks became a mandatory part of ourdaily routine, but there has been an increase in dry eye syndrome (DES) from regular used of facemasks. Health workers who is obliged to use face masks are the one that has risk factor forexperiencing DES, including health workers at Tabanan General Hospital, as one of the COVID-19referral hospitals in Bali. The purpose of this study was to calculate the prevalence of DESassociated to face mask and characteristics of DES among Tabanan General Hospital healthworkers in 2021.MethodThis research was a descriptive cross sectional study. The sample were 64 health workers atTabanan General Hospital with convenience sampling technique using OSDI questionnaire.ResultThe prevalence of DES associated to face mask among Tabanan General Hospital health workers in2021 was 70.3%, with prevalence of mild degree 15.6%, moderate 12.5%, and severe 42.2%. Theprevalence of surgical mask users was greater than FFP2 mask users in mild (10.9%) and severe(23.4%) degrees. Characteristics of DES among Tabanan General Hospital health workers in 2021were found mostly in age 30-39 years old (35.6%), more in women (71.1%), without DM history(95.6%), non-smokers (84.4%), and without eye surgery history (93.3%).ConclusionMost of health workers at Tabanan General Hospital experiencing DES associated to face mask,and mostly with severe degree. Among those with DES, there were more surgical mask users thanFFP2 mask users. Future studies needed to analyze association between DES and face masks.KeywordDry Eye Syndrome, Face Mask, COVID-19Latest UpdateMay 16, 2021StatusApproved As Free PaperFile Download272-FP-G-INACOS-10-Rania-Ayu-Permata-Putri-Kornia.pdf

338 FREE PAPER

FP-R-E-INACOS-11DIFFERENCES IN HEALTH CADRES KNOWLEDGE ABOUT CATARACTSBEFORE AND AFTER GETTING COUNSELING USING VIDEO MEDIATHROUGH THE WHATSAPP APPLICATION

Abstract TitleDIFFERENCES IN HEALTH CADRES KNOWLEDGE ABOUT CATARACTS BEFORE ANDAFTER GETTING COUNSELING USING VIDEO MEDIA THROUGH THE WHATSAPPAPPLICATION

First Author: RIMA FEBRY LESMANA

Author Institution: Department of Ophthalmology, Udayana University-Sanglah General Hospital, Bali

Co Author: IGA Made Juliari (Department of Ophthalmology, Udayana University-Sanglah General Hospital,

Bali ), Made Agus Kusumadjaja (Department of Ophthalmology, Udayana University-Sanglah General

Hospital, Bali )



Seminat: INACOS


Introduction & ObjectiveCataract is one of the causes of blindness in the world and the main cause of blindness inIndonesia. Blindness due to cataracts is a global health problem that must be addressedimmediately, because it can lead to reduced quality of human resources, loss of productivity andrequires a large amount of money for its treatment. The high number of blindness due to cataractsrequires prevention by providing information and education related to cataracts appropriately,optimally and efficiently. This study aims to determine the differences in knowledge of healthcadres before and after receiving cataract counseling using video media through the WhatsAppapplication.MethodAnalytic observational study with pre-post test design approach. The difference in pre and post testvalues was analyzed using the Wilcoxon test.ResultThe Results of the research from 45 samples showed that there were differences in the level ofknowledge of the cadres after being compared before given counseling about cataracts using videomedia through the Whatsapp application which was statistically significant with a p value <0.001.ConclusionThis study shows an increase in the level of knowledge of the cadres after given counseling aboutcataracts using video media through the Whatsapp application.Keywordcataracts, cadres, WhatsappLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download772-FP-R-E-INACOS-11-Rima-Febry-Lesmana.pdf

339FREE PAPER

FP-G-INACOS-12Prevalence and Risk Factors of Pterygium in Social Healthcare Service ofKsatria Airlangga Floating Hospital in Bawean Island

Abstract TitlePrevalence and Risk Factors of Pterygium in Social Healthcare Service of KsatriaAirlangga Floating Hospital in Bawean Island

First Author: Amelia Rahmah Kartika

Author Institution: General Practitioner, the volunteer doctors in the Ksatria Airlangga Floating Hospital

Co Author:

Ega Sekartika (General Practitioner, the volunteer doctors in the Ksatria Airlangga Floating Hospital)

Rusydiana (General Practitioner, the volunteer doctors in the Ksatria Airlangga Floating Hospital)

Dini Dharmawidiarini (Cataract and Refractive Surgery Division Undaan Eye Hospital, Surabaya, Indonesia)

Gadis Meinar Sari (Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia)



Seminat: INACOS


Introduction & ObjectivePterygium is a common disorder of the ocular surface that affects people all over the world.Pterygium is a wing-shaped development of conjunctiva and fibrovascular tissue on the surface ofthe cornea that can trigger astigmatism, vision impairment, and apparent cosmetic concerns. Thepurpose of the study was to describe the prevalence and evaluate the risk factors of pterygium insocial healthcare service of Ksatria Airlangga Floating Hospital in Bawean Island.MethodThis study used analytic observational Methods with case control design. This study was conductedin December, 2020 – April, 2021 and the number of samples in this study was carried out by totalsampling Method for all patients with pterygium. Compared to control subjects who were groupmatched for age. Pterygium was diagnosed by the ophthalmologist using physical examination. Thedata was analyzed by using SPSS version 20.0 statistical software.ResultThe prevalence of pterygium was evaluated in 39 patients. The mean age of patients was 46.9 (SD:11.55) years, and 64% (n = 25) of them were women. Most patients with pterygium have outdoorwork (53.8%), grade 3 (53.8%) and bilateral eyes (51.2%). Pterygium was independently associatedwith presence of outdoor work (p = 0.01; OR 5.3 (CI 95% 1.900-14.970)). Gender (p = 0.467; OR0.70 (CI 95% 0.270-1.825)) and age (p = 0.149) were not significantly associated with pterygium.ConclusionIn Conclusion, there is a statistically significant association between outdoor work and pterygiumformation in the Social Healthcare Service of Ksatria Airlangga Floating Hospital in Bawean Island.KeywordPterygium, Age, Outdoor workLatest UpdateMay 17, 2021StatusSubmittedFile Download

340 FREE PAPER

FP-R-O-INACOS-13Eye Care Health Services in Buleleng District

Abstract TitleEye Care Health Services in Buleleng District

First Author: I Gusti Ayu Dian Ratnasari

Author Institution: Ophthalmology Department, Faculty of Medicine Udayana University, Sanglah Hospital

Denpasar Bali

Co Author:

dr. Ni Made Ari Suryathi, M. Biomed, Sp.M (K) (Ophthalmology Department, Faculty of Medicine

Udayana University, Sanglah Hospital Denpasar Bali)

dr. Ni Made Suryanadi, Sp.M(K) (Bali Mandara Eye Hospital Denpasar Bali)

dr. I Made Agus Kusumadjaja, Sp.M (K) (Ophthalmology Department, Faculty of Medicine Udayana

University, Sanglah Hospital Denpasar Bali)

dr. Ni Made Ayu Surasmiati,M. Biomed, Sp.M(K) (Ophthalmology Department, Faculty of Medicine


dr. Made Paramita Wijayati, M.Biomed, Sp.M (Ophthalmology Department, Faculty of Medicine




Seminat: INACOS


Introduction & ObjectiveIntroduction Prevalence blindness in Indonesia based on RAAB is 3% and 2% in Bali with cataract isthe leading cause. Buleleng is one of the district on the island of Bali with 660.600 population with3,32% prevalence of blindness in 2007. Objective to explore problems in eye care system in buleleng that can make the blindness rate high so can reduce prevalence of blindnees in Bulleleng DistrictMethodDescriptive study using a qualitative Method approach in November 2020 at Buleleng Distric. Datawere taken from interviews with various groups of Eye Health Care.ResultBuleleng had 9 subdistricts with people over 50 years old is 170.000. Eye care in Buleleng spread out with 20 primary health care (Puskesmas),1 General Hospital, 3 private hospitals that serves eye health care with JKN. Human resources including 4 Ophthalmologist, PERDAMI Bali and a NonGovernment Organization (NGO) but there is no specific training for eye health care except from dr.delta (resident who made thesis in Buleleng District). Total number of cataract surgery in 2019 was 1846 eyes with Cataract Surgical Rate (CSR) was 2,8.ConclusionEye care services in Buleleng still not fully evaluated. There few things to more inprove eye careservices including training voluntary local people and give education to be a health eye care/ caderin Buleleng District. Collaboration of all stakeholders in Buleleng District can make equitable andquality eye health services for all people in Buleleng DistrictKeywordBuleleng District, Eye care service, caderLatest UpdateMay 17, 2021StatusSubmittedFile Download

341FREE PAPER

FP-R-O-INACOS-14VALIDITY OF ANDROID APPLICATION BASED ON INCEPTION-V3ALGORITHM AS DIAGNOSTIC TOOL FOR VISUAL THREATENING DIABETICRETINOPATHY

Abstract TitleVALIDITY OF ANDROID APPLICATION BASED ON INCEPTION-V3 ALGORITHM AS DIAGNOSTIC TOOL FOR VISUAL THREATENING DIABETIC RETINOPATHY

First Author: A F MARNIDA SIAHAAN

Author Institution: Perdami Sumut

Co Author:

MAYANG RINI (Perdami Jabar)

BUDIMAN (Perdami Jabar)

IRAWATI IRFANI (Perdami Jabar)

ANDIKA PRAHASTA (Perdami Jabar)

ROVA VIRGANA (Perdami Jabar)



Seminat: INACOS


Introduction & ObjectiveDiabetic retinopathy (DR) is the most common cause of blindness in Diabetes Mellitus patients,which is about 80%. Meanwhile, early diagnosis and therapy can reduce blindness by 90%.Unfortunately, the limited number of ophthalmologists can inhibit the acceleration of therapy. Atthe same time, there is an artificial intelligence that has been able to recognize DR from trainingdataset of fundus photographs. Since then, there is a potential solution to answer the large need fordiagnosis that can increase referral rates and accelerate Visual Threatening Diabetic Retinopathy(VTDR) therapy to reduce permanent blindness in the community. This research is intended todetermine the validity of Android application based on Inception-V3 Algorithm in diagnosing VTDR.MethodThis study is a diagnostic test. Fundus photographs from diabetic patients in Cicendo National EyeHospital obtained retrospectively. A total of 147 mydriatic single visual field portable fundusphotographs were selected randomly. Diagnostic test performed on the diagnosis of Androidapplication compared to a Vitreoretinal expert as the gold standard of diagnosis.ResultThe Android application has 71.8% (CI 95%: 68% - 76%) sensitivity, 76.8% (CI 95%: 73% - 80%)specificity, 77.7% (CI 95 %: 74% - 81%) positive predictive value, 70.6% (95% CI: 68% - 75%)negative predictive value, and 74.1% (95% CI: 72% - 77%) accuracy.ConclusionInception-V3 Algorithm based Android application does not meet the minimum statistical standardto be used as VTDR diagnostic tool at this time. However, it could be a very useful large-scalediagnostic tool with further development.KeywordVTDR, Inception-V3, validityLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download134-FP-R-O-INACOS-14-A-F-MARNIDA-SIAHAAN.pdf

342 FREE PAPER

FP-G-INACOS-15THE EFFECT OF SMOKING ON DRY EYE SYNDROME: A STUDY USING THEOCULAR SURFACE DISEASE INDEX (OSDI) QUESTIONNAIRE IN RURAL AREA

Abstract Title

THE EFFECT OF SMOKING ON DRY EYE SYNDROME: A STUDY USING THE OCULAR

SURFACE DISEASE INDEX (OSDI) QUESTIONNAIRE IN RURAL AREA

First Author: dr. Setya Ningrum TefbanaAuthor Institution: UPTD Puskesmas Delha, Kabupaten Rote Ndao

Co Author: dr. Joy Aprianis Haning (UPTD Puskesmas Sonimanu, Kabupaten Rote Ndao)



Seminat: INACOS


Introduction & ObjectiveSmoking is one of many risk factors that can stimulate dry eye syndrome. Ocular Surface DiseaseIndex (OSDI) questionnaire is one of the most valid and reliable instrument to define the level ofdry eye syndrome. This study aims to prove the effect of smoking on dry eye syndrome byevaluating the respondent’s symptoms using OSDI instrument to diagnose the dry eye syndrome inrural area.MethodObservational study with cross-sectional design was used in this study. Respondents from RoteNdao Police members were selected by Consecutive sampling. Data are collected subjectively usingsmoking questionnaire and Ocular Surface Disease Index (OSDI) questionnaire, analyzed by SPSSsoftware version 21 by Chi-square Test with significance level of 5%.ResultA total 178 respondents participated in this study consisting of 169 men (94.9%) and 9 women(5.1%), age distribution between 20-53 years old and the largest age group was 30-39 years as 102(57.3%) respondents. A total of 103 (57.9%) smokers and 112 (62.9%) respondents experienced dryeye. Cronbach-alpha reliability test of the questionnaire showed coefficient value of 0,840. TheResult of chi-square test p= 0.024 (P < 0.05).ConclusionA significant association was found between smoking and the dry eye syndrome. OSDIquestionnaire is a simple and easy instrument that can be used to diagnose dry eye syndrome inrural area reliably.KeywordDry Eye Syndrome, Smoking, Ocular Surface Disease Index (OSDI)Latest UpdateMay 17, 2021StatusSubmittedFile Download

343FREE PAPER

FP-R-O-INACOS-16Association of Visual Impairment Awareness and Social Factors: ACommunity-Based Study in Malang

Abstract TitleAssociation of Visual Impairment Awareness and Social Factors: A Community-Based Study in Malang

First Author: Diah Puspita Rifasanti


Co Author: Hera Dwi Novita (Universitas Brawijaya)



Seminat: INACOS


Introduction & ObjectiveVisual impairment awareness and its associated social factors in community is important toformulate intervention and prevention of visual problems. This study was aimed to identify visualimpairment based on subjective complaint and objective examination, its correlation with socialfactors, and level of awareness in community.MethodThis cross sectional study was conducted in Malang. Subjective complaint was obtained fromquestionnaire, while objective data was taken from presenting visual acuity examination.Association between social factors and both subjective and objective data was analyzed. Variablesof interest for this analysis were education level and occupation.ResultA total of 953 respondents participated in this study. 510 participants (53.5%) had no complaint ofvisual problem, while 443 (46.5%) complained of visual problem. Objective examination found that560 participants (61.1%) had normal visual acuity and 358 (38.9%) had decreased visual acuity.Difference of subjective complaint and objective examination indicated different level of awarenesswhich could be attributed to social factors. A significant negative association (r = -0.080) was foundbetween education level and visual problem, showing that lower education level was associatedwith more objective visual problem. Objective visual problem was also significantly associated withoccupation (p=0.05). This study was the first community-based study identifying visual impairmentawareness in Malang. However, due to its community-based nature, control of confounding factorswas difficult.ConclusionVisual impairment awareness based on subjective complaint and objective examination wasassociated with education level and occupation. Education level was negatively associated withvisual impairment awareness.Keywordvisual impairment, occupation, education levelLatest UpdateMay 17, 2021StatusSubmittedFile Download

344 FREE PAPER

FP-G-INACOS-17Prevalence and Risk Factors of Cataract in Social Healthcare Service ofKsatria Airlangga Floating Hospital in Bawean Island

Abstract TitlePrevalence and Risk Factors of Cataract in Social Healthcare Service of Ksatria AirlanggaFloating Hospital in Bawean Island

First Author: RusydianaAuthor Institution: General Practitioner, the volunteer doctors in the Ksatria Airlangga Floating Hospital

Co Author:

Amelia Rahmah Kartika (General Practitioner, the volunteer doctors in the Ksatria Airlangga Floating Hospital)

Ega Sekartika (General Practitioner, the volunteer doctors in the Ksatria Airlangga Floating Hospital)

Dini Dharmawidiarini (Cataract and Refractive Surgery Division Undaan Eye Hospital, Surabaya, Indonesia)

Gadis Meinar Sari (Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia)



Seminat: INACOS


Introduction & ObjectiveThe prevalence of cataract is higher in developing country. In Indonesia, cataract is a major causeblindness for its citizens. Hence, The purpose of this study is to describe the prevalence andevaluate the risk factors of cataract in social healthcare service of Ksatria Airlangga FloatingHospital in Bawean Island.MethodCase control study was conducted in Bawean Island, East Java, Indonesia. In this study, 56 subjectswith visually impairing cataracts (study group) and 56 ages matched controls (control group) wererecruited from social healthcare service of Ksatria Airlangga Floating Hospital in Bawean Island. Toassess risk factors for cataract, Odds Ratios (ORs) were calculated and adjusted according to age,gender, and work.ResultA total of 56 individuals were found to have cataract. The majority of patients were female (63,4%),with mean age of patients was 55,4 (SD: 12,21) years, had an indoor work (54,5%), bilateral eyes(69,6%), and grade 3 of the right eye (56,8%) and left eye (57,8%). Visual acuity of the right eyeworse than 3/60 (62,5%) and the left eye worse than 3/60 (66,1%). Cataract was observed to besignificantly associated with increasing age (P: 0,000), while gender (p = 0,327; OR 0,68 (CI 95%0,314 – 1,473)) and work (p = 0,85; OR 1,075 (CI 0,511 – 2,261)) were not significantly associatedwith cataract.ConclusionCataract in Social Healthcare Service of Ksatria Airlangga Floating Hospital in Bawean Island werestrongly associated with increasing age.KeywordCataract, Age, Visual Acuity.Latest UpdateMay 17, 2021StatusSubmittedFile Download

345FREE PAPER

FP-R-E-INAPOSS-01COMPARISON OF VISUAL EVOKED POTENTIAL WAVES BEFORE AND AFTERPATCHING THERAPY IN AMBLYOPIA SEVERE

Abstract TitleCOMPARISON OF VISUAL EVOKED POTENTIAL WAVES BEFORE AND AFTER PATCHINGTHERAPY IN AMBLYOPIA SEVERE

First Author: YETRINA

Author Institution: Ophthalmology Department Diponegoro University

Co Author:

Liana Ekowati (Ophthalmology Department Diponegoro University )

Riski Prihatningtias (Ophthalmology Department Diponegoro University )



Seminat: INAPOSS


Introduction & ObjectiveAmblyopia is a condition of decrease visual acuity without any abnormalities in the structure of theeyeball, which is caused by visual development disorders in early life. Visual impairment due toamblyopia can be prevented in principle and is reversible with proper management. One therapy inamblyopia is patching therapy.MethodA quasi experimental with pre-post test design. Study subjects 14 children with severe degrees ofamblyopia at Merpati eye clinic of Dr. RSUP Kariadi Semarang. VEP wave examination of latencyand amplitude was done before patching therapy and after patching therapy for 3 months.ResultThe mean age of severe amblyopia patients was 7.18±2.05 years with the youngest age being 4years and the oldest age being 12 years. Most age groups are 7-9 years (50%). The average wavelatency Result was decreased after patching therapy. The mean pre patching latency was115.78±11.62, the mean post patching latency was 114.36±12.09 (p=0.60). The amplitude Resultsdecreased significantly after patching therapy. The mean pre patching amplitude was 9.99±8.63,the mean post patching amplitude was 14.02±10.29 (p = 0.011).ConclusionThere is a significant difference in the amplitude of VEP pattern waves in children with severeamblyopia between before patching therapy and after patching therapy. There was no significantdifference in the latency of VEP pattern waves in children with severe amblyopia between beforepatching therapy and after patching therapy.KeywordSevere amblyopia, Pattern Visual evoked potential, patchingLatest UpdateMay 15, 2021StatusApproved As Free PaperFile Download901-FP-R-E-INAPOSS-01-Yetrina.pdf

346 FREE PAPER

FP-R-O-INAPOSS-02Comparison Between Flash Visual Evoked Potential and Pattern VisualEvoked Potential in Children with Severe Deprivation Amblyopia

Abstract TitleComparison Between Flash Visual Evoked Potential and Pattern Visual Evoked Potentialin Children with Severe Deprivation Amblyopia

First Author: YOSEPH SIAHAAN

Author Institution: DIPONEGORO UNIVERSITY

Co Author:

LIANA EKOWATI (Staff, Ophthalmology Department, Diponegoro University / Dr. Kariadi Hospital

Semarang)

TRILAKSANA NUGROHO (Staff, Ophthalmology Department, Diponegoro University / Dr. Kariadi Hospital

Semarang)



Seminat: INAPOSS


Introduction & ObjectiveAmblyopia is a reduction in best-corrected visual acuity,both unilateral or bilateral,that cannot beaccounted for by any structural abnormality, either in the eye or in the visual pathways.Amblyopiaindicates a neural development failure in immature visual system due to impaired visual experiencein early life. Amblyopia can cause electrophysiological and anatomical disorders in the striatecortex and lateral geniculate nucleus. including monocular and binocular cortex cells reduction,aswell as lateral geniculate lamina body and impaired quality of cell response.Visual Evoked Potential(VEP) can be used as a non-invasive neurophysiological parameter to assess optic organs, pathwaysand nerves function. VEP research on amblyopia are lacking.MethodMethods This observational cross-sectional study was conducted at the pediatric ophthalmologyclinic and Garuda diagnostic center Dr.Kariadi Hospital Semarang in August 2018-August 2019.Twenty cooperative children aged4-18 years with severe deprivation amblyopia with normalfundoscopic Results and no refractive media abnormalities were included in the study, andunderwent flash and pattern VEP examination. Latency and amplitude were measured andcompared with normative values and between flash and VEP patternsResultThe latency of flash and pattern VEP were longer than normative data (p0.05)ConclusionLatency and amplitude of VEP flash waves were longer than VEP patterns. VEP pattern was abetter choice for objective measurement of children with severe deprivation amblyopiaKeywordamblyopia,visual evoked potential,latencyLatest UpdateMay 15, 2021StatusApproved As Free PaperFile Download564-FP-R-O-INAPOSS-02-YOSEPH-SIAHAAN.pdf

347FREE PAPER

FP-R-O-INAPOSS-03Characteristic of Patients with Retinopathy of Prematurity in Dr. KariadiGeneral Hospital Semarang during 2020

Abstract TitleCharacteristic of Patients with Retinopathy of Prematurity in Dr. Kariadi General HospitalSemarang during 2020

First Author: Samuel Octovianus Dimara

Author Institution: Resident of Ophthalmology Departement of Diponegoro University, Kariadi Hospital,


Co Author: Arnila Novitasari Saubig (Staff of Pediatric Ophthalmology and Strabismus Departement of

Diponegoro University, Kariadi Hospital, Semarang, Central Java)



Seminat: INAPOSS


Introduction & ObjectiveRetinopathy of prematurity (ROP) refers to the developmental disorder of the retina in prematureinfants and is one of the most dangerous complications. Risk factors for the development of ROP inCentral Java have not been evaluated. Our aim was to classify the risk factors that contribute todevelopment of ROP.MethodA retrospective review of medical records, with descriptive approach, was performed of all ROPpatients who came to ophthalmology outpatient clinic from January to Desember 2020 in Dr.Kariadi General Hospital, Semarang. Uncomplete data of medical record was excluded.ResultThirtyeight patients (38 cases), most gender was female (52.63%) with gestational age ≤28 weeks(16 cases; 42.11%) and birth weight about 1001-1500 kg (20 cases; 52.63%). Most common riskfactors were no maternal risk (31 cases; 81.58%) and oxygen used for >7 days or high flow oxygen(35 cases; 79.55%). Stage V was the most common in post conceptional age >40 weeks (11 cases;68.75%), gestational age ≤28 weeks, birth weigh about 1000-1500 gr, (9 cases; 56.25%),respectively, and no risk in maternal, oxygen used for >7 days or high flow oxygen (15 cases;93.75%), respectively. Twelve patients (31.58%) had vision regression due to ROP. A total of 27cases (56.25%) were performed conservation as the most therapy.ConclusionWith post conceptional age >40 weeks, gestational age ≤28 weeks, low birth weight less than 1500gr, long-term oxygen used or high flow oxygen, the more risk to worsening ROP.KeywordChildhood blindness, Retinopathy of prematurity, PretermLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download923-FP-R-O-INAPOSS-03-Samuel-Octovianus-Dimara.pdf

348 FREE PAPER

FP-R-O-INAPOSS-04RELIABILITY AND ACCURACY OF EPICAM M AND RETCAM SHUTTLECOMPARED TO INDIRECT OPHTHALMOSCOPE IN DETECTION OFRETINOPATHY OF PREMATURITY

Abstract TitleRELIABILITY AND ACCURACY OF EPICAM M AND RETCAM SHUTTLE COMPARED TOINDIRECT OPHTHALMOSCOPE IN DETECTION OF RETINOPATHY OF PREMATURITY

First Author: MEILIATY A. ANGKY

Author Institution: OPHTHALMOLOGY DEPARTEMENT FK UNHAS

Co Author:

MARLIYANTI N AKIB (OPHTHALMOLOGY DEPARTEMENT FK UNHAS)

NOOR SYAMSU (OPHTHALMOLOGY DEPARTEMENT FK UNHAS)

ANDI MUHAMMAD ICHSAN (OPHTHALMOLOGY DEPARTEMENT FK UNHAS)

HABIBAH S MUHIDDIN (OPHTHALMOLOGY DEPARTEMENT FK UNHAS)

EMA ALASIRY (PEDIATRIC DEPARTMENT FK UNHAS)



Seminat: INAPOSS


Introduction & ObjectiveTo report the performance of 2 retinal camera types on premature infants in Retinopathy ofPrematurity (ROP) screening.MethodPremature infants went through : (1) examination by a pediatric ophthalmologist using indirectophthalmoscopy as a standard of reference; (2) digital imaging by a photographer using EpiCam Mand RetCam shuttle. After a month, images were interpreted randomly and single-blinded by thesame pediatric ophthalmologist (grader).ResultA total of 44 eyes from 22 premature infants were included in this study (ROP 11 subjects and nonROP 11 subjects). Detection of ROP with EpiCam M had a moderate agreement (Kappa 0.502) andvery good agreement with RetCam shuttle (Kappa 0.862). Sensitivity, specificity, and accuracy ofEpiCam M in detection of ROP were 80.95%, 85.71%, and 75%; RetCam shuttle 85.71%, 100%, and93.18% respectively.ConclusionThe EpiCam M and RetCam shuttle showed significant reliability and accuracy in ROP detection.EpiCam M proved to be a viable low-cost device for ROP screening in low resource environments.Some issues need to be considered if using epiCam M in telemedicine including an increase in glarefrequency and longer duration of documentationKeywordROP, screening, telemedicineLatest UpdateMay 16, 2021StatusApproved As Free PaperFile Download398-FP-R-O-INAPOSS-04-MEILIATY-ANGKY.pdf

349FREE PAPER

FP-R-O-INAPOSS-05Surgical Outcome of Congenital Cataract in Tertiary Referral Hospital inJakarta

Abstract TitleSurgical Outcome of Congenital Cataract in Tertiary Referral Hospital in Jakarta

First Author: Veronika Simarmata


Co Author: Julie Dewi Barliana (RSCM)



Seminat: INAPOSS


Introduction & ObjectiveIntroduction Congenital cataracts are the leading cause of blindness in children worldwide thatcause loss of vision function and amblyopia due to impaired visual stimuli and eye development.Objective To determine surgical outcome of congenital cataract in children 0-2 years old in atertiary ophthalmology referral hospital in JakartaMethodMethods Retrospective study was conducted on patient’s medical records from PediatricOphthalmologic clinic which underwent cataract surgery between Januari – December 2018. Thisstudy evaluates the patient’s demographic, type of surgery, the successful rate and surgicalcomplication of cataract surgical.ResultResults The data is collected from 67 patient’s medical record, with total eye affected are 117. Themean age of children with cataract congenital are 8 months and found rubella syndrome (25.4%) isthe common systemic problem. Most of the cases is bilateral cataract (74.6%) with range surgeryfor the second eye was 34 (13-327) days. Cataract extraction, primary posterior capsulotomy, andanterior vitrectomy (88%) is the most surgical performed, and there are 5.1% cases with insertionof intraocular lens. The good visual acuity after surgery is found 98.2% cases and the commoncomplication are posterior capsular opacification (37%), intraocular inflammation (12%), and visualacuity opacification (12%).ConclusionConclusion The changes of visual acuity of cataract surgery in this study was good and the commoncomplications after surgery were posterior capsular opacification, intraocular inflammation, andvisual acuity opacification.Keywordcongenital cataract, surgical outcomeLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download286-FP-R-O-INAPOSS-05---Veronika-Simarmata.pdf

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FP-R-O-INAPOSS-06Characteristics of Congenital Cataract Patients in Pediatric Ophthalmologyand Strabismus Polyclinic at Sardjito General Hospital

Abstract TitleCharacteristics of Congenital Cataract Patients in Pediatric Ophthalmology andStrabismus Polyclinic at Sardjito General Hospital

First Author: Pramudya Budi Kusumawardhana


Co Author:

Albaaza Nuady (Ilmu Kesehatan Mata FKKMK UGM)

Dhimas Hari Sakti (Ilmu Kesehatan Mata FKKMK UGM)

Haryo Yudono (Ilmu Kesehatan Mata FKKMK UGM)



Seminat: INAPOSS


Introduction & ObjectiveCataract is a clouding of the eye’s lens and it can occur at any age. Cataracts are classifiedaccording to the etiology, age of onset, morphology, location or degree of lens opacity. From age ofonset there are congenital/infantile and acquired/juvenile. It is estimated that congenital cataractsare responsible for 5% to 20% of blindness in children worldwide. This study aims to reportcharacteristics of congenital cataract patients who come to our hospital.MethodThe medical records congenital cataract patients coming to pediatric ophthalmology andstrabismus policlinic at sardjito general hospital from July until Desember 2020 were reviewedretrospectivelyResultA total of 25 eyes from 14 patients were included. The gender characteristics were 11 (78,57%)male and three (21,42%) female. We had 11 patients (78,57%) who got cataracts on both of theireyes, two patients (14,28%) on the left eyes, and 1 patient (7,14) on the right eye. The causes arecongenital rubella syndrome (CRS) in eight (57,14%) patients, idiopathic in four (28,57%) patients,and cytomegalovirus in two (14,28%) patients.ConclusionCongenital cataracts not only can affect both of the eyes both also can affect just one eye. From ourstudy CRS is the main cause of congenital cataract in our hospital.KeywordCongenital cataracts, CRS.Latest UpdateMay 17, 2021StatusApproved As Free PaperFile Download172-FP-R-O-INAPOSS-06-PRAMUDYA-BUDI-KUSUMAWARDHANA.pdf

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FP-R-O-INAPOSS-07Characteristics of Congenital Cataract Surgery at Sardjito General Hospital

Abstract TitleCharacteristics of Congenital Cataract Surgery at Sardjito General Hospital

First Author: Karisma Muhammad Sutomo


Co Author:



Haryo Yudono, (Ilmu Kesehatan Mata FKKMK UGM)



Seminat: INAPOSS


Introduction & ObjectiveCongenital cataract is a major problem in many countries. Childhood blindness from delayedcongenital cataracts surgery lead to tremendous economy, social, and emotional burden for thefamily and society. Nevertheless the procedure of congenital cataract surgery are varied in certainsteps depends on the several conditions and also surgeon preferences. This study aims to report thecharacteristics of congenital cataract surgery in Sardjito General Hospital YogyakartaMethodThe medical records and surgery report from patients underwent congenital cataract surgery atSardjito General Hospital from July 2020-Desember 2020 were reviewed retrospectivelyResultA total of 25 eyes from 14 patients were included. The gender characteristics were 11 (78.5%) maleand 3 (21.5%) female. The ages at cataract extraction were vary with the oldest was six years oldand the youngest was three months old. The cataract extraction with Anterior Vitrectomy were 23(92%) eyes and with PCCC (Posterior Continuous Curvilinear Capsulorhexis) were also 23 (92%)eyes. There are two patients (8%) with PCO (Posterior Capsular Opacity) after cataract surgerywith one eyes (4%) still have PCO even after PCCC. Children with PCO had to underwent furthersurgery afterwardsConclusionThe majority of congenital cataract surgery in Sardjito General Hospital were also include AnteriorVitrectomy and PCCC in single primary surgery to minimize further complications. Complicationssuch as PCO could be minimized with PCCC but the possibility of PCO occurs even after PCCC haveto be a consideration for pediatric ophthalmology surgeon.KeywordCongenital cataract, cataract surgery, Anterior vitrectomyLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download936-FP-R-O-INAPOSS-07-Karisma-Muhammad-Sutomo.pdf

352 FREE PAPER

FP-R-O-INAPOSS-08Characteristics Primary IOL Implantation of Congenital Cataract Patients atSardjito General Hospital

Abstract TitleCharacteristics Primary IOL Implantation of Congenital Cataract Patients at Sardjito General Hospital

First Author: Nisa El Zahra


Co Author:



Haryo Yudono (Ilmu Kesehatan Mata FKKMK UGM)



Seminat: INAPOSS


Introduction & ObjectiveCataract is a common problem that affects the vision in children and a major cause of amblyopia inchildren. Management of congenital cataract requires special considerations especially with regardto intraocular lens (IOL) implantation. Age at which an IOL can be implanted is a controversialissue. Implanting an IOL in very young children carries the risk of many complication that mayneed other surgeries and may affect the vision permanently. This study aim to report thecharacteristic of Primary IOL Implantation on congenital cataract in Sardjito General HospitalMethodThe medical records and surgery report from patients underwent congenital cataract surgery atSardjito General Hospital from July 2020-Desember 2020 were reviewed retrospectivelyResultA total of 25 eyes from 14 patients were included. The age at cataract extraction were vary with theoldest was six years old and the youngest was three months old. The cataract extraction withprimary IOL implantation were 8 (32%) eyes. There were 2 patients (3 eyes) aged less than 13months and 3 patients (6 eyes) were 2 year of age or older. Three of the patients with bilateralcataracts and 2 patients with unilateral cataracts.ConclusionPrimary IOL implantation should be considered in children who require cataract surgery after age 7months. Other considerations of this procedure including ; corneal size, laterality and compliance tovisual rehabilitationKeywordCongenital cataract, cataract surgery, primary IOL implantationLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download972-FP-R-O-INAPOSS-08-NISA-EL-ZAHRA.pdf

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FP-R-O-INAPOSS-09Factors that influence survival rate in Extraocular retinoblastoma Patients atCipto Mangunkusumo Hospital: 2018

Abstract TitleFactors that influence survival rate in Extraocular retinoblastoma Patients at CiptoMangunkusumo Hospital: 2018

First Author: Dwie Aprina


Co Author: Julie D Barliana (RSCM)



Seminat: INAPOSS


Introduction & ObjectiveOptimal therapeutic approach for extraocular retinoblastoma has not been determined. Prognosisremains relatively poor for extraocular retinoblastoma compared with intraocular retinoblastoma.The aim of our study is to to describe the most recent data regarding the characteristics, treatmentoutcomes and survival rates of extraocular retinoblastoma patients, as well as the factors thatinfluence the survival rate of extraocular retinoblastoma.MethodA retrospective study. Patients diagnosed with extraocular retinoblastoma in Cipto MangunkusumoHospital, within 1 January to 31 December 2018 were reviewed for patient and tumor features,ocular management, and patient survival.ResultDuring the study period, a total of 80 patients were diagnosed with retinoblastoma in our center,41.2% had an extra-ocular extension. The average age of diagnosis was 25.57 months. 56.7 % weremales. Leukocoria is the initial sign most often noticed by parents. The median lag period was 12months. Neoadjuvant chemotherapy was performed in 96.7% of cases, that carried out an averageof 3-4 cycles before enucleation/exenteration. At the end of September 2019, there were 17 deathsin our study. Overall survival was 19.82 months with a mean age of 27.6 months, whereasextraocular death time ranged from 4 months to 55 months.ConclusionDeath was more common in patients with age at first symptom less than 24 months, bilateralretinoblastoma, lag period more than 12 months, advanced stage (IV B) and delayed therapy afterproptosis more than 3 months.KeywordRetinoblastoma, prognosis, survivalLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download237-FP-R-O-INAPOSS-09---Dwie-Aprina.pdf

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FP-R-O-INAPOSS-10Comparison of Unilateral vs Bilateral Surgical Outcomes for IntermittentExotropia in Jakarta, Indonesia: A 5-Year Retrospective Study

Abstract TitleComparison of Unilateral vs Bilateral Surgical Outcomes for Intermittent Exotropia inJakarta, Indonesia: A 5-Year Retrospective Study

First Author: Hasiana Lumban Gaol

Author Institution: Ophthalmology Department, Faculty of Medicine, Universitas Indonesia, Cipto


Co Author:

Gusti Gede Suardana (Ophthalmology Department, Faculty of Medicine, Universitas Indonesia,

Cipto Mangunkusumo Hospital))

Anna Puspitasari Bani (Ophthalmology Department, Faculty of Medicine, Universitas Indonesia,

Cipto Mangunkusumo Hospital))



Seminat: INAPOSS


Introduction & ObjectiveThe aim of this study is to compare the outcome of two-muscle strabismus surgeries performedthrough two different approaches: unilateral and bilateral surgeries, for intermittent exotropia(X(T)) in Jakarta, Indonesia.MethodData from X(T) patients who had undergone unilateral lateral rectus recession-medial rectusresection (RR) or bilateral lateral rectus recession (BLR) at Cipto Mangunkusumo Hospital inJakarta, Indonesia from January 2013 to December 2017 were retrospectively reviewed. Theoutcome measures were post-operative deviation and success rates between RR and BLR groups.ResultA total of 39 X(T) patients were reviewed with male (51.3%) and female (48.7%) nearly equallyrepresented. The majority of cases were basic type (87.2%) with poor fusion control (71.79%). Eightpatients (20.51%) had a family history of strabismus. Both RR and BLR groups had similar preoperative deviation means, which were 40.6∆ and 40.3∆, respectively. Success rates in RR group at1-month, 2-month, and 6-month post surgery were 80%, 55%, and 50%, while in BLR group were67%, 79%, and 79%, respectively. Patients who underwent surgery less than five years after theonset had higher success rate (75% vs 41.67%).ConclusionRR surgical technique showed superior Results in early monitoring, but BLR was more stable inlong-term evaluation. Shorter duration from onset to surgery was associated with better Results.Age at surgery and preoperative deviation had no specific influence on surgical outcome.Keywordintermittent exotropia, unilateral lateral rectus recession with medial rectus resection, bilaterallateral rectus recessionLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download850-FP-R-O-INAPOSS-10-Hasiana-Lumban-Gaol.pdf

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FP-R-O-INAPOSS-11CHARACTERISTIC OF SECONDARY INTRAOCULAR LENS IMPLANTATION INAPHAKIC CHILDREN IN CICENDO NATIONAL EYE HOSPITAL

Abstract TitleCHARACTERISTIC OF SECONDARY INTRAOCULAR LENS IMPLANTATION IN APHAKICCHILDREN IN CICENDO NATIONAL EYE HOSPITAL

First Author : Lina Shabrina Qorib S.


Co Author:

Irawati Irfani (Departement of Pediatric Ophthalmology, Faculty of Medicine University of Padjadjaran)

Primawita O. Amiruddin (Departement of Pediatric Ophthalmology, Faculty of Medicine University of

Padjadjaran)

Maya Sari Wahyu (Departement of Pediatric Ophthalmology, Faculty of Medicine University of Padjadjaran)

Feti Karfiati (Departement of Pediatric Ophthalmology, Faculty of Medicine University of Padjadjaran)

Sesy caesarya (Departement of Pediatric Ophthalmology, Faculty of Medicine University of Padjadjaran)



Seminat: INAPOSS


Introduction & ObjectivePediatric cataract is responsible for 200.000 of preventable blindness in children. Early cataractextraction and correction after the lens removal is critical. Secondary intraocular (IOL)implantation might be considered when the child is intolerant to contact lenses/spectacle wear.Only a few study has been done regarding secondary IOL implantation in aphakic children. Thisstudy was aimed to describe the characteristic of secondary IOL implantation in aphakic children inCicendo National Eye Hospital.MethodThis retrospective observational study took samples from medical records of patients whounderwent secondary IOL implantation in 2016 – 2020 in Cicendo National Eye Hospital.ResultFifty nine eyes of forty pediatric patients underwent secondary IOL implantation surgery between2016 – 2020. Two patients were excluded. From the 38 patients, 56 eyes were observed. Total of 20patients were boys (52.6%). Cases were 71.1% bilateral cataract. The main initial diagnosis wascongenital cataract (47.4%). Mean age of secondary IOL implantation was 71 ± 35 (20–201)months. Mean duration between cataract surgery and secondary IOL implantation was 51 ± 36 (2 –189) months . Total of 80.4% of the IOL were fixated in the sulcus. Only 25% remained present formore than 12 months follow up and 65.8% of patients were corrected with bifocal spectacles.ConclusionSecondary IOL implantation in aphakic children were mostly done in the age of six years old. Mostof the IOL were fixated in the sulcus. Patients were mostly given bifocal spectacles.Keywordsecondary intraocular lens, aphakia, pediatric cataractLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download40-FP-R-O-INAPOSS-11_Lina-Shabrina.pdf

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FP-R-O-INAPOSS-12

Eye-tracking-controlled automated preferential looking in preschool children:an accuracy analysis study

Abstract TitleEye-tracking-controlled automated preferential looking in preschool children: an accuracyanalysis study

First Author: Natalia Christina Angsana

Author Institution: Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing,

Universitas Gadjah Mada – Dr. Sardjito General Hospital

Co Author:

Indra Tri Mahayana (Department of Ophthalmology, Faculty of Medicine, Public Health and

Nursing, Universitas Gadjah Mada – Dr. Sardjito General Hospital )

Krisna Dwi Purnomo Jati (Department of Ophthalmology, Faculty of Medicine, Public Health and

Nursing, Universitas Gadjah Mada – Dr. Sardjito General Hospital )

Dhimas Hari Sakti (Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing,

Universitas Gadjah Mada – Dr. Sardjito General Hospital )



Seminat: INAPOSS


Introduction & ObjectiveFrom birth to the age of 3-5 y-o is the critical period of visual acuity development in children.Preferential looking is an early eye examination to detect visual impairment in children and hasbeen known as an objective test for children below 5 years old. The purpose of this study was todetermine the analysis of the accuracy of the preferential looking examination.MethodThis research was conducted using a cross-sectional Method. The subjects used were children aged 3-5 years who were taken by convenience sampling technique in four urban kindergartens in Yogyakarta, Indonesia, and had met the inclusion and exclusion criteria. The visual acuity measurement technique used was a preferential looking with hemispatial Gabor patch written in Python application. The analytical Method used was descriptive analysis to determine the characteristics of the subject and the average accuracy of both eyes followed by the one-way ANOVA Method to see the significance of differences in overall eye accuracy.ResultMean Lea’s Chart visual acuity (LogMAR): 0.180 ± 0.144. The final threshold spatial resolution(cycle per degree/cpd): 9.18 ± 4.95 (equivalent to 0.30-0.80 LogMAR). The accuracy (n=84 eyes)for the 3, 4, and 5 y-o groups were: 79.39 ± 11.18, 77.69 ±10.72, 80.04 ± 10.32, respectively (p=0.679).ConclusionThe accuracy of eye-tracking-controlled automated preferential looking is remarkable. This Method is promising to be used as a basic examination to get objective visual acuity in preschool children.Keywordpediatric ophthalmology, preferential looking, visual acuity testingLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download339-FP-R-O-INAPOSS-12-Natalia-Christina-Angsana.pdf

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FP-O-INAPOSS-13Successful Correction and Occlusion Treatment of Refractive Amblyopia inChildren with Developmental Disabilities at Special Education ElementarySchool in Malang

Abstract TitleSuccessful Correction and Occlusion Treatment of Refractive Amblyopia in Children withDevelopmental Disabilities at Special Education Elementary School in Malang

First Author: ANGGASTA VASTHI

Author Institution: FK universitas Brawijaya

Co Author:

Lely Retno Wulandari (FK Universitas Brawijaya)

Anny Sulistiyowati (FK Universitas Brawijayal)

Nanda Wahyu Anandita (FK Universitas Brawijaya)



Seminat: INAPOSS


Introduction & ObjectiveTo determine the effect of refractive correction therapy and combination of refractive correction and occlusion therapy to refractive amblyopia condition in children with developmental disabilities in MalangMethodThis was prospective cohort from September 2019 until July 2020 with total population of 231 children. Data collected in this study included demographic data, best corrected visual acuity, type of refractive error, etiology and degree of amblyopia and evaluated at third months and sixth months after correctionResultThere were 231 children screened, with 23 children had amblyopia. Of 12 respondent withrefractive amblyopia, both anisometropic and isoametropic refractive amblyopia were found in 6respondent (50%). All of 6 respondents in anisometropia group were categorized to mild amblyopia.LogMar BCVA after 6 months was improved in refractive correction therapy only (right eye,0.233±0.121 LogMAR to 0.117±0.117 LogMAR; left eye,0.250±0.194 LogMAR to 0.117±0.117LogMAR) and in combination with occlusion therapy (right eye, 0.183 ±0.117 LogMAR to0.033±0.052 LogMAR; left eye, 0.217±0.194 LogMAR to 0.083±0.160 LogMAR). There weresignificant difference in BCVA improvement between groups, in which combination of refractivecorrection therapy and occlusion therapy was better than refractive correction therapy only (P ≤0.05). Data at 3 months follow up were unavailable due to COVID-19 pandemicConclusionThere were significant improvement (P ≤ 0.05) of refractive amblyopia after corrective refractivetherapy either alone or in combination with occlusion therapy in children with developmentaldisabilities during follow up. Combination of refractive correction therapy and occlusion therapywas better than refractive correction therapy onlyKeywordRefractive Correction, Occlusion Therapy, Refractive AmblyopiaLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download622-FP-O-INAPOSS-13-Anggasta-Vasthi.pdf

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FP-O-INAPOSS-14STRABISMUS IMPROVEMENT WITH REFRACTIVE CORRECTION INCHILDREN WITH DEVELOPMENTAL DISABILITIES AT SPECIAL EDICATIONELEMENTARY SCHOOL IN MALANG

Abstract TitleSTRABISMUS IMPROVEMENT WITH REFRACTIVE CORRECTION IN CHILDREN WITHDEVELOPMENTAL DISABILITIES AT SPECIAL EDICATION ELEMENTARY SCHOOL INMALANG

First Author: Tania Rahmania M.

Author Institution: RSSA Malang

Co Author:

dr. Lely Retno Wulandari , Sp.M (K) (RSSA Malang)

dr. Nanda Wahyu Anandita , Sp.M (K) (RSSA Malang)

dr. Anny Sulistyowati , Sp.M (K) (RSSA Malang)



Seminat: INAPOSS


Introduction & ObjectiveThis study aims to see the improvement of strabismus condition after the refractive correctiontheraphy in children with developmental disabilities in Malang cityMethodThis prospective cohort research was conducted from September 2019 to July 2020 and involved 13students of Special Education Elementary School in Malang. Data collected in this study isdemographic data, visual acuity, visus with the best correction (Best Corrected VisualAcuity/BCVA), types of refractive error, and also types and degrees of strabismus.ResultFrom 13 respondents, 30.77% were male with an average age of 11. 84.62% of the 13 respondentshad a type of exotropia deviation. There is significant improvements in the group with exotropiafrom 23.18ΔD ± 11.24 ΔD to 20.00ΔD ± 8.06ΔD (p 0.317) based on the examination with thekrimsky Method. A total of 69.23% of respondents used glasses for 2-4 hours per day, while 30.77%of respondents used glasses for 2-4 hours per day. Based on strabismus examination with krimskyMethod obtained significant improvement in the group with exotropic deviation condition.ConclusionThere was a significant improvement in the value of prism dioptry measured by the krimsky Methodin respondents with exotropic conditions (XT) after 6 months follow up of refractive correctionKeywordRefractive Correction, Strabismus, Developmental DisabilitiesLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download49-Jurnal-TA.pdf

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FP-G-INAPOSS-15Steroid as an Adjuvant Treatment in Orbital Cellulitis: a literature review

Abstract TitleSteroid as an Adjuvant Treatment in Orbital Cellulitis: a literature review

First Author: Kiara Nurmathias

Author Institution: Gandaria Hospital, Jakarta, Indonesia

Co Author:

Julie Dewi Barliana (Pediatric Ophthalmology Division, Department of Ophthalmology University of

Indonesia, Jakarta, Indonesia)



Seminat: INAPOSS


Introduction & ObjectiveOrbital cellulitis is the most common serious eye infection in children. It is potentially sight- andlife-threatening, giving rise to a variety of systemic and ocular complications. The management oforbital cellulitis include choice of antibiotic. The role of steroids has been shown to be a relativelysafe, hasten clinical recovery, and effective adjunct to antibiotics given their anti-inflammatoryproperties in the treatment of several infections. The purpose of this study is to determine thebenefit of steroids in treating pediatric patients with orbital cellulitis.MethodSystematic literature searched in PubMed, ProQuest, and Cochrane from 2005 to 2020 wasconducted using Keywords “Steroid” and “Orbital Cellulitis”. Full text articles in English that reportthe outcome of steroid in treating orbital cellulitis patients were included. Studies were includedirrespective of the type and dose of the systemic steroids. The primary outcome parametersincluded length of hospitalization, clinical outcomes including adverse effects.ResultThree prospective studies, one retrospective study, and one systematic review with meta-analysisdemonstrating the use of corticosteroid in orbital cellulitis were identified. In total 326 pediatricpatients received oral or intravenous steroid as an adjuvant therapy. All studies showed a betterclinical outcomes and a decrease length of stay. However, 1 study considered corticosteroid notsignificant enough in decreasing the length of stay. Furthermore, there are no adverse effectreported.ConclusionSteroids can be used as an adjuvant therapy to improve better clinical outcomes and reduce lengthof hospital stay in Orbital Cellulitis patient.KeywordOrbital Cellulitis. SteroidsLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download958-FP-G-INAPOSS-15-Kiara-Nurmathias.pdf

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FP-R-E-INAPOSS-16Effects of Sub-Tenon Ropivacaine Block in Combination with GeneralAnesthesia on Oculocardiac Reflex during Strabismus Surgery andPostoperative Pain

Abstract TitleEffects of Sub-Tenon Ropivacaine Block in Combination with General Anesthesia onOculocardiac Reflex during Strabismus Surgery and Postoperative Pain

First Author: LASMIDA RUTH A SIMATUPANG

Author Institution: Ophthalmology Department, Faculty of Medicine Universitas Indonesia, Cipto


Co Author:

Gusti Gede Suardana (Ophthalmology Department, Faculty of Medicine Universitas Indonesia,

Cipto Mangunkusumo Hospital), Anna Puspitasari Bani (Ophthalmology Department, Faculty of Medicine

Universitas Indonesia, Cipto Mangunkusumo Hospital), Susilo Chandra (Anesthesiology Department, Faculty

of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital)



Seminat: INAPOSS


Introduction & ObjectiveSquint surgery is associated with oculocardiac reflex with bradycardia, arrhythmia and even asystole case. Surgery in general anesthesia alone could not prevent the occurence of this reflex. The aim of this study was to investigate the effects of a sub-Tenon’s block combined with general anesthesia on oculocardiac reflex and postoperative pain.MethodThis double blind randomized controlled trial included 15 patients aged 7-60 years scheduled formedial/lateral rectus resection and American Society of Anesthesiologists Status were ASA I-II. Patients were randomly allocated to receive either sub-Tenon ropivacaine 0,75% or placebo prior to surgery. Changes in heart rate and incidence of oculocardiac reflex were measured during several stages intraoperative. Pain was evaluated with VAS score at 1,2,4,6 hour postoperative.ResultThe mean heart rate measured at post induction, conjunctival incision, muscle traction and resection in ropivacaine group were 70.4, 66.8, 65.4, and 65.4 bpm, respectively and in placebo group were 78, 74.5, 68.8, and 74.8 bpm. Incidence of oculocardiac reflex in ropivacaine and placebo group were 28,5% and 50% respectively (p>0.05). Median pain scores were lower in ropivacaine group with VAS score 4 compared to 6 in placebo group at the first hour postoperative.ConclusionWe conclude that eventhough statistically there was no difference between two groups (power75%), clinically, combination of ropivacaine 0,75% sub-Tenon block with general anesthesia showedlower incidence of oculocardiac reflex and lower pain score at the first hour after surgery.Keywordoculocardiac reflex, sub-TenonLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download59-FP-R-E-INAPOSS-16-LASMIDA-RUTH-A-SIMATUPANG.pdf

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FP-R-E-INAPOSS-17COMPARISON OF CYCLOPLEGIC AND MYDRIASIS EFFECTS BETWEEN THE COMBINATION OF 1% CYCLOPENTOLATE AND 2.5% PHENYLEPHRINE WITH AND WITHOUT 1% TROPICAMIDE IN CHILDREN WITH REFRACTIVE ERRORS

Abstract TitleCOMPARISON OF CYCLOPLEGIC AND MYDRIASIS EFFECTS BETWEEN THE COMBINATION OF 1% CYCLOPENTOLATE AND 2.5% PHENYLEPHRINE WITH AND WITHOUT 1% TROPICAMIDE IN CHILDREN WITH REFRACTIVE ERRORS

First Author: Fany Gunawan

Author Institution: Ophthalmology Department Faculty of Medicine Padjadjaran University

National Eye Hospital Cicendo Eye Hospital

Co Author: Irawati Irfani (Ophthalmology Department Faculty of Medicine Padjadjaran University National

Eye Hospital Cicendo Eye Hospital), Karmelita Satari (Ophthalmology Department Faculty of Medicine

Padjadjaran University, National Eye Hospital Cicendo Eye Hospital)



Seminat: INAPOSS


Introduction: Cycloplegic refraction is an essential component of pediatric eye examination. Inadequate cycloplegia gives inaccurate Results lead to inappropriate therapeutic approaches. There is no ideal single cycloplegic agent, so a combination regimen is used. Objective: To compare the cycloplegic and mydriasis effects between combination of 1% cyclopentolate and 2.5% phenylephrine with and without 1% tropicamide in children with refractive errors.Methods: This study is a single-blind randomized clinical trial involving children aged 6-18 years with mild to moderate refractive errors. Group A received 1% cyclopentolate, 1% tropicamide, and 2.5% phenylephrine (SFT) in both eyes, meanwhile group B received 1% cyclopentolate and 2.5% phenylephrine (SF). Refractive power and pupil diameter were measured using autorefractometer and IOL Master®700 before, 20, 30, 45, and 60 minutes after drug instillation.Results: A total of 54 subjects (108 eyes) were involved with a median age of 13 years (mean 12.85 ± 2.84 years). Most refractive disorders were compound myopic astigmatism (50.9%) and simple myopia (32.4%). Regimen SFT yielded slightly larger Results in mean differences of refractive power and pupil diameter rather than SF, but the difference was not significant (p=0.271; p=0.088). The cycloplegic peak time did not differ significantly (p=1,000), and reached within 45 minutes after instillation. SFT gave a significantly faster mydriasis peak time (p=0.031), reached within 30 minutes, while SF within 45 minutes.Conclusion: The combination of 1% cyclopentolate and 2.5% phenylephrine with or without 1% tropicamide both have the same cycloplegic effect, although addition of tropicamide provides a more rapid mydriasis effect.Keywords: cycloplegic, cyclopentolate, tropicamide Keywords: cycloplegic, cyclopentolate, tropicamideLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download983-PVSM---Fany-Gunawan.pdf

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FP-G-INOIIS-01Correlation Between Contact Lens Wear Duration with Schirmer Test Result

Abstract TitleCorrelation Between Contact Lens Wear Duration with Schirmer Test Result

First Author: Valda Garcia

Author Institution: Universitas Pelita Harapan

Co Author:

Regina Nathania (Universitas Pelita Harapan)

Josiah Irma (Universitas Pelita Harapan)



Seminat: INOIIS


Introduction & ObjectiveContact lens has being a most popular way to overcome eye refractive disorder. Many peopleexperience discomfort while using contact lens, especially dry eyes. This is supported by a researchin Malaysia, which states that 73% of contact lens users had dry eyes symptom as the Result ofSchirmer test examination. To know the xorrelation between the duration of contact lens wear andSchirmer test Result in preclinical student at Faculty of Medicine, Pelita Harapan University.MethodThis research was conducted in a cross-sectional study design with the analytic correlative Method.The sample needed was 42 people. Data was collected using questionnaire and Schirmer testexamination.ResultData from 43 samples (86 eyes) were tested by Spearman correlation test. The Results obtained arethe correlation coefficient (r) -0.332, p-value 0.002 and negative correlation.ConclusionThere is correlation between duration of contact lens wear and Schirmer test in preclinical studentsat Faculty of Medicine, Pelita Harapan University.KeywordContact lens, Dry Eyes, Schirmer TestLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download706-FP-G-INOIIS-01-Valda-Garcia.pdf

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FP-R-O-INOIIS-03THE PATTERN OF EYE CHEMICAL INJURY AND MANAGEMENT ININDONESIA NATIONAL EYE CENTRE, CICENDO EYE HOSPITAL BANDUNG

Abstract TitleTHE PATTERN OF EYE CHEMICAL INJURY AND MANAGEMENT IN INDONESIANATIONAL EYE CENTRE, CICENDO EYE HOSPITAL BANDUNG

First Author: Endi Pramudya Laksana

Author Institution: Department of Ophthalmology Faculty of Medicine, Padjadjaran University, Bandung

Indonesia

Co Author:

Irawati Irfani (Indonesia National Eye Center, Cicendo Eye Hospital Bandung)

Angga Fajriansyah (Indonesia National Eye Center, Cicendo Eye Hospital Bandung)



Seminat: INOIIS


Introduction & ObjectiveChemical injury of the conjunctiva and cornea is a true ocular emergency and requires immediateintervention. Severe chemical injury can lead to complete destruction of the ocular surface, cornealopacification, and permanent vision loss. Long-term management aims to restore the visualfunction by preserving tear production, managing limbal stem cell deficiency, and addressingassociated complications, such as lid malposition, symblefaron and glaucoma.MethodThis was a retrospective study from medical record in Cicendo Eye Hospital from patient diagnosedwith chemical injury of ocular surface from Januari 2015 to Desember 2019. Review includingdemographic data, type of chemical agent causing eye injury, time period between the injury andtherapy, pH, visual acuity at presentation and severity of ocular injury.ResultA total number of 191 patients (221 eyes) were treated of which 170 were males and 39 werefemales. The mean age across categories was 35,25 years. There were 173 patients with one eyeinvolved, most patient came at acute phase (83,3%). The visual acuity at presentation was normal in43,4% of eyes and the most common chemical is sodium hydroxide.ConclusionYoung male patients in the working age group are more prone to have work-related chemicalinjuries. Irrigation must be given as initial treatment.Keywordacid, alkali, chemical injuriesLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download73-FP-R-O-INOIIS-03-Endi-Pramudya-Laksana.pdf

364 FREE PAPER

FP-R-O-INOIIS-04CHARACTERISTICS OF OCULAR SYPHILIS IN HUMAN IMMUNODEFICIENCYVIRUS – POSITIVE PATIENTS IN TERTIARY EYE CARE CENTER : A TWOYEARS OBSERVATIONAL STUDY

Abstract TitleCHARACTERISTICS OF OCULAR SYPHILIS IN HUMAN IMMUNODEFICIENCY VIRUS –POSITIVE PATIENTS IN TERTIARY EYE CARE CENTER : A TWO-YEARS OBSERVATIONAL STUDY

First Author: Grace Setiawan

Author Institution: Department of Ophthalmology, Faculty of Medicine, Universitas Padjadjaran, Bandung

Co Author:

Arief Akhdestira Mustaram (Indonesia National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Patriotika Muslima (Indonesia National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Angga Fajriansyah (Indonesia National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)

Elfa Ali Idrus (Indonesia National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia)



Seminat: INOIIS


Introduction & ObjectiveIntroduction : Syphilis is a chronic systemic disease caused by the Treponema pallidum that istransmitted through sexual intercourse or trans-placental. Syphilis has the ability to mimic clinicalmanifestations of many organ systems, including the eye. Ocular syphilis can occur at any stage ofsyphilis A worldwide increase of ocular syphilis has been reported, especially in men having sexwith men (MSM) and in human immunodeficiency virus (HIV)-infected population. Objective : Todescribe the clinical characteristics of ocular syphilis in HIV-positive patients in the IndonesianNational Eye Center, Cicendo Eye Hospital.MethodA retrospective descriptive study was conducted from medical records of patients diagnosed asocular syphilis with HIV co-infection from January 2019 to March 2021. Gender, age, marital Status,educational level, sexual preference, clinical features, visual acuity, ocular lateralization, ocularmedications, systemic medications, and follow-up period were reviewed.ResultA total of 26 eyes from 15 patients were included in this study. The majority of the subjects weremales (93%) with the age of 20-30 years old (66%). Among all the subjects, 53% of them wereMSM. Bilateral ocular syphilis were found in 73% subjects with panuveitis as the most common(50%) clinical manifestation. The median of the follow-up period was 4 (3-11) months.ConclusionCharacteristics of population in this study were young-adult males that were tested positive for HIVwith the history of MSM. Bilateral panuveitis was the most prominent clinical manifestation.Keywordocular syphilis, human immunodeficiency virusLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download894-FP-R-O-INOIIS-04-Grace-Setiawan.pdf

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FP-R-O-INOIIS-05ENDOTHELIAL CELL DENSITY AND CENTRAL CORNEAL THICKNESS DIFFERENCES IN REGULAR HEMODIALYSIS PATIENT WITH AND WITHOUT DRY EYE SYNDROME

Abstract TitleENDOTHELIAL CELL DENSITY AND CENTRAL CORNEAL THICKNESS DIFFERENCES INREGULAR HEMODIALYSIS PATIENT WITH AND WITHOUT DRY EYE SYNDROME

First Author: dr Henry Santosa Sungkono, M.Biomed, Sp.M

Author Institution: NTB Eye Hospital

Co Author:

DR.dr. AA Mas Putrawati T, SpM(K) (Sanglah Hospital)



Seminat: INOIIS


Introduction & ObjectiveDry eye syndrome (DE) is a tear film dysfunction due to lack of tears production or excessive.Hemodialysis (HD) is a therapy for patients with chronic renal failure (CRF), and also can affect thetears quality which contribute to changes in central corneal thickness (CCT) and endothelialdensity (ED). Changes in the Results of CCT and ED have a role in the quality of vision. TheConclusion of this study is that age is a significant factor of endothelial cell density in patientsundergoing regular hemodialysis, with and without dry eye syndrome.MethodThis study aims to determine the differences of CCT and ED in patients undergoing regular HD,with and without DE. The research Method was an analytic observational cross-sectional study with consecutive sampling technique. Correlations were analyzed bivariate and multivariate with ageand sex, DM Status and HD duration.ResultFrom total 95 samples, men were more dominant with 63.2%. The most level of education werejunior high school (47.4%) and part of them unemployed or retired (38.9%). Only a small part of thesample (16.8%) suffered DM. Patients who underwent HD less than 5 years were 56.8%. TheResults of bivariate analysis showed that there was a statistically significant difference in CCT (p 0.045) in HD patients with and without DE, while multivariate analysis Results showed that age was a significant factor for ED (p <0.001) in patients undergoing HD, with and without DE.ConclusionThe Conclusion of this study is that age is a significant factor of endothelial cell densityKeywordEndothelial Density, Central Cornea Thickness, Dry Eye SyndromeLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download179-HSS.pdf

366 FREE PAPER

FP-R-O-INOIIS-06OCULAR MANIFESTATIONS AMONG ADULT HIV-POSITIVE PATIENTS ON HAART IN VCT CLINIC SANGLAH GENERAL HOSPITAL

Abstract TitleOCULAR MANIFESTATIONS AMONG ADULT HIV-POSITIVE PATIENTS ON HAART IN VCTCLINIC SANGLAH GENERAL HOSPITAL

First Author: Elvira

Author Institution: Department of Ophthalmology, Udayana University-Sanglah General Hospital, Bali

Co Author:

Ni Ketut Niti Susila (Department of Ophthalmology, Udayana University-Sanglah General Hospital, Bali )

Ida Ayu Ary Pramita (Department of Ophthalmology, Udayana University-Sanglah General Hospital, Bali )

IGA Made Juliari (Department of Ophthalmology, Udayana University-Sanglah General Hospital, Bali )

I Ketut Agus Somia (Department of Internal Medicine, Udayana University-Sanglah General Hospital, Bali )



Seminat: INOIIS


Introduction & ObjectiveHuman immunodeficiency virus (HIV)-positive patients are at increased risk of oportunistic infection, neoplasm and developed ocular manifestation in different segment of the eye. This study will describe the ocular manifestation of HIV-positive patients who are treated with HAART in Sanglah General HospitalMethodDescriptive cross sectional study was employed among HIV patients in VCT polyclinic Sanglah Hospital. This study was conducted from June 2020 to April 2021. Data were collected using ophthalmic examination, medical record and questionnaireResultFifty (46.3%) of 108 HIV-positive patients had at least one HIV-related ocular manifestation. Malepatients were 58% and most subjects (66%) were aged older than 40 years. Among patients whohad ocular manifestation, most of them had been diagnosed with HIV and using HAART within 1-5years were 23 and 22 (46% and 44%) respectively. Ocular manifestation was more common inpatient with CD4 value <100 and 250-500 cell/μL which is 16 (32%), but it is not statistically significant (p=0.729). The most common ocular manifestation were dry eye syndrome and followed by exudative retinal detachment. Most of the HIV-positive patient with dry eye syndrome had CD4 value 250-500 cell/μL (34.3%) but it is not statistically significant (p=0,609). The correlation between OSDI and duration from the first HIV diagnosis, age, sex, CD4 value, and HAART duration of HIV patients showed p>0.05.Conclusionhis study shows that ocular manifestations in HIV-positive patient with CD4 <100 and 250-500 cell/μL was the most common. Dry eye syndrome was the most prevalent. OSDI examination had no correlation with HIV and HAART.KeywordOcular manifestation, HIV, ocular surface disease index (OSDI)Latest UpdateMay 17, 2021StatusApproved As Free PaperFile Download132-FP-R-O-INOIIS-06-Elvira.pdf

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FP-R-O-INOIIS-07Differences in Anticardiolipin Antibodies Level Between Systemic LupusErythematosus Patient with Lupus Retinopathy and Uveitis Posterior

Abstract TitleDifferences in Anticardiolipin Antibodies Level Between Systemic Lupus ErythematosusPatient with Lupus Retinopathy and Uveitis Posterior

First Author: DICKY STEVANO ZUKHRI


Co Author:

dr. Ovi Sofia, SpM (K) (Universitas Brawijaya)

Dr. dr. Cesarius Singgih Wahono, SpPD-KR (Universitas Brawijaya)

Dr. dr. Nadia Artha Dewi, SpM (K) (Universitas Brawijaya)



Seminat: INOIIS


Introduction & ObjectiveSystemic Lupus Erythematosus (LES) is a multisystem autoimmune inflammatory disease that associated with a variety of autoantibodies, including anticardiolipin antibodies (ACA), and an increase in of immune complex deposits. ACA is presumed as autoantibody that may contribute to the incidence of Lupus Retinopathy (LR) and Posterior Uveitis (UP). This study aims to compare the ACA levels in LES patients with LR and UP.MethodThis was a cross-sectional study that conducted for 3 months, involving 114 patients diagnosed with LES at the Dr. Saiful Anwar General Hospital. There were 25 LES patients with LR, 2 LES patients with UP, and 87 LES patients without LR and UP. We performed blood test to determine ACA levels then evaluate the difference between ACA levels among patient groups.ResultLR occurred in 25/114 (21.9%) and UP occurred in 2/114 (1.8%) LES patients. In LES patients with LR, the mean value of IgM ACA level was 2.29 ± 1.41, IgG ACA level was 6.34 ± 1.95. In LES patients with UP the mean value of IgM ACA level was 0.60 ± 0.14, and IgG ACA level was 1.20 ±0.28.ConclusionComparison of the mean value of IgG and IgM ACA levels in LES patients with LR compared with LES patients with UP showed a significant difference (p <0.05). IgM ACA and IgG ACA levels in SLE patients with lupus retinopathy was higher than patients with or without other posterior segment manifestations.KeywordPosterior Uveitis, Systemic Lupus Erythematosus, Anticardiolipin antibodies.Latest UpdateMay 17, 2021StatusApproved As Free PaperFile Download904-FP-R-O-INOIIS-07-Dicky-Stevano-Zukhri.pdf

368 FREE PAPER

FP-G-INOIIS-09Ocular Surface Disease Symptoms among Office Workers during COVID-19 pandemic in Indonesia: a Cross-Sectional Study

Abstract TitleOcular Surface Disease Symptoms among Office Workers during COVID-19 pandemic inIndonesia: a Cross-Sectional Study

First Author: Adinda Mulya Pertiwi

Author Institution: Bunda Margonda Hospital

Co Author:

Ferdy Iskandar (Pondok Indah - Puri Indah Hospital)

Lukman Edwar (Cipto Mangunkusumo Hospital)



Seminat: INOIIS


Introduction & ObjectiveThe COVID-19 pandemic has replaced social human contact to electronic connection. Officemeetings were switched to digital meetings, which led to rising daily exposure to digital screens.Prolonged use of screen time is associated with dry eye symptoms, therefore we aim to investigatethe association between screen time and ocular surface disease symptoms among office workersduring COVID-19 pandemic in Indonesia.MethodThis is a cross-sectional study carried out among office workers during COVID-19 pandemic in Indonesia. Ocular surface disease index (OSDI) questionnaires together with the duration of screen time and sociodemographic details of the participants were filled out online to assess subjective symptoms and severity of the disease. Statistical analysis was done using SPSS.ResultA total of 149 office workers completed the survey. There was a statistically significant increasement in the duration of screen time, before and during COVID-19 pandemic (p=0.00). No significant mean difference of OSDI score was observed between before and during COVID-19 pandemic (p=0.264). Spectacle users had a statistically significant higher OSDI score than non- spectacle users (p=0.028).ConclusionThe duration of screen time is not significantly correlated to the severity of ocular surface disordersymptoms in office workers during COVID-19 pandemic in Indonesia, while those who wearspectacles seemed to have more ocular surface disorder symptoms than those who don’t.KeywordOSDI, Screen, Dry eyesLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download256-FP-G-INOIIS-09--Adinda-Mulya-Pertiwi.pdf

369FREE PAPER

FP-R-E-INOIIS-10Effect of 1% Prednisolone Acetate versus 0.03% Tacrolimus to LeukocyteInfiltration in Ciliary Body of Endotoxin-induced Uveitis Rat Model

Abstract TitleEffect of 1% Prednisolone Acetate versus 0.03% Tacrolimus to Leukocyte Infiltration inCiliary Body of Endotoxin-induced Uveitis Rat Model

First Author: NORA KUSUMA DAHLIA


Co Author:

dr. Ovi Sofia Sp.M(K) (Universitas Brawijaya)

dr. Eviana Norahmawati Sp.PA(K) (Universitas Brawijaya)



Seminat: INOIIS


Introduction & ObjectiveTopical steroid like prednisolone acetate 1% has been a mainstay treatment for anterior uveitis.However, long term side effect like cataract and intraocular pressure increase are often reported.Topical tacrolimus 0.03%, which is an immunomodulator used widely as allergy therapy inophthalmology, as an alternative treatment for anterior uveitis have not been widely studied. Thisresearch aims to study the difference of leukocyte cell infiltration on ciliary body oflipopolysaccharides (LPS) induced endotoxin-induced uveitis (EIU) rat model after administration ofprednisolone acetate 1% and tacrolimus 0.03%.MethodExperimental research was conducted at anatomic pathology laboratory of Faculty of MedicineUniversitas Brawijaya in August 2019. The subjects were divided into 4 groups, with the first groupwas negative control, second was positive control, third was LPS-induced and given prednisoloneacetate 1% eyedrop, and the last was LPS-induced and given tacrolimus 0.03% ointment. Fortyeight hours after LPS induction, subjects were enucleated and sent to pathology anatomylaboratory for ciliary body leukocyte count.ResultMean counts of ciliary body leukocyte count of group 1, 2, 3, and 4 were 3.333 ± 0.516, 20.833 ±4.119, 10.500 ± 1.517, and 11.667 ± 1.751. According to Tukey test, no significant difference ofciliary body leukocyte cell count between prednisolone acetate 1% group and tacrolimus 0.03%group (p<0.05, CI 95%).ConclusionTacrolimus 0.03% can be considered as alternative therapy for anterior uveitis because of its effectin decreasing ciliary body leukocyte count which is insignificant compared to prednisolone acetate1%.KeywordEndotoxin-induced uveitis, anterior uveitis, tacrolimus.Latest UpdateMay 17, 2021StatusApproved As Free PaperFile Download70-FP-R-E-INOIIS-10-Nora-Kusuma-Dahlia.pdf

370 FREE PAPER

FP-G-INOIIS-12Conjunctival-Limbal Autograft as Management of Pterygium at Hasta HusadaHospital Kepanjen : A Retrospective Study

Abstract TitleConjunctival-Limbal Autograft as Management of Pterygium at Hasta Husada HospitalKepanjen : A Retrospective Study

First Author: Fariza Rahma Safira

Author Institution: General Practitioner, Hasta Husada Hospital Kepanjen

Co Author:

Chairunisa Ferdiana ( General Ophthalmologist, Hasta Husada Hospital Kepanjen)

Lina Julianty (General Ophthalmologist, Hasta Husada Hospital Kepanjen)

Aryani Vindhya Putri (General Ophthalmologist, Hasta Husada Hospital Kepanjen)

Abstract Type:Research

Abstract Category:Free Paper

Seminat:INOIIS

Competition Category:General practitioner

Introduction & ObjectivePterygia are fibrovascular growths on the cornea that extend from the conjunctiva. Pterygium hasbeen treated using a variety of surgical procedures. Pterygium surgery, on the other hand, isconcerned about postoperative recurrence because fibrovascular development might extendbeyond the main presentation. Conjunctival or limbal conjunctival autograft is one of the surgicalprocedures to treat pterygium with a low recurrence rate ranging from 1.9 percent to 5.3 percentand a high degree of safety. This study aims to evaluate the surgical outcome of pterygium surgeryusing Conjunctival-Limbal Autograft.MethodThis is an observational study. Data were collected from medical records in Hasta Husada HospitalKepanjen within period of February 2020 – March 2021 and reviewed retrospectively. Subjectincluded were patient with pterygium who underwent Conjunctival-Limbal Autograft. Age, gender,pterygium grade, location, involved eyes, type of surgery, and complication were studied.ResultA total of 14 eyes from 11 patients were included in this study. Patients’ mean age were 57 yearsold. Majority of patients were female (63.6%). Fifty-seven percent of patients had pterygium inright eyes. There were 13 (92.9%) and 1 (7.1%) pterygium on nasal site and duplex, respectively.Pterygium grade 4 were found in most patients (92.3%). Grafts were found to be viable after allConjunctival-Limbal Autograft procedure (100%). No complication and recurrence of pterygiumwas recorded in this study.ConclusionIn our study, pterygium surgery with Conjunctival-Limbal Autograft were shown to be a successfulpterygium management.KeywordPterygium, Conjunctival-Limbal autograft, complicationLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download648-FP-G-INOIIS-12-Fariza-Rahma-Safira.pdf

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FP-R-O-INOIIS-13Graft Outcome in Corneal Patch Graft

Abstract TitleGraft Outcome in Corneal Patch Graft

First Author: Hajirah Salam

Author Institution: PPDS Mata Univ. Andalas

Co Author:

Havriza Vitresia (RSUP.Dr.M.Djamil Padang)

Reni Anggraini (RS. Padang Eye Centre)



Seminat: INOIIS


Introduction & ObjectiveCorneal patch graft has been advocated as the surgical procedure for corneal perforation orthinning. It involves patching the affected area with the full or partial thickness of corneal donortissue. To investigate the outcome of corneal patch grafts in perforated corneal ulcer (CU) inPadang Eye Centre Hospital during September 1st 2019 - April 31th 2021.MethodA retrospective study of perforated CU, size 3-6 mm, peripheral or paracentral cornea with irisprolapse. During the procedure, reposition of the iris followed by estimation of corneal donor sizeare performed. Irrigation of inflammatory debris, intracameral antibiotic, and adequate AC depthare also done. Post-operative management is topical antibiotic, topical steroid may be given if thereis no contraindication. Condition of graft, infection following the graft, and AC depth are observedfor one month after surgeryResultIn this study, found of 18 cases, 13 male (72%) and 5 female (23%). VA ranges LP to 0,4. The mostcommon etiology of CU is infection (88,9%) Mooren ulcer (11.1%). Graft condition after the surgeryis good in 15 (83.3%), infected in 1 (5.5%), and melting in 2 cases (11.1%). AC Depth is deep in77.7% cases. Improvement of VA in 44,4% cases, depend on the location and severity of ulcer.ConclusionCorneal patch graft is shown to be a great choice in treating perforated CU, to preserve the eyeball(tectonic keratoplasty). However, in non-infection ulcer, graft is found unsuccessful. It’s mayberelated with progressivity of disease.Keywordcorneal patch graft, perforated corneal ulcerLatest UpdateMay 17, 2021StatusApproved As Free PaperFile Download711-FP-R-O-INOIIS-13-Hajirah-Salam.pdf

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