Pediatric Traumatic Cataracts at a Tertiary Eye Center in Indonesia

Background: Traumatic cataract is the leading cause of significant monocular visual impairment in children. The cause of this type of cataract is preventable penetrating or blunt ocular injury. Lens extraction can improve the visual acuity but it also depends on the extent of the injury to other ocular structures. Objective: To describe the features of pediatric traumatic cataract presenting at a tertiary eye center in Indonesia. Methods: This study is a descriptive study and the data were collected retrospectively from the medical records of the patients who were diagnosed as pediatric traumatic cataract over the period of January 1st 2019 to December 31st 2019. Demographic data, trauma characteristics, clinical features, management, and pre- and post-operative Best Corrected Visual Acuity (BCVA) were reviewed retrospectively. Results: A total of 37 patients were diagnosed as pediatric traumatic cataract. Among these patients, 78.38% were boys, with the mean age of 9.14 ± 3.77 years old. Open globe injury was the mechanism of injury for 54.05% patients. Besides lens aspiration, additional procedures were membranectomy, anterior vitrectomy, primary posterior capsulotomy, and synechiolysis. Eighty-one percent patients had unilateral blindness preoperatively and 23.80% patients still had unilateral blindness on three months of follow-up. Conclusion: In pediatric patients, traumatic cataract occurred predominantly in boys while playing outside the house. The children who had ocular trauma still have the risk of blindness even after the surgery. Trauma prevention and avoidance by adult supervision when children engage in outdoor play activity are necessary.

Vision rehabilitation using microperimetric biofeedback training in age-related macular degeneration

·AIM: To determine the impact of microperimetric biofeedback training(MBFT) on the quality of vision in patients with age-related macular degeneration(AMD).·METHODS: This study was a prospective, interventional, comparative study with subjects of patients diagnosed with AMD in the National Eye Center Cicendo Eye Hospital, Indonesia. Patients were randomly divided into two groups, intervention and non-intervention with 18 patients in each group. The intervention group would receive six MBFT training sessions of 10-minute time duration each.·RESULTS: A statistically significant improvement of best corrected visual acuity(BCVA) was found after the intervention, from 1.24±0.416 to 0.83±0.242(log MAR;P<0.001). A statistically significant improvement for near vision acuity(NVA) was also observed, from 1.02±0.307 log MAR to 0.69±0.278 log MAR(P<0.001). In addition, reading rate increased, from 40.83±30.411 to 65.06±31.598 words/min(P<0.001). Similarly, a comparison of changes in BCVA, NVA, and reading rate between intervention and non-intervention groups showed a significant difference(P<0.001).·CONCLUSION: MBFT significantly and positively impacts visual acuity, NVA, and reading rate in patients with AMD.

Pediatric Retinal Detachment in Indonesia: Clinical Characteristics, Risk Factors, and Treatment Outcomes

Purpose: To describe the clinical features and risk factors of pediatric retinal detachment among patients in Indonesia. Methods: This is a retrospective study involving 46 eyes of 34 children (younger than 18 years) diagnosed with pediatric retinal detachment. A detailed history was taken and a complete ophthalmic examination and a systemic examination were performed as required. Clinical characteristics, risk factors, and treatment choices were noted. Retinal detachment was categorized as tractional, exudative, or rhegmatogenous. Results: Mean patient age was 8.5 years (range, 0–18 years). Most patients (70%) were boys. Twelve (35%) patients had bilateral involvement at presentation. Tractional retinal detachment was found in 17 eyes (37%) and in this study was caused by retinopathy of prematurity (grade IV-V) in all cases. Exudative retinal detachment was found in 12 eyes (26%), the most common causes of which were panuveitis and Coat’s disease (both 50%). Rhegmatogenous retinal detachment was found in 17 eyes (37%), the most common risk factor for which was trauma (58%). Conclusions: Different approaches are needed to treat pediatric retina detachment in patients with different risk factors. Recognition of risk factors and early management will help to prevent childhood blindness due to retinal detachment.

Clinical Manifestation of Congenital Aniridia in Indonesia

Background: Congenital aniridia is a rare, panophthalmic disorder that can cause vision loss. Knowledge of aniridia as an isolated ocular abnormality or as a part of systemic abnormalities is important. Management of congenital aniridia should be carried out comprehensively based on it. Objective: To describe clinical features and management of congenital aniridia in a top referral eye hospital in Indonesia. Methods: A retrospective study involving 43 eyes of 22 children (younger than 18 years) diagnosed with congenital aniridia from 2013 to 2018. A detailed history was taken and a complete ophthalmic examination and a systemic examination were performed as required. Clinical characteristics associated with ocular and systemic manifestation and its management were noted. Results: Mean age of patients was 7.6 ± 5.2 years (range 0 - 17 years). Most cases were female (55%) and sporadic (77%). Twenty-one (96%) patients had bilateral involvement at presentation. Foveal hypoplasia was found in 36 eyes (84%), followed by cataract in 26 eyes (61%) and secondary glaucoma in 13 eyes (30%). Nine patients (43%) with cataract had cataract surgery performed. Only 1 patient (5%) with secondary glaucoma underwent filtration surgery. All patients had moderate to severe visual impairment and low vision aid was considered. Regarding its systemic manifestation, none of the patients was diagnosed with an abnormality in the abdomen. Conclusion: There were various ocular features associated with congenital aniridia. Understanding the clinical characteristic and its management could improve the quality of vision in aniridia patients.