Background This case report describes two rare cases of Coats disease in nonjuvenile patients with preserved vision. Case presentation Two otherwise healthy Asian males aged 15 and 29 years old presented with unilateral gradual blurred vision and scotoma, respectively. Visual acuity was 6/6 (0 logMAR) with no other abnormalities observed in the anterior segment of the eyes. Both posterior segment examinations and fluorescein angiography revealed retinal telangiectatic vessels, exudation, and hemorrhage. Additionally, optical coherence tomography of the first patient showed subfoveal fluid. Both patients were diagnosed with stage 2 Coats disease. Laser photocoagulation was performed on both patients. The first patient showed initial good response to therapy with resolution of the subfoveal fluid; however, he developed cataract and underwent cataract surgery after 3 years. In the second case, although the exudates and hemorrhage still persisted, the macula was spared and the patient did not have visual complaints. No adverse events were reported, and final visual acuity of both patients remained 6/6. Conclusions Coats disease in adolescence and adulthood may present with good vision. In mild and moderate cases of Coats disease, laser photocoagulation monotherapy may help preserve vision. Nevertheless, as recurrences and complications may still occur later in life, lifelong monitoring is recommended.

Pendahuluan: Coronavirus disease 2019 (COVID-19) memiliki tingkat keparahan dari flu ringan hingga gagal napas dan kematian. Diabetes melitus (DM) dianggap sebagai salah satu faktor risiko kerentanan infeksi dan tingkat keparahan penyakit pada COVID-19. Serial kasus ini melaporkan gejala klinis, penemuan pemeriksaan penunjang, dan mortalitas pada pasien COVID-19 berat dengan komorbid DM.Ilustrasi Kasus: Laporan ini merupakan serial kasus dari tiga pasien perempuan usia 50-68 tahun, dengan COVID-19 terkonfirmasi dan komorbid DM yang dirawat di perawatan intensif dari bulan April hingga Juli 2020. Dua pasien mengalami hiperglikemia pada presentasi awal. Selama perawatan, dua pasien cenderung mengalami hiperglikemia, sementara satu pasien lebih sering mengalami hipoglikemia. Dua pasien mengalami pneumonia terkait infeksi rumah sakit dan gagal ginjal akut selama perawatan. Satu pasien meninggal dunia.Diskusi: Ketiga subjek mengalami fluktuasi kondisi dan gula darah yang sulit dicapai selama perawatan. Satu pasien mengalami mengalami gagal napas dan meninggal dunia, sementara dua pasien lainnya dipulangkan setelah perbaikan keadaan. Kondisi hiperglikemia dan hipoglikemia pada DM diperkirakan berperan dalam keparahan infeksi COVID-19.Kesimpulan: DM dapat memperburuk kondisi pasien yang terinfeksi COVID-19. Kadar gula darah normal saat presentasi awal tidak menjadi jaminan prognosis baik pada pasien; sehingga, kontrol gula darah pada pasien COVID-19 dengan DM merupakan hal yang krusial.

Leprosy is an important infectious disease, which is still prevalent in developing countries including  Indonesia. This disease may affect the skin, extremities, peripheral nerves, and the eyes, causing disabilities of the patient. Leprosy is known to cause various ocular disorders, however, posterior segment abnormalities which involve the retina, choroid dan vitreous, have rarely been reported. Therefore, we present a case series of patients with posterior segment pathologies in visually impaired leprosy patients. These patients were identified during a community-based screening program on 99 leprosy patients, held in July 2019 in Alverno Hospital, Singkawang West Kalimantan. Patient comprised of inpatients and former patients who lived within the city and nearby cities who were invited for the program. All patients underwent comprehensive ophthalmology examination, performed by general ophthalmologists. Visual impairment was found in 15 patients, and their pupils were dilated, followed with posterior segment examination with indirect ophthalmoscopy and fundus photograph, using a handheld fundus camera, done by a vitreoretina specialist. Out of all patients screened, we did not find any leprosy-related posterior segment abnormalities. However, posterior segment pathologies were found in six patients, including peripapillary atrophy, myopic crescent, drusen and chorioretinal atrophy. One patient showed extensive chorioretinal atrophy with pigment clumping, which may be caused by leprosy- related chronic inflammatory process.