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MANAGEMENT CASE OF POST PHAKIC INTRAOCULAR LENS IMPLANT IN HIGH MYOPIA WITH COMPLICATED CATARACT AFTER VITRECTOMY: POST SURGERY CHALLENGES 高度近视合并白内障玻璃体切除术后晶状体植入术的处理:术后挑战
Pub Date : 2022-09-27 DOI: 10.35479/ijretina.2022.vol005.iss002.196
S. Widyawati, H. Putri, V. D. Oktarina
Introduction: To highlight the therapeutic dilemma in managing complications in high myopia patient with complicated cataract after vitrectomy who previously had refractive surgery. Case Report: A 37-years old man, presented with half the right eye view was being blocked by a black curtain for one week before admission. He had a history of high myopia on both eyes and underwent phakic intraocular lens (PIOL) implantation 12 years ago. Presenting visual acuity (VA) of the right eye was hand motion (HM). Retinal detachment (RD) on inferior side, and clear lens with anterior chamber (AC) PIOL were found in the examination. Patient underwent vitrectomy, endolaser, and silicone oil in the next four days. A sudden severe pain with red-eye was found one month after surgery, intraocular pressure (IOP) was increased to 43 mmHg, the lens was white opaque with lens material seen in AC. Discussion: The diagnosis of traumatic cataract and lens-particle-induced glaucoma was made. Lens mass evacuation surgery was performed after initial antiglaucoma medication. Posterior capsule rupture was found intraoperatively with only a small amount of lens mass remaining. Visual acuity result after the second surgery is still dissatisfied with the presence of rubeosis iridis, with the possibility of retinal re-detachment was still present. Conclusion: High myopia still poses a greater risk of ocular complications. It can be corrected by refractive surgery, with expensive cost and it will not prevent potential future ocular problems. Repeated assessment before and after refractive surgery procedure is mandatory in order to prevent sight-threatening complications of high myopia which might lead to other blinding complications.
目的:探讨高度近视患者玻璃体切除术后并发白内障患者既往行屈光手术后并发症的治疗困境。病例报告:37岁男性,入院前用黑色门帘遮挡右眼一半视野一周。他有双眼高度近视史,12年前接受过有晶状体人工晶状体植入术。右眼呈现的视敏度(VA)为手部运动(HM)。检查发现下侧视网膜脱离(RD),晶状体透明伴前房PIOL。在接下来的四天里,患者接受了玻璃体切除术、激光治疗和硅油治疗。术后1个月发现突然剧烈疼痛伴红眼,眼压升高至43 mmHg,晶状体呈白色不透明,可见AC晶状体物质。讨论:诊断为外伤性白内障及晶状体颗粒性青光眼。在最初的抗青光眼药物治疗后进行晶状体清除手术。术中发现后囊膜破裂,仅剩少量晶状体块。第二次手术后的视力结果仍不满意,存在虹膜红肿,仍存在视网膜再脱离的可能性。结论:高度近视仍有较高的眼部并发症发生风险。它可以通过屈光手术矫正,但费用昂贵,而且不能预防未来潜在的眼部问题。屈光手术前后的反复评估是强制性的,以防止高度近视的视力威胁并发症,可能导致其他致盲并发症。
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引用次数: 0
DIAGNOSING VON HIPPEL LINDAU DISEASE BY RETINAL CAPILLARY HAEMANGIOBLASTOMAS 视网膜毛细血管母细胞瘤诊断血管性林道病
Pub Date : 2022-09-27 DOI: 10.35479/ijretina.2022.vol005.iss002.194
Yurike Mandrasari, Wino Vrieda Vierlia, Andhika Yudistira, N. Dewi
Introduction: Von Hippel-Lindau (VHL) syndrome is a disease characterized by the formation of tumors or cysts in many different parts of the body caused by germline. The prevalence of this autosomal dominant condition is very rare. Understanding of clinical manifestasion and diagnostic criteria is needed. Case Report: Female, 22-year-old was reffered from orthopaedic department suffered from blurred and misalignment of the left eye since 3 months ago . Based on indirect funduscopy examination, we found  disc swelling with exudative retinal detachment on her left eye and orange-reddish retinal mass concluded as Retinal Capillary Hemangioblastoma (RCH) with tortuosity and dilatation of blood vessel on her right eye. The MRI showed multiple masses in cervical to lumbar vertebrae and multiple cyst on pancreatic gland. Discussion: This patient had 1 ocular RCH, multiple spinal tumor and multiple pancreatic cysts with no confirmed family history, therefore almost fulfilling the diagnostic criteria of VHL. To further confirm the diagnosis, it was necessary to find other common comorbids of VHL such as gene testing of VHL heterozygous germline mutation. Interdisciplinary approach consists of not only diagnostic and treatment plans from one speciality department, but also the ones from other related divisions and departments. Conclusion: Screening and interdiciplinary approach in managing Von Hippel-Lindau syndrome are required to be performed promptly.
简介:Von Hippel-Lindau (VHL)综合征是一种由生殖细胞引起的身体许多不同部位形成肿瘤或囊肿的疾病。这种常染色体显性遗传病的患病率非常罕见。了解临床表现和诊断标准是必要的。病例报告:女,22岁,从骨科转介,3个月前左眼模糊、不对准。通过间接眼底检查,我们发现左眼椎间盘肿胀伴渗出性视网膜脱离,右眼视网膜呈橙红色肿块,诊断为视网膜毛细血管母细胞瘤(RCH)伴血管扭曲扩张。MRI显示颈腰椎多发肿块,胰腺多发囊肿。讨论:该患者有1个眼部RCH,多发性脊柱肿瘤和多发性胰腺囊肿,没有明确的家族史,因此几乎符合VHL的诊断标准。为了进一步确认诊断,需要寻找VHL的其他常见合并症,如VHL杂合种系突变基因检测。跨学科方法不仅包括一个专科的诊断和治疗方案,还包括其他相关科室和部门的诊断和治疗方案。结论:Von Hippel-Lindau综合征的筛查和多学科治疗应及时进行。
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引用次数: 0
Comparison of Amplitude and Implicit Time Between Jet Electrode, Dencott Electrode and Dawson-Trick-Litzkow Electrode in Multifocal Electroretinography Examination in Adult Jet电极、Dencott电极和Dawson-Trick-Litzkow电极在成人多焦视网膜电图检查中的振幅和隐式时间比较
Pub Date : 2022-09-26 DOI: 10.35479/ijretina.2022.vol005.iss002.187
Ika Citra Susanti, S. Nusanti, M. Sidik, A. Kekalih
Introduction: Multifocal electroretinography (ERG) is an examination which measures retinal electrical activity as a response to lighting stimulus and allows simultaneous recording in many topographic locations. Various electrodes have been developed to balance examination accuracy and also patients’ comfort. The objective of this study is to establish normal values of multifocal ERG and to compare the values and the comfort level using Jet, Dencott and DTL electrode in Indonesian Adult. Methods: Through convenient sampling 49 normal Indonesian subjects between 19 and 49 years old were selected. Multifocal ERG amplitudes and implicit time values were measured according to recommendation by the ISCEV. Evaluation consisted of N1 and P1 wave in ring 1 to 5. after the examination, all subjects filled in a questionnaire about comfort level, adopted from the visual analog scale. Result: We observed a statistically significant difference in multifocal ERG normal values between electrode with higher wave amplitudes and longer implicit time in Jet and Dencott electrodes compared to DTL electrodes. Jet and DTL electrodes are more comfortable than Dencott electrodes for Indonesian adults in multifocal ERG. Conclusion: DTL electrodes give the lowest wave amplitude and the shortest implicit time and are the most comfortable electrode compared to Jet and Dencott electrodes, in multifocal ERG in Indonesian adults.
介绍:多焦点视网膜电图(ERG)是一种测量视网膜电活动作为对光照刺激的反应的检查,并允许在许多地形位置同时记录。为了平衡检查的准确性和患者的舒适度,各种电极被开发出来。本研究的目的是建立印尼成人多焦电图的正常值,并比较Jet、Dencott和DTL电极的正常值和舒适度。方法:采用方便抽样的方法,选取年龄在19 ~ 49岁的印尼正常人群49例。根据ISCEV的建议测量多焦点ERG振幅和隐时值。评价为1 ~ 5环的N1波和P1波。测试结束后,所有受试者填写一份舒适度问卷,问卷采用视觉模拟量表。结果:与DTL电极相比,Jet电极和Dencott电极波幅较高、隐式时间较长,多焦ERG正常值差异有统计学意义。Jet和DTL电极比Dencott电极在印度尼西亚成人多焦ERG中更舒适。结论:与Jet和Dencott电极相比,DTL电极在印度尼西亚成人多焦ERG中具有最低的波幅和最短的隐式时间,是最舒适的电极。
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引用次数: 0
CENTRAL MACULAR THICKNESS REDUCTION AFTER INTRAVITREAL INJECTION OF BEVACIZUMAB COMPARED TO INTRAVITREAL KETOROLAC IN NAIVE DIABETIC MACULAR EDEMA 在原发性糖尿病黄斑水肿中,玻璃体内注射贝伐单抗与玻璃体内注射酮罗拉克相比,中央黄斑厚度减少
Pub Date : 2022-09-26 DOI: 10.35479/ijretina.2022.vol005.iss002.203
S. Supanji, A. N. Agni
Introduction: Diabetic macular edema (DME) is a debilitating complication of the diabetic eye. Vascular Endothelial Growth Factor (VEGF) was found to be responsible for this disease entity, and anti-VEGF remains the main treatment of DME. Inflammatory processes occur in diabetic eye, with some researchers postulates the role of them in the making of DME. This study’s objective is to search for anti-VEGF alternative using Non-Steroid Anti-Inflammatory Drugs (NSAID), ketorolac tromethamine. Methods: We conducted a double blind, randomized clinical trial in DME patients using intravitreal injection of bevacizumab and ketorolac. Central macular thickness (CMT) was assessed pre-treatment and one-month post-treatment. Best Corrected Visual Acuity (BCVA) and Intraocular Pressure (IOP) were also assessed. Wilcoxon tests were performed to evaluate changes in CMT, visual acuity, and IOP. Result: We enrolled 50 treatment-naïve DME patients from March 2020 to March 2021. Twenty-five patients were allocated for each group. There is a statistically significant difference in CMT at one-month follow-up between the two groups (p:0.001) and a markedly reduced CMT between the groups (p:0.001), with the reduction higher in bevacizumab group. BCVA changes significantly in bevacizumab group (p:0.01), but there is no statistically significant difference between the two groups (p:0.07). There’s a marked difference of IOP in 1 hour after injection in both groups, with higher transient IOP elevation in ketorolac group (p:0.02), but there is no marked difference in one-month follow-up (p:>0.05). The perceived pain right after intravitreal injection is not different between bevacizumab and ketorolac group. Conclusion: Intravitreal injection of ketorolac found to be inferior compared to bevacizumab in reducing CMT of DME. Meanwhile, there’s no differences in visual acuity, intraocular pressure (one-month follow-up) and pain after injection between two groups.
简介:糖尿病性黄斑水肿(DME)是糖尿病眼的一种衰弱性并发症。血管内皮生长因子(VEGF)被发现与这种疾病实体有关,抗VEGF仍然是DME的主要治疗方法。炎症过程发生在糖尿病眼,一些研究人员推测它们在二甲醚制造中的作用。本研究的目的是寻找非甾体抗炎药(NSAID),酮咯酸tromethamine的抗vegf替代品。方法:我们在双盲随机临床试验中对二甲醚患者进行玻璃体内注射贝伐单抗和酮咯酸。分别在治疗前和治疗后1个月评估黄斑中央厚度(CMT)。同时评估最佳矫正视力(BCVA)和眼压(IOP)。采用Wilcoxon试验评估CMT、视力和IOP的变化。结果:我们从2020年3月至2021年3月招募了50例treatment-naïve DME患者。每组25名患者。随访1个月后,两组间CMT差异有统计学意义(p:0.001),两组间CMT显著降低(p:0.001),贝伐单抗组降低幅度更高。贝伐单抗组BCVA变化显著(p:0.01),但两组间差异无统计学意义(p:0.07)。两组患者注射后1 h IOP差异有统计学意义,酮洛酸组瞬时IOP升高较高(p:0.02), 1个月随访无统计学意义(p:>0.05)。贝伐单抗组和酮咯酸组在玻璃体内注射后即刻感知疼痛无差异。结论:与贝伐单抗相比,玻璃体内注射酮咯酸降低二甲醚CMT的效果较差。同时,两组患者的视力、眼压(随访1个月)、注射后疼痛均无差异。
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引用次数: 0
CLINICAL MANIFESTATIONS AND CD4 COUNT CHARACTERISTICS OF PATIENTS WITH CYTOMEGALOVIRUS (CMV) RETINITIS 巨细胞病毒(cmv)视网膜炎的临床表现及cd4计数特征
Pub Date : 2022-09-26 DOI: 10.35479/ijretina.2022.vol005.iss002.201
Yunneke Renna Xaverina, Ovi Sofia
Introduction: To describe the clinical manifestations and CD4 count characteristics of patients with cytomegalovirus (CMV) retinitis. Methods: This is a retrospective study of patients diagnosed with CMV retinitis at the Ophthalmology Outpatient Clinic at Dr. Saiful Anwar General Hospital, Malang, between January 2016 to December 2019. The patients’ characteristics and clinical data including gender, age, visual acuity, slit lamp biomicroscopy, indirect ophthalmoscope, and laboratory findings were collected from medical records. Result: Twenty-one eyes from thirteen patients with CMV retinitis were enrolled. The mean age was 30.9 ± 7.12 years, with 54% of them male. Bilateral lesions were observed in 62% of the patients, and the mean visual acuity during the initial visit was 1.50 ±1.07 log MAR. All patients presented with the classic form of CMV retinitis. Mean CD4 count when commencing treatment was 62.23 ±11.82 cells/µL with 77% below 50 cells/µL. Patients with CD4 count < 50 cells/µL mostly presented with posterior uveitis, bilateral lesion, and visual acuity ≤1.00 logMAR. Ten patients were given oral valganciclovir and antiretroviral therapy. Retinal detachment condition was noted at seven eyes. Candidiasis was the most presenting opportunistic infection. Conclusion: Cytomegalovirus retinitis was found in patients infected with AIDS with low CD4 counts. In this study, patients with CD4 counts of below 50 cells/µL tend to have more severe clinical presentations.
前言:描述巨细胞病毒(CMV)视网膜炎患者的临床表现和CD4计数特征。方法:回顾性研究2016年1月至2019年12月期间在马朗赛弗·安瓦尔总医院眼科门诊诊断为巨细胞病毒性视网膜炎的患者。从病历中收集患者的特征和临床资料,包括性别、年龄、视力、裂隙灯生物显微镜、间接检眼镜和实验室检查结果。结果:纳入13例巨细胞病毒性视网膜炎患者的21只眼。平均年龄30.9±7.12岁,男性占54%。62%的患者出现双侧病变,初次就诊时的平均视力为1.50±1.07 log mar。所有患者均表现为巨细胞病毒性视网膜炎的典型形式。治疗开始时平均CD4计数为62.23±11.82个细胞/µL, 77%低于50个细胞/µL。CD4细胞计数< 50 cells/µL的患者多以后葡萄膜炎、双侧病变、视力≤1.00 logMAR为主。10例患者给予口服缬更昔洛韦和抗逆转录病毒治疗。7只眼视网膜脱离。念珠菌病是最常见的机会性感染。结论:巨细胞病毒性视网膜炎见于CD4细胞计数低的艾滋病患者。在本研究中,CD4计数低于50 cells/µL的患者往往有更严重的临床表现。
{"title":"CLINICAL MANIFESTATIONS AND CD4 COUNT CHARACTERISTICS OF PATIENTS WITH CYTOMEGALOVIRUS (CMV) RETINITIS","authors":"Yunneke Renna Xaverina, Ovi Sofia","doi":"10.35479/ijretina.2022.vol005.iss002.201","DOIUrl":"https://doi.org/10.35479/ijretina.2022.vol005.iss002.201","url":null,"abstract":"Introduction: To describe the clinical manifestations and CD4 count characteristics of patients with cytomegalovirus (CMV) retinitis. \u0000Methods: This is a retrospective study of patients diagnosed with CMV retinitis at the Ophthalmology Outpatient Clinic at Dr. Saiful Anwar General Hospital, Malang, between January 2016 to December 2019. The patients’ characteristics and clinical data including gender, age, visual acuity, slit lamp biomicroscopy, indirect ophthalmoscope, and laboratory findings were collected from medical records. \u0000Result: Twenty-one eyes from thirteen patients with CMV retinitis were enrolled. The mean age was 30.9 ± 7.12 years, with 54% of them male. Bilateral lesions were observed in 62% of the patients, and the mean visual acuity during the initial visit was 1.50 ±1.07 log MAR. All patients presented with the classic form of CMV retinitis. Mean CD4 count when commencing treatment was 62.23 ±11.82 cells/µL with 77% below 50 cells/µL. Patients with CD4 count < 50 cells/µL mostly presented with posterior uveitis, bilateral lesion, and visual acuity ≤1.00 logMAR. Ten patients were given oral valganciclovir and antiretroviral therapy. Retinal detachment condition was noted at seven eyes. Candidiasis was the most presenting opportunistic infection. \u0000Conclusion: Cytomegalovirus retinitis was found in patients infected with AIDS with low CD4 counts. In this study, patients with CD4 counts of below 50 cells/µL tend to have more severe clinical presentations.","PeriodicalId":33128,"journal":{"name":"IJRETINA International Journal of Retina","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88473313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A DIFFERENCE IN INCIDENCE OF VISUAL THREATENING DIABETIC RETINOPATHY BETWEEN PATIENTS WITH AND WITHOUT IMPAIRED SLEEP QUALITY 睡眠质量受损与非睡眠质量受损患者发生威胁视力的糖尿病视网膜病变的差异
Pub Date : 2022-09-22 DOI: 10.35479/ijretina.2022.vol005.iss002.199
Lucky Fitrada, Nina Ratnaningsih, Erwin Iskandar
Background: Diabetic retinopathy (DR) is a common and major complication of diabetes mellitus (DM), and is the leading cause of preventable blindness in adults of productive age after cataracts. The global prevalence of DR is 34.6% , consisting of proliferative diabetic retinopathy (7.0%), diabetic macular edema (6.8%), and  visual threatening diabetic retinopathy (VTDR) (10.2%.) The risk factors for VTDR are age, duration of diabetes, glycemic control, hypertension, obesity, HbAIC levels, and dyslipidemia. In addition, impaired sleep quality is also indicated to be connected with the incidence of VTDR. Objective: To compare the incidence of VTDR between patients with and without impaired sleep quality. Methods: This was a cross-sectional comparative analytic observational study involving 178 type 2 diabetes mellitus patients with DR at the National Eye Center of Cicendo Eye Hospital who met the inclusion criteria. Subject characteristic data were taken from medical records and sleep quality data were collected through a structured interview using the Indonesian version of the Shorten Pittsburgh Sleep Quality Index (PSQI) questionnaire. Subjects were distributed into poor and good sleep quality groups. The presence of VTDR was then assessed. The differences were then analyzed statistically using chi-square test with a p value of 0.05 considered statistically significant.Results: Results showed that 66.2% and 71.1% of patients in the poor and good quality sleep group suffered from VTDR, respectively (p> 0.05). Conclusion: There is no difference in VTDR incidence between patients in productive age with type 2 DM between those with and without impaired sleep quality.  
背景:糖尿病视网膜病变(DR)是糖尿病(DM)常见的主要并发症,是育龄成人白内障后可预防失明的主要原因。DR的全球患病率为34.6%,包括增殖性糖尿病视网膜病变(7.0%)、糖尿病黄斑水肿(6.8%)和视力威胁型糖尿病视网膜病变(VTDR)(10.2%)。VTDR的危险因素有年龄、糖尿病病程、血糖控制、高血压、肥胖、HbAIC水平和血脂异常。此外,睡眠质量受损也与VTDR的发生有关。目的:比较睡眠质量受损患者与非睡眠质量受损患者的VTDR发生率。方法:本研究是一项横断面比较分析观察性研究,纳入178例Cicendo眼科医院国家眼科中心符合纳入标准的2型糖尿病合并DR患者。从医疗记录中获取受试者特征数据,并通过结构化访谈收集睡眠质量数据,访谈采用印尼版缩短匹兹堡睡眠质量指数(PSQI)问卷。研究对象被分为睡眠质量差组和睡眠质量好的组。然后评估VTDR的存在。采用卡方检验对差异进行统计学分析,p值为0.05认为差异有统计学意义。结果:结果显示,睡眠质量差组和睡眠质量好组患者发生VTDR的比例分别为66.2%和71.1% (p> 0.05)。结论:生产年龄2型DM患者的VTDR发生率与睡眠质量受损与未受损患者无显著差异。
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引用次数: 1
VITREORETINAL DISEASES IN OUTPATIENT DEPARTMENT OF BALI MANDARA EYE HOSPITAL IN 2019 2019年巴厘曼达拉眼科医院门诊部玻璃体视网膜疾病分析
Pub Date : 2022-02-23 DOI: 10.35479/ijretina.2022.vol005.iss001.148
Tyastuti Dwi, Diah Pantjawati, Semara Budiyasa, C. Hartono
Introduction: The purpose of this study is to identify the pattern and distribution of vitreoretinal (VR) diseases in Bali Mandara Eye Hospital Methods: A retrospective descriptive study was conducted for this study. We reviewed all medical records of new patient diagnosed with VR diseases, from 1 January to 31 December 2019. We recorded and measured demography, history of systemic and eye disease, symptoms and onset, ophthalmic examinations, diagnostic investigations, final diagnoses, therapies, and the completion of the visit. Results: Out of 2118 total visits, we found 1191 new cases with VR diagnosis. The male to female ratio was 1.3:1. We found a group of 46-65 years is represented in 678 cases (56.9%). Type 2 diabetes mellitus was the most commonly found as a systemic disease (15.5%), followed by the combination of diabetes and hypertension (14%) and hypertension alone (12.9%). History of previous cataract surgery was found in 174 cases (14.6%). Out of 1191 patients, 553 patients (46.4%) were blind. The most common diagnosis was diabetic retinopathy (19.7%), followed by rhegmatogenous retinal detachment (10.8%), and vitreous opacity (9.9%). Diabetic retinopathy affected both eyes in 302 cases (89.6%), while rhegmatogenous retinal detachment and vitreous opacity commonly affected one eye in 177 cases (95%) and 123 cases (73%), respectively. Proliferative diabetic retinopathy was found in 171 cases (50.7%). Conclusions: Diabetic retinopathy and rhegmatogenous retinal detachment were the most two common diagnoses. The proliferative type was slightly common than Non-Proliferative Diabetic Retinopathy. As diabetes and hypertension were the most systemic conditions we found, a collaboration with another department is needed to create a strategic screening system and early detection. An evaluation related to rhegmatogenous retinal detachment is needed to decrease the number of cases.
前言:本研究的目的是确定巴厘岛曼达拉眼科医院玻璃体视网膜疾病的模式和分布。方法:采用回顾性描述性研究。我们回顾了2019年1月1日至12月31日期间所有新诊断为VR疾病患者的医疗记录。我们记录并测量了患者的人口统计、全身性和眼部疾病史、症状和发病、眼科检查、诊断调查、最终诊断、治疗和访视完成情况。结果:在2118次就诊中,我们发现了1191例新的VR诊断病例。男女比例为1.3:1。我们发现46-65岁的人群有678例(56.9%)。2型糖尿病是最常见的全身性疾病(15.5%),其次是糖尿病合并高血压(14%)和高血压单独(12.9%)。有白内障手术史174例(14.6%)。1191例患者中,553例(46.4%)患者失明。最常见的诊断是糖尿病视网膜病变(19.7%),其次是孔源性视网膜脱离(10.8%)和玻璃体浑浊(9.9%)。糖尿病性视网膜病变双眼302例(89.6%),而孔源性视网膜脱离和玻璃体混浊常累及单眼177例(95%)和123例(73%)。增生性糖尿病视网膜病变171例(50.7%)。结论:糖尿病视网膜病变和孔源性视网膜脱离是最常见的两种诊断。增生性糖尿病视网膜病变略多于非增生性糖尿病视网膜病变。由于糖尿病和高血压是我们发现的最全身性的疾病,需要与另一个部门合作,建立一个战略性的筛查系统和早期发现。需要对孔源性视网膜脱离进行评估,以减少病例的数量。
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引用次数: 0
REMARKABLE RESULT TOWARDS RETINOPATHY ASSOCIATED AUTOIMMUNE HEMOLYTIC ANEMIA 对视网膜病变相关自身免疫性溶血性贫血疗效显著
Pub Date : 2022-02-22 DOI: 10.35479/ijretina.2022.vol005.iss001.190
Rofa Husnul Khuluqi, N. Dewi, Susanto Nugroho, Lely Retno Wulandari
Introduction: To present the clinical findings of Autoimmune hemolytic anemia (AIHA) Retinopathy and its rapid resolutions following treatment with steroid. Case report: A 14-year-old female patient presented with decreased vision in the left eye. There was history of AIHA. Visual acuity was 1/60 in LE and 6/6 in RE. There was conjunctival pallor, and the other anterior segment were unremarkable. Fundus examination of left eye revealed flame shaped and dot blot hemorrhage, roth’s spots, optic disc swelling, venous turtuosity, and elevated macula. There were afferent pupil defect, red green deficiency, and contrast sensitivity decline. Hematological evaluation revealed anemia. A MRI Head and Orbital examination were unremarkable. Discussion: This patient was assessed with LE Anemic retinopathy due to AIHA. The patient’s visual acuity improved as the retinopathy resolved after 1 month of oral steroid therapy. Conclusion: Anemia may play a role in the occurrence of retinopathy. The diagnosis of retinopathy can be made by linking ophthalmic fndings with positive serological test. Accurate comprehensive examination can establish the systemic diagnosis, and control of systemic parameters will improve retinopathy, reverse vision loss, and avoid permanent blindness
介绍自身免疫性溶血性贫血(AIHA)视网膜病变的临床表现及其在类固醇治疗后的快速解决方案。病例报告:一名14岁的女性患者表现为左眼视力下降。有AIHA的历史。LE视力为1/60,RE视力为6/6,结膜苍白,其他前段无明显变化。左眼眼底检查发现火焰状及点状出血,罗氏斑,视盘肿胀,静脉曲张,黄斑升高。传入瞳孔缺损,红绿缺乏,对比敏感度下降。血液学检查显示贫血。头部及眼眶MRI检查无明显异常。讨论:该患者被评估为AIHA所致LE贫血性视网膜病变。口服类固醇治疗1个月后,视网膜病变消退,患者视力改善。结论:贫血可能与视网膜病变的发生有关。视网膜病变的诊断可以通过将眼科检查结果与阳性血清学试验联系起来进行。准确全面的检查可建立全身性诊断,控制全身性参数可改善视网膜病变,逆转视力下降,避免永久性失明
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引用次数: 0
Prevalence and Associated Factors of Diabetic Retinopathy in People with Type 2 Diabetes Attending Community Based Diabetic Retinopathy Screening in Greater Bandung, Indonesia 印度尼西亚大万隆参加社区糖尿病视网膜病变筛查的2型糖尿病患者糖尿病视网膜病变患病率及相关因素
Pub Date : 2022-02-22 DOI: 10.35479/ijretina.2022.vol005.iss001.172
Aldiana Halim, Syumarti Syumarti, Mayang Rini, Nina Ratnaningsih, Erwin Iskandar, I. Sovani, Rova Virgana, Muhammad Rinaldi Dahlan
Introduction: Determine the prevalence and associated factors of diabetic retinopathy (DR) among people with type 2 diabetes. Design: Cross-sectional study Methods: We obtained data of people with type 2 diabetes retrospectively from a community-based DR screening database in Greater Bandung, Indonesia. We encoded the two fields mydriatic 45-degree fundus images to estimate prevalence. The associated factors analysis used multivariate logistic regression. Results: We screened a total of 4,251 people with type 2 diabetes from January 2016 to December 2019. The overall age-standardised prevalence of any DR was 30.7% (95% CI: 28.7%-32.8%) and vision-threatening DR 7.6% (95% CI: 6.5%-9.0%). The following factors were associated with a higher prevalence of any DR: ages 50+ (OR:1.37;  95% CI:1.05-1.77), duration of diabetes five to ten years (OR:1.38; 95% CI:1.11-1.71) and more than ten years (OR:1.40; 95% CI:1.13-1.73), and postprandial blood glucose 200 mg/dl and higher (OR:1.27; 95% CI:1.03-1.52). The following factors were associated with a higher prevalence of vision-threatening DR: duration of diabetes five to ten years (OR:2.01; 95% CI:1.39-2.91) and more than ten years (OR:1.86; 95% CI:1.28-2.71), postprandial blood glucose 200 mg/dl or higher (OR:1.52; 95% CI:1.05-2.21) and systolic blood pressure 180 mmHg or higher (OR:2.67; 95% CI:1.16-6.17). Conclusion: Diabetic retinopathy is prevalent among people with type 2 diabetes. People with diabetes should regulate their blood glucose and blood pressure to prevent retinopathy related vision loss.
前言:确定2型糖尿病患者中糖尿病视网膜病变(DR)的患病率及相关因素。设计:横断面研究方法:我们从印度尼西亚大万隆的社区DR筛查数据库中回顾性获得2型糖尿病患者的数据。我们编码了两个领域散瞳45度眼底图像来估计患病率。相关因素分析采用多元逻辑回归。结果:从2016年1月到2019年12月,我们共筛查了4251名2型糖尿病患者。任何DR的总体年龄标准化患病率为30.7% (95% CI: 28.7%-32.8%),视力威胁DR为7.6% (95% CI: 6.5%-9.0%)。以下因素与任何DR的较高患病率相关:50岁以上(OR:1.37;95% CI:1.05-1.77),糖尿病病程5- 10年(OR:1.38;95% CI:1.11-1.71)和10年以上(OR:1.40;95% CI:1.13-1.73),餐后血糖≥200 mg/dl (OR:1.27;95%置信区间:1.03—-1.52)。以下因素与视力威胁DR的较高患病率相关:糖尿病病程5 - 10年(OR:2.01;95% CI:1.39-2.91)和10年以上(OR:1.86;95% CI:1.28-2.71),餐后血糖≥200 mg/dl (or:1.52;95% CI:1.05-2.21)和收缩压180 mmHg或更高(or:2.67;95%置信区间:1.16—-6.17)。结论:糖尿病视网膜病变在2型糖尿病患者中普遍存在。糖尿病患者应控制血糖和血压,以防止视网膜病变引起的视力下降。
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引用次数: 0
CONGENITAL ARTERIO-VENOUS MALFORMATION OF OPTIC NERVE HEAD- A RARE CASE 先天性视神经头动静脉畸形1例
Pub Date : 2022-02-22 DOI: 10.35479/ijretina.2022.vol005.iss001.173
Vikas Sharma, Ankuj Tinna, V. Ambiya, Ashutosh Kumar Singh, R. Waghray
Introduction: Retinal arterio-venous malformations (AVMs) are rare, congenital, high-flow congenital developmental vascular anomalies without intervening capillary bed also known as racemose angioma, They are unilateral, nonhereditary lesions located anywhere in retina and may involve optic nerve. Case report: A 55 year old male was found to have abnormal congenital arterio-venous malformation over optic nerve head in his left eye, as an incidental clinical finding. He had reported for his routine fundus examination due to diabetes. He had no other relevant systemic findings. Further follow up was advised to see the progression of the lesion and structural damage to optic nerve. Discussion: The typical clinical picture, fluorescein angiogram findings, normal MRI brain and orbits, and normal base line blood investigations all points in favour of a congenital arterio-venous malformation. Conclusion:  Arterio- venous malformations of Optic nerve head are very rare to find as compared to retinal malformations. This is the first such case report from India.  
视网膜动静脉畸形(AVMs)是一种罕见的先天性、高流量的先天性发育性血管异常,没有介入毛细血管床,也被称为总状血管瘤,它们是单侧、非遗传性病变,位于视网膜的任何位置,可能累及视神经。病例报告:一名55岁男性,在他的左眼视神经头被发现有异常先天性动静脉畸形,作为一个偶然的临床发现。由于糖尿病,他去做了眼底常规检查。他没有其他相关的系统性发现。建议进一步随访以观察病变的进展和视神经的结构损伤。讨论:典型的临床表现,荧光素血管造影结果,正常的MRI脑和眼眶,以及正常的基线血液检查都表明先天性动静脉畸形。结论:视神经头动静脉畸形与视网膜畸形相比是非常罕见的。这是印度首次报道此类病例。
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引用次数: 0
期刊
IJRETINA International Journal of Retina
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