Pub Date : 2019-09-18DOI: 10.35479/ijretina.2019.vol002.iss002.91
D. Rosati, Sauli Ari Widjaja, Wimbo Sasono, Muhammad Firmansjah, Ima Yustiarini, Ady Dwi Prakosa, Moestidjab Moestidjab, Gatut Suhendro
Introduction: HIV infection can manifest in a variety of ways in and around the eyes and it is most commonly due to retinal microvasculopathy, neoplasm and also opportunistic infection. Those usually occur associated with a significantly reduced CD4 T-cell counts. In this era of Highly Active Anti Retroviral Therapy (HAART) has caused a major decreasing of the ocular involvement prevalence itself. Case presentation : A 31 year-old-male came with blurred vision on the right eye, which has started 3 years ago and slowly worsened. Central scotoma also presented previously. Patient was an HIV-AIDS, that placed him on HAART. CD4+ T-lymphocyte count was 3 cells/mm3. The initial visual acuity was light perception and fundus examination showed Roth spots, massive exudates and hemorrhages covering the optic disc and decreased foveal reflex. Laboratory examination revealed positive Rubella and anti-CMV immunoglobulin-G (IgG). He also suffered from lung tuberculosis and took tuberculosis medication regularly. Patient was diagnosed with Cytomegalovirus (CMV) retinitis based on history of illness, fundus examination as well as laboratory testing and given oral induction valganciclovir 900 mg once daily for 3 weeks followed by maintenance dosage . Result : After valganciclovir induction, there was significant changes with decreased peripapillary exudates, hemorrhages and vasculitis, but the optic disc appeared pale. The patient also had bicytopenia due to valganciclovir therapy that complicate his condition and passed away after 3 months follow up. Conclusion: CMV retinitis is reported to occur in patient with extreme CD4 count usually less than 50 cells/mm3. The sooner of proper treatment would likely following better outcome. Making diagnosis of immunosuppresed patient with ocular manifestations was challenging so that comprehensive eye examination in HIV-infected individuals should be conducted. Oral valganciclovir could give satisfactory response to decrease the progression of retinitis but risk of blindness may still occur.
{"title":"Challenges in Cytomegalovirus (CMV) Retinitis Management","authors":"D. Rosati, Sauli Ari Widjaja, Wimbo Sasono, Muhammad Firmansjah, Ima Yustiarini, Ady Dwi Prakosa, Moestidjab Moestidjab, Gatut Suhendro","doi":"10.35479/ijretina.2019.vol002.iss002.91","DOIUrl":"https://doi.org/10.35479/ijretina.2019.vol002.iss002.91","url":null,"abstract":"Introduction: HIV infection can manifest in a variety of ways in and around the eyes and it is most commonly due to retinal microvasculopathy, neoplasm and also opportunistic infection. Those usually occur associated with a significantly reduced CD4 T-cell counts. In this era of Highly Active Anti Retroviral Therapy (HAART) has caused a major decreasing of the ocular involvement prevalence itself. \u0000Case presentation : A 31 year-old-male came with blurred vision on the right eye, which has started 3 years ago and slowly worsened. Central scotoma also presented previously. Patient was an HIV-AIDS, that placed him on HAART. CD4+ T-lymphocyte count was 3 cells/mm3. The initial visual acuity was light perception and fundus examination showed Roth spots, massive exudates and hemorrhages covering the optic disc and decreased foveal reflex. Laboratory examination revealed positive Rubella and anti-CMV immunoglobulin-G (IgG). He also suffered from lung tuberculosis and took tuberculosis medication regularly. Patient was diagnosed with Cytomegalovirus (CMV) retinitis based on history of illness, fundus examination as well as laboratory testing and given oral induction valganciclovir 900 mg once daily for 3 weeks followed by maintenance dosage . \u0000Result : After valganciclovir induction, there was significant changes with decreased peripapillary exudates, hemorrhages and vasculitis, but the optic disc appeared pale. The patient also had bicytopenia due to valganciclovir therapy that complicate his condition and passed away after 3 months follow up. \u0000Conclusion: CMV retinitis is reported to occur in patient with extreme CD4 count usually less than 50 cells/mm3. The sooner of proper treatment would likely following better outcome. Making diagnosis of immunosuppresed patient with ocular manifestations was challenging so that comprehensive eye examination in HIV-infected individuals should be conducted. Oral valganciclovir could give satisfactory response to decrease the progression of retinitis but risk of blindness may still occur.","PeriodicalId":33128,"journal":{"name":"IJRETINA International Journal of Retina","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75307685","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}
Pub Date : 2019-09-18DOI: 10.35479/ijretina.2019.vol002.iss002.96
Ovi Sofia, R. Hariyono
Introduction: Ocular toxoplasmosis is a major cause of infectious posterior uveitis worldwide. There was no exact number of ocular toxoplasmosis prevalence in Indonesia, but Indonesia was considered to have high seroprevalence in Southeast Asian. This study is conducted to determine clinical characteristics and management of ocular toxoplasmosis at outpatient clinic of Dr. Saiful Anwar General Hospital, a tertiary referral hospital in Malang, East Java. Methods : This was retrospective study. We reviewed the medical records of patients with ocular toxoplasmosis and collected the data associated with age, sex, laterality, visual outcome, type of lesions, serum serological titers, therapeutic regimens, and complications. Result : There were 48 eyes from 38 patients included in this study, mostly were female (66%) with mean age was 33,5 years. Unilateral infection (71%) was more frequent than bilateral cases (39%). Active lesions were found more than cicatrical lesions (56,25%). Most patients with active diseases had unilateral lesion (87,5%). The most common presenting complain was blurred vision (73%). Most of lesions (22 eyes; 81,4%) were located on macular region. All of patients have positive IgG antitoxoplasma serum. There were 22 patients received oral Trimethoprim-Sulfamethoxazole and steroid. Visual acuity improved in 6 patients at the end of follow-up period. Complications of retinal detachment and choroidal neovascularization were found in 3 patients. Conclusion : Active ocular toxoplasmosis is more likely to be unilateral infection with main presenting complain is blurred vision. Most of our patients show good responses to oral trimethoprim-sulfamethoxazole and steroid.
{"title":"CLINICAL CHARACTERISTICS AND MANAGEMENT OF OCULAR TOXOPLASMOSIS","authors":"Ovi Sofia, R. Hariyono","doi":"10.35479/ijretina.2019.vol002.iss002.96","DOIUrl":"https://doi.org/10.35479/ijretina.2019.vol002.iss002.96","url":null,"abstract":"Introduction: Ocular toxoplasmosis is a major cause of infectious posterior uveitis worldwide. There was no exact number of ocular toxoplasmosis prevalence in Indonesia, but Indonesia was considered to have high seroprevalence in Southeast Asian. This study is conducted to determine clinical characteristics and management of ocular toxoplasmosis at outpatient clinic of Dr. Saiful Anwar General Hospital, a tertiary referral hospital in Malang, East Java. \u0000Methods : This was retrospective study. We reviewed the medical records of patients with ocular toxoplasmosis and collected the data associated with age, sex, laterality, visual outcome, type of lesions, serum serological titers, therapeutic regimens, and complications. \u0000Result : There were 48 eyes from 38 patients included in this study, mostly were female (66%) with mean age was 33,5 years. Unilateral infection (71%) was more frequent than bilateral cases (39%). Active lesions were found more than cicatrical lesions (56,25%). Most patients with active diseases had unilateral lesion (87,5%). The most common presenting complain was blurred vision (73%). Most of lesions (22 eyes; 81,4%) were located on macular region. All of patients have positive IgG antitoxoplasma serum. There were 22 patients received oral Trimethoprim-Sulfamethoxazole and steroid. Visual acuity improved in 6 patients at the end of follow-up period. Complications of retinal detachment and choroidal neovascularization were found in 3 patients. \u0000Conclusion : Active ocular toxoplasmosis is more likely to be unilateral infection with main presenting complain is blurred vision. Most of our patients show good responses to oral trimethoprim-sulfamethoxazole and steroid.","PeriodicalId":33128,"journal":{"name":"IJRETINA International Journal of Retina","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80516003","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}
Pub Date : 2019-09-18DOI: 10.35479/ijretina.2019.vol002.iss002.73
Noviana K. Vivin, A. Djatikusumo, Elvioza Elvioza, Gitalisa Andayani, A. Yudantha, Mario Marbungaran Hutapea, A. Victor
Abstract Background: The incidence of nucleus drop or intraocular lens (IOL) drop as the complication of phacoemulsification increases due to the increased frequency of phacoemulsification. Pars plana vitrectomy (PPV) followed by endofragmentation and secondary IOL implantation is the choice of procedure for management. This study aims to determine the frequency, outcomes, and complication of PPV in the case of nucleus drop or IOL drop in the Department of Ophthalmology, Fakultas Kedokteran Universitas Indonesia – Rumah Sakit Cipto Mangunkusumo (FKUI-RSCM) Methods: This study is a retrospective descriptive study conducted in the Vitreoretinal Division of the Department of Ophthalmology, FKUI - RSCM. Research data was taken from the medical records of all nucleus drop or IOL drop patients underwent PPV in January 2017-December 2017. Results: There were 19 cases studied. The incidence of nucleus drop occurred in phacoemulsification surgery techniques (94.7%) and ECCE techniques (5.3%). Vitrectomy surgery was performed ≤2 weeks in 31.6% and >2 weeks in 68.4% after the patient first arrived at the vitreoretinal clinic. Most pre-PPV visual acuity was 1/60-6/60 (47.1%). In the final follow-up, visual acuity improved from 6/45 to 6/6 occurred in 42.2% of cases. Complication after PPV and secondary IOL implantation include elevated IOP (10.5%), IOL decentration (5.3%), corneal decompensation (5.3%), macular edema (5.3%), and retinal detachment (5.3%). Conclusion: Nucleus drop or IOL drop generally occurs in phacoemulsification cataract surgery techniques. Improved visual acuity was achieved after PPV and secondary IOL implantation at the end of the follow-up period. Most common post-PPV complication is elevated IOP.
{"title":"Nucleus Drop or Intraocular Lens Drop Underwent Pars Plana Vitrectomy due to Complication of Cataract Surgery","authors":"Noviana K. Vivin, A. Djatikusumo, Elvioza Elvioza, Gitalisa Andayani, A. Yudantha, Mario Marbungaran Hutapea, A. Victor","doi":"10.35479/ijretina.2019.vol002.iss002.73","DOIUrl":"https://doi.org/10.35479/ijretina.2019.vol002.iss002.73","url":null,"abstract":"Abstract \u0000Background: The incidence of nucleus drop or intraocular lens (IOL) drop as the complication of phacoemulsification increases due to the increased frequency of phacoemulsification. Pars plana vitrectomy (PPV) followed by endofragmentation and secondary IOL implantation is the choice of procedure for management. This study aims to determine the frequency, outcomes, and complication of PPV in the case of nucleus drop or IOL drop in the Department of Ophthalmology, Fakultas Kedokteran Universitas Indonesia – Rumah Sakit Cipto Mangunkusumo (FKUI-RSCM) \u0000Methods: This study is a retrospective descriptive study conducted in the Vitreoretinal Division of the Department of Ophthalmology, FKUI - RSCM. Research data was taken from the medical records of all nucleus drop or IOL drop patients underwent PPV in January 2017-December 2017. \u0000Results: There were 19 cases studied. The incidence of nucleus drop occurred in phacoemulsification surgery techniques (94.7%) and ECCE techniques (5.3%). Vitrectomy surgery was performed ≤2 weeks in 31.6% and >2 weeks in 68.4% after the patient first arrived at the vitreoretinal clinic. Most pre-PPV visual acuity was 1/60-6/60 (47.1%). In the final follow-up, visual acuity improved from 6/45 to 6/6 occurred in 42.2% of cases. Complication after PPV and secondary IOL implantation include elevated IOP (10.5%), IOL decentration (5.3%), corneal decompensation (5.3%), macular edema (5.3%), and retinal detachment (5.3%). \u0000Conclusion: Nucleus drop or IOL drop generally occurs in phacoemulsification cataract surgery techniques. Improved visual acuity was achieved after PPV and secondary IOL implantation at the end of the follow-up period. Most common post-PPV complication is elevated IOP. \u0000 ","PeriodicalId":33128,"journal":{"name":"IJRETINA International Journal of Retina","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89948681","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}
Pub Date : 2019-09-18DOI: 10.35479/ijretina.2019.vol002.iss002.98
A. Winarni, Ni Luh Putu Widyasti, Natalia Christina Angsana, Rizto Wisuda Senuari, A. N. Agni, Agus Supartoto, M. B. Sasongko, Haryo Yudono
Introduction : Bevacizumab intravitreal injection could be detectable in plasma that might interfere the coagulopathy and hemostasis condition. The purpose of this study was to investigate the difference of APTT between hypertensive and nonhypertensive diabetic mellitus patients with bevacizumab intravitreal injection. Methods : This was cohort study conducted at Sardjito General Hospital from March 2019 to June 2019. Thirty-two hypertension patients and 30 nonhypertension patients with diabetes mellitus who underwent bevacizumab intravitreal injection were included. Value of APTT was measured using ACLTOP300 machine prior and 1 week after IVB. The difference in mean APTT value prior and after IVB, range APTT value between two groups were assessed using independent t-test. The percentage of patients who had shortening of APTT in both groups was tested by two populations proportion test. Results : Mean APTT before IVB in hypertensive patients was 36.47 ± 2.92 seconds and in nonhypertensive patients was 36.33 ± 4.39 seconds with p value > 0.05. Mean value of APTT after IVB in hypertension patients was 35.42 ± 3.63 seconds and in nonhypertensive patients was 35.60 ± 3.13 seconds with p value > 0.05. APTT shortening in hypertensive patients was -1.03 ± 3.65 and nonhypertensive patients was -0.73 ± 2.55 with p value > 0.05. The risk of APTT shortening in hypertensive patients was 1.370 (0.831-2.258). The risk of APTT shortening in hypertensive patients who used antihypertensive drugs regularly was 0.538 (0.331- 0.874). Conclusion : There was no difference in shortening of APTT value 1 week after intravitreal bevacizumab injection between hypertensive and nonhypertensive groups in patients with diabetes mellitus. Hence, administration of IVB in hypertensive patients with regular antihypertensive therapy might be safe.
{"title":"Shortening Activated Partial Tromboplastin Time (APTT) Between Hypertension and Nonhypertension in Diabetic Mellitus Patients with Bevacizumab Intravitreal Injection","authors":"A. Winarni, Ni Luh Putu Widyasti, Natalia Christina Angsana, Rizto Wisuda Senuari, A. N. Agni, Agus Supartoto, M. B. Sasongko, Haryo Yudono","doi":"10.35479/ijretina.2019.vol002.iss002.98","DOIUrl":"https://doi.org/10.35479/ijretina.2019.vol002.iss002.98","url":null,"abstract":"Introduction : \u0000Bevacizumab intravitreal injection could be detectable in plasma that might interfere the coagulopathy and hemostasis condition. The purpose of this study was to investigate the difference of APTT between hypertensive and nonhypertensive diabetic mellitus patients with bevacizumab intravitreal injection. \u0000Methods : \u0000This was cohort study conducted at Sardjito General Hospital from March 2019 to June 2019. Thirty-two hypertension patients and 30 nonhypertension patients with diabetes mellitus who underwent bevacizumab intravitreal injection were included. Value of APTT was measured using ACLTOP300 machine prior and 1 week after IVB. The difference in mean APTT value prior and after IVB, range APTT value between two groups were assessed using independent t-test. The percentage of patients who had shortening of APTT in both groups was tested by two populations proportion test. \u0000Results : \u0000Mean APTT before IVB in hypertensive patients was 36.47 ± 2.92 seconds and in nonhypertensive patients was 36.33 ± 4.39 seconds with p value > 0.05. Mean value of APTT after IVB in hypertension patients was 35.42 ± 3.63 seconds and in nonhypertensive patients was 35.60 ± 3.13 seconds with p value > 0.05. APTT shortening in hypertensive patients was -1.03 ± 3.65 and nonhypertensive patients was -0.73 ± 2.55 with p value > 0.05. The risk of APTT shortening in hypertensive patients was 1.370 (0.831-2.258). The risk of APTT shortening in hypertensive patients who used antihypertensive drugs regularly was 0.538 (0.331- 0.874). \u0000Conclusion : \u0000There was no difference in shortening of APTT value 1 week after intravitreal bevacizumab injection between hypertensive and nonhypertensive groups in patients with diabetes mellitus. Hence, administration of IVB in hypertensive patients with regular antihypertensive therapy might be safe. \u0000 ","PeriodicalId":33128,"journal":{"name":"IJRETINA International Journal of Retina","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88610133","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}
Pub Date : 2019-09-18DOI: 10.35479/ijretina.2019.vol002.iss002.76
Danang Yoga Wiguna, Sauli Ari Widjaja, Wimbo Sasono, Muhammad Firmansjah, Ima Yustiarini, Ady Dwi Prakosa, Moestidjab Moestidjab, Gatut Suhendro
Condensing lens is a lens used as an auxiliary lens in indirect instruments to examines the fundus. This lens is used with binocular indirect ophthalmoscope and slit-lamp biomicroscope to reach a stereopsis image of fundus. Optical principle of condensing lens is to make the eye in myopic condition, so it can producesa real, aerial, inverted and reversed image. This lens was placed between the instruments and the eye of the patient which located closer to patient’s eye. Optimalized position of the lens can produce a good fundus image. Condensing lens have so many power of dioptre that each power produces different magnification and field of view. High powered lenses produces wider field of view than low powered ones. High powered lens can also used in patient with small dilated pupil and shorter distance of examination. Low powered lenses offer more magnification. Fundus examination with binocular indirect ophthalmoscope and slit-lamp biomicroscope have purpose to produces stereopsis image because of the binocularity system. These two instruments have each advantages and disadvantages. The advantages of binocular indirect ophthalmoscope are a portable instrument, relatively can be used in uncooperative patient and it can be used with scleral indentation to reach more peripheral view of the fundus. Meanwhile slit-lamp biomicroscope has the advantages to offer more magnification and flexible illumination system. With higher powered lens use in biomicroscope, it also give advantages in shorter distance of examination and wider field of view.
{"title":"CONDENSING LENS ON BINOCULAR INDIRECT OPHTHALMOSCOPY AND SLIT-LAMP BIOMICROSCOPY","authors":"Danang Yoga Wiguna, Sauli Ari Widjaja, Wimbo Sasono, Muhammad Firmansjah, Ima Yustiarini, Ady Dwi Prakosa, Moestidjab Moestidjab, Gatut Suhendro","doi":"10.35479/ijretina.2019.vol002.iss002.76","DOIUrl":"https://doi.org/10.35479/ijretina.2019.vol002.iss002.76","url":null,"abstract":"Condensing lens is a lens used as an auxiliary lens in indirect instruments to examines the fundus. This lens is used with binocular indirect ophthalmoscope and slit-lamp biomicroscope to reach a stereopsis image of fundus. Optical principle of condensing lens is to make the eye in myopic condition, so it can producesa real, aerial, inverted and reversed image. This lens was placed between the instruments and the eye of the patient which located closer to patient’s eye. Optimalized position of the lens can produce a good fundus image. \u0000Condensing lens have so many power of dioptre that each power produces different magnification and field of view. High powered lenses produces wider field of view than low powered ones. High powered lens can also used in patient with small dilated pupil and shorter distance of examination. Low powered lenses offer more magnification. \u0000Fundus examination with binocular indirect ophthalmoscope and slit-lamp biomicroscope have purpose to produces stereopsis image because of the binocularity system. These two instruments have each advantages and disadvantages. The advantages of binocular indirect ophthalmoscope are a portable instrument, relatively can be used in uncooperative patient and it can be used with scleral indentation to reach more peripheral view of the fundus. Meanwhile slit-lamp biomicroscope has the advantages to offer more magnification and flexible illumination system. With higher powered lens use in biomicroscope, it also give advantages in shorter distance of examination and wider field of view.","PeriodicalId":33128,"journal":{"name":"IJRETINA International Journal of Retina","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83878541","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}
Pub Date : 2019-09-18DOI: 10.35479/ijretina.2019.vol002.iss002.75
Ifan Romadhon Lukmana, Sauli Ari Widjaja, Wimbo Sasono, Muhammad Firmansjah, Ima Yustiarini, Ady Dwi Prakosa, Moestidjab Moestidjab, Gatut Suhendro
Introduction: The aim of this study is to evaluate the incidence and characteristics of retinal detachment patients with proliferative vitreoretinopathy. Methods: Retrospective review of medical record from primary retinal detachment (RD) patients with proliferative vitreoretinopathy (PVR) between 2013 and 2017 at Outpatient Department of Ophthalmology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Result: : The number of RD patients with PVR at Dr. Soetomo General Academic Hospital in 2013-2017 was 80 patients (21%), consisting of 59 men and 21 women with mean of age was 47.5 ± 14.3 years. The characteristics of the subjects were phakic 72.5%, aphakic 1.25%, high myopia 23.75%, history of trauma 18.75% and affected to right eye 60%. Retinal characteristics were break conditions in the retina (located at superotemporal (34%), horseshoe tear (56%), and single break (60%)), macula off (90%), area of detachments were 4 quadrants (43,75%), PVR conditions were grade B PVR (45%), mean duration of RD was 156 days, mean length of surgery waiting list was 61.1 days. The majority of treatment types were vitrectomy (70,4%), majority of tamponade using silicone oil (59.3%), majority of pre-operative and post-operative visual acuity were less than 3 meters counting finger, pre-operative (91.25%) , post-operative 1 month (76%) and 6 months (52.5%), and the majority of post-operative retinal reattachment were 77.3%. Conclusion: The results of this study indicate the number of RD patients with PVR was lower than previous studies. Various results of patient characteristics can be used as guidelines for ophthalmologists in determining actions and explaining the prognosis of the disease. Further research with a larger sample size and prospective methods will be better able to provide better results. Keywords: retinal detachment, proliferative vitreoretinopathy, characteristic pvr
{"title":"CHARACTERISTICS OF RETINAL DETACHMENT PATIENTS WITH PROLIFERATIVE VITREORETINOPATHY AT Dr. SOETOMO GENERAL ACADEMIC HOSPITAL","authors":"Ifan Romadhon Lukmana, Sauli Ari Widjaja, Wimbo Sasono, Muhammad Firmansjah, Ima Yustiarini, Ady Dwi Prakosa, Moestidjab Moestidjab, Gatut Suhendro","doi":"10.35479/ijretina.2019.vol002.iss002.75","DOIUrl":"https://doi.org/10.35479/ijretina.2019.vol002.iss002.75","url":null,"abstract":"Introduction: The aim of this study is to evaluate the incidence and characteristics of retinal detachment patients with proliferative vitreoretinopathy. \u0000Methods: Retrospective review of medical record from primary retinal detachment (RD) patients with proliferative vitreoretinopathy (PVR) between 2013 and 2017 at Outpatient Department of Ophthalmology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. \u0000Result: : The number of RD patients with PVR at Dr. Soetomo General Academic Hospital in 2013-2017 was 80 patients (21%), consisting of 59 men and 21 women with mean of age was 47.5 ± 14.3 years. The characteristics of the subjects were phakic 72.5%, aphakic 1.25%, high myopia 23.75%, history of trauma 18.75% and affected to right eye 60%. Retinal characteristics were break conditions in the retina (located at superotemporal (34%), horseshoe tear (56%), and single break (60%)), macula off (90%), area of detachments were 4 quadrants (43,75%), PVR conditions were grade B PVR (45%), mean duration of RD was 156 days, mean length of surgery waiting list was 61.1 days. The majority of treatment types were vitrectomy (70,4%), majority of tamponade using silicone oil (59.3%), majority of pre-operative and post-operative visual acuity were less than 3 meters counting finger, pre-operative (91.25%) , post-operative 1 month (76%) and 6 months (52.5%), and the majority of post-operative retinal reattachment were 77.3%. \u0000Conclusion: The results of this study indicate the number of RD patients with PVR was lower than previous studies. Various results of patient characteristics can be used as guidelines for ophthalmologists in determining actions and explaining the prognosis of the disease. Further research with a larger sample size and prospective methods will be better able to provide better results. \u0000Keywords: retinal detachment, proliferative vitreoretinopathy, characteristic pvr","PeriodicalId":33128,"journal":{"name":"IJRETINA International Journal of Retina","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83513840","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}
Pub Date : 2019-09-18DOI: 10.35479/ijretina.2019.vol002.iss002.70
A. Victor, Masniah Masniah, A. Djatikusumo, Elvioza Elvioza, G. Adriono, A. Yudantha, Mario Marbungaran Hutapea
Introduction: Diabetic Macular Edema (DME) is a manifestation of diabetic retinopathy and is the most common cause of vision loss in diabetics. The incidence of DME has a tendency to increase, concomitant with the prevalence of diabetes globally by more than 50% from 2000 to 2030. This study aims to evaluate the proportion of central macular thickness (CMT) improvement and visual acuity in DME patients treated with intravitreal bevacizumab (IVB) injection. Methods: This study is a retrospective descriptive study. The study was conducted in the Department of Ophthalmology at RSUP Cipto Mangunkusumo (RSCM) Jakarta. Data were obtained from the medical records of all diabetic retinopathy patients with macular edema who were treated with IVB at RSCM Kirana Vitreoretina Polyclinic on January – December 2017. Results: Of the 44 subjects, improvement in best corrected visual acuity (BCVA) occurred in 24 (54.54%) subjects at the first-month evaluation and 19 (43.18%) subjects at the third-month evaluation. CMT decreased in 37 (84.41%) subjects at the first-month evaluation and 35 (81.81%) subjects at the third-month evaluation. Conclusion: Visual acuity improvement and central macular thickness reduction 3 months after IVB injection. These results strengthen IVB injection to be an alternative to adjuvant therapy in DME. Keywords: Diabetic Macular Edema, Intravitreal Bevacizumab Injection
{"title":"Intravitreal Bevacizumab In Diabetic Macular Edema At RSUP Cipto Mangunkusumo in 2017","authors":"A. Victor, Masniah Masniah, A. Djatikusumo, Elvioza Elvioza, G. Adriono, A. Yudantha, Mario Marbungaran Hutapea","doi":"10.35479/ijretina.2019.vol002.iss002.70","DOIUrl":"https://doi.org/10.35479/ijretina.2019.vol002.iss002.70","url":null,"abstract":"Introduction: Diabetic Macular Edema (DME) is a manifestation of diabetic retinopathy and is the most common cause of vision loss in diabetics. The incidence of DME has a tendency to increase, concomitant with the prevalence of diabetes globally by more than 50% from 2000 to 2030. This study aims to evaluate the proportion of central macular thickness (CMT) improvement and visual acuity in DME patients treated with intravitreal bevacizumab (IVB) injection. \u0000Methods: This study is a retrospective descriptive study. The study was conducted in the Department of Ophthalmology at RSUP Cipto Mangunkusumo (RSCM) Jakarta. Data were obtained from the medical records of all diabetic retinopathy patients with macular edema who were treated with IVB at RSCM Kirana Vitreoretina Polyclinic on January – December 2017. \u0000Results: Of the 44 subjects, improvement in best corrected visual acuity (BCVA) occurred in 24 (54.54%) subjects at the first-month evaluation and 19 (43.18%) subjects at the third-month evaluation. CMT decreased in 37 (84.41%) subjects at the first-month evaluation and 35 (81.81%) subjects at the third-month evaluation. \u0000Conclusion: Visual acuity improvement and central macular thickness reduction 3 months after IVB injection. These results strengthen IVB injection to be an alternative to adjuvant therapy in DME. \u0000 \u0000Keywords: Diabetic Macular Edema, Intravitreal Bevacizumab Injection","PeriodicalId":33128,"journal":{"name":"IJRETINA International Journal of Retina","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86906857","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}
Pub Date : 2019-02-28DOI: 10.35479/IJRETINA.2019.VOL002.ISS001.58
Triwijayanti Triwijayanti, A. Djatikusumo, A. Victor, Elvioza Elvioza, G. Adriono, A. Yudantha, Mario Marbungaran Hutapea
Background: Injection of Silicon oil is a standard procedure for vitreous replacement in vitrectomy procedure for retinal detachment cases. It acts as a great tamponading agent for reattachment of retinal breaks or retinal detachment. Despite its minor side effect, silicon oil could cause several complications such as cataract, endothelia decompensation, increased intraocular pressure, and secondary glaucoma. Thus needed to be evacuated after the retinal reattachment is stabilized. Following evacuation procedure, visual acuity are known to be significantly improved. However, some cases shows decreased of visual acuity due to retinal redetachment, optic nerve damage due to secondary glaucoma, hypotonym vitreous hemorrhage, expulsive hemorrhage, and cornea abnormality. Methods: A retrospective descriptive study of retinal detachment patients underwent silicon oil evacuation procedure in Cipto Mangunkusumo Hospital, Indonesia from September 2017 until Januari 2018. Results: There were seventy seven cases of retinal detachment undergoes silicon oil evacuation within period of September 2017-Januari 2018. There were improvement of visual acuity (greater than 6/60) after one month of silicon oil evacuation. Anatomical retinal reattachment was successfully observed in 91% patient. The most occuring complication after silicon oil evacuation includes secondary glaucoma and retinal redetachment. Conclusion: Silicon oil evacuation is a standard procedure following a vitrectomy in retinal detachment cases. The evacuation procedure yields in positive benefit for patient in term of visual acuity and anatomical structure.
{"title":"The Evaluation of Silicon Oil Evacuation Procedure In Cipto Mangunkusumo Hospital Indonesia","authors":"Triwijayanti Triwijayanti, A. Djatikusumo, A. Victor, Elvioza Elvioza, G. Adriono, A. Yudantha, Mario Marbungaran Hutapea","doi":"10.35479/IJRETINA.2019.VOL002.ISS001.58","DOIUrl":"https://doi.org/10.35479/IJRETINA.2019.VOL002.ISS001.58","url":null,"abstract":"Background: Injection of Silicon oil is a standard procedure for vitreous replacement in vitrectomy procedure for retinal detachment cases. It acts as a great tamponading agent for reattachment of retinal breaks or retinal detachment. Despite its minor side effect, silicon oil could cause several complications such as cataract, endothelia decompensation, increased intraocular pressure, and secondary glaucoma. Thus needed to be evacuated after the retinal reattachment is stabilized. Following evacuation procedure, visual acuity are known to be significantly improved. However, some cases shows decreased of visual acuity due to retinal redetachment, optic nerve damage due to secondary glaucoma, hypotonym vitreous hemorrhage, expulsive hemorrhage, and cornea abnormality. \u0000Methods: A retrospective descriptive study of retinal detachment patients underwent silicon oil evacuation procedure in Cipto Mangunkusumo Hospital, Indonesia from September 2017 until Januari 2018. \u0000Results: There were seventy seven cases of retinal detachment undergoes silicon oil evacuation within period of September 2017-Januari 2018. There were improvement of visual acuity (greater than 6/60) after one month of silicon oil evacuation. Anatomical retinal reattachment was successfully observed in 91% patient. The most occuring complication after silicon oil evacuation includes secondary glaucoma and retinal redetachment. \u0000Conclusion: Silicon oil evacuation is a standard procedure following a vitrectomy in retinal detachment cases. The evacuation procedure yields in positive benefit for patient in term of visual acuity and anatomical structure.","PeriodicalId":33128,"journal":{"name":"IJRETINA International Journal of Retina","volume":"29 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72567755","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}
Pub Date : 2019-02-28DOI: 10.35479/IJRETINA.2019.VOL002.ISS001.60
Ressa Yuneta, T. Gondhowiardjo, R. Dharma, S. Jusman, J. Prihartono, A. Victor
Purpose: to assess the levels of Hypoxia-inducible factor-1α (HIF-1α) and intercellular adhesion molecule-1 (ICAM-1) in vitreous of proliferative diabetic retinopathy patients which were given intravitreal bevacizumab (IVB), as well as its relation to the central macular thickness (CMT) measured prior to vitrectomy. Methods: thirty-two eyes were randomized into two groups, one that received an IVB injection at 1-2 weeks previtrectomy and the control group which did not receive any injection. Measurement of HIF-1α and ICAM-1 was conducted using enzyme-linked immunosorbent assay (ELISA). The CMT were measured at the initial visit, prior to vitrectomy, and at follow up time (2, 4, and 12 weeks postoperatively) using Stratus OCT. Results: The mean levels of HIF-1α vitreous (ng/mg protein) in the control group and IVB respectively 0.020 (0.006; 0.077) and 0.029 (0.016; 0.21). Vitreous levels of ICAM-1 (ng /mL) in control group and IVB group were 20.10 (3.41; 40.16) and 23.33 (0.63; 68.5). The mean levels of HIF-1α and ICAM-1 vitreous obtained did not differ significantly between the two groups. Conclusion: The levels of HIF-1α and ICAM-1 in PDR patients do not decrease after one injection of intravitreal Bevacizumab 1-2 weeks prior to vitrectomy. The concentration of vitreous HIF-1α and ICAM-1 are not directly related to the CMT.
{"title":"LEVELS OF HYPOXIA INDUCIBLE FACTOR-1α (HIF-1α) AND INTERCELLULAR ADHESION MOLECULE-1 (ICAM-1) AFTER INTRAVITREAL BEVACIZUMAB IN PROLIFERATIVE DIABETIC RETINOPATHY","authors":"Ressa Yuneta, T. Gondhowiardjo, R. Dharma, S. Jusman, J. Prihartono, A. Victor","doi":"10.35479/IJRETINA.2019.VOL002.ISS001.60","DOIUrl":"https://doi.org/10.35479/IJRETINA.2019.VOL002.ISS001.60","url":null,"abstract":"Purpose: to assess the levels of Hypoxia-inducible factor-1α (HIF-1α) and intercellular adhesion molecule-1 (ICAM-1) in vitreous of proliferative diabetic retinopathy patients which were given intravitreal bevacizumab (IVB), as well as its relation to the central macular thickness (CMT) measured prior to vitrectomy. \u0000Methods: thirty-two eyes were randomized into two groups, one that received an IVB injection at 1-2 weeks previtrectomy and the control group which did not receive any injection. Measurement of HIF-1α and ICAM-1 was conducted using enzyme-linked immunosorbent assay (ELISA). The CMT were measured at the initial visit, prior to vitrectomy, and at follow up time (2, 4, and 12 weeks postoperatively) using Stratus OCT. \u0000Results: The mean levels of HIF-1α vitreous (ng/mg protein) in the control group and IVB respectively 0.020 (0.006; 0.077) and 0.029 (0.016; 0.21). Vitreous levels of ICAM-1 (ng /mL) in control group and IVB group were 20.10 (3.41; 40.16) and 23.33 (0.63; 68.5). The mean levels of HIF-1α and ICAM-1 vitreous obtained did not differ significantly between the two groups. \u0000Conclusion: The levels of HIF-1α and ICAM-1 in PDR patients do not decrease after one injection of intravitreal Bevacizumab 1-2 weeks prior to vitrectomy. The concentration of vitreous HIF-1α and ICAM-1 are not directly related to the CMT.","PeriodicalId":33128,"journal":{"name":"IJRETINA International Journal of Retina","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81862914","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}
Pub Date : 2019-02-28DOI: 10.35479/IJRETINA.2019.VOL002.ISS001.52
S. Nusanti, M. Sidik, A. Djatikusumo, E. Aditya
Introduction: Retinitis pigmentosa (RP) is a hereditary disorder that diffusely involve photoreceptor and retinal pigment epithelial (RPE). It is characterized by progressive visual field loss and abnormal ERG. Unilateral RP is a rare condition that is usually sporadic. Clinical presentation and ancillary test results are similar to bilateral RP, with only one eye affected. In making the diagnosis of unilateral RP, clinicians must be able to rule out secondary causes, document a normal ERG in the unaffected eye, and follow-up the patient for at least 5 years to rule out bilateral but asymmetric disease. the aim of this case report is how to diagnose a rare case unilateral RP from clinical examination and ancillary tests. Methods: We report a case of a 33-year-old female with slowly progressive restriction of visual field of the left eye in the last one year before admission. Ophthalmological examination of the left eye revealed bone spicules spreading to peripheral fundus. Visual field examination revealed severely constricted visual field of the left eye. The multifocal electroretinogram (mfERG) examination showed severely depressed ERG function with reduced foveal responses. The fellow eye was within normal limit. Results: Patient was diagnosed with unilateral RP and must be followed-up for at least five years to rule out bilateral yet asymmetric disease. Making diagnosis of unilateral RP become one of the challenging case. Clinicians must be able to rule out the secondary causes that also have unilateral pigmentary retinal degeneration. Conclusion: With a good clinical examination and some simple ancillary tests, we could correctly diagnose unilateral RP. However, in this case we still need five years follow up to rule out bilateral RP yet asymmetric disease.
{"title":"A Rare Case of Unilateral Retinitis Pigmentosa","authors":"S. Nusanti, M. Sidik, A. Djatikusumo, E. Aditya","doi":"10.35479/IJRETINA.2019.VOL002.ISS001.52","DOIUrl":"https://doi.org/10.35479/IJRETINA.2019.VOL002.ISS001.52","url":null,"abstract":"Introduction: Retinitis pigmentosa (RP) is a hereditary disorder that diffusely involve photoreceptor and retinal pigment epithelial (RPE). It is characterized by progressive visual field loss and abnormal ERG. Unilateral RP is a rare condition that is usually sporadic. Clinical presentation and ancillary test results are similar to bilateral RP, with only one eye affected. In making the diagnosis of unilateral RP, clinicians must be able to rule out secondary causes, document a normal ERG in the unaffected eye, and follow-up the patient for at least 5 years to rule out bilateral but asymmetric disease. the aim of this case report is how to diagnose a rare case unilateral RP from clinical examination and ancillary tests. \u0000Methods: We report a case of a 33-year-old female with slowly progressive restriction of visual field of the left eye in the last one year before admission. Ophthalmological examination of the left eye revealed bone spicules spreading to peripheral fundus. Visual field examination revealed severely constricted visual field of the left eye. The multifocal electroretinogram (mfERG) examination showed severely depressed ERG function with reduced foveal responses. The fellow eye was within normal limit. \u0000Results: Patient was diagnosed with unilateral RP and must be followed-up for at least five years to rule out bilateral yet asymmetric disease. Making diagnosis of unilateral RP become one of the challenging case. Clinicians must be able to rule out the secondary causes that also have unilateral pigmentary retinal degeneration. \u0000Conclusion: With a good clinical examination and some simple ancillary tests, we could correctly diagnose unilateral RP. However, in this case we still need five years follow up to rule out bilateral RP yet asymmetric disease.","PeriodicalId":33128,"journal":{"name":"IJRETINA International Journal of Retina","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78045242","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}
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