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International Journal of Retina
ISSN : 26148684     EISSN : 26148536     DOI : -
Core Subject : Health, Science,
International Journal of Retina is an open access journal, accepting article in English language from all over the worlds. The aims is to provide international researchers in the field of basic and clinical research in ophthalmology, especially retina to publish the original article.
Arjuna Subject : -
Articles 17 Documents
The Outcome of Vitrectomy in Acute Postoperative Endophthalmitis Sembiring, Sindy Boru; Aziza, Yulia; Adriono, Gitalisa Andayani
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Abstract

Introduction: Twenty years ago, the results of Endophthalmitis Vitrectomy Study (EVS) were adapted worldwide as the standard management of endophthalmitis. The study suggested that there was no benefit of performing vitrectomy for acute postoperative endophthalmitis, unless for patients who presents with visual acuity of light perception. However, vitrectomy with advanced technology and technique has been changed rapidly in the last decades; therefore, we need to reconsider its role. We conducted a study and the purpose of our study was to describe the indications for vitrectomy and the outcomes in acute postoperative endophthalmitis at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Methods: Our study was a descriptive-retrospective case series. We reviewed clinical and microbiological records of all patients with clinical diagnosis of acute postoperative endophthalmitis who underwent vitrectomy in Cipto Mangunkusumo Hospital between 2007 and September 2015.  Presenting visual acuity, visual outcome and complications were described. Result: Our study was a descriptive-retrospective case series. We reviewed clinical and microbiological records of all patients with clinical diagnosis of acute postoperative endophthalmitis who underwent vitrectomy in Cipto Mangunkusumo Hospital between 2007 and September 2015.  Presenting visual acuity, visual outcome and complications were described. Conclusion: An eight-year experience has taught us that vitrectomy offers better treatment outcome in the group with visual acuity of hand movement than those who only had visual acuity of light perception.
Giant Retinal Tear Management at Referral Eye Hospital Purnama, Mia; Iskandar, Erwin; Virgana, Rova; Ihsan, Grimaldi; Sovani, Iwan; Kartasasmita, Arief
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Introduction: to report the characteristics, management and outcome in giant retinal tear (GRT) associated retinal detachment patients at Cicendo Eye Hospital Methods: this retrospective study was performed on medical records who had undergone retinal detachment surgery between January 2014 and March 2017. Age, sex, etiologies, size of GRT, quadrant involvement, lens status, proliferative vitreo-retinopathy (PVR), managements and outcomes were evaluated in association with giant retinal tears Result: Twenty-six patients (23 males, 3 females) age between 11-59 years with follow up from 2 months to 18 months were enrolled in this study. Twenty-five eyes have retinal detachment with macular involvement and 11 patients had high myopia. Majority of patients had 90° of GRTs. Most retinal tears were located at temporal quadrant (73%). Nineteen patients had undergone pars plana vitrectomy (PPV) and 7 patients had combined PPV with encircling buckle. Fifteen patients had used heavy liquid, 24 patients had silicon oil and 2 had gas tamponade. Intraoperative complications included lens trauma, retinal slippage and choroidal detached were found in 1 eye respectively. Fourteen eyes had recurrent retinal detachment. At the last follow up, 14 patients had anatomically attached retina. Twelve patients had total retinal detachment and marked PVR. Five fellow eyes were treated with prophylactic laser. Visual acuity improved in 11 eyes. Conclusion: Giant retinal tears were more common in patients with high myopia. Management of GRT currently with PPV and PPV combined with encircling buckle. The success rate of anatomy and visual acuity was less than other previous studies
Polypoidal Choroidal Vasculopathy Metita, Mirza; Kitagawa, Yorihisa; Shimada, Hiroyuki; Nakashizuka, Hiroyuki
International Journal of Retina Vol 1 No 2 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Abstract

Introduction: to report a case of PCV that has been successfully treated with intravitreal injection of  t-PA,  ranibizumab, and pneumatic displacement. Method: A 65 years old man presented with blurred vision of his right eye. No systemic abnormalities were found. Initial visual acuity RE was  6/18. Funduscopy examination showed submacular hemorrhage in posterior pole. OCTA,  FA and ICG confirmed the diagnosis of PCV. We performed anterior chamber paracentesis and intravitreal injection of 0,05 ml t-PA,  0,05 ml ranibizumab, and 0,3 ml 100% C3F8 at a  time in retrobulbar anesthesia. The patient was instructed to maintain face down positioning for 2 days. Results: We evaluated the visual acuity, central retinal thickness (CRT), and central pigment epithelial detachment  (PED) thickness for 2 years. The visual acuity was increasing  gradually from 6/18 to 6/6 in the first year. The  hemorrhage was displaced completely, the CRT and central PED thickness  were decreased. In the second year the patient  had recurrence of PCV with serous retinal detachment and treated  with intravitreal aflibercept. Conclusion: Combined treatment of intravitreal t-PA, ranibizumab, and C3F8 can be used as a beneficial  therapy for PCV.
Correlation Between Systemic Risk Factors and Diabetic Retinopathy in Patients with Diabetes Mellitus at Cicendo National Eye Hospital Nauli, Rizki Rahma; Virgana, Rova; Kartasasmita, Arief; Sovani, Iwan; Iskandar, Erwin; Ihsan, Grimaldi
International Journal of Retina Vol 1 No 2 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Abstract

Introduction: Diabetic Retinopathy (DR) is a highly specific microvascular complication of both type 1 and type 2 diabetes mellitus (DM) that can cause significant visual impairment in adult populations worldwide. The risk of having and/or developing DR is influenced by many systemic features. Identification and management of particular systemic risk factors as early as possible during the course of DM might lower incidence of further progression and severity of DR. The aim of this study is to describe the correlation between systemic risk factors and DR in patients with DM in Cicendo National Eye Hospital on December 1st 2017 – January 31st 2018. Methods: An analytical cross-sectional study. The subjects were all patients diagnosed with DR based on ophthalmology examination at outpatient clinic of Vitreoretinal Division in Cicendo National Eye Hospital. The data were analyzed using chi-square (x2) with significances of p < 0.05. Result: Seventy-one eyes were included in this study, among of which has been classified as mild NPDR (n= 1), moderate NPDR (n= 9), severe NPDR (n= 27), and PDR (n= 34). Severe NPDR group had older age distribution at range 51-60 years old (n= 18, 66.7%, p = 0.001). Stage 1 hypertension was found to be dominant in PDR group (n= 18, 66.7%, p = 0.043). Both high total serum cholesterol group (n= 27, 76.5%, p = 0.048) and high fasting blood glucose (n= 27, 79.4%, p = 0.01) were significantly present in patients with PDR. Positive (+1) urine glucose was statistically significant in PDR group. Conclusion: There were several systemic risk factors from laboratory findings correlated in patient with DR in this study, however further study is needed to determine their role for predicting progression and severity of DR.
Bilateral Exudative Retinal Detachment Due to Hypertensive Retinopathy and Choroidopathy In Young Patient with Chronic Kidney Disease Kartikasari, Indha Dwi; Dewi, Nadia Artha; Metita, Mirza; Refa, Safaruddin
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Introduction: Severe systemic hypertension in chronic kidney disease can cause significant damage to the eye. Although hypertensive retinopathy is a well-known complication, hypertensive optic neuropathy and choroidopathy are much less common. The aim of this study is to report retinal manifestation in young patient with chronic kidney disease. Method: A 26-year-old man with underlying disease chronic kidney disease (CKD) gr-V underwent bilateral bullous exudative retinal detachments. Retinal arteriolar narrowing, vascular tortuosity, arteriovenous nicking, optic disc swelling, retinal haemorrhage, elschnig spot, siegrist streak were identified in both eyes. Blood pressure was 200/140mmHg with visual acuity 0,5/60 OU. The patient was diagnosed with bilateral hypertensive retinopathy and choroidopathy with bulous exudative retinal detachments. Results: After antihypertensive treatment, visual acuity improved, but the exudative retinal detachments and retinal hemorrhages reduced. A patient with those findings should be considered as having hypertensive retinopathy and choroidopathy and treated as soon as possible because of the poor prognostic. Conclusion: Hypertensive choroidopathy is a rare finding associated with acute increases in blood pressure. When the choroid is associated, the hypertensive event is often more acute and associated with increased morbidity. It is necessary to obtain fundus exam in any patient with elevated blood pressure and concomitant vision complaints. Therefore, screening hypertensive patients involves close collaboration between internist and ophthalmologist.
Resolution of Retinal Bleeding And Exudative Retinal Detachment After Chemotherapy with Melphalan In Multiple Myeloma Andayani, Ari; Budhiastra, I Putu; Adnyana, I Wayan Losen; Wijayati, Made Paramita
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Introduction: Multiple myeloma is the second most common hematologic cancer. It is characterized by the clonal proliferation of malignant plasma cells and associated organ dysfunction. Ophthalmic manifestations include hyperviscosity retinopathy and retinal detachment. The aim of this study is to report retinal manifestation in Multiple Myeloma. Methods: A man 45 years old, complained loss of vision on both eyes especially left eye over 1 month. He also feels weakness and 3 times spontaneous nose bleeding. His visual acquity is 6/12 on the right and 2/60 left eye with Retinal Bleeding and Retinal Detachment. His Laboratory examination result increase in WBC 65.91 x 103/µL (Neutrophil, Monocyte, Basophil and Lymphocyte) decrease RBC 3 x 106/µL, HGB 6.85 g/dL, normal PLT 193.60 103/µL, Normal Bleeding and Clotting Time and increase ESR 140 mm/hour. Multiple myeloma was diagnosed by Internal Department with bone marrow biopsy and increase of Gamma Globulin. Results: The patient was treated with melphalan 3 tablet 2 times a day and prednisone 4 mg 3 times a day for 5 days every 28 days.  After 8 month the VA 6/6 on the right and 6/10 on the left with complete resolution of on the right eye and there are resolution on the left eye with fibrosis, the laboratory examination normal WBC 3.8 x 103/µL with Neutrophil 59.3%, Monocyte 6.1 %, Eosinophil 6.3 %, Basophil 0.3 % and Lymphocyte 28.0 %, normal RBC 4.6 x 106/µL, slightly decrease HGB 12.8 g/dL, normal PLT 177.0 x 103/µL and decrease Gamma Globulin. Discussion: This case of bilateral Retinal Bleeding and Exudative Retinal Detachment are remarkable for both its presentation and response to melphalan therapy. Treatment with melphalan and prednison alone was sufficient to clear the Retinal Bleeding and restoration of Exudative Retinal Detachment. Conclusion: Complication of Multiple Myeloma can caused organ disfunction such as retinal bleeding and exudative retinal detachment. Early Diagnosis  is very crucial. In our case combination cemotheraphy with  Melphalan and Prednison showed clinically significant resolution. Workship Internal Department and Ophthalmology Department are very important for management and monitoring ophthalmology manifestation in multiple myeloma.
Profile of Patients with Floaters in Saiful Anwar Hospital Malang Hidayah, Fenti Kusumawardhani; Dewi, Nadia Artha; Refa, Safaruddin
International Journal of Retina Vol 1 No 2 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Introduction: To report the profile of patients with floaters as a subjective complain in Saiful Anwar Hospital from July 2012 until June 2013. Methods: an observasional descriptive study was conducted, collecting data on gender, age, subjective complain (floaters, flashes and subjective vision reduction), best corrected visual acuity and diagnose from patient’s medical record. Result: 169 patients (215 eyes) were included in this study. Female patients contributed a higher percentage than male with mean of age was 49 years old. The subjective complain was floaters (67%), floater with blurred vision (22%), floater with flashes (6%) and patients with floaters, flashes, and blurred vision was 5%. Myopia was the most common refraction problem. Diagnose recorded from this study were posterior vitreous detachment (PVD) (34%), no abnormalities (13%), PDR (10%), RRD (9%), peripheral retinal degeneration (14%) retinal break (6%), corpus vitreous degeneration (3%), vitreous haemorhage (3%), posterior uveitis (2%) and others (6%). Conclusion: The most common cause of floaters is PVD. Even it is usually a save condition but there are some condition with floater as a subjective complain which is threatening vision, so accurate eye examination from anterior to posterior segment were needed.
Branch Retinal Vein Occlusion with Vitreous Hemorrhage Identified During Intraoperative Vitrectomy Sukmono, Nafila Mahida; Amin, Ramzi
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
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Introduction Retinal vein occlusion is the largest group of retinal blood vessels after diabetic retinopathy. Occlusion occurring in the retinal vein is divided into central retinal vein occlusion (CRVO) occlusion and branch retinal vein occlusion (BRVO) occlusion. The Beijing Eye Study, reported a higher incidence of BRVO than CRVO, where 10-year incidents for BRVO were 1.6 per 100 subjects, and CRVO was only 0.3% 100 subjects.1 To report a case of Branch Retinal Vein Occlusion with vitreous hemorrhage identified during intraoperative vitrectomy Method: A 49-year-old woman with a history of 15 years of hypertension had right eye vision complaints, increasingly blurred since last 2 months. The right eye visual acuity 2/60 cannot be corrected and left eye 6/30 cannot be corrected. The posterior segment on right eye is difficult to assess. USG B-Scan right eye found vitreous echospike appearance of vitreous bleeding. We manage with vitrectomy and during intraoperative we identified bleeding and ghost vessel in superotemporal area. Bleeding in the superotemporal quadrant is done by photocoagulation laser action. Results: First day postoperative there was increased in visual acuity to 6/60 with a posterior segment that could be assessed, obtained tortous blood vessels, slight bleeding and ghost vessel in the superotemporal area with laser injury. Conclusion: In this case report, patients with BRVO with complications of vitreous hemorrhage performed vitrectomy with additional endolaser in the ischemic area. The result of this action of visual acuity improvement in patient.
Surgical Approach In Vitreous Hemorrhage Metita, Mirza; Sovani, Iwan; Kartasasmita, Arief; Iskandar, Erwin; Virgana, Rova
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Introduction: To report cases of retinal disorders that cause vitreous hemorrhage and the timing of pars plana vitrectomy in Cicendo Eye Hospital Methods: Retrospective observational study of all patients diagnosed with the vitreous hemorrhage who had undergone pars plana vitrectomy in 2016. Data were collected from medical record. Result: The mean age of this study is 54.65 years old from 260 vitreous hemorrhage patients. The most common retinal abnormalities are proliferative diabetic retinopathy (49.6%), wet age related macular degeneration (AMD) (13.5%), undetected retinal abnormalities (12.7%), retinal vein occlusion (8.8%), rhegmatogen retinal detachment (6.5%), trauma (3.45%), vasculitis (3.1%), idiopathic polypoidal choroidal vasculopathy (3.1%), and drop IOL (1.2%). PPV performed 1-3 months after initial assessment (31.25%), less than 1 month (13.2%), more than 3 months (14.6%) Conclusion: The most common etiology of vitreous hemorrhage is proliferative diabetic retinopathy. Pars plana vitrectomy was performed 1 – 3 months after an initial assessment of the patients.
Peripapillary Retinal Nerve Fiber Layer Thickness in Diabetic Retinopathy Patients measured by Optical Coherence Tomography Dwijayanti, Sindi; Kartasasmita, Arief; Sovani, Iwan; Iskandar, Erwin; Virgana, Rova; Ihsan, Grimaldi
International Journal of Retina Vol 1 No 2 (2018): International Journal of Retina (IJRetina) - INAVRS
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Introduction: Diabetic retinopathy (DR) is a microvascular complication of diabetes and one of the leading causes of blindness. Retinal function loss in diabetic patients is not only caused by microvascular abnormality but also retinal neurodegeneration. Optical coherence tomography (OCT) can detect retinal neural tissue loss caused by diabetes by measuring the retinal nerve fiber layer (RNFL) thickness on the cross-sectional imaging of the retina. This study is to evaluate the changes of peripapillary retinal nerve fiber layer (RNFL) thickness in diabetic retinopathy patients using OCT and compare it to age matched healthy controls. Methods: A cross-sectional study of 16 eyes from 11 diabetic retinopathy patients and 10 eyes from 7 aged matched healthy subjects for control. Patients underwent optic nerve OCT imaging, RNFL  thickness was recorded globally (average thickness) and segmented for superior, inferior, nasal, and temporal quadrants Result: There were no significant difference of  the average RNFL thickness in diabetic retinopathy group compared to healthy subjects. However, at the nasal quadrant, there were a significant increased thickness of RNFL compared to healthy subject (p value=0.009). Conclusion: Optical coherence tomography can be used to detect neurodegeneration progression in diabetic retinopathy patients by quantitatively measuring the peripapillary RNFL thickness. This can be used as a diagnostic and prognostic factor in cases of DR.

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