International Journal of Retina
ISSN : 26148684     EISSN : 26148536
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.
Articles
17
Articles
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.

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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Abstract

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.

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
Publisher : International Journal of Retina

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Abstract

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.

Intraocular Foreign Fody : A case Series

Purnama Sari, Mega Wulan, Sovani, Iwan, Kartasasmita, Arief, Iskandar, Erwin, Virgana, Rova, 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: The incidence of Intraocular Foreign Body (IOFBs) among open-globe injuries ranges from 18% to 41%. In addition to clinical examination at the slit-lamp and indirect ophthalmoscopy, various imaging modalities are valuable for the identification and localization of IOFB. Vision loss can be devastating as a result of endophthalmitis, retinal detachment or proliferative vitreoretinopathy (PVR). Timely and appropriate management often leads to favorable anatomic outcomes with restoration of good visual function in the majority of cases. This case report presents the clinical and diagnostic finding, management, outcomes and further plan of the patients with posterior segment IOFB. Purpose: To report some cases of posterior segment intraocular foreign body. Case report: Three patients with history of ocular  trauma of the right eye that happened at workplace. All of patients were men in age range 20-55 years old . There were also loss of vision, pain, redness, and from ophthalmological examinations revealed two scleral injuries and one corneal injury that suggest an IOFB in posterior segment. Two patients were suggest endophtalmitis before operation. The plain x ray film examination showed intraocular foreign body in the right eyes. The Ultrasonography (USG) examination also showed intraocular foreign body in the right eyes. All of patient were underwent pars plana vitrectomy. Durante operation 2 of 3 patients were succeed to extract IOFB from the posterior segment, while one patient was not. Conclusion: Preoperative, intraoperative and postoperative management should be done correctly for some cases of IOFB. Prompt treatment and full assessment of patients is important to provide good prognosis.

Outcome of Vitrectomy Surgery in Dropped Nucleus at Jakarta Eye Center

Agustiawan, Referano, Elvioza, Elvioza, Sjamsoe, Soedarman, Girsang, Waldensius

International Journal of Retina Vol 1 No 2 (2018): International Journal of Retina (IJRetina) - INAVRS
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Abstract

Introduction: To report management and outcome of dropped nucleus in Jakarta Eye Center Methods: Retrospective review of the records of 19 consecutive patients who underwent pars plana vitrectomy for retain lens fragments at Jakarta Eye Center from January 2010 to September 2012.  Result: The mean age of the patient was 57 years (range 48-79). There were 10 males (53%) and 9 females (47%). 10 patients (53%) had vitrectomy within 1 day of phacoemulsification, 6(32%) within 1 week and 3(15%) after more than 1 week. Eight patients (42%) achieved a final visual acuity of 0.5 or better, only 3 patients (15%) had final visual acuity 1-meter finger counting or worse. 74% patient achieved final acuity better than pre-op (14 patients). Early vitrectomy group has 3 patients (30%) with complication, intermediate vitrectomy group has 33% complication and late vitrectomy has 33 % complication. Posterior chamber IOL were implanted in 12 patients (63%), 2 patients had scleral fixation IOL, anterior chamber IOL in 2 patients, and only 3 patients (16%) were left aphakic. Conclusion: Surgical management in cases of nucleus drop in JEC showed good result with very limited complications.  In most cases, vitrectomy was performed immediately after cataract surgery. Early vitrectomy has no significant differences in complications and visual outcome than 1 week vitrectomy and late vitrectomy after cataract surgery.  

Management of Rhegmatogenous Retinal detachment with Buckle Sclera and Cryoretinopexcy

Mutiara, Ria, Amin, Ramzi

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: Retinal detachment is divided into three categories. The most common type is the regmatogen retinal detachment (rhegmatogenous retinal detachment), which is the result of the tearing of the retinal lining. Actions can be Buckle Sclera, vitrectomy pars plana and pneumatic retinopexy. The purpose of this case report to reported Management of Rhegmatogenous Retinal detachment with Buckle Sclera and Cryoretinopexcy. Method: A 58 years old man with chief complaint The left eye blurred like a curtain covered since 5 days,floaters (+), photopsia (+),headache (+), Patients never complain of lost vision suddenly before, eyeball pain is not there.History of trauma (+),On examination, the visual acuity 6/9 RE and 1/60 LE, anterior segment lens cloudy (+)nuclaer gr III, fundus photograph we found retinal contours of the blood vessels well, tear (+) is directed at 2-3 hours of superior-temporal and fovea reflex (-), B-scan ultrasound of the posterior segment the retina is not intact, Membran like lession detachment which attach to optic nerve. Results: The Sclera buckles and cryoretinopexy were performed under general antesthesia. Visual acuity post-operative on left eye 2/60. subconjunctival bleeding (+), the fundus photographs retinal attach but the macular reflex is still negative. post-operative theraphy with topical steroid and antibiotic eye drops, oral antibiotic, and oral analgetic. follow up 1-month post-operative visual acuity 5/60 with fundus photograph obtained retina attach. Conclusion: a diagnosis of retinal detachment can be found, with the discovery of fullthickness breaks or defects occurring from the retinal neurosensory, this break will allow the vitreous to enter the defect gap between the retinal neurosensory and RPE. Based on the clinical features of the posterior segment, the detachment area was found with the location of the Linchoff Rule 2 break based on the American Academy of Ophthalmology. The objective of operative therapy was to reattach the retinal portion of which one of them was buckle sclera and cryoretinopexcy.

The Difference of Visual Field Defect on Diabetic Retinopathy Patients Treated with Panretinal Laser Photocoagulation with 20-Milisecond and 100-Milisecond Duration

Herdana, Nova, Ansyori, AK, Amin, Ramzi, Saleh, Irsan

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: Panretinal laser photocoagulation (PRP) is a standard treatment for severe nonproliferative and proliferative diabetic retinopathy. Twenty-milisecond duration PRP show same effectiveness with 100-ms standard PRP in inhibit neovascularization progression. This shorter pulse tend to minimize retinal neuronal defect and visual field defect. This study aim to analyze the difference of visual field defect in diabetic retinopathy (DR) patients treated with 20-ms PRP compared with 100-ms PRP in Moh. Hoesin Hospital Palembang. Methods: A clinical trial with single blinding on severe-very severe NPDR and early PDR eyes treated with PRP between June and August 2016. Forty eyes (25 patients) were randomized into two groups. Twenty eyes were treated with 20-ms PRP, and other 20 eyes treated with 100-ms PRP. Visual field defect was evaluated using Humphrey Field Analyzer 30-2 SITA Standard at baseline and 2 weeks follow-up. Result: Unpaired t-test showed significant difference in mean deviation (MD) after laser on NPDR eyes (p=0.042, p<0.05), meanwhile there was no significant difference in early PDR eyes (p=0.17, p>0.05). In NPDR eyes, more MD improvement was found in 20-ms PRP group (0.79±0.93 dB) than in 100-ms group (-0.04±0.61 dB). In early PDR eyes, MD improvement was bigger (1.0±0.88 dB) in 20-ms PRP group than in 100-ms group (0.10±1.47 dB). There was no significant difference in pattern standard deviation (PSD) on both group at any DR grade (p=0.208; p=0.201; p>0.05). Conclusion: After 2 weeks, 20-ms PRP caused more improvement and lesser visual field defect (p=0.042, p<0.05) on NPDR eyes. There was no significant difference in PSD on both groups.

Anti-VEGF Therapy In Central Retinal Vein Occlusions

Rahmah, Meidina, Amin, Ramzi, Ansyori, AK

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: Central retinal vein occlusion (CRVO) is the second most common retinal vascular disease after diabetic retinopathy and is estimated to affect more than 16 million adults worldwide. Treating the underlying cause of occlusion of the central retinal vein, reducing the risk factors, and early and proper management are the keys toward a better prognosis in patients with CRVO. Repeated frequent treatment of CRVO with macular edema with intravitreal anti-vascular endothelial growth factor (anti-VEGF) is an effective treatment to improve visual outcome. In this case report we assess the 3-month efficacy of anti-VEGF therapy in CRVO. Method: In this case, a 52-year-old man presented with an acute loss of vision over the last week in his left eye. His baseline visual acuity was 1/60 and his central retinal thickness (CRT) on Optical Coherence Tomography (OCT) was 523 μm. Fundus examination revealed a hemorrhage in all four quadrants, hard exudates, swelling of the optic nerve, and macular edema. Laboratory test confirms hyperlipidemia and we consult this patient to Internal Medicine Department. This patient got 3 monthly injections of 1,25 mg Bevacizumab. Results: By 3 months, the OCT appeared fairly normal and the visual acuity improved to 6/60 Conclusion: Anti-VEGF therapy is effective for treating macular edema secondary to CRVO

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.