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All Journal Medicinus : Jurnal Kedokteran IJRETINA - International Journal of Retina Ophthalmologica Indonesiana
Djatikusumo, Ari
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Health Professions Medicine & Pharmacology Public Health

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Comparation of Bevacizumab Intravitreal Injection Effects with and without Yellow Subthreshold Micropulse Laser (577-nm) Combination on Central Macular Thickness and Best Corrected Visual Acuity of Mild-Moderate Diabetic Macular Edema Patients UTAMI, ALIA NESSA; Djatikusumo, Ari; Khoe, Levina Chandra
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/ff95wf62

Abstract

Introduction & ObjectivesThe management of macular edema is constantly evaluated, with anti-VEGF therapy being the firstline. Subthreshold micropulse laser (SML) has been proposed as alternative adjuvant. Previousretrospective studies demonstrated the effectiveness of 577-nm SML as monotherapy in macularedema with CMT below 400 ?m. However, prospective data on the effectiveness of SML as adjuvantis lacking. The aim is to assess the effect of the combination of bevacizumab and 577-nm SML lasercompared to bevacizumab monotherapy on central macular thickness and visual acuity in mildmoderatediabetic macular edema patients. MethodsA prospective randomized clinical trial was performed on diabetic macular edema patients withmacular thickness range of 300-600 ?m. Subjects are divided into two groups. The control groupreceived a standard protocol and the study group received a yellow SML laser adjuvant one weekafter injection. Patients underwent follow-up assessment of visual acuity and central macularthickness at 28 and 35 days post-injection. Results26 subjects were equally divided into study and control groups. Significant decrease in CMT werefound in study group (p=0.011 and 0.014) and the control group (p=0.006 and p=0.001). However,there was no significant difference in ?CMT values between the two groups in the 28-day (p=0.317)and 35-day controls (p=0.84). There was no difference in ?BCVA ETDRS between the study andcontrol groups at 28 days (p=0.568) and 35 days (p=0.128) after injection. ConclusionThe combination of SML and intravitreal bevacizumab can reduce central macular thickness andimprove visual acuity but there was no significant difference with standard monotherapy.
Combined Virna Glaucoma Implant (VGI) Implantation and Pars Plana Vitrectomy for Refractory Aphakic Glaucoma: Poster Presentation - Case Report - Resident Herdian, Felicia Sesih; Augiani, Amani Sakinah; Lumintang, Agnesstacia Vania; Iskandar, Ferdy; Oktariana, Virna Dwi; Djatikusumo, Ari
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/7e24y445

Abstract

Introduction : Glaucoma drainage devices (GDDs) implantation are frequently indicated for refractory glaucoma. The preferable anterior chamber may be inaccessible for patients with anterior chamber abnormalities. Case Illustration : A 6-year-old boy presented with high intraocular pressure (IOP) on the right eye (RE) four months before admission. Cataract surgery on both eye was done four years prior, due to congenital cataract. On examination, the visual acuity of the RE was hand movement with IOP 61mmHg with medications. Anterior chamber was shallow, posterior synechiae was found and posterior segment was hard to be evaluated. The fellow eye was nonfunctional with IOP 31mmHg. Pars plana vitrectomy (PPV) was performed followed by implantation of GDD (Virna Glaucoma Implant) with posterior chamber sulcus tube placement without adding a new incision. Post-operatively, IOP was 3mmHg and choroidal detachment was found. With steroid medication, satisfactory IOP control was achieved within three weeks of follow-up. Visual acuity of RE was improved to 0.5/60. Discussion : In eyes with shallow anterior segments, tube placed in the anterior chamber may increase the risk of corneal endothelial injury. Placement of the silicone tube in the posterior chamber sulcus is an effective alternative technique. Although it is relatively safe in experienced hands, vitrectomy and insertion of the tube into the posterior segment carries significant risks, including choroidal detachment. Careful monitoring and management is needed to control IOP and maintain vision. Conclusion : Combined GDD implantation and PPV may be considered for refractory aphakic glaucoma, showing favorable outcomes with a relatively safe procedure.
Classic Choroidal Neovascularization in Young Man: Poster Presentation - Case Report - Resident Mawarasti, Burhana; Augiani, Amani Sakinah; Pratiwi, Rianti Wulandari; Djatikusumo, Ari
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/kw1xdq52

Abstract

Introduction : Classic choroidal neovascularization (CNV 2) represent a pathological growth of blood vessels and can result in loss of visual function. The most common cause of CNV 2 in elderly patients is age- related macular degeneration, meanwhile in young age it is frequently due to inflammation, high myopia, angioid disks and hereditary disorders. Hence, the presented case reports the characteristic findings as well the management of the disease. Case Illustration : A 37-year-old man had two weeks history of metamorphopsia on both eyes. The left eye (LE) had a worse visual acuity, macular fibrosis with pigment epithelial detachment in funduscopy and Optical Coherence Tomography (OCT). A submacular hemorrhage and exudative lesion were recognized on the right eye (RE) with type 2 choroidal neovascularization. Fundus Fluorescence Angiography (FFA) was also performed. Systemic conditions were unremarkable. Intravitreal anti-VEGF injections on RE were given for three consecutive months and showed significant improvement. Discussion : The etiology of CNV 2 includes high myopia, and inflammation. However, none was found in this patient. Nonetheless, CNV type 2 is still uncommon in young age without predisposing conditions. As most common lesions involve the macula, symptoms shown include metamorphopsia, central scotoma and floaters. FFA is still considered to be the gold standard to differentiate the types of choroidal vascularization. Neovascularization and submacular hemorrhage can be treated with intravitreal injection of anti-VEGF, as previous studies reported significant improvement. Conclusion : This was a case of bilateral CNV type 2 in a young man without any previous predisposing conditions. Three monthly injections of anti-VEGF showed significant improvement.
An Uneventful Case of Unresolved Suprachoroidal Hemorrhage After Cataract Surgery: When to Operate? Poster Presentation - Case Report - Resident Dearaini; Ivanovna, Regina; Lumintang, Agnesstacia Vania; Augiani, Amani Sakinah; Mawarasti, Burhana; Djatikusumo, Ari
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/tvhx6r93

Abstract

Introduction : Suprachoroidal hemorrhage (SCH) is a rare, but potentially vision-threatening condition. The management options for SCH varied and still debatable. Case Illustration : Female 54 years old with chief complaint blurry vision of right eye (RE) since four days after she underwent cataract surgery. She also experienced radiating pain from RE with nausea and vomiting. No history of elevated intraocular pressure (IOP) before the surgery. Her left eye was blind for 20 years prior due to an unknown cause. Visual acuity (VA) on presentation was light perception good projection and IOP was 34mmHg. There was 2.5mm hyphema and fibrin on the anterior chamber. Lens appeared to be aphakic and there was lens material at pupillary margin. Ultrasonography (USG) of RE showed choroidal elevation with medium to high spike and positive after movement indicating SCH. She was hospitalised for IOP monitoring and serial USG was performed to monitor the hemorrhage. Six days after admission, IOP remain elevated despite medications and SCH didn’t resolve, then vitrectomy and scleral drainage was performed. Postoperative exam showed improved VA to 0.5/60, IOP to 16mmHg without medication, and reduced suprachoroidal hemorrhage on USG. Discussion : It’s imperative to perform complete evaluation of ocular and systemic conditions in preoperative period to prevent SCH. Ultrasonography is crucial during the close follow-up after developing SCH, it also aids in the timing of surgical intervention. Conclusion : Vitrectomy with scleral drainage is a valuable approach in managing extensive SCH, a condition generally associated with poor prognosis.
MINIMIZING PROLIFERATIVE VITREORETINOPATHY REACTION IN RHEGMATOGENOUS RETINAL DETACHMENT: IS THERE A ROLE OF PREOPERATIVE ANTI-INFLAMMATORY? Djatikusumo, Ari; Wiyogo, Widya Artini
Majalah Oftalmologi Indonesia Vol 50 No 1 (2024): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/jdcsm470

Abstract

FACTORS INFLUENCING THE OUTCOMES OF RECURRENT RETINAL DETACHMENT AFTER PARS PLANA VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT AT CIPTO MANGUNKUSUMO NATIONAL GENERAL HOSPITAL IN INDONESIA Ziaulhak, Samsul Rizal; Adriono, Gitalisa Andayani; Victor, Andi Arus; Djatikusumo, Ari; Yudantha, Anggun Rama; Hutapea, Mario Marbungaran; Ayuningtyas, Sita Paramita; Harlena, Filza Amara Kamila
International Journal of Retina Vol 9 No 1 (2026): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2026.vol009.iss001.345

Abstract

Introduction: Recurrent retinal detachment (re-RD) after primary pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) remains a major surgical challenge with often unsatisfactory visual outcomes. This study aims to determine the incidence and identify factors influencing the anatomical and functional outcomes after surgical repair of re-RD. Methods: This retrospective, descriptive analytical study was conducted between October 2024 and December 2024 at RSUPN Cipto Mangunkusumo Hospital, Indonesia. We reviewed 368 RRD cases that underwent primary PPV between January 2022 and December 2023. Of these, 110 developed re-RD, and 72 cases that underwent at least one repair surgery were included. Detailed data on demographics, clinical status (BCVA, high myopia and lens status), and intraoperative details (number and location of tears, extent of RD, macula and proliferative vitreoretinopathy status, tamponade type, presence of choroidal detachment) were analyzed. BCVA was converted to LogMAR. Outcomes were assessed using paired t-test, Chi-square test, and multivariate logistic regression. Result: From this study, the incidence of re-RD was 29.9% (110/368). Following repair, the anatomical success rate (retina attached) was 75% (54/72). Multivariate analysis found that undergoing only one repair surgery (OR, 4.90; CI95%, 1.28–18.79; p=0.020) was the only factor significantly associated with better anatomical success. Functional outcomes improved statistically (median LogMAR 1.7 [0.5−2.3] to 1.7 [0.4−3.0]; p<0.001), but only 11.1% (8/72) of patients achieved BCVA of ≥6/60. Multivariate analysis showed macula-on status at the time of re-RD (OR 9.67; p=0.006) was the only significant predictor for better final functional outcomes. Conclusion: The anatomical and functional outcomes of re-RD management are comparable to reports from other countries. Prognosis is associated with macula status at the time of recurrence and the number of repair surgeries performed.
Pars Plana Vitrectomy Management of Dropped Nucleus or Dropped IOL After Cataract Surgery at Cipto Mangunkusumo National General Hospital in Indonesia Putri, Karniela Ayuni; Djatikusumo, Ari; Victor, Andi Arus; Andayani, Gitalisa; Yudantha, Anggun Rama; Hutapea, Mario Marbungaran; Harlena, Filza Amara Kamila
International Journal of Retina Vol 9 No 1 (2026): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2026.vol009.iss001.339

Abstract

Introduction: Dropped nucleus or dropped intraocular lens (IOL) are two potential complications of cataract surgery that threaten visual acuity and require further intervention. The standard procedure for both conditions is pars plana vitrectomy (PPV). This retrospective study aimed to describe the demographic, clinical characteristics, and treatment outcomes of dropped nucleus or dropped IOL cases after PPV at Cipto Mangunkusumo National General Hospital between January 2023 and December 2024. Methods: This retrospective descriptive study analyzed the medical records of 120 patients diagnosed with dropped nucleus or dropped IOL who underwent PPV. Data collected included demographics, visual acuity (logMAR), procedure characteristics, and postoperative complications. They were then analyzed using SPSS. Result: Out of 120 total cases (63 dropped nucleus, 57 dropped IOL), the patients were predominantly male with a mean age of ≈60 years old. Mean preoperative visual acuity was poor (1.84 logMAR for dropped nucleus, 1.81 logMAR for dropped IOL). ​​The primary surgical management for dropped nucleus was vitrectomy with endofragmentation (≈53% of total cases) and for dropped IOL, the main procedure was vitrectomy with IOL explantation (≈41% of total cases). The management of most dropped nucleus cases (65.07%) was done within ≤1 month, while dropped IOL cases were often delayed. Postoperative complications were infrequent (≈92% complication-free), with increased IOP (4.76–5.26%) and retinal detachment (1.58–1.75%) being the most common. Mean postoperative visual acuity showed improvement for both groups (1.81 logMAR for dropped nucleus and 1.77 logMAR for dropped IOL). Conclusion: PPV with appropriate adjunct procedures, such as endofragmentation or IOL explantation, is an effective and necessary treatment for dropped nucleus or dropped IOL, leading to an improvement in postoperative visual acuity outcomes with minimal to no postoperative complications.
RETINAL REATTACHMENT OF SCLERAL BUCKLING WITH OR WITHOUT SUTURES FOR RHEGMATOGENOUS RETINAL DETACHMENT AT CIPTO MANGUNKUSUMO NATIONAL GENERAL HOSPITAL IN INDONESIA Adikusuma, Wirawan; Adriono, Gitalisa Andayani; Victor, Andi Arus; Djatikusumo, Ari; Yudantha, Anggun Rama; Hutapea, Mario Marbungaran; Ayuningtyas, Sita Paramita; Harlena, Filza Amara Kamila
International Journal of Retina Vol 9 No 1 (2026): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2026.vol009.iss001.346

Abstract

Introduction: Rhegmatogenous Retinal Detachment (RRD) is a common, vision-threatening condition traditionally managed by Scleral Buckling (SB), Pars Plana Vitrectomy (PPV), or Pneumatic Retinopexy. SB is effective, however, it carries risks such as strabismus and buckle extrusion, often linked to the use of sutures. This study aimed to determine the outcomes and compare complications of SB with and without sutures for primary RRD cases. Methods: This was a retrospective, analytical cross-sectional study of 65 patients who underwent primary SB (alone or combined with PPV) at Cipto Mangunkusumo National General Hospital (RSCM) from January 2023 to December 2024. Data on demographics, clinical factors, anatomical success (retinal reattachment), functional success (BCVA), and complications were collected and analyzed using descriptive statistics and comparative tests (Chi-square, t-test/Mann-Whitney). Result: During the period, 65 RRD patients underwent the SB procedure. Subjects included 28 cases with sutures and 37 cases without. The mean age was 32.88 years, with a majority of male patients (73.8%) with a mean RRD duration of 17.82 weeks. Preoperative clinical findings showed a high rate of myopia, phakic status, RRD extent in 1 and 4 quadrants, single tear, macula-on, and PVR grade A, with preoperative visual acuity of 1.49 logMAR. The overall anatomical success rate was 76.9%. Statistically, there was no significant difference in retinal reattachment success between SB without sutures (75.7%) and SB with sutures (78.6%) (p=0.784). No demographic or clinical factors was found to significantly predict reattachment success. Postoperative complications included cataract (24.6%) and glaucoma (21.5%). Strabismus (4.61%) was only found in the SB with sutures group. No buckle extrusion occurred in either group. Conclusion: Scleral buckling provides a high enough anatomical success rate for RRD. The SB without sutures technique is equally effective in achieving retinal reattachment and shows a lower incidence of strabismus compared to SB with sutures, making it a viable option for RRD management.
Co-Authors Agustiawan, Referano Ali, Reyno Satria Andayani, Gitalisa Andi Arus Victor Anna Rozaliyani Ardhia, Seruni Hanna Ari Andayani Arief S. Kartasasmita Arini Setiawati Augiani, Amani Sakinah Ayuningtyas, Sita Paramita Dearaini Dewiputri, Salmarezka Dharma, Andhika Guna Elvioza Elvioza, Elvioza Firmansyah, M Harlena, Filza Amara Kamila Harley, Ohisa Herdian, Felicia Sesih Hutapea, Mario Marbungaran Ichsan, Andi M Ikhwan Rinaldi Isfyanto, Isfyanto Iskandar, Erwin Iskandar, Ferdy Joedo Prihartono Khoe, Levina Chandra Kusumowidagdo, Gladys Leonedine, Tengku Viona Zohra Lisnawati Rachmadi Lukman Edwar Lumintang, Agnesstacia Vania Mardianto, Umar Maria Marietta Bali Larasati Martin Hertanto Mawarasti, Burhana Nadhira, Andi Marsa Nadia Artha Dewi Oktariana, Virna Dwi Pambudy, Indra Maharddhika Pratiwi, Rianti Wulandari Putri, Karniela Ayuni Regina Ivanovna Sampurna, Kirana Sembiring, Sindy Boru Sidik, Mohamad Sjahreza, Emil Sjahreza, Emil Fahrinandi Suryoadji, Kemal Akbar Susilo, Teguh Syntia Nusanti Taim, Abisyifa Rahma Triwijayanti, Triwijayanti Triyoga, Ichsan Fauzi UTAMI, ALIA NESSA Wirawan Adikusuma Wiyogo, Widya Artini Yudanta, Anggun Rama Yudantha, Anggun R. Yudantha, Anggun Rama Yudhanta, Anggun Rama Yustiarini, Ima Ziaulhak, Samsul Rizal