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All Journal Indonesian Journal of Medicine IJRETINA - International Journal of Retina Oftalmologi: Jurnal Kesehatan Mata Indonesia Ophthalmologica Indonesiana
Iskandar, Erwin
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Structure and Macular Sensitivity Characteristic After Silicone Oil Removal in Primary Rhegmatogenous Retinal Detachment Haryono, Aditia Apriyanto; Widyanatha, Made Indra; Iskandar, Erwin; Kartasasmita, Arief Sjamsulaksan; Virgana, Rova; Ihsan, Grimaldi
Oftalmologi : Jurnal Kesehatan Mata Indonesia Vol 4 No 3 (2022): Jurnal Oftalmologi
Publisher : Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ojkmi.v4i3.42

Abstract

Introduction: Silicone oil (SO) is an endotamponade to manage several retinal detachments.The emulsification of silicone oil is one of the complications that may occur in several patients. Retinal macular changes may occur even with successful tamponade. Purpose: to describethe structure and macular sensitivity characteristic after silicone oil removal in primary rhegmatogenous retinal detachment (RRD). Methods: a prospective, descriptive case series study of who underwent SO tamponade for primary RRD. Optical coherence tomography (OCT) and microperimetry (MP-3) were conducted before SO removal and one week after SO removal. Result: There were nine eyes that met the criteria. The mean age of the patients was 53.3±14 years. Most of the patients use silicon 1300 (66.67%) and under six months (77.8%) duration of silicone tamponade. After silicone oil removal, mean macular sensitivity in the central fovea decreased from 12.44 dB to 12.11 dB, and parafovea increased from 18.33 dB to 19.00 dB.The mean macular thickness in the fovea decreased from 269.89μm to 260μm. The mean macular thickness in parafovea was an increase from 316.16 to 328.00μm Conclusion: There was an increase in macular sensitivity and thickness at parafovea after one- week silicone oil removal in primary rhegmatogenous retinal detachment.
REVIEW 5 TAHUN KARAKTERISTIK KLINIS PASIEN BENDA ASING INTRAOKULAR DI PMN RS MATA CICENDO Desrina; Virgana, Rova; Kartasasmita, Arief S.; Iskandar, Erwin; Ihsan , Grimaldi; Widyanatha, Made Indra
Oftalmologi : Jurnal Kesehatan Mata Indonesia Vol 5 No 1 (2023): Jurnal Oftalmologi
Publisher : Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ojkmi.v5i1.46

Abstract

Introduction: Intraocular foreign bodies (IOFBs) are defined as intraocularly retained, unintentional projectiles that require urgent diagnosis and treatment to prevent blindness or globe loss. IOFBs account for 18–41% of open globe injuries, and frequently cause severe visual loss in patients with ocular trauma.The purpose of this study are is to describe the characteristics of open-globe injuries with posterior segment intraocular foreign bodies (IOFB). Subject and Methods: Retrospective data of all patients with posterior segment IOFBs from 2017 to 2022 was conducted. Data including demographics, mechanism of injury, type of IOFB, method of diagnosis, presenting examination, medical and surgical treatment, visual outcomes, and complications were recorded. Result: There were 39 patients (eyes) with IOFB, 38 (97,4%) were male, 10 (25,6%) were 46-55 years old. The most common IOFB occurred at workplace 30 patient (85,7%), 29 (74,3%) were insuranced, surgery were performed 1- 4 days in 15 (38,5%. The most Ocular trauma score were 3 (38,5%) and 2 (35,9%) initial VA were light perception – hand movement (25 or 64,1%), final VA with BCVA were > 20/40 (30,8%) patients and 6/60-6/15 (25,6%). The posterior segment IOFB (51,3%, metallic IOFB 25 (61,5%). Cataract 74,3% and Endophthalmitis (20,5%) were found in initial examination patient with IOFB (13 or 37,1%). Late complication in post surgery IOFB patient was glaucoma 14,4%. Conclusions: The IOFB occurred most commonly in adults, men, at the workplace. The IOFB mostly was metallic, found in the posterior segment. Cataract and endoftalmitis were common in initial finding IOFB patients.
Good Results in Open Globe Injury Including Intraocular Foreign Body Widhyasti, Rahayu; Widyanatha, Made Indra; S. Kartasasmita, Arief; Iskandar, Erwin; Virgana, Rova; Ihsan, Grimaldi
Oftalmologi : Jurnal Kesehatan Mata Indonesia Vol 6 No 1 (2024): Oftalmologi: Jurnal Kesehatan Mata Indonesia
Publisher : Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ojkmi.v6i1.61

Abstract

Introduction: The second most frequent cause of open globe injury (OGI) is an intraocular foreign body (IOFB), a serious ocular emergency that needs to be diagnosed and treated right once to avoid blindness. It can enter the eye and cause damage later on, resulting in direct harm. When treating post-traumatic endophthalmitis, an urgent pars plana vitrectomy (PPV) procedure helps maximize visual outcome. Case report: A 55-year-old male patient came to the Emergency Room Tertiary Eye Hospital with chief complaints of blurry vision, pain, and red-eye in his right eye 3 days before admission. The patient’s right eye was hit by a fragment of the sickle knife while mowing the grass in the yard without protective eyeglasses. His chief complaints getting worse accompanied by lacrimation. The patient was diagnosed with Open Globe Injury Type C Grade D Pupil B zone 1, suspected early endophthalmitis, traumatic cataract of the right eye, and hypertension. Pars plana vitrectomy, vitreous tap, antibiotic intravitreal injection (with Ceftazidime and Vancomycin), IOFB extraction, explore, corneal scraping on the wound, cultural resistance, primary hecting of the cornea were done. The visual acuity improved and the infection was resolved. The infection was treated, and visual acuity returned after a month. Conclusion: In ophthalmology, IOFB is one of the most frequent traumas and is regarded as an emergency. To identify this problem, a thorough ophthalmology examination and the relevant ancillary testing should be performed. A patient with good care will have a favorable visual prognosis.
Recurrent Bilateral Chronic Central Serous Chorioretinopathy Treated with Anti-VEGF Atisundara, Siti Mutia; Iskandar, Erwin
Oftalmologi : Jurnal Kesehatan Mata Indonesia Vol 6 No 2 (2024): Oftalmologi: Jurnal Kesehatan Mata Indonesia
Publisher : Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ojkmi.v6i2.67

Abstract

Introduction: After diabetic retinopathy, branch retinal vein occlusion, and age-related macular degeneration, central serous chorioretinopathy (CSC) is the fourth most frequent retinopathy. Males in their 20s to 50s who have acute or subacute central vision loss or distortion are usually the ones who develop CSC, males more than females. Localized serous macula detachment is its defining feature. Within three to six months, the majority of instances resolve on their own and return to normal vision, but in certain situations, laser or medication treatment may be necessary. Case: A 45-year-old male came with a chief complaint of gradually blurred vision in his right eye since a month ago. Optical computed tomography (OCT) examination showed an accumulation of sub-retinal fluid (SRF) suggestive of CSC. His visual acuity was declining even after being given oral spironolactone for 1 month, so he was scheduled for intravitreal injection Anti-Vascular Endothelial Growth Factor Therapy (Anti-VEGF). After three times in injection right eye the visual acuity improved. One month later he had a chief complaint of gradually blurred vision in his left eye. After three times in injection left eye, CSC in both eyes resolved and the visual acuity improved. Three years later he came back with a chief complaint on both eyes like three years ago. Conclusion: Normally resolution of symptoms from CSC takes several months, treatment with anti- VEGF injection an efficient way to treat CSC resolution time and improve vision.
Prevalence and Associated Factors of Diabetic Retinopathy in People with Type 2 Diabetes Attending Community Based Diabetic Retinopathy Screening in Greater Bandung, Indonesia Halim, Aldiana; Syumarti, Syumarti; Rini, Mayang; Ratnaningsih, Nina; Iskandar, Erwin; Sovani, Iwan; Virgana, Rova; Dahlan, Muhammad Rinaldi
International Journal of Retina Vol 5 No 1 (2022): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2022.vol005.iss001.172

Abstract

Introduction: Determine the prevalence and associated factors of diabetic retinopathy (DR) among people with type 2 diabetes. Design: Cross-sectional study Methods: We obtained data of people with type 2 diabetes retrospectively from a community-based DR screening database in Greater Bandung, Indonesia. We encoded the two fields mydriatic 45-degree fundus images to estimate prevalence. The associated factors analysis used multivariate logistic regression. Results: We screened a total of 4,251 people with type 2 diabetes from January 2016 to December 2019. The overall age-standardised prevalence of any DR was 30.7% (95% CI: 28.7%-32.8%) and vision-threatening DR 7.6% (95% CI: 6.5%-9.0%). The following factors were associated with a higher prevalence of any DR: ages 50+ (OR:1.37; 95% CI:1.05-1.77), duration of diabetes five to ten years (OR:1.38; 95% CI:1.11-1.71) and more than ten years (OR:1.40; 95% CI:1.13-1.73), and postprandial blood glucose 200 mg/dl and higher (OR:1.27; 95% CI:1.03-1.52). The following factors were associated with a higher prevalence of vision-threatening DR: duration of diabetes five to ten years (OR:2.01; 95% CI:1.39-2.91) and more than ten years (OR:1.86; 95% CI:1.28-2.71), postprandial blood glucose 200 mg/dl or higher (OR:1.52; 95% CI:1.05-2.21) and systolic blood pressure 180 mmHg or higher (OR:2.67; 95% CI:1.16-6.17). Conclusion: Diabetic retinopathy is prevalent among people with type 2 diabetes. People with diabetes should regulate their blood glucose and blood pressure to prevent retinopathy related vision loss.
Ocular Manifestations of Aplastic Anemia: Rare Case of Anemic Retinopathy Juanarta, Pieter; Ihsan, Grimaldi; Iskandar, Erwin; Kartasasmita, Arief; Virgana, Rova; Indra, Made
International Journal of Retina Vol 8 No 1 (2025): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2025.vol008.iss001.280

Abstract

Incidence of aplastic anemia was 1-2 cases per million population per years, and showed higher rate in Asia and 10-25 years old. Anemic retinopathy can occur in 28% of patient with severe anemia, especially if accompanied by thrombocytopenia. Most cases were asymptomatic, however decrease visual acuity were also commonly found caused by haemorrhage and Macular edema. A 65 years old female patient came with blurry vision ten days prior admission accompanied with loss of consciousness, recurrent bleeding from nose, gum, and bluish discoloration in her extremities four years ago. Visual acuity was 1/60 on the right eye and 0.4 log on the left eye. Funduscopic examination showed vitreous haemorrhage, dot blot, hard exudate, and tortuosity of vein. Laboratory Examination showed anemia and thrombocytopenia, and peripheral blood morphology showed normochromic anisopoikilocytosis caused by chronic disease. She was scheduled to underwent anti VEGF and showed improvement in her visual acuity after injection. Fundoscopic examination later shows sub-hyaloid haemorrhage, dot blot, hard exudate, and tortuosity of vein. She was scheduled to undergo pars plana vitrectomy and were consulted to internal medicine. Aplastic anemia is a rare disease that usually asymptomatic, thus causing late intervention and a high mortality rate. Early manifestation can be seen in retinal structure as anemic retinopathy thus ophthalmologist have valuable impact in early detection of this disease. Haemorrhage overlying the macula and macular edema is the most common cause of visual impairment. Anti VEGF treatment, transfusion of blood component, and immunosuppressive therapy is needed to prevent complication and increase patient survival rate. Patient visual acuity usually imporved after early transfusion and anti VEGF injection, however delayed intervention may cause irreversible vision loss.
A Rare Case Of Retinal Arterial Microaneurysm: Clinical Features And Diagnostic Insights Yuna, Uray Nabila; Ihsan, Grimaldi; Virgana, Rova; Kartasasmita, Arief S.; Iskandar, Erwin; Widyanatha, Made Indra
Indonesian Journal of Medicine Vol. 10 No. 1 (2025)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2025.10.1.773

Abstract

Background: In Retinal Arterial Macroaneurysms (RAM), the central retinal artery suffers from acquired focal hypertension. Clinical manifestations of the disease are diverse and easily misdiagnosed. Several imaging modalities may be used in order to confirm the diagnosis of RAM. This article aims to describe the clinical features and method of diagnosis of an uncommon case of retinal artery microaneurysm. Case report: A 57-year-old woman presented with a progressive loss of vision in her right eye months prior. Visual acuity in the right eye was 0.8 log 13. Upon funduscopic inspection of the right eye, firm exudates with low tortuosity and submacular hemorrhage were observed. The right eye’s OCTA revealed a localized expansion and significant constriction with twisted blood vessels on the reverse side of the deformed vessel, while the OCT of the macula revealed submacular hemorrhage. The patient was diagnosed with ruptured retinal Arterial Macroaneurysm or Macular Telangiectasia Type I and Retinopathy Hypertensive Grade II of both eyes, No Diabetic Retinopathy of both eyes with Diabetes Mellitus and Hypertension. The right eye of the patient received concentrated laser photocoagulation and an intravitreal injection of anti-VEGF. Conclusion: RAM is an acquired vascular disease defined by restricted, fusiform, or saccular dilation in the first three arteries of the main retinal artery. Retinal microaneurysms can be diagnosed with various imaging modalities. Ram may be treated with intravitreal anti-VEGF drugs, combination therapy, or laser photocoagulation.
Relationship of Peripapillary Retinal Perfusion with Peripapillary Retinal Nerve Fiber Layer Thickness in Diabetes Mellitus Patients without Diabetic Retinopathy Dwijayanti, Sindi; Irfani, Irawati; Sirait, Susanti Natalya; Gustianty, Elsa; Iskandar, Erwin; Kartiwa, R. Angga
International Journal of Retina Vol 4 No 2 (2021): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2021.vol004.iss002.161

Abstract

Introduction: Impaired blood flow is an early sign of retinal dysfunction in diabetes. Impaired blood flow of the radial peripapillary capillaries can affect the Retinal Nerve Fiber Layer (RNFL) or ganglion cell function. Methods: This was an analytic cross-sectional study in February-April 2019 at Bandung. The subjects of this study were 41 people (79 eyes) divided into two groups, group A (healthy subjects) 19 people (37 eyes) and group B (DM type 2 without diabetic retinopathy) 22 people (42 eyes). Peripapillary retinal perfusion was assesed using OCT Angiography and RNFL thickness was assesed using OCT. Pearson or Spearman correlation statistics test was used to analyze the result. P value ≤0.05 was consiedered significant. Results: There was a decrease in peripapillary retinal perfusion density in the inferior quadrant (P = 0.003) and flux index throughout the peripapillary retinal quadrant (P = 0.0001) but an increase in RNFL thickness in the peripapillary temporal quadrant (P = 0.012) compared to control grup. Positive correlation was found between peripapillary retinal perfusion density and RNFL thickness globally (r = 0.480, P = 0.001), superior quadrant (r = 0.436, P = 0.004), and inferior quadrant (r = 0.608, P = 0.000). A positive correlation was also found between the peripapillary flux and RNFL thickness globally (r = 0.517, P = 0.000), superior quadrant (r = 0.630, P = 0.000), and inferior quadrant (r = 0.519, P = 0.000). Conclusions: There was a relationship between peripapillary retinal perfusion and RNFL thickness in DM patients without diabetic retinopathy. Keywords: Peripapillary perfusion, RNFL thickness, Diabetes.
GUIDELINES FOR THE DIAGNOSIS AND MANAGEMENT OF DIABETIC RETINOPATHY AND DIABETIC MACULAR EDEMA IN INDONESIA Harley, Ohisa; Hertanto, Martin; Sembiring, Sindy Boru; Yustiarini, Ima; Susilo, Teguh; Dharma, Andhika Guna; Sjahreza, Emil; Firmansyah, M; Iskandar, Erwin; Agustiawan, Referano; Andayani, Ari; Dewi, Nadia Artha; Andayani, Gitalisa; Djatikusumo, Ari; Elvioza, Elvioza; Ichsan, Andi M; Kartasasmita, Arief S
International Journal of Retina Vol 7 No 2 (2024): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2024.vol007.iss002.300

Abstract

Diabetic retinopathy (DR) and diabetic macular edema (DME) are among the microvascular complications in individuals with diabetes mellitus (DM) that can lead to blindness if not diagnosed early and managed appropriately. Both disorders can be diagnosed and treated using a variety of techniques. Treatment modalities include laser photocoagulation therapy, vitrectomy surgery, intraocular steroid injections, and anti-vascular endothelial growth factor (anti-VEGF) injections. These methods can help avoid blindness when used in conjunction with metabolic control. These recommendations were created with the use of evidence-based medicine principles to help medical professionals—particularly ophthalmologists—identify and treat cases of DR and DME.The primary objective is to provide consensus recommendations and hopefully reduce the incidence of blindness caused by DR and DME in Indonesia.
CLINICAL CHARACTERISTICS OF CYTOMEGALOVIRUS RETINITIS IN HUMAN IMMUNODEFICIENCY VIRUS (HIV) PATIENTS UNDERGOING INTRAVITREAL GANCICLOVIR INJECTION effendi, yulia; Widyanatha, Made Indra; Ihsan, Grimaldi; Virgana, Rova; Iskandar, Erwin; Kartasasmita, Arief S
International Journal of Retina Vol 7 No 2 (2024): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2024.vol007.iss002.270

Abstract

Introduction: Cytomegalovirus (CMV) retinitis is the most common ocular opportunistic infection in patients with Human immunodeficiency virus (HIV). The disease is causing blindness and current management commonly characterized by delayed diagnosis and inadequate treatment. Purpose: to describe the clinical characteristic and visual outcome of CMV retinitis with HIV treated with intravitreal ganciclovir injection. Methods: This is a retrospective study included 23 patients (34 eyes) who presented with CMV Retinitis with HIV from January 2020 to July 2023 who received intravitreal ganciclovir in both the induction and maintenance phases until declared cured, characterized by lesion inactivation and CD4+ T-cell counts reaching >100/µL within period of 3 to 6 months. Data were collected including age, gender, affected eye laterality, CD4+ T-cell count at the initial visit at vitreoretinal polyclinic and the 6-month follow-up, total number of intravitreal ganciclovir injections, HAART history at the initial visit, visual acuity at the initial visit, 6-month follow-up, and systemic comorbidities. Result: The median age was 29 years old with 82,6% of them male. Bilateral lesions were observed in 60.9% of the patients. Median CD4 count initial visit was 50 with 52% below 50 cell/µL. Fifteen patients (65,2%) already treated with highly active antiretroviral therapy (HAART) before injection. Tuberculosis was the most common opportunistic infection. Mean intraviteral ganciclovir injection 9,12±3,40 in each eye. Eleven eyes (32.4%) with initial visual acuity ≤1.00 logMAR increased to 19 eyes (55.9%) at the 6-month follow-up. There were statistically significant difference between baseline visual acuity and 6-months follow up after intravitreal ganciclovir. (p= 0,008). Conclusion: Retinitis cytomegalovirus tend to have more severe clinical presentations in patients with CD4 counts below 50 cells/µL. Intravitreal ganciclovir is effective in controlling CMV retinitis.
Co-Authors Agustiawan, Referano Andayani, Gitalisa Ari Andayani Arief S. Kartasasmita Atisundara, Siti Mutia Dahlan, Muhammad Rinaldi Desrina Dharma, Andhika Guna Djatikusumo, Ari Dwijayanti, Sindi effendi, yulia Elsa Gustianty Elsyanty, Firda Muthia Elvioza Elvioza, Elvioza Firmansyah, M Graziani, Gabriella Halim, Aldiana Harley, Ohisa Haryono, Aditia Apriyanto Ichsan, Andi M Ihsan , Grimaldi Ihsan, Grimaldi Indra, Made Irawati Irfani Iwan Sovani Juanarta, Pieter Kartasasmita, Arief Sjamsulaksan Kartiwa, R. Angga Martin Hertanto Nadia Artha Dewi Nina Ratnaningsih Rini, Mayang Rova Virgana S. Kartasasmita, Arief Sembiring, Sindy Boru Setiawan, Grace Sirait, Susanti Natalya Sjahreza, Emil Susilo, Teguh Syumarti, Syumarti Widhyasti, Rahayu Widyanatha, Made Indra Yuna, Uray Nabila Yustiarini, Ima