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Oktariana, Virna Dwi
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Health Professions Medicine & Pharmacology Public Health

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Outcomes of GDD Implantation in NVG Patients at Cipto Mangunkusumo Hospital: A 3-Year Study Sieman, Andrew John Widya; Oktariana, Virna Dwi
Majalah Oftalmologi Indonesia Vol 51 No 1 (2025): 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/journal.v51i1.101689

Abstract

Introduction: Neovascular glaucoma is a challenging type of glaucoma to manage, due to its progressive nature. Achieving good intraocular pressure (IOP) in neovascular glaucoma cases often requires the aid of filtering surgery, preferably with a glaucoma implant/drainage device. This study aims to evaluate the outcomes of glaucoma drainage device (GDD) implantation for neovascular glaucoma patients in Cipto Mangunkusumo Hospital.   Methods: A total of 77 eyes with neovascular glaucoma were included in this study, which underwent GDD implantation in Cipto Mangunkusumo Hospital between 2020 to 2022. Baseline data include age, gender, laterality, implant type used, underlying ocular condition, systemic comorbid, visual acuity (VA), IOP, and prescribed glaucoma medications. The postoperative VA and IOP were measured at 1 day, 1 week, 1 month, 3 months, 6 months, 1 year, and 18 months or above. Complications and additional surgical interventions were noted. Success criteria based on the IOP and amount of glaucoma medications were evaluated at least 6 months postoperatively.   Results: The mean IOP at baseline was 45.91 ± 13.9 mmHg with 3.42 ± 0.77 glaucoma medications. At 6 months postoperative, mean IOP was decreased to 13.84 ± 8.6 mmHg with 1.21 ± 1.18 glaucoma medications. At 6 months follow-up, 32.0% patients achieved complete success and 48.0% patients achieved qualified success. At 1 year postoperative, the Kaplan-Meier analysis for GDD success in neovascular glaucoma cases was estimated to be 79.2%.   Conclusion: GDD implantation is an effective surgical option in treating neovascular glaucoma cases.
AGREEMENT OF MELBOURNE RAPID FIELDS PERIMETRY PARAMETERS TO HUMPHREY FIELD ANALYZER IN MODERATE-SEVERE GLAUCOMA PATIENTS: RELATIONSHIP BETWEEN VISUAL ACUITY AND MELBOURNE RAPID FIELDS ACCURACY: Oral Presentation - Observational Study - Resident Mayasari, Yuri Dwi; Oktariana, Virna Dwi; Fitriani, Dewi Yunia
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/cewap317

Abstract

Introduction & ObjectivesPerimetric examination is vital for measuring visual field defects and predicting the progression ofglaucoma. The Covid-19 pandemic prompted the use of perimetry at home. Tablet or website-basedperimetry becomes an option due to unavailability of Humphrey Field Analyzer (HFA). MelbourneRapid Fields (MRF) is affordable, portable and reliable, even provide the same benefits as HFA. Thisstudy aimed to assess the agreement of MRF results to HFA in moderate-severe glaucoma patientswith impaired visual acuity. MethodsObservational study using a cross-sectional design to assess the relationship between visual acuityand the agreement of MRF vs HFA in moderate-severe glaucoma patients. Subjects were groupedinto two groups based on visual acuity. Each subject was examined with MRF and HFA, the order ofexamination was randomized using block randomization. ResultsThe test durations were shorter on MRF than HFA (265.7±26.6 vs 384.4±46.7, P<0.001). There wasno significant difference in the reliability index of the two perimetry. MRF showed a high level ofconcordance in its outcomes with HFA (R=0.931, intraclass correlation coefficient (ICC)=0.957 formean defect (MD) and R=0.941, ICC=0.974 for Visual Field Index (VFI)). MRF also showed levels oftest-retest repeatability comparable to HFA (R=0.948, ICC=0.989 for MD and R=0.946, ICC=0.989for Visual Capacity (VC)). There was no correlation between visual acuity and MRF accuracy,p>0.05. ConclusionThe perimetry results from MRF have a very stong correlation to the HFA outcomes. MRF also hastest-retest repeatability comparable to HFA. The accuracy of the MRF results does not correlate withvisual acuity.
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.
Silent Progressive Glaucoma in Encephalofacial angiomatosis (Sturge-Weber Syndrome): A Vision-Preserving Trabeculectomy: Poster Presentation - Case Report - Resident Gunardi, Triana Hardianti; Iskandar, Ferdy; Herdian, Felicia Sesi; Amanda, Lia; Priscilla, Florentina; Oktariana, Virna Dwi
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/h8wd8052

Abstract

Introduction : Encephalofacial angiomatosis, also known as Sturge-Weber Syndrome (SWS), is a rare, non- hereditary condition affecting multiple organs. Glaucoma occurs in almost 70% SWS children, more commonly when the port-wine stain involves the upper eyelid skin. Secondary glaucoma was present due to elevated venous pressure. Case Illustration : An 8-year-old boy with typical port-wine stain involving eyelid, came with recurrent painful right eye (RE) and headache in the past 3 months. He was diagnosed with SWS at 1 year and was on daily doses of carbamazepine and valproic acid for seizure control. His best visual acuity and intraocular pressure were 0.5/60 RE, 6/38 LE, 38 mmHg RE, 28 mmHg LE, respectively. Examination revealed Cup-disc-ratio (CDR) 0.9-1.0 RE and 0.5-0.6 LE. During the first three months, he showed favourable outcome with timolol and latanoprost (controlled IOP with target of <12 mmHg and markedly similar Cup-Disc Ratio). However, at 4th and 5th month visit, his IOP significantly increased despite of additional regiments, thus underwent trabeculectomy on both eyes for preserving his sight. After procedure, his IOP remained stable <12mmHg with maintained bleb, deep anterior chamber, also attached posterior segment. Discussion : Treatments of secondary glaucoma of SWS typically involved surgery with significantly lower success rate compared to Primary Congenital Glaucoma. Trabeculectomy or tube shunt surgery should be performed with caution due to risks of choroidal effusion and hemorrhages. Conclusion : Secondary glaucoma in children with SWS is common and challenging. Trabeculectomy should be pursued when the benefit outweighs the risks, even with a slim chance, to preserve the vision.
Co-Authors Amanda, Lia Augiani, Amani Sakinah Dewi Yunia Fitriani Djatikusumo, Ari Gunardi, Triana Hardianti Herdian, Felicia Sesi Herdian, Felicia Sesih Iskandar, Ferdy Lumintang, Agnesstacia Vania Mayasari, Yuri Dwi Priscilla, Florentina Sieman, Andrew John Widya