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All Journal Journal of Community Empowerment for Health IJRETINA - International Journal of Retina Ophthalmologica Indonesiana
Wardhana, Firman Setya
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Education Health Professions Medicine & Pharmacology Nursing Public Health

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Outlook of Diabetic Retinopathy Management through Universal Health Care in Indonesia from 2015 – 2020: Oral Presentation - Observational Study - Resident Zaharo, Alfia Fatma; Wardhana, Firman Setya; Supanji; Sasongko, Muhammad Bayu
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/fcwc9x44

Abstract

Introduction & ObjectivesTo identify the National Health Expenditure associated with diabetic retinopathy (DR) from theperspective of Jaminan Kesehatan Nasional [JKN]. MethodsA dataset of 1% of all individuals registered in JKN database was used from 2015 to 2020. Weretrieved primary diagnosis with type 2 diabetes mellitus (T2DM) (ICD-10 E11) and/or T2DM withophthalmic complications (E11.3). Further diagnosis with DR (H36) was retrieved. Four groups ofmedical procedures related to DR management were developed according to Indonesian Case BaseGroups (INA-CBGs): diagnostic, laser photocoagulation and cryotherapy, minor (intravitrealinjection), and major surgical procedures (e.g., vitrectomy). We performed descriptive analyses forthe annual costs incurred for procedures, premium classifications, and regions. ResultsOverall DR costs were US $41.5 million from 156,752 individuals with DR in JKN database sample.The total cost and per unit procedures cost specifically increased annually from 2015 to 2019 butdeclined substantially in 2020. The largest amount was spent on intravitreal injection ($36.3 million[87.5%]), whereas vitrectomy was the least ($145.0 million [0.3%]). Region 1 (Java Island) with nonbeneficiariesof government subsidies (PBPU and PPU) was the major number of claims ($12.5million [30.1%] and ($7.3 million [17.7%]), while beneficiaries of government subsidies (PBI) outsideJava Island, conversely, were under average. ConclusionThere was significant increase in health expenditure associated with DR in Indonesia from 2015 to2019, but decreased in 2020 possibly due to COVID-19 pandemic. Majority of funding was spent totreat severe spectrum of DR and concerned in urban area.
Interleukin-1 (ɑ&β) Polymorphism and Bevacizumab Response in Neovascular AMD: Jogja Ageing and Genomic AMD Determinant (JAGAD) Study Number 4 Supanji, Supanji; Romdhoniyyah, Dewi Fathin; Alvionita, Yola Aulia; Salsabila, Kayla Prihatka; Anggraeni, Septya Olivia; Ar-Rosyid, Dewi Megarani; Indrawati, Vera Nurohmah; Qonitatun H., Khairunnissaa'; Mufidana, Neilil Muna; Anindita, Dinda Ajeng; Nursawitri, Syania; Syahriza, Sekar; Felisha, Hifdza Faza; Prayogo, Mohammad Eko; Wardhana, Firman Setya; Sasongko, Muhammad Bayu; Oka, Chio
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.iss001.340

Abstract

Introduction: Interleukin-1 (IL-1) gene polymorphisms may influence anti-vascular endothelial growth factor (VEGF) treatment response in neovascular age-related macular degeneration (nAMD) by modulating inflammatory pathways. This study evaluated associations between IL-1 (ɑ&β) and anatomical outcomes following intravitreal bevacizumab. Methods: We conducted a multi-center retrospective study involving 84 eyes from 71 nAMD patients at three tertiary hospitals in Yogyakarta, Indonesia. Patients were categorized as responders or non-responders according to whether they achieved a >10% reduction in central macular thickness (CMT) one month post-bevacizumab injection. Peripheral blood samples were collected for DNA extraction and genotyping. Results: Responders demonstrated significantly greater CMT improvement despite having higher baseline values (389.0 µM) compared to non-responders (303.0 µM, p=0.033). At one-month follow-up, responders achieved substantially lower CMT measurements (257.0 µM, p=0.002). The IL-1ɑ risk genotype was not detected in both groups. In addition, the genotype distribution for IL-1ɑ showed no statistical significance difference across age, sex, best corrected visual acuity (BCVA), and CMT. Genetic analysis revealed that carriers of the IL-1β T allele showed a 39% lower probability of being non-responders (OR 0.61; 95% CI 0.32-1.16). The CT and TT genotypes demonstrated even stronger trends, with 34% (OR 0.66; 95% CI 0.15-2.88) and 67% (OR 0.33; 95% CI 0.06-1.72) reduced probabilities of non-response, respectively. However, these associations did not reach statistical significance. Conclusion: Our findings indicate a potential protective effect of the IL-1β -511C/T polymorphism against poor response to bevacizumab therapy, though statistical significance was not achieved. Further investigation with larger sample sizes is necessary to confirm the predictive value of IL-1 genetic variations for anti-VEGF treatment outcomes in nAMD patients.
Association of the VEGF +405C/G gene polymorphism with diabetic retinopathy in an Indonesian (Yogyakarta) population Supanji, Supanji; Romdhoniyyah, Dewi Fathin; Maharani, Dinda Mutiara; Putri, Aurelia Priscilla Regita; Felisha, Hifdza Faza; Indrawati, Vera Nurohmah; Hasanah, Ummi Noor; Widya, Shanti; Imawati, Nurul; Aribowo, Eko; Adisetiadi, Agit Seno; Revana, Eva; Winarti, Tri; Ikhsan, Muhammad Robikhul; Susanti, Vina Yanti; Prayogo, Mohammad Eko; Wardhana, Firman Setya; Sasongko, Muhammad Bayu
Journal of Community Empowerment for Health Vol 9, No 1 (2026)
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jcoemph.113213

Abstract

Introduction: Diabetic retinopathy (DR) remains a major cause of vision loss, and while chronic hyperglycemia drives its pathogenesis, inconsistent findings on the VEGF +405G/C polymorphism and the absence of Indonesian data highlight the need to clarify potential genetic susceptibility. The purpose is to determine the association between the VEGF +405C/G rs2010963 gene polymorphism and the risk of diabetic retinopathy (DR) in an Indonesian population.Methods: Our observational case-control study enrolled 100 type-2 diabetes mellitus patients (50 DR patients vs. 50 non-DR)  who underwent comprehensive clinical and ophthalmic examinations. Genomic DNA was extracted from peripheral blood samples, and the VEGF +405C/G rs2010963 polymorphism was genotyped using RFLP-PCR, with results confirmed by sequencing.Results: Our study included a total of 100 participants with no significant differences in baseline characteristics other than poorer visual acuity and significantly higher LDL and lower HDL levels in the DR case group. Allelic and genotypic distributions of the VEGF +405 rs2010963 polymorphism were similar between both groups, with HWE equilibrium analysis showing no significant deviation. Neither crude (GG; crude OR 0.32 [0.87 - 1.21]), age and sex-adjusted analysis (0.41 [0.11 - 1.60]), nor blood pressure, HbA1c level, BMI, and smoking status-adjusted OR of 0.38 (0.70 - 2.06), demonstrated a significant association between VEGF +405 rs2010963 polymorphisms and DR risk in our cohorts.Conclusion: Our study suggests that VEGF +405C/G polymorphisms may not serve as an independent risk factor for DR in the Indonesian population.
Co-Authors Adisetiadi, Agit Seno Alvionita, Yola Aulia Anggraeni, Septya Olivia Anindita, Dinda Ajeng Ar-Rosyid, Dewi Megarani Chio Oka, Chio Eko Aribowo Felisha, Hifdza Faza Hasanah, Ummi Noor Ikhsan, Muhammad Robikhul Imawati, Nurul Indrawati, Vera Nurohmah Maharani, Dinda Mutiara Mohammad Eko Prayogo Mufidana, Neilil Muna Nursawitri, Syania Putri, Aurelia Priscilla Regita Qonitatun H., Khairunnissaa' Revana, Eva Romdhoniyyah, Dewi Fathin Salsabila, Kayla Prihatka Sasongko, Muhammad Bayu Supanji Supanji, Supanji Susanti, Vina Yanti Syahriza, Sekar Tri Winarti Widya, Shanti Zaharo, Alfia Fatma