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CENTRAL MACULAR THICKNESS AFTER COMBINED THERAPY OF BEVACIZUMAB INTRAVITREAL INJECTION AND TOPICAL DICLOFENAC COMPARED WITH BEVACIZUMAB INTRAVITREAL INJECTION ALONE IN DIABETIC MACULAR EDEMA Sandra, Melvina Nidya; Shabrina, Yumni; Widayanti, Tri Wahyu; Ekantini, Retno; Supartoto, Agus; Sasongko, Muhammad Bayu; Haryanto, Supanji
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.iss002.164

Introduction: To evaluate whether the combination of diclofenac eye drops and bevacizumab intravitreal injection would provide additional benefits over bevacizumab alone in the treatment of naïve diabetic macular edema (DME). Methods: A total of 43 patients were enrolled consecutively and randomized into two groups to receive combination treatment with intravitreal bevacizumab and topical diclofenac (group 1) or bevacizumab alone (group 2). Group 1 patients received single bevacizumab intravitreal injection and got self-administered diclofenac eye drop four times daily for one month. Group 2 patients received single bevacizumab intravitreal injection alone. Outcome data were obtained from patient visits at baseline and at 1 month after bevacizumab intravitreal injection. All patients underwent measurement of best corrected visual acuity (BCVA), a complete eye examination, and measurement of central macular thickness (CMT). Result: The mean reduction in CMT in the combination group was 130.42±32.57 µm (p<0.01), while in the bevacizumab alone group the reduction was 141.38±45.27 µm (p<0.01), there is no significant difference between the two groups (p=0.866). The mean improvement of BCVA was 0.32±0.10 log Mar in the combination group and 0.26±0.12 in group 2, there is no significant difference between the two groups (p=0.691). There was no adverse ocular event in the two groups. Conclusion: In patients with naïve DME, adding diclofenac eye drop as adjuvant of bevacizumab intravitreal injection are less likely to have a meaningful effect on reducing the central macular thickness. Keywords: Diabetic macular edema, NSAID, diclofenac, anti-VEGF, bevacizumab, central macular thickness

CORRELATION OF STRUCTURE AND FUNCTIONAL DEFECT WITH QUALITY OF LIFE IN PATIENT WITH GLAUCOMA Rahma An Nazzila, Meta; Jati, Krisna Dwi Purnomo; Ekantini, Retno; Gani, Tatang Talka
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: 10.35749/7rn3zx09

Introduction: Glaucoma damage generally produces a characteristic change in the morphology of the optic nerve, runs progressively and permanently that cause visual changes, decreased vision, and blindness. Blindness will affect one’s dependence to get help in their daily activities. This paper investigate the correlation between VFI, BCVA, MD and RNFL thickness with the quality of life of people with glaucoma using Glaucoma Quality of Life-15 (GQL-15). Methods: A cross-sectional study conducted at the Sardjito Eye Center in April 2021. Purposive sampling used to recruit glaucoma patients who had BCVA, Visual Field examination (Humphrey Field Analyzer (HFA) 3 Carl Zeiss Meditec Inc.), and OCT ONH (Cirrus HD-OCT 5000, Carl Zeiss). Glaucoma Quality of Life-15 (GQL-15) questionnaire were used to interview the patients. Results: Eight (32%) normotension glaucoma and 17 (68%) open angle glaucoma patients were included. Fifteen (60%) patients aged 17-40 y.o, 7 (28%) aged 41-60 y.o and 3 (12%) aged > 60 y.o were included. Majority of the samples 6 of them were unemployed (24%), 5 entrepreneurs 5 (20%) and 5 students (20%). GQL-15 score was significantly correlated with respondent's BCVA r= -0.39 (p= 0.05). However, there was no correlation between GQL-15 with RNFL r= 0.01 (p=0.94), VFI r= -0.21 (p= 0.29) and MD with r=0.09 (p= 0.66) respectively. It showed that VFI and GQL-15 has negative correlation with a correlation coefficient of -0.21 (p=0.29). Subscale score related to central and near was significantly correlated with VFI (p= 0,05) and MD (p= 0,03). Conclusion: There was a significant correlation between GQL-15 subscale score of central and near vision with VFI and MD. Subjects with lower VFI and MD tend to have worse problem with central and near vision. Total GQL-15 score has a weak negative correlation with BCVA and MD. There was no correlation between GQL-15 with VFI and RNFL.

Hasil Tindakan Bedah Implantasi Glaucoma Drainage Device pada Pasien Glaukoma Refrakter di RSUP dr Sardjito Saputra, Yuandani; Jati, Krisna Dwi Purnomo; Gani, Tatang Talka; Ekantini, Retno
Majalah Oftalmologi Indonesia Vol 49 No S1 (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/ak6fah94

Introduction: Glaucoma drainage device (GDD) implantation was an effective surgical procedure in treating uncontrolled intraocular pressure (IOP) of glaucoma patients in certain complicated conditions. GDD implants were classified into valved and non-valved in which its surgical outcomes in different types of device and various etiologies were not similar. This study aimed to evaluate the surgery outcomes of GDD implantation in patients with refractory glaucoma at Sardjito General Hospital. Methods: All 12 eyes of 11 patient’s medical records who underwent GDD implantation during 2022 at Sardjito General Hospital was reviewed. Baseline data include age, gender, eye laterality, type of glaucoma, IOP and visual acuity. The IOP and visual acuity (LogMAR) were measured at week 1, month 1, 2 and 3. Type of GDD implants, postoperative glaucoma medications, complications and need for further glaucoma surgery were documented. Results: The mean IOP at baseline was 44 ± 14.2 mmHg with 3.4 ± 0.6 glaucoma medications. It decreased after surgery into 19.1 ± 11.2 mmHg (p=0.003) at 3 months follow up with 0.7 ± 1.7 (p=0.002) glaucoma medications. The mean initial visual acuity was 1.9 ± 0.6 and changed insignificantly to 1.7 ± 0.8 (p=0.624) at last follow up. Six eyes (50%) were implanted with valved implant. The most common early postoperative complications were recurrent high IOP (4 eyes, 33.3%) associated to ripcord of non-valved implant (p=0.025). Five eyes (41.7%) needed additional surgery related to non-valved implant type (p=0.003). Conclusion: GDD implantation especially valved type appears to be safe and effective surgical option in treating refractory glaucoma patients Keywords: Glaucoma drainage device, refractory glaucoma, glaucoma surgery, intraocular pressure

INTRAOPERATIVE MITOMYCIN-C, 5-FLUOROURACIL, RETROBULBAR TRIAMCINOLON ACETONIDE, IS IT EQUALLY EFFECTIVE TO DECREASE INTRAOCULAR PRESSURE AFTER TRABECULECTOMY? Sari, Yessi Primanda; Ekantini, Retno; Gani, Tatang Talka; Jati, Krisna Dwi Purnomo
Majalah Oftalmologi Indonesia Vol 49 No S1 (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: 10.35749/8f22f839

Objectives: To evaluate the effect of mitomycin-C (MMC), 5-fluorouracil (5-FU), and retrobulbar triamcinolone acetonide (TA) on the surgical result of trabeculectomy Materials and Methods: All consecutive trabeculectomies with releasable sutures performed in Sardjito General Hospital between January 2022 and December 2022 were retrospectively reviewed from medical records. Patients without any intraoperative metabolite (control group, n=5) were compared to those with retrobulbar TA (n=5), MMC group (n=19), and 5-FU group (n=11) in terms of surgical success. Successful surgery results were defined as IOP between 5 - 21 mm Hg without any further medications or surgical intervention and fewer complications. Results: 40 eyes of 35 patients (15 male, 25 female, mean age 52.4 years) were included in the study. The IOP pre operative in TCA group was 47.12 ±12.16 mmHg, in MMC group was 35.53 ± 17.05 mmHg, in 5-FU group was 34.54 ± 17.77 mmHg, and 43.80 ± 15.79 mmHg in group without any metabolite. The patient was observed until the post-operation day (POD) 90. There were no significant differences in intraocular pressure at POD 1, 7, 30, 60, and 90 between the control group compared to TCA, MMC, and 5-FU group. In TCA group, pre operative IOP was 47.12 ±12.16 mmHg then decreases to 15.60 ± 4.61 mmHg at POD 90. In MMC group, pre operative IOP was 35.53 ± 17.05 mmHg, 90 days later became 14.42 ± 5.71 mmHg. In 5-FU group, pre operative IOP was 34.54 ± 17.77 mmHg then decrease to 13.64 ± 4.08 mmHg. In group without metabolite, pre operative IOP was 43.80 ± 15.79 mmHg, then became 21.00 ± 6.81 mmHg at POD 90. The lowest mean intraocular pressure of POD 90 was in the 5-FU group (13.64 ± 4.08 mmHg). Complication after trabeculectomy in the TCA group was 21%, the MMC group was 27%, the 5-FU group was 10%, and the control group was 42%. Conclusion: MMC, 5-FU, and TCA in this study are equally effective to decrease IOP after trabeculectomy.

THE CORRELATION BETWEEN RETINAL NERVE FIBRE LAYER THICKNESS, OPTIC NERVE HEAD PARAMETER, AND RELATED RISK FACTOR IN GLAUCOMA PATIENT Wardhana, Arif Kusuma; Ekantini, Retno; Gani, Tatang Talka; Jati, Krisna Dwi Purnomo
Majalah Oftalmologi Indonesia Vol 49 No S1 (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/mm777q10

Introduction and Objective: To investigate the correlation between retinal nerve fibre layer (RNFL) thickness and the past RNFL thickness, related risk factor (gender, age, myopia, intraocular pressure (IOP), blood pressure). And RNFL parameter (symmetricity and four quadrants RNFL thickness) and optic nerve head parameter (rim area and vertical cup disc ratio) Methods: 39 right eyes of both sex and various age underwent examination including IOP measurement, subjective refraction for determining refractive error, and optical coherence tomography (OCT) for RNFL and ONH analysis. The follow up were done after one year. Result: The RNFL symmetricity, superior, nasal, inferior, temporal RNFL thickness showed significance correlation with RNFL thickness (R= 0.487, p= 0.002), (R= 0.915, R= 0.749, R= 0.897, R= 0.702 with p= <0.001), but not showed significance correlation with rim area and vertical cup disc ratio (R= 0.175, p= 0.286) and (R= -0.093, p= 0.574). A significance correlation also showed with increasing age, gender, and systolic blood pressure (R= -0.387, p= 0.015), (R= 0.441, p= 0.005) and (R= -0.418, p= 0.008). But not showed significance correlation with history of past RNFL thickness, refractive error, IOP, and diastolic blood pressure (R= 0.258, p= 0.113), (R= 0.005, p= 0.975), (R= -0.234, p=0.152), and (R= 0.060, p=0.717). Conclusion: RNFL thickness measurements showed significance correlation with RNFL parameter. It is not clear if past RNFL thickness, refractive error and IOP related with RNFL thickness even showed significance correlation with age, gender, and systolic blood pressure. Keywords: Glaucoma, RNFL thickness, optical coherence tomography, optic nerve head

Surgery Outcomes of Glaucoma Drainage Device Implantation in Refractory Glaucoma Patients at Sardjito General Hospital: Oral Presentation - Observational Study - Resident Saputra, Yuandani; Jati, Krisna Dwi Purnomo; Ekantini, Retno; Gani, Tatang T
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: 10.35749/2fz26x42

Introduction & ObjectivesGlaucoma drainage device (GDD) implantation was an effective surgical procedure in treatinguncontrolled intraocular pressure (IOP) of glaucoma patients in certain complicated conditions. GDDimplants were classified into valved and non-valved in which its surgical outcomes in different typesof device and various etiologies were not similar. This study aimed to evaluate the surgery outcomesof GDD implantation in patients with refractory glaucoma at Sardjito General Hospital. MethodsAll 12 eyes of 11 patient’s medical records who underwent GDD implantation during 2022 at SardjitoGeneral Hospital was reviewed. Baseline data include age, gender, eye laterality, type of glaucoma,IOP and visual acuity. The IOP and visual acuity (LogMAR) were measured at week 1, month 1, 2and 3. Type of GDD implants, postoperative glaucoma medications, complications and need forfurther glaucoma surgery were documented. ResultsThe mean IOP at baseline was 44 ± 14.2 mmHg with 3.4 ± 0.6 glaucoma medications. It decreasedafter surgery into 19.1 ± 11.2 mmHg (p=0.003) at 3 months follow up with 0.7 ± 1.7 (p=0.002)glaucoma medications. The mean initial visual acuity was 1.9 ± 0.6 and changed insignificantly to1.7 ± 0.8 (p=0.624) at last follow up. Six eyes (50%) were implanted with valved implant. The mostcommon early postoperative complications were recurrent high IOP (4 eyes, 33.3%) associated toripcord of non-valved implant (p=0.025). Five eyes (41.7%) needed additional surgery related tonon-valved implant type (p=0.003). ConclusionGDD implantation especially valved type appears to be safe and effective surgical option in treatingrefractory glaucoma patients.

The Correlation between Retinal Nerve Fibre Layer Thickness, Optic Nerve Head Parameter, and Related Risk Factor in Glaucoma Patient: Oral Presentation - Observational Study - Resident Wardhana, Arif Kusuma; Ekantini, Retno; Gani, Tatang Talka; Jati , Krisna Dwi Purnomo
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: 10.35749/87d2ce77

Introduction & ObjectivesTo investigate the correlation between retinal nerve fibre layer (RNFL) thickness and the past RNFLthickness, related risk factor (gender, age, myopia, intraocular pressure (IOP), blood pressure). AndRNFL parameter (symmetricity and four quadrants RNFL thickness) and optic nerve head parameter(rim area and vertical cup disc ratio) Methods39 right eyes of both sex and various age underwent examination including IOP measurement,subjective refraction for determining refractive error, and optical coherence tomography (OCT) forRNFL and ONH analysis. The follow up were done after one year. ResultsThe RNFL symmetricity, superior, nasal, inferior, temporal RNFL thickness showed significancecorrelation with RNFL thickness (R= 0.487, p= 0.002), (R= 0.915, R= 0.749, R= 0.897, R= 0.702with p= <0.001), but not showed significance correlation with rim area and vertical cup disc ratio(R= 0.175, p= 0.286) and (R= -0.093, p= 0.574). A significance correlation also showed withincreasing age, gender, and systolic blood pressure (R= -0.387, p= 0.015), (R= 0.441, p= 0.005) and(R= -0.418, p= 0.008). But not showed significance correlation with history of past RNFL thickness,refractive error, IOP, and diastolic blood pressure (R= 0.258, p= 0.113), (R= 0.005, p= 0.975), (R=-0.234, p=0.152), and (R= 0.060, p=0.717). ConclusionRNFL thickness measurements showed significance correlation with RNFL parameter. It is not clearif past RNFL thickness, refractive error and IOP related with RNFL thickness even showedsignificance correlation with age, gender, and systolic blood pressure.

INTRAOPERATIVE MITOMYCIN-C, 5-FLUOROURACIL, RETROBULBAR TRIAMCINOLON ACETONIDE, IS IT EQUALLY EFFECTIVE TO DECREASE INTRA OCULAR PRESSURE AFTER TRABECULECTOMY? Sari, Yessi Primanda; Ekantini, Retno; Gani, Tatang Talka; Jati, Krisna Dwi Purnomo
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: 10.35749/4e85px09

Introduction & ObjectivesTo evaluate the effect of mitomycin-C (MMC), 5-fluorouracil (5-FU), and retrobulbar triamcinoloneacetonide (TA) on the surgical result of trabeculectomy. MethodsAll consecutive trabeculectomies with releasable sutures performed in Sardjito General Hospitalbetween January 2022 and December 2022 were retrospectively reviewed from medical records.Patients without any intraoperative metabolite (control group, n=5) were compared to those withretrobulbar TA (n=5), MMC group (n=19), and 5-FU group (n=11) in terms of surgical success.Successful surgery results were defined as IOP between 5 - 21 mm Hg without any furthermedications or surgical intervention and fewer complications. Results40 eyes of 35 patients (15 male, 25 female, mean age 52.4 years) were included in the study. Patientwas observed until post-operation day (POD) 90. There were no significant differences of intraocularpressure at POD 1, 7, 30, 60, and 90 between control group compared to TCA, MMC, and 5-FUgroup. Intraocular pressure pre- and post-operation in each group was significantly different(p<0.05). The lowest mean intraocular pressure of POD 90 was in 5-FU group (13.64 ± 4.08).Complication after trabeculectomy in TCA group was 21%, MMC group was 27%, 5-FU group was10%, and control group was 42%. ConclusionMMC, 5-FU, and TCA in this study are equally effective to decrease IOP after trabeculectomy.

Relationship Between Mean Deviation Slope with Related Risk Factors and Foveal Sensitivity of Humphrey Field Analyzer Test in Open Angle Glaucoma: Oral Presentation - Observational Study - Resident Rizki, Hanis Fatkhul; Gani, Tatang Talka; Ekantini, Retno; Jati , Krisna Dwi Purnomo
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/hcfjcs46

Introduction & ObjectivesTo analyze relationship between mean deviation (MD) slope with related risk factors and fovealsensitivity of Humphrey field analyzer (HFA) in open angle glaucoma. Patient and MethodsThis study was retrospective and consecutive sampling during a year follow up period in SardjitoGeneral Hospital. A total 95 eyes from 95 patient were exemained the MD slope by HFA (SITAstandard, 24-2 program) being follow up and compared first examination with the final VF test.Relation of MD slope with risk factors and HFA parameters were correlatively analyzed. ResultsMean Deviation slope was observed in 48/95 patients (50.52 %) and no progression was observed in47/95 patients (49.47 %). The related risk factors gender, age, spherical equivalent and IOP do notshowed significant correlation with MD slope (R= 0.02, P= 0.89), (R=0.10, p=0.47), (R=-0.27, p=0.06) and (R=-0,13, p= 0.35). Foveal sensitivity test in HFA parameter do not showed significantcorrelation with MD slope (R= 0.14, p=0.32). ConclusionWorsening value of spherical equivalent and IOP showed negative correlation to MD slope, butstatistically do not showed significant correlation caused there are not much differences betweenprogress and non progress group.

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