Gatut Suhendro
Department Of Ophthalmology, Faculty Of Medicine, Airlangga University Dr. Soetomo General Hospital, Surabaya, East Java

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Time-dependent Expression of Caspase-3 and Degeneration of Lateral Rectus Muscle on Experimental Esotropia in Rabbits Luki Indriaswati; Nurwasis; Gatut Suhendro; Soetjipto; Retno Handajani
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i2.14785

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Background: To identify correlation between caspase-3 expression and degeneration of lateral rectus muscleon experimental esotropia in rabbits by using time dependent analysis. Methods: Twenty four rabbits weredivided into 4 groups, first month sham (S1); second month sham (S2); first month esotropia (E1); andsecond month esotropia (E2) model groups. Immunohistochemical and haematoxyllin eosin staining wereperformed. Results: In first month observation no significant difference in caspase-3 expression between S1(1.56 ± 1.03) and E1 (3.93 ± 1.66) groups (p >0.05) and in the degeneration score of lateral rectus musclebetween S1 (1.33 ± 1.36) and E1 (3.83 ± 2.04) groups (p> 0.05). In second month observation no significantdifference in caspase-3 expression between S2 (1.80 ±1.08) and E2 (6.50 ± 3.26) groups (p >0.05); butthere was significant difference in the degeneration score of lateral rectus muscle between S2 (1.16 ± 1.16)and E2 (4.50 ± 1.04) groups (p <0.05). There was a significant correlation between caspase-3 expressionand the degeneration score of lateral rectus muscle (p=0.020; r=0.471). Conclusion: On the experimentalesotropia with prolonged lateral muscle contraction in rabbits, the increasing trend of caspase-3 expressionhas a correlation with the increasing degeneration score of lateral rectus muscle.
Metformin Reduced Collagen Deposition and Contractility, but Increased Collagen Degradation in in vitro Posterior Capsule Opacification Model Frisma Sagara Brilliyanto; Gatut Suhendro; Indri Wahyuni; Maftucah Rochmanti; Windhu Pramono
The Indonesian Biomedical Journal Vol 13, No 2 (2021)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v13i2.1480

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BACKGROUND: Posterior capsule opacification (PCO) often occurs after cataract surgery. Metformin has been known to have an ability to inhibit fibrosis. This study aimed to investigate the effects of metformin on cell contractility, collagen deposition and degradation in human lens epithelial cells (HLEC) of cataract patients.METHODS: HLEC were isolated from the anterior lens capsule of patients undergoing cataract surgery. The HLEC culture was carried out using explant culture technique. The in vitro PCO model was created by scratching technique on HLEC cultures. The treatment groups were given 0.1, 0.5 and 1 mM metformin, respectively, while the control group were given 10% fetal bovine serum (FBS). On the 7th day after scratching technique, the collagen deposition, collagen degradation and cell contractility were evaluated.RESULTS: Collagen deposition in HLEC was significantly reduced after given 0.1 mM, 0.5 mM and 1 mM metformin (17.92±6.16 mg/mL, 12.92±4.31 mg/mL, 11.25±5.30 mg/mL, respectively), compared to the control group (31.46±7.52 μg/mL, p=0.002). Collagen degradation significantly was increased in the 0.1 mM, 0.5 mM and 1 mM metformin groups (4.77±9.27 mg/mL, 6.59±1.16 mg/mL, 6.35±1.90 mg/mL, respectively) compared to the control group (2.21±2.78 μg/mL, p=0.002). While, collagen contractility in HLEC was significantly reduced in 0.1mM, 0.5mM and 1 mM metformin groups (16.39±3.89%, 13.89±2.59%, 11.93±2.44%, respectively), compared to the control group (44.25±4.95%, p=0.000).CONCLUSION: Metformin reduced collagen deposition and contractility, but increased collagen degradation in HLEC of cataract patients through mechanism of extracellular matrix remodeling.KEYWORDS: metformin, human lens epithelial cell, fibrosis
PENGARUH PENGAWET BEKU (CRYOPRESERVATION) TERHADAP KADAR EPIDERMAL GROWTH FACTOR (EGF) PADA SELAPUT AMNION Ety Retno S; Gunawan Effendi; Gatut Suhendro; I. Handojo
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 15, No 1 (2008)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v15i1.953

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to measure the difference of EgF concentration in between fresh amniotic membranes and with cryopreservation in 16 amnioticmembranes. Each amniotic membrane was divided into two parts. the first part was extracted in fresh forms and the second partunderwent cryopreservation with glycerol 50% and was stored at –80° C during 1 month before extraction. Both parts of the membranewere extracted using ultrasonic disintegrator and concentration of EgF was measured from the obtained extract using ELISA method.the average concentration of EgF in the fresh amniotic membrane was 122.76 ± 11.59 pg/g while the average concentration of EgFin the amniotic membrane underwent cryopreservation was 99.34 ± 9.49 pg/g. Average degradation of EgF concentration due tocryopreservation is 18.49% ± 10.20%. EgF concentration in fresh amniotic membrane is significantly higher than the EgF concentrationin amniotic membrane underwent cryopreservation (p = 0.000). Degradation of EgF concentration due to cryopreservation at 95%fidence interval is 12.33% to 24.66%
A First Step to Novel Approach for Treating Alkali Injury of the Cornea: Effect of Platelet Rich Fibrin Lysates on Cultured Rabbit (Oryctolagus cuniculus) Limbal Stem Cell Proliferation Exposed by Sodium Hydroxide Wahyu Endah Prabawati; Gatut Suhendro; Endang Retnowati
Folia Medica Indonesiana Vol. 58 No. 2 (2022): June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (964.761 KB) | DOI: 10.20473/fmi.v58i2.36321

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Highlights: Sodium hydroxide causing platelet rich fibrin stimulates limbal stem cell proliferation in chemical trauma. Limbal stem cell niche and influences limbal stemness was repaired by Platelet Rich Fibrin.   Abstract: Chemical injuries of the eye produce extensive damage to the ocular surface and limbal stem cells, resulting in permanent unilateral or bilateral visual impairment. Alkali injuries occur more frequently than acid injuries. Platelets are a rich source of potential wound healing, promoting polypeptide growth factors. This study aimed to investigate the effect of platelet-rich fibrin (PRF) lysates on limbal stem cell proliferation, which was exposed to sodium hydroxide that resembled limbal stem cell deficiency due to chemical trauma. Confluent rabbit (Oryctolagus cuniculus) limbal stem cells wounded using 20µL of 0.00625 M sodium hydroxide (pH 13) were treated with platelet-rich fibrin lysates (PRF) (0, 5, and 10%). PRF lysates were prepared from peripheral rabbit blood according to Choukroun's method without using anticoagulant and foreign factors for platelet activation. The proliferation of limbal stem cells was measured by a 3-(4,5-dimethylthiazol-2-yl)-2.50 diphenyl tetrazolium bromide (MTT) colorimetric assay at 24, 48, and 72 hours after exposure to sodium hydroxide. Proliferation significantly increased limbal stem cells with PRF lysates 5% (p<0.01) and 10% (p<0.01) group compared with the control (PRF 0%). There was no significant difference between PRF lysates of 5% and 10% (p>0.01). The highest proliferation of limbal stem cells was found in the PRF lysates 5% group after 48 hours (100.24%). PRF stimulated limbal stem cell proliferation in chemical trauma caused by the sodium hydroxide model. PRF repaired the limbal stem cell niche and influenced the limbal stemness. The present findings warrant further research on PRF as a novel alternative treatment for limbal stem cell deficiency.
SURGICAL MANAGEMENT ON POSTERIOR UVEITIS WITH VITREOUS OPACITY SUSPECTED RETINAL DETACHMENT Firda Ayu Muthie; Sauli Ari Widjaja; Wimbo Sasono; Muhammad Firmansjah; Ima Yustiarini; Ady Dwi Prakosa; Moestidjab Moestidjab; Gatut Suhendro
International Journal of Retina Vol 3 No 1 (2020): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2020.vol003.iss001.83

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Introduction: Posterior uveitis entities are varies between infective or non-infective in aetiology. It can affect the adjacent structures such as retina, vitreous, optic nerve head and retinal blood vessels. Vitreous opacity is the most common features of posterior uveitis and posterior segment evaluation is critical to determine the aetiology and management. Methods: Case report of 32-year-old male with gradual visual loss on right eye since 2 years ago and getting worse 1.5 months before admission. Visual acuity (VA) was hand movement. Posterior segment evaluation revealed vitreous opacity and ultrasound examination showed membrane shaped lesion attached to the optic nerve suggested retinal detachment. Result: Vitrectomy was done for diagnostic and therapeutic purpose. VA was remarkably improved by 6/6 and persist until 6 months post vitrectomy, and progressive improvement on posterior segment. Conclusion: Surgery in the management of posterior uveitis can be divided based on indication, either for therapeutic or diagnostic purposes or to manage its complications. Vitrectomy is one of the modality to manage vitreoretinal complications associated with uveitis
CHARACTERISTICS OF RETINAL DETACHMENT PATIENTS WITH PROLIFERATIVE VITREORETINOPATHY AT Dr. SOETOMO GENERAL ACADEMIC HOSPITAL Ifan Romadhon Lukmana; Sauli Ari Widjaja; Wimbo Sasono; Muhammad Firmansjah; Ima Yustiarini; Ady Dwi Prakosa; Moestidjab Moestidjab; Gatut Suhendro
International Journal of Retina Vol 2 No 2 (2019): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2019.vol002.iss002.75

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Introduction: The aim of this study is to evaluate the incidence and characteristics of retinal detachment patients with proliferative vitreoretinopathy. Methods: Retrospective review of medical record from primary retinal detachment (RD) patients with proliferative vitreoretinopathy (PVR) between 2013 and 2017 at Outpatient Department of Ophthalmology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Result: : The number of RD patients with PVR at Dr. Soetomo General Academic Hospital in 2013-2017 was 80 patients (21%), consisting of 59 men and 21 women with mean of age was 47.5 ± 14.3 years. The characteristics of the subjects were phakic 72.5%, aphakic 1.25%, high myopia 23.75%, history of trauma 18.75% and affected to right eye 60%. Retinal characteristics were break conditions in the retina (located at superotemporal (34%), horseshoe tear (56%), and single break (60%)), macula off (90%), area of detachments were 4 quadrants (43,75%), PVR conditions were grade B PVR (45%), mean duration of RD was 156 days, mean length of surgery waiting list was 61.1 days. The majority of treatment types were vitrectomy (70,4%), majority of tamponade using silicone oil (59.3%), majority of pre-operative and post-operative visual acuity were less than 3 meters counting finger, pre-operative (91.25%) , post-operative 1 month (76%) and 6 months (52.5%), and the majority of post-operative retinal reattachment were 77.3%. Conclusion: The results of this study indicate the number of RD patients with PVR was lower than previous studies. Various results of patient characteristics can be used as guidelines for ophthalmologists in determining actions and explaining the prognosis of the disease. Further research with a larger sample size and prospective methods will be better able to provide better results. Keywords: retinal detachment, proliferative vitreoretinopathy, characteristic pvr
IMPROVEMENT OF LEUKEMIC RETINOPATHY AFTER LEUKAPHERESIS IN CHRONIC MYELOGENOUS LEUKEMIA WITH LEUKOSTASIS Ruchyta Ranti; Sauli Ari Widjaja; Wimbo Sasono; Muhammad Firmansjah; Ima Yustiarini; Ady Dwi Prakosa; Moestidjab Moestidjab; Gatut Suhendro
International Journal of Retina Vol 3 No 1 (2020): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2020.vol003.iss001.87

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ABSTRACT Introduction: to report a case of bilateral leukemic retinopathy due to leukostasis that was successfully managed by leukapheresis. Case Presentation: 31-year-old male with mild visual disturbance was referred to ophthalmology department. He suffered from Chronic Myelogenous Leukemia (CML) with white blood cell (WBC) count 533.900/microL. He was started on hydroxyurea, allopurinol, and once leukapheresis. Ophthalmologic evaluation revealed visual acuity of 4/4 in the right eye and 4/6,3 in the left eye. Funduscopy examination showed the presence of bilateral papilledema, venous engorgement, tortuosity, and retinal hemorrhages. Then this patient continued with second leukapheresis. Result: Visual acuity, laboratory examination, and funduscopic finding was evaluated. His visual acuity was improved, papilledema and retinal blood vessels abnormality had markedly reduced concurring with the patient’s hematological remission. Decreasing WBC count after leukapheresis has improved blood flow that reflected from the retinal findings and visual acuity improvement. Conclusion: Leukapheresis treatment is sufficient to improved clinical condition for leukemic retinopathy caused by CML with leukostasis. Keywords: chronic myelogenous leukemia (CML), hyperleukocytosis, leukostasis, leukemic retinopathy
CONDENSING LENS ON BINOCULAR INDIRECT OPHTHALMOSCOPY AND SLIT-LAMP BIOMICROSCOPY Danang Yoga Wiguna; Sauli Ari Widjaja; Wimbo Sasono; Muhammad Firmansjah; Ima Yustiarini; Ady Dwi Prakosa; Moestidjab Moestidjab; Gatut Suhendro
International Journal of Retina Vol 2 No 2 (2019): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2019.vol002.iss002.76

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Condensing lens is a lens used as an auxiliary lens in indirect instruments to examines the fundus. This lens is used with binocular indirect ophthalmoscope and slit-lamp biomicroscope to reach a stereopsis image of fundus. Optical principle of condensing lens is to make the eye in myopic condition, so it can producesa real, aerial, inverted and reversed image. This lens was placed between the instruments and the eye of the patient which located closer to patient’s eye. Optimalized position of the lens can produce a good fundus image. Condensing lens have so many power of dioptre that each power produces different magnification and field of view. High powered lenses produces wider field of view than low powered ones. High powered lens can also used in patient with small dilated pupil and shorter distance of examination. Low powered lenses offer more magnification. Fundus examination with binocular indirect ophthalmoscope and slit-lamp biomicroscope have purpose to produces stereopsis image because of the binocularity system. These two instruments have each advantages and disadvantages. The advantages of binocular indirect ophthalmoscope are a portable instrument, relatively can be used in uncooperative patient and it can be used with scleral indentation to reach more peripheral view of the fundus. Meanwhile slit-lamp biomicroscope has the advantages to offer more magnification and flexible illumination system. With higher powered lens use in biomicroscope, it also give advantages in shorter distance of examination and wider field of view.
Challenges in Cytomegalovirus (CMV) Retinitis Management Denisa Rosati; Sauli Ari Widjaja; Wimbo Sasono; Muhammad Firmansjah; Ima Yustiarini; Ady Dwi Prakosa; Moestidjab Moestidjab; Gatut Suhendro
International Journal of Retina Vol 2 No 2 (2019): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2019.vol002.iss002.91

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Introduction: HIV infection can manifest in a variety of ways in and around the eyes and it is most commonly due to retinal microvasculopathy, neoplasm and also opportunistic infection. Those usually occur associated with a significantly reduced CD4 T-cell counts. In this era of Highly Active Anti Retroviral Therapy (HAART) has caused a major decreasing of the ocular involvement prevalence itself. Case presentation : A 31 year-old-male came with blurred vision on the right eye, which has started 3 years ago and slowly worsened. Central scotoma also presented previously. Patient was an HIV-AIDS, that placed him on HAART. CD4+ T-lymphocyte count was 3 cells/mm3. The initial visual acuity was light perception and fundus examination showed Roth spots, massive exudates and hemorrhages covering the optic disc and decreased foveal reflex. Laboratory examination revealed positive Rubella and anti-CMV immunoglobulin-G (IgG). He also suffered from lung tuberculosis and took tuberculosis medication regularly. Patient was diagnosed with Cytomegalovirus (CMV) retinitis based on history of illness, fundus examination as well as laboratory testing and given oral induction valganciclovir 900 mg once daily for 3 weeks followed by maintenance dosage . Result : After valganciclovir induction, there was significant changes with decreased peripapillary exudates, hemorrhages and vasculitis, but the optic disc appeared pale. The patient also had bicytopenia due to valganciclovir therapy that complicate his condition and passed away after 3 months follow up. Conclusion: CMV retinitis is reported to occur in patient with extreme CD4 count usually less than 50 cells/mm3. The sooner of proper treatment would likely following better outcome. Making diagnosis of immunosuppresed patient with ocular manifestations was challenging so that comprehensive eye examination in HIV-infected individuals should be conducted. Oral valganciclovir could give satisfactory response to decrease the progression of retinitis but risk of blindness may still occur.
Effect of Pterygium Size on Astgmatism and Corneal Topography Before and After Surgery Mochammad Sjarifudhin; Gatut Suhendro
Majalah Oftalmologi Indonesia Vol 41 No 2 (2015): 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.v41i2.31

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Background: Objective: To analyze the association between pterygium size with astigmatism and corneal topography changes before and after surgery. Methods: This study was conducted at Dr. Soetomo General Hospital and Surabaya Eye Clinic on February-June 2013. In 31 eyes of 20 patients with primary pterygium, size of pterygium was measured in millimeters from the limbus (horizontal length) by caliper and the beam of slit lamp microscope. Twenty four eyes with pterygium type 2 and 3 were excised with bare sclera technique and intraoperative MMC application. Astigmat and corneal topography was investigated with the help of Orbscan preoperatively and 4-6 weeks postoperatively. Result: The size of pterygia had a significant correlation on the elevation of the preoperative corneal astigmatism and irregularities (p<0.001). The mean Sim K astigmatism (p=0.005) and irregularity index (<0.001) significantly decreased after pterygium surgery. The mean refractive power significantly increased after the operation (p<0.001). Conclusion: Pterygium leads to significant changes in corneal refractive status, which increase with the increase in the size of pterygia and improve following pterygium surgery. Keywords: Pterygium, astigmatism, corneal topography