Tri Wahyu Widayanti
Department Of Ophthalmology, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada

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The risk of elevated plasma fibrinogen level in hypertensive and normotensive patientsafter bevacizumabintravitreal injection in diabetic retinopathy Ni Luh Putu Widhyasti; Anik Ika Winarni; Natalia Christina Angsana; Rizto Wisuda Senuari; Angela Nurini Agni; Agus Supartoto; Suhardjo Prawiroranu; Tri Wahyu Widayanti; Tatang Talka Gani; Usi Sukorini
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 1 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (282.269 KB) | DOI: 10.19106/JMedSci005201202007

Abstract

Bevacizumab intravitreal injection (IVB) could be detected in plasma that might cause an imbalance in the coagulation system. A hypercoagulable state is potentially involved in the risk for thrombosis, which is associated with high cardiovascular mortality.The objective of the current study was to investigate the risk of elevated plasma fibrinogen levelsin hypertensive and normotensive patients after IVB in diabetic retinopathy. This study was conducted at Dr. Sardjito General Hospital, Yogyakarta from March to June 2019. A total of 64 patients were enrolled in the study, included of 32 hypertensive and 32 non-hypertensive patients with diabetic retinopathy who underwent IVB. Patients were interviewed and investigated for physical condition and opthalmological examination. Fibrinogen levelwas measured before and 1 week after IVB. The mean fibrinogen level beforeand after IVB was slightly high in hypertensive patients than normotensive but not significantly different(p>0.05). There was no significant risk of increased fibrinogen levels after IVB in the hypertension group compared to the normotension group in diabetic retinopathy patients. The proportion of patients at high risk for cardiovascular disease after IVB was not significantly different between both groups.
CENTRAL MACULAR THICKNESS AFTER COMBINED THERAPY OF BEVACIZUMAB INTRAVITREAL INJECTION AND TOPICAL DICLOFENAC COMPARED WITH BEVACIZUMAB INTRAVITREAL INJECTION ALONE IN DIABETIC MACULAR EDEMA Melvina Nidya Sandra; Yumni Shabrina; Tri Wahyu Widayanti; Retno Ekantini; Agus Supartoto; Muhammad Bayu Sasongko; Supanji Haryanto
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

Abstract

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
Surgical Technique of Late Spontaneous IOL-Capsular Bag Complex Dislocation with Low Corneal Endothelial Cell Density: A Case Report Firman Setya Wardhana; Dhimas Hari Sakti; Supanji Supanji; Muhammad Bayu Sasongko; Tri Wahyu Widayanti; Angela Nurini Agni
International Journal of Retina Vol 2 No 1 (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.iss001.54

Abstract

Introduction: IOL-capsular bag complex dislocation is a rare but serious complication of phacoemulsification surgery. Technique to repair this complication should be based on various clinical parameters including quality of corneal endothelial cells and the type of dislocated IOL. Case Presentation: We present a case of a 67-year-old male with left eye spontaneous one-piece foldable IOL-capsular bag complex dislocation to vitreous cavity 4 years after phacoemulsification surgery. Visual acuity of the left eye was 1/60, pupil was round with 3 mm diameter and IOP was 15 mmHg. Noncontact specular microscopy examination showed that the corneal endothelial cell density was 1100 cells/mm2. It was managed with 23-gauge posterior vitrectomy, IOL evacuation to anterior chamber, releasing the capsular bag and repositioning the IOL into posterior chamber by sutured scleral fixation. Result: Follow-up at 6thmonth, best corrected visual acuity of the left eye achieved 6/6, IOL at central position and the last corneal endothelial cell density was 1076 cells/mm2. Conclusions: Late spontaneous IOL-capsular bag complex dislocation with low corneal endothelial cell density can be safely managed with proper surgical technique. Vitrectomy and sutured scleral fixation of the previously dislocated IOL were effective in managing such case. Longer follow-up should be done to assure the stability of IOL position and the quality of corneal endothelial cells.