Andayani, Gitalisa
Department Of Ophthalmology, Faculty Of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia; JEC Eye Hospital, Jakarta, Indonesia

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Real-World Evaluation of the Effectiveness of Intravitreal Bevacizumab Injection for Neovascular Age-Related Macular Degeneration at Cipto Mangunkusumo National Referral Hospital Adriono, Gitalisa Andayani; Pambudy, Indra Maharddhika; Victor, Andi Arus; Djatikusumo, Ari; Yudhanta, Anggun Rama; Hutapea, Mario Marbungaran; Triyoga, Ichsan Fauzi
International Journal of Retina Vol 8 No 2 (2025): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2025.vol008.iss002.319

Abstract

Introduction: Neovascular age-related macular degeneration (nAMD) is a leading cause of visual impairment globally. While intravitreal anti-VEGF therapy is the standard treatment, real-world data on bevacizumab (IVB), the most accessible agent in Indonesian public hospitals despite being off-label, remains limited. This study aims to evaluate the effectiveness of IVB in patients with nAMD at a tertiary referral center in Indonesia. Methods: This retrospective study included patients diagnosed with nAMD who received IVB injections at Cipto Mangunkusumo National Referral Hospital between January and December 2017. Inclusion criteria encompassed patients with confirmed nAMD and available clinical data pre- and post-injection. Data on demographics, best-corrected visual acuity (BCVA), central macular thickness (CMT) measured by OCT, and IVB injection regimen were extracted from electronic medical records. Statistical analysis was performed using Wilcoxon signed-rank and Mann–Whitney U tests, with p < 0.05 considered statistically significant. Result: A total of 138 eyes from 131 patients (mean age: 66.7 years; 51% male) were analyzed. The median number of injections was three (range: 1–6). Mean BCVA showed a non-significant improvement from 1.19 to 1.14 logMAR (mean change: 0.05 logMAR; p = 0.770). Subgroup analysis indicated significant improvement in eyes with baseline VA worse than 1.32 logMAR (mean gain: 0.54 logMAR; p < 0.01) and a significant decline in eyes with baseline VA between 0.48 and 1.00 logMAR (mean loss: 0.21 logMAR; p = 0.02). CMT significantly decreased by an average of 108.33 µm (p < 0.01). Conclusion: IVB treatment for nAMD resulted in significant anatomical improvement and was particularly effective in patients with poor baseline visual acuity. These findings highlight the role of IVB in real-world clinical practice within resource-limited settings.
Clinical Characteristics of Patients with Retinal Vein Occlusion and Macular Edema at Cipto Mangunkusumo Hospital Kirana in Indonesia Isfyanto, Isfyanto; Djatikusumo, Ari; Andayani, Gitalisa; Yudantha, Anggun Rama; Hutapea, Mario Marbungaran; Suryoadji, Kemal Akbar; Victor, Andi Arus
International Journal of Retina Vol 7 No 1 (2024): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2024.vol007.iss001.271

Abstract

Introduction: Retinal vein occlusion (RVO) is a significant retinal vascular disease, often resulting in macular edema and vision impairment. This study aims to investigate the clinical characteristics, management, and outcomes of RVO patients with macular edema at Cipto Mangunkusumo Hospital Kirana from January 2020 to December 2021. Methods: This retrospective descriptive study analyzed medical records of 85 RVO patients with macular edema. Demographic data, clinical characteristics, management approaches, and treatment outcomes were examined. Data were analyzed using SPSS. Results: Most patients were over 50 years old, predominantly male, and affected in one eye. Hypertension and diabetes mellitus were common comorbidities. Central RVO cases had worse initial visual acuity and macular thickness than branch RVO cases. Anti-VEGF injections were the primary therapy, and patients received an average of two injections in the first year. Macular thickness reduced after anti-VEGF injections, but visual acuity improvement was minimal. Conclusion: Patients with RVO and macular edema are often older males with systemic risk factors. Anti-VEGF injections are the primary treatment, with improvements in macular thickness but limited visual acuity gain. Patient education, comprehensive management, and public awareness are recommended to enhance RVO care. Further research to analyze parameter relationships is needed.
GUIDELINES FOR THE DIAGNOSIS AND MANAGEMENT OF DIABETIC RETINOPATHY AND DIABETIC MACULAR EDEMA IN INDONESIA Harley, Ohisa; Hertanto, Martin; Sembiring, Sindy Boru; Yustiarini, Ima; Susilo, Teguh; Dharma, Andhika Guna; Sjahreza, Emil; Firmansyah, M; Iskandar, Erwin; Agustiawan, Referano; Andayani, Ari; Dewi, Nadia Artha; Andayani, Gitalisa; Djatikusumo, Ari; Elvioza, Elvioza; Ichsan, Andi M; Kartasasmita, Arief S
International Journal of Retina Vol 7 No 2 (2024): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2024.vol007.iss002.300

Abstract

Diabetic retinopathy (DR) and diabetic macular edema (DME) are among the microvascular complications in individuals with diabetes mellitus (DM) that can lead to blindness if not diagnosed early and managed appropriately. Both disorders can be diagnosed and treated using a variety of techniques. Treatment modalities include laser photocoagulation therapy, vitrectomy surgery, intraocular steroid injections, and anti-vascular endothelial growth factor (anti-VEGF) injections. These methods can help avoid blindness when used in conjunction with metabolic control. These recommendations were created with the use of evidence-based medicine principles to help medical professionals—particularly ophthalmologists—identify and treat cases of DR and DME.The primary objective is to provide consensus recommendations and hopefully reduce the incidence of blindness caused by DR and DME in Indonesia.
CLINICAL CHARACTERISTICS OF PROLIFERATIVE DIABETIC RETINOPATHY (PDR) PATIENTS WITH VITREOUS HEMORRHAGE AT CIPTO MANGUNKUSUMO HOSPITAL Ali, Reyno Satria; Victor, Andi Arus; Djatikusumo, Ari; Andayani, Gitalisa; Yudanta, Anggun Rama; Hutapea, Mario Marbungaran
International Journal of Retina Vol 6 No 1 (2023): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2023.vol006.iss001.227

Abstract

Introduction: Proliferative Diabetic retinopathy is the most common cause of blindness in adults. In the management of vitreous hemorrhage, vitrectomy is the main choice and also laser photocoagulation with or without anti-VEGF administration as additional therapy. This study aims to determine the number of patients, demographic characteristics, clinics, risk factors, distribution of treatment, and treatment outcomes for PDR patients with vitreous hemorrhage at Cipto Mangunkusumo Hospital. Methods: This study was retrospective descriptive study conducted from January 2020 to October 2022 who met the inclusion criteria. Population in this study were patients at Cipto Mangunkusumo Hospital with PDR accompanied by vitreous hemorrhage. Data shown in the table were mean (standard deviation) and number (percentage) based on the type of the data. Result: A total of 146 patients with the diagnosis of Proliferative Diabetic Retinopathy (PDR) with vitreous hemorrhage. Majority of subjects were men (60,9%), diagnosed with DM more than 10 years (63,0%) with another systemic risk factor. The most common clinical characteristics found visual acuity at the initial visit <3/60 (80,8%), diagnosed phakia (78,9%), retinal detachment (85,3%), grade 2 vitreous hemorrhage (80,8%). The majority of eyes underwent vitrectomy (90,44%), Anti-VEGF injections (22,92%), Laser PRP (11,46 %), Phacoemulsification pre and post- vitrectomy as adjuvant treatment. The condition of the vitreous was clear after vitrectomy (99,1%). Mean visual acuity before vitrectomy is 2.10 (1.80 – 2.50), while mean visual acuity after vitctomy was 1.00 (1.30 – 2.40), with a difference in initial and final visual acuity of -0.10 (-0.50 – 0.60). Conclusion: Majority of study subjects were men with an age range of 25-77 years. Vitrectomy as the main treatment combined with intravitreal injection of anti-VEGF, laser PRP as adjuvant treatment. In nearly all cases, vitreous hemorrhage was clear after vitrectomy treatment. Visual acuity after vitrectomy shows progress even though in some cases there was no improvement.
Treatment of Vitreous Hemorrhage due to Proliferative Diabetic Retinopathy in Cipto Mangunkusumo Hospital During Pandemic Era (March 2020 - March 2022): Oral Presentation - Observational Study - Resident RAHAYU, TSANIA RACHMAH; Andayani, Gitalisa
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: 10.35749/11wn7q74

Abstract

Introduction & ObjectivesProliferative diabetic retinopathy (PDR) is the most common etiology for vitreous hemorrhage (VH)and can be sight-threatening. Current treatment modalities for VH in PDR included anti-VEGFinjection, panretinal photocoagulation (PRP) laser, and vitrectomy. We conducted study to evaluatetreatment modalities and outcomes of VH in PDR during the pandemic era. MethodsA retrospective study of VH in PDR was conducted at Cipto Mangunkusumo Hospital, Indonesia,from March 2020 to March 2022. Primary treatment was the therapy planned at the initial visit,while secondary treatment was subsequent treatment after follow-ups. Good anatomical outcomewas defined as vitreous clearing at last follow-up, while functional outcome was visual acuity (VA)improvement in LogMAR. ResultsThis study included 83 patients (97 eyes), which is smaller than the previous study in our centerbefore the pandemic. Mean age was 54,28±8,57 years, with almost equal males and females. InitialVA was LogMAR 2,48 (0,15 – 2,80). The most frequent treatment for VH in PDR was vitrectomy(53,5%), followed by anti-VEGF injection, PRP laser, and observation. Glaucoma after vitrectomy wasthe most common complication (5,2%). Vitreous clearing was achieved in 85,5% of cases, which wassignificantly associated with vitrectomy surgery (p=0,013) and initial treatment time (p=0,023). TheVA improvement was LogMAR -0,48(-2,48–2,40) which was related to initial VA (p<0.05), yet therewas no significant association with treatment modality. ConclusionVitrectomy is essential to achieve vitreous clearing in VH caused by PDR. Initial visual acuity, notthe type of treatment modality, is a significant factor in vision improvement.
From the Eye to the Heart: Association between Age-Related Macular Degeneration and Cardiovascular Disease (a Systematic Review): Oral Presentation - Observational Study - General practitioner Sausan; Presialia, Athira; Khalifah, Rasyad; Adriono, Gitalisa Andayani
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/ax8d9687

Abstract

Introduction & ObjectivesAge-related macular degeneration (AMD) is the third leading cause of global blindness, whilecardiovascular disease (CVD) is recognized as a major cause of morbidity and mortality. Both arecomplex diseases associated with aging. It has recently been argued that there is an associationbetween AMD and CVD. This study examined whether AMD increased the risk of CVD and/ or CVDmortality. MethodsA systematic review was conducted through three databases (Pubmed, Scopus, and Embase) forrelevant studies published between 2016-2023. We selected studies which focused on subjects withAMD, regardless of stages, and their risks for developing CVD and/or CVD mortality. ResultsTwo cohort studies and one case-control study are included, involving 93.388 patients aged >40years old. One cohort study found that subjects with choroidal neovascularization were associatedwith an increased rate of cardiovascular mortality (HR 3.16 95% CI 1.62-6.15). Another study alsofound that AMD was associated with a 1.58 fold increased risk of heart failure (adjusted OR, 1.56;95% CI, 1.16–1.87; P<0.001) after adjustment for confounders. Moreover, aside from the variableson which this systematic review focused on, the cohort studies also found AMD correlation withother diseases and causes of mortality. ConclusionIndividuals with AMD have higher risk for developing CVD. Thus, screening for AMD may bebeneficial in preventing CVD.
Did the metal object hit the cornea? A case report of penetrating ocular injury with embedded foreign body: Poster Presentation - Case Report - Resident AGUNG NUGROHO; Dearaini; Annisa Windyani; Susantono, Diannisa Paramitha; Pangestika, Rishka; Laksmita, Yulinda Arty; Widyawati, Syska; Adriono, Gitalisa Andayani
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: 10.35749/7fy1ce37

Abstract

Introduction : Penetrating ocular injury with IOFBs may cause severe ocular damage. We demonstrate the diagnostic and treatment approach in a case of scleral laceration with a large IOFB. Case Illustration : A-24-year-old male presented with a rusty segment of fence wire, sized 15x11 mm, embedded near the nasal corneal margin of the right eye. Upon initial examination the vision was 6/9 with normal IOP. The object obstructed the view of the entry site, therefore corneal wound was suspected. CT scan showed penetrating metal object without posterior segment involvement. Anti-tetanus injection, topical and oral levofloxacin were given. He underwent exploration, foreign body removal and repair surgery. During surgery, the wound was revealed as a scleral laceration, 4 mm from nasal limbus. One day post-operative, vision was 6/20. A 0.1 mm hypopyon was found, along with fibrin at nasal vitreous. Oral and topical corticosteroids were given, and hypopyon disappeared the next day. One week after surgery, vision improved to 6/7.5, with clear vitreous and normal retina. Discussion : Ocular injuries with large IOFBs can hinder clinical examination. Corneal entry wound should be ruled out, due to potential permanent damage to visual axis. CT scan was helpful in assessing the depth of object penetration. The object was removed successfully, with no damage to the cornea and retina. Anti-tetanus, antibiotics and corticosteroids were able to control infection and inflammation. Conclusion : Large IOFBs which do not affect the visual axis, can be managed with successful outcome, by prompt removal and repair of the entry wound, and control of infection and inflammation.
Leprosy Health Promotion during COVID-19 Pandemic in Indonesia Rahayu, Tri; Wicitra, Anindita; Lestari, Yeni Dwi; Irawati, Yunia; Bani, Anna Puspitasari; Andayani, Gitalisa; Susiyanti, Made; Daniel, Hisar; Puspitasari, Sitha Anisa
Journal of Community Empowerment for Health Vol 7, No 1 (2024)
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.71769

Abstract

Introduction: The COVID-19 pandemic has forced many conventional -face-to-face health promotion events to be conducted in an adaptive manner to keep healthcare in promotion, prevention, and even curative measures delivered to healthcare providers and patients. The same applies to leprosy, where Indonesia is still ranked as the third largest country with leprosy burden. This study aims to give rise to newer methods of health promotion on leprosy during this COVID-19 pandemic. Methods: Online training and case presentation workshop in the form of a KATAMATAKU webinar [MOU1] and live streaming via YouTube were held in August 2020. There were 120 general practitioners, 30 nurses, and 35 healthcare providers who registered and joined this event.[MOU2]  Pre- and post-test [MOU3] were conducted to evaluate the participants' knowledge about the topics lectured during this training[MOU4] . Pre- and post-test were conducted using an online form, and all participants needed to answer several questions from each session. Participants were evaluated before the webinar began and after all sessions. We assessed the different scores from the pre- and post-test. Results: In the general practitioner group, median scores were 68 (27 – 95) and 82 (50 – 100) for pre- and post-test scores, respectively, with a mean difference between post and pre-test of 14.23+9.72. In nurses and other health care providers, the median for the pre-test score was 56 (22-89), and the post-test was 72 (39 – 100), with a mean difference between the post and pre-test of 18.93+10.27. Conclusion: In the pandemic situation, online seminars can be chosen as an effective method for health promotion to increase health care provider's knowledge. Pre- and post-test can be performed to evaluate participant's knowledge after the training. Regular training using online methods can be held in order to maintain participants' knowledge. We hope it can impact all health providers to continue their participation in the management of leprosy.
A Multidimensional Welfare Status of Leprosy Patients Living in a Suburban Area Irawati, Yunia; Menaldi, Sri Linuwih SW; Harini, Melinda; Wahyuni, Luh Karunia; Alwin, Wanarani; Dwiranti, Astari; Menaldi, Adhityawarman; Luzanil, Sonny Tirta; Matsurah, Qaishum; ., Dadun; Kurniawan, Rico; Ruwaida, Ida; Wicaksono, Gunawan; Sahid, Muhammad Hidayat; Rahmayanti, Febrina; Priscilia, Florentina; Fitriana, Anis; Rahayu, Tri; Susiyanti, Made; Andayani, Gitalisa; Bani, Anna Puspitasari; Daniel, Hisar; Lestari, Yeni Dwi
ASEAN Journal of Community Engagement Vol. 5, No. 1
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Leprosy has a high incidence of physical complications that will impact directly the physiological, economic, and social status of patients. Indonesia has a high burden of the disease, and several leprosy settlements are still spread in the country. Neglasari Village, Sitanala, Tangerang serves as one of the places of residence of people who have had leprosy. A health service initiative known as Identifikasi Tanda-Tanda Mata, Ekstremitas, dan Kulit pada Kusta (KATAMATAKU) was launched as a collaboration of health services among multi-departments (ophthalmology, dermatovenereology, and medical rehabilitation). Sitanala has a relatively high incidence of people who have had leprosy with disabilities of the hand, foot, and eye. As a continuation of this health service and combined with the efforts to improve the welfare of leprosy patients, in November 2019, a multidisciplinary program titled KATAMATAKU Universitas Indonesia, was conducted. This program aimed to determine the demographic data regarding the health, psychological, social, and economic status of the leprosy population at Sitanala The project consisted of a collaborative anti-stigma program by the Faculty of Psychology, Public Health, Social and Political Sciences, Cultural Sciences, Administrative Sciences, and Vocational Educational Program; thematic health program, which supports the improvement of physical abilities and empowerment of former leprosy patients, by the Faculty of Medicine, Dentistry, Nursing, and Pharmacy; thematic economics program, which aims to increase the economic capacity of the leprosy community, by the Faculty of Economics and Business, Mathematics and Natural Sciences, and Engineering. This program enabled the construction of a multidimensional management model, in which every aspect plays important roles to improve the patients’ quality of life.
Co-Authors ., Dadun Agung Nugroho Agustiawan, Referano Ali, Reyno Satria Alia Arianti Alwin, Wanarani Andhika Guna Dharma Andi A Victor Andi A Victor Andi Arus Victor Andi Arus Victor Andi Arus Victor Andi Arus Victor Andi Arus Victor Andi Arus Victor Andi Arus Victor Andi Marsa Nadhira Anggun R Yudantha Anggun R Yudantha Anggun Rama Yudantha Anggun Rama Yudantha Anggun Rama Yudantha Anggun Rama Yudantha Anggun Rama Yudantha Anggun Rama Yudantha Anggun Rama Yudantha Anggun Rama Yudhanta Anggun Ramayudatha Annisa Windyani Ari Andayani Ari Djatikusumo Ari Djatikusumo Ari Djatikusumo Ari Djatikusumo Ari Djatikusumo Ari Djatikusumo Ari Djatikusumo Ari Djatikusumo Ari Djatikusumo Ari Djatikusumo Ari Djatikusumo Arief S. Kartasasmita Bani, Anna Puspitasari Barus, Dany Petra Pranata Daniel, Hisar Dearaini Dharma, Andhika Guna Dicky Budiman Simanjuntak Djatikusumo, Ari Dwiranti, Astari Eko Hadi Waluyojati Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza Elvioza, Elvioza Faraby Martha Faresa Hilda Fauzan Teuku Banta Febrina Rahmayanti Firmansyah, M Fitriana, Anis Gladys Kusumowidagdo Habsyiyah Habsyiyah Harini, Melinda Harley, Ohisa Hutapea, Mario Marbungaran Ichsan, Andi M Ida Ruwaida, Ida Irawati, Yunia Isfyanto, Isfyanto Iskandar, Erwin Kartika Rahayu Khalifah, Rasyad King Hans Kurnia Kurniawan, Rico Laksmita, Yulinda Arty Leonedine, Tengku Viona Zohra Luh Karunia Wahyuni, Luh Karunia Luzanil, Sonny Tirta Made Susiyanti Mahfudz, Sausan Rasyid Mario Marbungaran Hutapea Mario Marbungaran Hutapea Mario Marbungaran Hutapea Mario Marbungaran Hutapea Mario Marbungaran Hutapea Mario Marbungaran Hutapea Mario Marbungaran Hutapea Martin Hertanto Masniah Masniah Matsurah, Qaishum Menaldi, Adhityawarman Menaldi, Sri Linuwih SW Nadia Artha Dewi Noviana Kurniasari Vivin Pambudy, Indra Maharddhika Pangestika, Rishka Presialia, Athira Priscilia, Florentina Puspitasari, Sitha Anisa Putri A Idham RAHAYU, TSANIA RACHMAH Randy Sarayar Sahid, Muhammad Hidayat Sausan Sembiring, Sindy Boru Simon A Siregar Sindy Boru Sembiring Sjahreza, Emil Suryoadji, Kemal Akbar Susantono, Diannisa Paramitha Susilo, Teguh Tri Rahayu Triwijayanti Triwijayanti Triyoga, Ichsan Fauzi Victor, Andi Arus Wicaksono, Gunawan Wicitra, Anindita Widyawati, Syska Yeni Dwi Lestari Yudanta, Anggun Rama Yudantha, Anggun Rama Yudhanta, Anggun Rama Yulia Aziza Yustiarini, Ima