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All Journal Medicina International Journal of Retina Ophthalmologica Indonesiana
I Putu Budhiastra, I Putu
Bagian/SMF Ilmu Kesehatan Mata, Fakultas Kedokteran Universitas Udayana / Rumah Sakit Umum Pusat Sanglah Denpasar Bali
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Resolution of Retinal Bleeding And Exudative Retinal Detachment After Chemotherapy with Melphalan In Multiple Myeloma Andayani, Ari; Budhiastra, I Putu; Adnyana, I Wayan Losen; Wijayati, Made Paramita
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Introduction: Multiple myeloma is the second most common hematologic cancer. It is characterized by the clonal proliferation of malignant plasma cells and associated organ dysfunction. Ophthalmic manifestations include hyperviscosity retinopathy and retinal detachment. The aim of this study is to report retinal manifestation in Multiple Myeloma. Methods: A man 45 years old, complained loss of vision on both eyes especially left eye over 1 month. He also feels weakness and 3 times spontaneous nose bleeding. His visual acquity is 6/12 on the right and 2/60 left eye with Retinal Bleeding and Retinal Detachment. His Laboratory examination result increase in WBC 65.91 x 103/µL (Neutrophil, Monocyte, Basophil and Lymphocyte) decrease RBC 3 x 106/µL, HGB 6.85 g/dL, normal PLT 193.60 103/µL, Normal Bleeding and Clotting Time and increase ESR 140 mm/hour. Multiple myeloma was diagnosed by Internal Department with bone marrow biopsy and increase of Gamma Globulin. Results: The patient was treated with melphalan 3 tablet 2 times a day and prednisone 4 mg 3 times a day for 5 days every 28 days.  After 8 month the VA 6/6 on the right and 6/10 on the left with complete resolution of on the right eye and there are resolution on the left eye with fibrosis, the laboratory examination normal WBC 3.8 x 103/µL with Neutrophil 59.3%, Monocyte 6.1 %, Eosinophil 6.3 %, Basophil 0.3 % and Lymphocyte 28.0 %, normal RBC 4.6 x 106/µL, slightly decrease HGB 12.8 g/dL, normal PLT 177.0 x 103/µL and decrease Gamma Globulin. Discussion: This case of bilateral Retinal Bleeding and Exudative Retinal Detachment are remarkable for both its presentation and response to melphalan therapy. Treatment with melphalan and prednison alone was sufficient to clear the Retinal Bleeding and restoration of Exudative Retinal Detachment. Conclusion: Complication of Multiple Myeloma can caused organ disfunction such as retinal bleeding and exudative retinal detachment. Early Diagnosis  is very crucial. In our case combination cemotheraphy with  Melphalan and Prednison showed clinically significant resolution. Workship Internal Department and Ophthalmology Department are very important for management and monitoring ophthalmology manifestation in multiple myeloma.
KEJADIAN RETINOPATI DIABETIK PADA PASIEN DIABETES MELLITUS Suryathi, Ni Made Ari; Budhiastra, I Putu; Jayanegara, I Wayan Gede; Widiana, I Gede Raka
Medicina Vol 46 No 2 (2015): Mei 2015
Publisher : Medicina

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Retinopati diabetik adalah salah satu komplikasi mikrovaskular dari diabetes melitus (DM).Komplikasi ini terjadi karena hiperglikemia pada pembuluh darah dalam jangka waktu yang lama.Retinopati diabetik adalah penyebab kebutaan terbanyak setelah katarak. Retinopati diabetik terbagimenjadi retinopati diabetik proliferatif (RDP) dan retinopati diabetik nonproliferatif (RDNP). Penelitianini bertujuan untuk mengetahui karakteristik pasien retinopati diabetik pada pasien diabetes mellitus.Penelitian ini adalah penelitian diskriptif yang dilakukan di RSUP Sanglah dan RS Indera, Denpasardari bulan Oktober 2014 sampai dengan Januari 2015. Pada penelitian ini, didapatkan 123 pasienDM, yang terdiri dari 66 laki-laki dan 57 perempuan, rerata umur adalah 56,30 (SB 8,16) tahun danrerata menderita DM selama 9,11 (SB 3,42) tahun. Dari 123 pasien, didapatkan 60,16% pasienmengalami retinopati. Pada kelompok RDP ditemukan lama menderita DM lebih lama (9,72 (SB3,92) vs 8,50 (SB 2,92)) tahun, hemoglobin glikosilat yang lebih tinggi (9,40 (SB 2,17) vs 7,06 (SB1,97))%, rerata umur 56,00 (SB 7,60) tahun dan laki-laki mendominasi kelompok ini (51%). Simpulanpenelitian ini adalah lebih dari 50% pasien DM pada penelitian ini mengalami retinopati dengankadar hemoglobin glikosilat lebih dari 7%. [MEDICINA 2015;46:86-91].Diabetic retinopathy is one of microvascular complication on Diabetes Mellitus (DM). This complicationcauses by hyperglycemia on retinal blood artery and vein during long periods of time. Diabeticretinopathy is the second causes of blindness after cataract. It consists of Non Proliferative DiabeticRetinopathy (NPDR) and Proliferative Diabetic Retinopathy (PDR). This study has aimed to identifythe characteristics of retinopathy in DM patients. This was descriptive study which had conducted inSanglah and Indera Hospital Denpasar Bali, from October 2014 until January 2015. 123 patients DMwere included, consisted of 66 males and 57 females, with average of age was 56,30 (SD 8,16) years,average of duration diabetes was 9,11 (SD 3,42) years. Among those patients, 60,16% hadretinopathy.Those who had PDR tend to have longer duration of diabetes (9,72 (SD 3,92) vs 8,50 (SD2,92)) years, higher glycosilate hemoglobin (9,40 (SD 2,17) vs 7,06 (SD 1,97))%, average of age was56,00 (SD 7,60) years, and male dominance (51%). In conclusion, more than a half of diabetes in thisstudy has retinopathy with mean glycosilate hemoglobin more than 7%. [MEDICINA 2015;46:86-91].
BARRAGE LASER PHOTOCOAGULATION IN HIGH-MYOPIC PATIENT WITH SYMPTOMATIC RETINAL TEARS BEFORE PHACOEMULSIFICATION: A CASE REPORT: Poster Presentation - Case Report - Ophthalmologist Budhiastra, I Putu; Tridiyoga, Komang Putra; Jayanegara, I wayan Gede; Suryathi, Ni Made Ari; Andayani, Ari; Pitanatri, Nyoman Brahmani
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/zdtpyp85

Abstract

Introduction : Retinal tears can be present in up to 2.4% of cases of lattice degeneration, which is considered an important risk of retinal detachment in a high-myopic patient. Laser photocoagulation has been shown to reduce the risks of retinal detachment before phacoemulsification thus improve in the visual outcome. We report a case of a high myopic patient with symptomatic retinal tears who underwent phacoemulsification that was treated prophylactically with barrage laser photocoagulation. Case Illustration : A 43 years-old female with a history of high myopia complained of flashes and floaters on both eyes. She had high myopia measuring -13.0 dioptres and -28.0 dioptres in the right and left eyes respectively. Unaided visual acuity was 2/60 in both eyes. Fundus examination showed lattice degenerations with a small tear found on both eyes with no retinal detachments. She was treated with a barrage laser on both eyes followed by phacoemulsification. On the last follow-up, the retina remained stable and the visual acuity was significantly improved with no development of macular edema or retinal detachment in both eyes. Discussion : Although most cases of lattice degeneration do not need intervention, some present a risk of retinal detachment. Barrage laser photocoagulation may have a place in high myopic patient lattice degeneration with symptomatic retinal tears to maintain retinal stability and to obtain the optimal outcome after phacoemulsification. Conclusion : Barrage laser photocoagulation is beneficial as a prophylactic treatment of symptomatic retinal tears before phacoemulsification in high-myopic patients.
Co-Authors Ari Andayani I Gde Raka Widiana I Wayan Gede Jayanegara I Wayan Losen Adnyana Ni Made Ari Suryathi Pitanatri, Nyoman Brahmani Tridiyoga, Komang Putra Wijayati, Made Paramita