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Branch Retinal Vein Occlusion with Vitreous Hemorrhage Identified During Intraoperative Vitrectomy Nafila Mahida Sukmono; Ramzi Amin
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2018.vol001.iss001.37

Introduction Retinal vein occlusion is the largest group of retinal blood vessels after diabetic retinopathy. Occlusion occurring in the retinal vein is divided into central retinal vein occlusion (CRVO) occlusion and branch retinal vein occlusion (BRVO) occlusion. The Beijing Eye Study, reported a higher incidence of BRVO than CRVO, where 10-year incidents for BRVO were 1.6 per 100 subjects, and CRVO was only 0.3% 100 subjects.1 To report a case of Branch Retinal Vein Occlusion with vitreous hemorrhage identified during intraoperative vitrectomy Method: A 49-year-old woman with a history of 15 years of hypertension had right eye vision complaints, increasingly blurred since last 2 months. The right eye visual acuity 2/60 cannot be corrected and left eye 6/30 cannot be corrected. The posterior segment on right eye is difficult to assess. USG B-Scan right eye found vitreous echospike appearance of vitreous bleeding. We manage with vitrectomy and during intraoperative we identified bleeding and ghost vessel in superotemporal area. Bleeding in the superotemporal quadrant is done by photocoagulation laser action. Results: First day postoperative there was increased in visual acuity to 6/60 with a posterior segment that could be assessed, obtained tortous blood vessels, slight bleeding and ghost vessel in the superotemporal area with laser injury. Conclusion: In this case report, patients with BRVO with complications of vitreous hemorrhage performed vitrectomy with additional endolaser in the ischemic area. The result of this action of visual acuity improvement in patient.

Anti-VEGF Therapy In Central Retinal Vein Occlusions Meidina Rahmah; Ramzi Amin; AK Ansyori
International Journal of Retina Vol 1 No 2 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2018.vol001.iss002.42

Introduction: Central retinal vein occlusion (CRVO) is the second most common retinal vascular disease after diabetic retinopathy and is estimated to affect more than 16 million adults worldwide. Treating the underlying cause of occlusion of the central retinal vein, reducing the risk factors, and early and proper management are the keys toward a better prognosis in patients with CRVO. Repeated frequent treatment of CRVO with macular edema with intravitreal anti-vascular endothelial growth factor (anti-VEGF) is an effective treatment to improve visual outcome. In this case report we assess the 3-month efficacy of anti-VEGF therapy in CRVO. Method: In this case, a 52-year-old man presented with an acute loss of vision over the last week in his left eye. His baseline visual acuity was 1/60 and his central retinal thickness (CRT) on Optical Coherence Tomography (OCT) was 523 μm. Fundus examination revealed a hemorrhage in all four quadrants, hard exudates, swelling of the optic nerve, and macular edema. Laboratory test confirms hyperlipidemia and we consult this patient to Internal Medicine Department. This patient got 3 monthly injections of 1,25 mg Bevacizumab. Results: By 3 months, the OCT appeared fairly normal and the visual acuity improved to 6/60 Conclusion: Anti-VEGF therapy is effective for treating macular edema secondary to CRVO

Urine Albumin Creatinine Ratio Among Diabetic Retinopathy Patient With And Without Diabetic Macular Edema In Moh. Hoesin Hospital Palembang Rina Astuti; AK Ansyori; Ramzi Amin
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2018.vol001.iss001.32

Introduction: Diabetic Macular Edema is a diffuse thickening in macula which can be found in various severity of Diabetic Retinopathy. There are issue about relationship between Diabetic Macular Edema and albuminuria caused by chronic renal failure. The aim of this study is to know and compare urine albumin creatinine ratio among Diabetic Retinopathy patients with and without Diabetic Macular Edema in Moh. Hoesin Hospital. Methods: Cross sectional study with 25 sample was conducted. Diabetic Retinopathy and Diabetic Macular Edema was classified base on Early Treatment Of Diabetic Retinopathy Study (ETDRS) criteria. T-test, odd ratio and multiple logistic regretion analysis was used to analysed sociodemography characteristic (age and gender), clinical characteristic (duration of DM, hipertension, treatment, body mass indeks and antioksidan consumption), ophtalmology characteristic (visus, anterior segment anomaly and posterior segment/ severity of Diabetic Retinopathy), laboratory characteristic (HbA1c, ureum, creatinine, urine albumin creatinine ratio, and lipid profile). Result: Urine albumin creatinine ratio mean (2146.77 ± 3796.19) in Diabetic Macular Edema and (49.0 ± 45.35) in non-Diabetic Macular Edema; cutoff point 62.00 mg/dL. Odd ratio adjusted for urine albumin creatinine ratio = 18,8. In this research, risk factors which has significantly were urine albumin creatinine ratio (p=0.047) and High-Density Lipoprotein/HDL (p=0.028) with odd ratio 8.571 and 6.67 respectively. Urine albumin creatinine ratio showed significantly high Mann whitney analysis 0.02 (p<0.005). Conclusion: Urine albumin creatinine ratio in Diabetic Retinopathy with Diabetic Macular Edema was higher than without Diabetic Macular Edema. Urine albumin creatinine ratio and High Density Lipoprotein (HDL) are the two important risk factors associated with Diabetic Macular Edema.

Management of Rhegmatogenous Retinal detachment with Buckle Sclera and Cryoretinopexcy Ria Mutiara; Ramzi Amin
International Journal of Retina Vol 1 No 2 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2018.vol001.iss002.33

Introduction: Retinal detachment is divided into three categories. The most common type is the regmatogen retinal detachment (rhegmatogenous retinal detachment), which is the result of the tearing of the retinal lining. Actions can be Buckle Sclera, vitrectomy pars plana and pneumatic retinopexy. The purpose of this case report to reported Management of Rhegmatogenous Retinal detachment with Buckle Sclera and Cryoretinopexcy. Method: A 58 years old man with chief complaint The left eye blurred like a curtain covered since 5 days,floaters (+), photopsia (+),headache (+), Patients never complain of lost vision suddenly before, eyeball pain is not there.History of trauma (+),On examination, the visual acuity 6/9 RE and 1/60 LE, anterior segment lens cloudy (+)nuclaer gr III, fundus photograph we found retinal contours of the blood vessels well, tear (+) is directed at 2-3 hours of superior-temporal and fovea reflex (-), B-scan ultrasound of the posterior segment the retina is not intact, Membran like lession detachment which attach to optic nerve. Results: The Sclera buckles and cryoretinopexy were performed under general antesthesia. Visual acuity post-operative on left eye 2/60. subconjunctival bleeding (+), the fundus photographs retinal attach but the macular reflex is still negative. post-operative theraphy with topical steroid and antibiotic eye drops, oral antibiotic, and oral analgetic. follow up 1-month post-operative visual acuity 5/60 with fundus photograph obtained retina attach. Conclusion: a diagnosis of retinal detachment can be found, with the discovery of fullthickness breaks or defects occurring from the retinal neurosensory, this break will allow the vitreous to enter the defect gap between the retinal neurosensory and RPE. Based on the clinical features of the posterior segment, the detachment area was found with the location of the Linchoff Rule 2 break based on the American Academy of Ophthalmology. The objective of operative therapy was to reattach the retinal portion of which one of them was buckle sclera and cryoretinopexcy.

The Difference of Visual Field Defect on Diabetic Retinopathy Patients Treated with Panretinal Laser Photocoagulation with 20-Milisecond and 100-Milisecond Duration Nova Herdana; AK Ansyori; Ramzi Amin; Irsan Saleh
International Journal of Retina Vol 1 No 2 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

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

Introduction: Panretinal laser photocoagulation (PRP) is a standard treatment for severe nonproliferative and proliferative diabetic retinopathy. Twenty-milisecond duration PRP show same effectiveness with 100-ms standard PRP in inhibit neovascularization progression. This shorter pulse tend to minimize retinal neuronal defect and visual field defect. This study aim to analyze the difference of visual field defect in diabetic retinopathy (DR) patients treated with 20-ms PRP compared with 100-ms PRP in Moh. Hoesin Hospital Palembang. Methods: A clinical trial with single blinding on severe-very severe NPDR and early PDR eyes treated with PRP between June and August 2016. Forty eyes (25 patients) were randomized into two groups. Twenty eyes were treated with 20-ms PRP, and other 20 eyes treated with 100-ms PRP. Visual field defect was evaluated using Humphrey Field Analyzer 30-2 SITA Standard at baseline and 2 weeks follow-up. Result: Unpaired t-test showed significant difference in mean deviation (MD) after laser on NPDR eyes (p=0.042, p<0.05), meanwhile there was no significant difference in early PDR eyes (p=0.17, p>0.05). In NPDR eyes, more MD improvement was found in 20-ms PRP group (0.79±0.93 dB) than in 100-ms group (-0.04±0.61 dB). In early PDR eyes, MD improvement was bigger (1.0±0.88 dB) in 20-ms PRP group than in 100-ms group (0.10±1.47 dB). There was no significant difference in pattern standard deviation (PSD) on both group at any DR grade (p=0.208; p=0.201; p>0.05). Conclusion: After 2 weeks, 20-ms PRP caused more improvement and lesser visual field defect (p=0.042, p<0.05) on NPDR eyes. There was no significant difference in PSD on both groups.

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