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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

Abstract

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

Abstract

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.
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

Abstract

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.