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All Journal Majalah Kedokteran Bandung Althea Medical Journal Nusantara Medical Science Journal Indonesian Journal of Medicine Jurnal Pendidikan dan Pelayanan Kebidanan Indonesia (Indonesian Journal of Education and Midwifery Care) International Journal of Retina Jurnal Medika Malahayati Sehat Masada Narra J IJRETINA - International Journal of Retina Oftalmologi: Jurnal Kesehatan Mata Indonesia Ophthalmologica Indonesiana
Arief S. Kartasasmita
Department Of Ophthalmology, Faculty Of Medicine, Padjadjaran University Cicendo National Eye Center, Bandung, West Java
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Library & Information Science Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health

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CLINICAL CHARACTERISTICS OF CYTOMEGALOVIRUS RETINITIS IN HUMAN IMMUNODEFICIENCY VIRUS (HIV) PATIENTS UNDERGOING INTRAVITREAL GANCICLOVIR INJECTION effendi, yulia; Widyanatha, Made Indra; Ihsan, Grimaldi; Virgana, Rova; Iskandar, Erwin; 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.iss002.270

Abstract

Introduction: Cytomegalovirus (CMV) retinitis is the most common ocular opportunistic infection in patients with Human immunodeficiency virus (HIV). The disease is causing blindness and current management commonly characterized by delayed diagnosis and inadequate treatment. Purpose: to describe the clinical characteristic and visual outcome of CMV retinitis with HIV treated with intravitreal ganciclovir injection. Methods: This is a retrospective study included 23 patients (34 eyes) who presented with CMV Retinitis with HIV from January 2020 to July 2023 who received intravitreal ganciclovir in both the induction and maintenance phases until declared cured, characterized by lesion inactivation and CD4+ T-cell counts reaching >100/µL within period of 3 to 6 months. Data were collected including age, gender, affected eye laterality, CD4+ T-cell count at the initial visit at vitreoretinal polyclinic and the 6-month follow-up, total number of intravitreal ganciclovir injections, HAART history at the initial visit, visual acuity at the initial visit, 6-month follow-up, and systemic comorbidities. Result: The median age was 29 years old with 82,6% of them male. Bilateral lesions were observed in 60.9% of the patients. Median CD4 count initial visit was 50 with 52% below 50 cell/µL. Fifteen patients (65,2%) already treated with highly active antiretroviral therapy (HAART) before injection. Tuberculosis was the most common opportunistic infection. Mean intraviteral ganciclovir injection 9,12±3,40 in each eye. Eleven eyes (32.4%) with initial visual acuity ≤1.00 logMAR increased to 19 eyes (55.9%) at the 6-month follow-up. There were statistically significant difference between baseline visual acuity and 6-months follow up after intravitreal ganciclovir. (p= 0,008). Conclusion: Retinitis cytomegalovirus tend to have more severe clinical presentations in patients with CD4 counts below 50 cells/µL. Intravitreal ganciclovir is effective in controlling CMV retinitis.
Ocular Manifestations of Von Hippel-Lindau Disease: a Rare Sight- Threatening Condition: Poster Presentation - Case Report - Resident Elsyanty, Firda Muthia; Widyanatha, Made Indra; Ihsan, Grimaldi; Virgana, Rova; Iskandar, Erwin; Kartasasmita, Arief S.
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/hc3z9k23

Abstract

Introduction : Von Hippel-Lindau (VHL) disease is a rare phacomatosis characterized by multi-organ neoplasia which usually manifests in young adulthood. Ocular manifestations of this disease are frequently presented initially before the involvement of other organ systems. Case Illustration : An 18-year-old girl came with a chief complaint of photopsia in the left eye and complete vision loss in the right eye for five years. The visual acuity of the right eye was no light perception and the left eye was 0.8. The anterior segment of the right eye showed iris neovascularization. The posterior segment of the left eye demonstrated multiple elevated red-yellowish lesions fed by a dilated and tortuous vessel. The head CT scan revealed multiple lesions at the pons and cerebellum. The patient was diagnosed with multiple retinal and brain hemangioblastomas due to VHL disease, neovascular glaucoma, and chronic retinal detachment of the right eye due to sequelae of VHL. The patient was treated with cryotherapy and laser photocoagulation of the left eye. Five-month post-cryotherapy follow-up showed the lesions were still active then she underwent the second cryotherapy. The lesions became whitish in appearance with smaller feeder vessels one month after the second cryotherapy and the visual acuity was preserved. Discussion : Retinal hemangioblastoma is the most common ocular manifestation of VHL disease. Prolonged ischemia causes sight-threatening complications including neovascular glaucoma and exudative retinal detachment. Prompt treatment of detected lesions is crucial for visual preservation. Conclusion : Early detection of VHL ocular manifestations plays a critical role in establishing the diagnosis and initiating treatment for a better prognosis.
THE OUTCOME OF INTRAVITREAL BROLUCIZUMAB FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION TREATMENT: Poster Presentation - Case Report - Resident Graziani, Gabriella; Ihsan, Grimaldi; Widyanatha, Made Indra; Virgana, Rova; Kartasasmita, Arief S.; Iskandar, Erwin
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/nvxrf729

Abstract

Introduction : Age-related macular degeneration (AMD) is a disease that results in irreversible severe loss of central vision in people over 50 years old. Hence, anti-VEGF therapy has become a standard treatment for neovascular AMD. Brolucizumab is a single-chain antibody fragment that inhibits VEGF-A binding to VEGF receptors. It has a higher molar concentration that allows a greater reduction in the central subfield thickness (CST) Case Illustration : A 59-year-old male with a chief complaint of gradually blurred vision in the left eye for 2 years. BCVA of the left eye was 0.3, OCT showed a hyperreflective band in the sub-neurosensory space with subretinal fluid in the left eye (Figure 1), and OCT-A revealed choroidal neovascularization (Figure 2). The patient was diagnosed with AMD AREDS IV in the left eye. He had undergone three monthly injections of brolucizumab. BCVA of the left eye after injection improved to 1.0 and OCT imaging showed no subretinal fluid, no intraretinal fluid, and no pigment epithelial detachment. Discussion : Brolucizumab has a greater reduction in CST because of its high molecular concentration. Results of HAWK and HARRIER concluded that brolucizumab was non-inferior towards aflibercept in BCVA change at week 48. According to the HAWK trial, a greater reduction of CST was seen in week 16 among eyes treated with brolucizumab. Brolucizumab was also well tolerated and adverse event rates were similar to aflibercept. Conclusion : Brolucizumab could be an alternative treatment option considering its efficacy in improving visual acuity and reducing CST.
Co-Authors A M Ichsan Agustiawan, Referano Andayani, Gitalisa Andika Prahasta Anita Deborah Anwar Ari Andayani Chalid Kurniawan Dainty Maternity Deni K Sunjaya Desrina Dewi Marhaeni Diah Herawati Dharma, Andhika Guna Dinan S Bratakoesoma Djatikusumo, Ari Dwijayanti, Sindi effendi, yulia Elsyanty, Firda Muthia Elvioza Elvioza, Elvioza Endang Sri Wahyuni Erni Mayor Erwin Iskandar Erwin Iskandar Farid Husin Farid Husin Fauziah Hayati Feti Karfiati Memed Firmansyah, M Graziani, Gabriella Grimaldi Ihsan Grimaldi Ihsan Habibah S. Muhiddin Hadyana Sukandar Harley, Ohisa Ichsan, Andi M Ihsan , Grimaldi Ihsan, Grimaldi Ihsan, Grimaldi Indra, Made Iriani, Oktarina Sri Iskandar, Erwin Iwan Sovani Iwan Sovani Juanarta, Pieter Juliati Juliati Juliati, Juliati Kurniawan, Chalid Laila Wahyuni Made Indra Widyanatha Maimun Syukri, Maimun Marliana Rahma Marsha Rayfa Pintary Martin Hertanto Maya Sari Mayang Rini Mega Wulan Purnama Sari Metita, Mirza Mia Purnama Mirza Metita Nadia Artha Dewi Nauli, Rizki Rahma Nurul Aini Pintary, Marsha Rayfa Ponpon S Idjradinata Ponpon S Idjradinata Prettyla Yollamanda Purnama Sari, Mega Wulan Purnama, Mia Rahayu Widhyasti Rizki Rahma Nauli Ronny Lesmana Rova Virgana Rova Virgana Sembiring, Sindy Boru Setiawan . Setyohadji, Bambang Sindi Dwijayanti Sjahreza, Emil Susiarno, Hadi Susilo, Teguh Tjahjono D. Gondhowiardjo Vita Murniati Tarawan Widyanatha, Made Indra Yollamanda, Prettyla Yuna, Uray Nabila Yustiarini, Ima Zaini, Lia M.