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Outlook of Diabetic Retinopathy Management through Universal Health Care in Indonesia from 2015 – 2020: Oral Presentation - Observational Study - Resident Zaharo, Alfia Fatma; Wardhana, Firman Setya; Supanji; Sasongko, Muhammad Bayu
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/fcwc9x44

Abstract

Introduction & ObjectivesTo identify the National Health Expenditure associated with diabetic retinopathy (DR) from theperspective of Jaminan Kesehatan Nasional [JKN]. MethodsA dataset of 1% of all individuals registered in JKN database was used from 2015 to 2020. Weretrieved primary diagnosis with type 2 diabetes mellitus (T2DM) (ICD-10 E11) and/or T2DM withophthalmic complications (E11.3). Further diagnosis with DR (H36) was retrieved. Four groups ofmedical procedures related to DR management were developed according to Indonesian Case BaseGroups (INA-CBGs): diagnostic, laser photocoagulation and cryotherapy, minor (intravitrealinjection), and major surgical procedures (e.g., vitrectomy). We performed descriptive analyses forthe annual costs incurred for procedures, premium classifications, and regions. ResultsOverall DR costs were US $41.5 million from 156,752 individuals with DR in JKN database sample.The total cost and per unit procedures cost specifically increased annually from 2015 to 2019 butdeclined substantially in 2020. The largest amount was spent on intravitreal injection ($36.3 million[87.5%]), whereas vitrectomy was the least ($145.0 million [0.3%]). Region 1 (Java Island) with nonbeneficiariesof government subsidies (PBPU and PPU) was the major number of claims ($12.5million [30.1%] and ($7.3 million [17.7%]), while beneficiaries of government subsidies (PBI) outsideJava Island, conversely, were under average. ConclusionThere was significant increase in health expenditure associated with DR in Indonesia from 2015 to2019, but decreased in 2020 possibly due to COVID-19 pandemic. Majority of funding was spent totreat severe spectrum of DR and concerned in urban area.
Brolucizumab for Wet Aged-Related Macular Degeneration Patients : too Good to be True: Oral Presentation - Observational Study - Resident Purbonegoro, Tania; Prayogo, M. Eko; Agni, A. Nurini; W., Tri Wahyu; Supanji; W., Firman S.; Sasongko, M.B
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/jtysr533

Abstract

Introduction & ObjectivesBrolucizumab is the newest anti-vascular endothelial growth factor (anti-VEGF). It showed superioranatomic outcomes and noninferiority best corrected visual acuity (BCVA) results for Wet Aged-Related Macular Degeneration (Wet-AMD) compared to other anti-VEGF. In Yogyakarta, it's beenonly used in a few patients and we want to report the effectiveness and safety of brolucizumab inWetAMD MethodsIn this retrospective study, all wetAMD patients who underwent Brolucizuab intravitreal injectionsbetween December 2021 and January 2023 at Dr YAP Eye Hospital were studied. Patient’sdemographic data, before and after intravitreal brolucizumab injections (central macular thickness,intraocular pressure, and BCVA) were assessed. ResultsThis study included 6 eyes of 6 patients (3 women) with a mean age of 69.5 years old. The meanfollow-up period was 27 ± 10.1 weeks after the first injection of brolucizumab. Three patients werenaïve wetAMD patients, three anti-VEGF experienced wetAMD patients. The mean BCVA at baseline(before brolucizumab injection) was 0.12 decimal (6/48) and 0.29 decimal (6/20) at the last followup.Five out of six patients' visual acuity were improved. In four out of six patient central macularthickness were reduced (mean difference 29,2 um). None of the patient's intraocular pressureincreased over 21 mmHg. None of the patients reported any signs of inflammation, vasculitis, ocularor systemic adverse effects. ConclusionThis limited data demonstrated that brolucizumab was relatively safe and effective in stabilizingBCVA for both WetAMD patients who had previous treatment with other anti-VEGF agents andnaive. Larger sample sizes studies & future multicenter collaborative are warranted
Sutureless Scleral Fixation of Intraocular Lens in Aphakia: Characteristics and Visual Outcomes: Oral Presentation - Observational Study - Resident Rahma, Fatkhati Saida; W., Firman S.; A, Angela Nurini; W, Tri Wahyu; Supanji; Sasongko, M. Bayu
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/gqh2r204

Abstract

Introduction & ObjectivesSutureless scleral fixation (SSF) surgery is one of the secondary intraocular lens (IOL) implantationprocedures for aphakic patients with absent or deficient capsular bag support that is beingincreasingly performed these days. This study aimed to describe the characteristics, indications for,and visual outcomes of patients who had undergone sutureless scleral fixation of intraocular lensesat Sardjito Hospital. MethodsA retrospective cross-sectional study of 43 eyes that SSF intraocular lens at Sardjito Hospital,Yogyakarta. The data were collected from electronic medical records of patients from October 2020to December 2022. The data were analyzed descriptively by presenting numbers and percentages forcategorical variables and mean ± standard deviation (SD) for numerical variables. Outcomesincluded pre- and postoperative uncorrected visual acuity (UCVA). ResultsThere were 43 eyes obtained from 40 patients who underwent SSF intraocular lens in this study,consisting of 35 males (79.55%) and 9 females (20.45%). The mean age of the subjects was 50.04 ±19.2 years. Lens subluxation was the most common indication for surgery (32.5%), followed bydropped nucleus (20.45%), intraocular lens luxation (18.18%), lens luxation (15.91%), intraocularlens decentration (9.09%), and endophthalmitis (4.55%). Before surgery, most of the patients hadvisual acuity of less than 3/60 (81.4%) and after surgery, 32.56% had ?6/18, 34.88% had <6/18-6/60,and 18.60% had <6/60-3/60. ConclusionMales predominantly underwent SSF intraocular lens surgery at Sardjito Hospital. Lens subluxationwas the most common indication for the surgery. There was an improvement in visual outcome.
When do Ophthalmology Residents Study to Prepare for The National Exam? Oral Presentation - Observational Study - Ophthalmologist WIDYANA; FELICIA WIDYAPUTRI; SUPANJI; MUHAMMAD BAYU SASONGKO
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/s8v7c246

Abstract

Abstract Introduction & Objectives : Ophthalmology residents are occupied with clinical services in the hospital. They only have limited time to study. Since 2022, we established a progress test for residents to facilitate their study especially during the national examination preparation that is obligated to be completed once per year. To report the allocated time for completing the progress test by ophthalmology residents to inform educational centres about the recommended study time for residents. Methods : Data from the online progress test that was available from the Gadjah Mada eLearning (GAMEL) platform was extracted and analysed. The test was consisted of 60 multiple questions and opened for two weeks with a 24-hour access time. In this study, the scores, the time of the test, and time spent to complete the test were descriptively and quantitatively analysed. Results : Overall, 42 out of 55 (76.4%) and 42 out of 56 (75.0%) residents completed the progress test with a total test attempt of 60 and 51 times in 2022 and 2023, respectively. The mean score achieved was 43.3 (min-max 3.3-70.0). Majority of residents (65.8%) accessed the test at between 16.00 - 23.00 Western Indonesian Time (WIT), while 19.8% and 14.4% at between 09.00 - 16.00 and 03.00 - 9.00 WIT. The mean time spent to complete the test was 55.2  20.9 minutes. Conclusion : Most ophthalmology residents spent their time for completing the progress test after working hours with an average duration of less than an hour. Any national exam preparation programs can be scheduled in this time for better resident’s engagements.
Co-Authors A, Angela Nurini A. Nurini Agni FELICIA WIDYAPUTRI Muhammad Bayu Sasongko Prayogo, M. Eko Purbonegoro, Tania Rahma, Fatkhati Saida Sasongko, M. Bayu Sasongko, M.B Sasongko, Muhammad Bayu W, Tri Wahyu W., Firman S. W., Tri Wahyu Wardhana, Firman Setya WIDYANA Zaharo, Alfia Fatma