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All Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia IJRETINA - International Journal of Retina
Nadhira, Andi Marsa
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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Brolucizumab for Neovascular Age-Related Macular Degeneration in Real-World Setting Nadhira, Andi Marsa; Djatikusumo, Ari; Victor, Andi Arus
International Journal of Retina Vol 6 No 2 (2023): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2023.vol006.iss002.247

Abstract

Introduction: The mainstay treatment for neovascular AMD (nAMD) is intravitreal injections of anti-vascular growth factor (anti-VEGF) agents. Based on clinical trials, a newly developed anti-VEGF named brolucizumab showed noninferiority in anatomical and functional outcomes with longer injection interval, when compared to previous anti-VEGF agents; however, severe post-injection inflammation has been observed. This review aims to evaluate the efficacy and safety of brolucizumab in real-world clinical setting. Methods: We conducted systematic searches in Pubmed, Science Direct, Clinicalkey, and Scopus. Observational studies, case series, and individual case studies enrolling naïve-treatment and switch-therapy nAMD patients who received intravitreal injection of brolucizumab were eligible for this review. Result: We included 12 studies, comprising 772 patients and 848 eyes, that reported the outcome of intravitreal injection of brolucizumab in real-world practice. The mean age of patients was 77 years old. Follow-up period ranged from 7,2 weeks to 52 weeks. Improvement in visual acuity was mostly observed in treatment-naïve groups, ranging from +4,5 to +11,9 Early Treatment Diabetic Retinopathy Study (ETDRS) letters. Improvement in retinal thickness and reduction in retinal fluids were reported in both groups, with mean central retinal thickness (CRT) change of 94,92 μm. Significant reductions of subretinal fluid (SRF) were observed in 4 studies, intraretinal fluid (IRF) in 2 studies, and pigment epithelial detachment (PED) in 3 studies. Eight studies reported injection interval, the longest of which extended to 12 weeks. Inflammatory events following brolucizumab injection were reported in 8,01% of eyes, ranging from mild to severe inflammation, with 34,2% of the intraocular inflammation occurring in the vitreous (22 eyes). Brolucizumab may help alleviate treatment burden in real-world clinical setting by reducing disease activity, mainly demonstrated as improvement in retinal thickness, reduction in retinal fluid, and prolongation of injection interval. Clinicians must be aware of the possible inflammatory events following brolucizumab injection.
Kadar Gula Darah dan Keparahan COVID-19 pada Pasien Diabetes Melitus di Ruang Rawat Intensif: Serial Kasus Audita, Fatira Ratri; Hapsari, Arini Ika; Nadhira, Andi Marsa; Aini, Muhammad Hafiz
Majalah Kedokteran Indonesia Vol 71 No 5 (2021): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.71.5-2021-358

Abstract

Introduction: The severity of coronavirus disease 2019 (COVID-19) ranges from mild flu to respiratory distress and death. Diabetes mellitus (DM) is considered as one of the risk factors for infection susceptibility and disease severity. This case series reports the clinical features, ancillary test findings, and mortality in patients with severe COVID-19 and DM.Case Illustration: This study reports three female patients, aged 50-68 years old, with severe COVID-19 and DM whom were hospitalized in intensive care unit from April to July 2020. Two patients presented with hyperglycemia upon admission. During hospitalization, two patients tended to be hyperglycemic, while the other one had more episodes of hypoglycemia. Two patients suffered from hospital-associated pneumonia and acute kidney injury throughout hospital stay. One patient passed away.Discussion: All patients had fluctuating general condition and unstable blood glucose levels during hospitalization. One patient passed away due to respiratory distress, while the other two were discharged after their general condition improved. Hyperglycemic and hypoglycemic states in DM patients are proposed to play a role in the severity of COVID-19 infection.Conclusion: DM may aggravate COVID-19 infection. Initial normal blood glucose levels upon admission does not guarantee good prognosis; therefore, blood glucose control in COVID-19 patients remains extremely crucial.
Co-Authors Aini, Muhammad Hafiz Audita, Fatira Ratri Djatikusumo, Ari Hapsari, Arini Ika Victor, Andi Arus