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All Journal Medical Journal of Indonesia IJRETINA - International Journal of Retina
Triyoga, Ichsan Fauzi
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Health Professions Medicine & Pharmacology Public Health

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Multimodal approach in the diagnosis and management of Eales disease: a case report Adriono, Gitalisa Andayani; Mahfudz, Sausan Rasyid; Triyoga, Ichsan Fauzi
Medical Journal of Indonesia Vol. 33 No. 4 (2024): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.247454

Abstract

Eales disease is a rare idiopathic occlusive retinal vasculitis with low prevalence in the general population. Its infrequent occurrence limits diagnostic and treatment guidelines, emphasizing the need for ongoing reports to establish effective protocols. This case report describes a patient presenting with symptoms of bilateral retinal vasculitis. Fundus examination revealed vitreous hemorrhage (VH) and peripheral retinal vasculitis. Laboratory and imaging tests were performed to exclude differential diagnoses, leading to Eales disease as the primary diagnosis. Pars plana vitrectomy, panretinal laser photocoagulation, intravitreal anti-vascular endothelial growth factor, and anti-tuberculosis therapy were administered. Long-term follow-up showed satisfactory outcomes. This report suggested Eales disease to be a diagnosis of consideration for ophthalmologists encountering male patients with recurrent VH. Clinical suspicion, including appropriate laboratory testing and imaging, is essential to developing a holistic approach to diagnosis and management, aiming to prevent progression and achieve optimal visual outcomes.
Real-World Evaluation of the Effectiveness of Intravitreal Bevacizumab Injection for Neovascular Age-Related Macular Degeneration at Cipto Mangunkusumo National Referral Hospital Adriono, Gitalisa Andayani; Pambudy, Indra Maharddhika; Victor, Andi Arus; Djatikusumo, Ari; Yudhanta, Anggun Rama; Hutapea, Mario Marbungaran; Triyoga, Ichsan Fauzi
International Journal of Retina Vol 8 No 2 (2025): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2025.vol008.iss002.319

Abstract

Introduction: Neovascular age-related macular degeneration (nAMD) is a leading cause of visual impairment globally. While intravitreal anti-VEGF therapy is the standard treatment, real-world data on bevacizumab (IVB), the most accessible agent in Indonesian public hospitals despite being off-label, remains limited. This study aims to evaluate the effectiveness of IVB in patients with nAMD at a tertiary referral center in Indonesia. Methods: This retrospective study included patients diagnosed with nAMD who received IVB injections at Cipto Mangunkusumo National Referral Hospital between January and December 2017. Inclusion criteria encompassed patients with confirmed nAMD and available clinical data pre- and post-injection. Data on demographics, best-corrected visual acuity (BCVA), central macular thickness (CMT) measured by OCT, and IVB injection regimen were extracted from electronic medical records. Statistical analysis was performed using Wilcoxon signed-rank and Mann–Whitney U tests, with p < 0.05 considered statistically significant. Result: A total of 138 eyes from 131 patients (mean age: 66.7 years; 51% male) were analyzed. The median number of injections was three (range: 1–6). Mean BCVA showed a non-significant improvement from 1.19 to 1.14 logMAR (mean change: 0.05 logMAR; p = 0.770). Subgroup analysis indicated significant improvement in eyes with baseline VA worse than 1.32 logMAR (mean gain: 0.54 logMAR; p < 0.01) and a significant decline in eyes with baseline VA between 0.48 and 1.00 logMAR (mean loss: 0.21 logMAR; p = 0.02). CMT significantly decreased by an average of 108.33 µm (p < 0.01). Conclusion: IVB treatment for nAMD resulted in significant anatomical improvement and was particularly effective in patients with poor baseline visual acuity. These findings highlight the role of IVB in real-world clinical practice within resource-limited settings.
Co-Authors Andayani, Gitalisa Djatikusumo, Ari Hutapea, Mario Marbungaran Mahfudz, Sausan Rasyid Pambudy, Indra Maharddhika Victor, Andi Arus Yudhanta, Anggun Rama