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All Journal Nusantara Medical Science Journal International Journal of Retina eJournal Kedokteran Indonesia Jurnal Jalan Jembatan Oftalmologi: Jurnal Kesehatan Mata Indonesia Ophthalmologica Indonesiana
Erwin Iskandar
Department Of Ophthalmology Faculty Of Medicine, Padjadjaran University Cicendo Eye Hospital, Bandung, West Java
Biochemistry, Genetics & Molecular Biology Civil Engineering, Building, Construction & Architecture Education Health Professions Immunology & microbiology Library & Information Science Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health

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Giant Retinal Tear Management at Referral Eye Hospital Purnama, Mia; Iskandar, Erwin; Virgana, Rova; Ihsan, Grimaldi; Sovani, Iwan; Kartasasmita, Arief
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Abstract

Introduction: to report the characteristics, management and outcome in giant retinal tear (GRT) associated retinal detachment patients at Cicendo Eye Hospital Methods: this retrospective study was performed on medical records who had undergone retinal detachment surgery between January 2014 and March 2017. Age, sex, etiologies, size of GRT, quadrant involvement, lens status, proliferative vitreo-retinopathy (PVR), managements and outcomes were evaluated in association with giant retinal tears Result: Twenty-six patients (23 males, 3 females) age between 11-59 years with follow up from 2 months to 18 months were enrolled in this study. Twenty-five eyes have retinal detachment with macular involvement and 11 patients had high myopia. Majority of patients had 90° of GRTs. Most retinal tears were located at temporal quadrant (73%). Nineteen patients had undergone pars plana vitrectomy (PPV) and 7 patients had combined PPV with encircling buckle. Fifteen patients had used heavy liquid, 24 patients had silicon oil and 2 had gas tamponade. Intraoperative complications included lens trauma, retinal slippage and choroidal detached were found in 1 eye respectively. Fourteen eyes had recurrent retinal detachment. At the last follow up, 14 patients had anatomically attached retina. Twelve patients had total retinal detachment and marked PVR. Five fellow eyes were treated with prophylactic laser. Visual acuity improved in 11 eyes. Conclusion: Giant retinal tears were more common in patients with high myopia. Management of GRT currently with PPV and PPV combined with encircling buckle. The success rate of anatomy and visual acuity was less than other previous studies
Correlation Between Systemic Risk Factors and Diabetic Retinopathy in Patients with Diabetes Mellitus at Cicendo National Eye Hospital Nauli, Rizki Rahma; Virgana, Rova; Kartasasmita, Arief; Sovani, Iwan; Iskandar, Erwin; Ihsan, Grimaldi
International Journal of Retina Vol 1 No 2 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Introduction: Diabetic Retinopathy (DR) is a highly specific microvascular complication of both type 1 and type 2 diabetes mellitus (DM) that can cause significant visual impairment in adult populations worldwide. The risk of having and/or developing DR is influenced by many systemic features. Identification and management of particular systemic risk factors as early as possible during the course of DM might lower incidence of further progression and severity of DR. The aim of this study is to describe the correlation between systemic risk factors and DR in patients with DM in Cicendo National Eye Hospital on December 1st 2017 – January 31st 2018. Methods: An analytical cross-sectional study. The subjects were all patients diagnosed with DR based on ophthalmology examination at outpatient clinic of Vitreoretinal Division in Cicendo National Eye Hospital. The data were analyzed using chi-square (x2) with significances of p < 0.05. Result: Seventy-one eyes were included in this study, among of which has been classified as mild NPDR (n= 1), moderate NPDR (n= 9), severe NPDR (n= 27), and PDR (n= 34). Severe NPDR group had older age distribution at range 51-60 years old (n= 18, 66.7%, p = 0.001). Stage 1 hypertension was found to be dominant in PDR group (n= 18, 66.7%, p = 0.043). Both high total serum cholesterol group (n= 27, 76.5%, p = 0.048) and high fasting blood glucose (n= 27, 79.4%, p = 0.01) were significantly present in patients with PDR. Positive (+1) urine glucose was statistically significant in PDR group. Conclusion: There were several systemic risk factors from laboratory findings correlated in patient with DR in this study, however further study is needed to determine their role for predicting progression and severity of DR.
Surgical Approach In Vitreous Hemorrhage Metita, Mirza; Sovani, Iwan; Kartasasmita, Arief; Iskandar, Erwin; Virgana, Rova
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Introduction: To report cases of retinal disorders that cause vitreous hemorrhage and the timing of pars plana vitrectomy in Cicendo Eye Hospital Methods: Retrospective observational study of all patients diagnosed with the vitreous hemorrhage who had undergone pars plana vitrectomy in 2016. Data were collected from medical record. Result: The mean age of this study is 54.65 years old from 260 vitreous hemorrhage patients. The most common retinal abnormalities are proliferative diabetic retinopathy (49.6%), wet age related macular degeneration (AMD) (13.5%), undetected retinal abnormalities (12.7%), retinal vein occlusion (8.8%), rhegmatogen retinal detachment (6.5%), trauma (3.45%), vasculitis (3.1%), idiopathic polypoidal choroidal vasculopathy (3.1%), and drop IOL (1.2%). PPV performed 1-3 months after initial assessment (31.25%), less than 1 month (13.2%), more than 3 months (14.6%) Conclusion: The most common etiology of vitreous hemorrhage is proliferative diabetic retinopathy. Pars plana vitrectomy was performed 1 – 3 months after an initial assessment of the patients.
Peripapillary Retinal Nerve Fiber Layer Thickness in Diabetic Retinopathy Patients measured by Optical Coherence Tomography Dwijayanti, Sindi; Kartasasmita, Arief; Sovani, Iwan; Iskandar, Erwin; Virgana, Rova; Ihsan, Grimaldi
International Journal of Retina Vol 1 No 2 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Abstract

Introduction: Diabetic retinopathy (DR) is a microvascular complication of diabetes and one of the leading causes of blindness. Retinal function loss in diabetic patients is not only caused by microvascular abnormality but also retinal neurodegeneration. Optical coherence tomography (OCT) can detect retinal neural tissue loss caused by diabetes by measuring the retinal nerve fiber layer (RNFL) thickness on the cross-sectional imaging of the retina. This study is to evaluate the changes of peripapillary retinal nerve fiber layer (RNFL) thickness in diabetic retinopathy patients using OCT and compare it to age matched healthy controls. Methods: A cross-sectional study of 16 eyes from 11 diabetic retinopathy patients and 10 eyes from 7 aged matched healthy subjects for control. Patients underwent optic nerve OCT imaging, RNFL  thickness was recorded globally (average thickness) and segmented for superior, inferior, nasal, and temporal quadrants Result: There were no significant difference of  the average RNFL thickness in diabetic retinopathy group compared to healthy subjects. However, at the nasal quadrant, there were a significant increased thickness of RNFL compared to healthy subject (p value=0.009). Conclusion: Optical coherence tomography can be used to detect neurodegeneration progression in diabetic retinopathy patients by quantitatively measuring the peripapillary RNFL thickness. This can be used as a diagnostic and prognostic factor in cases of DR.
Quantitative Analysis of Retinal Microvascular Changes in Optical Coherence Tomography Angiography Of Diabetic Retinopathy Yollamanda, Prettyla; Kartasasmita, Arief; Sovani, Iwan; Iskandar, Erwin; Virgana, Rova; Ihsan, Grimaldi
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Abstract

Introduction: Diabetic Retinopathy (DR) is a common microvascular complication in patients with Diabetes Mellitus (DM) that can cause visual impairment and blindness in adult populations. Retinal microvascular changes, reflecting capillary drop out, non perfusion, and retinal ischemia seen in patients with DM can be assessed not only qualitatively, but also quantitatively with the introduction of a new, non invasive imaging modality Optical Coherence Tomography Angiography (OCTA), avoiding potential advese risks that can occur with the use of dye-injection imaging technique. We quantified retinal microvascular changes in healthy control eyes and Diabetic Retinopathy using OCTA. Methods: A cross sectional study included 13 eyes of 9 patients with DR, consists of 11 eyes with Non Proliferative Diabetic Retinopathy (NPDR) and 2 eyes with Proliferative Diabetic Retinopathy (PDR) and 5 eyes of 5 age-matched controls. Participants were imaged with commercial OCTA device (CIRRUS HD-OCT 5000 Angioplex). We analyzed in the Superficial Capillary Plexus (SCP) the following OCTA parameters : Vessel Density (VD), Foveal Avascular Zone (FAZ) area, and FAZ circularity. Result: Normal eyes had a higher mean VD, FAZ circularity (p >0.05) and lower mean FAZ area ( p <0.05) in the SCP compared with the DR (NPDR + PDR) group. If we excluded the PDR eyes from the analytic data, mean VD and FAZ area were found to be lower in control group, and mean FAZ circularity was higher. However, no quantitative parameters were statistically significant between control group and NPDR group. Conclusion: Microvascular changes in DR can be assessed with the use of Optical Coherence Tomography Angioraphy, which is non invasive and provides high quality of images acquired from the chosen level of retina.
Intraocular Foreign Fody : A case Series Purnama Sari, Mega Wulan; Sovani, Iwan; Kartasasmita, Arief; Iskandar, Erwin; Virgana, Rova; Ihsan, Grimaldi
International Journal of Retina Vol 1 No 2 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Introduction: The incidence of Intraocular Foreign Body (IOFBs) among open-globe injuries ranges from 18% to 41%. In addition to clinical examination at the slit-lamp and indirect ophthalmoscopy, various imaging modalities are valuable for the identification and localization of IOFB. Vision loss can be devastating as a result of endophthalmitis, retinal detachment or proliferative vitreoretinopathy (PVR). Timely and appropriate management often leads to favorable anatomic outcomes with restoration of good visual function in the majority of cases. This case report presents the clinical and diagnostic finding, management, outcomes and further plan of the patients with posterior segment IOFB. Purpose: To report some cases of posterior segment intraocular foreign body. Case report: Three patients with history of ocular  trauma of the right eye that happened at workplace. All of patients were men in age range 20-55 years old . There were also loss of vision, pain, redness, and from ophthalmological examinations revealed two scleral injuries and one corneal injury that suggest an IOFB in posterior segment. Two patients were suggest endophtalmitis before operation. The plain x ray film examination showed intraocular foreign body in the right eyes. The Ultrasonography (USG) examination also showed intraocular foreign body in the right eyes. All of patient were underwent pars plana vitrectomy. Durante operation 2 of 3 patients were succeed to extract IOFB from the posterior segment, while one patient was not. Conclusion: Preoperative, intraoperative and postoperative management should be done correctly for some cases of IOFB. Prompt treatment and full assessment of patients is important to provide good prognosis.
FREQUENCY OF RETINAL REDETACHMENT BASED ON THE PRIMARY REATTACHMENT TREATMENT AND INTRAOCULAR TAMPONADE A M Ichsan; Erwin Iskandar; Rova Virgana; Arief Kartasasmita; Habibah S. Muhiddin
Nusantara Medical Science Journal Volume 2 No. 1 Januari - Juni 2017
Publisher : Faculty of Medicine, Hasanuddin University.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/nmsj.v2i1.2254

Abstract

ABSTRACT Introduction: To observe the number and  presentation of retinal redetachment after primary reattachment treatment in a national eye  center. Methods:  This study was designed for ob- servational-descriptive of the medical record  from April 2011  to March 2012.  Selected cases were identified on the secondary retinal surgery for retinal reattachment followed the failure of the primary treatment. Cases were then classified into 4 groups based on the primary reattach- ment procedure: pneumatic retinopexy (PR), scleral buckle (SB), pars plana vitrectomy (PPV), and combined SB with PPV. Furthermore, in the group of PPV and SB+PPV  were then divided into 3 subgroups based on the intraocular tamponade: SF6  gas, silicone oil, and heavy  silicone oil. Results:  At one-year followed-up data, the presentation retinal redetachment was 7.1%, relative to the sex female (26%) was less than  male (74%) with the most common age  group was 41-50  years-old. Regarding with primary reattachment treatment, cases  of retinal redetachment after pneumatic retinopexy was 6%,  the  scleral buckle was 16%,  pars plana vitrectomy was 29%, and  combined sclera buckle with pars plana vitrectomy was 48%. Con- clusions: Rates of retinal redetachment after primary reattachment treatment varied from 6% to 48%, that were  performed by combined scleral buckling and  pars plana vitrectomy with or without tamponade silicone oil. Keyword : Retinal redetachment, pars plana vitrectomy, scleral buckle, silicon oil, intraocular gas 
Prevalensi Retinopati Diabetik di Puskesmas di Bandung Raya Periode Januari 2019-Desember 2020 Tiara Shaniaputri; Erwin Iskandar; Angga Fajriansyah
eJournal Kedokteran Indonesia Vol 10, No. 1 - April 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (268.372 KB) | DOI: 10.23886/ejki.10.119.39-45

Abstract

Peningkatan prevalensi penyandang Diabetes melitus (DM)  dari tahun ke tahun berdampak terhadap peningkatan prevalensi retinopati diabetik. Penelitian ini bertujuan untuk mengetahui prevalensi retinopatidiabetik yang diharapkan dapat memberikan kontribusi dalam pencegahan dan penatalaksanaan retinopatidiabetik yang lebih baik. Penelitian ini merupakan penelitian deskriptif dengan metode penelitian potong lintangyang menggunakan data sekunder yaitu data dari 1.835 pasien DM yang mengikuti skrining retinopati diabetikdi puskesmas di Bandung Raya periode Januari 2019-Desember 2020. Variabel yang dinilai pada penelitian iniadalah prevalensi retinopati diabetik dan vision threatening diabetic retinopathy (VTDR) , usia, jenis kelamin,durasi DM  Gula Darah Sewaktu (GDS), Gula Darah Puasa (GDP), Tekanan Darah Sistolik (TDS), TekananDarah Diastolik (TDD). Penelitian ini menunjukkan prevalensi retinopati diabetik dan VTDR sebesar 19,46%dan 7,68% secara berurutan. Prevalensi lebih tinggi  pada perempuan. Pasien dengan durasi DM  10 tahunserta kadar GDS dan GDP  200 mg/dl memiliki prevalensi tertinggi. Berdasarkan pemeriksaan tekanan darah,prevalensi tertinggi terdapat pada pasien dengan nilai TDS  140 mmHg dan TDD < 90 mmHg. Pada penelitianini didapatkan bahwa kurang lebih 1 dari 4 pasien diabetes pada populasi ini menderita retinopati diabetik.
Perubahan Komposisi Kendaraan di Jalan PerkotaanDibanding Nilai Normal Yang Ada Pada Kapasitas Jalan Indonesia Erwin Iskandar
Jurnal Jalan-Jembatan Vol 22 No 2 (2005)
Publisher : Direktorat Bina Teknik Jalan dan Jembatan

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Abstract

Salah satu masukan data dalam proses analisis kinerja kapasitas jalan raya dengan menggunakan Kapasitas Jalan Indonesia (KAJI) yaitu, data arus lalu lintas yang digolongkan atau tak tergolongkan dalam setiap kelompok kendaraan bermotor. Apabila data masukan tak tergolongkan, maka KAJI akan menggunakan nilai normal untuk komposisi kelompok kendaraan bermotor tersebut. Nilai prosentase komposisi jenis kendaraan terpengaruh oleh kondisi sosial ekonomi masyarakat, fungsi jalan, dan manajemen lalu lintas jalan bersangkutan. Dewasa ini sebagai dampak dari keberhasilan pembangunan, sejak KAJI mulai diterapkan pemakaiaannya (Thn. 1997) sampai sekarang, telah terjadi perubahan nilai prosentase komposisi jenis kendaraan bermotor. Nilai prosentase komposisi kendaraan dalam KAJI untuk jalan perkotaan terbagi lagi atas ukuran kotanya. Dalam tulisan ini yang mendjadi kasus lokasi studi dengan ukuran kota masuk dalam lingkup 1 s/d 3 juta penduduk, nilai prosentase KAJI dimana kendaraan ringan 60%, kendaraan berat 8%, dan sepeda motor 32%. Hasil penelitian yang telah dilakukan di Pusat Litbang Prasarana Transportasi menunjukan perubahan sebagai berikut, kendaraan ringan 35%, kendaraan berat 4%, dan sepeda motor 61%. Dengan adanya perubahan nilai komposisi tersebut, dalam analisis kinerja jalan menggunakan piranti KAJI, bisa memungkinkan luaran kinerja lalu lintas kurang akurat.
Good Outcome In Open Globe Injury With Intraocular Foreign Body Rahayu Widhyasti; Made Indra Widyanatha; Arief S. Kartasasmita; Erwin Iskandar; Rova Virgana; Grimaldi Ihsan
Oftalmologi : Jurnal Kesehatan Mata Indonesia Vol 6 No 1 (2024): Oftalmologi: Jurnal Kesehatan Mata Indonesia
Publisher : Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ojkmi.v6i1.61

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Introduction: Intraocular foreign body (IOFB) represents the second most common cause of open globe injury (OGI) and critical ophthalmic emergency that requires urgent diagnosis and treatment to prevent blindness. It can cause direct damage via entry into the eye and causing future damage. The immediate pars plana vitrectomy (PPV) surgery in post-traumatic endophthalmitis is beneficial for optimizing visual prognosis. Case report: A 55-year-old male patient came to the Emergency Room tertiary referral hospital with chief complaints of blurry vision, pain, and red-eye in his right eye 3 days before admission. The patient’s right eye was hit by a fragment of the sickle knife while mowing the grass in the yard without protective eyeglasses. Painful on his right eye is getting worse accompanied by lacrimation. The patient went to Tertiary Eye Hospital because of his complaints getting worse. The patient was diagnosed with Open Globe Injury Type C grade D pupil B zone 1, suspect early endophthalmitis, traumatic cataract of the right eye, and hypertension. Pars plana vitrectomy, vitreous tap, antibiotic intravitreal injection (with Ceftazidime and Vancomycin), IOFB extraction, explore, corneal scraping on the wound, cultural resistance, primary hecting of the cornea were done. The visual acuity improves and the infection was resolved. Conclusion : One of the most common traumas in ophthalmology is IOFB and it is considered an emergency condition. Proper ophthalmology examination and appropriate ancillary testing should be done to reveal this condition. Good management will give a good result of the patient’s visual prognosis.
Co-Authors A M Ichsan Angga Fajriansyah Arief S. Kartasasmita Dijah Dijah Dwijayanti, Sindi Grimaldi Ihsan Habibah S. Muhiddin Ihsan, Grimaldi Ine Renata Musa Iwan Sovani Kurniawan Chalid Made Indra Widyanatha Mayang Rini Metita, Mirza Nauli, Rizki Rahma Purnama Sari, Mega Wulan Purnama, Mia Rahayu Widhyasti Rova Virgana Tiara Shaniaputri Yollamanda, Prettyla