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All Journal Majalah Kedokteran Bandung Nusantara Medical Science Journal Indonesian Journal of Medicine International Journal of Retina IJRETINA - International Journal of Retina Oftalmologi: Jurnal Kesehatan Mata Indonesia Ophthalmologica Indonesiana
Rova Virgana
Department Of Ophthalmology, Faculty Of Medicine, Padjadjaran University Cicendo Eye Hospital
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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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.
Complete Resolution of Central Serous Chorioretinopathy Cases Treated with Low Power Mode Laser Technology : A Novel Approach: Poster Presentation - Case Series - Resident Setiawan, Grace; Virgana, Rova; Widyanatha, Made Indra; Ihsan, Grimaldi; Kartasasmita, Arief Sjamsulaksan; 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/qr43j813

Abstract

Introduction : Central serous chorioretinopathy (CSC) is an idiopathic condition mostly affecting men in their 20s to 50s. It is characterized by serous fluid accumulation behind the neurosensory retina resulting in a localized macular detachment. Aldosterone-receptor antagonist and photodynamic laser therapy are the current mainstay of treatments, although most CSC cases can resolves spontaneously within 2 to 3 months. Low power mode (LPM) laser has emerged as a new effective technology to treat CSC. Case Illustration : Case 1: A 50-year-old male was diagnosed with recurrent chronic CSC since 2 months ago. His visual acuity declined even after given oral aldosterone receptor antagonist for two weeks, so he was scheduled to undergo LPM. After three weeks of laser treatment, CSC resolved and the visual acuity improved (Figure1). Case 2 : A 47-year-old male complained of decreased vision and metamorphopsia on his right eye since two weeks ago. He was diagnosed with CSC and underwent LPM. Three weeks after LPM, his vision improved and the metamorphopsia resolved (Figure2). LPM helps the migration of retinal pigment epithelium (RPE) cells to restore the outer blood-retinal barrier through expression of heat shock proteins. We used MC-500ViXi laser system (Nidek Co., Gamagori, Japan) and the laser parameters used in this study were 100?m spot size, 0.01s exposure time, 0.25-0.5 spacing, and 30% LPM ratio. Discussion : Conclusion : LPM is a new yet promising treatment modalities to treat acute and chronic CSC. Its low power nature makes LPM a safe choice of treatment with less damage to the surrounding retina.
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 Aldiana Halim Andika Prahasta Arief S. Kartasasmita Dahlan, Muhammad Rinaldi Desrina Dianita Ginting Dwijayanti, Sindi effendi, yulia Elsa Gustianty Elsyanty, Firda Muthia Erwin Iskandar Graziani, Gabriella Grimaldi Ihsan Habibah S. Muhiddin Halim, Aldiana Haryono, Aditia Apriyanto Ihsan , Grimaldi Ihsan, Grimaldi Ihsan, Grimaldi Indra, Made Iskandar, Erwin Iwan Sovani Juanarta, Pieter Kartasasmita, Arief Sjamsulaksan Made Indra Widyanatha Metita, Mirza Naqiya, Wafa Nauli, Rizki Rahma Nina Ratnaningsih Purnama Sari, Mega Wulan Purnama, Mia Rahayu Widhyasti Rifada, R. Maula Rini, Mayang S. Kartasasmita, Arief Setiawan, Grace Shalim, Nikho Melga Susanti Natalya Syumarti, Syumarti Umbara, Sonie Vina Karina Apriyani Wardani, Sabrina Indri Widhyasti, Rahayu Widyanatha, Made Indra Yollamanda, Prettyla Yuna, Uray Nabila