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Management of Regmatogent Retinal Ablation by Buckle Sclera and Cryoteraphy Faneisha; AK Ansyori; Ramzi Amin
Sriwijaya Journal of Ophthalmology Vol. 3 No. 1 (2020): Sriwijaya Journal of Ophthalmology
Publisher : Department of Opthalmology, Faculty of Medicine, Universitas Sriwijaya

Introduction: The most common type is regmatogen retinal detachment (rhegmatogenous retinal detachment), which is a result of the process of tearing of the retinal layer. The principle of operative management of retinal detachment is to reattach the detached layer of the retina by previously identifying and closing if there is a retinal tear and releasing traction from vitreoretina. Actions can include sclera buckle, pars plana vitrectomy and pneumatic retinopexy. The consideration of the choice of operative therapy is dependent on the pathogenesis underlying each case of retinal detachment. Case presentation: This case report found complaints of patients with sudden blurred vision without red eyes or calm eye conditions and a diagnosis with regmatogen retinal detachment. From the history, in this patient was obtained, complaints of blurred vision such as closed curtains complained of the patient and complaints were preceded by views such as seeing flashes of light or photopsia and vision such as flying objects or floaters which are the most common complaints in 50% of patients with retinal regmatogen retention. occurs because of the lattice degeneration process. In cases of severe and extensive retinal detachment, the combination procedure for vitrectomy and scleral buckle is the primary choice for optimal outcome. Conclusion: At follow-up, posterior segment examination revealed retinal attachments that were uncomplicated. Follow up 2 weeks post therapy found that the retina was attached and had vision with improvement.

Management of Clinically Significant Macular Edema Elisa Taurisia; Ramzi Amin; AK Ansyori
Sriwijaya Journal of Ophthalmology Vol. 3 No. 1 (2020): Sriwijaya Journal of Ophthalmology
Publisher : Department of Opthalmology, Faculty of Medicine, Universitas Sriwijaya

Introduction: Macular edema is the most common cause of visual impairment in NPDR. Macular edema occurs due to increased perifoveal capillary permeability resulting in fluid accumulation in the macular area. Control of blood sugar levels is an important factor in the management of diabetic retinopathy because it can reduce the risk of progression of retinopathy, decreased vision and macular edema. Currently, focal photocoagulation argon lasers are the only proven long-term treatment for diabetic macular edema. Case presentation: Reported case of a 55-year-old woman, address outside the city, came to the Dr. Mohammad Hoesin General Hospital Palembang eye clinic with complaints of blurred vision since ± 6 months ago. three days ago, the patient went to an internal medicine clinic and was said to have high blood sugar and blood pressure. The views of both sufferers' eyes are increasingly blurred. The treatment chosen for this patient was intravitreal anti-VEGF (bevacizumab) injection in the right and left eye to reduce vascular permeability thereby reducing macular edema. 1-time bevacizumab injection has only a short-term optimal effect so re-injection is needed at 4-6 weeks intervals. Conclusion: A clinically significant case of macular edema (CSME) has been reported that is treated with intravitreal anti-VEGF combined with focal photon photocoagulation laser. The patient's final vision 1 week after the focal photocoagulation argon laser was performed showed improvement.

Management of Submacula Bleeding with Pneumatic Displacement Shaelva Lassa Sabatini; AK Ansyori; Ramzi Amin
Sriwijaya Journal of Ophthalmology Vol. 2 No. 1 (2019): Sriwijaya Journal of Ophthalmology
Publisher : Department of Opthalmology, Faculty of Medicine, Universitas Sriwijaya

Introduction. Submacular hemorrhage is defined as the presence of blood in the potential space between retinal pigment epithelium (RPE) and neurosensory retinal in the macula. Pneumatic displacement is one of the management procedures that is shifting the bleeding under the macula by injecting gas. The purpose of writing this case report is to report Sub-macula Bleeding cases which are managed with Pneumatic Displacement. Case Presentation. A 55-year-old woman, housewife, was living outside the city, came with complaints of a sudden blurred left eye since 2 weeks ago. At the ophthalmological examination, 612 pH (-) right eye vision and 1/300 left eye vision were obtained. On examination of the anterior segment in the right and left eye the lens is cloudy with grade I nuclear morphology. The image of the right eye fundoscopy is within normal limits, whereas in the left eye a macula is found: reflex fovea (-) blood (+). The choice of therapy in this patient is carried out by Pneumatic Displacement by injecting C3F8 gas, which aims to shift the bleeding under the macula by injecting gas. Conclusion. Pneumatic Displacement is a simple procedure, not too invasive, and the risk of intraocular complications is smaller. Pneumatic Displacement aims to shift blood from under the macula to other parts of the retina that are less vital for vision.

Management of Diabetic Retinopathy Nova Herdana; AK Ansyori; Ramzi Amin
Sriwijaya Journal of Ophthalmology Vol. 1 No. 2 (2018): Sriwijaya Journal of Ophthalmology
Publisher : Department of Opthalmology, Faculty of Medicine, Universitas Sriwijaya

Introduction. Diabetic retinopathy (RD) is one of the most common complications of diabetes mellitus, and is a major cause of blindness in patients aged 20-64 years worldwide. The main principle of the management of RD is to prevent, inhibit and overcome complications that occur. Vitrectomy, laser photocoagulation, intravitreal anti VEGF injection become modalities in RD therapy. If PDR has occurred, vitreous hemorrhage can occur or the retina is attracted by proliferation tissue, vitrectomy should be performed. Case Presentation. The patient is a 52-year-old man who came with the main complaint that both eyes have blurred slowly since ± 6 months ago. Blurred vision is not accompanied by red eyes, there is smoke-like vision. In the past the history of the disease obtained a history of DM 15 years of irregular control and hypertension of 3 years with regular control, a history of spectacles present. The ophthalmological examination of the right eye revealed a vision of 6/30 pH (-), TIOD within normal limits, and a grade II nuclear cataract in the lens. Right eye fundoscopy revealed decreased foveal reflexes and exudates in the macula, dot, blot, flame-shaped bleeding in 4 quadrants of the retina, exudate, venous beading, micro-aneurism. Management in these patients is pars plana vitrectomy, endolaser, and intravenous OS anti-VEGF injection under general anesthesia. Whereas the right eye was intravitreal photocoagulation laser and anti-VEGF laser (done 2 weeks before). Conclusion. A case of advanced left eye PDR with severe NPDR and right eye DME and grade II nuclear cataracts has been described in both eyes. Patients treated with laser photocoagulation in the right eye. In the left eye pars plana vitrectomy, endolaser, and intravitreal bevacizumab injection. Sharp vision of the left eye progressed postoperatively.

Retinometry : a Literature Review Febrina Art; Ramzi Amin; AK Ansyori
Sriwijaya Journal of Ophthalmology Vol. 1 No. 1 (2018): Sriwijaya Journal of Ophthalmology
Publisher : Department of Opthalmology, Faculty of Medicine, Universitas Sriwijaya

Sharp vision is a major concern in cataract cases. Sharp improvement in vision is the expected outcome of the management of cataract cases, namely by operative measures. Before surgery, there are several ophthalmological examinations that must be performed. Quantitative instruments have been developed to determine the visual potential of eyes that experience turbidity of refractive media. One examination that can be done is a retinometry examination that is the examination of the sharp potential of vision with a retinometer. Retinometry is a process of measuring sharp eyes using a retinometer to determine the potential for sharp eyesight. Retinometer is one tool that uses the principle of interference fringes to assess the patient's sharp vision through a cloudy lens. On a retinometer, a light source is split into two rays which then enter the least turbid lens area so that interference grating is formed on the retina. The lattice can have a vertical, horizontal or oblique meridian orientation

Stargardt's Disease : Case Report Dian Ariani; AK Ansyori; Ramzi Amin
Sriwijaya Journal of Ophthalmology Vol. 1 No. 1 (2018): Sriwijaya Journal of Ophthalmology
Publisher : Department of Opthalmology, Faculty of Medicine, Universitas Sriwijaya

Introduction. The Stargardt disease is a frequent macular dystrophy and the most common cause of decreased central visus in adults below 50 years. This condition is caused by the presence of mutations in the ABCA4 gene, located in the chromosome chain 1 short sleeve, which encode the ATP-binding cassette (ABC) protein transporter expressed by the outer trunk cell segment. Case Presentation. A man, 59 years old, civil servants, was living in the city, came to the eye Polyclinic RSMH on February 4, 2016. From anamnesis, main complaint of the right eye was view blurred since 2 years ago. The history of the illness since ± 2 years ago, the sufferer complained the right eye view blurred slowly, the longer the more blurred. Often glare (+), the sufferer also complains to see black spots, such as enclosed curtains (-). Conclusion. A case of Stargardt disease has been reported in a 58-year-old male. Patients come with complaints of blurry vision slowly in both eyes. On posterior segment examination, a picture of atrophy in the macula that typically leads to Stargardt disease. Additional examination of OCT also showed a stretch of RPE depletion. Supportive therapy such as correction with low vision aids or the provision of sun protective glasses can help in the daily lives of patients.

Relationship Between HbA1c Level with Retinal Nerve Fiber Layer Thickness in Diabetic Retinopathy Febrina Art; AK Ansyori; Ramzi Amin
Sriwijaya Journal of Ophthalmology Vol. 2 No. 2 (2019): Sriwijaya Journal of Ophthalmology
Publisher : Department of Opthalmology, Faculty of Medicine, Universitas Sriwijaya

Abstract Background: Diabetes mellitus (DM) have a direct effect to retinal neural tissue. Diabetic retinopathy slowly proggress with reserved visual acuity and no symptoms in early stage. Retinal nerve fiber layer thickness significantly decrease in type 2 diabetes mellitus patients related to glycemic blood level. Purpose: To analyze the relationship between HbA1c level and retinal nerve fiber layer thickness in diabetic retinopathy patients. Methods: A cross sectional analytical study was conducted in RSUP dr. Mohammad Hoesin Palembang from October 2017 until March 2018. Sixty eight type 2 diabetes mellitus patients consist of various grade of diabetic retinopathy. Measurement of HbA1c level was performed on these samples and retinal nerve fiber layer thickness was measured by Optical Coherence Tomography (OCT). Results: There is a significant relationship between duration of DM with RNFL thickness (p = 0,002). There is a significant relationship between hypertension with RNFL thickness (p = 0,007). There is a significant relationship between HbA1c level with RNFL thickness in all quadrants (superior, nasal, inferior quadrants p = 0,000, temporal quadrant p = 0,011). The most important factor of RNFL thinning in superior, nasal and inferior quadrants is HbA1c level (superior and nasal adjusted p value 0,002, inferior adjusted p value 0,002) while in temporal quadrant is hypertension (adjusted p value 0,042). Conclusion: There is a significant relationship between HbA1c level with RNFL thickness in all quadrants in which the patients with HbA1c > 7% have a higher risk of thinner RNFL compared to patients with HbA1c ≤ 7%.

Relationship between Retinal Nerve Fiber Layer with Visual Field Defect in Non Proliferative Diabetic Retinopathy Alfurqon Alfurqon; Ramzi Amin; AK Ansyori
Majalah Oftalmologi Indonesia Vol 41 No 3 (2015): Ophthalmologica Indonesiana
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/journal.v41i3.43

Background: In the early stages of diabetic retinopathy, neuronal abnormalities include changes in ganglion cell death. Neuronal apoptosis is suspected as one of the causes responsible for the occurrence of lesions at an early stage of diabetic retinopathy, which results in a decrease in number of ganglion cells and thinning of the layer of ganglion cells, which can be caused by several mechanisms including glutamat excitoxicitate, oxidatice stress, hyperglichemia, and neuroinflamation. Retinal ganglion cell death and axonal degeneration, will cause thinning of the retinal nerve fiber layer (RNFL) which may result in a decrease in neural function, which in turn have an impact on the occurrence of visual field defects. This study is to determine the relationship between the thickness of RNFL with visual field defects in patients with non-proliferative diabetic retinopathy (NPDR). Methods: This study is a comparative analytic cross-sectional design with sample of 66 eyes of 34 people in clinic of retina subdivision of Moh. Hoesin Hospital Palembang from July to November 2013. Patients of NPDR examined fundus photo, Oculo Coherence Tomograph and Humphrey Field analyzer. Results: RNFL thickness average in this study is 104.4Â±10.9 Î¼m. Visual field defect occur ini moderate and severe NPDR. Conclusion: There is a strong relationship between RNFL thickness with visual field defects in patients NPDR (r =-0.693). Keywords: RNFL thickness, visual field defect, NPDR Â

Management of Central Serous Chorioretinopathy (CSC) with Focal Laser Photocoagulation: Poster Presentation - Case Report - Resident Rezandi Aziztama; Ramzi Amin; AK Ansyori
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: 10.35749/17saar34

Introduction : Central Serous Chorioretinopathy (CSC) is an idiopathic retinal disease, characterized by focal leakage from the choroidal vessels due to RPE changes resulted in serous detachment of the neurosensory retina. CSC is suspected to be a multifactorial disease. Treatment of CSC is indicated for cases with SRF persisting for more than 4 months, decreased visual acuity, history of recurrence or history of previous CSC in other side with poor visual outcome. Case Illustration : A 41-year-old man complained sudden blurry vision on left eye since 3 months ago, accompanied by decreased ability to see in the middle field. In the left eye there was decrease fovea reflex. Fundus Fluorescein Angiography showed Central Serous Chorioretinopathy (CSC). Laser Focal Photocoagulation was performed for a patient in this case. Discussion : Conclusion : Patient was treated with Laser Focal Photocoagulation and pharmacological acetazolamide with the aim of closing the leak in the RPE and increasing SRF absorption.

MANAGEMENT EALES’ DISEASE GRADE III B: A RARE CASE: Poster Presentation - Case Report - Resident Agung Putra Evasha; Ramzi Amin; AK Ansyori
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: 10.35749/92cbvg28

Introduction : Eales' disease is an idiopathic occlusive retinal vasculopathy that mostly affects the peripheral retina bilaterally in young, predominately male patients. A hallmark of eales disease is recurrent vitreous hemorrage can all cause some patients to experience severe vision loss Case Illustration : A 39-year-old male with vitreous hemorrhage caused by Eales Disease grade III B with initial visual acuity 1/300. Ultrasound imaging showed the membrane like lesion with 1/2 retinal reflectivity, after moderate movement and vitreous hemorrhage on both eyes. The photo-fundus showed there is decreased fovea reflex and perimacular exudate with visible contours of sclerotic blood vessels, visible cotton wall spot, and macroaneurysm. There is also haze grade 3 on media, visible folds in the inferior part, visible shadows of cotton wall spots. The patient was managed with pars plana vitrectomy with endolaser Discussion : In this case, patient was diagnosed as vitreous hemorrhage caused by Eales Disease grade III B on both eyes but it getting worse on left eye further. We chose to perform PPV with endolaser on right eye. The outcome was good on right eye based on better visual acuity and decreased hemorrhage, but in the left eye, which not treated, worsen outcome occurred Conclusion : The management of this patient’s case showed good results in both anatomic and functional outcomes for right eye, but unfortunately left eye is on serious problem

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