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All Journal The Indonesian Biomedical Journal IJRETINA - International Journal of Retina
Mulya, Putri Nabillah
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Public Health

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HYPERTENSIVE OPTIC NEUROPATHY AS A PRESENTATION OF SYSTEMIC LUPUS ERYTHEMATOSUS Zaini, Lia Meuthia; Mulya, Putri Nabillah
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.iss002.323

Abstract

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease affecting multiple organ systems, including the eyes. Hypertensive optic neuropathy is a rare but serious manifestation of SLE that may precede SLE diagnosis. This case highlights the early ocular involvement in a young patient with undiagnosed SLE. Case Report: A 21-year-old female presented to our ophthalmology clinic with blurry vision in both eyes, along with elevated blood pressure at 165/126 mmHg. Ophthalmic examination revealed visual acuity of 20/200 on both eyes, bilateral optic disc swelling, macular edema, flame-shaped hemorrhages, and cotton-wool spots. These findings are consistent with hypertensive optic neuropathy. The antihypertensive drugs were initiated and planned for intravitreal bevacizumab administration. The patient was referred to internal medicine. Laboratory tests and clinical findings indicated secondary hypertension, anemia, leukopenia, and thrombocytopenia. Immuno-serological testing confirmed a diagnosis of SLE. The patient was initiated on systemic immunosuppressive therapy. Eight weeks after the first visit, she showed significant improvement, with the resolution of macular edema and optic disc swelling. The patient’s visual acuity improved to 20/50 in the right eye (RE) and 20/20 in the left eye (LE). Discussion: Hypertension in SLE is multifactorial, involving endothelial dysfunction, kidney injury, immune activation, and autoantibodies. Hypertensive retinopathy progresses through three phases: vasoconstrictive, sclerotic, and exudative, characterized by arterial narrowing, structural vascular changes, and blood-retina barrier disruption, leading to macular edema and ischemia. Diagnosis is based on fundoscopic examination and Optical Coherence Tomography (OCT), while management focuses on blood pressure control, anti-VEGF therapy, and close monitoring to prevent further complications. Conclusion: Early detection and multidisciplinary management are crucial in preventing irreversible visual loss and systemic complications. Regular ophthalmic follow-up and blood pressure monitoring are essential in SLE management.
Trends in CTGF Expression in Renal and Chorioretinal Tissues Following Metformin and SGLT2 Inhibitor Treatment in Diabetic Rats Syukri, Maimun; Zaini, Lia Meuthia; Kartasasmita, Arief Sjamsulaksan; Gondhowiardjo, Tjahjono Darminto; Lesmana, Ronny; Mulya, Putri Nabillah
The Indonesian Biomedical Journal Vol 17, No 6 (2025)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v17i6.3886

Abstract

BACKGROUND: Connective tissue growth factor (CTGF) plays a central role in fibrotic processes affecting both renal and retinal tissues in diabetes. Although sodium-glucose cotransporter 2 (SGLT2) inhibitors have been shown to exert renoprotective and antifibrotic effects, their impact on CTGF expression in renal and retinal tissues has not been clearly established. This preliminary study was conducted to evaluate whether SGLT2 inhibitors (SGLT2i) could influence CTGF expression in the kidneys and eyes of diabetes-induced rats.METHODS: After two weeks of adaptation, 24 rats were randomized and distributed equally into four groups (n=6 each): 1) Healthy Control, healthy rats without diabetic induction; 2) Negative Control, diabetic rats induced with streptozotocin (STZ) without treatment; 3) Metformin Group, diabetic rats treated with metformin; and 4) SGLT2i Group, diabetic rats treated with empagliflozin. Following eight weeks of intervention, CTGF expression was analyzed by Western blot in renal tissue (right kidney) and chorioretinal tissue (right eye). Four samples per group yielded analyzable bands and were included in the final quantification.RESULTS: In renal tissue, CTGF levels (mean±SD) were highest in Negative Control Group (0.81±0.06). Both the Metformin Group (0.58±0.14) and SGLT2i Group (0.57±0.33) demonstrated a trend toward reduced CTGF expression. In chorioretinal tissue, CTGF values were relatively similar across groups (Healthy Control: 0.67±0.05; Negative Control: 0.63±0.12), with Metformin Group (0.61±0.12) and SGLT2i Group (0.64±0.22) showing a modest reduction trend.CONCLUSION: In diabetic rats, CTGF expression levels are markedly increased. Following treatment with metformin and SGLT2i, CTGF expression demonstrates a noticeable reduction trend.KEYWORDS: SGLT2 inhibitor, metformin, connective tissue growth factor, cellular communication network factor 2, renal, retina
Co-Authors Gondhowiardjo, Tjahjono Darminto Kartasasmita, Arief Sjamsulaksan Lia Meuthia Zaini, Lia Meuthia Maimun Syukri, Maimun Ronny Lesmana