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Rizky Akbar
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IJRETINA - International Journal of Retina
Published by Indonesian Vitreoretinal Society
ISSN : 26148684     EISSN : 26148536     DOI : https://doi.org/10.35479/ijretina.2023.vol006.iss0
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
International Journal of Retina is an open access journal, accepting article in English language from all over the worlds. The aims is to provide international researchers, doctors, and clinicians in the basic and clinical fields of ophthalmology, especially retina to publish the original article, case reports, or systematic review.
Arjuna Subject : Kedokteran - Ophthalmology
Articles 148 Documents
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Simple Encircling Scleral Band for Uncomplicated Retinal Detachment Djatikusumo, Ari; Sjahreza, Emil Fahrinandi; Triwijayanti, Triwijayanti; Taim, Abisyifa Rahma; Ardhia, Seruni Hanna
International Journal of Retina Vol 7 No 1 (2024): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2024.vol007.iss001.258

Abstract

Introduction: Report the surgical and visual outcome of using a narrow band in encircling scleral buckling for selected rhegmatogenous retinal detachment (RRD). Methods: A retrospective case series review of 16 patients with primary RRD treated with encircling scleral buckling using a narrow band 240 (2.5 mm) in KMN Eye Care from June 2018 to June 2020. Results: A total of 16 eyes in 16 patients with RRD underwent encircling scleral buckling with a narrow silicone band 240 (2.5 mm) without any additional tire or sponge. All patients have myopic eyes, with the mean pre-operative best-corrected visual acuity (BCVA) is less than 0.50. The primary success rate of retinal reattachment was 81.25%. Three patients had retinal re-detachment within one month post-surgery, and 2 patients had persistent sub-macular fluid, despite retinal reattachment. In patients with retinal reattachment, the BCVA showed improvement better than 0.5 at 1-month follow-up (9 patients, 69.2%). Spherical equivalent changes before and after scleral buckling were -1.90 D. Conclusion: Narrow encircling scleral buckle surgery can be considered an effective and safe technique in selected RRDs, including anteriorly located, multiple, or invisible retinal breaks. A further, large-size randomized controlled study is needed to confirm its efficacy.
DIAGNOSTIC APPROACHES FOR MACULAR DYSTROPHY BY USING OCT AND VEP : A CASE SERIES Saldianovitta, Rahajeng Anugrahing; Dewi, Nadia Artha
International Journal of Retina Vol 7 No 2 (2024): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2024.vol007.iss002.259

Abstract

Introduction: Macular dystrophies (MDs) consist of a heterogeneous group of disorders that are characterized by bilateral symmetrical central visual loss. Clinical manifestation including atrophy in macula. This cases series provides clinical manifestation and characteristics in ancillary testing for better approach to macular disease Case report: Case 1 is 13-year-old girl with decrease visual acuity, uncorrected visual acuity (UCVA) was 2/60 on both eyes. The ophthalmologic examination showed an area of atrophy at macula accompanied with yellowish flecks on both eyes. Optical coherence tomography (OCT) shows thinning in all areas of macula and loss of outer nuclear layer (ONL) and photoreceptor. From VEP, there were low amplitude N75, P100, and N145 waves without any latency. Case 2 is 39-year-old woman with decrease of visual acuity, UCVA was 6/60 on both eyes, accompanied with partial colour blindness and red-green deficiencies. From ophthalmology examination showed large atrophy area at macula. OCT examination shows thinning in most of macula area and decrease of ONL thickness and photoreceptor. VEP showed normal wave without any latency. Discussion: There were a gradual central vision loss, at a more advanced stage, color blindness can occur due to photoreceptor damage in the macular area. From the posterior segment there was a yellowish spot on the macula which suggested lipofuscin deposition on the retinal pigment epithelium (RPE). From OCT, there ware loss of ONL and VEP showed low amplitude or normal waves. This findings suggested macular dystrophy due to Stargardt disease. Conclusion: OCT and VEP can be used to detect anatomical and physiological abnormalities that can aid in the diagnosis of macular dystrophy in the case of incomplete ancillary testing tools.
CLINICAL CHARACTERISTICS OF CYTOMEGALOVIRUS RETINITIS IN HUMAN IMMUNODEFICIENCY VIRUS (HIV) PATIENTS UNDERGOING INTRAVITREAL GANCICLOVIR INJECTION effendi, yulia; Widyanatha, Made Indra; Ihsan, Grimaldi; Virgana, Rova; Iskandar, Erwin; Kartasasmita, Arief S
International Journal of Retina Vol 7 No 2 (2024): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2024.vol007.iss002.270

Abstract

Introduction: Cytomegalovirus (CMV) retinitis is the most common ocular opportunistic infection in patients with Human immunodeficiency virus (HIV). The disease is causing blindness and current management commonly characterized by delayed diagnosis and inadequate treatment. Purpose: to describe the clinical characteristic and visual outcome of CMV retinitis with HIV treated with intravitreal ganciclovir injection. Methods: This is a retrospective study included 23 patients (34 eyes) who presented with CMV Retinitis with HIV from January 2020 to July 2023 who received intravitreal ganciclovir in both the induction and maintenance phases until declared cured, characterized by lesion inactivation and CD4+ T-cell counts reaching >100/µL within period of 3 to 6 months. Data were collected including age, gender, affected eye laterality, CD4+ T-cell count at the initial visit at vitreoretinal polyclinic and the 6-month follow-up, total number of intravitreal ganciclovir injections, HAART history at the initial visit, visual acuity at the initial visit, 6-month follow-up, and systemic comorbidities. Result: The median age was 29 years old with 82,6% of them male. Bilateral lesions were observed in 60.9% of the patients. Median CD4 count initial visit was 50 with 52% below 50 cell/µL. Fifteen patients (65,2%) already treated with highly active antiretroviral therapy (HAART) before injection. Tuberculosis was the most common opportunistic infection. Mean intraviteral ganciclovir injection 9,12±3,40 in each eye. Eleven eyes (32.4%) with initial visual acuity ≤1.00 logMAR increased to 19 eyes (55.9%) at the 6-month follow-up. There were statistically significant difference between baseline visual acuity and 6-months follow up after intravitreal ganciclovir. (p= 0,008). Conclusion: Retinitis cytomegalovirus tend to have more severe clinical presentations in patients with CD4 counts below 50 cells/µL. Intravitreal ganciclovir is effective in controlling CMV retinitis.
A CURIOUS CASE OF CENTRAL RETINAL VEIN OCCLUSION IN A YOUNG PATIENT FOLLOWING DENGUE FEVER Singh, Anuradha; Sharma, Vikas; Mogra, Shailesh
International Journal of Retina Vol 7 No 1 (2024): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2024.vol007.iss001.272

Abstract

Introduction: Central retinal vein occlusion (CRVO) is a common ocular disease which can be responsible for significant ocular morbidity in the adult population. It is most commonly associated with lifestyle diseases especially hypertension in older age groups, but may have a variety of etiologies including genetically inherited disorders. Case report: A 27-year-old female patient presented to our out patient department (OPD) with history of diminished vision in left eye of 03 days duration. The patient gave history of contracting dengue fever three weeks prior to the onset of symptoms. On evaluation she was found to have CRVO of the left eye with no macular edema. The patient was investigated for other causes of CRVO and was found to have mildly reduced serum homocysteine and deranged serum iron studies. The patient was managed conservatively with good visual recovery and is presently on follow up for early detection of complications for CRVO. Discussion: The patient presented with multiple etiologies of CRVO, however, each was subclinical in nature. Conservative management for ocular symptoms along with treatment of systemic deficiencies by the physician lead to good visual outcome and generalized well being of the patient. Conclusion: CRVO is being increasingly seen in the younger age group. Multiple etiologies may need to be ruled out, along with lifestyle diseases which are on an incline in the younger population. Close follow up with treatment is required to detect complications early, and provide a good visual outcome. To our knowledge, this is the third reported case of CRVO related to dengue fever.
Assessment of early and late dry age-related macular degeneration with spectral-domain optical coherence tomography and fundus autofluorescence Singh, Archana; Agrawal, Mohini; Vannadil, Harikrishnan; Bhatta, Sunandan
International Journal of Retina Vol 7 No 1 (2024): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2024.vol007.iss001.264

Abstract

Aim: To assess features of early and late dry age-related macular degeneration (ARMD) using spectral-domain optical coherence tomography (SDOCT) versus fundus Autofluorescence (FAF). Method: Observational cross-sectional study conducted from January-2022 to December-2022 in a tertiary eye care center, India. Patients >55 years and clinically diagnosed dry ARMD underwent SDOCT and FAF. OCT and FAF were assessed and correlated with best-corrected visual acuity (BCVA). Results: 106 eyes of 60 cases were included. Mean age was 65.24+4.80 years. Mean BCVA was 0.4±0.24 LogMAR. Among clinically evident drusen, hard drusen (>63µm) was 88.6% (n=94 eyes), confluent soft-drusen 9% (n=10 eyes) and pigmentary changes at macula in 01 eye only. On OCT, 65% (n=69) eyes showed RPE irregularity, which was there in all the cases with soft drusen, whereas it varied in cases with hard drusen. On FAF, hypo/hyper was observed in 81 eyes (76%). When correlated with BCVA, RPE irregularity was not seen in cases with BCVA>6/12. An abnormality in macular autofluorescence was evident in 62% (n= 31) in cases with vision >6/12; whereas in cases with vision<6/18, it was seen in 80% (n=49) cases. A strong correlation was found between the OCT findings and abnormal FAF (kappa=0.60), suggesting comparable results by both the modalities in cases of early and late dry ARMD. Conclusion: OCT and FAF show good correlation in assessing early and late dry ARMD, thereby explaining the correlation between anatomical and biochemical changes. Thus, these can be used as a progression predictor, when used together.
BILATERAL RHEGMATOGENOUS RETINAL DETACHMENT IN A YOUNG ADULT WITH NEUROFIBROMATOSIS 1 Tanveer, Shafiq; Peters, Khushbakht H; Bibi, Hafsa; Tahir, Asna; Shahnawaz, Ghazala
International Journal of Retina Vol 7 No 2 (2024): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2024.vol007.iss002.284

Abstract

Introduction: Neurofibromatosis (NF) is a set of phakomatoses involving genetic disorders, commonly associated with nerve sheath tumor development. NF1 affects various bodily systems, with ocular signs like optic pathway gliomas and Lisch nodules. Case Presentation: We present a unique case of a 33-year-old man with a classic presentation of neurofibromatosis type 1 (NF1), who sought a routine ocular examination without any specific complaints. The detailed ocular examination revealed oculus uterque (OU) retinal detachments (RD) with superonasal retinal cysts and inferior retinal dialysis in the ocular RD in NF1 patients, distinct from the previously documented cases of unilateral RD with ora serrata dialysis in NF1 patients. Discussion: This case report contributes to the expanding body of literature on atypical ophthalmic presentations in NF1 patients and suggests a potential link between suboptimal fibroblastic function in NF1 and the development of retinal complications, proposing a mechanism involving faulty collagen production and subsequent vitreous base avulsion leading to retinal dialysis and detachment. Conclusion: This case underscores the significance of thorough routine ocular examination in NF1 patients, emphasizing the need for a heightened suspicion of unusual ocular manifestations.
EVALUATING EFFECTIVENESS OF LASER PHOTOCOAGULATION AND INTRAVITREAL ANTI-VEGF INJECTIONS IN STAGE III RETINOPATHY OF PREMATURITY Juneja, Stuti Vikas; Patel, Diti; Rathod, Afsa
International Journal of Retina Vol 7 No 2 (2024): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2024.vol007.iss002.286

Abstract

Purpose: To compare the effectiveness of anti VEGF and laser photocoagulation treatment in stage III retinopathy of prematurity in infants at tertiary care hospital in central Gujarat. Methods: This was a comparative prospective and retrospective observational study. 60 infants were diagnosed with stage III retinopathy of prematurity from which 20 infants were treated with laser and 40 infants treated with anti VEGF injection of 0.25 mg/0.025 mL Ranibizumab. Efficacy of both the treatments were compared in terms of regression of disease clinically. All Demographic and medical data was analyzed using MS excel for finding frequency, percentages and associations applying Chi-squared test and by Epi info™ (version-7.2.5). Result: In this study 32(80%) infants who received anti VEGF and 8(40%) infants who received laser treatment showed stopped progression of neovascularization in single dose. Only 8(20%) infants needed re-treatment anti VEGF injection while 11(55%) infants required re-treatment laser therapy. So there was a statistically significant higher recurrence rate among infants who underwent laser therapy as compared to infants who underwent anti VEGF therapy (P=0.006).1(5%) infant lost both his eyes even after being treated with 2 sittings of laser treatment and who was <800g and very pre term birth so even with effort to treat, there was no regression and infant developed retinal detachment in both eyes. Conclusion: Both the treatments are effective for treating ROP stage III infants but higher recurrence rate was found among infants who underwent laser therapy as compared to anti VEGF therapy.
A SUCCESSFULL PNEUMATIC RETINOPEXY FOR THE TREATMENT OF RHEGMATOGENOUS RETINAL DETACHMENT FOLLOWING BLUNT TRAUMA Wahyudi, I Nyoman Surya Ari; Metita, Mirza
International Journal of Retina Vol 7 No 1 (2024): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2024.vol007.iss001.268

Abstract

Introduction: To report the successful single operative method using Pneumatic Retinopexy as management of rhegmatogenous retinal detachment following ocular blunt trauma. Case Report: A 17 years old boy admitted to clinic with blurred vision in lower part of right eye that worsen over time for 3 weeks with a history of blunt trauma. Initial examination showed the visual acuity of 6/6 on both eyes. Posterior segment evaluation revealed superior retinal detachment on right eye with macular sparing. The main retinal break located in superotemporal part. Patient then treated with Pneumatic Retinopexy using SF6 gas followed by a serial of laser demarcation on right eye. Three months follow up after procedure resulted in reattachment of retina with preserved visual acuity of 6/6 and reduced visual field defect on right eye. Discussion: Rhegmatogenous retinal detachment is the most common form of retinal detachment. Specific procedure of Pneumatic Retinopexy may vary based on expert preference respective surgery. However procedures should always include retinopexy, tamponade by gas and posturing of the patient. Conclusion: Pneumatic Retinopexy is a minimally invasive procedure that can be performed for the management of rhegmatogenous retinal detachment. In order to optimizing post operative outcome, ophthalmologists must be able to select suitable patient, proper examinations and good surgical techniques to achieve a high success rate.
THE LEVELS OF IL-6, CRP, and LDH IN THE VITREOUS HUMOUR OF DIABETIC RETINOPATHY PATIENTS. Singh, Kalyan; Khan, Perwez; Khan, Lubna; Mohan, Shalini; Singh, Parul; Agarawal, Surbhi; Patel, Namrata; Datta, Ditsha
International Journal of Retina Vol 7 No 1 (2024): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2024.vol007.iss001.244

Abstract

Introduction: Diabetic retinopathy (DR) is a significant complication of diabetes mellitus (DM) and remains a leading cause of vision loss among working-age individuals. Level of inflammatory biomarkers rise in DR. Main focus on Interleukin-6(IL-6), C-Reactive Protein (CRP) and Lactate Dehydrogenase (LDH) as IL-6 induces excess production of VEGF, CRP has both pro-inflammatory and anti-inflammatory properties whereas, LDH acts through oxidation process on pyruvate to be converted into lactate. Altered lactate levels reflect changes in glucose metabolism rates or pyruvate levels. Methods: Prospective hospital-based cross-sectional study was carried out on diagnosed cases of Diabetic Retinopathy at a tertiary care centre. Selection of 50 patients was done as per inclusion criteria and exclusion criteria. Results: Among NPDR patients, Mean of IL-6 levels was 23.59 ± 19.02, LDH was 99.46 ± 51.17 CRP was 0.49 ± 0.30 whereas in PDR patients, Mean of IL-6 was 58.91 ± 26.50, LDH was 202.5 ± 63.93 and CRP was 0.93 ± 0.33 showing 2-fold raised in PDR patients. Conclusion: Our study emphasizes the crucial role of inflammatory biomarkers in the pathogenesis of diabetic retinopathy. The elevated levels of IL-6, LDH, and CRP in vitreous humor samples from PDR patients compared to NPDR patients indicate the activation of an inflammatory pathway during the disease’s progression. This research paves the way for further investigations into targeted therapies that can modulate these inflammatory mediators, potentially improving the prognosis of diabetic retinopathy.
Case Report SUCCESSFUL MANAGEMENT OF EALES DISEASE WITH TUBERCULAR ETIOLOGY Kusumajati, Anindya Putri; Metita, Mirza
International Journal of Retina Vol 7 No 2 (2024): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2024.vol007.iss002.265

Abstract

Introduction: Recurrent vitreous hemorrhage is a defining indication of Eales disease, an idiopathic occlusive vasculitis of the peripheral retinal veins that primarily affects young males, and 38.7% of patients had a history of tuberculosis. This case study aims to illustrate the effective treatment of Eales disease, which includes vitreous hemorrhage and associated tuberculosis. Case report: A 23-year-old male presented with the primary complaint of impaired vision in his left eye since two weeks ago. Visual acuity was 1/60, and ultrasonography revealed vitreous hemorrhage. The right eye also has a history of vitrectomy and silicon oil from a vitreous hemorrhage two months prior. A full work-up was completed, with positive interferon-gamma release assay (IGRA) results. The patient received a 6-month course of antituberculous medication and an oral steroid on a tapering dose. The vitrectomy procedure was conducted on the left eye, but vitreous hemorrhage persisted even after the surgery. Three months following surgery, the vitreous hemorrhage cleared, and the visual acuity improved to 6/6 with a negative IGRA result. Discussion:Eales disease is identified in the condition of occlusive periphlebitis and retinal neovascularization, especially in the peripheral retina, in one or both eyes, after excluding other causes. Some patients may experience floaters, impaired vision, or even decreased visual acuity due to massive vitreous hemorrhage. In the earliest days of retinal perivasculitis, most patients are asymptomatic. Anti-tuberculosis treatment is considered for Eales disease with acute retinal periphlebitis with extensive infiltration, nodule development, and venous segment disappearance. In cases with persistent vitreous hemorrhage with decreased central vision for 3 months, vitrectomy is an option. Conclusion: One of the features of Eales disease is a young adult with recurrent vitreous hemorrhage that is tuberculous in nature. Early identification and a thorough eye examination, including USG and IGRA testing, as well as appropriate medicinal and surgical care, will result in a positive outcome.

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