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Rizky Akbar
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INDONESIA
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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PROTECTIVE EFFECTS OF SELENIUM SUPPLEMENTATION AGAINST HIGH FRUCTOSE CORN SYRUP-INDUCED RETINAL DAMAGE IN RATS THROUGH REDUCTION OF INFLAMMATION AND APOPTOSIS Usta, Gulsah; Savran, Mehtap; Özkaya, Dilek; Karaca, Umut; Karakuyu, Nasıf Fatih
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.iss002.301

Abstract

Introduction: High fructose corn syrup (HFCS) consumption is associated with metabolic complications, including retinopathy. The aim of the current study is to investigate the potential protective effect of selenium (Se) against HFCS-induced retinal damage. Methods: Forty Wistar albino rats were divided into four groups (n=7 each): (I) control; (II) high fructose corn syrup (HFCS, 20% in diet); (III) HFCS + Se (20% in diet, 0.3 mg/kg orally); (IV) Se only. Retinal damage was assessed using histopathological (retinal thickness) and immunohistochemical (TNF-α, and Cas-3 expression) analysis. Results: Retinal thickness measurements revealed a significant increase in the HFCS group compared to the Control group, HFCS+Se group and Se group (all group, p<0.0001). Immunohistochemical analysis showed increased TNF-α expression in the HFCS group compared to the Control and Se groups (p<0.01), with a non-significant decrease in the HFCS+Se group (p > 0.05). Cas-3 expression was significantly increased in the HFCS group compared to the Control, Se groups (p<0.001 for both) and HFCS+Se group (p<0.01). Conclusion: Se supplementation partially protects against HFCS-induced retinal damage, particularly by reducing inflammation and apoptosis.
Evaluating the Real-World Efficacy and Safety of Intravitreal Faricimab in the Management of Neovascular Age-Related Macular Degeneration: A Systematic Review Barus, Dany Petra Pranata; Adriono, Gitalisa Andayani
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.iss002.329

Abstract

Introduction: Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible vision loss in the elderly. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapies have revolutionized the treatment of nAMD. Faricimab, a novel bi-specific anti-VEGF and anti-angiopoietin-2 antibody, has shown promise in clinical trials. This comprehensive systematic review aims to evaluate the real-world efficacy and safety of intravitreal faricimab in the management of nAMD. Methods: A comprehensive search was conducted in major electronic databases to identify studies reporting outcomes related to faricimab treatment for nAMD in real-world settings. A total of 6 studies were included, comprising 800 patients including 874 eyes. The primary outcomes of interest included visual acuity improvements, central subfield thickness of retina, and safety. Result: The review reveals that intravitreal faricimab is associated with significant visual acuity improvements in patients with nAMD, with outcomes comparable to or better than existing anti-VEGF agents. Furthermore, patients receiving faricimab typically required fewer injections, resulting in a potentially lower treatment burden. The findings also suggest that faricimab may offer a longer treatment interval, which could have a positive impact on patient quality of life. Conclusion: Regarding safety, faricimab demonstrated a favorable safety profile in the real-world setting, with a low incidence of ocular and systemic adverse events. This suggests that faricimab is well-tolerated by patients, supporting its long-term use in the management of nAMD.
OBSERVATION VS. SURGERY IN TRAUMATIC MACULAR HOLE: A CASE REPORT HIGHLIGHTING FUNCTIONAL OUTCOME Kartika, Amelia Rahmah; Yustiarini, Ima; Prakosa, Ady Dwi; Widjaja, Sauli Ari; Firmansjah, Muhammad; Sasono, Wimbo
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.iss002.322

Abstract

Introduction: Traumatic macular hole (TMH) is a rare consequence of blunt ocular trauma, often leading to visual impairment. While spontaneous closure is possible, the decision between observation and surgical intervention remains debated. Case Report: A 15-year-old male presented with blurry vision in his left eye two weeks after being punched. Examination revealed a macular hole, choroidal rupture, and vitreous hemorrhage. Optical coherence tomography (OCT) confirmed a full-thickness macular hole. Given the potential for spontaneous closure, a three-month observation period was chosen. Follow-ups showed no improvement in visual acuity or anatomical closure, leading to the decision against surgery. Discussion: While vitrectomy has high anatomical success rates, final visual acuity may not differ significantly between surgically and spontaneously closed holes. Factors such as initial visual acuity, ellipsoid zone integrity, and associated ocular injuries influence functional outcomes. In this case, the presence of choroidal rupture and vitreous hemorrhage supported the decision for conservative management. Conclusion: TMH management should balance anatomical and functional outcomes. Observation is a reasonable approach in select cases, particularly in younger patients with a chance of spontaneous closure. Individualized treatment decisions are essential, considering potential surgical risks and visual prognosis.
The Demographic Profile, Etiology and Outcomes of Acute Postoperative Endophthalmitis Dewi, Amalia Zahra; Sofia, Ovi
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.iss002.330

Abstract

Introduction: To describe patient characteristics, bacterial patterns, management, and outcomes of therapy in patients with acute postoperative endophthalmitis. Method: This observational, descriptive study was conducted at Dr. Saiful Anwar General Hospital in Malang, Indonesia, between 2020 and 2024, involving all patients with newly diagnosed acute postoperative endophthalmitis with periode follow up patient's initial visit, on day 7, and on day 28 following treatment Results: A total of 74 patients were included in the study. The majority were male (51.3%), with a mean age of 61.57 ± 11.54 years. The most common comorbid was diabetes mellitus (16.2%). The etiology was most commonly due to gram-negative bacilli (13%), and phacoemulsification was the most common surgical procedure associated with endophthalmitis (74%). Quinolones exhibited the highest sensitivity. The most common management was a combination of medical and surgical treatments, including intravitreal antibiotic injections (59%) and combination of intravitreal antibiotic injections and pars plana vitrectomy (PPV) (18%) . The visual acuity outcomes revealed that 45,9% patients experienced improvement. Conclusion: The incidence of endophthalmitis increases with advancing patient age, correlating with a higher frequency of cataract surgeries performed. Current management outcomes for endophthalmitis are favorable, reflecting improvements aligned with updated clinical guidelines. The comprehensive management of endophthalmitis will result in an improved visual outcome.
Minimally Invasive Management of Retinal Detachment: Insights from a Pneumatic Retinopexy Case Report Pramesti, Karina Ayu; Prakosa, Ady Dwi; Sasono, Wimbo; Firmansjah, Muhammad; Widjaja, Sauli Ari; Yustiarini, Ima
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.iss002.326

Abstract

Introduction: Rhegmatogenous Retinal Detachment (RRD) caused by a tear in the retina, causes fluid accumulation and separation of neurosensory retina from retinal pigment epithelium which can lead to blindness. The goal for treatment is to reduce vitreoretinal tension and fix retinal tears and holes. The case report discusses about management in uncomplicated RRD. Case Report: Patient came with blurry vision on his right eye (RE) since two weeks ago. Four days before, He was seeing black curtain on lower left direction while working, but it did not get any wider. No complaints on his left eye. Patient has hypertension only known recently. No history of trauma, spectacles. His occupation was labourer. General examination within normal limits. Visual acuity (VA) RE 6/24. Anterior segment within normal limits. Posterior segment, detachment at 9-2 o'clock, horse shoe tear at 11 o'clock and a small hole at 1 o'clock. Lattice degeneration at 8-12 o'clock, macula on. Patient then underwent pneumatic retinopexy. Intraocular pressure (IOP) 13mmHg. Discussion: Retinal detachment occurs when subretinal fluid accumulates between the neurosensory retina and the retinal pigment epithelium. This can happen in three ways, and the cause for our patient was a tear of retina, for that reason we diagnosed with RRD. Prognosis for patients with RRD depends on the condition off the macula, and the symptom onset. Conclusion: Optimization of retinal detachment detection and the success of rapid-onset retinopexy still need improvement. Proliferative Vitreoretinopathy (PVR) remains a common cause of failure, necessitating new strategies for its management. However, the choice of technique is still influenced by the considerations and experience of each vitreoretinal surgeon.
Real-World Evaluation of the Effectiveness of Intravitreal Bevacizumab Injection for Neovascular Age-Related Macular Degeneration at Cipto Mangunkusumo National Referral Hospital Adriono, Gitalisa Andayani; Pambudy, Indra Maharddhika; Victor, Andi Arus; Djatikusumo, Ari; Yudhanta, Anggun Rama; Hutapea, Mario Marbungaran; Triyoga, Ichsan Fauzi
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.iss002.319

Abstract

Introduction: Neovascular age-related macular degeneration (nAMD) is a leading cause of visual impairment globally. While intravitreal anti-VEGF therapy is the standard treatment, real-world data on bevacizumab (IVB), the most accessible agent in Indonesian public hospitals despite being off-label, remains limited. This study aims to evaluate the effectiveness of IVB in patients with nAMD at a tertiary referral center in Indonesia. Methods: This retrospective study included patients diagnosed with nAMD who received IVB injections at Cipto Mangunkusumo National Referral Hospital between January and December 2017. Inclusion criteria encompassed patients with confirmed nAMD and available clinical data pre- and post-injection. Data on demographics, best-corrected visual acuity (BCVA), central macular thickness (CMT) measured by OCT, and IVB injection regimen were extracted from electronic medical records. Statistical analysis was performed using Wilcoxon signed-rank and Mann–Whitney U tests, with p < 0.05 considered statistically significant. Result: A total of 138 eyes from 131 patients (mean age: 66.7 years; 51% male) were analyzed. The median number of injections was three (range: 1–6). Mean BCVA showed a non-significant improvement from 1.19 to 1.14 logMAR (mean change: 0.05 logMAR; p = 0.770). Subgroup analysis indicated significant improvement in eyes with baseline VA worse than 1.32 logMAR (mean gain: 0.54 logMAR; p < 0.01) and a significant decline in eyes with baseline VA between 0.48 and 1.00 logMAR (mean loss: 0.21 logMAR; p = 0.02). CMT significantly decreased by an average of 108.33 µm (p < 0.01). Conclusion: IVB treatment for nAMD resulted in significant anatomical improvement and was particularly effective in patients with poor baseline visual acuity. These findings highlight the role of IVB in real-world clinical practice within resource-limited settings.
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.
RESTORING VISION IN CENTRAL MACULAR EDEMA (CME) CAUSED BY CENTRAL RETINAL VEIN OCCLUSION (CRVO): SINGLE INTRAVITREAL BEVACIZUMAB INJECTION Iskandar, Ferdy; Pertiwi, Adinda Mulya; Hutapea, Mario Marbungaran
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.iss002.325

Abstract

Introduction: Central retinal vein occlusion (CRVO) stands as a prevalent contributor to vision impairment from retinal vascular issues, affecting approximately 0.08% of individuals over 30. Cystoid macular edema (CME) is the most frequent cause of reduced vision among these cases. This study aimed to report the promising outcome of a single intravitreal bevacizumab injection in treating CME secondary to CRVO. Case Report: A 41-year-old male came with a sudden blurry vision of the left eye (LE) 10 hours before admission, particularly in the superior and temporal areas. He denied any history of red eyes, sudden light flashes, curtain-like shadows, double vision, or pain with eye movements. He had a history of hypertension but was not on medication. His blood pressure was 180/120 mmHg, with visual acuity (VA) of 1/60, positive relative afferent pupillary defect (RAPD), edematous optic nerve head (ONH) with tortuous veins, and hemorrhages throughout the retina of the LE. Macular optical coherence tomography (OCT) of the LE showed massive intraretinal fluid (IRF) with a central macular thickness (CMT) of 779 µm. He had unremarkable laboratory results, with normal coagulation factors. Amlodipine 10 mg once daily (qd) and candesartan 16 mg qd was prescribed, and no antiplatelet or anticoagulant therapy was initiated by the internal medicine. A single intravitreal bevacizumab injection (1.25mg) was performed on the LE. During a 1-month follow-up, his best corrected visual acuity (BCVA) improved to 6/18, with a normal optic nerve head, tortuous veins, flame-shaped hemorrhages, with no IRF and a CMT of 240 on macular OCT. The BCVA and CMT remained stable at the 6-month follow-up, with no complications. Discussion: A Treat and extend (T&E) regimen was initially planned, with ≥ 3 consecutive monthly injections until disease inactivity was established, followed by a gradual extension of the treatment interval in increments of 2 to 4 weeks. We initially planned to administer bevacizumab intravitreal injections according to the T&E regimen. However, the patient showed significant clinical improvement, and macular OCT demonstrated resolution of the IRF after the first injection. Therefore, we decided to discontinue the remaining injections and switch to a pro re nata (PRN) approach, administering bevacizumab as needed. In real-life conditions, the number of anti-vascular endothelial growth factor (VEGF) injections was lower than in randomized controlled trials (RCTs), due to many factors, such as declining motivation after improvement, poor access to hospital facilities, and unaffordable travel expenses. The PRN regimen is also a good option to minimize costs and reduce the burden on both patients and healthcare providers. Conclusion: Single intravitreal bevacizumab is an effective treatment for CME secondary to CRVO. However, the decision to use the T&E and PRN regimen should be based on the patient’s improvement and clinical examination. Additionally, any systemic conditions related to the vascular condition must also be addressed and treated.

Page 15 of 15 | Total Record : 148

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