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Randomized Trial Comparing Adjuvant Intravitreal Triamcinolone Acetonide 2mg and Bevacizumab 12,5mg for Diabetic Macular Edema maria Larasati; Arini Setiawati; Ari Djatikusumo
Medicinus Vol 7, No 2 (2018): February 2018 - May 2018
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i2.1792

Abstract

ObjectivesTo evaluate the efficacy and safety of Intravitreal Triamcinolone Acetonide (IVTA) 2 mg and Bevacizumab (IVB) 12,5 mg for adjuvant therapy of Diabetic Macular Edema (DME)DesignThis was a prospective, randomized clinical trial. Each participants with DME was randomized to received single intravitreal injection of IVTA or IVB  and then being followed until fourth week after injection. The efficacy parameters were the improvement in Best Corrected Visual Acuity (BCVA) in logMAR and Standardized Central Macular Thickness (SCMT) by Optical Coherence Tomography. The safety parameters were the Intra Ocular Pressure (IOP) and Posterior Capsular cataract progression using LOCSIII criteria.ResultsTwenty five eyes of 20 participants were randomly assigned to receive IVTA 2 mg (n=12) and IVB (n=13). At 4 weeks, mean BCVA was better in IVTA group than in IVB group -0,39 logMAR (p<0,05). CMT reduction were significant in all visits of both groups. The SCMT showed 78,37%  at final follow-up for IVTA group. There were no statistic significant difference in the mean IOP and posterior capsular cataract changes among two groups. (p>0,05)ConclusionAdjuvant IVTA injections were more effective than IVB injections in patients with DME. However, it was associated with higher increment in IOP, despite not reaching statistical significance.
Pars Plana Vitrectomy in Rhegmatogenous Retinal Detachment in Paediatric Patients in Dr. Cipto Mangunkusumo Hospital, Indonesia 2017 Faresa Hilda; Ari Djatikusumo; Elvioza Elvioza; Gitalisa Andayani Adriono; Anggun Rama Yudantha; Mario Marbungaran Hutapea; Andi Arus Victor
eJournal Kedokteran Indonesia Vol 9, No. 2 - Agustus 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (367.126 KB) | DOI: 10.23886/ejki.9.4.94

Abstract

In the past decades, indications for PPV in paediatric patients has been rising with large heterogeneity outcomes among studies. Our objective is to present a pilot descriptive study in Indonesia, regarding pars plana vitrectomy (PPV) success rate in paediatric patients with rhegmatogenous retinal detachment (RRD) in Dr. Cipto Mangunkusumo Hospital (CMH). A retrospective study was conducted on 16 paediatric eyes diagnosed for RRD and treated in CMH during the period of January 2017 to December 2017. A total of 16 RRD eyes were identified in 15 individuals. Majority of the patients were male and were in the age group of 12-18 years. There were 13 patients undergone PPV with or without SB. Functional anatomical success rate was determined from the macula status while functional success rate on final BCVA. Among 16 patients, 14 had constant or increased final BCVA and 11 had reattached macula. The success rate of PPV in terms of anatomical outcome was 11 out of 16 eyes and in functional outcome was 8 out of 16 eyes. Keywords: pars plana vitrectomy, paediatric ophthalmology, rhegmatogenous retinal detachment.   Karakteristik dan Hasil Vitrektomi Pars Plana pada Pasien Pediatrik di Divisi Vitreoretina Rumah Sakit Cipto Mangunkusumo Tahun 2017 Abstrak Indikasi tindakan vitrektomi pars plana (PPV) pada pasien pediatrik bertambah secara signifikan dalam beberapa dekade terakhir. Penelitian ini dilakukan sebagai studi awal di Indonesia, terkait tingkat keberhasilan PPV pada pasien anak dengan rhegmatogenous retinal detachment (RRD) khususnya di RS Cipto Mangunkusumo (RSCM). Studi retrospektif dilakukan terhadap 16 mata RRD pada 15 pasien anak di RSCM pada periode Januari 2017 – Desember 2017. Mayoritas pasien merupakan laki-laki dalam kelompok umur 12-18 tahun. Terdapat 13 pasien yang menjalani PPV dengan atau tanpa scleral buckle (SB). Tingkat keberhasilan anatomi dilihat dari status penempelan makula, sementara tingkat keberhasilan fungsional dinilai dari visus akhir. Tingkat keberhasilan anatomi PPV dalam studi ini adalah 11/16 mata, dan tingkat keberhasilan fungsional mencapai 8/16 mata. Kata kunci: vitrektomi pars plana, oftalmologi pediatrik, rhegmatogenous retinal detachment.
CLINICAL CHARACTERISTICS OF PROLIFERATIVE DIABETIC RETINOPATHY (PDR) PATIENTS WITH VITREOUS HEMORRHAGE AT CIPTO MANGUNKUSUMO HOSPITAL Reyno Satria Ali; Andi Arus Victor; Ari Djatikusumo; Gitalisa Andayani; Anggun Rama Yudanta; Mario Marbungaran Hutapea
International Journal of Retina Vol 6 No 1 (2023): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2023.vol006.iss001.227

Abstract

Introduction: Proliferative Diabetic retinopathy is the most common cause of blindness in adults. In the management of vitreous hemorrhage, vitrectomy is the main choice and also laser photocoagulation with or without anti-VEGF administration as additional therapy. This study aims to determine the number of patients, demographic characteristics, clinics, risk factors, distribution of treatment, and treatment outcomes for PDR patients with vitreous hemorrhage at Cipto Mangunkusumo Hospital. Methods: This study was retrospective descriptive study conducted from January 2020 to October 2022 who met the inclusion criteria. Population in this study were patients at Cipto Mangunkusumo Hospital with PDR accompanied by vitreous hemorrhage. Data shown in the table were mean (standard deviation) and number (percentage) based on the type of the data. Result: A total of 146 patients with the diagnosis of Proliferative Diabetic Retinopathy (PDR) with vitreous hemorrhage. Majority of subjects were men (60,9%), diagnosed with DM more than 10 years (63,0%) with another systemic risk factor. The most common clinical characteristics found visual acuity at the initial visit <3/60 (80,8%), diagnosed phakia (78,9%), retinal detachment (85,3%), grade 2 vitreous hemorrhage (80,8%). The majority of eyes underwent vitrectomy (90,44%), Anti-VEGF injections (22,92%), Laser PRP (11,46 %), Phacoemulsification pre and post- vitrectomy as adjuvant treatment. The condition of the vitreous was clear after vitrectomy (99,1%). Mean visual acuity before vitrectomy is 2.10 (1.80 – 2.50), while mean visual acuity after vitctomy was 1.00 (1.30 – 2.40), with a difference in initial and final visual acuity of -0.10 (-0.50 – 0.60). Conclusion: Majority of study subjects were men with an age range of 25-77 years. Vitrectomy as the main treatment combined with intravitreal injection of anti-VEGF, laser PRP as adjuvant treatment. In nearly all cases, vitreous hemorrhage was clear after vitrectomy treatment. Visual acuity after vitrectomy shows progress even though in some cases there was no improvement.
Intravitreal Bevacizumab In Diabetic Macular Edema At RSUP Cipto Mangunkusumo in 2017 Andi Arus Victor; Masniah Masniah; Ari Djatikusumo; Elvioza Elvioza; Gitalisa Andayani Adriono; Anggun Rama Yudantha; Mario Marbungaran Hutapea
International Journal of Retina Vol 2 No 2 (2019): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2019.vol002.iss002.70

Abstract

Introduction: Diabetic Macular Edema (DME) is a manifestation of diabetic retinopathy and is the most common cause of vision loss in diabetics. The incidence of DME has a tendency to increase, concomitant with the prevalence of diabetes globally by more than 50% from 2000 to 2030. This study aims to evaluate the proportion of central macular thickness (CMT) improvement and visual acuity in DME patients treated with intravitreal bevacizumab (IVB) injection. Methods: This study is a retrospective descriptive study. The study was conducted in the Department of Ophthalmology at RSUP Cipto Mangunkusumo (RSCM) Jakarta. Data were obtained from the medical records of all diabetic retinopathy patients with macular edema who were treated with IVB at RSCM Kirana Vitreoretina Polyclinic on January – December 2017. Results: Of the 44 subjects, improvement in best corrected visual acuity (BCVA) occurred in 24 (54.54%) subjects at the first-month evaluation and 19 (43.18%) subjects at the third-month evaluation. CMT decreased in 37 (84.41%) subjects at the first-month evaluation and 35 (81.81%) subjects at the third-month evaluation. Conclusion: Visual acuity improvement and central macular thickness reduction 3 months after IVB injection. These results strengthen IVB injection to be an alternative to adjuvant therapy in DME. Keywords: Diabetic Macular Edema, Intravitreal Bevacizumab Injection