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Virna Dwi Oktariana
Department of Ophthalmology, Faculty of Medicine, Indonesia University Cipto Mangunkusumo Hospital, Jakarta
Health Professions Medicine & Pharmacology Physics Public Health

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 1 
A Comparison 24 Hour Intraocular Pressures Between Travoprost 0.004% and Timolol Gel 0.1% on Controlled Primary Open Angle Glaucoma Puranto Budi Susetyo; Virna Dwi Oktariana; Edi Supiandi; Joedo Prihartono
Majalah Oftalmologi Indonesia Vol 41 No 2 (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 | Full PDF (263.382 KB) | DOI: 10.35749/journal.v41i2.27

Abstract

Background: To compare 24 hours intraocular pressure (IOP) in patients controlled primary open angle glaucoma treated with timolol gel 0.1% versus travoprost 0.004%. Method: 26 controlled primary open angle glaucoma patients were randomized to received travoprost 0.004% dosed in the evening or timolol gel 0.1% dosed in the morning. After 4 weeks of treatments 24 hours IOP curved was performed at 9 a.m until 6 a.m every 3 hours. Result: The mean IOP of travoprost 0.004% group was 12.2±1.5 mmHg and timolol 0.1% group was 13.4±1.9 mmHg (p>0.05). The IOP fluctuation of travoprost 0.004% was 3.9±1.4 mmHg and timolol gel 0.1% was 5.9±1.4 mmHg (p<0.05). Peak IOP travoprost 0.004% was 14.3±1.7 mmHg and timolol gel 0.1 % was 16.8±1.7 mmHg (p<0.05). Travoprost 0.004% has lower IOP in almost each point measurement compare to timolol gel 0.1%. Conclusion: Travoprost 0.004% has lower fluctuation, peak and mean IOP compare to timolol gel 0.1%. Keywords: Primary open angle glaucoma, IOP fluctuation, peak IOP, travoprost 0.004%, timolol gel 0.1%
Comparison of Peripapillary Retinal Nerve Fiber Layer (RNFL) Thickness between the Normal and Glaucoma Eyes with the Same Vertical Cup Disc Ratio (CDR) using Optical Coherence Tomography (OCT) Ni Gusti Ari Ayu Raiasih; Elvioza Elvioza; Virna Dwi Oktariana; Joedo Prihartono
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 | Full PDF (328.226 KB) | DOI: 10.35749/journal.v41i3.44

Abstract

Background: Glaucoma is a disease that belongs to a group of neurodegenerative diseases, such as impaired visual field and optic neuropathy with progressive damage to the optic nerve and retinal nerve fiber layer (RNFL) which is caused by the loss of ganglion cells and axon of the optic. Changes in the optic nerve and RNFL may occur prior to the abnormalities of the visual field nerves. Currently, the visual field examination should be performed to diagnose glaucoma but with patient-subjective result. Before it is detectable, visual field abnormalities are likely going to lose its ganglion cells by 40%. The purpose of this study was to assess and compare the peripapillary retinal nerve fiber layer (RNFL) between the normal and glaucoma eyes with vertical cup disc ratio (CDR) 0.4 to 0.7 in eye clinic Cipto Mangunkusumo Hospital (RSCM) Kirana. Methods: A total of 40 eyes of normal group and 34 eyes of glaucoma following Humphrey field analyzer examination and Optical Coherence Tomography (OCT) were evaluated. Peripapillary RNFL thickness between normal and glaucoma eyes were analyzed and compared each other. Eyes of glaucoma group then were grouped into early-stage glaucoma, according to the criteria in the initial stages of the examination results of Humphrey field analyzer. Result of peripapillary RNFL thickness was analyzed to get a cut off value. Results: Peripapillary RNFL thickness in the normal group with vertical CDR 0.4 to 0.7 was 111.3±9.8 μm to 118.0±3.0 μm, and glaucoma groups with vertical CDR 0.4 to 0.7 was 105.6±12.6 μm to 113.7±6.1 μm. Retinal nerve fiber layer thickness in normal group compared to glaucoma group in the superior quadrant, inferior, nasal, temporal and average on CDR 0.4 to 0.7 was not statistically significant (p>0.05), except on vertical CDR 0.6 average peripapillary RNFL (p<0.05). Cut off value of peripapillary RNFL in superior quadrant was 164 μm, inferior 169.5 μm, nasal 82.5 μm, temporal 73.5 μm and average 111.8 μm. Conclusion: There was no difference in changes of peripapillary RNFL along with the progression of vertical CDR but clinically, peripapillary RFNL thickness in glaucoma group is thinner than that of normal group with the same vertical CDR except in temporal quadrant. Keywords: Retinal nerve fiber layer (RNFL), cup disc ratio (CDR), optical coherence tomography (OCT)
Challenge in Diagnosing and Managing Carotid Caverous Fistula in Patient with Intermittent Angle Closure Glaucoma Maria Magdalena; Virna Dwi Oktariana; M Sidik
Majalah Oftalmologi Indonesia Vol 42 No 3 (2016): 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.v42i3.92

Abstract

Background: The purpose of this case report is to present a patient with Carotid Cavernous Fistula (CCF) superimposed angle closure glaucoma and how to manage the IOP and to describe treatment options for CCF. Case Report: A 72-year old female patient was consulted to Glaucoma Division with chief complain the redness of the right eye (RE). She also had blurred vision on both eyes and high IOP of the RE. The IOP of the RE tend to be fluctuated even after laser peripheral iridotomy (LPI) from prior hospital, and was different from the LE, which was stable on anti-glaucoma medication. A careful history taking, clinical examination including visual acuity and visual field defect test, and also ancillary test to confirm the diagnosis were done. The patient was assessed with intermittent angle closure glaucoma (ACG) of both eyes superimposed with carotid-cavernous fistula (CCF) of the RE and planned to undergo trabeculectomy and phacoemulsification surgery from glaucoma division, and also embolization procedure from neuro ophthalmology division. However, the schedule of embolization will be done one year later due to long waiting list at Radiology Departement.Conclusion: This case demonstrates CCF of the RE superimposed intermittent ACG of both eyes. The Clinical manifestation of CCF were subtle, therefore clinical examination and acillary test such as CT angiography were needed to establish the diagnosis and to exclude differential diagnosis. The definitive therapy for CCF is to closure the fistula, but due to long waiting list we have to consider carotid massage as conservative management. In this case carotid massage gave good result in reducing ocular manifestation of CCF.  Keyword: Carotid Cavernous Fistula, Glaucoma, Angle-closure Glaucoma, Carotid Massage
A Comparison 24 Hour Intraocular Pressures Between Travoprost 0.004% and Timolol Gel 0.1% on Controlled Primary Open Angle Glaucoma Puranto Budi Susetyo; Virna Dwi Oktariana; Edi Supiandi; Joedo Prihartono
Majalah Oftalmologi Indonesia Vol 41 No 2 (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.v41i2.27

Abstract

Background: To compare 24 hours intraocular pressure (IOP) in patients controlled primary open angle glaucoma treated with timolol gel 0.1% versus travoprost 0.004%. Method: 26 controlled primary open angle glaucoma patients were randomized to received travoprost 0.004% dosed in the evening or timolol gel 0.1% dosed in the morning. After 4 weeks of treatments 24 hours IOP curved was performed at 9 a.m until 6 a.m every 3 hours. Result: The mean IOP of travoprost 0.004% group was 12.2±1.5 mmHg and timolol 0.1% group was 13.4±1.9 mmHg (p>0.05). The IOP fluctuation of travoprost 0.004% was 3.9±1.4 mmHg and timolol gel 0.1% was 5.9±1.4 mmHg (p<0.05). Peak IOP travoprost 0.004% was 14.3±1.7 mmHg and timolol gel 0.1 % was 16.8±1.7 mmHg (p<0.05). Travoprost 0.004% has lower IOP in almost each point measurement compare to timolol gel 0.1%. Conclusion: Travoprost 0.004% has lower fluctuation, peak and mean IOP compare to timolol gel 0.1%. Keywords: Primary open angle glaucoma, IOP fluctuation, peak IOP, travoprost 0.004%, timolol gel 0.1%
Comparison of Peripapillary Retinal Nerve Fiber Layer (RNFL) Thickness between the Normal and Glaucoma Eyes with the Same Vertical Cup Disc Ratio (CDR) using Optical Coherence Tomography (OCT) Ni Gusti Ari Ayu Raiasih; Elvioza Elvioza; Virna Dwi Oktariana; Joedo Prihartono
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.v41i3.44

Abstract

Background: Glaucoma is a disease that belongs to a group of neurodegenerative diseases, such as impaired visual field and optic neuropathy with progressive damage to the optic nerve and retinal nerve fiber layer (RNFL) which is caused by the loss of ganglion cells and axon of the optic. Changes in the optic nerve and RNFL may occur prior to the abnormalities of the visual field nerves. Currently, the visual field examination should be performed to diagnose glaucoma but with patient-subjective result. Before it is detectable, visual field abnormalities are likely going to lose its ganglion cells by 40%. The purpose of this study was to assess and compare the peripapillary retinal nerve fiber layer (RNFL) between the normal and glaucoma eyes with vertical cup disc ratio (CDR) 0.4 to 0.7 in eye clinic Cipto Mangunkusumo Hospital (RSCM) Kirana. Methods: A total of 40 eyes of normal group and 34 eyes of glaucoma following Humphrey field analyzer examination and Optical Coherence Tomography (OCT) were evaluated. Peripapillary RNFL thickness between normal and glaucoma eyes were analyzed and compared each other. Eyes of glaucoma group then were grouped into early-stage glaucoma, according to the criteria in the initial stages of the examination results of Humphrey field analyzer. Result of peripapillary RNFL thickness was analyzed to get a cut off value. Results: Peripapillary RNFL thickness in the normal group with vertical CDR 0.4 to 0.7 was 111.3±9.8 μm to 118.0±3.0 μm, and glaucoma groups with vertical CDR 0.4 to 0.7 was 105.6±12.6 μm to 113.7±6.1 μm. Retinal nerve fiber layer thickness in normal group compared to glaucoma group in the superior quadrant, inferior, nasal, temporal and average on CDR 0.4 to 0.7 was not statistically significant (p>0.05), except on vertical CDR 0.6 average peripapillary RNFL (p<0.05). Cut off value of peripapillary RNFL in superior quadrant was 164 μm, inferior 169.5 μm, nasal 82.5 μm, temporal 73.5 μm and average 111.8 μm. Conclusion: There was no difference in changes of peripapillary RNFL along with the progression of vertical CDR but clinically, peripapillary RFNL thickness in glaucoma group is thinner than that of normal group with the same vertical CDR except in temporal quadrant. Keywords: Retinal nerve fiber layer (RNFL), cup disc ratio (CDR), optical coherence tomography (OCT)
Challenge in Diagnosing and Managing Carotid Caverous Fistula in Patient with Intermittent Angle Closure Glaucoma Maria Magdalena; Virna Dwi Oktariana; M Sidik
Majalah Oftalmologi Indonesia Vol 42 No 3 (2016): 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.v42i3.92

Abstract

Background: The purpose of this case report is to present a patient with Carotid Cavernous Fistula (CCF) superimposed angle closure glaucoma and how to manage the IOP and to describe treatment options for CCF. Case Report: A 72-year old female patient was consulted to Glaucoma Division with chief complain the redness of the right eye (RE). She also had blurred vision on both eyes and high IOP of the RE. The IOP of the RE tend to be fluctuated even after laser peripheral iridotomy (LPI) from prior hospital, and was different from the LE, which was stable on anti-glaucoma medication. A careful history taking, clinical examination including visual acuity and visual field defect test, and also ancillary test to confirm the diagnosis were done. The patient was assessed with intermittent angle closure glaucoma (ACG) of both eyes superimposed with carotid-cavernous fistula (CCF) of the RE and planned to undergo trabeculectomy and phacoemulsification surgery from glaucoma division, and also embolization procedure from neuro ophthalmology division. However, the schedule of embolization will be done one year later due to long waiting list at Radiology Departement.Conclusion: This case demonstrates CCF of the RE superimposed intermittent ACG of both eyes. The Clinical manifestation of CCF were subtle, therefore clinical examination and acillary test such as CT angiography were needed to establish the diagnosis and to exclude differential diagnosis. The definitive therapy for CCF is to closure the fistula, but due to long waiting list we have to consider carotid massage as conservative management. In this case carotid massage gave good result in reducing ocular manifestation of CCF.  Keyword: Carotid Cavernous Fistula, Glaucoma, Angle-closure Glaucoma, Carotid Massage
Co-Authors Edi Supiandi Elvioza Elvioza Joedo Prihartono M Sidik Maria Magdalena Ni Gusti Ari Ayu Raiasih Puranto Budi Susetyo