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All Journal IJRETINA - International Journal of Retina
Ima Yustiarini
Department of Ophthalmology, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital Surabaya, Indonesia
Health Professions Medicine & Pharmacology Public Health

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CHARACTERISTICS OF RETINAL DETACHMENT PATIENTS WITH PROLIFERATIVE VITREORETINOPATHY AT Dr. SOETOMO GENERAL ACADEMIC HOSPITAL Ifan Romadhon Lukmana; Sauli Ari Widjaja; Wimbo Sasono; Muhammad Firmansjah; Ima Yustiarini; Ady Dwi Prakosa; Moestidjab Moestidjab; Gatut Suhendro
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.iss002.75

Abstract

Introduction: The aim of this study is to evaluate the incidence and characteristics of retinal detachment patients with proliferative vitreoretinopathy. Methods: Retrospective review of medical record from primary retinal detachment (RD) patients with proliferative vitreoretinopathy (PVR) between 2013 and 2017 at Outpatient Department of Ophthalmology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Result: : The number of RD patients with PVR at Dr. Soetomo General Academic Hospital in 2013-2017 was 80 patients (21%), consisting of 59 men and 21 women with mean of age was 47.5 ± 14.3 years. The characteristics of the subjects were phakic 72.5%, aphakic 1.25%, high myopia 23.75%, history of trauma 18.75% and affected to right eye 60%. Retinal characteristics were break conditions in the retina (located at superotemporal (34%), horseshoe tear (56%), and single break (60%)), macula off (90%), area of detachments were 4 quadrants (43,75%), PVR conditions were grade B PVR (45%), mean duration of RD was 156 days, mean length of surgery waiting list was 61.1 days. The majority of treatment types were vitrectomy (70,4%), majority of tamponade using silicone oil (59.3%), majority of pre-operative and post-operative visual acuity were less than 3 meters counting finger, pre-operative (91.25%) , post-operative 1 month (76%) and 6 months (52.5%), and the majority of post-operative retinal reattachment were 77.3%. Conclusion: The results of this study indicate the number of RD patients with PVR was lower than previous studies. Various results of patient characteristics can be used as guidelines for ophthalmologists in determining actions and explaining the prognosis of the disease. Further research with a larger sample size and prospective methods will be better able to provide better results. Keywords: retinal detachment, proliferative vitreoretinopathy, characteristic pvr
CONDENSING LENS ON BINOCULAR INDIRECT OPHTHALMOSCOPY AND SLIT-LAMP BIOMICROSCOPY Danang Yoga Wiguna; Sauli Ari Widjaja; Wimbo Sasono; Muhammad Firmansjah; Ima Yustiarini; Ady Dwi Prakosa; Moestidjab Moestidjab; Gatut Suhendro
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.iss002.76

Abstract

Condensing lens is a lens used as an auxiliary lens in indirect instruments to examines the fundus. This lens is used with binocular indirect ophthalmoscope and slit-lamp biomicroscope to reach a stereopsis image of fundus. Optical principle of condensing lens is to make the eye in myopic condition, so it can producesa real, aerial, inverted and reversed image. This lens was placed between the instruments and the eye of the patient which located closer to patient’s eye. Optimalized position of the lens can produce a good fundus image. Condensing lens have so many power of dioptre that each power produces different magnification and field of view. High powered lenses produces wider field of view than low powered ones. High powered lens can also used in patient with small dilated pupil and shorter distance of examination. Low powered lenses offer more magnification. Fundus examination with binocular indirect ophthalmoscope and slit-lamp biomicroscope have purpose to produces stereopsis image because of the binocularity system. These two instruments have each advantages and disadvantages. The advantages of binocular indirect ophthalmoscope are a portable instrument, relatively can be used in uncooperative patient and it can be used with scleral indentation to reach more peripheral view of the fundus. Meanwhile slit-lamp biomicroscope has the advantages to offer more magnification and flexible illumination system. With higher powered lens use in biomicroscope, it also give advantages in shorter distance of examination and wider field of view.
Challenges in Cytomegalovirus (CMV) Retinitis Management Denisa Rosati; Sauli Ari Widjaja; Wimbo Sasono; Muhammad Firmansjah; Ima Yustiarini; Ady Dwi Prakosa; Moestidjab Moestidjab; Gatut Suhendro
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.iss002.91

Abstract

Introduction: HIV infection can manifest in a variety of ways in and around the eyes and it is most commonly due to retinal microvasculopathy, neoplasm and also opportunistic infection. Those usually occur associated with a significantly reduced CD4 T-cell counts. In this era of Highly Active Anti Retroviral Therapy (HAART) has caused a major decreasing of the ocular involvement prevalence itself. Case presentation : A 31 year-old-male came with blurred vision on the right eye, which has started 3 years ago and slowly worsened. Central scotoma also presented previously. Patient was an HIV-AIDS, that placed him on HAART. CD4+ T-lymphocyte count was 3 cells/mm3. The initial visual acuity was light perception and fundus examination showed Roth spots, massive exudates and hemorrhages covering the optic disc and decreased foveal reflex. Laboratory examination revealed positive Rubella and anti-CMV immunoglobulin-G (IgG). He also suffered from lung tuberculosis and took tuberculosis medication regularly. Patient was diagnosed with Cytomegalovirus (CMV) retinitis based on history of illness, fundus examination as well as laboratory testing and given oral induction valganciclovir 900 mg once daily for 3 weeks followed by maintenance dosage . Result : After valganciclovir induction, there was significant changes with decreased peripapillary exudates, hemorrhages and vasculitis, but the optic disc appeared pale. The patient also had bicytopenia due to valganciclovir therapy that complicate his condition and passed away after 3 months follow up. Conclusion: CMV retinitis is reported to occur in patient with extreme CD4 count usually less than 50 cells/mm3. The sooner of proper treatment would likely following better outcome. Making diagnosis of immunosuppresed patient with ocular manifestations was challenging so that comprehensive eye examination in HIV-infected individuals should be conducted. Oral valganciclovir could give satisfactory response to decrease the progression of retinitis but risk of blindness may still occur.
Co-Authors Ady Dwi Prakosa Danang Yoga Wiguna Denisa Rosati Gatut Suhendro Ifan Romadhon Lukmana Moestidjab Moestidjab Muhammad Firmansjah Sauli Ari Widjaja Wimbo Sasono