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All Journal Majalah Kedokteran Bandung Althea Medical Journal Nusantara Medical Science Journal Jurnal Pendidikan dan Pelayanan Kebidanan Indonesia (Indonesian Journal of Education and Midwifery Care) International Journal of Retina Jurnal Medika Malahayati Sehat Masada Ophthalmologica Indonesiana IJRETINA - International Journal of Retina
Arief S. Kartasasmita
Department Of Ophthalmology, Faculty Of Medicine, Padjadjaran University Cicendo National Eye Center, Bandung, West Java
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Physics Public Health

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Characteristics of Patient with Proliferative Diabetic Retinopathy Underwent Anti-Vascular Endothelial Growth Factors Injection in Cicendo Eye Hospital, Bandung in January–December 2013 Pintary, Marsha Rayfa; Kartasasmita, Arief S.; Juliati, Juliati
Althea Medical Journal Vol 3, No 2 (2016)
Publisher : Althea Medical Journal

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Abstract

Background: Proliferative Diabetic Retinopathy (DR) is one of the microvascular complications of diabetes mellitus (DM) that is prevalent to the blindness risk. The World Health Organization (WHO) considers Proliferative DR one of the priorities of eye diseases. This disease is caused by angiogenesis brought about by Vascular Endothelial Growth Factors (VEGF). The Anti-VEGF Bevacizumab (Avastin) injection is considered sufficient in preventing proliferative DR patients from blindness. This study aimed to identify the characteristics of patients with proliferative DR underwent Anti-VEGF injection at Cicendo Eye Hospital, Bandung.Methods: This was a retrospective study conducted from August−October 2014 using 40 medical records of patients with proliferative DR underwent Anti-VEGF Bevacizumab (Avastin) injection at the Cicendo Eye Hospital Bandung from January−December 2013. Inclusion criteria were the patients underwent anti-VEGF injection with complete medical records with minimum follow up of 3 weeks.Results: Among 40 patients, 55% were male and 45% were female. Furthermore, there was 100% found for DM Type 2. Moreover, random blood glucose varied among 140–200mg/dl (50%), while the hypertension was mostly at stage 2. Some of these patients had proliferative DR with vitreal hemorrhage (25%), macular edema (40%), and/or tractionalablasio retina (22.5%). Most patients had an improvement in their visual acuity (60%).Conclusions: Most of patients are male, aged 50–59 years old, random blood glucose among 140– 200mg/dl, followed DM Type 2 and hypertension stage 2. Anti-VEGF injection improves visual acuity. [AMJ.2016;3(2):280–5]DOI: 10.15850/amj.v3n2.781
Giant Retinal Tear Management at Referral Eye Hospital Purnama, Mia; Iskandar, Erwin; Virgana, Rova; Ihsan, Grimaldi; Sovani, Iwan; Kartasasmita, Arief
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Introduction: to report the characteristics, management and outcome in giant retinal tear (GRT) associated retinal detachment patients at Cicendo Eye Hospital Methods: this retrospective study was performed on medical records who had undergone retinal detachment surgery between January 2014 and March 2017. Age, sex, etiologies, size of GRT, quadrant involvement, lens status, proliferative vitreo-retinopathy (PVR), managements and outcomes were evaluated in association with giant retinal tears Result: Twenty-six patients (23 males, 3 females) age between 11-59 years with follow up from 2 months to 18 months were enrolled in this study. Twenty-five eyes have retinal detachment with macular involvement and 11 patients had high myopia. Majority of patients had 90° of GRTs. Most retinal tears were located at temporal quadrant (73%). Nineteen patients had undergone pars plana vitrectomy (PPV) and 7 patients had combined PPV with encircling buckle. Fifteen patients had used heavy liquid, 24 patients had silicon oil and 2 had gas tamponade. Intraoperative complications included lens trauma, retinal slippage and choroidal detached were found in 1 eye respectively. Fourteen eyes had recurrent retinal detachment. At the last follow up, 14 patients had anatomically attached retina. Twelve patients had total retinal detachment and marked PVR. Five fellow eyes were treated with prophylactic laser. Visual acuity improved in 11 eyes. Conclusion: Giant retinal tears were more common in patients with high myopia. Management of GRT currently with PPV and PPV combined with encircling buckle. The success rate of anatomy and visual acuity was less than other previous studies
Correlation Between Systemic Risk Factors and Diabetic Retinopathy in Patients with Diabetes Mellitus at Cicendo National Eye Hospital Nauli, Rizki Rahma; Virgana, Rova; Kartasasmita, Arief; Sovani, Iwan; Iskandar, Erwin; Ihsan, Grimaldi
International Journal of Retina Vol 1 No 2 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Introduction: Diabetic Retinopathy (DR) is a highly specific microvascular complication of both type 1 and type 2 diabetes mellitus (DM) that can cause significant visual impairment in adult populations worldwide. The risk of having and/or developing DR is influenced by many systemic features. Identification and management of particular systemic risk factors as early as possible during the course of DM might lower incidence of further progression and severity of DR. The aim of this study is to describe the correlation between systemic risk factors and DR in patients with DM in Cicendo National Eye Hospital on December 1st 2017 – January 31st 2018. Methods: An analytical cross-sectional study. The subjects were all patients diagnosed with DR based on ophthalmology examination at outpatient clinic of Vitreoretinal Division in Cicendo National Eye Hospital. The data were analyzed using chi-square (x2) with significances of p < 0.05. Result: Seventy-one eyes were included in this study, among of which has been classified as mild NPDR (n= 1), moderate NPDR (n= 9), severe NPDR (n= 27), and PDR (n= 34). Severe NPDR group had older age distribution at range 51-60 years old (n= 18, 66.7%, p = 0.001). Stage 1 hypertension was found to be dominant in PDR group (n= 18, 66.7%, p = 0.043). Both high total serum cholesterol group (n= 27, 76.5%, p = 0.048) and high fasting blood glucose (n= 27, 79.4%, p = 0.01) were significantly present in patients with PDR. Positive (+1) urine glucose was statistically significant in PDR group. Conclusion: There were several systemic risk factors from laboratory findings correlated in patient with DR in this study, however further study is needed to determine their role for predicting progression and severity of DR.
Surgical Approach In Vitreous Hemorrhage Metita, Mirza; Sovani, Iwan; Kartasasmita, Arief; Iskandar, Erwin; Virgana, Rova
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Introduction: To report cases of retinal disorders that cause vitreous hemorrhage and the timing of pars plana vitrectomy in Cicendo Eye Hospital Methods: Retrospective observational study of all patients diagnosed with the vitreous hemorrhage who had undergone pars plana vitrectomy in 2016. Data were collected from medical record. Result: The mean age of this study is 54.65 years old from 260 vitreous hemorrhage patients. The most common retinal abnormalities are proliferative diabetic retinopathy (49.6%), wet age related macular degeneration (AMD) (13.5%), undetected retinal abnormalities (12.7%), retinal vein occlusion (8.8%), rhegmatogen retinal detachment (6.5%), trauma (3.45%), vasculitis (3.1%), idiopathic polypoidal choroidal vasculopathy (3.1%), and drop IOL (1.2%). PPV performed 1-3 months after initial assessment (31.25%), less than 1 month (13.2%), more than 3 months (14.6%) Conclusion: The most common etiology of vitreous hemorrhage is proliferative diabetic retinopathy. Pars plana vitrectomy was performed 1 – 3 months after an initial assessment of the patients.
Peripapillary Retinal Nerve Fiber Layer Thickness in Diabetic Retinopathy Patients measured by Optical Coherence Tomography Dwijayanti, Sindi; Kartasasmita, Arief; Sovani, Iwan; Iskandar, Erwin; Virgana, Rova; Ihsan, Grimaldi
International Journal of Retina Vol 1 No 2 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Introduction: Diabetic retinopathy (DR) is a microvascular complication of diabetes and one of the leading causes of blindness. Retinal function loss in diabetic patients is not only caused by microvascular abnormality but also retinal neurodegeneration. Optical coherence tomography (OCT) can detect retinal neural tissue loss caused by diabetes by measuring the retinal nerve fiber layer (RNFL) thickness on the cross-sectional imaging of the retina. This study is to evaluate the changes of peripapillary retinal nerve fiber layer (RNFL) thickness in diabetic retinopathy patients using OCT and compare it to age matched healthy controls. Methods: A cross-sectional study of 16 eyes from 11 diabetic retinopathy patients and 10 eyes from 7 aged matched healthy subjects for control. Patients underwent optic nerve OCT imaging, RNFL  thickness was recorded globally (average thickness) and segmented for superior, inferior, nasal, and temporal quadrants Result: There were no significant difference of  the average RNFL thickness in diabetic retinopathy group compared to healthy subjects. However, at the nasal quadrant, there were a significant increased thickness of RNFL compared to healthy subject (p value=0.009). Conclusion: Optical coherence tomography can be used to detect neurodegeneration progression in diabetic retinopathy patients by quantitatively measuring the peripapillary RNFL thickness. This can be used as a diagnostic and prognostic factor in cases of DR.
Quantitative Analysis of Retinal Microvascular Changes in Optical Coherence Tomography Angiography Of Diabetic Retinopathy Yollamanda, Prettyla; Kartasasmita, Arief; Sovani, Iwan; Iskandar, Erwin; Virgana, Rova; Ihsan, Grimaldi
International Journal of Retina Vol 1 No 1 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Introduction: Diabetic Retinopathy (DR) is a common microvascular complication in patients with Diabetes Mellitus (DM) that can cause visual impairment and blindness in adult populations. Retinal microvascular changes, reflecting capillary drop out, non perfusion, and retinal ischemia seen in patients with DM can be assessed not only qualitatively, but also quantitatively with the introduction of a new, non invasive imaging modality Optical Coherence Tomography Angiography (OCTA), avoiding potential advese risks that can occur with the use of dye-injection imaging technique. We quantified retinal microvascular changes in healthy control eyes and Diabetic Retinopathy using OCTA. Methods: A cross sectional study included 13 eyes of 9 patients with DR, consists of 11 eyes with Non Proliferative Diabetic Retinopathy (NPDR) and 2 eyes with Proliferative Diabetic Retinopathy (PDR) and 5 eyes of 5 age-matched controls. Participants were imaged with commercial OCTA device (CIRRUS HD-OCT 5000 Angioplex). We analyzed in the Superficial Capillary Plexus (SCP) the following OCTA parameters : Vessel Density (VD), Foveal Avascular Zone (FAZ) area, and FAZ circularity. Result: Normal eyes had a higher mean VD, FAZ circularity (p >0.05) and lower mean FAZ area ( p <0.05) in the SCP compared with the DR (NPDR + PDR) group. If we excluded the PDR eyes from the analytic data, mean VD and FAZ area were found to be lower in control group, and mean FAZ circularity was higher. However, no quantitative parameters were statistically significant between control group and NPDR group. Conclusion: Microvascular changes in DR can be assessed with the use of Optical Coherence Tomography Angioraphy, which is non invasive and provides high quality of images acquired from the chosen level of retina.
Intraocular Foreign Fody : A case Series Purnama Sari, Mega Wulan; Sovani, Iwan; Kartasasmita, Arief; Iskandar, Erwin; Virgana, Rova; Ihsan, Grimaldi
International Journal of Retina Vol 1 No 2 (2018): International Journal of Retina (IJRetina) - INAVRS
Publisher : International Journal of Retina

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Introduction: The incidence of Intraocular Foreign Body (IOFBs) among open-globe injuries ranges from 18% to 41%. In addition to clinical examination at the slit-lamp and indirect ophthalmoscopy, various imaging modalities are valuable for the identification and localization of IOFB. Vision loss can be devastating as a result of endophthalmitis, retinal detachment or proliferative vitreoretinopathy (PVR). Timely and appropriate management often leads to favorable anatomic outcomes with restoration of good visual function in the majority of cases. This case report presents the clinical and diagnostic finding, management, outcomes and further plan of the patients with posterior segment IOFB. Purpose: To report some cases of posterior segment intraocular foreign body. Case report: Three patients with history of ocular  trauma of the right eye that happened at workplace. All of patients were men in age range 20-55 years old . There were also loss of vision, pain, redness, and from ophthalmological examinations revealed two scleral injuries and one corneal injury that suggest an IOFB in posterior segment. Two patients were suggest endophtalmitis before operation. The plain x ray film examination showed intraocular foreign body in the right eyes. The Ultrasonography (USG) examination also showed intraocular foreign body in the right eyes. All of patient were underwent pars plana vitrectomy. Durante operation 2 of 3 patients were succeed to extract IOFB from the posterior segment, while one patient was not. Conclusion: Preoperative, intraoperative and postoperative management should be done correctly for some cases of IOFB. Prompt treatment and full assessment of patients is important to provide good prognosis.
EFEKTIVITAS PENAMBAHAN NATRIUM DIKLOFENAK TERHADAP LARUTAN OBAT DILATASI PUPIL PADA PASIEN RETINOPATI DIABETIK Kartasasmita, Arief S.; Sovani, Iwan; Setyohadji, Bambang; Karfiati, Feti; Prahasta, Andika
Majalah Kedokteran Bandung Vol 49, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.925 KB) | DOI: 10.15395/mkb.v49n3.1122

Abstract

Pemeriksaan fundus memerlukan akses visualisasi yang baik. Pada penderita diabetes melitus, pupil sulit lebar menggunakan obat pelebar pupil standar sehingga perlu ditambahkan agen pelebar pupil. Penelitian ini dilakukan di Rumah Sakit Mata Cicendo periode Januari sampai Juli 2014 menggunakan metode double masked rendomized cotrolled trial terhadap 64 mata dari 32 subjek penelitian yang telah didiagnosis menderita retinopati diabetika dengan tingkat yang sama antara mata kiri dan kanan. Dibuat larutan kombinasi campuran 10 mL tropikamid 0,5%/fenilefrin 0,5%, 10 mL fenilefrin 5% dan 10 ml 0,1% Na diklofenak (larutan I) dan campuran 10 mL tropikamid 0,5%/fenilefrin 0,5%, dan 10 mL fenilefrin 5% (larutan II). Setiap subjek mendapat salah satu larutan pada mata dan larutan yang lain pada sebelahnya secara acak. Dilakukan pemantauan dengan cara memotret pupil pada menit ke-15, 20, dan 25 pada kedua mata. Lebar pupil kedua kelompok perlakuan diukur dengan perangkat lunak khusus (image processing). Dari penenelitian terdapat perbedaan bermakna antara penggunaan larutan I dan larutan II dalam melebarkan pupil baik pada menit ke-15 (t=2,02; p=0,047), menit ke 20 (t=2,23; p=0,029), dan pada menit ke-25 (t=2,041; p=0,045). Larutan kombinasi fenilefrin, tropikamid, dan natrium diklofenak menghasilkan efek dilatasi pupil yang lebih baik dibanding dengan larutan kombinasi fenilefrin dan tropikamid saja pada kasus retinopati diabetes. [MKB. 2017;49(3):199?207]Kata kunci: Dilatasi pupil, natrium diklofenak, retinopati diabetika Effectiveness of Sodium Diclofenac Addition to Pupil Dilatation Agent on Diabetic Retinopathy PatientsFundus examination requires good visualization of fundus. In diabetic patients, it is difficult for the pupil to dilate using the standard pupilarry dilating agent. To achieve proper dilation, special agents have to be added to the standard dilation agent. The study was conducted in Cicendo Eye Hospital from January to July 2014, using double masked randomized controlled trial to 32 patients (64 eyes) who were diagnosed as suffering from diabetic retinopathy with the same grade on both eyes. Eye drop solutions were developed beforehand by mixing 10 mL of 0.5% tropicamide/0.5% phenylephrine, 10 mL of 5% phenylephrine, and 10 mL of 0.1% diclofenac-natrium (solution I) and also by mixing 10 mL of 0.5% tropicamide/0.5% phenylephrine and 10 mL of 5% phenylephrine (solution II). Every subject received one drop of one solution on one eye and the other solution on the other eye in randomly fashion. The observation was performed by taking photographs of the pupil on both eyes 15, 20, and 25 minutes of observation. The resulting pupil photographs were then analyzed and measured using special image processing software and compared. It was revealed that there were statistical differences in pupil dilation between solution I and solution II at 15 minutes (t=2.02; p=0.047), 20 minutes (t=2.23, p=0.029), and 25 minutes (t=2.041, p=0.045). Phenilefrine, tropicamide and diclofenac-natrium combination solution provides better dilation effect on the pupil compared to the combination of phenilefrine and tropicamide alone in diabetic retinopathy patient. [MKB. 2017;49(3):199?207]Key words: Diabetic retinopathy, natrium diclofenac, pupil dilatation
Characteristics of Patient with Proliferative Diabetic Retinopathy Underwent Anti-Vascular Endothelial Growth Factors Injection in Cicendo Eye Hospital, Bandung in January–December 2013 Marsha Rayfa Pintary; Arief S. Kartasasmita; Juliati Juliati
Althea Medical Journal Vol 3, No 2 (2016)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (141.364 KB)

Abstract

Background: Proliferative Diabetic Retinopathy (DR) is one of the microvascular complications of diabetes mellitus (DM) that is prevalent to the blindness risk. The World Health Organization (WHO) considers Proliferative DR one of the priorities of eye diseases. This disease is caused by angiogenesis brought about by Vascular Endothelial Growth Factors (VEGF). The Anti-VEGF Bevacizumab (Avastin) injection is considered sufficient in preventing proliferative DR patients from blindness. This study aimed to identify the characteristics of patients with proliferative DR underwent Anti-VEGF injection at Cicendo Eye Hospital, Bandung.Methods: This was a retrospective study conducted from August−October 2014 using 40 medical records of patients with proliferative DR underwent Anti-VEGF Bevacizumab (Avastin) injection at the Cicendo Eye Hospital Bandung from January−December 2013. Inclusion criteria were the patients underwent anti-VEGF injection with complete medical records with minimum follow up of 3 weeks.Results: Among 40 patients, 55% were male and 45% were female. Furthermore, there was 100% found for DM Type 2. Moreover, random blood glucose varied among 140–200mg/dl (50%), while the hypertension was mostly at stage 2. Some of these patients had proliferative DR with vitreal hemorrhage (25%), macular edema (40%), and/or tractionalablasio retina (22.5%). Most patients had an improvement in their visual acuity (60%).Conclusions: Most of patients are male, aged 50–59 years old, random blood glucose among 140– 200mg/dl, followed DM Type 2 and hypertension stage 2. Anti-VEGF injection improves visual acuity. [AMJ.2016;3(2):280–5]DOI: 10.15850/amj.v3n2.781
Analisis Kadar Zat Aktif dan Perubahan Kadar Hemoglobin Berdasarkan Tempat Penyimpanan Tablet Tambah Darah (TTD) oleh Ibu Hamil di Kabupaten Bantul Oktarina Sri Iriani; Setiawan .; Arief Kartasasmita; Farid Husin; Dewi Marhaeni Diah; Hadi Susiarno
Sehat MasadaJurnal Vol 12 No 1 (2018): Sehat Masada Journal
Publisher : stikes dharma husada bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.38037/jsm.v12i1.57

Abstract

Anemia merupakan masalah gizi utama yang sebagian besar disebabkan oleh anemia defisiensi besi, anemia juga merupakan penyebab tidak langsung tingginya Angka Kematian Ibu (AKI) di Indonesia. Untuk mengatasi anemia ibu hamil, pemerintah menerapkan program pemberian tablet tambah darah (TTD) yang mengandung Ferro sulfat.. Kondisi tempat penyimpanan yang sesuai standar di tingkat ibu hamil akan berdampak pada mutu TTD yang sesuai dengan standar farmakope Indonesia, sehingga diharapkan TTD yang terjaga mutunya akan memberikan efek terapeutik yang baik bagi penggunanya yaitu peningkatan kadar hemoglobin ibu hamil. Tujuan penelitian ini adalah menganalisis dampak kondisi penyimpanan TTD oleh ibu hamil terhadap mutu dan kadar hemoglobin di Kabupaten Bantul. Penelitian ini menggunakan desain observasi analisis uji laboratorium dengan pendekatan cross sectional. Pemilihan sampel dan bahan penelitian dilakukan pada 6 puskesmas di wilayah Kabupaten Bantul sesuai kriteria inklusi. Ceklist observasi digunakan untuk mengobservasi kondisi penyimpanan, uji kadar zat aktif dilakukan di laboratorium sentral UNPAD dengan metode Atomic Absorption Spektrophotometry (AAS). Uji T tidak berpasangan dan Mann Whitney digunakan untuk melihat perbedaan kondisi penyimpanan dengan kadar zat aktif dan perubahan kadar hemoglobin. Hasil penelitian menunjukan tidak terdapat perbedaan yang bermakna antara kondisi penyimpanan TTD terhadap kadar zat aktif yang terkandung pada TTD (p>0,05), tetapi terdapat perbedaan yang bermakna antara peningkatan kadar hemoglobin pada penyimpanan TTD yang sesuai dengan yang tidak sesuai standar penyimpanan obat (p<0,05). Simpulan pada penelitian ini tidak terdapat perbedaan yang bermakna antara kondisi penyimpanan terhadap kadar zat aktif, terdapat perbedaan yang bermakna pada kadar hemoglobin ibu hamil dengan penyimpanan TTD sesuai dan tidak sesuai
Co-Authors A M Ichsan Andika Prahasta Anita Deborah Anwar Chalid Kurniawan Dainty Maternity Deni K Sunjaya Dewi Marhaeni Diah Herawati Dinan S Bratakoesoma Dwijayanti, Sindi Endang Sri Wahyuni Erni Mayor Erwin Iskandar Erwin Iskandar Farid Husin Farid Husin Fauziah Hayati Feti Karfiati Memed Grimaldi Ihsan Habibah S. Muhiddin Hadyana Sukandar Ihsan, Grimaldi Iwan Sovani Iwan Sovani Juliati Juliati Juliati, Juliati Laila Wahyuni Marliana Rahma Marsha Rayfa Pintary Maya Sari Mayang Rini Mega Wulan Purnama Sari Metita, Mirza Mia Purnama Mirza Metita Nauli, Rizki Rahma Nurul Aini Oktarina Sri Iriani Pintary, Marsha Rayfa Ponpon S Idjradinata Ponpon S Idjradinata Prettyla Yollamanda Purnama Sari, Mega Wulan Purnama, Mia Rizki Rahma Nauli Rova Virgana Rova Virgana Setiawan . Setyohadji, Bambang Sindi Dwijayanti Susiarno, Hadi Vita Murniati Tarawan Yollamanda, Prettyla