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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 109 Documents
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Brolucizumab for Neovascular Age-Related Macular Degeneration in Real-World Setting Andi Marsa Nadhira; Ari Djatikusumo; Andi Arus Victor
International Journal of Retina Vol 6 No 2 (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.iss002.247

Abstract

Introduction: The mainstay treatment for neovascular AMD (nAMD) is intravitreal injections of anti-vascular growth factor (anti-VEGF) agents. Based on clinical trials, a newly developed anti-VEGF named brolucizumab showed noninferiority in anatomical and functional outcomes with longer injection interval, when compared to previous anti-VEGF agents; however, severe post-injection inflammation has been observed. This review aims to evaluate the efficacy and safety of brolucizumab in real-world clinical setting. Methods: We conducted systematic searches in Pubmed, Science Direct, Clinicalkey, and Scopus. Observational studies, case series, and individual case studies enrolling naïve-treatment and switch-therapy nAMD patients who received intravitreal injection of brolucizumab were eligible for this review. Result: We included 12 studies, comprising 772 patients and 848 eyes, that reported the outcome of intravitreal injection of brolucizumab in real-world practice. The mean age of patients was 77 years old. Follow-up period ranged from 7,2 weeks to 52 weeks. Improvement in visual acuity was mostly observed in treatment-naïve groups, ranging from +4,5 to +11,9 Early Treatment Diabetic Retinopathy Study (ETDRS) letters. Improvement in retinal thickness and reduction in retinal fluids were reported in both groups, with mean central retinal thickness (CRT) change of 94,92 μm. Significant reductions of subretinal fluid (SRF) were observed in 4 studies, intraretinal fluid (IRF) in 2 studies, and pigment epithelial detachment (PED) in 3 studies. Eight studies reported injection interval, the longest of which extended to 12 weeks. Inflammatory events following brolucizumab injection were reported in 8,01% of eyes, ranging from mild to severe inflammation, with 34,2% of the intraocular inflammation occurring in the vitreous (22 eyes). Brolucizumab may help alleviate treatment burden in real-world clinical setting by reducing disease activity, mainly demonstrated as improvement in retinal thickness, reduction in retinal fluid, and prolongation of injection interval. Clinicians must be aware of the possible inflammatory events following brolucizumab injection.
Incidence Rates of Endophthalmitis after Various Pharmaceutical Intravitreal Injections Harrison Sciulli; Alexander Miller; Chase Miller; David G Miller
International Journal of Retina Vol 6 No 2 (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.iss002.237

Abstract

Introduction: The purpose of this study is to analyze incidence rates of endophthalmitis after intravitreal injection(s) of bevacizumab (BEVA), brolucizumab (BROL), aflibercept (AFL), ranibizumab (RAN), dexamethasone implant (DEXA), and triamcinolone acetonide (TRIA). Methods: In this retrospective cohort study data was collected from patients who received intravitreal injections from January 2020 through November 2021, of AFL, BEVA, BROL, DEXA, TRIA and RAN. Data collected includes patient identification number, injection dates, medication injected, and procedure codes. Endophthalmitis rates were compared amongst medications and total percentage tabulated. Result: From January 2020 through November 2021, 109,202 injections were administered. Of the 109,202 injections administered: 66,095 were aflibercept, 28,762 bevacizumab, 8,650 ranibizumab, 3,010 brolucizumab, 1,958 dexamethasone implant, and 95 triamcinolone acetonide. Thirty-nine (0.036%) endophthalmitis cases occurred. Of the 39 endophthalmitis cases, 22 of the cases occurred (0.033% of total aflibercept injections) after aflibercept injection(s), 5 (0.688% of total triamcinolone acetonide injections) after triamcinolone acetonide injection(s), 5 (0.03% of total bevacizumab injections) after bevacizumab injection(s), 3 (0.153% of total dexamethasone implants) after dexamethasone implantation(s), 2 (0.066% of total brolucizumab injections) after brolucizumab injection(s), 2 (0.023% of total ranibizumab injections) after ranibizumab injection(s).(Table 1) Using a student’s t-test, the rate of endophthalmitis for TRIA versus all other medications was statistically significant with a p-value of 0.00152. Conclusion: Results show an endophthalmitis incidence rate of 0.036% after intravitreal injection(s) administration. This review suggests triamcinolone acetonide (TRIA) yielded a significantly higher incidence rate of endophthalmitis as compared to the other medications.
The Validity of Artificial Intelligence (AI) for Diabetic Retinopathy Screening in Asia: A Systematic Review Yeni Dwi Lestari; Andi Putra Jayanegara
International Journal of Retina Vol 6 No 2 (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.iss002.241

Abstract

Introduction: One of the major diabetes mellitus (DM) complications is diabetic retinopathy (DR) which may lead to visual impairment. Unfortunately, estimated that more than one-third of diabetic patients in Asia have never undergone an ophthalmological examination. Screening for DR is an essential aspect of DM management. With advanced technological development, the use of artificial intelligence (AI) for DR screening have been increasing in popularity, especially since Deep Learning (DL) technologies in AI can process a large amount of data automatically without human intervention. Therefore, this review aims to evaluate the validity of AI as DR screening tool in Asian countries compared to ophthalmologist DR grading as a reference standard. Methods: A comprehensive search was conducted using relevant search terms from the electronic database (Pubmed, Cochrane, and EMBASE). Included studies were selected based on predefined inclusion criteria. Result: Twelve studies reported a good sensitivity of AI for detecting Referable DR (RDR). The lowest sensitivity was 79.2 %, and the highest was 100 %. For specificity, eleven studies reported good specificity, with only one study reporting a low value, with only 68.8% for detecting RDR. Conclusion: The AI can detect DR by screening large amounts of retina images quickly without the assistance of a trained retina specialist. In this review of local Asia population settings, AI has a good result for detecting RDR in almost all studies.
The RELIABILITY AND ACCURACY OF EPICAM M AND RETCAM SHUTTLE COMPARED TO INDIRECT OPHTHALMOSCOPE IN DETECTION OF RETINOPATHY OF PREMATURITY Meiliaty Ariesta Angky; Marliyanti N Akib; Noor Syamsu; Andi Muhammad Ichsan; Habibah S Muhiddin; Ema Alasiry
International Journal of Retina Vol 6 No 2 (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.iss002.233

Abstract

Introduction: In this study, we reported the performance of 2 retinal camera types on premature infants in Retinopathy of Prematurity (ROP) screening. Methods: Premature infants went through : (1) examination by a pediatric ophthalmologist using indirect ophthalmoscopy as a standard of reference; (2) digital imaging by a photographer using EpiCam M and RetCam shuttle. After a month, images were interpreted randomly and single-blinded by the same pediatric ophthalmologist (grader). Result: A total of 44 eyes from 22 premature infants were included in this study (ROP 11 subjects and non-ROP 11 subjects). Detection of ROP with EpiCam M had a moderate agreement (Kappa 0.502, p 0.009) and very good agreement with RetCam shuttle (Kappa 0.862, p <0.0001). Sensitivity, specificity, and accuracy of EpiCam M in detection of ROP were 80.95%, 69.56%, and 75%; RetCam shuttle 85.71%, 100%, and 93.18% respectively. Conclusion: Both EpiCam M and RetCam shuttle displayed significant agreement with indirect ophthalmoscope in detecting ROP. EpiCam M can potentially be allowed to be a viable low-cost alternative device for ROP screening in low resource environments but should be noted that EpiCam M has a high false positive rate which affects its specificity and accuracy rate. Some issues also need to be considered if using epiCam M in telemedicine includes frequent glare and longer duration of documentation
POST FEVER RETINITIS AND SINGLE WONDER DRUG FOR ITS VARIOUS ETIOLOGIES Vikas Sharma; Raji K; Sankalp Seth; Yogesh Yadav; Gaurav Kapoor
International Journal of Retina Vol 6 No 2 (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.iss002.219

Abstract

Introduction: Post-fever retinitis is an infectious or para-infectious entity which involve retinal layer of the eye and has variable clinical manifestations. Post-fever retinitis has varied etiologies, namely bacteria or viral. Case Report: We present a series of four cases of post fever retinitis with common history of flu-like illness followed by blurring of vision, all four patients had different clinical picture, they were investigated thoroughly to ascertain etiological agents and were treated with oral Doxycycline. All cases had an excellent visual recovery by the end of the treatment with complete resolution of clinical signs. Discussion: It is difficult to pin-point the exact etiology of PFR just on the basis of clinical presentation and hence, proper history, clinical examination, serological investigations and awareness of ongoing epidemics may help to identify the etiological organism. Conclusion: Post fever retinitis is an easy diagnosis based on antecedent history of flu like illness and typical fundus findings. Oral doxycycline is a safe and wonderful drug for PFR cases.
Characteristics and topographical distribution of retinal thinning on optical coherence tomography in Schizophrenics and healthy Nabaratna Bista; K Shyamsundar; Mohini Agrawal; Sagar Rajkarnikar; Sachit Dhakal; Kamala Thapa; Pradip KC; Imroz Jindal
International Journal of Retina Vol 6 No 2 (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.iss002.228

Abstract

Introduction: To compare results of spectral-domain optical coherence tomography (SD-OCT) like retinal nerve fiber layer (RNFL) and macular thickness (MT) in Schizophrenic patients and healthy individuals. Method: Cross-sectional study. Forty schizophrenic patients and age-gender matched 40 healthy individuals were included in the study. Using SD-OCT, peripapillary RNFL thickness, MT, neuro-retinal rim area (NRR) and mean cup-to-disc ratio (CDR) were measured and compared in 4 quadrants. Results: Mean age of schizophrenic patients was 30.9±7.57years and healthy individuals was 29.65±5.53years (p>0.05). Mean duration of illness was 4.63±2.75 years. Schizophrenic patients showed a significant reduction in overall RNFL thickness (patients: 87.75±8.49µm in the right eye [RE] and 88.42±10.51µm in the left eye [LE]; healthy: 97.75±8.74µm RE and 98±8.744µm LE; p=0.0001 both eyes); except in temporal quadrant. Average MT (patients: 251.92±19.55µm RE and 249.37±22.24µm LE; healthy: 262.07±24.55µm RE and 260.92±23.37µm LE; p=0.044 RE and p=0.026 LE). However, there was no significant difference in central MT (p=0.52 RE, p=0.37 LE), NRR area (p=0.45 RE, p=0.11 LE) and mean CDR (p=0.26 RE, p=0.19 LE) between schizophrenics and healthy. Conclusion: RNFL and macular thickness reduces in schizophrenics when compared to normal, particularly in the superior, inferior and nasal quadrants.
Management Of Eales’ Disease Grade III B: A Rare Case Agung Putra Evasha; Ramzi Amin; A.K. Ansyori
International Journal of Retina Vol 6 No 2 (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.iss002.248

Abstract

Introduction: Eales' disease is an idiopathic, bilateral, occlusive retinal vasculopathy that primarily affects young, predominately male patients. It seems to have multiple causes and is probably immunologic in nature. Recurrent vitreous hemorrhages, macular degeneration, and tractional or mixed retinal detachments involving the macula can all cause some patients to experience severe vision loss. Case Report: A 39-year-old male with vitreous hemorrhage caused by Eales Disease grade III Bwith an initial visual acuity 1/300 came to our department. Ultrasound imaging showed themembrane like lesion with 1/2 retinal reflectivity, after moderate movement and vitreoushemorrhage on both eyes. The photo-fundus showed there is decreased fovea reflex andperimacular exudate with visible contours of sclerotic blood vessels, visible cotton wall spot, andmacroaneurysm. There is also haze grade 3 on media, visible folds in the inferior part, visibleshadows of cotton wall spots. The patient underwent pars plana vitrectomy with endolaser tomanage the disease. Discussion: In this case, patient was diagnosed as vitreous hemorrhage caused by Eales Diseasegrade III B on both eyes but it getting worse on left eye further. We chose to perform PPV withendolaser on right eye. Based on improved visual acuity and less hemorrhage, the right eye'soutcome was favorable, while the left eye, which was not treated, had a worsening of thesituation. Only eyes with a non-resolving vitreous hemorrhage after three months should have avitrectomy.Conclusion: The treatment of this patient's case produced good anatomical and functionaloutcomes for the right eye, but the left eye, unfortunately, has a major issue. In order to furtherconfirm the results, longer follow-up is still required.
STUDY OF FETAL HEMOGLOBIN WITH GESTATIONAL AGE, BIRTH WEIGHT AND RETINOPATHY OF PREMATURITY IN PRETERM INFANTS Nishi Prasad; Aditi Dubey; Kavita Kumar; Jyotsna Shrivastava
International Journal of Retina Vol 6 No 2 (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.iss002.253

Abstract

ABSTRACT Introduction: The objective of this study was to find an association of fetal hemoglobin (HbF) with gestational age, birth weight and retinopathy of prematurity (ROP) in preterm infants. Methods: Observational prospective study. We included a total of 410 preterm infants with <36 gestational weeks and <2.5 kg birth weight, in a tertiary care hospital of central India for a period of one year. All infants were divided into 3 groups based on their gestational age and 4 groups based on their birth weight. Fetal hemoglobin and ROP were compared between these groups. The infants were then categorized into ROP and no ROP groups based on International Classification for Retinopathy of Prematurity (ICROP), 2021. The relationship between gestational age, birth weight, fetal hemoglobin and ROP was evaluated. Results: A total of 410 preterm infants were included out of which 110 infants had ROP. Fetal Hb concentration was higher in 33-36 weeks when compared to lower gestational age showing a positive corelation with gestational age. Similarly, fetal Hb concentration was higher in birth weight 1.5-2 kg compared to lower birth weight showing a positive corelation. Infants with ROP had a significantly lower concentration of HbF, with gestational age and birth weight groups compared to infants without ROP. Conclusions: Lower gestational age, lower birth weight and lower concentration of HbF was found significantly associated with the development of ROP in preterm infants. Preterm infants have a positive corelation between fetal hemoglobin and gestational age/birth weight.
PATTERN OF ANTERIOR UVEITIS IN KMN EYECARE Kevin Kevin; Rifna Lutfiamida
International Journal of Retina Vol 6 No 2 (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.iss002.245

Abstract

Introduction: Anterior uveitis is the most common form of uveitis, but there are relatively few anterior uveitis studies in Indonesia. The purpose of this study is to analyze the pattern of anterior uveitis in KMN EyeCare. Methods: This is a retrospective analytic descriptive study. The samples are new patients diagnosed with anterior uveitis in KMN EyeCare between 2019 – 2021. Data collected from medical records are age, gender, clinical manifestation, etiology, and visual outcome. Result: Two hundred fifty-three (253) patients are included in this study. The most common manifestations of anterior uveitis are keratic precipitates (34%), posterior synechiae (23.3%), hypopyon (7.9%), increased IOP (7.1%), and secondary cataract (6.3%). Visual outcome more than 0.5 in 90.1% of patients and below 0.5 in 9.9% of patients. The etiology is non-infectious autoimmune-related (46.7%) consists of HLA-B27 related, and rheumatoid arthritis; followed by infectious etiology (36%) consisting of herpetic, tuberculosis, cytomegalovirus, and idiopathic (17.3%). HLA-B27 anterior uveitis is more likely to affect males than females with a statistically significant p<0.05. Conclusion: The most common etiology of anterior uveitis is non-infectious autoimmune-related, especially HLA-B27-related anterior uveitis. The HLA-B27-related anterior uveitis is predominantly in males. Keratic precipitates, posterior synechiae, and hypopyon are common clinical manifestations of anterior uveitis. The visual outcomes are good in this study.

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