Introduction. Diabetic retinopathy (RD) is one of the most common complications of diabetes mellitus, and is a major cause of blindness in patients aged 20-64 years worldwide. The main principle of the management of RD is to prevent, inhibit and overcome complications that occur. Vitrectomy, laser photocoagulation, intravitreal anti VEGF injection become modalities in RD therapy. If PDR has occurred, vitreous hemorrhage can occur or the retina is attracted by proliferation tissue, vitrectomy should be performed. Case Presentation. The patient is a 52-year-old man who came with the main complaint that both eyes have blurred slowly since ± 6 months ago. Blurred vision is not accompanied by red eyes, there is smoke-like vision. In the past the history of the disease obtained a history of DM 15 years of irregular control and hypertension of 3 years with regular control, a history of spectacles present. The ophthalmological examination of the right eye revealed a vision of 6/30 pH (-), TIOD within normal limits, and a grade II nuclear cataract in the lens. Right eye fundoscopy revealed decreased foveal reflexes and exudates in the macula, dot, blot, flame-shaped bleeding in 4 quadrants of the retina, exudate, venous beading, micro-aneurism. Management in these patients is pars plana vitrectomy, endolaser, and intravenous OS anti-VEGF injection under general anesthesia. Whereas the right eye was intravitreal photocoagulation laser and anti-VEGF laser (done 2 weeks before). Conclusion. A case of advanced left eye PDR with severe NPDR and right eye DME and grade II nuclear cataracts has been described in both eyes. Patients treated with laser photocoagulation in the right eye. In the left eye pars plana vitrectomy, endolaser, and intravitreal bevacizumab injection. Sharp vision of the left eye progressed postoperatively.

BACKGROUND: Diabetic retinopathy is an emerging microvascular complication of diabetes mellitus and a causes of blindness in individuals between ages 30 and 70 years, which is characterized by increased proliferation of blood vessels, vascular occlusion, angiogenesis, loss of pericytes from retinal capillaries, microaneurysms, retinal bleeding, increased retinal capillary permeability, thickening of capillary basal membranes, and infarcts that affect the retina, induced to permanent blindness. AIM: This study aimed to find the role of receptor advanced glycation end products (RAGE) inhibition in lowering the vascularization process which causes a decrease in retinal function on diabetic retinopathy. MATERIALS AND METHODS: This research was an in vivo experimental study. A total of 30 male Wistar rats (200 ± 20 g) were obtained from Eureka Research Laboratory (Palembang, Indonesia). Experimental animals were placed in cages under controlled conditions (12 h of light/dark cycles with temperatures of 22 ± 1°C and humidity of 40–60%), fed and drank ad libitum. White rats were induced by diabetes mellitus using alloxan at a dose of 120 mg/kgBW, intraperitoneally, accompanied by drinking 10% glucose solution for 140 days. Furthermore, experimental animals were grouped into five groups (at eight animals per group), Group 1: Normal control, Group 2: Negative control (induced diabetics retinopathy and given intravenous aquadest), Group 3: Given anti-RAGE 1 ng/mL, Group 4: Given anti-RAGE 10 ng/mL, and Group 5: Given anti-RAGE 100 ng/mL. Giving anti-RAGE was done in a single dosage and intravitreal. After the rats were sacrificed by intraperitoneal injection of 10% chloral hydrate, the evacuation of the eye’s retinal tissue was then carried out, fixed in a 4% paraformaldehyde buffer for immunohistochemistry examination of the eye’s retinal tissue. Evaluation of the expression of nuclear factor-κβ (NF-kB) and intercellular adhesion molecule-1 (ICAM-1) used Image J Software so that the percentage of NF-kB and ICAM-1 expression would be obtained. RESULTS: Negative control group showed an increase in NF-kB expression in the retinal tissue of diabetic retinopathy rats. Administration of anti-RAGE showed its potential to suppress NF-kB expression in retinal tissue of diabetic retinopathy white rats as well with an increase of anti-RAGE dose from 1 ng/mL to 100 ng/mL. Activation of NF-kB causes activation of the inflammatory cascade, which is characterized by the production of pro-inflammatory cytokines, one of which is ICAM-1. Giving anti-RAGE could suppress the expression of ICAM-1 along with an increase in anti-RAGE dose. CONCLUSION: Anti-RAGE is able to block the inflammatory process, by inhibiting the expression of NF-kB and ICAM-1 in the retinal tissue of diabetics retinopathy in white rats.

Introduction. Retinal Vein Occlusion (RVO) is the second most common retinal blood vessel disease after diabetic retinopathy. CRVO is an acute blockage of the central retinal vein that causes abnormalities in the retina, characterized by sudden decreased vision. Based on the potential for vision loss from this retinal disease, proper diagnosis and management is needed to prevent further complications. Case Presentation. A man, age 50 years old, a civil servant, came to the eye clinic of Mohammad Hosein Hospital on February 2017. The main complaint was vision of right eye suddenly blurred since 5 months before. Based on the above examination found decreased vision in one eye, with visual acuity better than 6/60 and no RAPD. The funduscopic examination above shows the presence of dilatation and tortousity in the central retinal vein, dot / blot bleeding and flame shaped hemorrhages in all quadrants, exudates, neovascularization of the retina and optic disk, and the presence of edema in the optic disc and macula. Conclusion. Management performed on these patients is by performing a Pan-Retinal Photocoagulation (PRP) laser and Grid-Pattern Photocoagulation. The selection of this therapy is based on the consideration that the patient has been suffering from CRVO for more than 3 months.

Optical Coherence Tomography Angiography (OCTA) is a new high-resolution imaging method for visualizing retinal and choroidal circulation without any dye injection By detecting intravascular flow quickly when needed and being able to repeat images, as often as needed, without risk to patients, doctors will value OCTA as one of the most important applications of OCT imaging because of its ability to offer precise visualization of intravascular flow in the inner retina layer and outside, as well as the inner choroid. OCTA uses high-speed structural OCT imaging and provides three-dimensional data about microvascular structures, enabling visualization of the en face apart from the retinal capillary plexus and choriocapillaris, combined with co-registered en face and cross-sectional structural OCT. Although OCTA is a strong modality, it can have imaging artifacts and provide information that is inherently more complex than structural OCT alone. Successful interpretation of OCTA findings requires an understanding of how OCTA works, the relationship of various ocular pathologies to its angiographic features, and integrated assessment of angiographic and structural OCT data.

Introduction. Submacular hemorrhage is defined as the presence of blood in the potential space between retinal pigment epithelium (RPE) and neurosensory retinal in the macula. Pneumatic displacement is one of the management procedures that is shifting the bleeding under the macula by injecting gas. The purpose of writing this case report is to report Sub-macula Bleeding cases which are managed with Pneumatic Displacement. Case Presentation. A 55-year-old woman, housewife, was living outside the city, came with complaints of a sudden blurred left eye since 2 weeks ago. At the ophthalmological examination, 612 pH (-) right eye vision and 1/300 left eye vision were obtained. On examination of the anterior segment in the right and left eye the lens is cloudy with grade I nuclear morphology. The image of the right eye fundoscopy is within normal limits, whereas in the left eye a macula is found: reflex fovea (-) blood (+). The choice of therapy in this patient is carried out by Pneumatic Displacement by injecting C3F8 gas, which aims to shift the bleeding under the macula by injecting gas. Conclusion. Pneumatic Displacement is a simple procedure, not too invasive, and the risk of intraocular complications is smaller. Pneumatic Displacement aims to shift blood from under the macula to other parts of the retina that are less vital for vision.