No abstract

Background: To evaluate the effect of prophylactic nepafenac eye drops on macular thickness changes after phacoemulsification surgery in mild to moderate NPDR patients. Method: This study is an open label randomized clinical trial. Thirty-six subjects who met the inclusion criteria underwent phacoemulsification. One group (18 subjects) were given nepafenac 0.1% eye drops and the rest were given placebo. Foveal thickness was measured by SD-OCT before surgery and the fourth week after phacoemulsification. Best corrected visual acuity (BCVA) and degree of inflammation in the anterior chamber were also being assessed. Result: There was a statistically significant increase foveal thickness in the placebo group 4 weeks after phacoemulsification (p=0.022). Clinically, percentage degree of inflammation in anterior chamber in placebo group was higher than nepafenac group (38.9% : 5.6%) but not significantly different between 2 groups (p=0.27). Nepafenac group achieved clinically better BCVA than the placebo group 4 weeks after phacoemulsification, although statistically there was no significant difference between 2 groups (p=0.991). Conclusion: Nepafenac 0.1% eye drops could prevent foveal thickening 4 weeks after phacoemulsification in mild to moderate NPDR patients. Clinically, nepafenac 0.1% eye drops could decrease the risk of inflammation in the anterior chamber, risk of CME, and vision deterioration although did not reach statistically significant. Keywords: Nepafenac, macular thickness, phacoemulsification, retinopathy diabetic

Introduction: Ophthalmic trauma is defined as injuries affecting the ocular structures, including the globe, eyelid, lacrimal system, and surrounding orbital walls. Blunt trauma acts as the leading cause of injury and it may affect both the anterior and posterior parts of the globe. Prompt diagnosis, early management, and sustained follow-up are mandatory for an optimal outcome. Purpose: This report presents a one-step surgery management process for an intricate case of blunt facial trauma with complex ophthalmic and nasal injury. Patients and Methods: A 45-year-old male with blunt force trauma of the left eye from a wooden block, suffered from naso-orbital-ethmoidal fractures, eyelid laceration with canalicular, close-globe injuries of traumatic cataract and vitreous hemorrhage with retinal detachment. A simultaneous one-step surgery was performed by a trauma team of ophthalmological and ENT surgeons during the height of the COVID-19 pandemic to lessen the risk of cross-transmission. After ruling out the possibility of open-globe rupture, traumatic cataract extraction, retinal detachment surgery, the repair of an eyelid laceration with canalicular involvement, and septorhinoplasty were performed on concomitantly. Results: Anatomical success was achieved for the repair of the nasoorbitoethmoidal (NOE) type II fracture and close-globe injuries, including the anatomical reattachment of the retina. However, the functional outcome remained unsatisfactory. Visual acuity failed to show further improvement at a later follow-up. Traumatic optic neuropathy was, at the final follow-up, considered to be the cause of the suboptimal visual acuity. Conclusion:A single-step multi-procedure for a complex ophthalmic blunt trauma, as demonstrated in this case, may be beneficial for reducing the complications that might arise due to treatment delay. The complex nature of the injury, however, creates the higher possibility for residual post-operative complications. Risks of residual functional impairment should be considered in such complex trauma prior to surgery, to determine the surgical prognostic value and provide appropriate consent to the patient.

Tujuan: menunjukkan adanya perubahan pada best corrected visual acuity (BCVA) dan ketebalan retina sentral (central retinal thickness/CRT) setelah 1 tahun pemberian intravitreal ranibizumab pada kasus Age Related Macular Degeneration (ARMD) neovascular berdasarkan jumlah injeksi dan metode pemberian. Metode: Penelitian retrospektif ini terdiri dari 38 mata yang mendapatkan injeksi ranibizumab pada tahun 2011-2012 di Jakarta Eye Center. Berdasarkan jumlah injeksi, 24 mata mendapatkan 1-3 kali injeksi/tahun dan 14 mata mendapat lebih dari 3 kali injeksi/tahun. Berdasarkan metode pemberian, 10 mata diberikan loading dose dan 28 mata diberikan injeksi sesuai dengan kebutuhan. Hasil: usia rata-rata subyek adalah 72.5±8.83 tahun. Pengamatan dalam 1 tahun dimulai sejak injeksi intravitreal ranibizumab pertama diberikan. Berdasarkan jumlah injeksi, keompok dengan lebih dari 3 kali injeksi/tahun menunjukkan peningkatan BCVA yang lebih tinggi dibandingkan dengan kelompok yang mendapatkan 1-3 kali injeksi/tahun (-0.1 LogMAR vs -0.05 LogMAR). Kelompok yang mendapat lebih dari 3 kali injeksi/tahun juga menunjukkan pengurangan CRT yang lebih besar dibandingan dengan kelompok yang mendapat 1-3 kali injeksi/tahun (118.29 ?m vs 107.6 ?m). Berdasarkan metode pemberian, kelompok dengan loading dose menunjukan BCVA -0.1 LogMAR sedangkan pada kelompok yang mendapat dosis sesuai kebutuhan tidak menunjukkan perubahan. Kelompok metode loading dose menunukkan pengurangan CRT yang lebih besar dibandingan kelompok yang mendapat dosis sesuai kebutuhan. Simpulan: injeksi intravitreal ranibizumab dengan lebih dari 3 kali injeksi dan dengan metode loading dose memberikan hasil yang lebih baik dalam tatalaksana ARMD neovaskular.

Aim : To evaluate the effectiveness of pneumatic retinopexy (PR) for repair of primary rhegmatogenous retinal detachment (RRD) with respect to single operation success (SOS) and best corrected visual acuity (BCVA). Method : This retrospective review comprised 8 eyes with primary rhegmatogenous retinal detachment with superior break that undergone pneumatic retinopexy as the initial procedure between 2009-2014 at Jakarta Eye Center, Indonesia. Result : The mean age of subjects was 49 ± 14.35 years. Four subjects (50%) had Single operation had only done success after 6 months of observation. The eyes that failed single procedure underwent vitrectomy and silicon oil tamponade.  Subjects that only done single procedure had better BCVA (0.01 ± 1,3 logMAR) compare to subjects that done secondary procedure (0.3 ± 0.42 logMAR) after 6 months of observation. Conclusion : Pneumatic retinopexy is still an effective procedure for primary rhegmatogenous retinal detachment with superior breaks although in our study the single operation success was 50%.