<p><strong><em>Introduction: </em></strong><em>Polypoidal choroidal vasculopathy (PCV) is a peculiar form of choroidal neovascularization characterized by protrusion of the aneurysm at the end of the choroidal blood vessels. The aim of this study is to report a case of   PCV in a young woman who treated with intravitreal ranibizumab injection. <strong>Method: </strong>The patient undergoes general ophthalmic examinations, amsler grid, funduscopic photography and OCT analysis. The repeated examination performed after intravitreal injection of ranibizumab to assess the effect of therapy.</em> <strong><em>Result:  </em></strong><em>Two weeks after intravitreal ranibizumab injection, the visual acuity was improved and on OCT examination revealed decreasing in macular thickness. <strong>Conclusion:</strong> Intravitreal ranibizumab injection can give good result, but in this case the effectiveness hasn’t so evident because of the administration only once and follow-up only in two weeks.</em></p>

Hyperglycemia has a toxic effect on almost all cells in the body. Ocular complications due to hyperglycemia can occur in the cornea and retina. Retinal microvascular disorders in patients with type II DM are called diabetic retinopathy. Type II diabetes mellitus has a significant influence on the morphological, metabolic, physiological, and clinical aspects of the cornea that can be evaluated by measuring central corneal thickness (CCT) using Anterior Segment -Optical Coherence Tomography (AS-OCT). Morphological changes occur in corneal epithelium, epithelial basement membrane and basement, stromal and endothelial membrane complexes. CCT changes as changes in the retina of type II DM patients are chronic processes that lead to changes in the structure and biomechanics of the cornea and retina. Method: The subjects of this study consisted of 36 eyes of type II DM patients divided into 4 diabetic retinopathy groups (mild, moderate, severe NPDR and PDR) with GDS> 200mg / dl then CCT values were measured using thick (33.3%); thin (13.9%); ; very thick CCT (8.3%). There is no statistically significant relationship between the degree of CCT and severity of diabetic retinopathy. Conclusion: The CCT value of DM type II sufferers in the PDR group was higher than in the NPDR group, where there was an increase in CCT value along with an increase in severity of diabetic retinopathy, but the results were statistically not significant. CCT examination is expected to be one of the evaluations to evaluate the progression of hyperglycemic in type II DM against ocular disorders, especially cornea.

Diabetic Macular Edema (DME) adalah penyebab utama kebutaan pada populasi diabetes. Salah satu patogenesis pada DME adalah karena peningkatan ekspresi VEGF. Bevacizumab adalah anti-VEGF yang dapat meningkatkan Best Corrected Visual Acuity (BCVA) dan mengurangi Central Macular Thickness (CMT) pada pasien DME. Tujuan: Mengetahui persentase jenis kelamin, usia, durasi DM tipe II, BCVA dan CMT sebelum dan setelah injeksi pada bulan pertama dan bulan ketiga pada pasien DME serta menganalisis pengaruh intravitreal bevacizumab anti-VEGF terhadap BCVA dan CMT pada DME di Rumah Sakit M Djamil Padang. Metode: Penelitian ini adalah studi retrospektif analitik berdasarkan rekam medis dari 16 pasien DME yang telah injeksi bevacizumab intravitreal pada tahun 2017. Data dianalisis secara statistik menggunakan uji one way Anova dengan p < 0,05 dianggap signifikan. Hasil: Pasien terdiri dari 11 wanita (68,8%) dan 5 pria (31,2%). Jumlah usia pasien terbanyak antara 51-55 tahun (43,8%) dan durasi terlama yang diketahui DM tipe II adalah 5-10 tahun (50,0%). Rata-rata BCVA (logMAR) sebelum injeksi intravitreal bevacizumab adalah 0,95, bulan pertama setelah injeksi adalah 0,68, dan bulan ketiga setelah injeksi adalah 0,55. CMT rata-rata sebelum injeksi bevacizumab intravitreal adalah 427,62, bulan pertama setelah injeksi 359,59, dan bulan ketiga setelah injeksi 318,12. Simpulan: Terdapat pengaruh bevacizumab anti-VEGF intravitreal terhadap BCVA dan CMT di DME di Rumah Sakit M Djamil Padang.

Background: Changes in choroidal thickness may be associated with increased severity of diabetic retinopathy and may occur simultaneously or even earlier than diabetic retinopathy. This study aims to compare the value of subfoveal choroidal thickness (SCT) with the severity of RD in patients with type 2 DM without RD with NPDR at Dr. M. Djamil General Hospital Padang, Indonesia. Methods: This research is a cross-sectional analytic observational study. The study was conducted on 36 eyes obtained from 29 study subjects. Data analysis was performed with the help of SPSS to determine the ratio of SCT thickness in diabetic retinopathy patients, p<0.05. Results: The thickest mean SCT value was found in the type 2 DM group without RD (328.78 + 14.78 mm) and the thinnest in the severe NPDR group (234,22 + 12,30 mm). Conclusion: The more severe the severity of diabetic retinopathy, the thinner the SCT (subfoveal choroidal thickness).

Abstrak CME merupakan penebalan retina lokal dimana cairan terakumulasi dalam ruang kistik pada lapisan luar retina di makula. Irvine Gass Syndrome merupakan CME yang terjadi setelah operasi katarak yang ditandai dengan cystoid multipel pada makula. Tujuan: Untuk melaporkan kasus Irvine Gass Syndrome. Hasil: Laki-laki 60 tahun dengan visus mata kanan 5/60, IOL pada posterior chamber dengan PCO. Pada funduskopi terdapat edema makula. OCT ditemukan CME. Pada pasien dilakukan ECCE 4 bulan sebelumnya. Pseudofakic CME dapat muncul paling cepat 3 minggu dan paling lambat 6 bulan setelah operasi. CME didefinisikan jika visus 20/40 atau lebih buruk disertai ruang cystoid. OCT menunjukkan hyporeflektif di dalam retina, dengan penebalan makula. Perubahan ketebalan makula ≥40μm merupakan indeks OCT significant macular edema. Pasien diberikan NSAIDs topikal yang menghambat cyclooxygenase yang berperan dalam biosintesa prostaglandin karena patogenesa Irvine Gass syndrome disebabkan oleh inflamasi. Setelah itu visus membaik dan pada OCT terdapat pengurangan ketebalan makula. Pasien juga diberikan Carbonic anhidrase inhibitor oral yang menstimulasi pompa RPE untuk mengurangi cairan di macula. Kesimpulan: Pada Kasus ini Pseudofakic CME terjadi 12 minggu setelah operasi katarak. Terdapat respon terapi yang baik dengan NSAIDs topikal, kortikosteroid oral dan Carbonic Anhidrase Inhibitor. AbstractIntroduction: CME is a localized thickened of the retina where there was an accumulation of fluid within cyst at the retinal outer layer of macula . Irvine Gass Syndrome is a type of CME typically with multiple cystoid form of macula which formed after cataract surgery Aim : presentation a case report of Irvine gass Syndrome. Report: a 60 man years old presenting with right visual acuity 5/60, IOL at posterior chamber with PCO. By funduscopy examination, found that there was a macular oedem. OCT found CME. The patient had performed ECCE 4 month ago. Pseudophakic CME could occured ranging from 3 weeks to 6 month after surgery. CME defined as visual acuity < 20/40 followed with cyst. OCT examination found hyporeflection of the retina, and also thickened of macula. Thickened of macula ≥40μm from OCT examination reflect a significant of macular oedem. The patient then treated with topical NSAID with aim to inhibit cyclooxygenase which is important in prostaglandin synthesis that is vital in inflammation procces . There was an improvement of vsual acuity after treatment and OCT examination found a reduction of macular thickness. Patient also treated with Carbonic anhidrase inhibitor peroral which could stimulate RPE pumping mechanism so could reduce the fluid of macula conclusion: in this case report , pseudiphakic CME develop 12 weeks after cataract surgery. There was favourable respons of therapy with topical NSAID , oral corticosteroids and Carbonic Anhidrase Inhibitor.