Background Retinopathy of prematurity (ROP) is the main causeof visual impairment in premature infants. Due to advances inneonatal care, the increased survival of extremely low birth weight(ELBW) infants in recent years has produced a population ofinfants at very high risk of ROP.Objective The aims of this study were to determine theprevalence and potential risk factors for ROP.Methods This retrospective study was conducted at theNeonatalogy Ward, Cipto Mangunkusumo Hospital, fromJanuary 2005 to August 2010. We included all prematureinfants of gestational age (GA) < 37 weeks, body weight(BW) not exceeding 2000 grams, as well as those who hadeye examinations and complete medical records. Risk factorssuch as GA, BW, duration of oxygen (Oz) therapy, sepsis, andred blood cell (RBC) transfusion were analyzed using the Chisquare and logistic regression tests. Pediatric ophthalmologistshad performed eye examinations on all infants. ROP was gradedaccording to the International Classification of ROP.Results The prevalence of ROP and of stage 3 or greaterROP was 11.9% and 4.8% of all subjects, respectively. Bodyweight, GA, duration of Oz therapy, and sepsis were found tobe associated with the development ofROP. However, stepwiselogistic regression analysis revealed that only BW of:s 1000g [odds ratio (OR) 10.88; 95% CI 3.09 to 38.31; P < 0.000],02 therapy 2: 7 days (OR 5.56; 95% CI 1.86 to 16.58; P <0.0001), and GA of oS 28 weeks (OR 4.26; 95% CI 1.15 to15.81; P = 0.030) were statistically significant risk factors forROP. The equation obtained was y -4.092 + 2.388 (BW)+ 1.451 (GA) + 1.716 (duration of 02 therapy). The modelshowed good calibration (a nonsignificant HosmerLemeshowtest; P = 0.816) and discriminative ability. The area underthe curve (AUC) value was 92.2% (95% CI 0.867 to 0.976;P < 0.0001).Conclusion Prevalence ofROP in this study (11.9%) was lowerthan that of previous studies. By regression logistic analysis, themain risk factors for development ofROP were BW of:s 1000g, Oz therapy 2: 7 days, and GA :s 28 weeks. The probability ofROP occurrence increased v.ith greater number of risk factors.[Paediatr rndones. 2012;52:138-44].
Introduction: to determine the effect of citicoline 1000 mg oral supplementation given for 4 weeks on electroretinography abnormalities in patients with NPDR (non-proliferative diabetic retinopathy).Methods : prospective, double blind, randomized clinical trial. Thirty-eight patients who matched the inclusion and exclusion criteria were randomized into two groups: the placebo (P-NPDR) and citicoline (C-NPDR). In the end, there were 18 eyes in citicoline group and 16 eyes in placebo group. The primary outcome was P50 and N95 amplitude in PERG within group and intergroup which were taken at the baseline and 4 weeks after treatment.Results : at the end of treatment, the N95 amplitude in C-NPDR showed improvement, 4.85 (1.9-10.3) µV, before treatment to 5.7 (1.9-17.1) µV, after treatment with P = 0.04. Median P50 amplitude improved in both groups, with C-NPDR: 3.1 µV to 3.8 µV (p = 0.89), and P-NPDR: 3.5 µV, to 4.5 µV (p = 0.10). Delta ∆N95 amplitude is higher in C-NPDR, while delta ∆P50 amplitude is higher in P-NPDR, with P values 0.35 and 0.45. Conclusion :Oral citicoline may induce a significant improvement in mean N95 amplitude before and after the treatment. P-NPDR showed positive trend in P50 amplitude while in C-NPDR showed positive trend in N95 amplitude, but these values were not statistically significant (P = 0.45; P= 0.35).
Background: Injection of Silicon oil (SO) is a standard procedure for vitreous replacement in vitrectomy procedure for retinal detachment cases. It acts as a great tamponading agent for reattachment of retinal breaks or retinal detachment. Despite its minor side effect, SO could cause several complications such as cataract, endothelial decompensation, increased intraocular pressure, and secondary glaucoma. Thus needed to be evacuated after the retinal reattachment is stabilized. Following the evacuation procedure, visual acuity is known to be significantly improved. However, some cases show decreased of visual acuity due to retinal redetachment, optic nerve damage due to secondary glaucoma, hypotony, vitreous hemorrhage, expulsive hemorrhage, and cornea abnormality. Methods: A retrospective descriptive study of retinal detachment patients underwent SO evacuation procedure in Cipto Mangunkusumo Hospital,Results: There were seventy-seven cases of retinal detachment undergoes SO evacuation within the period of September 2017-January 2018. There was an improvement of visual acuity (greater than 6/60) after one month of SO evacuation. Anatomical retinal reattachment was successfully observed in 91% patient. The most occurring complication after SO evacuation includes secondary glaucoma and retinal redetachment.Conclusion: SO evacuation is a standard procedure following a vitrectomy in retinal detachment cases. The evacuation procedure yields in positive benefit for patient in term of visual acuity and anatomical structure.
Introduction: Endophthalmitis is an inflammation of the intraocular tissues and fluid, and an emergency in ophthalmology. One of the most common causes of endophthalmitis is post-traumatic endophthalmitis. Post-traumatic endophthalmitis has a poorer prognosis than post-cataract surgery endophthalmitis. The immediate pars plana vitrectomy (PPV) surgery in post-traumatic endophthalmitis is beneficial for optimizing of final visual. Methods: A retrospective descriptive study of post-traumatic endophthalmitis patients underwent pars plana vitrectomy in the Ciptomangunkusumo Hospital, Indonesia from January 2017 – June 2017. Result: There were twelve cases of post-traumatic endophthalmitis undergoes pars plana vitrectomy within the period of January 2017-June 2017. The most frequently identified causative organism was Staphylococcus (33,3%). There was an improvement of final visual acuity after the procedure of pars plana vitrectomy in 58.3% post-traumatic endophthalmitis patients. Conclusion: Early PPV leads to vision improvement and maintains visual acuity in post-traumatic endophthalmitis. Keywords: Pars Plana Vitrectomy, Endophthalmitis, Post-traumatic
Introduction: Epiretinal membrane is one post-operative complication of vitrectomy that can lead to decrease visual acuity. Epiretinal membrane is the early step of proliferative vitreoretinopathy caused by inflammation. Steroid has been used in the treatment of intraocular inflammation. The aim of this study is to compare oral methylprednisolone and placebo toward incidence and severity of epiretinal membrane post pars plana vitrectomy in rhegmatogenous retinal detachment. Methods: This was prospective, double blind, randomized clinical trial. Fourty six eyes who met inclusion criteria were randomized into 2 groups: 26 patients received oral methylprednisolone 0.8 mg /kgBW/day for 6 days, 0.4 mg/kg BW/day for 4 days, and 0.2 mg/kg BW/days for 4 days. The control group of 26 patients received placebo in a comparable manner. Result: Four weeks after vitrectomy incidences of epiretinal membrane were 47.6 % and 58.8 % in methylprednisolone group and placebo group, respectively. Eight weeks post vitrectomy incidences of epiretinal membrane was 47.6 % and 56.2 % in methylprednisolone group and placebo group, respectively. At 4 weeks the severity of epiretinal membrane in methylprednisolone group was 60%; 0%; 40% in grade 0, 1, and 2, respectively. Meanwhile, in placebo group were 60%; 10%; 30% in grade 0, 1, and 2,respectively. Eight weeks post vitrectomy the severity of epiretinal membrane in methylprednisolone group were 40%; 0 %; 60% in grade 0, 1, and 2, respectively. Meanwhile, at placebo group were 55.6 %; 11.1 %; and 33.3 % in grade 0, 1, and 2, respectively. Conclusion: There were no significant differences in incidence and severity of epiretinal membrane at 4 and 8 weeks among 2 groups. Oral methylprednisolone had a tendency to lower incidence of epiretinal membrane compared to placebo.
Background: To review the literature and report relative efficacy and safety of various tamponade agents used with surgery for rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy (PVR) regarding functional success rate, anatomical success rate, and adverse effects. Methods: We searched articles from PubMed and Clinical Key database starting from the year of 1990 to November 2014. Information needed from all articles were extracted into data extraction sheet. We reviewed the efficacy of both tamponade agents regarding the postoperative visual acuity, macular attachment, and adverse effect. Results: Eight articles were included after fulfilling inclusion and exclusion criteria. Our analysis showed all studies shows an increasing visual acuity and percentage of macular attachment postoperatively of all type tamponade agents. Functional and anatomical success rate of Sulfur hexafluoride gas (SF6) was high in study with PVR stage B or less (94-98%). In patient with complex or recurrent RD associated with PVR, silicone oil had a better functional success (51% vs 32.5%) and better anatomical success (80% vs 60%) than SF6 gas. The anatomical success rate also higher in C3F8 than in SF6 group (73.9% vs 57.5% respectively). Functional and anatomical success rate of HSO as tamponade was high in patients with a severe PVR located mainly in the inferior quadrants (92.3%).Conclusion: As tamponade agents, C3F8 and silicone oil appear to have more visual and anatomic advantages over SF6 in participants with complex or recurrent RD associated with PVR. Silicone oil was better than C3F8 gas to obtain final visual and anatomic successs in patient with recurrent RD associated with higher grade PVR. Heavy silicone oil would be useful in particular cases complicated by recurrent inferior RD with PVR. Retinal redetachment, glaucoma, cataract, hypotony and keratopathy were reported in both gases and silicone group. Keywords: Tamponade in retinal detachment surgery, SF6, C3F8, silicon oil, and heavy silicone oil
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