Diabetic retinopathy is a leading cause of blindness in industrial world and is rapidly becoming an important cause in developing countries. Many factors related with the severity of diabetic retinopathy, such as HbA1c and serum lipid. The study wants to know whether those factors have any correlation with the severity of diabetic retinopathy or not. The objective this study was to determine the correlation between HbA1c and serum lipid with the severity of diabetic retinopathy. An analytic cross sectional observational research had been done at Saiful Anwar hospital. The samples (diabetic retinopaty patients) were taken with consecutive sampling. These patient underwent funduscopy, fundus photography, laboratory examination including HbA1c, serum lipid (total serum cholesterol, LDL, HDL, triglycerides), and blood glucose. These patient were questioned about risk factors previously determined by the authors. The laboratory findings were thease are compared to the severity of diabetic retinopathy. Patient were classified into 2 group, mild and severe diabetic retinopathy. A total of 38 patients were selected, consisted of 20 males, 18 females. Nineteen patients had mild diabetic retinopathy, and the rests had severe diabetic retinopathy. Logistic regression analysis found that there was a significant correlation between HbA1c with the severity of diabetic retinopathy (p=0.017). An increases of 1% in HbA1c will result in two folds (1,995) increases, in probability of severity of diabetic retinopathy. The cut off value for HbA1c was 8.147%. The variables of total serum cholesterol (p= 0.338), LDL (p=0.241), HDL (p=0.685), and triglycerides (p=0.127) were not significant..There was significant correlation between HbA1c with the severity of diabetic retinopathy. There was no significant correlation of serum lipid with the severity of diabetic retinopathy. The higher level HbA1c influences the severity of diabetic retinopathy.
Retinal neovascularization is the main problem that causes blindness in many types of eye desease. Neovascularization occurs in ischemic retina, and several important mediators that induce neovascularization is secreted by the surrounding cell and endothelial cell vessels. Matrix metalloproteinase-9 is an enzyme secreted by endothelial cell vessels and plays an important role in the pathogenesis of retinal induce neovascularization. Vascular endothelial cells were cultured and transfected with Matrix Metalloproteinase -9 RNA interference in two doses (100nM or 200nM) and the cells were taken at 24, 48 and 72 hours. The expression of Matrix Metalloproteinase -9 protein levels were examined by immunocytochemistry, and compared with control group. The data were analyzed with factorial anova. Statistical analysis showed that transfection with different doses of MMP-9 RNAi gave a significant different effect on MMP-9 expression (pvalue < 0.05), while exposure time did not give significant difference (p-value < 0.05). This in-vitro study indicated that transfection of MMP-9 RNAi with dose 200nM reduced the expression of MMP-9 by 50% compared to the control. Because exposure time was not significant, the lowest expression of MMP-9 can be achieved by transfecting MMP-9 RNAi 200nM for 24 hours. This is the first study that demonstrates the effectiveness of RNA interference mediated targeting of MMP-9 to reduce the MMP-9 expression in vascular endothelial cell lines Key Words : Matrix Metalloproteinase -9 -RNA interference -vascular endothelial cell lines. PENDAHULUANAngiogenesis merupakan suatu proses terbentuknya pembuluh darah baru dari endotel vaskular. Proses angiogenesis sangat penting dalam reproduksi, pertumbuhan dan proses penyembuhan luka. Pada proses tersebut angiogenesis terkontrol dengan baik dimana proses pembentukan pembuluh darah baru akan berlangsung dalam beberapa waktu dan pada saat tertentu prosesnya akan berhenti. Ada beberapa penyakit yang mengakibatkan proses angiogenesis menjadi tidak terkontrol sama sekali. Retinopati diabetika proliferatif, degenerasi makula terkait usia tipe eksudatif, oklusi vena retina sentral dan retinopathy of prematurity seringkali mengakibatkan proses angiogenesis yang tidak terkontrol, hal ini akan mengakibatkan munculnya pembuluh darah baru pada retina dan selanjutnya bisa mengakibatkan kebutaaan. Proses angiogenesis terdiri dari beberapa mekanisme yaitu peningkatan angiogenic growth factor, degradasi matriks ekstra sel, migrasi dan proliferasi sel endotel, pembentukan komponen matriks ekstra sel baru dan diikuti dengan pembentukan pipa kapiler baru.Degradasi matriks ekstra sel atau proteolisis merupakan proses penting dalam pembentukan neovaskularisasi sehingga terjadi kerusakan pertahanan anatomi dari pembuluh darah. Pada tahap ini dibutuhkan peranan matrix metalloproteinases (MMPs). Matrix metalloproteinase-9 adalah anggota MMPs kelompok gelatinase yang memiliki keistimewaan yaitu dapat memecah kolagen tipe IV. Kolagen tipe IV sendiri harus dipecah untuk memfa...
Introduction: Usher Syndrome is a rare genetic disorder involving abnormalities in the retina and hearing, where the patients will experience blindness and hearing loss due to mutations of the gene. Blindness caused by Usher Syndrome has not been prevented until now, but the emphasis is more on focusing early diagnosis, especially patients with Retinitis Pigmentosa. Methods: This Case represent of two siblings with Retinitis Pigmentose (RP) and profound bilateral sensorineural deafness. Diagnosis based on patients decreases of vision since teenagers and worst at night, visual acuity and visual field examination in both patients, Ophthalmoscopic findings, and sensorineural deafness diagnosed by Ear, Nose, and Throat (ENT) department. Electroretinogram (ERG) was not carried out in the two patients because of the limitations of diagnostic facilities.Results: In both eyes of both siblings, ophthalmoscopic evaluation disclosed numerous bone spiculae at peripheral area. Humphrey perimetry showed a tunnel vision. The hearing test also showed a sensorineural hearing loss (SNHL).Conclusion: two affected member of the family were found to exhibit an usher syndrome, this pedigree supports the genetic cotransmission of the traits.
Introduction: Severe systemic hypertension in chronic kidney disease can cause significant damage to the eye. Although hypertensive retinopathy is a well-known complication, hypertensive optic neuropathy and choroidopathy are much less common. The aim of this study is to report retinal manifestation in young patient with chronic kidney disease. Method: A 26-year-old man with underlying disease chronic kidney disease (CKD) gr-V underwent bilateral bullous exudative retinal detachments. Retinal arteriolar narrowing, vascular tortuosity, arteriovenous nicking, optic disc swelling, retinal haemorrhage, elschnig spot, siegrist streak were identified in both eyes. Blood pressure was 200/140mmHg with visual acuity 0,5/60 OU. The patient was diagnosed with bilateral hypertensive retinopathy and choroidopathy with bulous exudative retinal detachments. Results: After antihypertensive treatment, visual acuity improved, but the exudative retinal detachments and retinal hemorrhages reduced. A patient with those findings should be considered as having hypertensive retinopathy and choroidopathy and treated as soon as possible because of the poor prognostic. Conclusion: Hypertensive choroidopathy is a rare finding associated with acute increases in blood pressure. When the choroid is associated, the hypertensive event is often more acute and associated with increased morbidity. It is necessary to obtain fundus exam in any patient with elevated blood pressure and concomitant vision complaints. Therefore, screening hypertensive patients involves close collaboration between internist and ophthalmologist.
ABSTRAKKomplikasi vaskuler pada diabetes mellitus (DM) menimbulkan keadaan hipoksia yang berlanjut pada proses angiogenesis yang dapat dicegah dengan antiioksidan diantaranya caffeic acid phenethyl Ester (CAPE). Penelitian ini bertujuan untuk mengetahui efek pemberian CAPE terhadap ekspresi endoglin pada HUVECs yang dipapar glukosa tinggi. Penelitian ini menggunakan desain analitik eksperimental pada HUVECs primer yang dipapar glukosa tinggi. HUVECs dibagi menjadi 5 kelompok yaitu: 1. HUVECs+DMSO (kontrol negatif), 2. HUVECs+glukosa 22 mM+DMSO (kontrol positif), 3. HUVECs+glukosa 22 mM+CAPE 3 µM+DMSO 4. HUVECs+glukosa 22 mM+CAPE 10 µM+DMSO, 5. HUVECs+glukosa 22 mM+CAPE 30 µM+DMSO. Inkubasi dilakukan selama 48 jam pada suhu 37°C, lalu dilakukan pengecatan imunositokimia menggunakan antibodi endoglin. Ekspresi endoglin diamati dengan mikroskop cahaya 400x, endoglin tervisualisasi berwarna coklat. Didapatkan perbedaan efek CAPE di antara kelompok perlakuan terhadap ekspresi endoglin pada HUVECs yang dipapar glukosa tinggi (ANOVA p=0,000). Ekspresi endoglin pada tiap kelompok didapatkan perbedaan signifikan (Tukey test, p<0,05), kecuali antar kelompok 1 dan 5 tidak didapatkan perbedaan signifikan (Tukey test, p>0,05). Dengan Person test didapatkan korelasi positif signifikan antara pemberian CAPE dengan ekspresi endoglin pada HUVECs yang dipapar glukosa tinggi (r=-0,839; p=0,000). Pemberian CAPE dapat menurunkan ekspresi endoglin pada HUVECs yang dipapar glukosa tinggi. 839; p=0,000). Increasing dose of CAPE will decrease endoglin expression. Administration of CAPE will decrease endoglin expression in glucose exposed HUVECs. Kata Kunci: Caffeic acid phenetyl ester, endoglin, HUVECs ABSTRACT Hypoxia is a vascular complication in diabetes mellitus (DM) that lead to angigenesis process which can be prevented using antioxidant such as caffeic acid phenethyl ester (CAPE). This research was aimed to determine the effect of caffeic acid phenethyl ester (CAPE) on endoglin expression in
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