One Year Data of New Secondary Glaucoma Patients at Top Referral Eye Hospital in Indonesia

Background: Glaucoma is the second most common cause of blindness after cataract in the world and also in Indonesia. Based on the etiology, glaucoma is classified into primary and secondary glaucoma. Secondary glaucoma can cause severe visual function disorders and affect the patient’s quality of life. This study was carried out to indentify the characteristics of new secondary glaucoma patients at Cicendo Eye Hospital from January to December 2013. Methods: This descriptive study was carried out at Cicendo Eye Hospital from November to December 2014. Secondary data were retrieved from medical records of new secondary glaucoma patients who came to the Glaucoma unit from January to December 2013. Inclusion criteria were medical records comprising data about age, gender, location of the affected eyes by secondary glaucoma, etiology of secondary glaucoma and value of intraocular pressure. The collected data were recorded and analyzed to  illustrate their frequency distribution and proportion.Results: Out of 63 patients, 42.9% was 40–59 years old and 63.5% was men. Most cases were unilateral (82.5%). It was found that 74 eyes (52 unilateral, 11 bilateral), diagnosed as secondary glaucoma, had intraocular pressure ≥30 mmHg which were 54.1%. Secondary glaucoma were caused by lens induced (36.5%), inflammation (22.2%), and trauma (9.5%).Conclusions: Most cases are middle-aged patients and dominated by men. The eye diagnosed as secondary glaucoma occurred more in the unilateral eye which has intraocular pressure ≥30 mmHg and is caused by lens induced and inflammation. DOI: 10.15850/amj.v4n2.106

Pseudoexfoliation Glaucoma in the National Eye Center, Cicendo Eye Hospital, January–October 2012

  Background: Pseudoexfoliation syndrome is characterized by the deposition of a distinctive fibrillar material in the anterior segment of the eye. This condition is a major risk factor for development of glaucoma, termed pseudoexfoliation glaucoma (PEXG). The aim of this study was to describe the characteristic and management of PEXG in the National Eye Center Cicendo Eye Hospital.Methods: A descriptive retrospective study was conducted in October–November 2012 using medical records of PEXG patients in the National Eye Center Cicendo Eye Hospital during January–October 2012. Results: There were 32 patients (43 eyes) diagnosed as PEXG, most of them were male (78.1%), age 70–74 years old (34.4%) and followed by those in the range of age 65–69 years old (21.9%). Most of the cases were unilateral (65.6%) decrease of visual acuity less than 3/60 (76.7%), increase of intraocular pressure (IOP) with majority in the range of 31–40 mmHg (32.6%) and 41–50 mmHg (32.6%), Cup/Disc Ratio 0.9–1.0 (46.51%) and followed by those classified as majority which were hard to assess because of the presence of opaque media (34.89%). The type of glaucoma was open angle glaucoma (88.4%). The treatment received was a combination of two types of antiglaucoma medication and surgery IOPConclusion: PEXG is mostly found in elderly patients. While most of the patients come with high IOP and late stage of the disease IOPKeywords: Characteristics, glaucoma, pseudoexfoliation DOI: 10.15850/amj.v2n1.446

KARAKTERISTIK KLINIS GLAUKOMA PRIMER SUDUT TERTUTUP DI PUSAT MATA NASIONAL RUMAH SAKIT MATA CICENDO PADA TAHUN 2020

Glaukoma primer sudut tertutup (GPSTp) adalah penyakit kerusakan pada saraf mata akibat penutupan sudut bilik anterior dengan faktor risiko utama peningkatan TIO yang menyebabkan menyempitnya lapang pandang dan menurunnya fungsi penglihatan. Tatalaksana glaukoma bertujuan untuk menurunkan TIO. Penelitian ini bertujuan untuk mengetahui karakteristik penderita GPSTp di PMN RS Mata Cicendo Bandung tahun 2020 berdasarkan jenis kelamin, sebaran wilayah, profesi, usia, keluhan utama, lateralitas, diagnosis, visus, C/D ratio, TIO, faktor risiko, penyakit penyerta, tatalaksana dan lama kontrol. Penelitian menggunakan desain cross sectional deskriptif, menggunakan data sekunder melalui data rekam medis pasien glaukoma di RS Mata Cicendo Bandung periode Januari 2020 – Desember 2020. Sampel penelitian berjumlah 176 pasien dan terdapat 290 mata yang terdiagnosis GPSTp. Hasil penelitian ini menunjukkan GPSTp lebih banyak terjadi pada perempuan (64,2%) dengan rata-rata usia 61 tahun. Mayoritas pasien didiagnosis pada dua mata (64,8%). Penurunan penglihatan (70,5%) merupakan keluhan utama terbanyak. Rata-rata TIO pasien adalah 32,7 dengan visus terbanyak di bawah 3/60 (21%). Hipertensi (40,9%) menjadi penyakit penyerta terbanyak. Medikamentosa (95,9%) diberikan pada hampir semua pasien dengan trabekulektomi menjadi pilihan tindakan terbanyak. Pasien paling banyak melakukan kontrol selama 1 bulan (36,9%) dengan kontrol selama 12 bulan memiliki rata-rata TIO pada kontrol terakhir yang paling rendah, yakni 20,36

Efficacy and Safety of Micropulse Transscleral Cyclophotocoagulation Use in Refractory Glaucoma Patients

Glaucoma is the leading cause of irreversible blindness worldwide. Micropulse Transscleral Cyclophotocoagulation (MP-TSCPC) is a new method for treatment for refractory glaucoma with lesser complications than coventional TSCPC. This study aimed to evaluate the effectiveness and safety of MP-TSCPC (IRIDEX IQ810 Laser systems, CA) for refractory glaucoma treatment. This was a retrospective study using data obtained from the medical records of patients who underwent a MP-TSCPC procedure at Cicendo National Eye Hospital from July 2018 to September 2019. The outcomes measured were success rate (IOP decreased ≥30% from baseline with or without anti glaucoma medication at first month follow up) and post-operative complications. Fifty-seven eyes from 56 patients with a mean age of 57 years old underwent MP-TSCPC with 3 month follow up. The mean pre-operative intraocular pressure (IOP) dropped from 51.8 mmHg to 36.0 mmHg at 1 month follow up and 36.8 mmHg at the final follow up, representing an IOP decrease of 31% (1 month) and 28% (3 month). There was also a decrease of anti glaucoma medication usage from 2.51 to 2.16. The overall success rate at 1 month follow up was 49% and only 5% complication were found in this study. MP-TSCPC is safe and effective for lowering IOP and decreasing the need of anti glaucoma -medications in refractory glaucoma case. Further long-term evaluation and comparison to conventional TSCPC are still necessary

TRABEKULEKTOMI PADA GLAUKOMA SEKUNDER PASCA VITREKTOMI PARS PLANA DENGAN SILICONE OIL INTRAVITREAL

Latar belakang: untuk mengetahui keberhasilan operasi trabekulektomi pada glaukoma sekunder pasca vitrektomi pars plana dengan silicone oil intravitrealMetode: data dari 7 pasien dengan glaukoma sekunder pasca vitrektomi pars plana dengan silicone oil intravitreal yang telah dilakukan pengambilan silicone oil dan trabekulektomi dengan atau tanpa mitomicin C di rumah sakit Cicendo dari Januari 2009 sampai dengan Februari 2011. Tekanan intraokuler (TIO) sebelum operasi, 1 hari, 1minggu, 1 bulan dan 2 bulan pasca operasi dicatat dan dianalisis. Hasil: empat (57,14%) dari 7 pasien berusia diatas 45 tahun, dengan rata-rata usia 46,14 tahun (rentang usia 29–63). Semua pasien laki- laki. Lima (71,43%) subjek afakia. Onset glaucoma sekunder rata-rata 78 hari (rentang waktu 2–270). rata rata TIO 1 hari pasca bedah 7,86 mmHg , 1 minggu pasca bedah 25,83 mmHg , 1 bulan pasca bedah 17,50 mmHg, 2 bulan pasca bedah 16,33 mmHg. Satu pasien mengalami keberhasilan tanpa pemberian antiglaukoma topikal pasca bedah, 3 pasien mengalami keberhasilan namun dengan penambahan antiglaukoma topikal pasca bedah dan 2 pasien mengalami kegagalan dan 1 penderita tidak diperoleh data TIO setelah 1 hari pasca bedah. Enam subjek (85,71%) terdapat silicone oil di bilik mata depan, empat diantaranya telah terjadi emulsifikasi, 57,1% mengalami keberhasilan penurunan TIO dan 28,4% mengalami kegagalan. Lima subjek dilakukan trbekulektomi dengan MMC dan empat (57,1%) diantaranya mengalami keberhasilan (p=0,427).Simpulan: usia, status lensa, adanya silicone oil di bilik mata depan dan penggunaan antifibrotik tidak mempengaruhi keberhasilan operasi trabekulektomi pada glaukoma sekunder pasca vitrektomi pars plana dengan silicone oil intravitrealKata kunci: Trabekulektomi, glaucoma sekunder, silicone oli, tekanan intraokule

Pseudoexfoliation Glaucoma in the National Eye Center, Cicendo Eye Hospital, January–October 2012

  Background: Pseudoexfoliation syndrome is characterized by the deposition of a distinctive fibrillar material in the anterior segment of the eye. This condition is a major risk factor for development of glaucoma, termed pseudoexfoliation glaucoma (PEXG). The aim of this study was to describe the characteristic and management of PEXG in the National Eye Center Cicendo Eye Hospital.Methods: A descriptive retrospective study was conducted in October–November 2012 using medical records of PEXG patients in the National Eye Center Cicendo Eye Hospital during January–October 2012. Results: There were 32 patients (43 eyes) diagnosed as PEXG, most of them were male (78.1%), age 70–74 years old (34.4%) and followed by those in the range of age 65–69 years old (21.9%). Most of the cases were unilateral (65.6%) decrease of visual acuity less than 3/60 (76.7%), increase of intraocular pressure (IOP) with majority in the range of 31–40 mmHg (32.6%) and 41–50 mmHg (32.6%), Cup/Disc Ratio 0.9–1.0 (46.51%) and followed by those classified as majority which were hard to assess because of the presence of opaque media (34.89%). The type of glaucoma was open angle glaucoma (88.4%). The treatment received was a combination of two types of antiglaucoma medication and surgery IOPConclusion: PEXG is mostly found in elderly patients. While most of the patients come with high IOP and late stage of the disease IOPKeywords: Characteristics, glaucoma, pseudoexfoliation DOI: 10.15850/amj.v2n1.446

Automated Post-Trabeculectomy Bleb Assesment by Using Image Processing

Glaucoma is a second leading cause of blindness after cataract. Glaucoma caused by unbalance absorption of aqueus humour so it increase intraocular pressure. As a result, it surpresses nerve cells so that nerve cells can not get enough blood flow as nutrition intake and can lead to permanent blindness. One of the treatment for glaucoma is by surgical procedure, called trabeculectomy. After the surgery a slightly lifted tissue due to passing fluid, called bleb, should appears. Bleb assesment is necessary to examine the successful of trabeculectomy surgery. One of standard assesment is Indiana Bleb Appearance Grading Scale (IBAGS). Ophthalmologist used this standard to grade the bleb images manually so the result is subjective. This work offered a new approach to standardize the system of bleb assessment by computer software. Features related to bleb height, width and vascularity were extracted from the bleb image by using image processing algorithm. The KNN algorithm then used to classify the image according the IBAGS. The proposed method has successfully increased the Cohen’s kappa coefficient from 0.56 to 0.63. Therefore, it potentially reduced the subjectivity of the bleb grading

Pseudoexfoliation Glaucoma in the National Eye Center, Cicendo Eye Hospital, January–October 2012

Background: Pseudoexfoliation syndrome is characterized by the deposition of a distinctive fibrillar material in the anterior segment of the eye. This condition is a major risk factor for development of glaucoma, termed pseudoexfoliation glaucoma (PEXG). The aim of this study was to describe the characteristic and management of PEXG in the National Eye Center Cicendo Eye Hospital. Methods: A descriptive retrospective study was conducted in October–November 2012 using medical records of PEXG patients in the National Eye Center Cicendo Eye Hospital during January–October 2012. Results: There were 32 patients (43 eyes) diagnosed as PEXG, most of them were male (78.1%), age 70–74 years old (34.4%) and followed by those in the range of age 65–69 years old (21.9%). Most of the cases were unilateral (65.6%) decrease of visual acuity less than 3/60 (76.7%), increase of intraocular pressure (IOP) with majority in the range of 31–40 mmHg (32.6%) and 41–50 mmHg (32.6%), Cup/Disc Ratio 0.9–1.0 (46.51%) and followed by those classified as majority which were hard to assess because of the presence of opaque media (34.89%). The type of glaucoma was open angle glaucoma (88.4%). The treatment received was a combination of two types of antiglaucoma medication and surgery IOP Conclusion: PEXG is mostly found in elderly patients. While most of the patients come with high IOP and late stage of the disease IO

Karakteristik Klinis Glaukoma Uveitis di Pusat Mata Nasional Rumah Sakit Cicendo Bandung Tahun 2021-2022

Uveitic glaucoma is a complication of uveitis that can occur due to severe intraocular inflammation. Objective: To determined the clinical characteristics of uveitic glaucoma based on clinical features and management at the Cicendo Hospital National Eye Center from 2021 until 2022. Methods: This study used a retrospective descriptive method and a cross-sectional design with secondary data as subjects in the form of electronic medical records of patients at the National Eye Center Cicendo Hospital Bandung who had a diagnosis of uveitic glaucoma in the period January 2021 until December 2022. Results: 162 patients (228 eyes) met the inclusion criteria. Most of the patients were women, with a percentage of 66%. Anterior uveitis (44.3%) was the most common type of uveitis. The mean IOP at the initial visit was 30.1 mmHg. One hundred fourteen eyes (50%) were below 3/60 visual acuity. Infection (41.4%) was the most common cause of uveitis. A total of 107 eyes (46,9%) underwent surgery. There was a decrease in the average IOP in each follow-up period. Conclusions: Glaucoma uveitis is commonly found in women with an average age of 48.6 years. Anterior uveitis with an infectious cause is the most common type and cause of uveitis. The most common surgery is a combination of trabeculectomy, lens extraction, and IOL implantation. Keywords:  management of glaucoma,  secondary glaucoma, uveitic glaucom