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""Written by a pioneering leader in the development of vitreoretinal surgical techniques and instruments, Vitreous Microsurgery is a comprehensive how-to guide to all vitreoretinal procedures. This thoroughly updated Fifth Edition describes many new techniques and refinements of established procedures and includes new chapters and new illustrations. More than 170 three-dimensional full-color illustrations--many by the Charles Retina Institute's resident medical artist, Byron Wood--enable surgeons to clearly visualize the techniques. The focus of the text is on the decision making process a surgeon goes through in evaluating the best course of treatment for his/​her patient undergoing vitreous surgery. The book describes in detail clinically proven methods of managing the anterior and posterior segment vitreous surgery patient in a systematic manner. The text is organized in a building block approach with general methodology preceding its application to specific disease states. The book stresses algorithms for intra-operative decision making, relying on knowledge of physical principles and performed in the order of ascending risk. A companion website included with purchase offers the fully searchable text and an online image bank"--Provided by publisher."

"Latar Belakang : Uveitis adalah suatu kelompok penyakit yang ditandai dengan adanya inflamasi intraokular, berkontribusi sebanyak 25% kebutaan di dunia. Kekeruhan vitreus adalah salah satu tanda klinis yang penting untuk evaluasi dan monitor penyakit khususnya pada uveitis intermediet, posterior, dan panuveitis.Tujuan : Memperoleh pengukuran kuantitatif dari kekeruhan vitreus menggunakan optical coherence tomography (OCT) dengan Image J sebagai metode alternatif dari standar baku pengukuran kualitatif, skala Nussenblatt.Metode: Studi ini adalah studi potong lintang, prospektif. Studi ini menyertakan karakteristik klinis dan demografis pasien uveitis dan kontrol. Penilaian OCT makula dan foto fundus dilakukan oleh dua orang yang berbeda.Hasil: Sebanyak 29 partisipan dengan uveitis dan 29 kontrol sehat diikutkan dalam penelitian. Lebih dari setengah pasien memiliki panuveitis (59.6%) dengan toksoplasma sebagai etiologi tersering (27.6%). Median dari Vitreus/Epitel Pigmen Retina intensitas relatif (VRIr) sebagai pengukuran yang didapat dari OCT didapatkan lebih tinggi pada pasien dengan uveitis dibandingkan dengan kontrol sehat (0.265; 0.168-0.605 dan 0.175;0.152-0.199 secara berurutan). Nilai intra-rater dengan kedua metode ini menunjukkan hasil yang sangat baik dengan penilai 1 memperoleh 0. 975 (0.958, 0.985); penilai 2 memperoleh 1.00 (0.999, 1.000) untuk VRIr, dan penilai 1 memperoleh 0.920 (0.829, 0.962) dan penilai 2 memperoleh 0.908 (0.804, 0.957) untuk skala Nussenblatt. VRIr memiliki nilai inter-rater yang lebih tinggi jika dibandingkan dengan skala Nussenblatt (0.998; 0.996 - 0.999 dan 0.717; 0.696 - 0.737, p<0.001). Korelasi positif yang kuat ditemukan diantara VRIr dan skala Nussebblatt (rho= 0.713, p<0.001).Kesimpulan: VRIr memiliki nilai inter-rater dengan kesesuaian yang hampir sempurna dan kesesuaian intra-rater yang sangat baik dengan adanya korelasi positif yang kuat terhadap skala Nussenblatt, menjadikan VRIr sebagai metode kuantitatif dari pengukuran kekeruhan vitreus.

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Background : Uveitis is a group of diseases characterized by intraocular inflammation, causing 25% of blindness world-wide. Vitreous haziness is one of important clinical endpoint for disease evaluation and monitoring in intermediate, posterior uveitis and panuveitis.

Purpose : To obtain quantitative measurement of vitreous haziness using optical coherence tomography (OCT) with Image J as alternative method to gold standard qualitative measurement, Nussenblatt scale.

Methods: Prospective , cross-sectional study was conducted for this purpose. Clinical and demographic characteristic of uveitic and healthy control were recorded in this study. OCT macula and fundus photograph were obtained and graded by two independent graders.

Result: A total of 29 uveitic eyes and 29 healthy controls were included in this study. More than half of recruited patients had panuveitis (59.6%) with toxoplasma as the most common etiology (27.6%). Median of Vitreous/RPE relative intensity (VRI) as the OCT-derived measurement showed higher in uveitic patients compared to healthy controls (0.265; 0.168-0.605 and 0.175;0.152-0.199 respectively). Intra-rater of two methods showed excellent result with grader 1 was 0.975 (0.958, 0.985) ; grader 2 was 1.00 (0.999, 1.000) for VRI, and grader 1 was 0.920 (0.829, 0.962) and grader 2 was 0.908 (0.804, 0.957) for Nussenblatt Scale. VRI had higher inter-rater agreement compared to Nussenblatt scale (0.998; 0.996 - 0.999 and 0.717; 0.696 - 0.737, p<0.001). Strong positive correlation was found between VRI and Nussenblatt scale (rho= 0.713, p<0.001).

Conclusion: VRI had near perfect inter-rater agreement and excellent intra-rater agreement with strong positive correlation with Nussenblatt scale, making VRI a quantitative method of vitreous haziness measurement."

"ABSTRACTBACKGROUND:proliferative diabetic retinopathy (DR) is an advanced form of DR that eventually could lead to blindness. Levels of vitreous advanced glycation end products (AGEs) and D-dimer may reflect the pathological changes in the retina, but only few studies have assessed their correlation with blood hemoglobin A1C (HbA1c) levels. This study aimed to find the association between blood HbA1c levels with vitreous AGEs and D-dimer levels in patients with proliferative DR. METHODS:an analytical cross-sectional study was performed in subjects with proliferative DR who underwent vitrectomy. Subjects were divided into 2 subgroups, i.e. uncontrolled (HbA1c >7%) and controlled (HbA1c <7%) groups. Vitreous AGEs and D-dimer levels were assessed; the levels were compared between uncontrolled and controlled hyperglycemic patients. Statistic correlation tests were also performed for evaluating blood HbA1c, vitreous AGEs, and D-dimer levels.RESULTS:a total of 47 patients were enrolled in this study and 32 (68.1%) of them were women. Median vitreous AGEs level was 11.0 (3.0 - 48.0) µg/mL; whereas median vitreous D-dimers level was 5,446.0 (44.0 - 37,394.0 ) ng/mL. The median vitreous AGEs levels was significantly higher in patients with uncontrolled vs. controlled hyperglycemia (14.0 vs. 4.0 mg/mL; p<0.001). There was a significant positive correlation with moderate strength between blood HbA1c level and vitreous AGEs level (r=0.524; r2=0.130; p=0.0001). Blood HbA1c level could be used to predict vitreous AGEs level by using the following calculation: vitreous AGEs = -1.442+ (1.740xblood HbA1c). Vitreous D-dimer levels were not significantly different between uncontrolled and controlled hyperglycemia (median 4607.5 vs. 5701.6 ng/mL; p = 0.458). There was a positive significant correlation between blood HbA1c and vitreous D-dimer levels (r = 0.342; p = 0.019); however the correlation was weak. Vitreous AGEs level had a positive significant correlation with vitreous D-dimer levels (r = 0.292; p = 0.046) and the correlation strength was also weak.CONCLUSION:median vitreous AGEs levels were significantly higher in proliferative DR patients with uncontrolled than those with controlled hyperglycemia. Blood HbA1c level can be used to assess vitreous AGEs level in patients with proliferative DR by using the following calculation: vitreous AGEs = -1.442+(1.740 x HbA1c). However, the blood HbA1c level can not be used to predict vitreous D-dimer level in patients with proliferative DR."

"Retinopati diabetik merupakan salah satu komplikasi yang disebabkan oleh diabetes mellitus. Kelainan mata ini telah menjadi salah satu dari dua penyebab utama kebutaan di Amerika Serikat. Penghantaran obat secara sistemik dan topical tidak dapat dilakukan karena berbagai keterbatasan. Ditemukan bahwa metode paling efektif untuk menghantarkan obat ini adalah dengan injeksi intravitreal. Akan tetapi, ditemukan juga bahwa metode ini dapat meningkatkan tekanan di dalam mata dan pendarahan retina. Oleh karena itu dibutuhkan metode enkapsulasi obat terkendali yang mampu membantu obat agar dapat dilepaskan dalam jangka waktu yang lebih panjang, sehingga frekuensi injeksi dapat dikurangi. Sistem seperti ini dapat dibuat dengan memformulasikan triamsinolon dengan polimer PLGA ke dalam bentuk mikropartikel. Mikropartikel ini dapat dibuat dengan metode emulsifikasi-penguapan pelarut yang menghasilkan effisiensi enkapsulasi obat sebesar 25,3% dan penjeratan obat sebesar 6,17%. Penggunaan polimer sebagai material enkapsulan dikombinasikan dengan penggunaan surfaktan kationik, dengan variasi konsentrasi sebesar 0,5; 1,0; 1,5% (m/v). Zeta potensial dari mikropartikel yang dimodifikasi dengan DDAB diukur dan ditemukan bahwa nilai tersebut sebanding dengan perubahan konsentrasi DDAB yang ditambahkan. Interaksi elektrostatis dari mikropartikel yang bermuatan positif dengan HA yang bermuatan negatif pada vitreous juga ditentukan dengan pengukuran zeta potensial. Vitreous yang digunakan adalah vitreous sapi yang memiliki kandungan HA yang mirip dengan vitreous mata manusia. Hasil pengukuran menunjukkan bahwa zeta potensial semua sampel pada vitreous dengan konsentrasi DDAB yang berbeda tidak berbeda secara signifikan. Hal ini kemungkinan besar terjadi karena HA yang mendominan di dalam campuran vitreous-mikropartikel.

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Diabetic retinopathy is one of the complications caused by diabetes mellitus. This disorder of the eyes has become one of two major blindness in the United States. Systemic and topical drug delivery cannot be done because of various limitations. The drug is most likely delivered intraocular using intravitreal injection. However, it was later found that this method can lead to an increase in intraocular pressure (IOP) and retinal bleeding. Therefore, controlled drug encapsulation system which allows drug release within a longer time is required, so the frequency of injection may be reduced. Such systems can be made by formulating triamsinolon with PLGA in the form of microspheres. The microspheres are fabricated using emulsification-solvent evaporation method and have an average drug encapsulation of 25.3% and drug loading of 6.17%.

The use of polymers as material encapsulant also be combined with the use of cationic surfactants, whose concentration is varied by 0.5; 1.0; and 1.5% (w/v). Zeta potential of the modified microparticles are measured and it is found that this variable directly proportional to the DDAB concentration. Electrostatic interaction of the positively charged microspheres with negatively charged HA in vitreous will be also determined by measuring the zeta potential. Vitreous used in the experiments is bovine vitreous, which contains nearly same amount of HA with human?s vitreous. Nearly the same amount of zeta potential is measured from sampels with different DDAB concentration. It is most likely caused by the dominance of HA in the vitreous-microspheres mixture."