Doctor of Medicine's Latest Research Reveals Risk Factors for Proliferative Diabetic Retinopathy in Type-2 Diabetes Mellitus Patients

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  • Selasa, 28 Mei 2024
  • Has been read 525 time(s)


Located in the Hall Room Lt.III, Udayana University Postgraduate Building, Denpasar, a Doctoral Promotion examination was held with Promovenda candidate Dr. Ni Made Ari Suryathi, M.Biomed., Sp.M (K), with the dissertation title "Low Vitreous MicroRNA-124 Expression, TNF Alpha Levels and High Vitreous Vascular Endothelial Growth Factor Levels as Risk Factors for Proliperative Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients." (28/5/2024).


Type-2 diabetes mellitus (DM) is a metabolic disease that can cause various complications. One of the complications of type-2 DM that can occur in the eye is Proliferative Diabetic Retinopathy (PDR). PDR can cause a decrease in sharp vision up to blindness. The global prevalence of DM is 8.3% and the prevalence of DM in Bali is 5.9%. PDR complications occur in 26.3% of type-2 DM patients. This study aims to prove the role of miRNA-124 and TNF-α in the inflammatory pathway and the role of VEGF in the angiogenesis pathway as risk factors for PDR in type-2 DM.


This study was a case control study and matching was performed on age and gender variables. A total of 38 subjects in this study, where the case group was patients with type 2 DM with PDR who underwent vitrectomy, and the control group was patients without type 2 DM who underwent vitrectomy according to medical indications. The materials of this study were vitreous with miRNA-124 expression examination using Reverse Transcription Quantitative Polymerase Chain Reaction (RT-qPCR) and vitreous TNF-α and VEGF levels measured using Enzyme Linked Immunosorbent Assay (ELISA) technique.


Cut off points for miRNA-124, TNF-α and VEGF were 1.719; 15.795 pg/ml; and 22.980 pg/ml, respectively. OR miRNA-124 was 4.78; OR TNF-α was 5.13; OR VEGF was 3.86. Multinominal logistic regression analysis test showed OR TNF-α remained dominant as a risk factor for PDR followed by miRNA-124 and VEGF. Contingency coefficient and Lambda correlation analysis revealed a moderate correlation between miRNA-124 and TNF-α (r = -0.449 and r = -0.425, respectively), and a significant value of < 0.05. The negative r value indicates the opposite direction of correlation or the higher the TNF- level, the miRNA-124 expression decreases.


This study proves that low vitreous miRNA-124 expression, high vitreous TNF-α and VEGF levels are risk factors for PDR in type 2 DM. These findings strengthen the theory of the pathogenesis of PDR through the inflammatory pathway (miRNA-124 and TNF-α) and the angiogenesis pathway (VEGF) in type 2 DM.


This examination was chaired by the Dean of FK Unud Prof. Dr. dr. Komang Januartha Putra Pinatih, M.Kes., with a team of examiners:

1. Prof. Dr. dr. Ketut Suastika, Sp.PD-KEMD (Promoter)

2. Prof. Dr. Ir. Ida Bagus Putra Manuaba, M.Phil (Copromotor I)

3. Prof. Dr. dr. I Gusti Ayu Sri Mahendra Dewi, Sp.P.A., Subsp.O.G.P.(K) (Kopromotor (II)

4. Prof. Dr. dr. I Made Bakta, Sp.PD-KHOM 

5. Prof. drh. I Nyoman Mantik Astawa, Ph.D 

6. Dr. rer. nat. dr. Ni Nyoman Ayu Dewi, M.Si 

7. Dr. dr. Putu Yuliawati, Sp.M(K)  

8. Dr. dr. I Nyoman Wande, S.Ked.,Sp.PK 

9. Dr.dr.Ni Made Linawati,S.Ked.,M.Si 

10. Dr.dr.Ni Putu Sriwidyani, Sp.PA.,Subsp.S.M.(K)


While academic invitations are :

1. Dr. dr. Ida Ayu Ika Wahyuniari, M.Kes & nbsp;

2. Dr. dr. Anak Agung Mas Putrawati Triningrat, Sp.M(K);

3. Dr. dr. Ari Andayani, Sp.M(K) 

4. Dr. dr. I Wayan Eka Sutyawan, Sp.M(K) 

5. Dr. dr. I Wayan Gede Jayanegara, Sp.M(K)


In this exam, Dr. dr. Ni Made Ari Suryathi, M.Biomed, Sp.M (K), was declared to have graduated as the 416th Doctoral Graduate of the Medical Science Doctoral Study Program, Faculty of Medicine, Udayana University with the title Cumlaude.


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