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"Latar belakang: Salah satu efek samping yang cukup dikenal dalam pengobatan TB adalah efek samping akibat konsumsi etambutol, yang dikenal sebagai neuropati optik etambutol (NOE). Beberapa studi baru-baru ini pada hewan coba yang diberikan etambutol mendapatkan adanya penurunan jumlah sel ganglion retina pasca konsumsi etambutol. Tujuan: Untuk mengetahui perubahan ketebalan RNFL peripapil dengan menggunakan OCT setelah konsumsi etambutol dan mengetahui korelasi perubahan ketebalan RNFL peripapil dengan perubahan fungsi penglihatan. Desain Penelitian prospektif dengan uji klinis tunggal.Hasil: Terdapat 29 subjek yang berpartisipasi pada studi ini, dengan rerata dosis etambutol yang dikonsumsi 16,44 ± 2,7 mg/kgBB/hari. Ditemukan perubahan signifikan ketebalan RNFL 2 bulan setelah konsumsi etambutol pada kuadran superior (147 ; 141μm), nasal (92 ; 88μm) dan pada rerata seluruh kuadran (116,77 ; 112,65 μm). Nilai rerata tajam penglihatan, sensitivitas warna dan lapang pandangan mengalami perubahan signifikan, namun bukan perubahan yang bermakna secara klinis. Pada studi ini korelasi antara perubahan masing-masing parameter fungsi penglihatan dengan perubahan ketebalan rerata RNFL tidak bermakna secara statistik (p > 0,05). Kesimpulan: Terdapat penurunan ketebalan RNFL peripapil setelah mengkonsumsi etambutol selama 2 bulan, namun belum mencapai penurunan yang bermakna klinis. Terdapat perubahan tajam penglihatan, sensitivitas warna, dan lapang pandangan yang bermakna setelah mengkonsumsi etambutol selama 2 bulan. Tidak terdapat korelasi antara perubahan ketebalan RNFL peripapil dengan perubahan masing-masing fungsi penglihatan.

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Background: Ethambutol Optic Neuropathy (EON) is a well-known side effect within patients receiving ethambutol therapy. Recent studies performed in animals reveal decreased amount of retinal ganglion cells after they are given ethambutol.

Purpose: To evaluate peripapillary RNFL thickness changes using OCT, before and after patients receive ethambutol therapy. To know the correlation of RNFL thickness changes with the changes of visual function.

Study design: One group pretest-posttest study.

Result: There was 29 subjects enrolling the study, with the mean dose of ethambutol 16,44 ± 2,7 mg/kgBW/day. We found significant changes of peripapillary RNFL thickness 2 months after consuming ethambutol in superior (147 ; 141 μm), nasal (92 ; 88 μm) and average RNFL thickness (116,77 ; 112,65 μm). The mean visual acuity, color sensitivity and visual field also change significantly, without clinically meaningful changes. This study did not found any statistically significant correlation between RNFL thickness changes and the changes of visual function parameters (p>0,05).

Conclusion: After 2 months ethambutol consumption, there was a statistically significant peripapillary RNFL thinning, with non-clinically significant amount of reduction. There was also significant changes of visual acuity, color sensitivity and visual field. No correlation was found between RNFL thickness thinning and visual function parameters changes."

"Tujuan mengetahui pengaruh sitikolin 1000 mg per hari selama 60 hari terhadap hasil pattern electroretinography, ketebalan sel ganglion dan lapang pandang pasien NAION non-arteritic anterior ischemic optic neuropathy fase kronik. Metode Uji klinis acak terkontrol tersamar ganda dilakukan pada 38 subyek penelitian. Randomisasi membagi subyek menjadi 2 kelompok yaitu 18 subyek kelompok sitikolin S-NAION dan 20 subyek plasebo P-NAION. Analisis dilakukan pada 17 subyek penelitian di tiap kelompok. Hasil Terjadi peningkatan ? amplitudo P50 30 hari di kelompok S-NAION 0,775 2,6 V , namun tidak bermakna secara statistik bila dibandingkan dengan kelompok P-NAION p = 0,182. Terjadi perbaikan ? amplitudo N95 60 hari di kelompok S-NAION -0,356 2,992 V, namun tidak bermakna secara statistik bila dibandingkan dengan kelompok P-NAION p = 0,779. Pemberian sitikolin tidak menunjukkan perubahan ketebalan sel ganglion retina. Terjadi peningkatan ? mean deviation 60 hari di kelompok S-NAION 3,13 6,467 dB, namun tidak bermakna secara statistik bila dibandingkan dengan kelompok P-NAION p = 0,344. Kesimpulan Sitikolin cenderung meningkatkan ? amplitudo P50 dan N95 serta ? mean deviation pada NAION fase kronik.

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Purpose to determine the effect of 1000 mg citicoline each day given for 60 days on pattern electroretinography, retinal ganglion cell thickness and visual field in chronic phase NAION non arteritic anterior ischemic optic neuropathy patients. Methods Double masked randomized clinical trial were performed in 38 patients. Randomization divided the patients into 2 groups of 18 subjects in the citicoline group C NAION and 20 subjects in the placebo group P NAION . The analysis was performed on 17 subjects in each group.

Results There were increament of amplitude P50 30 days in C NAION group 0,775 2,6 V, but statistically insignificant compared to P NAION p 0,182. There were also improvement of amplitude N95 60 days in C NAION group 0,356 2,992 V, but statistically insignificant compared to P NAION p 0,779. Citicoline supplementation did not show any changes in retinal ganglion cell thickness. There were improvement of mean deviation 60 days in C NAION group 3,13 6,467 dB, but statistically insignificant compared to P NAION p 0,344. Conclusions Citicoline tends to increase the amplitude of P50 and N95 and mean deviation in chronic phase NAION."

"Koroid memiliki peran dalam mengatur metabolisme fotoreseptor dan epitel pigmen retina (EPR) serta sumber perdarahan ke lapisan luar retina. Pada miopia terjadi elongasi aksial yang berdampak pada penipisan ketebalan koroid dan memengaruhi prognosis visual. Studi ini bertujuan mengetahui hubungan antara ketebalan koroid dengan derajat miopia dan ketebalan fotoreseptor-EPR. Studi ini merupakan studi potong lintang yang dilakukan pada 102 mata. Setiap subjek dikelompokkan menjadi empat kelompok, yaitu emetropia, miopia ringan, sedang, dan berat. Setiap subjek dilakukan pemeriksaan mata menyeluruh dan pemindaian makula menggunakan spectral domain optical coherence tomography (SD-OCT), dengan pengaturan HD-1-Line100x dan enhanced depth imaging (EDI). Gambar pemindaian dinilai secara manual dan dikelompokkan berdasarkan Early Treatment of Diabetic Retinopathy Study (ETDRS) grid. Hasil studi menunjukkan ketebalan koroid terbesar ditemukan di subfovea atau lingkar superior bergantung pada kelompok, dan ketebalan terendah ditemukan pada regio nasal setiap kelompok. Terdapat perbedaan signifikan ketebalan koroid dengan derajat miopia pada setiap kelompok. Korelasi signifikan ketebalan koroid dan ketebalan lapisan fotoreseptor-EPR hanya ditemukan pada lingkar inferior dalam (r=0,34; p<0,001). Penelitian ini menunjukkan ketebalan koroid yang beragam dan signifikan tiap derajat miopia, serta korelasi negatif lemah antara ketebalan koroid dan ketebalan lapisan fotoreseptor-EPR pada di regio inferior.

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The choroid is crucial for regulating the metabolism of photoreceptors and the retinal pigment epithelium (RPE) while supplying blood to the outer retinal layer. Myopia, characterized by axial elongation, is linked to choroidal thinning, impacting visual prognosis. This study investigates the relationship between choroidal thickness (CT), different myopia degrees, and photoreceptor-RPE thickness. In a cross-sectional study of 102 eyes, categorized into emmetropia, mild, moderate, and high myopia groups, comprehensive eye exams and macular scans using spectral domain optical coherence tomography (SD-OCT) with HD-1-Line100x settings and enhanced depth imaging (EDI) were conducted. Manual evaluations of scan images based on the Early Treatment of Diabetic Retinopathy Study (ETDRS) grid revealed varied and significant CT across myopia degrees. The thickest CT found either in the subfovea or superior ring depending on the group, and the thinnest consistently in the nasal region for all groups. A significant correlation between choroidal thickness and photoreceptor-RPE layer thickness was noted in the inner inferior circle (r=0.34; p<0.001). In summary, this study unveils varying and significant CT across myopia degrees, emphasizing weak negative correlations between choroidal thickness and photoreceptor-RPE layer thickness, specifically in the inferior region."

"Latar belakang: Fakoemulsifikasi merupakan tindakan yang sering dilakukan dalam mengatasi katarak saat ini.Fluktuasi tekanan intra okular (TIO) dapat mempengaruhi ketebalan lapisan serabut saraf (RNFL) peripapil. TujuanMengetahui perubahan ketebalan lapisan serabut saraf (RNFL) peripapildan mengetahui rerata mean deviation (MD) lapang pandangan sesudah fakoemulsifikasi pada pasien glaukoma kronis dan non glaukoma. Desain: Studi kohort. Hasil: Sebanyak 26 pasien yang didapat secara konsekutif dibagi atas dua kelompok yaitu 13 subyek glaukoma dan 13 subyek non glaukoma.Tidak terdapat perubahan signifikan ketebalan RNFL pasca fakoemulsifikasi pada kedua kelompok. Kelompok glaukoma pada kuadran superior (115,5 ; 121,6 μm), inferior ( 110,9 ; 116,5 μm), temporal (75,3 ; 77,5 μm),nasal (77,1 ; 80,9μm) dan pada rerata seluruh kuadran (94,9 ; 99,1 μm). Kelompok non glaukoma pada kuadran superior (13,9 ; 124,9 μm), inferior ( 124,8 ; 126,2 μm), temporal (79,0 ; 81,5 μm),nasal (74,1 ; 74,6 μm) dan pada rerata seluruh kuadran (100,2 ; 101,7 μm).Pada kelompok non glaukoma terjadi peningkatan MD lapang pandangan yang berbeda bermakna secara statistik yaitu p = 0.005. Sedangkan pada kelompok glaukoma terjadi penurunan MD lapang pandangan yang secara uji statistik tidak bermakna yaitu p = 0.071. Kesimpulan: Terdapat peningkatan ketebalan serabut saraf retina peripapil setelah fakoemulsifikasi pada kelompok glaukoma dan non glaukoma pada empat kuadran dan rerata semua kuadran, namun tidak bermakna secara uji statitik. Terdapat penurunan MD lapang pandangan pada kelompok glaukoma yang tidak bermakna secara statistik. Terdapat peningkatan MD lapang pandangan pada kelompok non glaukoma yang bermakna pada uji statistic.

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Introduction: Nowadays, phacoemulsification is the chosen surgery for relatively safe removal of cataractous lenses. Intraocular pressure (IOP) fluctuation may influence the thickness of peripapillary retinal nerve fiber layer (RNFL). Purpose: To evaluate the change in peripapillary RNFL thickness and mean deviation (MD) of visual field before and after phacoemulsification in chronic primary glaucoma and non-glaucoma patients.

Study Design: A cohort study.

Result: There were 13 eyes with chronic glaucoma and 13 eyes with non-glaucoma that were enrolled consecutively. We got no significant different of RNFL thickness before and after phacoemulsification between two groups. Retinal nerve fiber layer thickness in glaucoma groups was(115,5; 121,6 μm) superiorly, (110,9; 116,5 μm) inferiorly, (75,3; 77,5 μm) temporally, (77,1; 80,9μm) nasally, and (94,9; 99,1) as the mean RNFL thickness of all quadrans. While in non-glaucoma groups, we got (13,9; 124,9 μm) superiorly, (124,8 ; 126,2 μm) inferiorly, (79,0 ; 81,5 μm) temporally,(74,1 ; 74,6 μm) nasally, and mean RNFL of all quadrans were (100,2 ; 101,7 μm). Mean deviation of visual field after surgery was statistically higher in non-glaucoma groups (p=0,005). In other hand, glaucoma patients yielded decreasing MD of visual field, even it was not statistically significant (p=0,071).

Conclusion: There were increasing peripapillay RNFL thickness following phacoemulsification in both chronic glaucoma and non-glaucoma patients. Mean deviation of visual field in chronic glaucoma patient revealed a decline, and otherwise, an increment of visual field wasobtained in non-glaucoma patient after surgery."

"Penelitian ini merupakan penelitian dengan menggunakan desain potong lintang (comparative cross sectional) yang bertujuan untuk menilai dan membandingkan ketebalan lapisan serabut saraf retina/retinal nerve fiber layer (RNFL) peripapil antara kelompok normal dan kelompok glaukoma dengan cup disk ratio (CDR) vertikal 0,4 sampai dengan 0,7 di poliklinik mata Rumah Sakit Cipto Mangunkusumo (RSCM) kirana. Sebanyak 40 mata kelompok normal dan 34 mata kelompok glaukoma mengikuti pemeriksaan Humphrey field analyzer dan Optical Coherence Tomography (OCT). Kemudian ketebalan RNFL peripapil kelompok normal dan glaukoma dianalisis untuk mendapatkan perbandingan ketebalan RNFL peripapil antara kelompok normal dan glaukoma. Pada penelitian ini didapatkan hasil tidak ada perbedaan perubahan ketebalan lapisan serabut saraf retina peripapil seiring dengan penambahan CDR vertikal namun secara klinis ketebalan RNFL peripapil pada kelompok glaukoma lebih tipis dibandingkan kelompok normal dengan CDR vertikal yang sama kecuali pada kuadran temporal.

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This was a comparative cross-sectional study. The purpose of this study was to assess and compare the peripapillary retinal nerve fiber layer (RNFL) thickness between the normal and glaucoma eyes with vertical cup disc ratio (CDR) 0.4 to 0.7 in eye clinic Cipto Mangunkusumo Hospital (RSCM) Kirana. A total of 40 eyes of normal group and 34 eyes of glaucoma following Humphrey field analyzer examination and Optical Coherence Tomography (OCT). Peripapillary RNFL thickness between normal and glaucoma eyes were analysed and compared each other. The result of this study was no difference in changes of peripapillary RNFL along with the progression of vertical CDR but clinically, peripapillary RFNL thickness in glaucoma group is thinner than that of normal group with the same vertical CDR except in temporal quadr."

"Latar Belakang: Silicone oil (SO) merupakan salah satu substitusi vitreus yang digunakan pasca vitrektomi pars plana (VPP) dalam manajemen ablasio retina rhegmatogen. Beberapa komplikasi penggunaan SO meliputi katarak, peningkatan tekanan bola mata, emulsifikasi, keratopati hingga menurunnya ketebalan dan densitas vaskular makula. Tujuan: Mengetahui perubahan ketebalan makula sentral serta densitas vaskular pleksus superfisial pada pasien ablasio retina rhegmatogen pasca VPP dengan tamponade SO. Metode: 41 pasien ablasio dianalisis dalam studi ini yang menggunakan dua desain: observasional prospektif tanpa pembanding untuk membandingkan efek tamponade SO minggu-1 dengan minggu-4 dan potong lintang untuk membandingkan mata kontralateral dengan minggu-1 pasca tamponade SO. Hasil: Central subfield thickness (CST), superficial vascular density (SVD) serta superficial perfusion density (SPD) pada minggu-1 lebih rendah dibandingkan mata kontralateral (p<0,001). Pada minggu-4 pasca tamponade SO ditemukan peningkatan CST, SVD, SPD dibandingkan minggu-1 meskipun tidak signifikan secara statistik. Pada analisis tambahan, didapatkan usia diatas 50 tahun mengalami kecenderungan penurunan SVD (p 0,033) dan SPD (0,011) dibandingkan kelompok usia muda. Kesimpulan: Tidak didapatkan penurunan ketebalan makula sentral dan densitas vaskular pleksus kapiler superfisial makula di minggu-4 pasca PPV dengan SO. Didapatkan ketebalan makula sentral dan densitas vaskular pleksus kapiler superfisial makula yang lebih rendah di minggu-1 pasca tamponade SO dibandingkan mata kontralateral

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Background: Silicone oil (SO) is one of the vitreous substitutes used after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) management. Complications arising from SO include cataracts, increased ocular pressure, emulsification, keratopathy, and decreased macular thickness and vascular density. Objective: To determine changes in central macular thickness and superficial vascular density in RRD patients after PPV with SO. Method: 41 patients were included in this study, which comprises two designs: a prospective observational without comparison to compare the effect of SO tamponade week-1 with week-4 and a cross-sectional design to compare the contralateral eye with week-1 after SO tamponade. Results: Central subfield thickness (CST), superficial vascular density (SVD), and superficial perfusion density (SPD) were lower at week 1 after PPV with SO compared to the contralateral eye (p<0.001). At week 4 after PPV with SO, there was an increase in CST, SVD, and SPD compared to week 1, although not statistically significant. In additional analysis, we found that those aged over 50 had tendencies toward decreased SVD (p 0.033) and SPD (0.011) compared to the younger age group. Conclusion: There was no reduction in central macular thickness or superficial vascular density at week 4 after PPV with SO in RRD patients. Central macular thickness and superficial vascular density were lower on week 1 after SO tamponade compared to the contralateral eye."

"[ABSTRAKTujuan: Untuk mengevaluasi pengaruh pemberian suplementasi Mirtogenol terhadap perubahan ketebalan lapisan serabut saraf retina dan lapang pandang pada pasien dengan glaukoma primer sudut terbuka (GPSTa) dengan tekanan intraokular (TIO) terkontrol.Metode: Penelitian ini merupakan penelitian prospektif, acak, tersamar ganda. Empat puluh satu pasien dengan GPSTa dengan TIO ≤ 18 mmHg diacak untuk mendapatkan Mirtogenol atau plasebo. Perubahan ketebalan RNFL dan MD lapang pandang diperiksa sebelum penelitian, 4 minggu serta 8 minggu setelah pemberian obat. Efek samping pengobatan ditanyakan kepada pasien selama penelitian.Hasil: Rerata ketebalan RNFL kelompok Mirtogenol mengalami penurunan sebesar -0.70±1.63 μm dari 87.29±19.39 μm di awal penelitian menjadi 86.58±19.43 μm setelah 8 minggu, namun perubahan yang terjadi tidak bermakna secara statistik (p=0.121). Rerata ketebalan RNFL kelompok plasebo mengalami penurunan sebesar -1.74±1.79 μm dari 97.14±17.19 μm di awal penelitianmenjadi 95.40±18.56 μm setelah 8 minggu, perubahan yang terjadi bermakna secara statistik (p< 0.001). Rerata MD lapang pandang kelompok Mirtogenol mengalami peningkatan 0.542±1.93 dB setelah 8 minggu sedangkan rerata MD lapang pandang kelompok plasebo mengalami penurunan sebesar -0.083±1.36 dB setelah 8 minggu. Namun perubahan rerata MD lapang pandang kedua kelompoktidak bermakna secara statistik (p>0.05). Selama penelitian tidak didapatkan adanya efek samping.Kesimpulan: Mirtogenol dapat mempertahankan ketebalan lapisan serabut saraf retina, dan MD lapang pandang pada pemberian Mirtogenol cenderung meningkat.

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ABSTRACTObjective: To evaluate the effect of Mirtogenol towards the changes in retinal nerve fiber layer (RNFL) thickness and visual field in patients with primary open angle glaucoma (POAG) with controlled IOP.Methods: This is a prospective, double blind, randomized study. Forty one POAG patients with IOP ≤ 18 mmHg were randomly assigned to receive either Mirtogenol or placebo. Changes in RNFL thickness and mean deviation of visual fields were evaluated before the treatment, as well as 4 weeks and 8 weeks after the treatment. Patients were asked for any side effects during the treatment period.Results: The average RNFL thickness in the Mirtogenol group decreased 0.70±1.63 μm from 87.29±19.39 μm before the treatment to 86.58±19.43 μm after 8 weeks of treatment, however the change was not significant (p=0.121). The average RNFL thickness in the placebo group decreased -1.74±1.79 μm from 97.14±17.19 μm before the treatment to 95.40±18.56 μm after 8 weeks of treatment, the change was statistically significant (p< 0.001). The average MD of visual field in the Mirtogenol group increased 0.542±1.93 dB after 8 weeks oftreatment while the MD of visual field in the placebo group decreased 0.083 ± 1.36 dB after 8 weeks of treatment. Hoewever the changes in MD of visual field was not significant (p>0.05). No side effect was found throughout the study.Conclusions: Mirtogenol seemed to maintain retinal nerve fiber layer thickness and increased mean deviation of visual fields.;Objective: To evaluate the effect of Mirtogenol towards the changes in retinalnerve fiber layer (RNFL) thickness and visual field in patients with primary openangle glaucoma (POAG) with controlled IOP.Methods: This is a prospective, double blind, randomized study. Forty onePOAG patients with IOP ≤ 18 mmHg were randomly assigned to receive eitherMirtogenol or placebo. Changes in RNFL thickness and mean deviation of visualfields were evaluated before the treatment, as well as 4 weeks and 8 weeks afterthe treatment. Patients were asked for any side effects during the treatment period.Results: The average RNFL thickness in the Mirtogenol group decreased 0.70±1.63μmfrom87.29±19.39μmbeforethetreatmentto86.58±19.43μmafter8weeks of treatment, however the change was not significant (p=0.121). Theaverage RNFL thickness in the placebo group decreased -1.74±1.79 μm from97.14±17.19 μm before the treatment to 95.40±18.56 μm after 8 weeks oftreatment, the change was statistically significant (p< 0.001). The average MD ofvisual field in the Mirtogenol group increased 0.542±1.93 dB after 8 weeks oftreatment while the MD of visual field in the placebo group decreased 0.083±1.36dBafter8weeksoftreatment.HoeweverthechangesinMDofvisualfieldwasnotsignificant(p>0.05).Noside effectwasfound throughoutthestudy.Conclusions: Mirtogenol seemed to maintain retinal nerve fiber layer thickness and increased mean deviation of visual fields., Objective: To evaluate the effect of Mirtogenol towards the changes in retinalnerve fiber layer (RNFL) thickness and visual field in patients with primary openangle glaucoma (POAG) with controlled IOP.Methods: This is a prospective, double blind, randomized study. Forty onePOAG patients with IOP ≤ 18 mmHg were randomly assigned to receive eitherMirtogenol or placebo. Changes in RNFL thickness and mean deviation of visualfields were evaluated before the treatment, as well as 4 weeks and 8 weeks afterthe treatment. Patients were asked for any side effects during the treatment period.Results: The average RNFL thickness in the Mirtogenol group decreased 0.70±1.63μmfrom87.29±19.39μmbeforethetreatmentto86.58±19.43μmafter8weeks of treatment, however the change was not significant (p=0.121). Theaverage RNFL thickness in the placebo group decreased -1.74±1.79 μm from97.14±17.19 μm before the treatment to 95.40±18.56 μm after 8 weeks oftreatment, the change was statistically significant (p< 0.001). The average MD ofvisual field in the Mirtogenol group increased 0.542±1.93 dB after 8 weeks oftreatment while the MD of visual field in the placebo group decreased 0.083±1.36dBafter8weeksoftreatment.HoeweverthechangesinMDofvisualfieldwasnotsignificant(p>0.05).Noside effectwasfound throughoutthestudy.Conclusions: Mirtogenol seemed to maintain retinal nerve fiber layer thickness and increased mean deviation of visual fields.]"

"ABSTRAK Latar belakang Glaukoma masih merupakan salah satu penyebab kebutaan terbesar di dunia. Belakangan ini, ketebalan RFNL dan GCIPL diketahui memilikihubungan terhadap perubahan struktural yang disebabkan oleh glaukoma. Tujuan untuk mengkaji kemampuan diagnostik dari pengukuran ketebalan RFNLdan GCIPL dalam mendeteksi glaukoma pada tahap awal.Metode Enam puluh empat mata dengan sudut bilik mata sempit (32 glaukoma,32 non-glaukoma) dari 48 pasien menjalani pengukuran menggunakan CirrusOCT dengan protokol 3,4 mm pemindaian cepat RFNL peripapilar. Pengukurandilakukan pada sisi superior, inferior, nasal, temporal dari GCIPL dan RFNL,begitu juga dengan GCIPL superotemporal, superonasal, inferotemporal,inferonasal, dan minimal. Hasil Semua parameter yang diuji pada studi ini menunjukkan angka yang lebihrendah pada kelompok PACG dibandingkan kelompok PAC. Rerata ketebalanRFNL dan ketebalan GCIPL inferotemporal masing-masing memiliki nilaispesifitias dan sensitifitas yang paling baik. Parameter dengan determinan terbaikadalah ketebalan GCIPL inferotemporal dengan sensitifitas dan spesifitas masingmasing75%dan75%.KesimpulanKetebalan GCIPL dan RFNL peripapil memiliki potensi besarsebagai parameter diagnostik seperti skrining dan evaluasi respon terapi.ABSTRACT Background Glaucoma remains one of the biggest causes of blindnessworldwide. Recently, RFNL and GCIPL thickness were shown to be correlatedwith early structural changes caused by glaucoma. Objective to evaluate the diagnostic performance of RFNL and GCIPL thicknessmeasurement in detecting early glaucoma Method Sixty-four eyes with primary angle closure (32 glaucomatous, 32 nonglaucomatous)of48patients underwent peripapillar scanning using Cirrus OCTusing 3,4 mm protocol fast RNFL peripapillary thickness scan. The measurementincludes superior, inferior, nasal, temporal, mean GCIPL and RFNL, as well assuperotemporal, superonasal, inferotemporal, inferonasal, minimal GCIPL. Result All parameters studied were significantly thinner in PACG groupcompared to PAC group. Mean RFNL thickness and inferotemporal GCIPL hasthe highest specificity and sensitivity, respectively, in detecting glaucoma.Parameter with the best determinant is inferotemporal GCIPL thickness withsensitivity and specificity, 75% and 71.9%, respectively. Conclusion Peripapillary RFNL and GCIPL could be a potential diagnosticparameter in detecting early glaucoma and monitoring therapy response inglaucoma patients. ;Background Glaucoma remains one of the biggest causes of blindnessworldwide. Recently, RFNL and GCIPL thickness were shown to be correlatedwith early structural changes caused by glaucoma. Objective to evaluate the diagnostic performance of RFNL and GCIPL thicknessmeasurement in detecting early glaucoma Method Sixty-four eyes with primary angle closure (32 glaucomatous, 32 nonglaucomatous)of48patients underwent peripapillar scanning using Cirrus OCTusing 3,4 mm protocol fast RNFL peripapillary thickness scan. The measurementincludes superior, inferior, nasal, temporal, mean GCIPL and RFNL, as well assuperotemporal, superonasal, inferotemporal, inferonasal, minimal GCIPL. Result All parameters studied were significantly thinner in PACG groupcompared to PAC group. Mean RFNL thickness and inferotemporal GCIPL hasthe highest specificity and sensitivity, respectively, in detecting glaucoma.Parameter with the best determinant is inferotemporal GCIPL thickness withsensitivity and specificity, 75% and 71.9%, respectively. Conclusion Peripapillary RFNL and GCIPL could be a potential diagnosticparameter in detecting early glaucoma and monitoring therapy response inglaucoma patients. ;Background Glaucoma remains one of the biggest causes of blindnessworldwide. Recently, RFNL and GCIPL thickness were shown to be correlatedwith early structural changes caused by glaucoma. Objective to evaluate the diagnostic performance of RFNL and GCIPL thicknessmeasurement in detecting early glaucoma Method Sixty-four eyes with primary angle closure (32 glaucomatous, 32 nonglaucomatous)of48patients underwent peripapillar scanning using Cirrus OCTusing 3,4 mm protocol fast RNFL peripapillary thickness scan. The measurementincludes superior, inferior, nasal, temporal, mean GCIPL and RFNL, as well assuperotemporal, superonasal, inferotemporal, inferonasal, minimal GCIPL. Result All parameters studied were significantly thinner in PACG groupcompared to PAC group. Mean RFNL thickness and inferotemporal GCIPL hasthe highest specificity and sensitivity, respectively, in detecting glaucoma.Parameter with the best determinant is inferotemporal GCIPL thickness withsensitivity and specificity, 75% and 71.9%, respectively. Conclusion Peripapillary RFNL and GCIPL could be a potential diagnosticparameter in detecting early glaucoma and monitoring therapy response inglaucoma patients. "

"Perkembangan terapi adjuvan pada glaukoma untuk memperlambat progresi glaukoma saat ini terus dieksplorasi. Penelitian ini mengevaluasi efek Mirtogenol, pada perubahan perfusi okular (perfusi kapiler dan flux index), ketebalan lapisan serabut saraf retina (LSSR), dan tekanan intraokular (TIO) pada pasien glaukoma primer sudut terbuka (GPSTa) yang menerima terapi timolol maleat 0,5% tetes mata. Penelitian ini merupakan uji klinis acak terkontrol tersamar ganda. Terdapat 36 subjek (37 mata) dengan GPSTa dan TIO < 21 mmHg yang diacak untuk mendapatkan Mirtogenol atau plasebo selama 8 minggu. Kedua grup dibandingkan, pada kelompok Mirtogenol, rata-rata peningkatan perfusi kapiler dan flux index lebih baik, dan pada kuadran superior terdapat hasil yang signifikan secara statistik setelah 4 minggu (p=0.018). Rerata perbedaan ketebalan LSSR di seluruh kuadran terdapat penurunan dengan nilai yang lebih sedikit pada kelompok Mirtogenol (p>0.05). Penurunan TIO yang konsisten pada kelompok Mirtogenol setelah 8 minggu (p>0.05). Ditemukan efek samping pada 1 subjek yaitu gangguan lambung. Suplementasi Mirtogenol, sebagai terapi adjuvan pada pengobatan glaukoma dapat meningkatkan perfusi okular, mempertahankan ketebalan LSSR, dan menurunkan TIO.

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The development of adjuvant therapies in glaucoma to slow its progression is currently being explored. This study evaluates the effects of Mirtogenol on changes in ocular perfusion (capillary perfusion and flux index), retinal nerve fiber layer (RNFL) thickness, and intraocular pressure (IOP) in primary open-angle glaucoma (POAG) patients receiving 0.5% timolol maleate eye drops. This study is a double-blind, randomized controlled clinical trial. There were 36 subjects (37 eyes) with POAG and IOP < 21 mmHg randomized to receive Mirtogenol or placebo for 8 weeks. Compared between the two groups, the Mirtogenol group showed a better average improvement in capillary perfusion and flux index, with statistically significant results in the superior quadrant after 4 weeks (p=0.018). The mean difference in RNFL thickness across all quadrants showed a smaller reduction in the Mirtogenol group (p>0.05). There was a consistent decrease in IOP in the Mirtogenol group after 8 weeks (p>0.05). One subject experienced side effects, specifically stomach disturbances. Mirtogenol supplementation, as an adjuvant therapy in glaucoma treatment, can improve ocular perfusion, maintain RNFL thickness, and reduce IOP."

"Terdapat banyak laporan mengenai biaya-efektifitas di bidang ilmu penyakit mata, tetapi laporan biaya-efektifitas vitrektomi antara bius lokal dibandingkan bius umum belum ditemukan di literatur nasional/internasional. Penelitian ini bermanfaat untuk pengambil kebijakan, penyedia jasa kesehatan dan asuransi. Untuk menjawab hal ini, peneliti melakukan penelitian kohort retrospektif di dua rumah sakit dengan jumlah 100 sampel yang memenuhi kriteria inklusi dan eksklusi. Efektifitas dihitung sebagai perbaikan tajam 2 skala logMAR atau lebih, dan biaya dihitung berdasarkan data yang diperoleh dari wawancara dan dikonfirmasi dengan surat keterangan yang berwenang. Hasil yang diperoleh adalah dibutuhkan biaya sebesar Rp. 23.959.000,- untuk mencapai efektifitas operasi (Perbaikan) sebesar 32% dengan bius umum. Sebesar Rp. 15.950.200,- diperlukan untuk mencapai efektifitas operasi (Perbaikan) sebesar 80 % dengan bius lokal. Interpretasi data ini butuh kehatian-hatian, juga untuk diterapkan secara umum (extrapolation). Penghematan biaya yang terjadi adalah sebesar 50,21% dengan bius lokal dibandingkan bius umum. Faktor yang berpengaruh secara multivariat terhadap perbaikan setelah operasi dan biaya adalah lamanya retina lepas (RR 1.85) bila lepas < 4 minggu, dan bius lokal (RR 2.58). Waktu tunggu (antara pertama kali berobat hingga dioperasi) lebih singkat di bius lokal (p 0.00) dan tindakan membrane peeling lebih banyak di bius lokal (p 0.00) merupakan dua hal yang berbeda bermakna. Dapat disimpulkan bahwa operasi vitrektomi untuk retina lepas dapat dilakukan dengan bius lokal dengan efektifitas lebih baik dan biaya lebih sedikit.

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There were reports on cost-effectiveness in ophthalmology, but so far none of report on cost-effectiveness of vitrectomy between local and general anesthesia for rhegmatogenous retinal detachment, either in national or international journal. Meanwhile, this report is beneficial for health policy decision maker, health provider and insurance. To answer this limitation, we conduct retrospective cohort study in two hospitals with 100 subjects that fulfill inclusion and exclusion criteria. Effectiveness was visual acuity improvement in two or more logMAR scale after vitrectomy, and units cost data were given by both hospitals. The amount of Rp. 23.959.000,- was needed to achieve effectiveness 32% in general anesthesia. The amount of Rp. 15.950.200,- was needed to achieve effectiveness 80% in local anesthesia. These data interpretation and extrapolation should be done cautiously. There is cost-minimization 50,12% when doing vitrectomy under local versus general anesthesia. Multivariate analysis of effectiveness and cost showed that variables of detachment duration if less than 4 weeks (RR 1.85) and of local anesthesia (RR 2.58) were contributing for better surgical outcome. Shorter waiting time (time needed for surgery after diagnosed), and more membrane peeling done in local anesthesia group were different variabels (p 0.00) between two groups significantly. As conclusion, vitrectomy for rhegmatogenous retinal detachment can be done under local anesthesia with higher effectiveness and lower cost."