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"[ABSTRAKTujuan : Mengevaluasi ada tidaknya perbedaan kualitas air mata pada penderita glaukoma yangmengalami mata kering antara yang diberi tetes mata sodium hialuronat 0,1% mengandung bahanpengawet benzalkonium klorida dan tetes mata sodium hialuronat 0,1% tanpa bahan pengawet.Metode : Penelitian ini merupakan penelitian prospektif terandomisasi. 30 pasien glaukoma yangmengalami mata kering dirandomisasi ke dalam kedua kelompok. Kelompokpertama,mendapatkan obat tetes mata artificial tear mengandung sodium hialuronat 0,1% denganpengawet benzalkonium klorida, sedangkan kelompok II, mendapatkan obat tetes mata artificialtear mengandung sodium hialuronat 0,1% tanpa pengawet selama 1 bulan. Pemeriksaan Schirmertest, TFBUT, OPI, dan sitologi impresi dilakukan pada kedua kelompok baik sebelum dan sesudah1 bulan penetesan obat tetes mata artificial tear.Results: Nilai median sitologi impresi sel goblet pasca penetesan artificial tear meningkat padakelompok I (118,15-485) dan kelompok II (67.0-200), namun secara statistik tidak ada perbedaanbermakna. Nilai rata ? rata TFBUT pasca penetesan pada kelompok I (14,45±7,85) dan kelompokII (13,91±7,46) meningkat dibandingkan sebelum penetesan, serta secara statitstik memilikiperbedaan yang bermakna. Nilai Schirmer test dan OPI pasca penetesan pada kedua kelompokmengalami peningkatan secara klinis dibandingkan sebelum penetesan, namun tidak terdapatperbedaan bermakna secara statistik.Conclusions : Pemberian artificial tear mengandung sodium hialuronat 0,1% baik denganpengawet maupun tanpa pengawet selama 1 bulan memberikan peningkatan Schirmer test,TFBUT,OPI dan sitologi impresi sel goblet.

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ABSTRACTObjectives: To evaluate the difference of quality of tears between glaucoma patients sufferingfrom dry eyes treated with 0.1% sodium hyaluronat eyedrops with preservativebenzalconiumchloride and those treated with 0.1% sodium hyaluronat eyedrops withoutpreservative.Methods: This is a randomized prospective study. Subjects were 30 glaucoma patients sufferingfrom dry eyes, whom later randomized into two groups. Group I was treated with artificial tearseye drops, which contained 0.1% sodium hyaluronat and benzalconium chloride preservative,whereas Group II was treated with artificial tears eye drops, which contained 0.1% sodiumhyaluronat without preservative for one-month duration. Before and after the treatment withartificial tears eyedrops, subjects of both groups were tested with Schirmer test, TFBUT, OPI, andimpression cytology.Results: The median of goblet cells in impression cytology after treatment with artificial tears eyedrops increased in group I (118, 15 ? 485) and group II (67, 0 ? 200), even though not statisticallysignificant. Mean TFBUT after treatment was also higher in Group I (14.45±7.85) and Group II(13.91±7.46), yet not statistically significant. Schirmer test and OPI results after treatment showeda clinical improvement in both groups, however no statistic result was found to be significant.Conclusions: Treatment with artifical tears eye drops containing 0.1% sodium hyaluronat with orwithout preservative for one month will improve Schirmer test, TFBUT, OPI, and goblet cellsimpressions cytology result on glaucoma patients suffering from dry eyes.;Objectives: To evaluate the difference of quality of tears between glaucoma patients sufferingfrom dry eyes treated with 0.1% sodium hyaluronat eyedrops with preservativebenzalconiumchloride and those treated with 0.1% sodium hyaluronat eyedrops withoutpreservative.Methods: This is a randomized prospective study. Subjects were 30 glaucoma patients sufferingfrom dry eyes, whom later randomized into two groups. Group I was treated with artificial tearseye drops, which contained 0.1% sodium hyaluronat and benzalconium chloride preservative,whereas Group II was treated with artificial tears eye drops, which contained 0.1% sodiumhyaluronat without preservative for one-month duration. Before and after the treatment withartificial tears eyedrops, subjects of both groups were tested with Schirmer test, TFBUT, OPI, andimpression cytology.Results: The median of goblet cells in impression cytology after treatment with artificial tears eyedrops increased in group I (118, 15 – 485) and group II (67, 0 – 200), even though not statisticallysignificant. Mean TFBUT after treatment was also higher in Group I (14.45±7.85) and Group II(13.91±7.46), yet not statistically significant. Schirmer test and OPI results after treatment showeda clinical improvement in both groups, however no statistic result was found to be significant.Conclusions: Treatment with artifical tears eye drops containing 0.1% sodium hyaluronat with orwithout preservative for one month will improve Schirmer test, TFBUT, OPI, and goblet cellsimpressions cytology result on glaucoma patients suffering from dry eyes., Objectives: To evaluate the difference of quality of tears between glaucoma patients sufferingfrom dry eyes treated with 0.1% sodium hyaluronat eyedrops with preservativebenzalconiumchloride and those treated with 0.1% sodium hyaluronat eyedrops withoutpreservative.Methods: This is a randomized prospective study. Subjects were 30 glaucoma patients sufferingfrom dry eyes, whom later randomized into two groups. Group I was treated with artificial tearseye drops, which contained 0.1% sodium hyaluronat and benzalconium chloride preservative,whereas Group II was treated with artificial tears eye drops, which contained 0.1% sodiumhyaluronat without preservative for one-month duration. Before and after the treatment withartificial tears eyedrops, subjects of both groups were tested with Schirmer test, TFBUT, OPI, andimpression cytology.Results: The median of goblet cells in impression cytology after treatment with artificial tears eyedrops increased in group I (118, 15 – 485) and group II (67, 0 – 200), even though not statisticallysignificant. Mean TFBUT after treatment was also higher in Group I (14.45±7.85) and Group II(13.91±7.46), yet not statistically significant. Schirmer test and OPI results after treatment showeda clinical improvement in both groups, however no statistic result was found to be significant.Conclusions: Treatment with artifical tears eye drops containing 0.1% sodium hyaluronat with orwithout preservative for one month will improve Schirmer test, TFBUT, OPI, and goblet cellsimpressions cytology result on glaucoma patients suffering from dry eyes.]"

"Tujuan:Membandingkan perubahan,nilai puncak dan rata-rata tekanan intra okular (TIO) pada pasien glaukoma primer sudut terbuka (GPSTa) yang terkontrol menggunakan travoprost 0,004 %dengantimolol hydrogel 0,1% padauji provokes iminum air. Metode: ujieksperimental tersamar tunggal pada 42 pasien GPSTa yang dibagi secara acak menjadi dua kelompok. Kelompok yang mendapatkan pengobatan dengan Travoprost 0,004% dengan frekuensi sekali/hari, selanjutnya dibandingkan dengan yang mendapatkan Timolol hydrogel 0,1% sekali/hari. Pemeriksaan TIO dilakukan pada evaluasi minggu ke-empat pasca terapi, meliputi TIO baseline sebelum uji provokasi minum air, TIO menit ke-15, 30, 45, 60, 75, 90, 105, dan 120 pasca uji provokasi minum air. Hasil:Setelah terapi selama empat minggu, TIO baseline sebelum uji provokasi minum air tidak berbeda bermakna antara kelompok travoprost 0,004% dibandingkan dengan timolol hydrogel 0,1% (p=0,28; uji T tidak berpasangan). Nilai TIO minimal dan maksimal pasca uji provokasi minum air secara signifikan lebih rendah pada kelompok travoprost 0,004% dibandingkan dengan timolol hydrogel 0,1% (p=0,04; p=0,01, uji T tidak berpasangan). Nilai mean TIO pada kelompok travoprost juga didapatkan lebih rendah dibandingkan dengan timolol hydrogel 0,1% (p=0,02, uji T tidak berpasangan). Tidak didapatkan perbedaan bermakna antara fluktuasi TIO kelompok travoprost 0,004% dengan timolol hydrogel 0,1% (p=0,15, uji Mann Whitney). Kesimpulan: Travoprost 0,004% lebihbaikdalammempertahankanTIO dibandingkan dengan Timolol Hydrogel 0,1% pada uji Provokasi Minum Air.

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Objective: To evaluate the intraocular pressure (IOP) profile after water drinking test (WDT) in primary open angle glaucoma (POAG) patients who had already treated with travoprost 0,004% eye drop versus timolol hydrogel 0,1%.

Methods: A single-blind experimental study. Fourty two POAG patients were randomly assigned to receive travoprost 0,004% once daily or timolol hydrogel 0,1% once daily. The IOP profiles were evaluated 4-weeks after treatment, including baseline IOP before WDT, IOP 15-, 30-, 45-, 60-, 75-, 90-, 105-, and 120-minutes after WDT.

Results: At 4-week after treatment, travoprost 0,004% and timolol hydrogel 0,1% had equivalent effect on baseline IOP (p=0,28; unpaired t-test). Minimum and maximum IOP after WDT of travoprost 0,004% group were significantly less than timolol hydrogel 0,1% group (p=0,04; p=0,01; unpaired t-test, respectively). Mean IOP of travoprost 0,004% group was lower than hydrogel 0,1% group as well (p=0,02; unpaired t-test). The IOP fluctuation was not different between two groups (p=0,15; Mann Whitney test).

Conclusion: This study suggests that travoprost 0,004% was more likely to maintain IOP after WDT compared to timolol hydrogel 0,1% treatment."

"ABSTRACTTujuan: Menilai keamanan injeksi intrakamera levofloksasin 0,5 sediaan tetes mata dosis tunggal 0,6 mL steril tanpa pengawet pada hewan coba kelinci. Desain: Penelitian ini merupakan uji eksperimental dengan desain paralel, acak, tersamar terhadap hewan coba kelinci albino New Zealand White . Metode: Dua puluh empat mata dari dua belas ekor kelinci dibagi kedalam ketiga kelompok, kelompok pertama LFX mendapat perlakuan injeksi intrakamera levofloksasin 0,5 sediaan tetes mata dosis tunggal steril tanpa pengawet 0,6 mL n = 6 , kelompok kedua CRAV mendapat injeksi intrakamera levofloksasin 0,5 sediaan tetes mata botol 5 mL n = 6 dan kelompok ketiga BSS mendapat balanced salt solution intrakamera sebagai kontrol n = 12 . Hasil: Skor klinis pada hari 1, 3, 5, dan 7 tidak menunjukkan adanya perbedaan antara ketiga kelompok. Perubahan klinis maksimal yang ditemukan berupa kekeruhan kornea ringan serta sel dan flare ringan dalam bilik mata depan. Pemeriksaan histopatologi tidak menunjukkan adanya perbedaan statistik kelainan akibat efek toksik yang signifikan pada semua kelompok. Vakuolisasi endotel ditemukan pada semua kelompok sehingga tidak signifikan sebagai perubahan akibat efek toksik. Kesimpulan: Injeksi intrakamera 0,1 mL levofloksasin 0,5 dalam sediaan tetes mata dosis tunggal 0,6 mL steril tanpa pengawet memiliki keamanan yang sama dengan sediaan tetes mata botol 5 mL tanpa pengawet pada mata hewan coba kelinci dalam hal perubahan klinis dan histopatologis."

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""ABSTRACT"Purpose To evaluate the safety of intracameral injection of levofloxacin 0,5 eye drop single dose 0,6 mL preservative free LFX on rabbit eye. Methods This was an experimental, pararel, and randomized study. Twenty four eyes of twelve New Zealand White rabbit were divided to three groups. First group LFX were treated with 0,1 mL intracameral injection levofloxacin 0,5 eye drop single dose 0,6 mL preservative free n 6 , second group CRAV were treated with 0,1 mL intracameral levofloxacin 0.5 eye drop bottle 5 mL preservative free n 6 , and third group BSS were treated with 0,1 mL intracameral injection balanced salt solution n 12 . The clinical evaluation was performed on day 1st, 3rd, 5th and 7th. Each eye was enucleated on day 7th and underwent histopathology examination. Results The clinical scores among three groups did not show any significant difference on day 1st, 2nd, 3rd, and 7th p 0.05 . Mild corneal opacity, mild cells and flares in anterior chamber were the only noted in clinical scores. Histopathology score demonstrated no statistically significant difference between three groups p 0.05 . Vacuolization of corneal endothelial cells were notes in all groups, but not statistically significant.Conclusion Intracameral injection of levofloxacin 0.5 eye drop single dose 0.6 mL preservative free was safe to rabbit eye, in clinical and histopathology scores, similar with levofloxacin 0.5 eye drop bottle 5 mL preservative free"

"ABSTRAKPenelitian ini merupakan uji klinis acak tersamar tunggal yang bertujuanmembandingkan TIO antara terapi timolol hydrogel 0,1% (®Cendo Timol hydrogel*)satu kali sehari dengan timolol tetes 0,5% (®Cendo Timol ED*) dua kali sehari padapada glaukoma primer kronis terkontrol. Sebanyak 45 pasien dibagi secara acakmenjadi 2 kelompok. Dilakukan pemeriksaan TIO diurnal menggunakan applanasiGoldmann pada minggu keempat (pk.07.00±2 jam) dan minggu kedelapan(pk.12.00±2 jam dan pk.17.00±2 jam). Hasil penelitian ini mendapatkan timololhydrogel 0,1% satu kali sehari mempunyai kemampuan mempertahankan TIO setaradengan timolol tetes 0,5% dua kali sehari.

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ABSTRACTThis was a prospective, single blind randomized clinical trial. The purpose of thisstudy was to compare IOP between the use of timolol hydrogel 0,1% (®Cendo Timolhydrogel*) once daily and timolol solution 0,5% (®Cendo Timol ED*) two timesdaily on controlled chronic primary glaucoma. Forty five patients divided randomlyinto two groups. Diurnal IOP measurement was followed using Goldmannapplanation at the fourth week (07.00 AM ± 2 hours) and the eighth week (12.00noon ± 2 hours and 05.00 PM ± 2 hours). The result of this study was timololhydrogel 0,1% once daily have the ability to maintain IOP equal to timolol eyedrop0,5% twice daily."

"Latar Belakang : Pasien Non-Proliferative Diabetic Retinopathy (NPDR), Proliferative Diabetic Retinopathy (PDR) dengan neuropati kornea akan mengalami terganggunya stabilitas air mata. Penurunan sekresi dan konsituen air mata akan menyebabkan gangguan berupa mata kering. Pada pasien Diabetes dengan retinopati diabetik, gangguan kornea ini berpotensi lebih memperburuk gangguan penglihatan yang terjadi. Tujuan : Menilai stabilitas air mata pada pasien NPDR, PDR dengan neuropati kornea sebelum, sesudah diberikan tetes mata Sodium hyaluronat+Vitamin A,E (HA+Vit A,E) atau Sodium Hyaluronat saja (HA). Metodologi : Penelitian ini merupakan uji eksperimental randomisasi acak terkontrol, dengan dua kelompok utama (NPDR, PDR), kedua kelompok mendapatkan tetes mata HA+Vit A,E atau HA selama 28 hari. Sensitivitas kornea, Skoring Ocular Surface Disease Index (OSDI), Non-Invasive Break Up Time (NIBUT), Schirmer I, jumlah sel goblet konjungtiva dinilai pada 0, 2, 4 minggu. Hasil : 96 subyek berpartisipasi, 65.6% wanita, 34.4% laki-laki (rerata usia 54.4 tahun). Skor OSDI memperlihatkan perbaikan signifikan, nilai terbesar pada kelompok PDR HA+Vit A,E dengan -4.86±5.76 (P= 0.000), NIBUT memperlihatkan perbaikan signifikan, nilai terbesar pada kelompok NPDR HA dengan 4.79±2.63 (P= 0.000), Schirmer I memperlihatkan perbaikan signifikan, hasil terbesar pada kelompok NPDR HA dengan 2.41±2.35 (P= 0.000). Sitologi impressi konjungtiva memperlihatkan perbaikan signifikan, terutama pada kelompok NPDR HA+Vit A,E (66% perbaikan). Seluruh kelompok memperlihatkan perbaikan signifikan, tetapi perbaikan antar kelompok tidak bermakna. Kesimpulan : Parameter seluruh kelompok memperlihatkan perbaikan yang signifikan setelah diberikan tetes mata HA+Vit A,E maupun HA saja, Tetapi jika dibandingkan antar kelompok, tidak terdapat perbedaan perbaikan yang signifikan.

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Background : Patient with Non-Proliferative Diabetic Retinopathy (NPDR), Proliferative Diabetic Retinopathy (PDR) with corneal neuropathy will experiencing disruption in tear film stability. Decrease in tear film secretion and constituent will cause dry eyes. In Diabetic patients with diabetic retinopathy, this corneal disorder has the potential to further worsen visual impairment.

Purpose : To Assess tear film stability in NPDR, PDR patients with corneal neuropathy before, after treatment with topical Sodium hyaluronat+Vitamin A,E (HA+Vit A,E) or Sodium Hyaluronat only (HA).

Method : This study was a double blind experimental randomized control trial with two parallel groups (NPDR, PDR), both group receives HA+Vit A,E or HA for 28 days. Corneal sensitivity, Ocular Surface Disease Index (OSDI), Non-Invasive Break Up Time (NIBUT), Schirmer I, conjungtival goblet cells will be assessed on 0, 2, 4 weeks.

Result : 96 subjects participated, 65.6% female, 34.4% male, mean age 54.4 years old. OSDI score shows significant improvement, highest improvement seen on PDR HA+Vit A,E with -4.86±5.76 (P= 0.000), NIBUT hows significant improvement, highest improvement seen on NPDR HA with 4.79±2.63 (P= 0.000), Schirmer I shows significant improvement, highest improvement seen on NPDR HA with 2.41±2.35 (P= 0.000). Conjungtival goblet cells shows significant improvement, highest improvement seen on NPDR HA+Vit A,E (66% improved). All groups shows shows significant improvement, but between groups the improvement was not statistically significant.

Conclusion : Parameters on all groups shows statistically significant improvement after topical HA+Vit A,E or HA. But, if compared between groups, the improvement was not significantly differed."

"Glaukoma adalah penyebab kebutaan yang ireversibel dengan prevalensi yang kian meningkat. Sebagian besar penderita glaukoma juga mengalami mata kering. Mata kering merupakan efek samping tersering akibat obat tetes mata topikal berpengawet benzalkonium klorida pada penderita glaukoma. Selain itu, glaukoma dan mata kering memiliki faktor risiko yang sama, yaitu usia lanjut dan jenis kelamin wanita. Mata kering pada penderita glaukoma perlu ditangani segera karena menyebabkan ketidaknyamanan, mengurangi kepatuhan berobat, dan menurunkan tingkat keberhasilan terapi. Penanganan mata kering pada penderita glaukoma dapat dilakukan melalui penggunaan obat tanpa pengawet benzalkonium klorida, kombinasi dengan obat yang tidak mengandung pengawet untuk mengurangi paparan, pemberian air mata buatan, dan pembedahan untuk mengurangi kebutuhan obat anti glaukoma topikal.

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Glaucoma is a common cause of irreversible blindness with increasing prevalence. Some of glaucoma patients will also experience dry eye. Dry eye is the most frequent side effects related to benzalkonium chloride (BAC)-containing eye drop used for glaucoma patients. In addition, glaucoma and dry eye have shared risk factors that are old age and female. Dry eye among glaucoma patients needs to be treated promptly as it produces discomfort, reduces patients? compliance and decreases success rate of glaucoma therapy. Dry eye symptoms can be treated by applying preservative-free eye drop, giving combination with preservative-free eye drop to reduce BAC exposure, prescribing artificial tear and conducting surgery to minimize or eliminate the need of topical medication."

"[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.]"

"Kebutaan, penurunan fungsi penglihatan dan kesakitan mata telah dinyatakan sebagai masalah kesehatan masyarakat yang penting di wilayah Asia Tenggara (WHO). Berdasarkan WHO maka diperkirakan terdapat 12 juta kebutaan dan 60 juta penurunan penglihatan di Asia Tenggara. Di Indonesia sendiri berdasarkan survai morbiditas mata dan kebutaan tahun 1982 yang dikelola oleh Direktorat Jendral Pembinaan Kesehatan Masyarakat Departemen Kesehatan RI menyatakan bahwa prevalensi kebutaan di Indonesia berkisar 1,2% dari jumlah penduduk Indonesia. Dari angka tersebut prosentase penyebab kebutaan utama ialah :- katarak 0.70%- kelainan kornea 0.13% - penyakit glaukoma 0.10%- kelainan refraksi 0.06%- kelainan retina 0.03%- kelainan nutrisi 0.02%Banyak macam cara pengobatan penyakit glaukoma baik secara obat-obatan maupun secara operasi. Cara operasi bisa dilakukan dengan membuka aliran akuos dari bilik mata depan ke celah sub konjungtiva pada mata taripa blok pupil, untuk membentuk pengaliran cairan akuos, atau dengan mengurangi pembentukan cairan akuos di badan siliar(3,4,5).Dari pengalaman klinis dapat terjadi suatu keadaan glaukoma yang berat misalnya glaukoma refrakter atau glaukoma absolut, glaukoma hemaragik atau glaukoma neovaskular, dimana tindakan operasi kurang berhasil. Pada keadaan diatas perlu dipikirkan cara pengobatan yang lebih efektif lain untuk menurunkan tekanan intra okular. Di Rumah Sakit Dr.Cipto Mangunkusumo, pada glaukoma neovaskular dilakukan tindakan transkleral kriokoagulasi dan transkleral diatermi dengan tujuan mengurangi keadaan iskemia retina/koroid, untuk menurunkan tekanan intra okular.Sikatrik korioretina terjadi karena kerusakan epitel pigmen retina dan reseptor retina, terjadi penggabungan dari lapisan retina luar ke membrana Bruch, terjadi perubahan jaringan ikat korio-kapiler dan lapisan pembuluh darah koroid dalam, degenerasi dan disorganisasi dari retina sensoris dan sel-sel penyokong (6,8). Keadaan ini dapat terjadi akibat perubahan atau setelah tindakan krioterapi atau diatermi dari pada retina, baik pada perubahan penyakit retina maupun pada terapi glaukoma diatas.Pada suatu kelainan di retina , dapat di ikuti dengan penurunan tekanan intra okular (T.I.O.) yang moderat, pengurangan aliran humor akuos melalui bilik mata depan, suar ringan di akuos dan peningkatan kadar protein cairan subretinal. Ada 2 hipotesa kemungkinan terjadinya keadaan tersebut. Hipotesa pertama menyatakan bahwa kelainan retina akan menimbulkan inflamasi ringan sistem traktus uvea, disebabkan kegagalan sawar darah-akuos, disertai suar akuos & pengurangan produksi akuos, mengakibatkan peninggian protein cairan sub retinal. Hipotesa kedua mengatakan bahwa terjadi kegagalan ringan sawar darah akuos. Dan juga, produksi akuos tetap normal tetapi terjadi perubahan aliran dari bilik mata belakang kerongga badan kaca, melalui kelainan diretina dan melewati epitel pigmen retina.Aliran yang tidak lazim ini (misdirected/unconvention al route) dari humor akuos menyebabkan penurunan tekanan intra okular, dan membawa protein dari bilik mata belakang yang akan mengumpui di celah subretinal.Pembuktian adanya aliran cairan dari badan kaca ke celah retina ini terlihat pada percobaan binatang kera yang disuntikan cairan fluoresin iso tiosianat dextran. Disini terjadi kerusakan intregitas retina sensoris, yang diikuti pengaliran cairan badan kaca ke celah subretinal dan akan di absorpsi pembuluh darah koroid dan menimbulkan penurunan tekanan intra okular."