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Abstrak :
After diabetic retinopathy, the varieties of retinal vein occlusion constitute the most prevalent category of retinal vascular disease. For macular edema associated with central retinal vein occlusion (CRVO), no effective therapy existed until 2009, despite decades of research and failed pilot therapies. This comprehensive, illustrated text integrates recent advances in treatments with the parallel progress in understanding of disease mechanisms. Complete with case studies, this text is perfect for retina specialists, ophthalmologists, optometrists, and residents and fellows in these fields.

Abstrak :
The Sclera is the definitive text on the diagnosis and treatment of scleral diseases, with in-depth chapters on non-infectious scleritis, infectious sclertitis, non-inflammatory diseases of the sclera, and systemic implications of scleral disease. Basic physiology, anatomy, and biochemistry are addressed as well. Written for the ophthalmologist, the revised and updated new edition of The Sclera contains the most current information available on newer characterizations of the composition of the sclera, immune derangements of it, and success in medical and surgical treatment of the inflammatory diseases of the sclera.

Abstrak :
This book is designed with two overriding objectives, to help readers understand the impact of vision impairment in people living daily with diabetes rather than considering diabetic retinopathy solely as a medical problem, and to explore what we know and don't know about the ways diabetes affect the eye. With the plethora of new information being generated, there are still a series of fundamental questions that must be addressed if effective treatments for diabetic retinopathy are to be found and applied. Developed by a renowned group of authorities, Visual dysfunction in diabetes, the science of patient impairment and improvement offers responses and context for a range of questions, such as, do metabolic factors beyond glucose contribute to vision-threatening diabetic retinopathy? If so, how do these lead to vision impairment? Is diabetic retinopathy a response to systemic metabolic abnormalities or are there unique ocular problems related to insulin resistance? What is the relationship between the neural, vascular, and inflammatory abnormalities in diabetic retinopathy? Do they represent a pathological cascade induced sequentially or simultaneous responses to one or more metabolic perturbations? The authors note that if we do not address these types of questions, it is possible that the long process of developing new therapeutic

Abstrak :
Gonioscopy is a very important differential diagnostic tool that permits assessment of the anterior chamber angle and correct classification of glaucoma as a basis for specific treatment. This book clearly explains how to perform gonioscopy to best effect. The anatomy of the chamber angle is systematically described, and the impact of age, developmental disorders, and other pathologies on the chamber angle is explained. Particular attention is focused on primary and secondary open-angle and angle-closure glaucomas. In each case, the role of gonioscopy in evaluating the chamber angle is described with the help of many photographs and illustrations. The importance of knowledge of the chamber angle for laser treatment and surgery is fully explained, and the impact of medications is discussed.

Abstrak :
BAB I PENDAHULUAN

A. LATAR BELAKANG

Pengukuran tekanan bola mata merupakan hal yang panting pada pemeriksaan mata karena dapat dipakai untuk menilai salah satu parameter dinamika cairan akuos. Alat yang paling banyak dipakai mengukur tekananan bolamata pada saat ini adalah tonometer indentasi Schiotz dan tonometer aplanasi Goldmann (1).

Hasil pemeriksaan tonometri aplanasi Goldmann diakui paling teliti, hal ini disebabkan perubahan volume cairan akuos selama pemeriksaan sedikit sekali Yaitu ± 4,5 ul, sehingga dianggap hasil pemeriksaan tersebut tidak dipengaruhi oleh kekakuan
dinding bola mata (ocular rigidity) seperti halnya hasil pemeriksaan dengan tonometri indentasi Schiotz {2,3). Keadaan di atas menyebabkan tonometri aplanasi Goldmann menjadi rujukan dari pemeriksaan tonometri Schiotz. Sayangnya bila tidak digunakan dengan hati-hati dapat terjadi kerusakan epitel kornea akibat obat anestesi yang dipakai dan tersentuhnya kornea oleh alat tersebut. Dilaporkan bahwa pemeriksaan tonometer ini dapat pula menyebarkan infeksi seperti radang konjungtiva, hepatitis,
maupun penyakit AIDS melalui alat yang terkontaminasi (3).

Oleh karena itu kebutuhan terhadap alat yang dapat mengukur tekanan bola mata dengan teliti tanpa menyentuh kornea amat terasa. Baru pada tahun 1972 alat yang demikian diperkenalkan oleh Bernard Goldman yang disebutnya tonometer nonkontak (4). Pengukuran tekanan bola mata dilakukan dengan jalan meniupkan udara ke kornea, jadi tanpa menyentuhnya secara langsung. Penilaian tingginya tekanan bola mata dilakukan dengan mengamati pantulan cahaya dari kornea pada saat aplanasi terjadi, lalu diproses oleh komputer dan hasilnya disajikan dalam bentuk angka angka.

Penelitian di beberapa negara Barat memperlihatkan bahwa hasil pemeriksaan tonometri nonkontak tidak banyak berbeda secara bermakna dibandingkan tonometer aplanasi Goldmann pada tekanan bola mata yang normal (5). Akan tetapi penelitian pendahuluan yang dilakukan oleh Hitam (8) di Indonesia memperlihatkan keadaan yang sebaliknya. Dalam laporannya setelah memeriksa 20 penderita, ia menyatakan bahwa terdapat perbedaan yang bermakna dari kedua cara pemeriksaan di atas, walaupun yang dilakukannya bukan suatu pemeriksaan tersamar ganda yang selama ini dianggap blebih ideal. Perbedaan hasil yang didapat dari beberapa penelitian di luar negri dibandingkan penelitian pendahuluan yang dikerjakan Hitam di Indonesia, mendorong penulis untuk melanjutkan penelitian pendahuluan tersebut dengan jumlah sampel yang lebih banyak disertai pemeriksaan yang lebih baik yaitu dengan milakukannya secara tersamar ganda.

Pada tekanan bola mata yang lebih tinggi ketelitian tonometer nonkontak berkurang (5). Seperti halnya tonometer aplanasi Goldmann, tonometer nonkontak tidak dapat dilakukan pada keadaan kornea yang tidak normal, penderita dengan fiksasi yang jelek, serta penderita yang tidak dapat bekerjasama (4,5)?

Abstrak :
ABSTRAK
Latar Belakang: Banyaknya jumlah kasus ROP yang terlambat dirujuk ke RSCM-Kirana menunjukkan bahwa penanganan ROP di Indonesia masih merupakan tantangan. Keterlambatan diagnosis ROP yang ditemukan di RSCM tersebut dapat disebabkan oleh terbatasnya dokter mata ahli retina dan pediatric ophthalmologist (PO) dan kurangnya pengetahuan dokter mata umum dalam mendiagnosis ROP. Pengetahuan dan keterampilan mendiagnosis ROP merupakan salah satu mata ajar dalam program pendidikan dokter spesialis mata di FKUI. Data mengenai seberapa baik pengetahuan PPDS tersebut dalam mendiagnosis ROP belum tersedia. Tujuan: Mengevaluasi kemampuan PPDS mata dalam mendiagnosis ROP berdasarkan pembacaan hasil foto wide field digital retinal imaging (WFDRI) bayi prematur. Metode: Sebanyak 25 set foto WFDRI dibaca dan diinterpretasi oleh 15 subjek PPDS mata, dan digolongkan ke dalam 4 klasifikasi: tidak ada ROP, ROP ringan, ROP tipe 2, dan ROP yang memerlukan terapi. Pembacaan oleh subjek tersebut dihitung nilai kesesuaiannya (Kappa) terhadap pembacaan oleh 3 konsultan PO sebagai referensi, kemudian ditentukan tingkat kesesuaian berdasarkan penggolongan nilai Kappa. Tingkat kesesuaian yang diharapkan adalah ?sangat baik?, khusus untuk penentuan ROP perlu terapi, nilai Kappa yang diharapkan adalah 1,00. Hasil: Dalam penentuan adanya ROP, seluruh subjek memiliki tingkat kesesuaian ?sangat baik? (Kappa 1,00); dalam penentuan ROP ringan atau lebih berat, hanya 1 dari 15 subjek memiliki tingkat kesesuaian ?sangat baik?, 9 subjek memiliki kesesuaian ?baik?, dan 5 subjek memiliki kesesuian ?sedang? (Kappa 0,65+0,15); dalam penentuan ROP tipe 2 atau lebih berat, 10 dari 15 subjek memiliki tingkat kesesuaian ?sangat baik?, 3 subjek memiliki kesesuaian ?baik?, dan 2 subjek memiliki kesesuaian ?sedang? (Kappa 0,45-1,00); dalam penentuan ROP yang memerlukan terapi, hanya 7 dari 15 subjek yang memiliki nilai Kappa 1,00, namun 12 dari 15 subjek memiliki tingkat kesesuaian ?sangat baik?, dan 3 subjek memiliki kesesuaian ?baik? (Kappa 0,75-1,00). Dalam penentuan zona dan stadium, hanya sebagian kecil subjek yang memiliki tingkat kesesuaian ?sangat baik? (Kappa 0,35-0,81 dan 0,32-0,91); sedangkan dalam penentuan plus disease, hanya 6 dari 15 subjek yang memiliki nilai Kappa 1,00. Kesimpulan: Kemampuan PPDS mata dalam mendiagosis ROP belum seluruhnya mencapai target yang diharapkan. ABSTRACT
Background: Numerous late-stage ROP cases that referred to Cipto Mangunkusumo Hospital (Kirana) showed us that ROP management in Indonesia is still a challenge. The delayed management might be caused by limited number of vitreoretinal specialist or pediatric ophthalmologist, and inadequate diagnostic knowledge of ROP of the general ophthalmologists. In condition of limited number of vitreoretinal and pediatric ophthalmologists, the general ophthalmologists are suggested to be taking part in ROP screening program. In FKUI, ROP screening has been a part of residency training program, however, there was no available data of ROP diagnostic knowledge of the residents. Purpose: To measure agreement of image-based ROP diagnosis between ophthalmology residents and pediatric ophthalmologist. Methods: Twenty-five sets of retinal photographs of premature infants were interpreted by 15 ophthalmology residents and pediatric ophthalmologists, and classified into 4 categories: no ROP, mild ROP, type 2 ROP, and treatmentrequiring ROP. Agreements are measured for diagnosis classification, stage, zone, and plus disease detection. Level of agreement was measured based on Kappa value of each subjects. The expected level of agreement for each category was ?very good agreement?. For treatment-requiring ROP and plus disease, the expected Kappa value was 1.00. Results: For detection of no ROP, agreement of all subjects was ?very good? (Kappa 1,00); for detection of mild or worse ROP, only 1 of 15 subjects has ?very good agreement?, 9 of 15 subjects have ?good agreement?, and 5 subjects have ?moderate agreement? (Kappa 0,65+0,15); for detection of type 2 or worse ROP, 10 of 15 subjects have ?very good agreement?, 3 subjects have ?good agreement?, and 2 subjects have ?moderate agreement? (Kappa 0,45-1,00); for detection of requiring-therapy ROP, only 7 of 15 subjects that have Kappa value of 1.00, however, 12 of 15 subjects have ?very good agreement?, and only 3 subjects have ?good agreement? (Kappa 0,75-1,00). For detection of stage and zone of ROP, only a little number of subjects have ?very good agreement? (Kappa 0.35-0.81, and 0.32-0.91, respectively); and for plus disease detection, only 6 of 15 subjects have Kappa value of 1.00. Conclusion: Agreement of image-based ROP diagnosis between ophthalmology residents and pediatric ophthalmologist has not achieved the expected target yet. ;Background: Numerous late-stage ROP cases that referred to Cipto Mangunkusumo Hospital (Kirana) showed us that ROP management in Indonesia is still a challenge. The delayed management might be caused by limited number of vitreoretinal specialist or pediatric ophthalmologist, and inadequate diagnostic knowledge of ROP of the general ophthalmologists. In condition of limited number of vitreoretinal and pediatric ophthalmologists, the general ophthalmologists are suggested to be taking part in ROP screening program. In FKUI, ROP screening has been a part of residency training program, however, there was no available data of ROP diagnostic knowledge of the residents. Purpose: To measure agreement of image-based ROP diagnosis between ophthalmology residents and pediatric ophthalmologist. Methods: Twenty-five sets of retinal photographs of premature infants were interpreted by 15 ophthalmology residents and pediatric ophthalmologists, and classified into 4 categories: no ROP, mild ROP, type 2 ROP, and treatmentrequiring ROP. Agreements are measured for diagnosis classification, stage, zone, and plus disease detection. Level of agreement was measured based on Kappa value of each subjects. The expected level of agreement for each category was ?very good agreement?. For treatment-requiring ROP and plus disease, the expected Kappa value was 1.00. Results: For detection of no ROP, agreement of all subjects was ?very good? (Kappa 1,00); for detection of mild or worse ROP, only 1 of 15 subjects has ?very good agreement?, 9 of 15 subjects have ?good agreement?, and 5 subjects have ?moderate agreement? (Kappa 0,65+0,15); for detection of type 2 or worse ROP, 10 of 15 subjects have ?very good agreement?, 3 subjects have ?good agreement?, and 2 subjects have ?moderate agreement? (Kappa 0,45-1,00); for detection of requiring-therapy ROP, only 7 of 15 subjects that have Kappa value of 1.00, however, 12 of 15 subjects have ?very good agreement?, and only 3 subjects have ?good agreement? (Kappa 0,75-1,00). For detection of stage and zone of ROP, only a little number of subjects have ?very good agreement? (Kappa 0.35-0.81, and 0.32-0.91, respectively); and for plus disease detection, only 6 of 15 subjects have Kappa value of 1.00. Conclusion: Agreement of image-based ROP diagnosis between ophthalmology residents and pediatric ophthalmologist has not achieved the expected target yet. ;Background: Numerous late-stage ROP cases that referred to Cipto Mangunkusumo Hospital (Kirana) showed us that ROP management in Indonesia is still a challenge. The delayed management might be caused by limited number of vitreoretinal specialist or pediatric ophthalmologist, and inadequate diagnostic knowledge of ROP of the general ophthalmologists. In condition of limited number of vitreoretinal and pediatric ophthalmologists, the general ophthalmologists are suggested to be taking part in ROP screening program. In FKUI, ROP screening has been a part of residency training program, however, there was no available data of ROP diagnostic knowledge of the residents. Purpose: To measure agreement of image-based ROP diagnosis between ophthalmology residents and pediatric ophthalmologist. Methods: Twenty-five sets of retinal photographs of premature infants were interpreted by 15 ophthalmology residents and pediatric ophthalmologists, and classified into 4 categories: no ROP, mild ROP, type 2 ROP, and treatmentrequiring ROP. Agreements are measured for diagnosis classification, stage, zone, and plus disease detection. Level of agreement was measured based on Kappa value of each subjects. The expected level of agreement for each category was ?very good agreement?. For treatment-requiring ROP and plus disease, the expected Kappa value was 1.00. Results: For detection of no ROP, agreement of all subjects was ?very good? (Kappa 1,00); for detection of mild or worse ROP, only 1 of 15 subjects has ?very good agreement?, 9 of 15 subjects have ?good agreement?, and 5 subjects have ?moderate agreement? (Kappa 0,65+0,15); for detection of type 2 or worse ROP, 10 of 15 subjects have ?very good agreement?, 3 subjects have ?good agreement?, and 2 subjects have ?moderate agreement? (Kappa 0,45-1,00); for detection of requiring-therapy ROP, only 7 of 15 subjects that have Kappa value of 1.00, however, 12 of 15 subjects have ?very good agreement?, and only 3 subjects have ?good agreement? (Kappa 0,75-1,00). For detection of stage and zone of ROP, only a little number of subjects have ?very good agreement? (Kappa 0.35-0.81, and 0.32-0.91, respectively); and for plus disease detection, only 6 of 15 subjects have Kappa value of 1.00. Conclusion: Agreement of image-based ROP diagnosis between ophthalmology residents and pediatric ophthalmologist has not achieved the expected target yet.

Abstrak :
Pterygium is an epithelial conjunctiva bulbi and connective tissue growth that could cause viston problem. Pterygium is mainly found at tropical and subtropical areas. There is no accurate data about pterygium prevalence in Indonesia.Those analyzed were respondents aged 5 years and more from Basic Health Research (RISKESAS) 2010, a cross sectional non intervention study. Diagnosis was made using flashlight and compared it to a chart. Results: The prevalence of pterygium at both eyes was 3.2% and at one eye was 1.9%. The highest prevalence of pterygium atboth eyes was at West Sumatra province (9.4%), the lowest prevalence was at Jakarta province (0. 4%). The highest prevalence of pterygium at one eye was at West Nusa Tenggara province, the lowest was at Jakarta province (0. 2%). The lowest prevalence of pterygium at both eyes as well as at one eye was at those aged 5-9 years (0. 03%) while the highest prevalence were found at age 70 years and more. The prevalence of pterygium at both eyes and the prevalence of pterygium at one eye based on gender were almost similar, the prevalence of pterygium among farmers was the highest (6.1%)and the lowest were among school children (1.0%); the highest prevalence were those with no schooling (11.0%) and the lowest were those that finished Junior High School (1.6%); the highest was at rural area for both eye (3.7%) as well as for one eye (2.2%) as compared to urban area. The prevalence of pterygium of both eyes was highest at lowest household expenditure (3.2%) while the lowest for one eye pterygium ( 1. 7%) at highest household's expenditure. Pterygium is a community health problem at rural areas especially among farmers and sailors that were used for high sunlight exposure. This type eye problem increased among those who lived in the equator.