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Abstrak :
ABSTRAK
Penelitian ini bertujuan untuk menilai akurasi skrining ROP bayi prematur dengan menggunakan wide field retinal imaging system (RetCam vi ® ) yang dilakukan oleh dokter umum terlatih dibandingkan dengan menggunakan oftalmoskopi indirek binokuler (BIO). Penelitian ini merupakan penelitian potong lintang dan bersifat uji diagnostik. Semua bayi prematur yang memenuhi kriteria skrining menurut workshop ROP dan bayi prematur di Indonesia diikutsertakan pada penelitian ini. Pada penelitian ini didapatkan hasil bahwa WFDRI (RetCam ® ) yang dilakukan oleh dokter umum yang terlatih secara baku sama akuratnya dengan oftalmoskopi indirek binokuler (BIO) dalam skrining ROP pada bayi lahir prematur.ABSTRACT
The aim of this study was to evaluate the accuracy of wide field digital retinal imaging (RetCam ®) conducted by trained general practitioner in comparison with binocular indirect ophthalmoscopy (BIO). The design of this study was a cross sectional, diagnostic trial study. Preterm infants that met the inclusion criteria according to Indonesia retinopathy of prematurity workshop were included in the study. The result of this study revealed that the accuracy of WFDRI (RetCam ) performed by trained general practitioner were similar to those performed using BIO in ROP screening.;The aim of this study was to evaluate the accuracy of wide field digital retinal imaging (RetCam ® ) conducted by trained general practitioner in comparison with binocular indirect ophthalmoscopy (BIO). The design of this study was a cross sectional, diagnostic trial study. Preterm infants that met the inclusion criteria according to Indonesia retinopathy of prematurity workshop were included in the study. The result of this study revealed that the accuracy of WFDRI (RetCam ) performed by trained general practitioner were similar to those performed using BIO in ROP screening.;The aim of this study was to evaluate the accuracy of wide field digital retinal imaging (RetCam ® ) conducted by trained general practitioner in comparison with binocular indirect ophthalmoscopy (BIO). The design of this study was a cross sectional, diagnostic trial study. Preterm infants that met the inclusion criteria according to Indonesia retinopathy of prematurity workshop were included in the study. The result of this study revealed that the accuracy of WFDRI (RetCam ) performed by trained general practitioner were similar to those performed using BIO in ROP screening.;The aim of this study was to evaluate the accuracy of wide field digital retinal imaging (RetCam ® ) conducted by trained general practitioner in comparison with binocular indirect ophthalmoscopy (BIO). The design of this study was a cross sectional, diagnostic trial study. Preterm infants that met the inclusion criteria according to Indonesia retinopathy of prematurity workshop were included in the study. The result of this study revealed that the accuracy of WFDRI (RetCam ) performed by trained general practitioner were similar to those performed using BIO in ROP screening.

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 :
Miopia adalah kelainan refraksi yang paling banyak ditemukan di dunia. Pandemi Covid- 19 berhubungan dengan peningkatan prevalensi miopia dan progresivitas miopia akibat pembelajaran jarak jauh pada anak usia sekolah. Penelitian ini bertujuan untuk mendapatkan angka kejadian miopia pada pelajar Sekolah Menengah Pertama (SMP) di Jakarta di era pandemi Covid-19 dan mencari faktor-faktor yang berhubungan dengan kejadian miopia pada kelompok tersebut. Penelitian ini terdiri dari 2 tahapan, yaitu: (1) Adaptasi lintas kultur kuesioner Sydney Myopia Study; (2) Pemeriksaan refraksi subjektif pada pada pelajar SMP di Jakarta dan pengisian kuesioner yang sudah tervalidasi. Dari 415 subjek penelitian, didapatkan angka kejadian miopia pada pelajar SMP di Jakarta sebesar 67,5% dengan sebagian besar subjek termasuk dalam kategori miopia sedang (37,1%). Faktor yang berhubungan dengan kejadian miopia pada kelompok tersebut adalah jenis kelamin perempuan, riwayat miopia pada orang tua, dan skor aktivitas melihat dekat > 9,5 jam per hari. ......Myopia is the most common refractive error in the world. The Covid-19 pandemic is associated with an increase in the prevalence of myopia and myopia progression due to online learning in school-age children. This study aims to obtain the prevalence of myopia in junior high school students in Jakarta during the Covid-19 pandemic era and its related factors. This study consisted of 2 stages; (1) Cross-cultural adaptation of the Sydney Myopia Study questionnaire; (2) Subjective refraction examination of junior high school students in Jakarta and completion of the validated questionnaire. Of the 415 research subjects, the prevalence of myopia in junior high school students in Jakarta was 67.5%, with most of the subjects falling into the category of moderate myopia (37.1%). Factors related to myopia in this group were female gender, parental myopia, and a near work activity score of > 9.5 hours per day.

Abstrak :
Penelitian ini bertujuan untuk mengetahui keluhan subjektif mata kering dan gangguan komponen air mata (lipid, akuos, mucin) pada pasien thalassemia mayor dengan riwayat transfusi darah jangka panjang, serta menganalisis hubungan antara kadar feritin serum, durasi, dan frekuensi transfusi darah dengan masing-masing parameter penilaian komponen lapisan air mata. Penelitian ini merupakan studi potong lintang (cross sectional) pada pasien thalassemia mayor yang sudah berusia dan mengalami transfusi darah selama minimal 10 tahun. Penilaian mata kering terdiri dari pengisian kuesioner OSDI untuk menilai keluhan subjektif, pemeriksaan biomikroskopi lampu celah dan nilai tear break up time (TBUT) untuk menilai tingkat keparahan mata kering, pemeriksaan Schirmer basal, Ferning, dan sitologi impressi konjungtiva untuk menghitung jumlah sel goblet. Data perhitungan tingkat keparahan mata kering, nilai uji Schirmer basal, TBUT, dan jumlah sel goblet dianalisis dan dicari hubungannya dengan kadar feritin serum, durasi dan frekuensi transfusi. Pada 77 subyek, mata kering terjadi sebanyak 14.3%, penurunan nilai TBUT (39%), nilai Schirmer basal (37.7%), nilai Ferning (24.7%), dan jumlah sel goblet (45.5%). Tidak terdapat perbedaan bermakna antara tingkat keparahan mata kering, nilai TBUT, nilai Schirmer basal, nilai Ferning, dan jumlah sel goblet dengan kadar feritin serum, durasi, dan frekuensi transfusi. Namun, terdapat hubungan yang bermakna antara tingkat keparahan mata kering dan usia (p = 0.014), serta nilai TBUT (p = 0.012) dan Schirmer (p = 0.014) dengan jenis kelamin. Penelitian ini memperlihatkan 14.3% subyek thalassemia mayor mengalami mata kering berdasarkan kriteria DEWS 2007. Kejadian mata kering pada thalassemia mayor tidak dipengaruhi oleh faktor transfusi dan kadar feritin serum, melainkan dipengaruhi oleh usia dan jenis kelamin. ......This study is aimed to understand subjective complaints for dry eyes and disruption of component of tear fluid (lipid, aqueous, mucin) in patients with major thalassemia with a history of long-term blood transfusions and to analyse the correlation between serum ferritin level, duration and frequency of blood transfusion. This study is a cross-sectional study. The subject of this study is patients with major thalassemia age minimum of 10 years old and have had blood transfusion for at least 10 years. OSDI questionnaire, slit-lamp biomicroscopy examination, tear break up time (TBUT), and basal Schirmer test was used to assess dry eyes severity. Ferning and conjunctiva impression cytology examination was used to assess mucin quality and count the amount of goblet cells. The correlation analysis between the result of these assessments and serum ferritin level and duration and frequency of blood transfusion was done. In 77 subjects, the prevalence of dry eyes is 14.3%. There is a decrease in TBUT (39%), basal Schirmer (37.7%), Ferning (24.7%), and goblet cells (45.5%). There is no significant correlation between dry eyes severity and TBUT, basal Schirmer, Ferning, and the amount of goblet cells with serum ferritin level, duration, and frequency of blood transfusion. There is a significant correlation between dry eyes severity and patient s age (p = 0.014); TBUT (p = 0.012), as well as, Schirmer (p = 0.014) with sex. This study showed that 14.3% of patients with major thalassemia suffer from dry eyes with severity level grade 2 according to DEWS 2007. The incidence of dry eyes is not influenced by transfusion and serum ferritin level but is influenced by age and sex.

Abstrak :
Latar Belakang: Pembelajaran jarak jauh anak sekolah selama pandemi COVID-19 menyebabkan penggunaan perangkat digital sebagai media pembelajaran. Peningkatan pajanan monitor dan aktivitas melihat dekat diduga meningkatkan angka kejadian astenopia. Tujuan: Mendapatkan angka kejadian astenopia subjektif dan menilai faktor yang mempengaruhinya pada anak SMP dan SMA Negeri di Jakarta di era pandemi COVID-19. Metode: Penelitian dengan desain potong lintang menggunakan kuesioner Revised Convergence Insufficiency Symptom Survey (CISS) diadaptasi ke dalam Bahasa melalui tahapan validasi. Skoring CISS 16 sebagai batasan keluhan astenopia yang dialami subjek. Hasil: Kuesioner CISS versi Bahasa adalah valid dan reliabel dengan nilai p<0,05 dengan koefisien Cronbach’s ±  sebesar 0,910 dan 0,925. Subjek penelitian sebanyak 901 responden. Angka kejadian astenopia sebesar 36%. Analisis multivariat didapatkan pencahayaan ruangan yang kurang terang di luar PJJ (OR=8,25;p=0,001), durasi screen time >2 jam saat PJJ (OR>3,73;p=0,001), penyakit mata lain (OR=3,72;p=0,002), melakukan aktivitas dekat dengan posisi berbaring (OR=2,45;p=0,014), durasi tidur malam <8 jam (OR=2,29;p<0,001), penggunaan kacamata (OR=2,10;p<0,001), aktivitas dekat menonton film dengan perangkat digital/TV (OR=1,67;p=0,004), dan jarak baca <30 cm saat PJJ (OR=1,47;p=0,016) merupakan faktor risiko independent untuk astenopia pada anak sekolah. Kesimpulan: Kuesioner CISS versi Bahasa merupakan instrumen yang valid dan reliabel untuk mendiagnosis astenopia pada anak sekolah. Angka kejadian astenopia di Jakarta cukup tinggi dengan faktor risiko berupa pencahayaan ruangan kurang terang, durasi daring >2 jam, penyakit mata lain, aktivitas dekat dengan posisi berbaring, durasi tidur malam <8 jam, penggunaan kacamata, aktivitas dekat menonton film dengan perangkat digital/TV, dan jarak baca <30 cm saat PJJ. ......Background: Schoolchildren's distance learning during the COVID-19 pandemic has led to digital devices as learning media. Increased exposure to monitors and near-vision activities is thought to increase asthenopia incidence. Obtain the incidence of subjective asthenopia and assess the factors that influence Jakarta's junior high and high school students during the COVID-19 pandemic. Methods: A cross-sectional design study using the Revised Convergence Insufficiency Symptom Survey (CISS) questionnaire was adapted into Indonesian through a validation stage. CISS score 16 as a limitation of asthenopia complaints experienced by the subject. Result: Indonesian version of the CISS questionnaire is valid and reliable with p-value <0.05 with Cronbach's coefficient of 0.910 and 0.925, respectively. The research subjects were 901 respondents. The incidence of asthenopia is 36%. Multivariate analysis showed that the room lighting was not bright when distance learning (OR=8.25; p=0.001), screen time duration >2 hours during distance learning (OR>3.73;p=0.001), other eye diseases (OR=3 ,72;p=0,002), doing activities close to the lying position (OR=2,45;p=0,014), sleep duration <8 hours (OR=2,29;p<0,001), wearing glasses (OR=2 ,10;p<0.001), close activity watching movies with digital devices/TV (OR=1.67;p=0.004), and reading distance <30 cm during distance learning (OR=1.47;p=0.016) were independent risk factors for asthenopia in schoolchildren. Conclusion: Indonesian version of the CISS questionnaire is a valid and reliable instrument for diagnosing asthenopia in school children. The incidence of asthenopia in Jakarta is relatively high with risk factors in the form of poor lighting, online duration >2 hours, other eye diseases, activities close to lying down, sleep duration <8 hours, use of glasses, close activities watching movies with digital devices/ TV, and reading distance <30 cm during distance learning.