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"Latar Belakang: Dry eye (DE) menjadi salah satu masalah kesehatan terbanyak yang dilaporkan di lingkungan kantor. Studi sebelumnya telah melaporkan sebesar 1 dari 3 pekerja perkantoran mengalami DE. Gejala DE dapat memengaruhi kenyamatan mata dan menurunkan kualitas hidup, yang selanjutnya dapat memperburuk produktivitas kerja dan menimbulkan beban ekonomi akibat perawatan medis dan menurunnya performa pekerja. Tujuan dari penelitian ini adalah membandingkan gejala DE pada pekerja perkantoran dan pekerja lapangan di Indonesia. Metode: Penelitian ini merupakan studi observasional potong lintang untuk menilai gejala DE pada pekerja perkantoran dan penebang tebu dengan menggunakan kuesioner Ocular Surface Disease Index (OSDI) versi Bahasa Indonesia. Penelitian ini juga menilai faktor risiko yang berperan pada terjadinya DE. Hasil: Sebanyak 268 subjek penelitian (142 pekerja kantoran dan 126 penebang tebu) diikutsertakan dalam analisis data. Lebih dari setengah (56.3%) pekerja mengalami gejala DE (OSDI >12). Prevalensi DE lebih besar pada pekerja perkantoran (37.7%) dibandingkan penebang tebu (18.7%) (OR 3.74, IK 95% 2.25, 6.23). Faktor yang mempengaruhi terjadinya DE antara lain usia, jenis kelamin, jenis pekerjaan, durasi jam kerja, status merokok, penggunaan lensa kontak, penyakit sistemik dan durasi menggunakan gadget. Hasil analisis multivariat menunjukan usia merupakan faktor yang paling memengaruhi terjadinya DE (p < 0.001). Kesimpulan: Penebang tebu memiliki risiko tiga kali lebih rendah untuk mengalami DE dibandingkan pekerja perkantoran. Hal ini disebabkan adanya pengaruh lingkungan pada pekerja perkantoran yang dapat meningkatkan risiko terjadinya DE. Kata Kunci: Dry Eye; Mata Kering; OSDI; Risiko Pekerjaan; Pekerja Perkantoran; Penebang Tebu.

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Background: Dry eye (DE) is one of the most common health problems in the office environment. Previous study has reported that 1 out of 3 office workers experienced DE. The symptoms of DE may affect eye health and reduce the quality of life, which in turn decrease work productivity and cause an economic burden due to medical treatment and decreased worker performance. This study aimed to compare the severity of DE in office workers and field workers in Indonesia. Methods: This study was a cross-sectional observational study to assess the severity of DE in office workers and sugarcane loggers using the Indonesian version of the Ocular Surface Disease Index (OSDI) questionnaire. This study also assessed the risk factors that play a role in the occurrence of DE. Results: A total of 268 research subjects (142 office workers and 126 sugarcane loggers) were included in the data analysis. More than half (56.3%) of workers experienced DE symptoms (OSDI >12). The prevalence of DE was higher among office workers (37.7%) than sugarcane loggers (18.7%) (OR 3.74, 95% CI 2.25, 6.23). Factors that influence the occurrence of DE included age, gender, type of work, duration of working hours, smoking status, use of contact lenses, systemic diseases and duration of using gadgets. The results of multivariate analysis indicated that age was the most influencing factor for ED (p < 0.001). Conclusion: Sugarcane loggers have three times less risk of presenting DE symptoms than office workers. It is due to environmental influences on office workers which might increase the risk of DE. "

"Latar belakang: Ulkus kornea dapat menyebabkan kebutaan karena sikatriks kornea. Transplantasi kornea sebagai tatalaksana sikatriks kornea berisiko tinggi mengalami kegagalan dengan adanya neovaskular pada kornea resipien. VEGF-A diduga sebagai faktor angiogenik utama dalam terbentuknya neovaskular kornea. Berdasarkan pengamatan klinis, neovaskular kornea pada pasien ulkus kornea bakteri lebih luas dibandingkan ulkus kornea jamur, namun belum pernah dibandingkan secara ilmiah. Tujuan: Studi ini membandingkan VEGF-A air mata dan neovaskularisasi kornea antara ulkus kornea bakteri dan jamur. Korelasi antara VEGF-A dengan luas neovaskular juga dihitung. Metode: Penelitian dilakukan terhadap pasien ulkus kornea bakteri dan jamur dengan sampel foto kornea dan air mata. Pengambilan sampel dilakukan pada hari pertama kedatangan dan diulang pada minggu keempat. Analisis foto kornea menggunakan peranti lunak ImageJ® untuk menilai luas neovaskular kornea dan luas defek kornea. Analisis VEGF-A air mata menggunakan enzyme-linked immunosorbent assay (ELISA). Perbedaan dianggap signifikan jika p<0,05. Hasil: Didapatkan 12 subjek ulkus kornea bakteri dan 10 subjek ulkus kornea jamur dengan rerata usia 37 tahun. Bakteri terbanyak Pseudomonas aeruginosa. dan jamur terbanyak Fusarium sp. Defek kornea setara pada awal (bakteri 25,6% (1,8-81,5) vs jamur 22,7% (3,0-45,0), p = 0,644) dan membaik pada minggu keempat (bakteri 0,04% (0-30,5) vs jamur 2,5% (0-15,1), p=0,368). Luas neovaskular kornea pada hari pertama setara (bakteri 10,3% (2,3-37,5) vs jamur 8,0% (3,7-22,8), p = 0,262) namun pada minggu keempat lebih luas pada kelompok bakteri (bakteri 21,6% (2,3-58,0) vs jamur 11,0% (5,4-22,5), p=0,033). VEGF-A air mata setara pada hari pertama (bakteri 215,6 pg/ml (58,0-1111,6) vs jamur 339,3 pg/ml (22,7-1313,0), p=0,391) dan minggu keempat (bakteri 399,7 pg/ml (181,9-1496,3) vs jamur 743,8 pg/ml (78,7-1416,5), p=0,792). Tidak didapatkan korelasi VEGF-A terhadap luas area neovaskular kornea (hari pertama r -0,28, p=0,212, minggu keempat r -0,04 p=0,855). Kesimpulan: Perbedaan luas neovaskular pada minggu keempat diduga karena faktor proangiogenik pada bakteri yang jarasnya melalui VEGF-A serta faktor antiangiogenik pada jamur yang mengalahkan pengaruh VEGF-A. Diperlukan penelitian mendasar yang mencari faktor antiangiogenik tersebut pada jamur.

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Background: Corneal ulcer can cause blindness due to corneal cicatrix. Corneal transplantation as the treatment of corneal cicatrix had higher risk for rejection or failure if the recipient’s cornea possessed neovascularization. VEGF-A was thought to be the major angiogenic factor in corneal neovascularization. Based on clinical observation, corneal neovascularization in bacterial corneal ulcers had more area than in fungal corneal ulcers, however it was never proved scientifically. Objective: This study aimed to compare tear fluid VEGF-A and corneal neovascularization between bacterial and fungal corneal ulcers. The correlation between VEGF-A and neovascular area was also measured. Methods: Corneal photograph and tear fluid samples of bacterial and fungal in corneal ulcer patients were studied. Sample was taken at the first visit and at the fourth week follow up. Corneal photograph was analyzed using ImageJ® software to measure neovascular area and defect area. Tear fluid VEGF-A was examined using enzyme-linked immunosorbent assay (ELISA). Difference was considered significant if p<0,05. Results: There were 12 bacterial corneal ulcer patients and 10 fungal corneal ulcer patients with mean age 37 years old. Most common bacteria was Pseudomonas aeruginosa and most common fungi was Fusarium sp. Corneal defect area between the groups was similar at the first visit (bacterial 25,6% (1,8-81,5) vs fungal 22,7% (3,0-45,0), p = 0,644) and improved at the fourth week (bacterial 0,04% (0-30,5) vs fungal 2,5% (0-15,1), p=0,368). Neovascular area was similar among the groups at the first visit (bacterial 10,3% (2,3-37,5) vs fungal 8,0% (3,7-22,8), p = 0,262), however bacterial group showed larger area at the fourth week (bacterial 21,6% (2,3-58,0) vs fungal 11,0% (5,4-22,5), p=0,033). Tear fluid VEGF-A was similar at the first visit (bacterial 215,6 pg/ml (58,0-1111,6) vs fungal 339,3 pg/ml (22,7-1313,0), p=0,391) and the fourth week (bacterial 399,7 pg/ml (181,9-1496,3) vs fungal 743,8 pg/ml (78,7-1416,5), p=0,792). No correlation obtained between VEGF-A and corneal neovascular area (first visit r -0,28, p=0,212, fourth week r -0,04 p=0,855). Conclusion: The difference of neovascular area at the fourth week could be due to proangiogenic factor of bacteria through its effect on VEGF-A and antiangiogenic factor in fungi that may overcome VEGF-A effect. Further study is needed to confirm the antiangiogenic factor that fungi possess."

"Latar belakang: Diagnosis dry eye disease (DED) ditegakkan dengan serangkaian pemeriksaan gejala subjektif dam tanda klinis objektif, namun sayangnya alat penunjang pemeriksaan tidak selalu dimiliki oleh fasilitas layanan kesehatan, sehingga kuesioner yang valid dan reliabel berperan sebagai alternatif untuk menegakkan diagnosis. Kuesioner dry eye Indonesia yang telah dikembangkan untuk populasi Indonesia masih belum tervalidasi dengan jumlah pertanyaan yang belum ideal. Tujuan: Mendapatkan item pertanyaan kuesioner dry eye Indonesia bagian diagnosis yang valid dan reliabel serta mengetahui korelasi klinis antara gejala subjektif dan tanda klinis objektif DED pada pasien. Metode: Penelitian ini terdiri dari tiga tahapan, yaitu (1) focus group discussion (FGD) untuk menilai content validity index (CVI), (2) pretesting untuk menilai cognitive debriefing, validitas, dan reliabilitas pada 30 sampel, dan (3) testing untuk menilai validitas, reliabilitas, dan korelasi klinis dengan tanda klinis objektif pada 60 partisipan. Partisipan melengkapi kuesioner dry eye Indonesia dan ocular surface disease index (OSDI), kemudian dilakukan uji tear break up time (TBUT), tear break up pattern (TBUP), pewarnaan okular, dan Schirmer. Hasil: Jumlah pertanyaan kuesioner dry eye Indonesia dari studi sebelumnya adalah 31 item. Dari hasil FGD dikerucutkan menjadi 14 item pertanyaan, dengan nilai CVI 0,98. Pada tahap pretesting, seluruh item dinyatakan dapat dipahami oleh seluruh subjek dengan nilai validitas dan reliabilitas baik. Dari hasil testing, didapatkan validitas yang dinilai dari corrected item total correlation dan reliabilitas yang dinilai dari Cronbach’s alpha yang baik pada 10 item pertanyaan kuesioner. Sensitivitas dan spesifisitas kuesioner didapatkan 91,1% dan 100% dengan AUC 98,2% (IK95% 94,4%-100%), nilai potong diagnosis DED adalah 10,5. Skor kuesioner dry eye Indonesia didapati berkorelasi positif kuat dengan skor OSDI (r=0,808; p<0,001) dan berkorelasi negatif lemah (r=- 0,339; p=0,008) dengan TBUT, namun tidak didapati korelasi yang bermakna terhadap Schirmer dan pewarnaan okular. Kesimpulan: Kuesioner dry eye Indonesia bagian diagnosis memiliki validitas, reliabilitas, serta sensitivitas dan spesifisitas yang sangat baik untuk mendiagnosis DED. Korelasi klinis antara skor kuesioner dry eye Indonesia didapatkan bermakna terhadap skor OSDI dan TBUT.

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Background: Diagnosis of dry eye disease (DED) is established through a series of examinations of subjective symptoms and objective clinical signs. Unfortunately, diagnostic tools are not always available in healthcare facilities, making valid and reliable questionnaires an alternative for diagnosis. Indonesian dry eye questionnaire developed for the Indonesian population has not yet been validated with an ideal number of questions. Objective: To obtain valid and reliable diagnostic questions for the Indonesian dry eye questionnaire and to determine the clinical correlation between subjective symptoms and objective clinical signs of DED in patients. Methods: This study consists of three stages: (1) focus group discussion (FGD) to assess the content validity index (CVI), (2) pretesting to evaluate cognitive debriefing, validity, and reliability in 30 samples, and (3) testing to assess the validity, reliability, and clinical correlation with objective clinical signs in 60 participants. Participants completed the Indonesian dry eye questionnaire and the Ocular Surface Disease Index (OSDI), followed by testing tear break-up time (TBUT), tear break-up pattern (TBUP), ocular staining, and Schirmer. Results: Thenumber of questions in the Indonesian dry eye questionnaire from the previous study was 31 items, narrowed down to 14 items through FGD with a CVI value of 0.98. In the pretesting stage, all items were found to be understandable by all subjects with good validity and reliability. In the testing phase, 10 questionnaire items showed good validity assessed from corrected item total correlation and reliability assessed from Cronbach’s alpha. The questionnaire demonstrated a sensitivity of 91.1%, specificity of 100%, and an AUC of 98.2% (95% CI 94.4%-100%), with a diagnostic cutoff score for DED at 10.5. The Indonesian dry eye questionnaire score showed a strong positive correlation with OSDI score (r=0.808; p<0.001) and a weak negative correlation (r=- 0.339; p=0.008) with TBUT, but no significant correlation was found with Schirmer and ocular staining. Conclusion: The diagnostic section of the Indonesian dry eye questionnaire has excellent validity, reliability, sensitivity, and specificity for diagnosing DED. Clinical correlations were found between the questionnaire score and OSDI score and TBUT."