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Judul jurnal
Ocular Surface Disease and Quality of Life in Patients With
Glaucoma
Latar belakang
Assessment of quality of life (QoL) is important in the management
of glaucoma patients; it reflects the burden of disease experienced by
the patient it holistically assesses the impact of glaucoma on the
indi!idual and it can be used to monitor progress in patients "ith
glaucoma#
Tujuan $o in!estigate the relationship bet"een ocular surface disease and
glaucoma%related quality of life (QoL) glaucoma se!erity and
treatment in patients "ith open%angle glaucoma#
Metodologi
setting: &linical practice# study population: 'ne hundred t"enty%
four participants(patients "ith mild (n ) *+) moderate (n ) ,*) or
se!ere (n ) 1-) glaucoma and ., controls (glaucoma suspects) not
recei!ing glaucoma treatment("ere enrolled# /e!erity "as
stratified according to binocular !isual field loss# observed
procedures: 0emographic information the 'cular /urface 0isease
1ndex ('/01) and 2laucoma Quality of Life%13 (2QL%13)
questionnaires "ere administered# main outcome measures: '/01
score 2QL%13 score number and type of glaucoma medications
daily dose of ben4al5onium chloride (6A7) and !isual field indices#
Hasil
'/01 scores and the number of patients "ith '/0 increased "ith
increasing glaucoma se!erity (P 8 #991 and P 8 #993)# 2QL%13
scores reflected decreased QoL "ith increasing glaucoma se!erity (P
8 #991)# $hese trends "ere maintained after sub%stratification for age
and sex# 'n uni!ariate regression '/01 "as significantly correlated
"ith 2QL%13 summary score glaucoma se!erity multiple topical
glaucoma medications "orse eye mean de!iation and pattern
standard de!iation use of topical beta bloc5ers topical carbonic
anhydrase inhibitors daily dose of 6A7 and glaucoma filtration
surgery# 'n multi!ariate regression 2QL%13 summary score (odds
ratio :'R; *#1* -3< confidence inter!al :&1; .#3-=>#>, P 8 #991)
and a daily dose of 6A7 greater than , ('R .#*? -3< &1 1#1?%3#.1
P ) #91+) "ere predicti!e of '/01 score#
Kesimpulan
'/0 is more common in patients "ith increasing glaucoma se!erity
and is associated "ith poorer glaucoma%related QoL and higher
exposure to 6A
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Assessment of quality of life (QoL) is important in the management
of glaucoma patients; it reflects the burden of disease experienced by
the patient it holistically assesses the impact of glaucoma on the
indi!idual and it can be used to monitor progress in patients "ith
glaucoma#
Resume Jurnal .
Judul A ree !etinal Pigment "pithelium#$horoid Graft in Patients
With "%udative Age&!elated 'acular Degeneration: !esults up
to ( )ears
Latar belakang
Age%related macular degeneration (A@0) is the third%leading cause
of blindness globally and the leading cause of irre!ersible legal
blindness in elderly people in industriali4ed countries#
Tujuan
$o report and analy4e long%term best%corrected !isual acuity (6&AA)
outcomes follo"ing a free autologous retinal pigment epithelium
(RBC)%choroid graft translocation in patients "ith exudati!e age%
related macular degeneration (A@0)#
Metodologi
setting: 1nstitutional# study population: 'ne hundred and thirty
consecuti!e patients (1,, eyes) "ith A@0 under"ent RBC%choroid
graft translocation bet"een 'ctober .991 and Debruary .99># All
patients had a subfo!eal choroidal neo!ascular membrane "ith or
"ithout hemorrhage andEor an RBC tear# All "ere either ineligible for
or nonresponsi!e to photodynamic therapy the standard treatment at
the time of surgery# observation procedures: 0ata collection
included preoperati!e and postoperati!e !isual acuity measurements
fundus photography fluorescein and indocyanine green angiography
and microperimetry# main outcome measures: Bostoperati!e
6&AA#
Hasil
$he mean preoperati!e 6&AA "as .9E.39# Dour years after surgery
13< of the eyes had a 6&AA of F.9E.99 and 3< had a 6&AA of
G.9E*9# 'ne patient achie!ed a 6&AA of .9E,. "hich "as
maintained at ? years after surgery# &omplications consisted of
proliferati!e !itreoretinopathy (n ) 1,) recurrent neo!asculari4ation
(n ) 1,) and hypotony (n ) .)#
Kesimpulan
RBC%choroid graft transplantation may maintain macular function for
up to ? years after surgery "ith relati!ely lo" complication and
recurrence rates# Retinal sensiti!ity 6&AA data and fixation on the
graft suggest that the graft rather than simply the remo!al of
submacular hemorrhage andEor choroidal neo!ascular membrane
"as responsible for the preser!ation of macular function#
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$his surgery may be an alternati!e for patients "ith A@0 "ho ha!e
not benefitted from or cannot undergo other standard treatments#
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Judul jurnal
*eratocyte Density + 'onths, -. 'onths, and + )ears After
$orneal Surface Ablation With 'itomycin $
Latar belakang @itomycin & (@@&) has allo"ed for the re!i!al of excimer laser
surface ablation techniques#
1
$he @@& reduces the myofibroblast
repopulation after laser surface ablation and therefore reduces the
ris5 of postoperati!e corneal ha4e#
Tujuan $o study the effects of surface ablation "ith mitomycin & (@@&) on
5eratocyte population#
Metodologi
$hirty t"o eyes treated "ith surface ablation "ith 9#9.< @@& "ere
compared "ith nontreated eyes at Aissum /anta Hortensia @adrid
/pain# 7eratocyte density "as measured "ith the Heidelberg Retina
$omograph 11 (Rostoc5 &ornea @odule) , 13 and ,> to *. months
after the surgery in the anterior mid and posterior stroma and
compared "ith control eyes#
Hasil $hree months postoperati!ely "e found a lo"er stromal bed density
compared to controls (1> --, I +991 !s .- >>9 I 3-9* cellsEmm
,
P
) #9991) "hile there "as a significantly higher cell density in the
mid (,9 ?+, I -,99 !s 1+ 393 I 1--> cellsEmm
,
P ) #9991) and
deep stroma (,9 .>+ I +,.1 !s 1+ *,+ I .1,- cellsEmm
,
P ) #9991)#
$hree years after the surgery the cellularity in the stromal bed had
not significantly changed from the ,%month follo"%up but the
density in the mid (1+ ++- I ,*?* cellsEmm
,
) and posterior stroma
(1+ --. I ,*9. cellsEmm
,
) had decreased to sho" no difference from
controls# $he mean cell density bet"een the anterior mid and
posterior stroma "as not significantly different from controls 13
months and , years after the surgery#
Kesimpulan 'ur study suggests that there is a reorgani4ation of the stromal cell
population soon after surface ablation "ith @@& "ith a decrease in
the stromal bed compensated initially "ith an increase in the mid and
posterior stroma# &orneal cellularity tends to normali4e o!er time
and , years postoperati!ely the mean cell density throughout the
cornea seems to maintain normal !alues#
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excimer laser surface ablation surgery "ith intraoperati!e @@&
does not lead to permanent 5eratocyte depletion but leads to a
redistribution of the cell density in different corneal layers "ith a
temporary decrease in the anterior stromal cells compensated "ith
an increase in deeper layers follo"ed by a normali4ation of stromal
cell density throughout the cornea#
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Judul
Structural and unctional Predictors of /isual Outcome of
"piretinal 'embrane Surgery
Latar belakang 1diopathic epiretinal membrane (CR@) is a common disorder
occurring in about ?< of the population#
1
A fibrocellular gro"th in
the form of an CR@ induces tangential tractional force on the retina
leading to macular constriction and thic5ening#
Tujuan
$o e!aluate the utility of preoperati!e optical coherence tomography
('&$) and multifocal electroretinography (mfCR2) in prediction of
!isual outcomes after idiopathic epiretinal membrane (CR@)
surgery#
Metodologi
'ne hundred eyes of 199 patients "ith idiopathic unilateral CR@
"ho under"ent !itrectomy for CR@ remo!al "ere retrospecti!ely
re!ie"ed# &orrelations bet"een preoperati!e data ('&$ and
mfCR2) and final best%corrected !isual acuity (6&AA) "ere
in!estigated using Bearson correlation analysis# 'ne%"ay analysis of
!ariance (AJ'AA) "as used to determine "hether final 6&AA and
mfCR2 !alues differed among subgroups !arying in photoreceptor
integrity status# Recei!er operating characteristic (R'&) cur!e
analysis "as performed to obtain a cutoff !alue of the B1 implicit
time predicting !isual reco!ery (final 6&AA G.9E.3)#
Hasil 6&AA significantly impro!ed and >3 of +* eyes (??<) achie!ed
!isual reco!ery of more than . /nellen lines after CR@ surgery#
Dinal 6&AA "as significantly correlated "ith preoperati!e
photoreceptor integrity and B1 implicit time# $he area under the
R'& (AKR'&) cur!e "as statistically significant "hen B1 implicit
time "as examined and the cutoff !alue for good !isual prognosis
"as *9#+1 msec (sensiti!ityL ?.#?<; specificityL +1#,<)#
Kesimpulan Bhotoreceptor disruption detected by '&$ and B1 implicit time
delay on mfCR2 "ere significant predictors of poor !isual reco!ery
after CR@ surgery#
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both structural integrity assessed by '&$ and functional assessment
using mfCR2 "ere useful predictors of !isual outcome after CR@
surgery# As expected photoreceptor integrity of the 1/E'/ Munction
had a significant association "ith !isual outcome after CR@ surgery#
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Judul
Panretinal Photocoagulation for Proliferative Diabetic
!etinopathy: Pattern Scan Laser /ersus Argon Laser
Latar belakang 1n 1-?> the 0iabetic Retinopathy /tudy (0R/) reported that
panretinal photocoagulation (BRB) for proliferati!e diabetic
retinopathy (B0R) "ith high%ris5 characteristics decreased the ris5
of se!ere !ision loss by o!er 39< out to * years of follo"%up#
1

$hereafter BRB became the gold standard for treatment of high%ris5
B0R#
Tujuan $o e!aluate the efficacy of the pattern scan laser (BA/&AL) in
treating ne"ly diagnosed high%ris5 proliferati!e diabetic retinopathy
(B0R)#
Metodologi settingL 1nstitutional# study populationL Cighty%t"o consecuti!e eyes
of the same number of patients "ith ne"ly diagnosed high%ris5 B0R
treated "ith panretinal photocoagulation (BRB) using either argon
green laser (*1 eyes treated before Debruary .99?) or BA/&AL (*1
eyes treated Debruary .99? or thereafter) then follo"ed for at least >
months# procedureL Retrospecti!e chart re!ie" "ith attention to main
outcome measures age sex race follo"%up inter!al insulin
dependence hemoglobin A1c and total number of lasers spots# main
outcome measuresL Bersistence or recurrence of neo!asculari4ation
incidence of !itreous hemorrhage (AH) neo!asculari4ation of the
iris (JA1) neo!ascular glaucoma (JA2) and need for !itrectomy#
Hasil
Batients treated "ith the BA/&AL and argon laser recei!ed a similar
number of spots (1*,+ !s 1,+>; P ) #3-)# Batients treated "ith the
BA/&AL "ere more li5ely to experience persistence or recurrence of
neo!asculari4ation "ithin > months of initial treatment (?,< !s
,*<; P 8 #999+)# $he study "as not adequately po"ered to detect a
significant difference in incidence of !itreous hemorrhage JA1
JA2 or need for !itrectomy#
Kesimpulan Nhen using traditional laser settings BRB performed "ith the
BA/&AL is less effecti!e than that performed "ith traditional argon
laser in effecting lasting regression of retinal neo!asculari4ation in
the setting of pre!iously untreated high%ris5 B0R# Bhysicians may
need to change treatment parameters "hen using BA/&AL pattern
laser therapy for high%ris5 B0R#
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$hough BRB has represented the gold standard for treatment of high%
ris5 B0R for o!er , decades the exact mechanism by "hich it
causes regression of neo!asculari4ation remains un5no"n#
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Judul
"ndogenous ungal "ndophthalmitis: $ausative Organisms,
'anagement Strategies, and /isual Acuity Outcomes
Latar belakang Cndogenous fungal endophthalmitis is a serious ocular condition
"ith potentially de!astating !isual outcomes# 'cular seeding occurs
through hematogenous spread and may in!ol!e both the anterior and
posterior segments of the eye#
Tujuan $o report the causati!e organisms management strategies and !isual
outcomes in endogenous fungal endophthalmitis
Metodologi @icrobiologic and medical records "ere re!ie"ed retrospecti!ely for
all patients "ith culture%positi!e endogenous fungal endophthalmitis
bet"een January 1 1--9 and July 1 .99-#
Hasil
/tudy criteria "ere met in >3 eyes of 31 patients "ith mean follo"%
up of 1+ months# Oeasts "ere the most common causati!e organism
in ,+ (?3<) patients compared "ith molds in 1, (.3<) patients#
Retinal detachment occurred in 1? eyes (.><)# Aisual acuity of
.9E.99 or better "as present in .+ (3><) eyes "ith yeasts and in 3
(,,<) eyes "ith molds at the last follo"%up#
Kesimpulan Oeasts "ere the most common cause of culture%pro!en unilateral or
bilateral endogenous fungal endophthalmitis# Cndogenous fungal
endophthalmitis generally is associated "ith poor !isual acuity
outcomes especially "hen caused by molds# Retinal detachment is a
frequent occurrence during follo"%up#
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on endogenous fungal endophthalmitis that there is a predominance
of Candida cases poor !isual outcomes among mold cases and
frequent retinal detachment (.-<) in in!ol!ed eyes# 1n addition this
series documents that !itrectomy is more li5ely to yield positi!e
diagnostic culture results than anterior chamber or !itreous tap
"ithout !itrectomy#
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Judul
Anatomical and unctional 'acular $hanges After
!hegmatogenous !etinal Detachment With 'acula Off
Latar belakang
Aisual reco!ery may remain incomplete after rhegmatogenous retinal
detachment (RR0) especially in cases of retinal detachments "ith
macula off e!en after a successful surgery "ith a normal%appearing
fundus examination#
1
Boor !isual acuity color !ision defects or
persistent metamorphopsia may persist o!er time suggesting the
existence of microstructural macular damage that standard fundus
biomicroscopy could not detect#
.
Tujuan
$o e!aluate the correlation bet"een morphologic changes in the
outer retina and !isual function after successful repair of
rhegmatogenous retinal detachment "ith macula off#
Metodologi
settings: 0iMon Kni!ersity Hospital# patients: $hirty patients (,9
eyes) "ith successful repair of rhegmatogenous retinal detachment
after macula off and a minimum >%month follo"%up after surgery#
main outcome measures: /pectral%domain optical coherence
tomography (/0%'&$) of the outer retina fundus autofluorescence
(DAD) and microperimetry#
Hasil
$"enty of ,9 eyes presented microstructural changes "ithin the
photoreceptor layer (>>#?<)# 'f these half of the patients (39<) had
more than 1 lesion# 0isrupted inner segmentEouter segment (1/E'/)
Munction "as noted in 1> out of ,9 eyes (3,#,<) irregular
hyporeflecti!ity in the photoreceptor outer segments (BR'/) "as
obser!ed in 1? eyes (3>#?<) external limiting membrane "as
discontinued in 19 eyes (,,#,<) and hyperreflecti!e spots in the
outer nuclear layer "ere obser!ed in 3 eyes (1>#?<)# DAD changes
"ere detected in only 3 eyes (1>#?<)# Abnormalities in the 1/E'/
Munction "ere significantly associated "ith lo"er fo!eal and macular
sensiti!ity thinner BR'/ and global photoreceptor changes (P ) #
91* P ) #99, P ) #99> P 8 #9991 respecti!ely)# Batients "ith a
normal fo!eal profile sho"ed similar findings#
Kesimpulan
/0%'&$ and microperimetry seem to be appropriate tools to
determine the !isual and the anatomic reco!ery of the macula after
surgery#
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preoperati!e acuity and macular status as "ell as height and
duration of macular detachment may induce impaired !isual
function e!en after successful surgery# @oreo!er epiretinal
membranes (CR@) and cystoid macular edema (&@C) are also "ell%
5no"n postoperati!e complications responsible for secondary !isual
impairment#
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