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"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."

"Glaukoma umumnya memiliki karakteristik neuropati optik yang terkait dengan hilangnya fungsi penglihatan. Glaukoma merupakan penyebab kebutaan kedua dengan prevalensi sebesar 0,46 %. Terapi glaukoma saat ini ditujukan untuk menurunkan tekanan intraokular (TIO). Namun efek samping obat dan hasil terapi yang suboptimal merupakan permasalahan yang menantang. Akupunktur diharapkan dapat menjadi salah satu pilihan terapi ataupun terapi penunjang untuk glaukoma. Penelitian ini bertujuan untuk mengetahui efek elektroakupunktur (EA) dalam menurunkan TIO dan intensitas nyeri pasien glaukoma absolut atau glaukoma kronik lanjut yang belum atau telah mendapat terapi standar namun TIO masih tinggi. Desain penelitian yang digunakan adalah uji klinis sebelum dan sesudah intervensi. Penelitian ini melibatkan 14 pasien glaukoma absolut atau glaukoma kronik lanjut. TIO dan skor Visual Analog Scale (VAS) nyeri dinilai sebelum dan sesudah 1 kali terapi EA. Hasil penelitian menunjukkan TIO satu jam setelah EA menurun sebesar 6,14 ± 1,90 mmHg dibanding sebelum EA (p <0,05). TIO tiga jam setelah EA menurun sebesar 7,43 ± 1,98 mmHg dibanding sebelum EA (p <0,05). Skor VAS sebelum EA 5.56 ± 1.01 turun menjadi 1.33 ± 1.50 setelah EA (p <0,05). Kesimpulan penelitian ini bahwa EA mempunyai efek menurunkan TIO dan skor VAS secara signifikan.

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Glaucoma generally has characteristic of optic neuropathy associated with loss of visual function. Glaucoma is the second leading cause of blindness with a prevalence of 0.46%. Current glaucoma therapies aimed at lowering the intraocular pressure (IOP). However, the side effects relating to drugs and suboptimal therapeutic outcome remain as challenging problems. Acupuncture is expected to become one of alternative or adjunctive therapies in glaucoma.

This study aimed to determine the effect of electroacupuncture (EA) in lowering IOP and pain intensity among patients with absolute glaucoma or advanced chronic glaucoma who have not or have received standard therapy but still have elevated IOP.

This study used before and after intervention trial design. This study involved fourteen patients with absolute or advanced chronic glaucoma. IOP and the Visual Analog Scale (VAS) score were evaluated before and after the single EA therapy.

The results of this study showed that IOP at one hour after EA decreased by 6.14 ± 1.90 mmHg compared to before EA (p <0.05). IOP at three hours after EA decreased by 7.43 ± 1.98 mmHg compared to before EA (p <0.05). VAS score before EA was 5.56 ± 1.01 and decreased to 1.33 ± 1.50 after EA (p <0.05).

It can be concluded that electroacupuncture had effect in lowering IOP and VAS score significantly."

"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."

"[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.]"

"Deteksi progresi glaukoma penting untuk menentukan efektivitas terapi, dan inisiasi atau eskalasi terapi glaukoma sering kali bergantung pada penilaian progresi. Meskipun demikian, tingkat kesepakatan (agreement) di antara para ahli dalam mengidentifikasi progresi glaukoma bervariasi antar penelitian. Penelitian ini membandingkan agreement dan waktu interpretasi progresivitas glaukoma oleh dokter spesialis mata menggunakan dua metode: perangkat lunak FORUM® dan printouts hasil pemeriksaan OCT dan Humphrey. Sebanyak 36 sample cases yang masing-masing terdiri dari minimal 3 laporan OCT dan 5 laporan Humphrey dinilai oleh 12 dokter spesialis mata non-glaukoma (observers). Agreement terhadap status progresi glaukoma antara observers dan konsensus spesialis glaukoma dan dinyatakan dalam nilai Kappa. Waktu interpretasi merupakan total waktu yang dibutuhkan oleh observers untuk menilai progresivitas glaukoma pada seluruh kasus (n=36). Tingkat agreement terhadap status progresi glaukoma ketika menggunakan FORUM® dan ketika menggunakan metode konvensional (printouts) sama baik, dengan nilai Kappa rata-rata 0,62±0,16 vs. 0,63±0,22 (p=0,928). Metode FORUM® memiliki waktu interpretasi rata-rata yang lebih singkat dibandingkan dengan metode printouts, namun tidak bermakna secara statistik (29,1±9,5 vs. 38,8±13,6 menit, p=0,055). Studi ini menunjukkan bahwa penilaian progresi glaukoma menggunakan perangkat lunak FORUM® Glaucoma Workplace tidak memiliki keunggulan dibandingkan metode printouts dalam hal agreement terhadap status progresi dan waktu interpretasi.

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Detecting glaucoma progression is crucial for determining whether current therapy is effective, and the initiation or escalation of glaucoma therapy often depends on progression status. However, the level of agreement among experts in identifying glaucoma progression varies across studies. This study aims to compare the agreement and interpretation time of glaucoma progression assessment using two methods: the FORUM® software and printouts of OCT and Humphrey reports, as assessed by ophthalmologists. A total of 36 sample cases comprising minimum 3 OCT and 5 Humphrey reports were assessed by 12 ophthalmologists. Agreement on glaucoma progression between observers and standard reference was presented as Kappa value. Interpretation time was defined as the total time required by observers to assess glaucoma progression across all sample cases (n=36). The level of agreement on progression status between the observers when they used FORUM® and conventional (printouts) method were both good, with mean Kappa value 0.62±0.16 vs. 0.63±0.22 respectively (p=0.928). The FORUM® method had a shorter mean interpretation time compared to printouts method, but not statistically significant (29.1±9.5 vs. 38.8±13.6 minutes, p=0.055). This study showed that the assessment of glaucoma progression using FORUM® Glaucoma Workplace software has no superiority to printouts method in terms of agreement on progression status and interpretation time."

"Penyakit glaukoma ditandai dengan hilangnya serabut saraf optik dan astrosit. Kehilangan ini dapat diperiksa dengan mengukur ketebalan neuro-retinal rim dan ukuran optic cup sehubungan dengan optic disc. Namun, penentuan glaukoma masih membutuhkan pemeriksaan mata lengkap oleh dokter mata. Beberapa metodologi otomatis berdasarkan transfer learning deep convolutional neural network untuk klasifikasi glaukoma telah dikembangkan. Untuk meningkatkan akurasi dari penelitian sebelumnya, digunakan metode transfer learning dari metode klasifikasi skin cancer. Arsitektur Inception-v3 dan ResNet50 serta pengklasifikasi serial dari kedua arsitektur tersebut dikembangkan untuk klasifikasi glaukoma otomatis menggunakan citra fundus. Selain arsitektur, variasi splitting dataset dengan metode train-test-split validation serta k-fold cross validation dibandingkan untuk mendapatkan nilai akurasi tertinggi. Berdasarkan hasil penelitian, model terbaik yang didapatkan berupa Inception-v3 dengan metode validasi train-valid-test rasio 80:20 dengan akurasi 95%, presisi 96%, sensitivitas 95%, dan skor-f1 95%. Pembagian 80:20 dipilih karena cocok dengan ukuran dataset yang digunakan. Performa model ini lebih baik dari metode yang telah ada sebelumnya, yaitu Xception dengan peningkatan akurasi sebanyak 2%.

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Glaucoma is characterized by loss of optic nerve fibers and astrocytes. This loss can be checked by measuring the thickness of the neuro-retinal rim and the size of the optic cup in relation to the optic disc. However, the determination of glaucoma still requires a complete eye examination by an ophthalmologist. Several automated methodologies based on transfer learning deep convolutional neural networks for glaucoma classification have been developed. To increase the accuracy of previous research, transfer learning method is used from the skin cancer classification method. The Inception-v3 and ResNet50 architectures also the serial classifiers of the two architectures were developed for automatic glaucoma classification using fundus images. In addition to the architecture, variations of splitting datasets using the train-test-split validation method and k-fold cross validation were compared to get the highest accuracy value. Based on the results of the study, the best model obtained was Inception-v3 with a train-valid-test ratio validation method of 80:20 with 95% accuracy, 96% precision, 95% sensitivity, and 95% f1-score. The 80:20 division was chosen because it matches the size of the dataset used. The performance of this model is better than the previous method, namely Xception with an increase in accuracy of 2%."

"Glaukoma merupakan suatu kelompok neuropati optik progresif yang ditandai dengan kelainan struktural dan fungsi saraf optik. Fungsi penglihatan yang paling terganggu pada penderita glaukoma adalah lapang pandangan. Pemeriksaan perimetri berguna untuk mengidentifikasidan mengukur defek lapang pandangan serta memperkirakan progresivitas glaukoma. Aplikasi perimetri berbasis tablet atau website sangat berguna untuk pemantauan pasien selama pandemi Covid-19 dan dapat digunakan di daerah terpencil dengan keterbatasan alat Humphrey Field Analyzer (HFA). Perimetri Melbourne Rapid Fields (MRF) merupakan teknologi baru yang terjangkau, mudah dibawa dan andal, serta dapat memberikan manfaat yang sama dengan perimetri HFA. Tujuan: Menilai kesesuaian hasil perimetri MRF terhadap HFA pada pasien glaukoma derajat sedang– berat dengan tajam penglihatan terganggu. Metode: Penelitian observasional dengan desain potong lintang untuk menilai hubungan tajam penglihatan terhadap kesesuaian hasil perimetri MRF 24-2 dibandingkan dengan HFA 24-2 pada pasien glaukoma derajat sedang-berat. Dilakukan pengelompokan subjek ke dalam dua grup berdasarkan tajam penglihatan. Setiap subjek dilakukan pemeriksaan dengan dua macam alat, urutan pemeriksaan dilakukan randomisasi blok. Pemeriksaan perimetri HFA sebanyak satu kali dan pemeriksaan MRF sebanyak dua kali. Hasil pemeriksaan yang memenuhi kriteria dilakukan analisis komparatif, korelasi, kesesuaian, serta test-retest repeatability. Hasil: Total 64 mata dari 57 subjek terbagi dalam dua kelompok. Durasi pemeriksaan MRF lebih singkat dibanding HFA (265,7 ± 26,6 vs 384,4 ± 46,7, p < 0,001). Tidak terdapat perbadaan bermakna pada indeks reliabilitas kedua alat. MRF menunjukkan korelasi dan kesesuaian yang sangat kuat dan baik dengan HFA (R = 0,931, ICC = 0,957, p < 0,001 pada hasil mean deviation (MD) dan R = 0,941, ICC = 0,974, p < 0,001 pada hasil Visual Field Index (VFI)). Test-retest repeatability MRF menunjukkan korelasi dan kesesuaian yang sangat baik (R = 0,948, ICC = 0,989, p < 0,001 pada hasil MD dan R = 0,946, ICC = 0,989, p < 0,001 pada hasil Visual Capacity (VC)). Tidak didapatkan korelasi antara tajam penglihatan dengan Root Mean Squared Error (RMSE) hasil MRF, p > 0,05. Kesimpulan: Hasil perimetri MRF memiliki korelasi yang sangat kuat dnegan HFA. MRF juga menunjukkan hasil test-retest repeatability yang sebanding dengan HFA.Keakuratan hasil MRF tidak berkorelasi dengan perbedaan tajam penglihatan.

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Background: Glaucoma is a group of progressive optic neuropathy characterized by structural and functional abnormalities of the optic nerve. The most impaired visual function in glaucoma sufferers is the visual field. Perimetric examination is useful for identifying and measuring visual field defects and predicting the progression of glaucoma. Tablet or website-based perimetry applications are very useful for monitoring patients during the Covid-19 pandemic and can be used in remote areas with limited Humphrey Field Analyzer (HFA) perimetry. Melbourne Rapid Fields (MRF) is a new perimetry technology that is affordable, portable and reliable, also can provide the same benefits as HFA perimetry.

Objective: To assess the agreement of MRF perimetry results with HFA in moderate to severe glaucoma patients with impaired visual acuity.

Methods: Observational study with a cross-sectional design to assess the relationship of visual acuity to the agreement of perimetry MRF 24-2 versus HFA 24-2 in patients with moderate-to-severe glaucoma. Subjects were grouped into two groups based on visual acuity. Each subject was examined with two kinds of perimetry, the order of examination was randomized using block randomization. Participants were tested once on HFA and twice on MRF. Examination results that meet the criteria are analyzed for comparative, correlation, agreement, and test-retest repeatability

Results: A total of 64 eyes from 57 subjects were divided into two groups. MRF examination duration was shorter than HFA (265.7 ± 26.6 vs 384.4 ± 46.7, p < 0.001). There is no significant difference in the reliability index of the two perimetry. MRF showed a very strong and good correlation and agreement with the HFA (R = 0.931, ICC = 0.957, p < 0.001 in the mean deviation (MD) and R = 0.941, ICC = 0.974, p < 0.001 in the results of the Visual Field Index (VFI)). The MRF test-retest repeatability showed a very good correlation and agreement (R = 0.948, ICC = 0.989, p < 0.001 on the MD and R = 0.946, ICC = 0.989, p < 0.001 on the Visual Capacity (VC)). There was no correlation between visual acuity and Root Mean Squared Error (RMSE) MRF, p > 0.05. 

Conclusion: The perimetry results from MRF have a very stong correlation to the HFA outcomes. MRF reveals test-retest repeatability comparable to HFA. The accuracy of MRF results did not correlate with differences in visual acuity."

"Perkembangan terapi adjuvan pada glaukoma untuk memperlambat progresi glaukoma saat ini terus dieksplorasi. Penelitian ini mengevaluasi efek Mirtogenol, pada perubahan perfusi okular (perfusi kapiler dan flux index), ketebalan lapisan serabut saraf retina (LSSR), dan tekanan intraokular (TIO) pada pasien glaukoma primer sudut terbuka (GPSTa) yang menerima terapi timolol maleat 0,5% tetes mata. Penelitian ini merupakan uji klinis acak terkontrol tersamar ganda. Terdapat 36 subjek (37 mata) dengan GPSTa dan TIO < 21 mmHg yang diacak untuk mendapatkan Mirtogenol atau plasebo selama 8 minggu. Kedua grup dibandingkan, pada kelompok Mirtogenol, rata-rata peningkatan perfusi kapiler dan flux index lebih baik, dan pada kuadran superior terdapat hasil yang signifikan secara statistik setelah 4 minggu (p=0.018). Rerata perbedaan ketebalan LSSR di seluruh kuadran terdapat penurunan dengan nilai yang lebih sedikit pada kelompok Mirtogenol (p>0.05). Penurunan TIO yang konsisten pada kelompok Mirtogenol setelah 8 minggu (p>0.05). Ditemukan efek samping pada 1 subjek yaitu gangguan lambung. Suplementasi Mirtogenol, sebagai terapi adjuvan pada pengobatan glaukoma dapat meningkatkan perfusi okular, mempertahankan ketebalan LSSR, dan menurunkan TIO.

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The development of adjuvant therapies in glaucoma to slow its progression is currently being explored. This study evaluates the effects of Mirtogenol on changes in ocular perfusion (capillary perfusion and flux index), retinal nerve fiber layer (RNFL) thickness, and intraocular pressure (IOP) in primary open-angle glaucoma (POAG) patients receiving 0.5% timolol maleate eye drops. This study is a double-blind, randomized controlled clinical trial. There were 36 subjects (37 eyes) with POAG and IOP < 21 mmHg randomized to receive Mirtogenol or placebo for 8 weeks. Compared between the two groups, the Mirtogenol group showed a better average improvement in capillary perfusion and flux index, with statistically significant results in the superior quadrant after 4 weeks (p=0.018). The mean difference in RNFL thickness across all quadrants showed a smaller reduction in the Mirtogenol group (p>0.05). There was a consistent decrease in IOP in the Mirtogenol group after 8 weeks (p>0.05). One subject experienced side effects, specifically stomach disturbances. Mirtogenol supplementation, as an adjuvant therapy in glaucoma treatment, can improve ocular perfusion, maintain RNFL thickness, and reduce IOP."

"Tujuan: Mengevaluasi ada tidaknya perbedaan kualitas air mata pada penderita glaukoma yang mengalami mata kering antara yang diberi tetes mata sodium hialuronat 0,1% mengandung bahan pengawet benzalkonium klorida dan tetes mata sodium hialuronat 0,1% tanpa bahan pengawet. Metode: Penelitian ini merupakan penelitian prospektif terandomisasi. 30 pasien glaukoma yang mengalami mata kering dirandomisasi ke dalam kedua kelompok. Kelompok pertama,mendapatkan obat tetes mata artificial tear mengandung sodium hialuronat 0,1% dengan pengawet benzalkonium klorida, sedangkan kelompok II, mendapatkan obat tetes mata artificial tear mengandung sodium hialuronat 0,1% tanpa pengawet selama 1 bulan. Pemeriksaan Schirmer test, TFBUT, OPI, dan sitologi impresi dilakukan pada kedua kelompok baik sebelum dan sesudah 1 bulan penetesan obat tetes mata artificial tear. Hasil: Nilai median sitologi impresi sel goblet pasca penetesan artificial tear meningkat pada kelompok I (118,15-485) dan kelompok II (67.0-200), namun secara statistik tidak ada perbedaan bermakna. Nilai rata ? rata TFBUT pasca penetesan pada kelompok I (14,45±7,85) dan kelompok II (13,91±7,46) meningkat dibandingkan sebelum penetesan, serta secara statitstik memiliki perbedaan yang bermakna. Nilai Schirmer test dan OPI pasca penetesan pada kedua kelompok mengalami peningkatan secara klinis dibandingkan sebelum penetesan, namun tidak terdapat perbedaan bermakna secara statistik. Simpulan: Pemberian artificial tear mengandung sodium hialuronat 0,1% baik dengan pengawet maupun tanpa pengawet selama 1 bulan memberikan peningkatan Schirmer test, TFBUT,OPI dan sitologi impresi sel goblet.

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Objectives: To evaluate the difference of quality of tears between glaucoma patients suffering from dry eyes treated with 0.1% sodium hyaluronat eyedrops with preservative benzalconiumchloride and those treated with 0.1% sodium hyaluronat eyedrops without preservative.

Methods: This is a randomized prospective study. Subjects were 30 glaucoma patients suffering from dry eyes, whom later randomized into two groups. Group I was treated with artificial tears eye 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% sodium hyaluronat without preservative for one-month duration. Before and after the treatment with artificial tears eyedrops, subjects of both groups were tested with Schirmer test, TFBUT, OPI, and impression cytology.

Results: The median of goblet cells in impression cytology after treatment with artificial tears eye drops increased in group I (118, 15 ? 485) and group II (67, 0 ? 200), even though not statistically significant. 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 showed a 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 or without preservative for one month will improve Schirmer test, TFBUT, OPI, and goblet cells impressions cytology result on glaucoma patients suffering from dry eyes."

"Tujuan tulisan ini adalah untuk membandingkan penurunan tekanan intraokuler (TIO) setelah pemberian obat tetes mata Trovoprost 0,004% dengan setelah pemberian timolol 0,5% pada glaukoma primer sudut tertutup kronik. Penelitian prospektif yang dilakukan dari April 2005 sampai Juli 2005 di Departemen Mata Rumah Sakit Cipto Mangunkitsumo (RSCM) Jakarta pada pasien glaukoma primer sudut tertutup kronik. Subjek dibagi secara acak menjadi 2 grup: grup pertama diberi tetes mata Travoprost 0,004% sekali sehari, dan grup ke dua diberi timolol 0,5% dim kali sehari. Dua minggu sesudah pengobatan dengan obat yang pertama, obat diganti dengan obat yang kedua. Tekanan intraokuler dicatat sebelum pengobatan dimulai, pada hari 1, hari 7 dan hari 14. Masa wash out terlaksanakan selama tiga minggu sebelum terapi awal dan setelah dilakukkan cross over. Enam belas pasien (32 mata) memenuhi kriteria inklusi dan diikutsertakan pada penelitian ini. Sebelum terapi, TIO pada grup Travoprost sebesar 25.38 ± 3,01 sedangkan pada grup timolol sebesar 25,88 ± 2,55 mmHg (p=0,354). Pada hari ke 7 pengobatan, TIO untuk masing-masing sebesar 16,75 ± 1,92 dan 21,25 +_ 3,09 (p=0,00l). Sedangkan pada hari ke 14 pengobatan, TIO untuk masing-masing grup sebesar 13,94 ±_ 2,02 dan 19,25 ± 2,18 (p=000). Dengan demikian Travoprost secara statistik bermakna menurunkan TIO lebih cepat dan besar dari pada timolol (p<0.05). Telex mala Travoprost 0,004% menurunkan tekanan intraokuler lebih cepai dan lebih besar daripada teles mata limolol 0,5%. (Med J Indones 2006; 15:242-5).

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The objective of this study is to compare the reduction of intraocular pressure (IOP) after instillation of Travoprost compared with timolol in chronic primary angle-closure glaucoma. A prospective randomized, crossover study was conducted from April 2005 to July 2005 at Department of Ophthalmology, National Central General. Hospital (RSCM) Jakarta on subjects with chronic primary angle-closure glaucoma. Subjects were randomly divided into 2 groups: those taking Tmvoprost once daily and those taking timolol twice daily. Two weeks after treatment with the first drug, the second drug was substituted. Intraocular pressure was recorded before therapy, at day 1, day 7, and day 14. There was a wash out period of three weeks prior to initial treatment and after the cross over. Sixteen subjects (32 eyes) met the inclusion criteria and were included in this study. The mean baseline (OP in the Travoprost group was 25.38 ±3.01 mmHg, while in the timolol group it was 25.88 ±2.55 mmHg (p=0.354). At dav 7, the IOP were consecutively 16.75 ± 1.92 mmHg and 21.25 ± 3.09 mmHg (p=0.00i) and at day 14 IOP were 13.94 + 2.02 mmHg and 19.25 + 2.18 mmHg (p=000). This showed that Travoprost decreased the IOP faster and greater than timolol. The mean baseline IOP was 25.38 ± 3.01 mmHg was decreased to 11.44 ± 1.90 mmHg with Travoprost. In the timolol group, the mean baseline IOP of 25.88 ± 2.55 mmHg was decreased to 6.63 ± 2.25 mmHg. Statistically, Travoprost significantly reduced the IOP faster and greater than timolol "