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Abstrak :
Aim: To obtain the prevalence and pattern causes of childhood blindness in schools for the blind in Java island (Indonesia) with a view to determining potentially preventable and treatable causes. To evaluate risk factors that influence the pattern of causes of blindness. Methods: Four hundred and seventy nine students in five school for blind in Java island, Indonesia, were examined clinically during December 2005 until January 2006 using the standard WHO/PBL eye examination record for blindness and low vision form. Data were analyzed for those children with blindness visual acuity less than 3/60, aged less than 16 years or the onset of the visual loss younger than 16 years. Relation between avoidable causes of blindness and social demography or medical characteristics factors were analyzed. Results: Most of the students (95%) were blind (BL); 4.6% were severe visual impairment (SVI) and 0.4% visual impairment (VI). The major anatomical site of blindness were whole globe (pthisis bulbi) in 37.1%, retina (retinal dystrophies) in 15.4%, Iens (cataract) in 15.4% and cornea (corneal scar) in 11.6%. The underlying causes of blindness were undetermined/ unknown in 32.5%, genetic diseases in 30.8% (mainly retinal dystrophies) and postnatal infection in 29.5% (mainly measles or vitamin A deficiency). The risk factors that influence the pattern of cause childhood blindness were consanguinity, presence of family history and onset of blindness since birth. Conclusions: The major causes of blindness were a mixed pattern of hereditary/ genetic diseases and postnatal infection. Measles and vitamin A deficiency were the major causes of preventable blindness, while cataract and glaucoma/ buphthalmos were the major causes of treatable blindness. There is a need to strengthen current primary preventions strategies with improved the efficacy of immunization and vitamin A supplementation coverage. Tertiary referral centres for paediatric ophthalmology should be set up to manage treatable causes, such as cataract and glaucoma.

Abstrak :
Tujuan Untuk mengetahui efektivitas pemberian suplemen antioksidan vitamin C dan E terhadap perbaikan sensitivitas kontras pada anak-anak penderita defisiensi vitamin A. Subyek dan Metode Penelitian uji klinis tersamar ganda pada anak usia 7-10 tahun di Nanggroe Aceh Darussalam. Subyek dengan kadar serum vitamin A rendah ( 0,35-0,70pmolll ) dan fungsi sensitivitas kontras abnormal ( <1,75 log unit ) diikutkan dalam penelitian ini. Pemberian suplemen vitamin dibagi atas dua kelompok, yaitu vitamin A 200.000 IU dan plasebo serta kelompok vitamin A 200,000 IU, vit.C 250mg dan vit.E 200 IU pada hari 1,2,14. Evaluasi kadar serum vitamin A dilakukan pada hari ke-21 dan sensitivitas kontras pad hari ke-8,9,14 dan 21. Hasil : Ditemukan sebanyak 48 (26,6%) anak dari 180 anak usia 7-10 tahun menderita defisiensi vitamin A dengan sensitivitas kontras abnormal. Peningkatan kadar serum vitamin A tidak menunjukkan perbedaan yang berbeda bermakna pada kedua kelompok (p=0.84), tapi perbaikan fungsi sensitivitas kontras lebih cepat dan tinggi ditunjukkan oleh subyek kelompok suplemen vit.A, C dan E pada hari ke-8 dan 14. Kesimpulan : Pemberian suplemen antioksidan secara bermakna meningkatkan kinerja vitamin A dalam memperbaiki fungsi sensitivitas kontras pada anak-anak penderita defisiensi vitamin A.

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Purpose To evaluate the effectiveness of vitamin A, C and E supplementations to the recovery of contrast sensitivity in children with vitamin A deficiency. Material and methods This research is double blind clinical study to 7-10 year old children in Nanggroe Aceh Darussalam. The subject are patients with low concentration of vitamin A serum ( 0,35-0,70µmoV1 ) and abnormal contrast sensitivity ( <1,75 log unit ). The vitamin supplementations were divided into two groups, e.g. vitamin A 200.000 IU with placebo and vitamin A 200.000 IU, vit.C 250mg and vit.E 200 IU, which were given on the 1S1 ,2nd and 14'h day . The vitamin A serum concentration was evaluated on the day 21st and evaluation of contrast sensitivity on 8u' , 9`h, 14th and 215` day. Results There were 48 (26,6% ) out of 180 7-10 year old children that suffered vitamin A deficiency with abnormal contrast sensitivity. There were no significant differenciess of vitamin A serum concentration between two groups (p=0,84), however there was faster and higher contrast sensitivity function recovery to the subject with vit.A,C and E supplementation on the 8th and 14'h day. Conclusion Multi vitamin (antioxidants ) supplementations was significantly improve the vitamin A function in recovering the contrast sensitivity on children with vitamin A deficiency.

Abstrak :
Tujuan: Mengetahui hubungan polimorfisme genetik MnSOD Ala-9Val dengan retinoblastoma pada pasien-pasien di Indonesia, serta menilai hubungan polimorfisme gen MnSOD ini dengan aktivitas enzim SOD. Disain: Penelitian kasus-kontrol Metode: Polimorfisme gen MnSOD Ala-9Va1 dideteksi pada 35 pasien retinoblastoma yang berasal dari Divisi Pediatri Departemen Mata RS Cipto Mangunkusumo Jakarta dan 81 kontrol anak sehat dengan menggunakan metode polymerase chain reaction (PCR) dan restriction fragment length polymorphism (RFLP) menggunakan enzim restriksi NgoMIV. Aktivitas SOD dinilai dengan menggunakan prinsip perubahan dl-epinefrin menjadi adenokrom yang dapat dibaca dengan spektrofotometer. Hasil: Pada penelitian ini hanya ditemukan genotip Val/Val dan Ala/Val. Frekuensi polimorfisme gen MnSOD genotip Ala/Val meningkat pada kelompok kasus dibandingkan kontrol meskipun tidak bermakna (OR 2,643 95% CI=0,850-8,217). Frekuensi ale! juga meningkat pada kelompok pasien dibandingkan kontrol (OR=2,46, 95% CI=0,829-7,302). Aktivitas SOD lebih tinggi pada kelompok kasus daripada kontrol (p=0,433). Namun tidak ditemukan perbedaan aktivitas SOD antara kelompok genotip Val/Val dan Ala/Val. Kesimpulan: Sejauh ini frekuensi polimorfisme gen MnSOD Ala-9 Val genotip Ala/Val meningkat pada pasien retinoblastoma, namun genotip ini belum dapat dikatakan sebagai faktor resiko retinoblastoma. Selain itu tidak ditemukan hubungan bermakna antara polimorfisme gen MnSOD Ala-9 Val dengan retinoblastoma dan aktivitas SOD.

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Objectives: In the present study, we investigated the genetic association between a functional polymorphism Ala-9Va1 in the human manganese SOD (MnSOD) gene and retinoblastoma; and the association between this polymorphism and SOD activity. Methods: This case-control study was examined in 35 retinoblastoma cases and 81 controls. The Ala-9Val polymorphism was detected by PCR and RFLP using NgoMV restriction enzyme. SOD activities was evaluated by the changes of dlepinefrin to adenochrom which measured by spectrofotometry. Results: No significant differences in the allelic or genotipic distribution between retinoblastoma and controls were observed. Retinoblastoma risk was slightly elevated in Ala/Val genotype (OR: 2,643, 95%CI: 0,85-8,217) as compared with Va JVal genotype. We did not find AlalAla genotype in both groups. There was significant difference in SOD activity between cases and controls (p=0,033). The SOD activity was higher in retinoblastoma than controls. Conclusions: The MnSOD gene polymorphism Ala-9Val was not found to be associated with retinoblastoma in this case-control study. It seemed that the Ala-9Val polymorphism was not a risk factor for retinoblastoma. There was also no association between MnSOD gene Ala-9VaI polymorphism and SOD activities. Studies with a larger sample size are needed to confirm the findings.

Abstrak :
[ABSTRAK
Penelitian ini merupakan randomized, single blind controlled trial yang bertujuan untuk menilai keamanan pemakaian ulang vitrektor single-use. Penelitian ini menilai proporsi, jumlah koloni dan spesies mikroorganisme yang tumbuh pada vitrektor bekas pakai satu kali yang menjalani reprocessing dengan dan tanpa pembilasan povidone-iodine 5%. Sebanyak 88 sampel vitrektor 23G dirandomisasi menjadi dua kelompok yaitu kelompok I yang menjalani reprocessing saja dan kelompok II yang menjalani pembilasan povidone-iodine 5% dan reprocessing. Kultur mikroorganisme dilakukan pada bagian tip dan bilasan lumen tip-connector-extension cairan. Pada kelompok I, ditemukan pertumbuhan bakteri Staphylococcus hominis pada satu tip (2,3%), sedangkan semua bilasan lumen steril. Pada kelompok II, semua kultur tip dan bilasan lumen steril. Walaupun tidak terdapat perbedaan signifikan proporsi pertumbuhan mikroorgansime di kedua kelompok (p=1,000), pertumbuhan bakteri pada kelompok I dapat berpotensi memiliki dampak klinis dan mikrobiologi yang berarti.

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ABSTRACT
A randomized, single blind controlled trial was done to evaluate the safety of reusing a single-use vitrector. This study evaluated the proportion, number of colony, and the species of microorganism growth from vitrectors, which underwent reprocessing with and without 5% povidone-iodine flushing. Eighty-eight samples of 23G vitrector were randomized into two groups; Group I undergone direct reprocessing (cleaning, disinfection, repackaging, and ethylene oxide sterilization), whereas Group II were flushed with 5% povidone-iodine before undergone reprocessing. Microorganism culture of vitrector was performed for the tip and flushing of the tip-connector-fluid extension lumen. In Group I, Staphylococcus hominis was found on culture of one tip (2,3%), whereas all lumen cultures were negative or sterile. In Group II, all tip and lumen cultures were negative or sterile. Although no significant difference in proportion of microorganism growth between groups (p=1.000), microorganism growth found in Group I might have a clinical and microbiological effect. ;A randomized, single blind controlled trial was done to evaluate the safety of reusing a single-use vitrector. This study evaluated the proportion, number of colony, and the species of microorganism growth from vitrectors, which underwent reprocessing with and without 5% povidone-iodine flushing. Eighty-eight samples of 23G vitrector were randomized into two groups; Group I undergone direct reprocessing (cleaning, disinfection, repackaging, and ethylene oxide sterilization), whereas Group II were flushed with 5% povidone-iodine before undergone reprocessing. Microorganism culture of vitrector was performed for the tip and flushing of the tip-connector-fluid extension lumen. In Group I, Staphylococcus hominis was found on culture of one tip (2,3%), whereas all lumen cultures were negative or sterile. In Group II, all tip and lumen cultures were negative or sterile. Although no significant difference in proportion of microorganism growth between groups (p=1.000), microorganism growth found in Group I might have a clinical and microbiological effect. , A randomized, single blind controlled trial was done to evaluate the safety of reusing a single-use vitrector. This study evaluated the proportion, number of colony, and the species of microorganism growth from vitrectors, which underwent reprocessing with and without 5% povidone-iodine flushing. Eighty-eight samples of 23G vitrector were randomized into two groups; Group I undergone direct reprocessing (cleaning, disinfection, repackaging, and ethylene oxide sterilization), whereas Group II were flushed with 5% povidone-iodine before undergone reprocessing. Microorganism culture of vitrector was performed for the tip and flushing of the tip-connector-fluid extension lumen. In Group I, Staphylococcus hominis was found on culture of one tip (2,3%), whereas all lumen cultures were negative or sterile. In Group II, all tip and lumen cultures were negative or sterile. Although no significant difference in proportion of microorganism growth between groups (p=1.000), microorganism growth found in Group I might have a clinical and microbiological effect. ]

Abstrak :
ABSTRAK Tujuan: Membandingkan ukuran, perubahan dilatasi, dan laju dilatasi pupil serta perubahan tekanan darah sistolik, diastolik, mean arterial pressure (MAP), dan frekuensi nadi pada neonatus yang diberikan tetes mata tropikamid 0,5% dan fenilefrin 2,5% dengan maupun tanpa penambahan tetrakain 0,5%. Metode: Uji eksperimental acak tersamar ganda ini membandingkan dua kelompok, yaitu yang mendapat tetes mata tetrakain 0,5% 5 menit sebelum penetesan prosedur standar midriatikum (tropikamid 0,5% + fenilefrin 2,5% - 3x penetesan tiap 15 menit) atau artificial tears + prosedur standar midriatikum. Seratus mata neonatus aterm sehat dirandomisasi ke dalam masing-masing kelompok. Pemeriksaan diameter pupil, tekanan sistolik, diastolik, MAP, dan frekuensi nadi dilakukan pada baseline, menit ke-15, 30, 45, dan 60 pasca penetesan obat. Hasil: Penambahan tetrakain 0,5% setelah 60 menit menghasilkan diameter pupil dan selisih perubahan dilatasi lebih besar, serta laju dilatasi pupil lebih cepat yang secara statistik bermakna (p<0,05). Terjadi peningkatan tekanan sistolik dan MAP serta penurunan frekuensi nadi yang lebih rendah dengan penambahan tetrakain 0,5%, tetapi tidak berefek serupa terhadap peningkatan tekanan diastolik. Perbedaan tersebut tidak bermakna secara statistik. Simpulan: Penambahan tetrakain 0,5% terhadap tropikamid 0,5% dan fenilefrin 2,5% menghasilkan efek dilatasi pupil yang lebih besar dan lebih cepat. Prosedur ini aman dilakukan pada neonatus.

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ABSTRACT Objective: To evaluate the efficacy and safety in pre-instilling tetracaine 0.5% over mydriatic agents in dilating the pupil of newborn eyes. Design: Double-blind randomized-controlled experimental study. Methods: The study was performed in 100 eyes of full-term healthy newborns. Each eye was randomized to receive either 0.5% tetracaine (intervention group) or artificial tears (placebo group) five minutes prior to 0.5% tropicamide + 2.5% phenyleprine - 15 minutes apart for 3 times. Pupil diameter, size changes and dilatation rate, as well as systolic, diastolic, mean arterial blood pressure and pulse rate were measured at baseline, 15, 30, 45 and 60 minutes after eye drops instillation. Results: Pupil diameter and size changes were significantly larger, and the rate of pupillary dilatation significantly faster in the intervention group compare to the placebo group after 60 minutes (p<0.05). Increasing systolic and mean arterial pressure, along with decreasing pulse rate in the intervention group were lower than the placebo group. Higher increase of diastolic blood pressure was observed in the intervention group, although the value was not statistically significant. Conclusions: Pre-instillation of 0.5% tetracaine over 0.5% tropicamide and 2.5% phenylephrine effected in larger and faster pupillary dilatation; and it appears safe to administer in newborn eyes.

Abstrak :
Pendahuluan: Pemberian terapi adjuvant (kemoterapi dan/atau radiasi) direkomendasikan untuk semua penderita retinoblastoma yang memperlihatkan gambaran histopatologik risiko tinggi untuk residif atau... .. metiiStasls jauh, diantaranya diferensiasi tumor, invasi khoroid dan sklera, serta nervus optikus. Apoptosis diperkirakan memegang peranan penting dalam menentukan respon terhadap kemo- dan radioterapi. Defek pada mekanisme apoptosis akan mengakibatkan sel tumor bersifat radio- atau kemoresisten. Eksekusi apoptosis tergantung kepada keadekuatan easpase efektor, terutama caspase-3. Ekspresi caspase-3 yang tinggi meneerminkan bahwa kedua jalur easpase yaitu jalur endogen dan eksogen berfungsi adekuat, sehingga sel tumor akan responsif terhadap kemo- dan radioterapi serta merefleksikan prognosis yang baik. Metode: Diperoleh 12 spesimen hasil enukleasi atau eksenterasi penderita retinoblastoma unilateral dengan gambaran histopatologik risiko tinggi. Ekspresi caspase-3 aktif diperiksa seeara imunohistokimia. Dilakukan penghitungan sel tumor dengan ekspresi easpase-3 aktif positif dan kemudian dihubungkan dengan ketahanan hidup penderita pasea pemberian tempi adjuvan. Dinilai juga hubungan antara derajat diferensiasi tumor dengan ketahanan hidup 5 tahun penderita. Basil: Seluruh penderita retinoblastoma mempunyai lebih dari satu gambaran histopatologik risiko tinggi, 58,3% memperlihatkan ekspresi easpase-3 aktif negatif dan 41,7% positif. Penderita dengan invasi sel tumor trans-skIera dan batas sayatan nervus optikus (N II) tidak bebas tumor memperlihatkan ketahanan hidup 5 tahun yang lebih buruk (p=O,03). Lima dari 7 penderita dengan ekspresi caspase-3 aktif negatif dan 3 dari 5 dengan ekspresi caspase-3 aktif meninggal dunia sebelum 5 tahun (RR=1.19, p=O,81l). Empat dari 7 penderita retinoblastoma berdiferensiasi buruk meninggal dunia sebelum 5 tahun sedangkan pada yang berdiferensiasi baik sebanyak 4 dari 5 penderita (RR=O,71, p=O,634). Tiga dari 7 tumor berdiferensiasi buruk memperlihatkan ekspresi easpase- aktif negatif dibandingkan dengan 4 dari 5 tumor (RR=O,53, p=O,414) Kesimpulan: lnvasi trans-skIera dan batas sayatan N II yang tidak bebas tumor berhubungan dengan ketahanan hidup 5 tahun yang buruk pada penderita retinoblastoma .. Terdapat hubungan dengan kekuatan sedang antara derajat diferensiasi tumor dengan ketabanan hidup 5 tahun penderita dan dengan derajat diferensiasi tumor walaupun seeara statistik tidak bermakna dikarenakan jurnlah sampel yang kecil. Tumor yang berdiferensiasi buruk memperlihatkan ketahanan hidup 5 tahun yang lebih baik (meneerminkan respon yarIg baik terhadap kemo- danlatau radioterapi) serta ekspresi caspase-3 aktif yang positif. Bagaimanapun juga, berdasarkan penelitian ini tidak terdapat hubungan antara besar caspase-3 aktif dengan ketahanan hidup 5 tahun penderita.

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 :
Katarak subkapsular posterior (SKP) dan peningkatan tekanan intraokular (TIO) adalah komplikasi okular tersering akibat penggunaan kortikosteroid oral. Hal ini dapat terjadi pada pemberian dosis tinggi dan jangka panjang. Di Indonesia, tidak data mengenai hubungan antara dosis dan lama terapi terhadap kedua komplikasi tersebut pada anak sindrom nefrotik idiopatik (SNI). Tujuan penelitian ini adalah untuk mengetahui hubungan antara dosis kumulatif, lama terapi dengan kejadian katarak SKP maupun peningkatan TIO dan faktor yang memengaruhinya pada anak SNI di rumah sakit Cipto Mangunkusumo (RSCM). Studi ini merupakan studi potong lintang pada anak SNI usia 4-18 tahun yang mendapat terapi kortikosteroid oral minimal enam bulan secara terus menerus. Pemeriksaan mata lengkap dilakukan untuk mengevaluasi katarak SKP, tajam penglihatan dan peningkatan TIO. Dari 92 anak yang dianalisis, terdapat 19,6% anak yang menderita katarak SKP, 12% anak dengan peningkatan TIO dan satu anak dengan best corrected visual acuity (BCVA) <6/20. Median dosis kumulatif kortikosteroid oral adalah 12.161 mg (rentang 1.795-81.398) dan median lama terapi adalah 23 bulan (rentang 6-84). Terdapat hubungan antara dosis kumulatif (P=0,007) dan lama terapi (P=0,006) terhadap kejadian katarak SKP dengan titik potong optimal 11.475 mg dan 24 bulan. Jenis kelamin perempuan akan meningkatkan kejadian katarak SKP sebesar empat kali dibandingkan lelaki (PR=4; IK 95%=1,57-13,38; P=0.001). Penelitian ini menunjukkan makin tinggi dosis kumulatif dan/atau makin lama terapi kortikosteroid oral, maka makin besar angka kejadian katarak SKP (nilai batasan ≥ 11.475 mg dan  ≥ 24 bulan). Dosis kumulatif dan lama terapi tidak berhubungan dengan kejadian peningkatan TIO. ......Posterior subcapsular cataract (PSC) and raised intraocular pressure (IOP) are the most common ocular complications due to administration oral corticosteroid. These can occur in high dose and long term use. In Indonesia, no data regarding correlation between dose, therapeutic duration and both complications in children with idiopathic nephrotic syndrome (INS). The aim of this study was to evaluate the correlation between cumulative dose, therapeutic duration with the occurrence of PSC and raised IOP and factors associated with these complications in children with INS at Cipto Mangunkusumo Hospital (CMH). This is a cross-sectional study of children with INS aged 4-18 years who received oral corticosteroid therapy for at least six months continuously. A complete eye examination was performed to evaluate PSC, raised IOP and visual acuity. Of the 92 children analyzed, 19.6% had PSC, 12% had raised IOP and one child with best corrected visual acuity (BCVA) <6/20. The median cumulative dose of oral corticosteroids was 12,161 mg (range 1,795-81,398) and the median duration of therapy was 23 months (range 6-84). There were associaton between cumulative dose (P=0.007) and duration of therapy (P=0.006) to the occurrence of PSC with cut off point 11,475 mg and 24 months. Female sex will increase the occurence of PSC four times compared to male (PR=4; 95% CI=1.57-13.38; P=0.001). This study revealed that the higher cumulative dose and/or the longer of oral corticosteroid therapy, the higher occurence of PSC (cut off point ≥ 11.475 mg and ≥ 24 months). Cumulative dose and therapeutic duration were not associated with the occurence of raised IOP.

Abstrak :
Latar belakang: Pandemi COVID-19 merupakan tantangan bagi dokter spesialis mata di Indonesia. Kondisi ini mengakibatkan terjadinya perubahan pada pola pelayanan kesehatan dan dapat menjadi faktor risiko terjadinya infeksi COVID-19 pada dokter spesialis mata. Tujuan: Menilai dampak pandemi terhadap faktor pola pelayanan kesehatan mata dan hubungannya dengan riwayat terinfeksi COVID-19 pada dokter spesialis mata di Indonesia Metode: Penelitian menggunakan desain potong lintang dengan survei daring (Google form) pada November 2022. Hasil: Kuesioner terdiri dari 30 pertanyaan yang dikirimkan kepada 1555 responden dengan respon rate 20,97%, sehingga diperoleh 318 responden. Responden umumnya berusia 30-40 tahun dengan pengalaman kerja >10 tahun, dan merupakan dokter mata umum. Terdapat 175 responden yang memiliki riwayat terinfeksi COVID-19 di awal pandemi (Maret 2020 – Desember 2021) dan di masa transisi pandemi (Januari – November 2022). Faktor pola pelayanan kesehatan mata (penggunaan APD, pembatasan jumlah pasien di poliklinik, pembatasan jumlah praktik, pembatasan jumlah operasi mata, konsultasi telemedisin) tidak berhubungan dengan riwayat terinfeksi COVID-19 pada dokter spesialis mata di masa pandemi (p>0,05). Kesimpulan: Terdapat lebih dari separuh jumlah dokter spesialis mata yang pernah terinfeksi COVID-19 selama pandemi. Pembatasan jumlah pasien di poliklinik rawat jalan tidak berhubungan dengan riwayat terinfeksi COVID-19 pada dokter spesialis mata di Indonesia di awal dan masa transisi pandemi. ......Background: The COVID-19 pandemic is a challenge for ophthalmologists in Indonesia. This condition causes a change of eye health services and can be a risk factor for COVID-19 infection in ophthalmologists. Purpose: To evaluate changes in patterns of eye health services and risk factors related to COVID-19 infection in ophthalmologists Methods: The design of this study was used a cross-sectional study with an online survey (Google form) in November 2022. Results: The questionnaire consisted of 30 questions which were sent to 1555 respondents with a response rate of 20.97%, so that 318 respondents were obtained. Respondents are generally aged 30-40 years with work experience >10 years, and work as general ophthalmologists. There were 175 respondents who had a history of being infected with COVID-19 in early pandemic (March 2020 – December 2021) and transition period of pandemic (January – November 2022). Factors in the pattern of eye health services (use of PPE, limiting the number of patients at the polyclinic, limiting the number of practices, limiting the number of eye surgeries, telemedicine consultations) were not associated with a history of COVID-19 infection among ophthalmologists during the pandemic (p>0.05). Conclusion: More than half of ophthalmologists have been infected with COVID-19 during the pandemic. Limiting the number of patients at the polyclinic was not related to a history of COVID-19 infection among ophthalmologists in Indonesia at the early and transition period of the pandemic.