REFERAT
GLAUKOMA FAKOMORFIK
DISUSUN OLEH: TRIYOGA PERKASA 1102008257
PEMBIMBING: DR HERMAN NUR SP.M
DEPARTEMEN ILMU PENYAKIT MATA RSPAD GATOT SOEBROTO JAKARTA
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KATA PENGANTAR
Puj !"u#u$ #%&'($') #%&'($') A**'& S+T, #'$%-' (%-'- $'&/') ('- #'$u-'N"' #'$u-'N"' %-u*! ('') /%-"%*%!'#'- %-u*!'- $%%$') (%-'- ju(u* 3 G*'u#4/' F'#4/4$# R%%$') - ()u*! u-)u# /%-'/6'& %-%)'&u'- ('- ''!'- /%-%-' G*'u#4/' F'#4/4$# ('- /%$u'#'- !'*'& !')u !"'$') ('*'/ /%-#u) K%'-)%$''- K*-# ( D%'$)%/%- M')' RSPAD G')4) S4%6$4)4. P'(' #%!%/')'- - %-u*! -- /%-u'#'- )%$/'#'!& #%'(' (4!%- %/6/6-, ($. H%$/'H%$/'-
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I. L')'$ B% B%*'#'- M')' M')' '('* '('*'& '& !'*' !'*'& & !')u !')u -($ -($'' %-) %-)- '(' '(' )u6u& )u6u& /'-u! /'-u!' '.. B%$ B%$u- u-! ! !%6' !%6'' ' -($ -($'' %-*&')'-. A ( ' 6 % 6 %$ ' ' ' - u ' - ' ( ' / ' ) ' " ' - ( ' ' ) /% /6 u ' ) u - ! /')' 6%$#u$'-. B%6%$'' '-u'- '(' /')' )%$!%6u) ( '-)'$'-"' "')u *'u#4/'. O*%& #'$%-' )u, !'-')*'& %-)- u-)u# #)' /%-%-'* *'u#4/'. G*'u#4/' '('*'& !u')u -%u$4') 4)# #$4-# (('') "'- ()'-(' 4*%& %-%#u-';u ;u-< -< (!#u! (!#u! 4)#u 4)#u!! ('- %-% %-%*'*'- *''- *''-''- '-('- '-('-,, 6'!'6'!'-"' "' (!%$) (!%$)' ' %--#' %--#')')')%#'-')%#'-'- -)$'4 -)$'4#u* #u*'$. '$. M%#'- M%#'-!/% !/% %--#' %--#')')'- )%#'-' )%#'-'- -)$'4 -)$'4#u* #u*'$ '$ '(' '(' *'u#4 *'u#4/' /' '('*'& '('*'& '-u'- '*$'- #%*u'$ '=u%4u! &u/4$ '#6') #%*'-'- !!)%/ ($'-'!% !u(u) 6*# /')' (%';*'u#4/' !u(u) )%$6u#'< ')'u '-u'- '#!%! '=u%4u! &u/4$ #% !!)%/ ($'-'!% ;*'u#4/' !u(u) )%$)u)u<. G*'u#4/ G*'u#4/'' '#4/4 '#4/4$ $# # /%$u'# /%$u'#''- *'u#4 *'u#4/' /' !%#u-(% !%#u-(%$$ !u(u) !u(u) )%$)u) )%$)u)u, u, "'- "'- (#'$% (#'$%-'#' -'#''#6') *%-!' -)u/%!%-. P%--#')'- #%)%6'*'- *%-!' 4*%& #'$%-' $4$%!>)'! #')'$'# /%/6u') *%-!' /%-j'( -)u/%!%- !%'$' %'), ')'u #')'$'# )$'u/')#' ('') 6%$'#6') '(' &'/6')'('- !u(u) )%$)u)u. Su(u) )%$)u)u /%$u'#'- '#6') ('$ /%#'-!/% )%$&'*'--"' u*, ')'u #'$%-' ('$'/' *%-!'$! "'- !'*'& %-%/')'--"' ;*u#!'!4<.
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1. A-') A-')4/ 4/ L%-! L%-!'' P'(' /'-u!', *%-!' /')' 6#4->%#!, 6#4->%#!, )('# /%-'-(u- /%-'-(u- %/6u*u& ('$'&, )%/6u! '-('-, (%-'- ('/%)%$ ? //, ('- )%6'* !%#)'$ 5 //. L%-!' )%$($ ('$ #'!u*, %)%*, #4$)%#! ('- -u#*%u!. K% '$'& /')' '-)%$4$, *%-!' 6%$&u6u-'- (%-'- '$'- 6*# /')', ('- #% '$'& /')' 4!)%$4$, *%-!' 6%$&u6u-'- (%-'- 6'('- #''. D 6%*'#'- $!, *%-!' ('-)u- '(' $4!%!u! !*'$! 4*%&
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L%-!' L%-!' /%/* /%/*# # u-! u-! u)'/' u)'/' u-)u# u-)u# /%/4# /%/4#u!# u!#''- 6%$#'! 6%$#'! '&'"' '&'"' #% $%)-' $%)-' (%-'(%-'/%-u6 /%-u6'&u '&u6'& 6'& ('"' $%$'# $%$'#! ! ''$ ''$ !%!u' !%!u' (%-'(%-'- !-'$ !-'$ "'- (')'- (')'- !%j'j' !%j'j'$$ ')'u ')'u (>%$ (>%$%-. %-. P%$u6'&'- ('"' $%$'#! *%-!' - (!%6u) !%6'' '#4/4('!. H'* - ('') ('' (%-'/%-u6'& #%*%-#u-'- *%-!' )%$u)'/' #u$>')u$ '-)%$4$.2 O)4)4)4) !*'$! $%*'#!'!, !%$') @4-u*' /%-%'-, ('- ('/%)%$ '-)%$44!)%$4$ *%-!' /%-% /%-%* * u-)u# u-)u# /%/4# /%/4#u!# u!#''- '&'"' '&'"' "'- (')'- (')'- ('$ ('$ j'u&. j'u&. D'*'/ D'*'/ 4!! 4!! )%$!%6 )%$!%6u), u), *%-!' *%-!' (%$ (%$#% #% ** &- &-' ' 6%$# 6%$#'! '! '&' '&'"' "' '$' '$'$% $%** '#''#'- )%$ )%$4#u 4#u!! #% $%) $%)-'. -'. S%/%S%/%-)' )'$' $' )u, )u, u-)u# u-)u# /%/4#u!#'- '&'"' ('$ 6%-(' (%#'), 4)4) !*'$! 6%$#4-)$'#! &-' )%'-'- @4-u*' @- 6%$#u$'-. K'!u* *%-!' "'- %*'!)# #%/u('- /%/%-'$u& *%-!' /%-j'( *%6& !%$! ($- 4*%& ('"' 6'!-"'. K%$j'!'/' !4*4! '-)'$' #4$u! !*'$!, !4-u*' @-, ('- *%-!' u-)u# /%/4#u!#'- 6%-(' (%#') #% $%)-' (!%6u) !%6'' '#4/4('!. S%$- (%-'- %$)'/6'&'u!', #%/'/u'- $%$'#! *%-!' %$*'&'-*'&'- 6%$#u$'-.5 P'(' %)u!, *%-!' 6%$6%-)u# &'/$ !%$! ('- *%/'&, !%/%-)'$' '(' 4$'- (%'!' *%-!' *%6& '(') ('- 6''- 4!)%$4$ *%6& #4->%#!. P$4!%! !#*%$4!! 6''- !%-)$'* *%-!', (/u*' '(' /'!' #'-'##'-'# ('- )%$u! 6%$*'-!u- !%'$' %$*'&'-*'&'- &-' (%'!', ('- $4!%! 6%$)'/6'& %') (/'-' -u#*%u! /%-j'( *%6& 6%!'$ ('- #4$)%#! 6%$)'/6'& )!. P'(' 4$'- )u' *%-!' /%-j'( *%6& 6%!'$, *%6& %%-, 6%$'$-' #%#u--#u--'-, #u$'- j%$-& ('- )'/'# !%6' !%6'' ' grey reflex reflex ') ')'u senile reflex, reflex, "'- "'- !%$- !%$- (!'- (!'-#' #' #')'$' #')'$'#. #. P$4!%! P$4!%! !#*%$4 !#*%$4!! !! - /%-"%6'6#'- *%-!' /%-j'( #u$'- %*'!)! ('- ('"' '#4/4('!-"' u- 6%$#u$'-. K%'(''- - (!%6u) $%!64', ('- 6'!'-"' (/u*' '(' u/u$ 0 )'&u-.2
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G'/6'$ 2. L%-!' ('- S)$u#)u$ P%-(u#u--"'
9. Su(u) Su(u) B* B*# # M') M')'' D% D%''Su(u) 6*# /')' "'- (6%-)u# j'$-'- #4$-%4!#*%$' (%-'- '-#'* $!. P'(' 6''- - )%$j'( %-'*$'- #%*u'$ '$'- 6*# /')'. B*' )%$('') &'/6')'- %-'*$'- #%*u'$ '$'- /')' '#'- )%$j'( %-/6u-'- '$'- 6*# /')' ( ('*'/ 64*' /')' !%&-' )%#'-'- 64*'
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. A=u4 A=u4%4 %4u! u! Hu/ Hu/4$ A=u%4u! &u/4$ ($4(u#! 4*%& 4$u! *'$%. S%)%*'& /%/'!u# 6*# /')' 6%*'#'-, '=u%4u! &u/4$ /%*'*u u* ('- /'!u# #% 6*# /')' (%'-. K%/u('- #% %$%$ /%-uju !u(u) 6*# /')' (%'-.. A=u4%4u! &u/4$ '('*'& !u')u '$'- j%$-& "'- /%-! #'/%$' '-)%$4$ (' 4!)%$4$ /')'. 4*u/%-"' !%#)'$ 250 uL. Hu/4$ '#u4! ($4(u#! 4*%& #4$u! !*'$!. D'$ 6'('- !*'$, '$'- /'!u# #% 6*# /')' 4!)%$4$, &u/4$ '#u4! /%-'*$ /%*'*u u* #% 6*# '-)%$4$ *'*u #% j'*-'- )$'6%#u*'$ ( !u(u) 6*# /')' '-)%$4$. K%/u('- '$'- /'!u# #% ('*'/ !'*u$'- #4*%#)4$, *'*u #% ('*'/ *%#!u! >%-' ( j'$-'- !#*%$' ('- %!#*%$', ('- ju' #% ('*'/ >%-' !*'$! '-)%$4$ ( 6'('- !*'$.2
G'/6'$ 9. A*$'- A=u%4u! Hu/4$
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GLAUKOMA FAKOMORFIK
Definisi
G*'u#4 G*'u#4/' /' '#4/4 '#4/4$ $#, #, !%%$) !%%$) "'- ('/6 ('/6'$# '$#''- 4*%& 4*%& )%$/ )%$/-4* -4*44-"' "' ;'#4: ;'#4: *%-!' *%-!' /4$#: 6%-)u#< /%$u'#'- *'u#4/' "'- 6%$#%/6'- !%#u-(%$ (#'$%-'#'- 4*%& %$u6'&' 6%-)u# *%-!'. G*'u#4/' !u(u) )%$)u)u "'- ('') )%$j'( !%'$' '#u), !u6'#u), ')'uu- #$4-# 4*%& #'$%-' #')'$'# /')u$ ')'u -)u/%!%-.
Patofisiologi
G*'u#4/' '#4/4$# ('') )%$j'( #'$%-' u* )%$&'*'- 4*%& %$u6'&'- u#u$'- (' 4!! %$/u#''- '-)%$4$ *%-!' "'- /%-(4$4- *%-!' #% '-)%$4$ !%&-' /%-%#'- $!. T%$&'* T%$&'*'- '--"' -"' u* u* ')'u ')'u *u#!'! *u#!'! ('$' ('$'/' /' *%-!' *%-!'$ $!! ('') ('') /%-"%6' /%-"%6'6#' 6#'- !u(u) !u(u) 6*# 6*# /')' /')' )%$)u)u. S%*'- )u, *'u#4/' '#4/4$# ju' ('') (!%6'6#'- 4*%& /')' &%$4' (%-'*%-!' "'- )%*'& *%6& 6%!'$ (6'-(-#'- (%-'- '-j'- '#!'*. M')' !%%$) - /%/*# 6*# /')' (%'- "'- *%6& !%/) !%&-' ('') /%-%)u!#'- *'u#4/'. P'(' /')' (%-'- *'u#4/' '#4/4$# )%$('') %--#')'- )%#'-'- -)$' 4#u*'$ "'- ')4*4!. P%-"%6'6-"' '('*'& 6%-)u# *%-!' "'- /%-%6'* ')'u -)u/%!%-. P%-%6'*'- - ('') (!%6' (!%6'6#'6#'- 4*%& 4*%& %/6%%/6%-)u# )u#''- #')'$' #')'$'# # /')u$ /')u$ #'$%-' #'$%-' &($'! &($'! #4$)%# #4$)%#!. !. S'') S'') /')u$' /')u$'! ! #')'$' #')'$'# # 6%$*'-!u-
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@- !%&-' )%$j'( %$%!%$'- *%-!' #% '-)%$4$, ('- /%/6u') 6*# /')' (%'- /%-j'( ('-#'*. L%-!' "'- )%6'* ('') /%-"%6'6#'- %-"%/)'- !u(u) $(4)$'6%#u*'$ !%'$' $4$%!. H'* - /%--#')#'- )%#'-'- -)$' 4#u*'$, !%&-' )/6u* )'-(')'-(' ('- %j'*' !%$'-'*'u#4/ *'u#4/'' '#u) !u(u) !u(u) )%$)u) )%$)u)u, u, ')'u ')'u (!%6u (!%6u)) ju' ju' *'u#4/ *'u#4/'' '#4/4 '#4/4$ $# # !u(u) !u(u) )%$)u) )%$)u)u u '#u). '#u). S%*'/' *'u#4/' '#4/4$# 6%*u/ /%-/6u*#'- -%u$4') 4)#, /'#' *'u#4/' )%$!%6u) '('*'& '#u). 3,5,7
Epidemiologi
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Gejala2
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Pemeriksaan Penunjang 5 Pemeriksaan tonometri
1. T4-4/%)$ S&4)@
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T4-4/%)%$ ()u$u-#'- 4*%& )'-'- !')u-"' !'/' uju- %#u- *'$'! /%-"%-)u& #4$-%'. #4$-%'. D%-'D%-'- '"' "'- "'- ()%)' ()%)'#' #'- (%-'(%-'- 6%6'6%6'- )%$'! )%$'!'-, '-, )4-j4* )4-j4*''- *u-% *u-%$$ 6%$uju- )u/u* /%-%#'- '(' #4$-%' ('- !%(#) /%*%#u##'- u!') #4$-%'.
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G'/6'$ . P%/%$#!''- G4-4!#4
B4/%)$ u-)u# /%-%)'&u #%)%6'*'- *%-!' ('- #%('*'/'- 6*# /')' '-)%$4$. P'(' *'u#4/' *'u#4/' '#4/4$# '#4/4$# #%)%6'*'- *%-!' !%)('#-"' !%)('#-"' 5// ;$')'$')' ;$')'$')' #%)%6'*'#%)%6'*'*%-!' -4$/'* '('*'& ,9 //< ('- #%('*'/'- 6*# /')' '-)%$4$ 2//.
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PENATALAKSANAAN P%-')'*'#!'-''- *'u#4/' '#4/4$# 6%$)uju'- u-)u# /%-u$u-#'- )%#'-'- -)$'4#u*'$ !%'$' !%'$' %')
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P%-')'*'#!'-''- -!'* &'$u! ()uju#'- '(' %/u*&'- !u(u) )%$)u)u-"' "')u (%-'beta-blocker, alpha 2-adrenergik agonis, dan carbonic anhydrase inhibitor
P%-')'*'#!''- !%#u-(%$ (/u*' (%-'- $(4)4/ *'!%$ u-)u# /%/u*&#'- )%$&'*'--"' u*
G4-4!#4 6%$u-' !%)%*'& $(4)4/ (*'#u#'- u-)u# %-*''- $%)$4!%#) !u(u) 6*# /')' /')'.. J#' J#' !u(u !u(u)) 6* 6*# # /')' /')' /%*% /%*%6' 6'$, $, /'#' /'#' /%#'/%#'-! !/% /% )%$& )%$&'* '*''--"' "' u u** "'- "'- %-(% %-(%$u $u- - /%- /%-'# '#6 6') ')#' #'-
)%#' )%#'-'-'- -)$ -)$'4 '4#u* #u*'$ '$ /%- /%-- -#' #'), ), ('('- $( $(4) 4)4/ 4/ *'!% *'!%$$
/%$u'#'- )%$' %%#) u-)u# #'!u! )%$!%6u). J#' !u(u) )('# )%$*'*u ('*'/ !%'$' !- !-#' #'-, -, *%-!' *%-!' -)u/% -)u/%!%!%- ')'u ')'u )%$(4$ )%$(4$4- 4--"' -"' *%-!' *%-!' #% (%'(%'- /%$u' /%$u'#'#'- '#)4$ '#)4$ %-"%6'6-"', ('- '!%- &'$u! ()')'*'#!'-' (%-'- %#!)$'#! #')'$'#. J#' !u(u) )%$)u)u )('# u*& (%-'- $(4)4/ *'!%$, /'#' %$*u (%$)/6'-#'- $! *')%'u
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KESIMPULAN G*'u#4/' '#4/4$# /%$u'#'- *'u#4/' !%#u-(%$ "'- (!%6'6#'- 4*%& #%*'-' '(' *%-!'. D'') /%-"%$'- !''u-. G*'u#4/' '#4/4$# /u('& )%$j'( '(' '!%- (%-'#')' #')'$' $'# # /')u /')u$. $. M%- M%-'# '#6' 6')# )#''- !u(u !u(u)) 6* 6*# # /')' /')' )%$) )%$)u) u)u u ('('- /%- /%-'# '#6 6') ')#' #'- *'u *'u#4/ #4/'' '#4/4$#. P'!%- "'- /%-'*'/ *'u#4/' '#4/4$# /%-%*u& -"%$ "'- !'-') '#u), '-('-'- #'6u$, /%*&') 6'"'-'- !%%$) %*'- ;&'*4< (!%#)'$ '&'"', /u'*, /u-)'&. P'!%- !%'$' u/u/ /%-'*'/ %-u$u-'- >!u!. G*'u#4/' '#4/4$# *%6& u/u/ )%$j'( '(' /')' &%$4# "'- #%* (%-'- *%-!' 6%!'$%/6u- ('- !u(u) 6*# /')' "'- ('-#'*. P%-')'*'#!'-''- *'u#4/' '#4/4$# 6%$)uju'- u-)u# /%-u$u-#'- )%#'-'- -)$'4#u*'$ !%'$' !%'$' %') %') u-)u# u-)u# /%-%' /%-%'& & #%$u!' #%$u!'#'#'- *%6& *%6& *'-ju) *'-ju) '(' '(' !'$' !'$' 4)#, 4)#, #4$-%' #4$-%',, ('- u-)u# u-)u# /%-%'& )%$j'(-"' !-%#'
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1. 'u&''u&'- A!6u$". A!6u$". O)'*/4 O)'*/4*4 *4 U/u/, U/u/, E(! E(! 17, A*& A*& 6'&'!' 6'&'!' B$'&/ B$'&/ U P%-() P%-(),, E()4$ E()4$ E(! B'&'!' I-(4-%!' D'-' Su!'-)4. EG. J'#'$)', 200? 2. +j'" +j'"', ', N'-' S.D, I*/u P%-"'# P%-"'#)) M')', %)'#'%)'#'- #%, P%-%$6 P%-%$6) ) A6'( A6'( T%'*, J'#'$) J'#'$)', ', 1??9 : 1?01? 9. I*"' I*"'!, !, S(' S('$) $)', ',,, I*/u I*/u P%-"' P%-"'# #)) M')' M')',, %)' %)'#'#'- #% 9, 9, B'(' B'('- P%-% P%-%$6 $6) ) F'#u* F'#u*)' )'!! K%(4 K%(4#) #)%$ %$''U->%$!)'! I-(4-%!'. J'#'$)', 2019 . P$'j-' P$'j-' N, R'/'#$!&-' R'/'#$!&-'- R, K$!&-'('! K$!&-'('! R, %) '*. L%-! -(u%( -(u%( *'u4/'! *'u4/'!>!u' >!u'** $%!u*)! $%!u*)! '-( $!# ')4$! 4$ -'* >!u'* 'u)". Indian 'u)". Indian J Opthamol 1??;9<:1?55 1??;9<:1?55 5. G*'u G*'u4/ 4/'' P&' P&'4/ 4/4$ 4$& & &)):%/%(-%./%(!'%.4/'$)*%120?17/%(' 6.
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