PERBANDINGAN RETINAL NERVE FIBER LAYER DAN GANGLION CELL LAYER THICKNESS PASIEN PASKA STROKE ISKEMIK PADA PENGUKURAN BASELINE DAN SETELAH 2 BULAN DI RSUP DR. M. DJAMIL PADANG

Pendahuluan : Penurunan visus dan defek lapang pandang merupakan komplikasi paska stroke iskemik yang sering terjadi namun sering terlewatkan. Komplikasi tersebut terjadi akibat kerusakan sel ganglion retina akibat iskemik di otak dan mengakibatkan transneuronal retrograde degeneration (TRD). Proses TRD dibuktikan dengan terdapatnya penipisan retinal nerve fiber layer (RNFL) dan ganglion cell layer (GCL) yang dinilai melalui pemeriksaan OCT. Metode: Sebelas pasien paska stroke iskemik fase sub akut dilakukan pemeriksaan BCVA dan OCT pada baseline kemudian hasil dibandingkan dengan pemeriksaan kedua (2 bulan kemudian). Hasil: Iskemik serebri ditemukan lebih banyak mengenai lebih 1 area di serebral. RNFL thickness setelah 2 bulan (85,55 ± 5,90 m) lebih tipis dibandingkan baseline (89,91 ± 5,65 m) terutama pada mata kiri. GCL thickness setelah 2 bulan lebih tipis (68,09±6,37 m) dibandingkan baseline (74,54±6,25m) terutama pada mata kiri. Rentang BCVA pada kedua mata adalah 0,40 – 1,00 (rerata 0,81±0,27) dan tidak ada perbedaan baseline dan setelah 2 bulan. Tidak ditemukan hubungan yang bermakna antara penipisan RNFL dan GCL thickness dengan BCVA pada kedua mata (p>0.05). Kesimpulan: Pada penelitian ini, RNFL dan GCL thickness pasien paska stroke iskemik lebih tipis di pengukuran setelah 2 bulan, tetapi BCVA tidak mengalami perubahan, kemungkinan karena lesi iskemik tidak langsung berada di jalur visual, dan penipisan tersebut belum cukup untuk mengakibatkan terganggunya visus sentral, namun mungkin berdampak pada sensitifitas kontras dan lapang pandang. Kata Kunci: Stroke iskemik, BCVA, RNFL, GCL, OCT, transneuronal retrograde degeneratio

Orbital Lymphoma: Clinical Features and Management at Dr. M. Djamil General Hospital in 2018

Background: Orbital lymphoma is found in 50-60% of ocular adnexal lymphomas, with approximately 90% of orbital lymphomas being Non-Hodgkin's lymphomas. Clinical features may include proptosis, ptosis, limitation of eye movement, and salmon patch lesions on the conjunctiva. If an orbital tumor is present, an accurate histopathological examination is important in the management of orbital lymphoma. Because of nonspecific clinical signs and symptoms, some diagnostic delays may occur. The purpose of the study was to evaluate the clinical features, diagnostic approach, and treatment choice in orbital lymphomas. Methods: We identified patients diagnosed with orbital lymphoma in an outpatient clinic in Dr. M. Djamil General Hospital from January to December 2018. Patients’ medical records were reviewed retrospectively. Results: The patient group consisted of 6 patients (five males and one female) with a median age of 58 years. Proptosis and orbital swelling were the leading clinical symptoms, mainly found unilateral (five cases). The diagnosis was confirmed by a surgical biopsy. One histology result showed lymph node hyperplasia, which didn't suit the clinical manifestation and got re-reviewed. All histology results then showed non-Hodgkin’s lymphoma with the small lymphocytic type (100%). Five patients received systemic chemotherapy with the CHOP regimen protocol, and one patient refused to get further chemotherapy treatment. Conclusion: When unmatched orbital symptoms with histology results are present, re-reviewing the histology result is essential. Once the diagnosis is established, systemic chemotherapy is indicated and can proceed so there will be no delay in treatment &nbsp