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RETINOPATI DIABETIKA

dr. ROCHASIH MUDJAJANTI Sp. M


DEFINISI
• MIKROANGIOPATI OKULER
• KELAINAN RETINA AKIBAT GANGGUAN
MIKROVASKULER YANG DISEBABKAN
HIPERGLIKEMIA KRONIK
EPIDEMIOLOGI
• PENYEBAB UTAMA KEBUTAAN PADA USIA
PRODUKTIF DI NEGARA BERKEMBANG
• 90% PENDERITA DIABETES MENGALAMI
RETINOPATI SETELAH 20 TAHUN
• PREVALENSI RETINOPATI DIABETIKA – 30%
• PREVALENSI KEBUTAAN AKIBAT
RETINOPATI – 5%
PATOGENESIS
• DIABETES MELITUS MENYEBABKAN
KELAINAN : KERATOKONJUNGTIVITIS
SICCA, XANTHELASMA, MYCOTIC
ORBITAL INFECTIONS, PERUBAHAN
REFRAKSI SEMENTARA, KATARAK,
GLAUKOMA, NEUROPATI OPTIK,
KELUMPUHAN OCULOMOTOR
PATOGENESIS
FAKTOR RISIKO
• Duration of DM
• Control of DM. Will not prevent but delays
• Hypertension
• Renal Disease
• Pregnancy
• Obesity, hyperlipidaemia, smoking,
anaemia
KLASIFIKASI
• Background /Non Proliferative
• Diabetic maculopathy
• Pre-proliferative
• Proliferative
• End-stage diabetic eye disease
BACKGROUND/ NPDR
Microaneurism

Exudate
Blot haemorrhage
Diabetic maculopathy

Hard exudate
Pre-proliferative
CWS

Haemorrhage

Vascular Microaneurism
tortuosity
Proliferative retinopathy

NVD
NVE

Pre-retinal haemorrhage

Laser burn scars


Advanced diabetic eye disease
Preretinal fibrosis and
tractional retinal detachment

Rubeosis iridis
End-stage diabetic eye disease
PHTHISIS
Shrunken, soft eye with
opaque vascularised
cornea and no visual
potential
SYMPTOMS/ GEJALA
• ASIMPTOMATIK UNTUK JANGKA LAMA
• STADIUM LANJUT DG EDEMA MAKULA/
VITREOUS HEMORRHAGE – VISUS
TURUN MENDADAK
PEM. DIAGNOSTIK
• PEM. FUNDUS DG PUPIL DIDILATASI –
OFTALMOSKOPI, FOTO FUNDUS, FFA
DD
• VASCULAR RETINAL DISEASE
TERAPI
• LASER: Light
Amplification by the
Stimulated Emission
of Radiation
– Focal
– Grid
– Panretinal
photocoagulation
SCREENING
• No retinopathy or BDR with normal vision
– See yearly, or sooner if vision deteriorates

• Refer to ophthalmologist
– BDR with macular changes
– BDR with decrease in vision
– Pre-proliferative retinopathy
– Proliferative retinopathy
PROGNOSIS
• KONTROL GD – DELAY RETINOPATHY
• RUBEOSIS IRIDIS - IRREVERSIBLE