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PENYAKIT SISTEMIK DAN
DEGENERATIFDr. Sriana Wulansari, SpM
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• .
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PenyakitSistemik
Manifest pada MataRetinopathy
Uveitis
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Retinopat
hy1. IN!"SI• #u$er%ulosis
• &at's%rat%h diseases
• !ndo(en %andida !ndophthalmitis• )sper(ilus %andida !ndophthalmitis
• Syphiliti% %horeoretinitis
• #oo%ariasis• &o%%idioidomy%osis
• &ytome(alovirus
*I+
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Retinopathy
. De(enerasi Retina
1. "elainan meliputi sistem or(an-
Infantil syndr
ardet'iedl %omple of disease
Neomuskular disorder&an%er assosiated retinopathy /&)R0
. Defek meta$olik
)l$inisme&NS meta$oli% a$normalities
Mito%ondrial DN) disorder
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• . Sistemi% Dru( #o2i%ity
• &hloro3uin derivatives
• Phenothia4ine, &hlorproma4ine• #amo2ifen, %antha2antine,
metho2i5uran anesthesia
• !tham$uthol, di(italis
Retinopathy
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•)nkylosin( spondilitis•Reiter syndr /nonspesi6% uretritis, polyarthritis,%on7un(tival in5amation0•Psoriati% arthritis
•eh%et syndrom /a%ute iritis d( hipopion, aphtousstomatitis, (enital
ul%eration0•+iral infe%tion /adenovirus, in5uen4a, *erpeti%disease, %itome(alovirus, !pstein $arr virus,
ru$elaa, measles0•un(al infe%tion /%andida, histoplasmosis0•Proto4oa infe%tion /tooplasma0ariasis, %y%ti%er%osis0•a%terial infe%tion - Syphilis, #&, leptospirosis,lyme disease•*elminti% infe%tion /too%•Dru( indu%e /rifa$utin, %idovir0
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)(e'related Ma%ular De(eneration/)MD0
• 9eadin( %ause of severe%entral visual a%uity loss
• :; y.o < ==
•De(enerative diseasea>e%t - – RP!
– ru%h?s mem$rane
– &horio%apillaris
• Divided - – Nonneovas%ular /Dry
type0
– Neovas%ular /Wet type0
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Non Neovascular AMD
• &ommon type
• Mild de%rease of vision
• *allmark - Drusen
/ (ranular material @ithin
ru%h?s mem$rane0
• )$normalities of RP! -(eo(raphi% A non(eo(raphi% atrophy, fo%al
hyperpi(mentation0• #2 - edu%ation B follo@
up, Mi%ronutrients
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Neovascular AMD
• Severe visual loss
• Si(n - – Soft drusen /%on5uent0
– RP! deta%hment – Su$retinal elevation of
5uid,$lood
– &horoidal
neovas%ulari4ation /&N+0• )n%illary test - ),
Indo%yanine (reenan(io(raphy /I&C)0,
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&N+ in(ro@th of ne@
vessels from%horio%apilaris throu(h a
$reak of ru%h?smem$rane, into su$'pi(ment epithelial spa%e
FFA
OCT
Choroidal
neovascularization CN!"
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Mana(ement of Neovas%ular)MD
• 9aser photo%oa(ulation /thermal laser0
• Photodynami% #herapy /PD#0 nonthermal laser @ith vertepor6n in7e%tion
• #riam%inolon /steroid0 intravitreal in7e%tion• )nti +!C intravitreal in7e%tion
– Pe(aptani$ sodium /Ma%u(en0
– Rani$i4uma$ /9u%entis0
– eva%i4uma$ /)vastin0• &om$ine - PD# E Intravitreal in7e%tion
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#erima
"asih