5. retinopathy of prematurity (rop)

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RETINOPATHY OF

PREMATURITY (ROP)

ROCHASIH MUDJAJANTI

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DEFINISI

DULU DIKENAL SEBAGAI

RETROLENTAL FIBROPLASI

RETINOPATI PROLIFERATIF PADA BAYI

BBLR DAN PREMATUR

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EPIDEMIOLOGI

 JARANG

BBLR <1000 GR  – RISIKO TINGGI

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ETIOLOGI

PREMATUR

BBLR

PAPARAN OKSIGEN KONSENTRASI

TINGGI & BERLEBIHAN – 

BERHENTINYA PERKEMBANGN

VASKULER, OBLITERASI KAPILER BARU,

PEMBENTUKAN ARTERIOVENOUSSHUNT MAYOR

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PATHOGENESIS AND STAGING

VASKULARISASI RETINA NORMAL :

OPTIC DISC KE PERIFER KOMPLIT

PADA KUADRAN NASAL ± 36 MG

GESTASI, KUADRAN TEMPORAL ± 40MG GESTASI.

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VASKULARISASI RETINA PERIFER

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KLASIFIKASI DAN TERMINOLOGI

ZONA I : LINGKARAN 2 X RADIUS

OPTIC DISC  – FOVEOLA

ZONA II : LINGKARAN DG PUSAT

OPTIC DISC, RADIUS OPTIC DISC – 

ORA SERRATA NASAL

ZONA III : SISA FUNDUS DI LUAR

ZONA I & II, PROGNOSIS BAIK

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DERAJAT ROP SESUAI LOKASI

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PROGRESIFITAS ROP

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SEVERITY(International Committee

on Classification of Acute ROP)

STAGE 1 : GARIS DEMARKASI ANT VASCULARIZED& NON VASCULARIZED RETINA

STAGE 2 : GARIS DEMARKASI DG TINGGI, LUAS &VOLUME (RIDGE)

STAGE 3 : RIDGE DG PROLIFERASIFIBROVASKULER EXTRARETINA (RINGAN, SEDANG,BERAT, DITENTUKAN JML JAR. PROLIFERATIF)

STAGE 4 : RD SUB TOTAL, A. EXTRAFOVEAL &B. FOVEA TERLIBAT

STAGE 5 : RD TOTAL DG FUNNEL (ANT & POST,TERBUKA & SEMPIT)

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ROP STAGE 2

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ROP STAGE 3

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ROP STAGE 4

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ROP STAGE 5

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CICATRICIAL ROP

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CICATRICIAL ROP

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PROBLEM YG BERHUB DG ROP

REGRESI

MIOP DG ASTIGMAT

ANISOMETROPIA

STRABISMUS

AMBLIOP

KATARAK

GLAUKOMA

RETINAL DETACHMENT

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TERAPI

VIT E & ANTIOKSIDAN LAIN CRYOTERAPY PADA RETINA AVASKULER;

ROP THRESHOLD SEPARO INSIDEN,OUTCOME BURUK (MACULAR DRAGGING

RD, RETROLENTAL CICATRIX); VISUS ~ANATOMIS

LASER TERAPI : FULL SCATTER PD RETINAAVASCULER, PD ROP THRESHOLD & PRETHRESHOLD, < TRAUMATIK

SB, VITRECTOMY ROP STAGE 4

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 JEJAS LASER FOTOKOAGULASI

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CRYOTHERAPY PD ROP