Tesis

Proporsi dan Faktor-faktor yang Berhubungan dengan Retinopati Diabetik di Puskesmas Jakarta Timur dan Jakarta Selatan = Proportion and Risk Factors of Diabetic Retinopathy at Primary Health Care in East Jakarta and South Jakarta.

Tujuan tesis ini adalah untuk mengetahui proporsi, karakteristik, dan faktor risiko retinopati diabetik pada responden diabetes melitus di puskesmas Jakarta Timur dan Jakarta Selatan. Desain penelitian berbasis populasi, studi deskriptif-analitik dengan metode potong lintang. Kriteria inklusi adalah pasien diabetes melitus berusia > 18 tahun yang dilakukan pemeriksaan foto fundus di puskesmas kecamatan Jakarta Timur dan Jakarta Selatan. Dilakukan cluster random sampling dan didapatkan 17 kecamatan intervensi yang dilakukan pemeriksaan foto fundus. Dilakukan consecutive sampling dengan pemberitahuan secara aktif kepada responden. Responden diperiksa foto fundus tanpa dilatasi dan retinopati digrading dengan menggunakan klasifikasi NSC (National Screening Committee). Responden diperiksa tajam penglihatan, tekanan darah, lingkar pinggang, lingkar panggul, pemeriksaan laboratorium, dan dilakukan wawancara terpimpin untuk evaluasi faktor risiko. Jumlah total sampel dari penelitian ini adalah 419 responden dengan proporsi retinopati diabetik adalah 49 responden (11.7%). Pada analisis multivariat, faktor risiko independen untuk DR adalah usia ≥ 60 saat datang (OR 0.46; 95% CI, 0.24-0.89), durasi DM ≥ 5 tahun (OR 1.43; 95% CI, 0.79-2.59), keturunan DM (+) (OR 1.89; 95% CI, 0.98-3.63), GDP ≥ 126mg/dl (OR 2.06; 95% CI, 0.95-4.44), penyakit komplikasi (+) (OR 1.41; 95% CI, 0.78-2.57), gangguan penglihatan ringan (OR 1.81; 95% CI, 0.84-3.88), lingkar pinggang berlebih (OR 0.39; 95% CI, 0.20-0.73). Responden dengan retinopati diabetik cenderung memiliki indeks massa tubuh normal, tanpa obesitas sentral, dengan lingkar pinggang normal. Berdasarkan data yang didapatkan, satu dari 10 responden diabetes melitus di puskesmas Jakarta Timur dan Jakarta Selatan memiliki retinopati diabetik. Faktor risiko independen yang berkaitan dengan retinopati diabetik adalah usia ≥ 60 tahun dan lingkar pinggang berlebih
Kata kunci : diabetes melitus, retinopati diabetik


The purpose of this study was to describe the proportion, characteristics, and risk factors of diabetic retinopathy in diabetic population at primary health care (PHC) in East Jakarta and South Jakarta. Population-based cross sectional study, analytic – descriptive. Method : Diabetic individuals > 18 years were screened for diabetic retinopathy with single field nonmydriatil 45 0 retinal photograph at PHC in East Jakarta and South Jakarta and retinopathy was graded in NSC (National Screening Committee) system. We had cluster random sampling for 34 PHC and 17 were selected and performed retinal photography for DR screening. Consecutive sampling was performed with active announcement for diabetic patients in PHC within the scope of the study. All participants underwent guided interview and examination including uncorrected visual acuity, blood pressure, waist-hip circumference, body mass index, and collection of blood samples. Results : We had 419 diabetic person who participated in this study. The overall proportion of DR was 49 (11.7%). In logistic regression analysis, independent risk factors for DR were age ≥ 60 years (OR 0.46; 95% CI, 0.24-0.89), diabetic duration ≥ 5 years (OR 1.43; 95% CI, 0.792.59), related to diabetes mellitus (OR 1.89; 95% CI, 0.98-3.63), fasting blood glucose
≥ 126mg/dl (OR 2.06; 95% CI, 0.95-4.44), complications of diabetes (OR 1.41; 95% CI, 0.78-2.57), mild visual acuity disturbance (OR 1.81; 95% CI, 0.84-3.88), excessive waist circumference (OR 0.39; 95% CI, 0.20-0.73). Person with DR tend to have normal body mass index, without central obesity, with a normal waist circumference. Conclusion : One in 10 adults with diabetes at PHC in East Jakarta and South Jakarta has diabetic retinopathy. The independent association of DR with established risk factors were age more than or equal to 60 years old and excessive waist circumference.
Keywords: Diabetes mellitus, diabetic retinopathy