Tesis

Analisis Korelasi antara Fungsi Penglihatan, Ketebalan Lapisan Retina, serta Mikrosirkulasi Nervus Optik dan Makula terhadap Kualitas Hidup pada Pasien Non-Arteritic Anterior Ischemic Optic Neuropathy Kronik = Correlation Analysis Between Visual Function, Retinal Layer Thickness, and Microcirculation of the Optic Nerve and Macula on Quality of Life in Patients with Chronic Non-Arteritic Anterior Ischemic Optic Neuropathy.

Latar belakang: Non-arteritic ischemic optic neuropathy (NAION) dapat menyebabkan penurunan tajam penglihatan, gangguan warna, dan lapang pandang. Pada tahap kronik, terjadi atrofi papil dan tidak ada terapi yang efektif, sehingga dapat mempengaruhi kualitas hidup. Evaluasi kualitas hidup diperlukan untuk memahami dampak fungsional dan rehabilitasi yang sesuai. Tujuan: untuk mengetahui korelasi tajam penglihatan, lapang pandang, penglihatan warna, ketebalan retinal nerve fiber layer (RNFL), ganglion cell inner plexiform layer (GCIPL), parameter Optical coherence tomography-Angiography (OCT-A) peripapiler dan makula terhadap kualitas hidup terkait penglihatan pada pasien NAION kronik. Metode: Studi cross-sectional pada 38 pasien NAION kronik (onset >6 minggu, visus ≥3/60) menjalani pemeriksaan oftalmologi, OCT RNFL dan GCIPL, perimetri, OCT-A papil dan makula, serta wawancara dengan NEI-VFQ 25. Skor total dan subskala dikorelasikan dengan parameter fungsi penglihatan, ketebalan lapisan retina dan mikrosirkulasi nervus optik dan makula. Hasil: Tajam penglihatan (best corrected visual acuity) berhubungan signifikan dengan skor total (r = -0,371, p = 0,022), penglihatan jauh (r = -0,509, p = 0,001), fungsi sosial (r = -0,429, p = 0,007), dan penglihatan perifer (r = -0,395, p = 0,014). Lapang pandang (mean deviation) berkorelasi signifikan dengan skor fungsi sosial (r = 0,396; p = 0,014) dan penglihatan perifer (r = 0,542; p < 0,001). Selain itu, visual field index berkorelasi dengan skor berkendara (r = 0,398; p = 0,044) dan penglihatan perifer (r = 0,370; p = 0,022). Tidak ditemukan korelasi antara ketebalan RNFL, GCIPL, maupun parameter OCT-A papil dan makula dengan skor kualitas hidup. Kesimpulan: Tajam penglihatan jauh dan lapang pandang berkorelasi signifikan dengan kualitas hidup pada pasien NAION kronik.
Kata kunci: Non arteritic anterior ischemic optic neuropathy kronik, NEI-VFQ 25, OCTA, OCT, kualitas hidup


Background: Non-arteritic ischemic optic neuropathy (NAION) can cause decreased visual acuity, color vision disturbance, and visual field defects. In the chronic phase, optic disc atrophy occurs and no effective treatment is available, which may impact quality of life. Assessing vision-related quality of life is essential to understand the functional impact and plan appropriate rehabilitation. Objective: To determine the correlation between visual acuity, visual field, color vision, ketebalan retinal nerve fiber layer (RNFL), ganglion cell inner plexiform layer (GCIPL), and peripapillary and macular Optical coherence tomography-Angiography (OCT-A) parameters with vision-related quality of life in patients with chronic NAION. Methods: A cross-sectional study was conducted on 38 patients with chronic NAION (onset >6 weeks, visual acuity ≥3/60) who underwent ophthalmologic examination, OCT of RNFL and GCIPL, visual field testing, peripapillary and macular OCT-Angiography (OCT-A), and interviews using the NEI VFQ-25. Total and subscale scores were correlated with visual function, retinal layer thickness, and microcirculation of the optic nerve and macula. Results: Visual acuity (best corrected visual acuity) was significantly correlated with total score (r = -0.371, p = 0.022), distance vision (r = -0.509, p = 0.001), social functioning (r = - 0.429, p = 0.007), and peripheral vision (r = -0.395, p = 0.014). Visual field (mean deviation) showed significant correlations with social functioning (r = 0.396, p = 0.014) and peripheral vision (r = 0.542, p < 0.001). Visual field index was also correlated with driving (r = 0.398, p = 0.044) and peripheral vision (r = 0.370, p = 0.022). No significant correlation was found between RNFL or GCIPL thickness and OCT-A parameters with quality of life scores. Conclusion: Distance visual acuity and visual field are significantly correlated with quality of life in patients with chronic NAION.
Keywords: Chronic non-arteritic anterior ischemic optic neuropathy, NEI-VFQ 25, OCTA, OCT, quality of life