NEODYMIUM:YTTRIUM-ALUMINIUM-GARNET LASER HYALOIDOTOMI PADA PERDARAHAN SUBHYALOID PREMAKULA

Abstract

Perdarahan subhyaloid premakula merupakan akumulasi darah pada lapisan subhyaloid di depanmakula yang menimbulkan penurunan visus mendadak tanpa rasa nyeri. Penyebabnya adalah kelainanvaskular, kelainan hematologi, valsalva retinopati, trauma atau sindrom Terson’s.Dilaporkan satukasus perdarahan subhyaloid premakula yang ditangani dengan laser hyaloidotomi menggunakanlensa goldmann three-mirror di RSUP Sanglah Denpasar. Penderita mengeluh mata kiri kaburmendadak tanpa nyeri 2 hari sebelumnya.Visus mata kiri 1/60 pinhole tidak maju.Segmen anteriordalam batas normal.Segmen posterior terlihat gambaran perdarahan subhyaloid pada area makulaberbatas tegas,boat-shaped,air fluid level, dan berukuran 6 disc diameter.Terapi konservatif, laserhyaloidotomi dengan lensa mainster, dan pneumatic displacement tidak berhasil,kemudian dilakukanlaser hyaloidotomi ulang dengan lensa goldmann three-mirror. Visus menjadi 6/10 pada 15 menitsetelah laser hyaloidotomi ulang dan 6/6 saat kontrol 1 bulan. [MEDICINA 2015;46:189-94].

Premacular subhyaloid hemorrhageis defined as blood accumulation in the subhyaloid membranewhich on premacular area can cause significant visual acuity loss without pain. It caused by vascular orhematologic disorders, valsalva retinopathy, trauma or Terson’s syndrome. We reported a case ofpremacular subhyaloid hemorrhage managed by laser hyaloidotomy with goldmann three-mirror lensin Sanglah Hospital. The patient complained with left eye blur suddenly without pain since 2 daysbefore. Visual acuity on left eye 1/60 pinhole no improved. Anterior segment within normal limit.Posterior segment was found premacular subhyaloid hemorrhage with well demarcated, boat shaped,air fluid level, and 6 disc diameters in size. Conservative management, laser hyaloidotomy with mainsterlens, and pneumatic displacement showed no improvement, then laser hyaloidotomy with goldmannthree-mirror lens was performed. Visual acuity became 6/10 fifteen minutes afterward and 6/6 on 1month follow up. [MEDICINA 2015;46:189-94].