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1. DEFINISI, KLASIFIKASI, ETIOLLOGI PATOGENESIS GLAUCOMA

2. DEFINISI A group of diseases by characteristic optic neuropahty that consistent with excavation, undermining of neural , connective tissue of optic disc and development of visual dysfunction patterns . ( AAO ) Intraocular pressure (IOP) is the primary risk factor The optic nerve and visual field changes determined by IOP

3. KLASIFIKASI 1. Glaukoma Pigmentasi 2. Glaukoma Pseudoeksfoliasi 3. Glaukoma akibat Dislokasi Lensa 4. Glaukoma Fakolitik 5. Glaukoma akibat Uveitis 6. Glaukoma N eova skular dll

4. ETIOLOGI Primary Glaucoma Glaucoma results from an abnormality of the resistance charac­teristics of the humor aquous outflow system

5. PATOGENESIS Trabecular outflow (conventional outflow) Ciliary proc – COP – pupil – COA – Trabecular messwork – Schlemm canal - Episcleral ve i n 70 - 85 % aqueous absorb Uveoscleral outflow 5 - 15 % aqueous absorb

6. Gambaran patologik utama pada glaukoma sudut terbuka primer adalah adanya proses degeneratife anyaman trabekular , termasuk pengendapan materi ekstrasel di dalam anyaman dan di bawah lapisan endotel canal Schlemm . Akibatnya adalah penurunan drainase aquous humor yang menyebabkan peningkatan tekanan intraokular . Open Anterior Chamber Glaukoma sudut terbuka onset juvenile 5 % familier 3 % non familier mutasi gen myocilin pada kromosom I.

7. 1. Acute Angle Closure Glaucoma 2. Chronic Angle Closure Glaucoma Close Anterior Chamber

8. Intraocular Pressure (IOP) Intraocular pressure (IOP) is one of the strongest risk factors for glaucoma progression. The mean IOP 15,5 mmHg with SD of 2,6 mmHg IOP > 21 mmHg in half of people cause optic nerve damage Variability in diurnal IOP and large IOP differences between fellow eyes were found to be more common in patients with POAG (36%) than in normal subjects (6%). TARGET PRESSURE

9. Gloumatous Optic Neuropathy (GON)

10. Theories of the Pathogenesis of GON Pressure Theory - Muller GON is a direct consequence of elevated IOP, damag e the lamina cribrosa , neural axon , Retinal ganglion cells A xo n s compression leads to axonal death Vascular Theory - V on Jaeger Intraneural ischemia resulting from decreased optic nerve perfusion and blood supply to optic nerve or from intrinsic to the optic nerve I schemi c caus e axonal necrosis