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Pendahuluan

Istilah retinopati pada prematuritas (RPP) pertama kali diutarakan oleh Terry pada tahun
1942
1
dan didefinisikan sebagai suatu perkembangan abnormal pembuluh darah retinal pada
bayi yang lahir prematur, menetap sebagai salah satu penyebab utama kebutaan yang,
kejadiannya dapat dicegah
2
. Sebagian besar bayi dengan RPP tidak berkembang melebihi tahap
sedang sehingga, gangguan hilang secara spontan tanpa pengobatan. Pada kasus minoritas,
ROP berkembang menjadi gangguan penglihatan berat sehingga semua bayi dengan resiko
tinggi memerlukan pemeriksaan dini retina untuk mencegah kebutaan.
Dikutip oleh Flynn dari Silvermann, selama 1 dekade period 1943-1953, RPP telah
mengakibatkan kebutaan pada 7000 anak di Amerika dan 10 000 anak di seluruh belahan
dunia
3
. Palmer et al, melaporkan 65.8% bayi dengan BB lahir 1250 gram dan 81.6% bayi
dengan BB lahir 1000 gram, mengalami RPP pada berbagai tingkat pada sebuah penelitian
meliputi 4099 bayi BBLR
4
. Phelps melaporkan insidensi kebutaan akibat RPP di Amerika
Serikat selama tahun 1979 telah menyentuh 546 kasus dan diestimasikan 2 100 bayi akan
mengidap RPP pada tingkat sikatrik setiap tahun di negara tersebut
5
.
Sistem vaskularisasi retina yang normal berawal dari diskus optikus menuju ke perifer dan
terbentuk sempurna pada sisi nasal pada usia kehamilan 36 minggu dan pada sis temporal pada
kehamilan 40 minggu
1
. Pemahaman mengenai terjadinya RPP belum sepenuhnya dimengerti

Sembilan puluh persen retinopati tingkat I dan II menghilang secara spontan, laporan
terbaru menunjukan 50% tingkat III+ juga hilang secara spontan
1
. Akibat dari RPP yang lambat
mendapat penatalaksanaan setelah mengalami regresi berupa miopia, strabismus, ambliopia,
glaukoma, dan ablatio retina yang muncul lambat
8,9
.
Perkembangan ICU neonatus pada akhir dekade 60-an dan kemajuan pesat dalam
teknologi penunjang kelangsungan hidup bayi-bayi prematur, buka hanya meningkatkan
jumlah bayi dengan berat badan lahir sangat rendah yang bertahan hidup, tapi juga
meningkatkan jumlah bayi yang beresiko terhadap RPP
1
. Insidensi meningkatnya BBLR yang
bertahan hidup telah meningkatkan minat untuk menelaah dasar-dasar dan perjalanan penyakit
ini
1
.
Penelitian kolaboratif seperti ini ditunjukan secara spesifik terhadap faktor resiko RPP
diantaranya, berat badan lahir bayi yang sangat rendah, lamanya pemberian oksigen dan
konsentrasi oksigen sebagai faktor resiko yang berperan dalam kejadian RPP
5
. Dalam
penelitian lain, ditemukan faktor usia kehamilan, apne yang memerlukan faktor usia
kehamilan, apne yang memerlukan resusitasi dengan sungkup, sepsis, beratnya penyakit,
transfusi darah, perdarahan intraventrikular, dan ventilasi mekanis, sebagai faktor yang juga
berperan meningkatkan resiko terjadinya RPP
1

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