Anang Tribowo
Ophthalmology Department
Medical Faculty of Sriwijaya University
KORNEA
Lapisan Stroma.
Tebal 0,5 mm.
Terdiri fibroblast(keratosit), substansi dasar, lamela
kolagen.
Peran susunan kolagen fibril pada matrik ekstrasel:
Membuat kornea transparan.
Menurunkan pendaran sinar. Indeks bias epitel
1.401, stroma 1.380, posterior 1,373.
Lapisan Endotel.
Selapis sel poligonal (hexagonal).
Kepadatan sel 3000sel/mm².
Tidak bisa beregenerasi.
Peran proses transport aktif dan mempertahankan
deturgensi kornea.
BACTERIAL CORNEAL ULCERS
BACKGROUND
destroy microorganism
Inflammatory cascade
Genetic & environment
Protease
LTB4 cytokine lymphokine
Complement
Ag-Ab complex Tissue Denaturation
activation
Chemotaxis of
Leukosit
40
30
21.1%
20
13.2%
10 7.9%
5.3% 5.3%
0
Staphylococcus Pseudomona Staphylococcus Serratia Streptococcus Other
epidermidis s aureus pneumoniae
aeruginosa
Bacterial 45,71%
Fungi 21,43%
Virus 18,57%
Others 14,29%
France
Diplobacillus of morax (H. duplex)
Palestine
Koch-Weeks bacillus (H. influenzae)
US
Staphylococcus aureus
Problem Magnitude
• Corneal leukoma
• Irregular astigmatism
• Corneal perforation
Ulcer
Hypopion
(pus in the AC)
Corneal Ulcer – affected area
Criteria of Ideal Topical Antibiotic
Provision of appropiate
Avoid dose reduction
New generation of AB
Less likely to induced resistance strain
Corneal Ulcers associated with location progressivity
C = 0,677 (p = 0,000)
Table 1. Bacterial Distribution and Progressivity
and TGF-β
subjects)
Cole, and Hume (2006)
mechanism
Suggestion:
of ulcer
• Staphilococcus Aureus identifikasi melalui:
– Morfologi mikroskopis grm + dan coccus +
bergerombol seperti anggur. Katalase +.
– Morfologi koloni, aktivitas hemolisis+.
– Differensiasi Staphilococcus, warna koloni emas,
coagulase+, mannitol+, hemolisis+, novobiocin
sensitif.
– Reaksi plasma okslat dan plasma sitrat +.
• Staphilococcus Epidemidis identifikasi melalui:
– Morfologi mikroskopis grm + dan coccus +
bergerombol seperti anggur. Katalase +.
– Morfologi koloni, aktivitas hemolisis+.
– Differensiasi Staphilococcus, warna koloni putih,
coagulase -, mannitol -, hemolisis -, novobiocin
sensitif.
– Reaksi plasma okslat dan plasma sitrat +.