• Tidak ada hasil yang ditemukan

BAB 6 KESIMPULAN DAN SARAN

6.2. Saran

1. Lokasi penelitian sebaiknya diperluas dengan melibatkan sentra yang lebih banyak agar hasil lebih representatif.

2. Rekam medik sebagai sumber data penelitian, sebaiknya lebih lengkap dan rapi dalam melampirkan unsur-unsur demografi, pelaporan hasil pemeriksaan, dan follow up yang dilakukan sehingga proses pengumpulan dan pengolahan data akan lebih mudah.

3. Sehubungan dengan karakteristik sampel, pasien lebih banyak datang dalam stadium IV atau keadaan ekstraokular. Hal ini kiranya mengingatkan pihak-pihak yang berkaitan untuk melakukan edukasi dan tindakan preventif agar sekiranya pasien dibawa dalam keadaan klinis yang lebih awal, sehingga kebutaan dapat dicegah.

4. Peneliti lainnya di masa mendatang diharapkan dapat melakukan penelitian lanjutan berkaitan dengan karakteristik pasien retinoblastoma untuk menilai peningkatan kualitas pasien dan sebagai pembaharuan epidemiologi.

DAFTAR PUSTAKA

Aerts, I., Lumbroso-Le Ruic, L., Gauthier-Villars, M., Brisse, H., Doz, F., Desjardins, L., 2006. Orphanet Journal of Rare Disease: Retinoblastoma. Available from:

http://www.ojrd.com/content/1/1/31 [Accesed 5 Mei 2014]

Ajiki, dkk., 2001. An Epidemiological Assesment of Childhood Cancer in Greater Mumbai. Dalam: Yeole B.B., Advani S.H., Lizzy S. Indian Pediatrics, 38: 1270-1277

American Cancer Society, 2013. How is Retinoblastoma Diagnosed. Available from: http://www.cancer.org/cancer/retinoblastoma/detailedguide/retinoblastoma- diagnosis [Accessed 18 Mei 2014].

Asih, D., Gatot, D., Sitorus, R.S., 2009. Computed Tomography Findings of Retinoblastoma Patient at Cipto Mangunkusumo Hospital Jakarta. Med J Indones, 18(4): 239-244.

Bosaleh, A., dkk., 2012. Outcome of children with retinoblastoma and isolated choroidal invasion. PubMed for MEDLINE, 130(6): 724-9

Boughton, B., 2010. Retinoblastoma, Part Two: Secondary Neoplasms in Older Children. American Academy of Ophthalmology, 148: 192-198.

Canadian Cancer Society, 2014. Risk factors for Retinoblastoma. Available from: http://www.cancer.ca/en/cancerinformation/cancertype/retinoblastoma/risks/?reg ion=on [Accessed 16 Mei 2014]

Carol, P., 2010. Essentials of Pathophysiology: Concepts of Altered Health States. 3rd ed. USA: Lippincott Williams & Willkins, 139-141

Dahl, A., 2013. Retina Anatomy. USA: WebMD. Available from: http://emedicine.medscape.com/article/2019624-overview [Accessed 15 Mei 2014]

Dharmawidiarini, D., Prijanto, Soebagjo, H.D., 2010. Ocular Survival Rate Penderita Retinoblastoma yang Telah Dilakukan Enukleasi atau Eksenterasi di RSUD Dr. Soetomo Surabaya. Jurnal Oftalmologi Indonesia, 7(3): 94-102

D’Elia, dkk., 2013. Two Novel Cases of Trilateral Retinoblastoma: Genetics and Review of the Literature. PubMed for MEDLINE, 206(11): 398-401

Edi & Siswono, 2009. Gambaran Epidemiologi Leukemia Anak di Rumah Sakit Kanker Dharmais Jakarta Tahun 2004-2008. Dalam: Chandrayani, S. Fakultas Kesehatan Masyarakat Universitas Indonesia: 1-5.Kaiser, P.K., Scott I.U., O’brien, J.M., Murray, T.G., 2014. Retinoblastoma. Available from:

http://www.djo.harvard.edu/site.php?url=/patients/pi/436 [Accessed 5 Mei 2014] Etter, J., Bansal, P., 2005. Diagnosis and Treating Retinoblastoma. American

Academy of Ophthalomology. Available from:

http://www.aao.org/publications/eyenet/200505/pearls.cfm [Accessed 16 Mei 2014].

Ganong, W.F., 2005. Buku Ajar Fisiologi Kedokteran. Ed.22. Jakarta: Penerbit Buku Kedokteran EGC, 155-168

Ilyas, S., Yulianti, S.R., 2011. Ilmu Penyakit Mata. Ed. 4. Jakarta: Badan Penerbit Fakultas Kedokteran Indonesia.

Jijelava, K.P., Grossniklaus, H.E., 2013. Diffuse Anterior Retinoblastoma: A Review. Saudi Journal of Ophthalmology, 27: 135-139.

Joseph, B., Kumaramanickavel, G., 2007. ‘Insight’ into Molecular Genetic: Testing in Retinoblastoma. International Journal Human Genetic, 7(1): 23-28.

Kandalam, M., Mitra, M., Subramanian, K., Biswas, J., 2010. Molecular Pathology of Retinoblastoma. Middle East Africa Journal Ophthalmology, 17(3): 217-223. Mescher, A.L., 2010. Junqueira’s Basic Histology Text & Atlas. USA: McGraw Hill,

426.

Krishnakumar, S., dkk., 2005. Role of Nitrid Oxide Synthases and Nitrotyrosine in Retinoblastoma. Invest Ophthalmology & Visual Science, 46: 1105-1110.

Laurie, dkk., 2010. Molecular Pathology of Retinoblastoma. Dalam: Kandalam, M. Middle East Africa Journal Ophthalmology, 17(3): 217-223.

Lin, P., O’brien, J. M., 2009. Frontiers in the Management of Retinoblastoma. American Journal of Ophthalmology, 148(2): 193-200.

Nafianti, S., 2006. Retinoblastoma in Children in Haji Adam Malik Hospital Medan. Majalah Kedokteran Nusantara, 39(3): 147-150.

National Cancer Institute of Spain, 2013. Retinoblastoma Treatment: Stage Information. U.S. Departement of Health and Human Services, National Institute of Health.

Netter, F. H., 2006. Atlas of Human Anatomy. 5th ed. USA: Saunders Elsevier, 90. Orjuela, M.A., dkk., 2012. Risk of Retinoblastoma is Associated with a Maternal

Polymorphism in Dihydrofolatereductase (DHFR) and Prenatal Folic Acid Intake. PubMed for MEDLINE, 118(23): 5912-5919.

Othman, I.S., 2012. Retinoblastoma Major Review with Updates on Middle East Management Protocols. Saudi Journal of Ophthalmology, 26: 163-175.

Pandey, A. N., 2013. Retinoblastoma: An Overview. Saudi Journal of Ophthalmology, 11(1): 1-6.

Parulekar, M.V., 2010. Current Treatment and Future Direction. Early Human Development (Elsevier), 86: 619-625.

Radhakrishnan, V., dkk., 2012. Outcome, Pathologic Findings, and Compliance in Orbital Retinoblastoma (International Retinoblastoma Staging System Stage III) Treated with Neoadjuvant Chemotherapy. American Academy of Ophtalmology, 119(7): 1470-1477

Reddy, VAP., Honavar, SG., 2008. Retinoblastoma – Advances in Management. Apollo Medicine, 5(3): 183-190.

Riordan-Eva, P., Witcher, J.P., 2007. Vaughan & Asbury’s General Ophthalmology. In: Fletcher, E.C., ed. Primary Malignant Tumors of Retina. USA: Chapter 10. Rodriguez-Gallindo, C., dkk., 2010. Retinoblastoma: One World, One Vision.

National Center for Biotechnology Information, U.S. National Library of Medicine, 122(3): e763-e770

Rosdiana, N., 2011. Gambaran Klinis dan Laboratorium Retinoblastoma. Sari Pediatri, 12(5): 319-322.

Saxena, P., Kaur, J., 2011. Differential Expression of Genes in Retinoblastoma. Clinica Chimica Acta (Elsevier), 412: 2015-2021.

Sherwood, L., 2010. Human Physiology from Cells to Systems. 7th ed. USA: Brook/Cole, 195-213.

World Health Organization, 2014. Vision 2020 The Right to Sight. International Agency for the Prevention of Blindness.

Yeole, B.B., Advani, S.H., Retinoblastoma: An Epidemiological Appraisal with Reference to a Population in Mumbai, India. Asian Pacific Journal of Cancer Prevention, 3: 17-21.

LAMPIRAN

Pekerjaan Orang Tua

Frequency Percent Valid Percent

Cumulative Percent Valid Buruh 1 2.2 2.2 2.2 Pegawai Honorer 1 2.2 2.2 4.3 Pegawai Swasta 2 4.3 4.3 8.7 Pekerja Lepas 1 2.2 2.2 10.9 Petani 13 28.3 28.3 39.1 PNS 5 10.9 10.9 50.0 Supir 1 2.2 2.2 52.2 Wiraswasta 22 47.8 47.8 100.0 Total 46 100.0 100.0 Status Pekerjaan

Frequency Percent Valid Percent

Cumulative Percent

Valid Menengah Bawah 15 32.6 32.6 32.6

Menengah 31 67.4 67.4 100.0

Usia * Gender Crosstabulation

Gender

Total Laki-Laki Perempuan

Usia 3-5 tahun Count 12 10 22

% within Gender 50.0% 45.5% 47.8% % of Total 26.1% 21.7% 47.8% < 3 tahun Count 6 8 14 % within Gender 25.0% 36.4% 30.4% % of Total 13.0% 17.4% 30.4% > 5 tahun Count 6 4 10 % within Gender 25.0% 18.2% 21.7% % of Total 13.0% 8.7% 21.7% Total Count 24 22 46 % within Gender 100.0% 100.0% 100.0% % of Total 52.2% 47.8% 100.0%

Jenis Kelamin Anak

Frequency Percent Valid Percent

Cumulative Percent

Valid Laki-laki 24 52.2 52.2 52.2

Perempuan 22 47.8 47.8 100.0

Total 46 100.0 100.0

Status Gizi Anak

Frequency Percent Valid Percent

Cumulative Percent

Valid Kurang 34 73.9 73.9 73.9

Normal 12 26.1 26.1 100.0

Didapat atau Herediter

Frequency Percent Valid Percent

Cumulative Percent

Valid Didapat 46 100.0 100.0 100.0

Unilateral atau Bilateral

Frequency Percent Valid Percent

Cumulative Percent Valid Unilateral 41 89.1 89.1 89.1 Bilateral 5 10.9 10.9 100.0 Total 46 100.0 100.0 Arah perkembangan

Frequency Percent Valid Percent

Cumulative Percent Valid Intraokular 4 8.7 8.7 8.7 Ekstraokular 38 82.6 82.6 91.3 Campuran 4 8.7 8.7 100.0 Total 46 100.0 100.0 Tingkat Keparahan

Frequency Percent Valid Percent

Cumulative Percent Valid 1 4 8.7 8.7 8.7 3 1 2.2 2.2 10.9 4 41 89.1 89.1 100.0 Total 46 100.0 100.0

Gejala Klinis

Frequency Percent Valid Percent

Cumulative Percent

Valid Cat Eye 3 6.5 6.5 6.5

Mata Bengkak 1 2.2 2.2 8.7

Mata Menonjol 40 87.0 87.0 95.7

Mata merah tidak bisa

melihat 1 2.2 2.2 97.8

Proptosis Bulbi 1 2.2 2.2 100.0

Total 46 100.0 100.0

Onset

Frequency Percent Valid Percent

Cumulative Percent Valid < 1 tahun 4 8.7 8.7 8.7 > 3 tahun 2 4.3 4.3 13.0 1 - 2 tahun 27 58.7 58.7 71.7 2 - 3 tahun 13 28.3 28.3 100.0 Total 46 100.0 100.0

Dokumen terkait