Kompetensi kualifikasi tambahan SUBSPESIALIS yang telah dilaksanakan

selama 5 tahun terakhir (bidang retina)

Keterampilan diagnosis medical retina

Pernyataan Disetujui oleh

pemohon
No Diagnosis reviewer
*centang
*diisi oleh peer
kompetensi yang
reviewer
telah dikuasai

KELAINAN MAKULA

1 Wet Age Macular Degeneration (AMD)

2 Sindrom histoplasmosis okular

3 Angioid Streak

4 Myopia Patologis

5 Choroidal Neovascularization (CNV) Idiopatik

6 Cystoid Macular Edema (CME)

KELAINAN PEMBULUH DARAH RETINA

Retinopati Diabetik Proliferatif/ Proliferative Diabetic

7
Retinopathy (PDR)

8 Branch Retinal Vein Occlusion (BRVO)

9 Central Retinal Vein Occlusion (CRVO)

10 Sindroma iskemik okular

11 Branch Retinal artery Occlusion (BRAO)

12 Central Retinal Artery Occlusion (CRAO)

13 Oklusi aretri Cilioretinal

14 Oklusi Arteri Ophthalmica

Paraf atasan : Paraf Pemohon :

15 Makroaneurisma Arterial

16 Retinopati Sickle Cell

17 Vaskulitis

18 Coats Disease

19 Telangiektasis Parafoveal

20 Penyakit Von Hippel-Lindau

21 Sindrom Wyburn -Mason

22 Retinal Cavernous Hemangioma

23 Retinopati akibat Radiasi

24 Retinopati Valsalva

25 Purtscher-and Purtscherlike Retinopathy

26 Sindrom Terson

27 Retinopathy of Prematurity (ROP)

KELAINAN KOROID

28 Central Serous Choroidopathy (CSC)

29 Choroidal Perfusion Abnormalities

30 Hemangioma koroid

31 Uveal Effusion Syndrome

32 Bilateral Diffuse Uveal Melanocytic Proliferation

INFLAMASI KOROID DAN RETINA

33 White Dot Syndromes

34 Choroidal Autoimmune Conditions

35 Sympathetic Ophthalmia

Paraf atasan : Paraf Pemohon :

36 Intraocular Lymphoma

37 Retinitis Cytomeglovirus (CMV)

38 Non-CMV Necrotizing Herpetic Retinitis

39 Endophthalmitis

40 Tuberculosis ocular

41 Chorioretinitis syphilis

42 Cat-scratch Disease

43 Retinochoroiditis Toxoplasma

44 Toxocariasis

45 Lyme Disease

46 Diffuse Unilateral Subacute Neuroretinitis

CONGENITAL AND STATIONARY RETINAL DISEASE

47 Colour Vision (cone system) abnormalities

48 Night Vision (rod system) abnormalities

HEREDITARY RETINAL AND CHOROIDAL DYSTROPHIES

49 Retinitis Pigmentosa

50 Leber Congenital Amaurosis

51 Cone Dystrophies

52 Stargardt Disease

53 Vitelliform Degenerations

54 Pattern Dystrophies

55 Sorsby Macular Distrophy

56 Choroidal Dystrophies

Paraf atasan : Paraf Pemohon :

57 X-Linked Retinoschisis

58 Enhanced S-cone Syndrome

DEGENERASI RETINA

59 Bardet-Biedl Syndrome

60 Usher Syndrome

61 Retinal Albinism

SYSTEMIC-DRUG-INDUCED RETINAL TOXICITY

62 Drug causing RPE + Photoreceptor abnormalities

63 Drug causing Occlusive Retinopathy

64 Drug causing Ganglion cells + Optic nerve abnormalities

65 Drug causing Macular Oedema

66 Drug causing Crystalline Retinopathy

67 Drug causing Colour vision and ERG abnormalities

ABLASI RETINA (Retinal Detachment)

68 Retinal Breaks

69 Posterior Vitreous Detachment (PVD)

70 Lattice Degeneration

71 Vitreoretinal Tufts

72 Meridional Folds

73 Paving-stone Degeneration

74 Hyperplasia Retinal Pigment Epithelium (RPE)

75 Hypertrophy Retinal Pigment Epithelium (RPE)

76 Ablatio Retina

Paraf atasan : Paraf Pemohon :

 77 Optic Pit Maculopathy

DISEASES OF THE VITREOUS AND VITREORETINAL INTERFACE

78 Epiretinal membranes

79 Vitreomacular Traction Diseases

80 Idiopathic Macular Hole

81 Wagner and Stickler Syndromes

82 Familial Exudative Vitreoretinopathy

83 Asteroid Hyalosis

MANIFESTASI TRAUMA PADA SEGMEN POSTERIOR

84 Perdarahan Vitreus

85 Ruptur koroid

86 Macular Hole pasca trauma

87 Benda asing intraokular

88 Drop IOL

89 Drop Nukleus

Keterampilan diagnosis surgical retina

Pernyataan Disetujui oleh
pemohon reviewer
No Diagnosis *centang
*diisi oleh peer
kompetensi yang
reviewer
telah dikuasai

KELAINAN MAKULA

1 Dry Age Macular Degeneration (AMD)

2 Sindrom histoplasmosis okular

3 Angioid Streak

4 Myopia Patologis

Paraf atasan : Paraf Pemohon :

5 Choroidal Neovascularization (CNV) Idiopatik

6 Cystoid macular oedema (CME)

KELAINAN PEMBULUH DARAH RETINA

Retinopati Diabetik Proliferatif/ Proliferative Diabetic

7
Retinopathy (PDR)

8 Branch Retinal Vein Occlusion (BRVO)

9 Central Retinal Vein Occlusion (CRVO)

10 Sindroma iskemik ocular

11 Branch Retinal artery Occlusion (BRAO)

12 Central Retinal Artery Occlusion (CRAO)

13 Oklusi arteri Cilioretinal

14 Oklusi Arteri Ophthalmica

15 Makroaneurisma Arterial

16 Retinopati Sickle Cell

17 Vaskulitis

18 Coats Disease

19 Telangiektasis Parafoveal

20 Penyakit Von Hippel-Lindau

21 Sindrom Wyburn -Mason

22 Retinal Cavernous Hemangioma

23 Retinopati akibat Radiasi

24 Retinopati Valsalva

25 Purtscher-and Purtscherlike Retinopathy

Paraf atasan : Paraf Pemohon :

26 Sindrom Terson

27 Retinopathy of Prematurity (ROP)

KELAINAN KOROID

28 Central Serous Choroidopathy (CSC)

29 Choroidal Perfusion Abnormalities

30 Hemangioma koroid

31 Uveal Effusion Syndrome

32 Bilateral Diffuse Uveal Melanocytic Proliferation

INFLAMASI KOROID DAN RETINA

33 White Dot Syndromes

34 Choroidal Autoimmune Conditions

35 Sympathetic Ophthalmia

36 Intraocular Lymphoma

37 Retinitis Cytomeglovirus (CMV)

38 Non-CMV Necrotizing Herpetic Retinitis

39 Endophthalmitis

40 Tuberculosis okular

41 Chorioretinitis syphilis

42 Cat-scratch Disease

43 Retinochoroiditis Toxoplasma

44 Toxocariasis

45 Lyme Disease

46 Diffuse Unilateral Subacute Neuroretinitis

Paraf atasan : Paraf Pemohon :

 CONGENITAL AND STATIONARY RETINAL DISEASE

47 Colour Vision (cone system) abnormalities

48 Night Vision (rod system) abnormalities

HEREDITARY RETINAL AND CHOROIDAL DYSTROPHIES

49 Retinitis Pigmentosa

50 Leber Congenital Amaurosis

51 Cone Dystrophies

52 Stargardt Disease

53 Vitelliform Degenerations

54 Pattern Dystrophies

55 Sorsby Macular Distrophy

56 Choroidal Dystrophies

57 X-Linked Retinoschisis

58 Enhanced S-cone Syndrome

DEGENERASI RETINA

59 Bardet-Biedl Syndrome

60 Usher Syndrome

61 Retinal Albinism

SYSTEMIC-DRUG-INDUCED RETINAL TOXICITY

62 Drug causing RPE + Photoreceptor abnormalities

63 Drug causing Occlusive Retinopathy

64 Drug causing Ganglion cells + Optic nerve abnormalities

Paraf atasan : Paraf Pemohon :

65 Drug causing Macular Oedema

66 Drug causing Crystalline Retinopathy

67 Drug causing Colour vision and ERG abnormalities

ABLASI RETINA (Retinal Detachment)

68 Retinal Breaks

69 Lattice Degeneration

70 Vitreoretinal Tufts

71 Meridional Folds

72 Ablatio Retina

73 Optic Pit Maculopathy

DISEASES OF THE VITREOUS AND VITREORETINAL INTERFACE

74 Epiretinal membranes

75 Vitreomacular Traction Diseases

76 Idiopathic Macular Hole

77 Wagner and Stickler Syndromes

78 Familial Exudative Vitreoretinopathy

79 Asteroid Hyalosis

MANIFESTASI TRAUMA PADA SEGMEN POSTERIOR

80 Perdarahan Vitreus
81 Ruptur Koroid
82 Macular Hole pasca trauma
83 Benda asing intraokular
84 Drop Nukleus
85 Drop IOL
86 Solar Retinopathy

Paraf atasan : Paraf Pemohon :

 Keterampilan Klinis Vitreoretina
Pernyataan
pemohon Disetujui oleh
No Keterampilan Klinis *centang reviewer
kompetensi *diisi oleh
yang telah peer reviewer
dikuasai

1 Pemeriksaan dan interpretasi Indocyanine Green (ICG)

2 Pemeriksaan dan interpretasi Electroretinogram (ERG)

3 Laser PDT
4 Laser indirect ophthalmoscope
Laser fotokoagulasi pada kelainan makula (focal, grid dan
5
micro pulse)
Laser retinopexy (demarcation) pada kasus isolated retinal
6
breaks.
7 Cryotherapy pada retinal break
8 Scleral buckling
9 Vitrektomi
10 Macular Surgery
Injeksi vitreous substitute (Tamponade dan subretinal
11
injection)
Pengambilan benda asing dari segmen posterior mata
12p
(IOFB)
13 Pneumatik retinopeksi dan displacement

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Pemohon,

Materai 6000

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