Efektifitas dan keamanan terapi pseudotumor yang rekuren atau refrakter terhadap kortikosteroid sistemik

Muhammad Asroruddin, Neni Anggraini, Rossalyn S Andrisa

Abstract


Latar Belakang: Pseudotumor orbita merupakan suatu proses inflamasi jinak pada orbita yang jika tidak diterapi dengan baik akan menyebabkan disfungsi okulomotor berat dan gangguan penglihatan ireversibel. Evaluasi efektivitas dan keamanan terapi pseudotumor yang rekuren atau refrakter terhadap kortikosteroid sistemik diperlukan karena telah ditemukan hasil yang bervariasi, tidak adanya panduan terapi yang spesifik, dan karena kurangnya profil efektivitas dan keamanan masing-masing agen terapi. Metode: Peneliti telah meninjau beberapa artikel yang berkaitan dengan terapi sesuai kasus di atas. Kriteria inklusi adalah semua jenis jurnal dengan semua level of evidence yang mempublikasikan efektivitas masing-masing terapi, komplikasi, angka rekurensi, masa tindak lanjut, dan efek samping. Hasil: Tinjauan telah dilakukan terhadap 20 jurnal yang membahas tentang terapi radiasi, injeksi steroid intralesi, imunosupresan, dan agen imunobiologik. Semua jurnal tergolong dalam level of evidence IV yang memuat durasi gejala, dosis dan durasi, respons klinis, efek samping, dan rekurensi. Besar subjek yang tercakup dalam tinjauan ini bervariasi dari 1 hingga 37 subjek, dengan rerata masa followup 9 bulan hingga 4,5 tahun. Sebagian besar penelitian menunjukkan respons klinik yang baik. Angka rekurensi dan efek samping/komplikasi sangat rendah bahkan nihil. Kelompok terapi radiasi menunjukkan respons terapi yang lebih rendah dan rekurensi serta komplikasi yang lebih tinggi bila dibandingkan dengan modalitas terapi lainnya yang dapat mencapai complete response hingga 100%. Kesimpulan: Semua jenis modalitas terapi untuk penatalaksanaan pseudotumor orbita rekuren atau refrakter terhadap kortikosteroid sistemik terbukti efektif dan aman. Penelitian yang lebih besar dan valid diperlukan lebih lanjut untuk menentukan efektivitas dan keamanan terapi.

Keywords


pseudotumor orbita, kortikosteroid

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References


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DOI: http://dx.doi.org/10.26418/jurkeswa.v1i1.42978

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