Diyabetik Hastalarda Gözyaşı Fonksiyonlarının Değerlendirilmesi

Year 2019, Volume: 11 Issue: 2, 67 - 76, 01.09.2019

Şerife Gülhan Konuk Selim Demir Nurullah Koçak

Abstract

Amaç: Diabetus mellitus (DM) hastalarında kuru göz semptom ve bulgularının yaş ve cinsiyet açısından eşleşmiş sağlıklı kontrol grubu ile karşılaştırılması.
Gereç ve Yöntem: Çalışmaya yaş ve cinsiyet açısından benzer özelliklere sahip 75 kişi dahil edildi. Hastalar diyabet mevcudiyeti ve evresine göre 3 gruba ayrıldı. Grup 1 sağlıklı kontrol grubundan oluşan 25 kişi, grup 2 diyabeti mevcut olup diyabetik retinopatisi olmayan 25 kişi ve grup 3 diyabetik retinopatisi olan 25 kişi olarak sınıflandırıldı. Oküler yüzey hastalık indeksi (OSDİ) skorlaması, schirmer testi (<5 mm/5 dk), gözyaşı kırılma zamanı (GKZ, <10sn), korneanın fluoresein boyanması değerlendirildi. İstatiksel yöntemler olarak 3 farklı bağımsızın karşılaştırılmasında Kruskal Wallis Testi, 2 farklı bağımsız için Mann Whitney U testi, korelasyon analizi için Spearman Testi kullanıldı. p<0.05 istatiksel olarak anlamlı kabul edildi.
Bulgular: OSDİ skorlaması grup 1 de 15.9±11.1, grup 2 de 14.5±13.1, grup 3 de 17.7±15.5 idi. Anestezisiz yapılan schirmer testi grup 1 de 16.4±10.6/5 dk, grup 2 de 14,2±9.9/5dk, grup 3 de 13.7±8.9/5dk olarak bulundu. Schirmer ve OSDİ skorunda 3 grup arasında anlamı fark saptanmadı (p>0,05). Ayrıca diyabet yılı ve glikolize hemoglobin (HbA1c) değerleri testlerde farklılık yaratmadı. GKZ 10 saniye altında kaydedilen kişi sayısı grup 1 de 2, grup 2 de 10, grup 3 de 10 kişi idi. Grup 1 ile grup 2 ve 3 arasındaki fark istatiksel olarak anlamı idi ( p=0.017). Korneada 5 ve üzeri punktat epitel defekti grup 1 de 3 olgu, grup 2 de 10 olgu ve grup 3 de 9 olguda vardı. Grup 1 ve 2 (p=0.025), grup 1 ve 3 arasında (p=0.049) anlamlı farklılık mevcut idi.
Sonuç: Diyabet hastalarında schirmer ve OSDİ skor testlerinde anlamlı fark saptanmadı. Korneal punktat boyanma ve GKZ diyabet hastalarında kontrol grubuna göre daha fazla olup bu durum diyabet hastalarında daha fazla görülen kurugöz semptomlarını açıklayabilir.

Keywords

Diabetus mellitus, diyabetik retinopati, kuru göz

The Evaluation of Tear Functions in Diabetic Patients

Abstract

Objective: To compare the dry eye symptoms and findings with the age and sex matched healthy control group in patients with diabetes mellitus (DM)
Materials and Methods: Seventy-five people with similar features in terms of age and gender were included in the study. Patients were divided into 3 groups according to the presence and stage of diabetes. Group 1 consisted of 25 people with healthy control group, group 2 25 people with diabetes with no sign of retinopathy and 25 people with group 3 diabetic retinopathy. Ocular surface disease index (OSDI) scoring, schirmer test (<5mm / 5min), tear break-up time (GKZ, <10 sec), fluorescein corneal staining were evaluated. Kruskal Wallis test was used for statistical analysis of 3 different independent samples, Mann Whitney U test was used for 2 independent samples and Spearman's test for correlation analysis. p <0.05 was considered statistically significant.
Results: The OSDI scores were 15.9 ± 11.1 in the group 1, 14.5 ± 13.1 in the group 2 and 17.7 ± 15.5 in the group 3. Schirmer test without anesthesia was found to be 16.4 ± 10.6 / 5 min in group 1, 14.2 ± 9.9 / 5min in group 2 and 13.7 ± 8.9 / 5min in group 3. There were no significant differences between the 3 groups in Schirmer and OSDI scores. In addition, the year of diabetes and glycated hemoglobin (hbA1c) did not make any difference. GKZ under 10 seconds was recorded as 2 people in group 1, 10 people in group 2 and 10 people in group 3. The difference between group 1 and group 2 and 3 was statistically significant (p <0.017). In the corneal staining test with fluorescein, the presence of corneal 5 and above punctate was 3 in group 1, in group 2 in 10 and in group 3 in 9. There was a significant difference between groups 1 and 2 (p <0.025), between group 1 and 3 (p <0.049).
Conclusion: There was no difference in schirmer and OSDİ score tests in diabetic patients. The meaning of dry eye was found to be different in patients with corneal staining and GKZ diabetes compared to the control group.

Keywords

diabetes mellitus, diabetic retinopathy, dry eye

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