Perubahan Kadar interleukin-6 (IL-6) di air mata dan serum darah pada graves orbitopati sebelum dan sesudah pemberian kortikosteroid intravena

RETNA MUSTIKA DEWI, Prof. Dr. dr. Agus Supartoto, Sp.M(K) dr. Tri Wahyu Widayanti, SpM(K), M.Kes., KVR

2022 | Tesis-Spesialis | ILMU KESEHATAN MATA

Median of serum IL-6 in patients with moderate-severe active Graves orbitopathy after intravenous injection of methylprednisone with a total dose of 3 grams was lower than before therapy. However, the decrease in serum IL-6 levels was not statistically significant. Median IL-6 tears in patients with moderate-severe active Graves orbitopathy after intravenous injection of methylprednisone with a total dose of 3 grams were higher than before therapy. However, the increase in tear IL-6 levels was not statistically significant. A significant relationship was found between changes in serum IL-6 and improvement in the Schimer test. There was no significant relationship between changes in serum IL-6 and tears on improvement in OSDI, CAS scores, and TBUT after Methylprednisolone 3 gram injection therapy

Objective: to determine changes in IL-6 levels in tears and blood serum sample in moderate to severe active graves orbitopathy before and after a total of 3 grams intravenous methylprednisolone therapy and its relationship with clinical outcomes. Methods: pre-post design research conducted on 21 patients, including all patients diagnosed with moderate to severe active graves orbitopathy, whom will be receiving a total of 3 grams methylprednisolone therapy among 6 weeks at the ophthalmology clinic of Dr. Sardjito Hospital, Yogyakata. Tears and serum samples were taken before and after the 7th day of therapy. Tear samples were taken using schirmer paper in a sterile manner, while serum samples were taken from venous blood. Clinical changes in the form of improvements in CAS scores, OSDI, TBUT, and Schimer tests were recorded Results: There is no significant decrease in serum IL-6 levels after 6 weeks of a total 3 grams methylprednisolone administered intravenously, with a median of 2.01 (1.5-6.10) pg/ml to 1.84 (1.5-8.39)pg/ml (p=0.975). There is no decrease in IL-6 level in tear samples after intravenous administration of 3 grams methylprednisolone, 52.92 (22.74-239) pg/ml to 54.76 (15.61-163.32) pg/ml (p=0.068). There are clinical improvements found during post 6 weeks evaluation of 3 grams methylprednisolone therapy with a decrease in CAS score (p<0.001), decreased OSDI (p<0.001), increased TBUT (p<0.001), and an increase in Schimer test result (p=0.001). There is no correlation between changes in IL-6 levels in tears with changes in TBUT (p=0.763), changes in Schirmer test (p=0.750), OSDI (0.804), and CAS score (p=0.584). There is no correlation in changes of serum IL-6 level with changes in TBUT (p=0.603), OSDI (p=0.679), and CAS score (p=0.274). There is significant correlation in the changes of serum IL-6 levels with changes in Schirmer test result (p=0.024 , r ���¢�¯�¿�½�¯�¿�½ 0.492) Conclusion: IL-6 levels in tears and serum samples in patients with moderate to severe active Graves orbitopathy after administration of 3 gram intravenous methylprednisolone therapy were no different compared to before therapy. Changes in serum IL-6 were negatively correlated with changes in the Schirmer test.

Kata Kunci : Active Graves Orbitopahy, Interleukin-6, Methylprednisolone