PENURUNAN KADAR INTERLEUKIN-6 (IL-6) AIR MATA DAN PERUBAHAN KLINIS PADA SUBJEK DENGAN ULKUS KORNEA INFEKSI DERAJAT SEDANG-BERAT DENGAN TERAPI TAMBAHAN LISAT PLATELET RICH FIBRIN (PRF) TETES MATA
Jehan Fauzi Rakhmandani, Prof. Dr. dr. Agus Supartoto, Sp.M(K) Prof. dr. Suhardjo. SU, Sp.M(K) Prof. Dr. dr. Y. Widodo W., Sp. KK(K)
2023 | Tesis-Spesialis | S2 Ilmu Penyakit Mata
Latar Belakang
Metode
Penelitian ini merupakan penelitian randomized double blind
controlled trial yang membandingkan dua kelompok pasien di Rumah
Sakit Dr. Sardjito Yogyakarta. Sebanyak 42 pasien (42 mata) dibagi menjadi
kelompok kontrol (21 pasien) dan kelompok intervensi (21 pasien). Tingkat IL-6
dan perubahan klinis pada pasien, seperti defek kornea, injeksi perikorneal, dan tingkat blepharospasm diukur pada awal, hari ke 6 dan hari
ke 13 setelah memulai pengobatan. Data dilaporkan dalam median.
Hasil
Dibandingkan dengan baseline, rata-rata kadar IL-6 pada hari ke-13
menurun sebesar 178,1 (11,1-2637,7) pg/ml (p=0,005) dan 432,1 (11,3-3570,6) pg/ml (p=0,079) pada kelompok intervensi dan kontrol.
Namun, perbedaan antara kedua kelompok secara statistik tidak signifikan
(p=0,164). Dalam luas defek kornea, terdapat penurunan yang signifikan pada hari ke-6 dan hari
ke-13 pada kedua kelompok tetapi tidak ada perbedaan yang signifikan secara
statistik antara kedua kelompok. Demikian pula, blepharospasm dan
injeksi perikorneal tampak berkurang terutama pada hari ke-13 pada kedua kelompok
tetapi secara statistik tidak berbeda antara keduanya.
Kesimpulan
Terdapat penurunan yang signifikan secara statistik pada kadar IL-6 pada
air mata pada pasien yang menggunakan PRF lisat, namun tidak ada perbedaan yang
signifikan bila dibandingkan dengan yang menggunakan serum autolog.
Perbedaan luas area defek, derajat blepharospasm dan injeksi perikornea tidak signifikan secara statistik antara kedua pilihan pengobatan.
Corneal ulcer, one
of the corneal diseases that has caused worldwide visual impairment and
blindness. IL-6 is produced by corneal fibroblast cells around the site of injury.
Elevated IL-6 level is associated with inflammatory processes, while decreased
IL-6 level is associated with inflammatory repair and wound healing. The purpose of this study to assess the change of Interleukin-6 (IL-6) levels in tears and ocular
clinical parameters in corneal ulcer patients with moderate-to-severe infection
after adjunctive therapy with Platelet Rich Fibrin (PRF) lysate eyedrops
compared with autologous serum eyedrops.
Method
This study was a
randomized double blind controlled trial, which compared two groups of patients
at Dr. Sardjito Hospital, Yogyakarta. A total of 42 patients (42 eyes) were
divided into the control group (21 patients) and the intervention group (21
patients). The IL-6 levels and clinical changes in patients, such as the area
of corneal defects, pericorneal injection, and the level of blepharospasm were
measured at the baseline, day 6 and day 13 after starting the treatment. Data are reported in the median.
Results
Compared to
baseline, the mean IL-6 level in day 13 decreased by 178.1 (11.1-2637.7)pg/ml (p=0.005) and 432.1 (11.3-3570.6) pg/ml (p=0.079) in the intervention and control groups, respectively.
However, the difference between the two groups was not statistically
significant (p=0.164). In term of corneal defect area, there were a significant
decrease at day 6 and day 13 in both groups but there was no statistically
significant difference between the two groups in all time points. Similarly,
the difference of blepharospasm and pericorneal injection severity appeared to especially reduce on day 13 in both groups but were not statistically different between
the two.
Conclusion
There was a statistically significant decrease in IL-6
levels in the tears in patient using PRF lysate, but there was no significant
difference when compared to those using autologous serum. The difference in
defect area, degree of blepharospasm and pericorneal injection were not
statistically significant between the two treatment options.
Kata Kunci : IL-6, corneal ulcer, autologous serum, PRF lysate