HASIL GUNA PEMBERIAN KURKUMIN ORAL DALAM PENCEGAHAN EDEMA MAKULA PASCA FOTOKOAGULASI LASER PANRETINA PADA PASIEN RETINOPATI DIABETI

Firman Setya Wardhana, Prof. dr. Suhardjo, SU, SpM(K)

2013 | Tesis | S2 Ilmu Penyakit Mata

Salah satu komplikasi dari tindakan fotokoagulasi laser panretina pada pasien retinopati diabetika adalah edema makula. Peningkatan mediator inflamasi dan radikal bebas pasca fotokoagulasi laser panretina diduga berperan dalam terjadinya edema makula. Kurkumin memiliki efek anti-inflamasi dan antioksidan. Tujuan penelitian ini adalah untuk mengetahui pengaruh pemberiaan kurkumin oral dalam mengurangi edema makula pasca fotokoagulasi laser panretina pada penderita retinopati diabetika. Sebuah penelitian uji klinis teracak buta ganda. Terdapat 35 subyek dengan 58 mata diikutkan dalam peneltian ini. Subyek kemudian dilakukan pengelompokan secara acak. Kelompok kurkumin mendapat terapi serbuk Curcuma ® 200 mg 3 kali 1 kapsul setiap hari selama 4 minggu, sedangkan kelompok kontrol dengan plasebo 3 kali 1 kapsul setiap hari selama 4 minggu. Kapsul mulai dikonsumsi setelah dilakukan fotokoagulasi laser panretina sesi pertama. Metode Fast Macular Thicknes scan dengan alat Stratus OCT digunakan untuk menilai ketebalan makula sesaat sebelum dan 4 minggu setelah fotokoagulasi laser panretina. ( Didapatkan peningkatan ketebalan makula lebih ringan yang bermakna secara klinis dan statistik didapatkan pada kelompok kurkumin dibandingkan kontrol pada subyek yang dilakukan fotokoagulasi laser panretina dengan maupun tanpa dilakukan laser grid 5,86 ± 28,01 vs 25,07 ± 36,43 µm; p=0,029). Pada subyek yang dilakukan fotokoagulasi laser panretina tanpa laser grid, peningkatan lebih ringan ketebalan makula secara klinis didapatkan pada kelompok kurkumin dibandingkan kontrol (8,07 ± 19,67 vs 17,00 ± 41,75 µm), akan tetapi tidak bermakna secara statistik (p=0,457). Kesimpulan penelitian ini, pemberian kurkumin oral dapat meminimalisir edema makula pasca fotokoagulasi laser panretina pada pasien retinopati diabetika.

One of the complications of panretinal laser photocoagulation patients for diabetic retinopathy is macular edema. Increased of inflammatory mediators and free radicals after panretinal laser photocoagulation was sugested play role in the occurrence of macular edema. Curcumin has anti-inflammatory and anti-oxidant actions. The objective of this study was to determine the effect of administration of oral curcumin to prevent macular edema after panretina laser photocoagulation in diabetic retinopathy patients. A double blind randomized clinical trial study.. There were 35 subjects with diabetic retinopathy consists of 58 eyes were included in this study. The subjects then devided into two group by randomization. The curcumin group was treated with capsulated Curcuma ® 200 mg powder 3 times 1 capsule daily for 4 weeks, while the control group was treated with placebo 3 times 1 capsule daily for 4 weeks. Capsules began consumed after first session of panretinal laser photocoagulation. Fast Macular Thicness scan methode with Stratus OCT instrument used to assess the macular thickness just before and 4 weeks after underwent panretinal after laser. There was smaller increase in macular thickness which was clinically and statisticaly significant found in the curcumin group compared to control who underwent panretinal laser photocoagulation with or without grid laser (5,86 ± 28,01 vs 25,07 ± 36,43 µm; p=0,029). In subjects underwent laser photocoagulation panretina without grid laser, smaller increase of macular thickness was clinically found curcumin group compared to control group (8,07 ± 19,67 vs 17,00 ± 41,75 µm; p=0,457), but it was not statistically significant. The conclusion of this study is the administration of oral curcumin can minimize the macular edema after panretinal laser photocoagulation in diabetic retinopathy patients.

Kata Kunci : retinopati diabetika, fotokoagulasi laser panretina, edema makula, kurkumin