Efektivitas Penambahan Natrium Diklofenak terhadap Larutan Obat Dilatasi Pupil pada Pasien Retinopati Diabetik

Abstract

Pemeriksaan fundus memerlukan akses visualisasi yang baik. Pada penderita diabetes melitus, pupil sulit lebar menggunakan obat pelebar pupil standar sehingga perlu ditambahkan agen pelebar pupil. Penelitian ini dilakukan di Rumah Sakit Mata Cicendo periode Januari sampai Juli 2014 menggunakan metode double masked rendomized cotrolled trial terhadap 64 mata dari 32 subjek penelitian yang telah didiagnosis menderita retinopati diabetika dengan tingkat yang sama antara mata kiri dan kanan. Dibuat larutan kombinasi campuran 10 mL tropikamid 0,5%/fenilefrin 0,5%, 10 mL fenilefrin 5% dan 10 ml 0,1% Na diklofenak (larutan I) dan campuran 10 mL tropikamid 0,5%/fenilefrin 0,5%, dan 10 mL fenilefrin 5% (larutan II). Setiap subjek mendapat salah satu larutan pada mata dan larutan yang lain pada sebelahnya secara acak. Dilakukan pemantauan dengan cara memotret pupil pada menit ke-15, 20, dan 25 pada kedua mata. Lebar pupil kedua kelompok perlakuan diukur dengan perangkat lunak khusus (image processing). Dari penenelitian terdapat perbedaan bermakna antara penggunaan larutan I dan larutan II dalam melebarkan pupil baik pada menit ke-15 (t=2,02; p=0,047), menit ke 20 (t=2,23; p=0,029), dan pada menit ke-25 (t=2,041; p=0,045). Larutan kombinasi fenilefrin, tropikamid, dan natrium diklofenak menghasilkan efek dilatasi pupil yang lebih baik dibanding dengan larutan kombinasi fenilefrin dan tropikamid saja pada kasus retinopati diabetes. [MKB. 2017;49(3):199–207]

Kata kunci: Dilatasi pupil, natrium diklofenak, retinopati diabetika

Effectiveness of Sodium Diclofenac Addition to Pupil Dilatation Agent on Diabetic Retinopathy Patients

Fundus examination requires good visualization of fundus. In diabetic patients, it is difficult for the pupil to dilate using the standard pupilarry dilating agent. To achieve proper dilation, special agents have to be added to the standard dilation agent. The study was conducted in Cicendo Eye Hospital from January to July 2014, using double masked randomized controlled trial to 32 patients (64 eyes) who were diagnosed as suffering from diabetic retinopathy with the same grade on both eyes. Eye drop solutions were developed beforehand by mixing 10 mL of 0.5% tropicamide/0.5% phenylephrine, 10 mL of 5% phenylephrine, and 10 mL of 0.1% diclofenac-natrium (solution I) and also by mixing 10 mL of 0.5% tropicamide/0.5% phenylephrine and 10 mL of 5% phenylephrine (solution II). Every subject received one drop of one solution on one eye and the other solution on the other eye in randomly fashion. The observation was performed by taking photographs of the pupil on both eyes 15, 20, and 25 minutes of observation. The resulting pupil photographs were then analyzed and measured using special image processing software and compared. It was revealed that there were statistical differences in pupil dilation between solution I and solution II at 15 minutes (t=2.02; p=0.047), 20 minutes (t=2.23, p=0.029), and 25 minutes (t=2.041, p=0.045). Phenilefrine, tropicamide and diclofenac-natrium combination solution provides better dilation effect on the pupil compared to the combination of phenilefrine and tropicamide alone in diabetic retinopathy patient. [MKB. 2017;49(3):199–207]

Key words: Diabetic retinopathy, natrium diclofenac, pupil dilatation