İrritabl barsak sendromu tanılı hastalarla sağlıklı kişilerin kornealarının yapısal ve fonksiyonel farklılıklarının değerlendirilmesi
Evaluation of structural and functional differences of cornea between patients with irritable bowel syndrome and healthy controls
- Tez No: 547653
- Danışmanlar: DR. ÖĞR. ÜYESİ VEYSEL AYKUT
- Tez Türü: Tıpta Uzmanlık
- Konular: Göz Hastalıkları, Eye Diseases
- Anahtar Kelimeler: Belirtilmemiş.
- Yıl: 2019
- Dil: Türkçe
- Üniversite: İstanbul Medeniyet Üniversitesi
- Enstitü: Göztepe Eğitim ve Araştırma Hastanesi
- Ana Bilim Dalı: Göz Hastalıkları Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: 49
Özet
AMAÇ. İrritabl barsak sendromu (İBS) hastalarında kornea hassasiyeti ve oküler yüzey bulgularını değerlendirmek YÖNTEM. İstanbul Medeniyet Üniversitesi Göztepe Eğitim ve Araştırma Hastanesi Gastroenteroloji bölümünde İBS tanısı almış 29 hastanın 58 gözü ve kontrol gurubu olarak da yaş ve cinsiyet olarak eşleştirilmiş, göz hastalıkları polikliniğimize başvuran 37 kişinin 74 gözü çalışmaya dahil edildi. İki gruba detaylı oftalmolojik muayene yapıldı. Ardından sırasıyla Cochet-Bonnet esteziyometri testi, gözyaşı filmi kırılma zamanı (GFKZ) ölçümü ve topikal anestezi ile Schirmer-I testini içeren oküler yüzey testleri yapıldı. Oküler yüzey hastalık indeksi (=Ocular Surface Disease Index (OSDI)) anketi cevaplandırılarak sonuçlar kaydedildi. Tüm parametreler gruplar arasında istatistiksel olarak karşılaştırıldı ve p
Özet (Çeviri)
PURPOSE. To evaluate corneal sensitivity and ocular surface findings in patients with irritable bowel syndrome (IBS). MATERIAL AND METHODS. In this study, we included 29 patients with IBS and 37 age and gender matched healthy controls. We performed detailed ophthalmological examination and ocular surface tests including Cochet-Bonnet esthesiometer, tear film break-up time (TBUT) and Schirmer I test with topical anesthetic. Subjective complaints of the patients were evaluated with ocular surface disease index (OSDI) scores. RESULTS. In IBS group there were 20 (%69) females and 9 (%31) males and the mean age of the patients was 45,28 (±10,15) years. In control group there were 25 (%65,8) females and 12 (%34,2) males and the mean age of the subjects was 44,95 (±9,76) years. There was no significant difference between IBS group and control group in age and gender. (p=0,53 p=0,78) When TBUT was evaluated for each eye, in IBS group the mean TBUT-right eye was 9,51 (±4,43) seconds, TBUT-left eye was 10,72 (±5,55) seconds. In control group the mean TBUT-right eye was 17,61 (±12,05) seconds, TBUT-left eye was 16,59 (±11,46) seconds. There was a significant difference between these measurements. (TBUT-right p=0,001 TBUT-left p=0,014) The mean TBUT was 10,12 (±4,63) seconds in IBS group and 16,86 (±10,75) seconds in control group. There was a significant difference between these measurements. (p=0,002) There was no significant difference between Schirmer readings. (p=0,70) Although the corneal sensation was found to be higher than the control group in the other 4 quadrants except the central zone, this difference was not statistically significant. In IBS group corneal sensation measurements was 54,39 (±6,83) mm in central zone, 51,46 (±9,94) mm in superior zone, 53,70 (±8,92) mm in inferior zone, 54,39 (±6,11) mm in nasal zone and 55,86 (±4,87) mm in temporal zone. In control group the measurements was 55,70 (±5,99) mm in central zone, 48,04 (±10,01) mm in superior zone, 50,26 (±11,38) mm in inferior zone, 53,35 (±9,91) mm in nasal zone and 54,60(±7,32) mm in temporal zone. CONCLUSION. Chronic pain syndromes (CPS) are the common name of wide variety of disease spectrum which have common mechanical factors included dry eye disease (DED). The lower TBUT is found related with IBS, which is part of CPS. This finding is compatible with the previous studies in order to reveal common mechanistic factors. The higher OSDI scores with normal corneal sensitivity measurements can point out the underlying neuropathic disease. The reason of increased dry eye symptoms in CPS patients cannot be just explained with reduced tear production but also neuropathic ocular pain can cause these symptoms. In outpatient clinic, we recommend that neuropathic ocular pain should be evaluated in patients with dry eye who do not improve their symptoms despite the use of multiple artificial tear.
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