Littérature scientifique sur le sujet « Test di Schirmer »

<p><strong>Abstrak</strong></p><p><strong>Latar Belakang : </strong>Prevalensi Hipertensi di Indonesia semakin meningkat mencapai 25,8% pada penduduk berusia 18 tahun keatas. Amlodipin merupakan salah satu pilihan obat untuk terapi Hipertensi yang termasuk golongan Calsium Channel Blocker (CCB). Penggunaan obat antihipertensi sendiri merupakan salah satu faktor risiko yang menyebabkan sindroma mata kering.</p><p><strong>Tujuan : </strong>Penelitian ini bertujuan untuk mengetahui pengaruh penggunaan obat antihipertensi terhadap sindroma mata kering pada penderita Hipertensi di wilayah kerja Puskesmas Jagir kota Surabaya.</p><p><strong>Metode penelitian : </strong>Penelitian ini adalah penelitian observasional analitik dengan metode cross-sectional. Subyek pada penelitian ini adalah 48 responden yang didapatkan dibagi kedalam 2 kelompok yakni, kelompok minum obat antihipertensi &gt;6 bulan dan tidak minum obat. Dilakukan pengisian kuesioner DEQ-5 dan pemeriksaan schirmer I.</p><p><strong>Hasil penelitian : </strong>Analisa deskriptif dari tes schirmer I frekuensi sindroma mata kering lebih tinggi pada responden yang mengkonsumsi obat antihipertensi dari pada responden yang tidak minum obat antihipertensi. Hasil analisa statistik menggunakan uji chi-square signifikansinya yaitu sebesar &lt;0,001 atau dapat dikatakan bahwa p&lt;α (0,05), menunjukkan ada pengaruh pemberian obat antihipertensi terhadap sindroma mata kering yang berdasarkan tes Schirmer pada pasien Hipertensi di wilayah kerja puskesmas Jagir kota Surabaya.</p><p><strong>Simpulan : </strong>Penggunaan obat antihipertensi berpengaruh terhadap sindroma mata kering pada penderita hipertensi di wilayah kerja Puskesmas Jagir kota Surabaya</p><p><strong>Kata Kunci : </strong>Sindroma mata kering, obat antihipertensi, hipertensi</p><p><strong> </strong></p><p><strong>Abstract</strong></p><p><strong>Background: </strong>Hypertension prevalence in Indonesia is increasing to reach 25.8% in the population aged 18 years and over. Amlodipine is one of the drugs for hypertension therapy which is included in the Calcium Channel Blocker (CCB) class. The use of antihypertensive medication itself is one of the risk factors that cause dry eye syndrome.</p><p><strong>Purpose</strong>: This study aims to determine the effect of the use of antihypertensive drugs on dry eye syndrome in patients with hypertension at Jagir Public Health Center in Surabaya working area.</p><p><strong>Methods:</strong> This study was an observational analytic study with a cross-sectional method. The subjects in this study were 48 respondents found divided into 2 groups namely, the group taking antihypertensive drugs&gt; 6 months and not taking medication. The DEQ-5 questionnaire was completed and Schirmer I was examined.</p><p><strong>Results:</strong> Descriptive analysis of the Schirmer I test for the frequency of dry eye syndrome was higher in respondents who took antihypertensive drugs than those who did not take antihypertensive drugs. The results of statistical analysis using the chi-square test of significance that is equal to &lt;0.001 or it can be said that p &lt;α (0.05), indicates there is an effect of antihypertensive drug administration on dry eye syndrome based on the Schirmer test in hypertension patients at Jagir Public Health Center in Surabaya..</p><p><strong>Conclusion:</strong> The use of antihypertensive drugs has an effect on dry eye syndrome in patients with hypertension at the Jagir Public Health Center in Surabaya</p><strong>Keywords:</strong> Dry eye syndrome, antihypertensive drugs, hypertension

Penurunan jumlah refleks berkedip berperan terhadap rendahnya produksi air mata dan secara temporer menimbulkan stres pada kornea dan mengakibatkan mata kering. Untuk mengurangi kemugkinan terjadinya mata kering ketika menggunakan komputer, dianjurkan untuk lebih sering berkedip untuk menjaga kelembaban permukaan okular. Refleks berkedip yang tidak sempurna juga ditemukan pada pengguna komputer yang juga berdampak terhadap stabilitas air mata. Tujuan penelitian ini untuk mengetahui perbedaan hasil uji schirmer test I sebelum dan sesudah 2 jam penggunaan komputer. Jenis Penelitian dengan Pre dan Post sebelum dan sesudah 2 jam menggunakan komputer secara cross sectional dengan metode penelitian menggunakan purposive sampling dengan metode perhitungan Uji Wilcoxon. Penelitian ini menggunakan Tes Schirmer dan Lembar Observasional. Hasil penelitian di dapat bahwa 23 orang (76.7%) sesudah 2 jam menggunakan komputer dikategorikan mengalami Non Dry Eye, kemudian sebanyak 3 orang (10.0%) dikategorikan mengalami Dry Eye Ringan dan 7 orang (13.3%) dikategorikan Dry Eye Sedang dari jumlah sampel sebanyak 30 orang. Terdapat perbedaan sebelum dan sesudah menggunakan komputer (p=0.03). Disarankan agar tidak menggunakan komputer pada jam istirahat mengistirahatkan mata, mengatur tingkat kesilauan komputer, dan mengatur jarak pandang ke layar.

<p><strong>Abstract</strong><strong></strong></p><p><strong>Background: </strong>Diabetes mellitus is a public health problem experienced by many countries and becomes a serious problem, affecting health in the world. Various complications of DM related to the surface of the eye is dry eye syndrome. Dry eye syndrome is an eye disorder with symptoms of discomfort, pain, dryness and foreign body sensation in the eye. The level of glycosylated hemoglobin (HbA1c) is one indicator of DM and it is stated that the prevalence of dry eye syndrome is significantly higher in DM sufferers than in healthy individuals. The Aim of this study to know the effect of HbA1c on dry eye syndrome in patients with diabetes mellitus <strong>Method :</strong>. This study used a cross sectional method and the sampling method used was purposive sampling. Samples taken as many as 34 people are patients with diabetes mellitus aged 18-55 years who have HbA1c results seen from medical records at the Public Health Center Jagir Surabaya. The research data was taken using the Dry Eye Questionnaire (DEQ), interviews and Schirmer Test I. The research data was then analyzed using a contingency test.<strong></strong></p><p><strong>Result: </strong>The significance value of the HbA1c test with the Schirmer I Test showed p = 0.026; that’s means a significant effect between HbA1c levels on dry eye syndrome with the Schirmer I Test and the significance value of the HbA1c test with the DEQ questionnaire shows p &lt;0.001; that’s means a significant effect between HbA1c levels on dry eye syndrome and DEQ questionnaire, performed on patients with diabetes mellitus in Jagir Health Center, Surabaya City</p><pre><strong>Conclusion: </strong>There is an influence of HbA1c levels on dry eye syndrome</pre><p><strong> </strong></p><p><em>K</em><em>ey Word</em><em> : D</em><em>ry Eye</em><em>, </em><em>Dry Eye Questionnaire, HbA1c</em><em>, </em><em>Diabetes Mellitus</em><em>.</em></p><em></em>

Keratitis merupakan kelainan mata akibat terjadinya infiltrasi sel radang pada kornea yang akan mengakibatkan kornea menjadi keruh sehingga menyebabkan terganggunya penglihatan hewan. Seekor kucing domestik betina diperiksa di Rumah Sakit Hewan Pendidikan Fakultas Kedokteran Hewan, Universitas Brawijaya dengan keluhan mata kucing terlihat tidak jernih atau keruh. Pemeriksaan fisik dan pemeriksaan refleks mata menunjukkan hasil normal. Pemeriksaan mata dengan ophthalmoscope menunjukkan kornea mata yang keruh. Fluorescein test menunjukkan tidak ada kelainan pada mata, sedangkan Schirmer Tear Test menunjukkan penurunan produksi air mata pada mata kanan. Hasil hematologi menunjukkan adanya leukositosis. Berdasarkan hasil pemeriksaan, kucing tersebut mengalami non-ulceratif keratitis atau keratitis superficial. Pengobatan yang diberikan pada kucing tersebut diantaranya adalah antibiotik amoxicillin, vitamin A, dan Cendo Tobroson Eye Drop®. Kondisi mata Caramel tampak membaik setelah dilaksanakan terapi selama 14 hari.

BackgroundXerostomia and xerophthalmia can occur in many diseases, rheumatological or not and are often reported by patients affected by cryoglobulinemia vasculitis1, particularly if related to the Hepatitis C virus infection (HCV)2. On the other hand, the Ultrasound (US) was extensively used for detecting pathological findings of the salivary glands3, possibly associated to many rheumatological diseases.ObjectivesThe aim of this study was to detect, in patients affected by cryoglobulinemia vasculitis, the presence and the grade of pathological findings at level of the major salivary glands.MethodsFrom January to December 2021, we enrolled consecutive oupatients patients affected by cryoglobulinemia (age ≥ 18 yo and a diagnosis of cryoglobulinemia vasculitis according to 2002 or 2011 classification criteria). Exclusion criteria were a previous diagnosis of other vasculitis/connective tissue diseases/inflammatory arthropathies, concomitant not rheumatological diseases or the intake of drugs possibly related to sicca syndrome symptoms. For each patient, the demographic, anthropometric and clinical history data, particularly about the cryoglobulinemia symptoms (either previous and ongoing) and past or current therapies have been collected. Furthermore, the values of erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], Rheumatoid Factor [RF] and C4 serum complement fraction have been recorded. The presence and the titre of the cryoglobulins have been recorded. For each patient, the Schirmer’s Test and the evaluation of the unstimulated whole salivary (UWS) flow were performed. The Schirmer Test was considered positive if < 5 mm/min at least in one eye and the UWS flow was defined pathological if < 1,5 ml/15 min.Each patient was submitted to the US examination (Esaote MyLab Twice) of both parotid and submandibular glands. Each gland was evaluated using a semiquantitative score 0-3, according to the OMERACT definitions3. The US score was considered pathological if ≥2. Thus, at patient level, a sum dichotomous score (normal/pathological>) was provided, defining it as “pathological” if any parotid or submandibular glands scored ≥ 2.ResultsWe enrolled 20 patients, all females, with a mean age of 68.8 years (SD± 13.32) and a mean disease duration of 11.76 (SD±8.25). For 18 patients was reported a previous HCV infection. 16/18 HCV + subjects reached the remission of the infection with undetectable HCV viremia. Among the patients enrolled, 10 referred at least one syndrome sicca symptom: 5 patients both xerostomia and xerophthalmia, 4 only xerostomia and 1 only xeropthalmia. Considering blood tests, the cryoglobulins were detected in 14, the ESR title was above the limit in 7 patients and the CRP in 3. The RF was detected in 12 subjects. The Schirmer’s test was pathological in 9 patients while the UWS flow was under the limit in 3. As regards the US reports, 2 patients had pathological features scored as≥2, while 7 patients showed minor alterations scored as 1. So, according to the sum score, only 2 patients were classified as pathological. No correlations were identified between the clinical and the US data.ConclusionIn this cohort of patients with cryoglobulinemia, the US mainly showed mild pathological features at level of the parotid and submandibular structure, suggesting that syndrome sicca symptoms could be related to different pathological mechanisms in these patients, possibly strongly associated to HCV infection. Further and larger studies are necessary to confirm our preliminary data.References[1]Baer AN et al, Rheum Dis Clin North Am. 2018[2]Sebastiani M et al, Current Drug Targets 2017[3]La Paglia G et al, Clin Rheumatology 2019Disclosure of InterestsAntonella Adinolfi Speakers bureau: BMS, Paid instructor for: Janseen, Nicola Ughi Speakers bureau: ROCHE, PFIZER, ALFASIGMA, ABBVIE, GALAPAGOS, BRISTOL MYERS SQUIBB, Paid instructor for: JANSSEN, Davide Antonio Filippini: None declared, Michel Chevallard: None declared, Laura Belloli: None declared, Cinzia Casu: None declared, Maria Di Cicco: None declared, Clizia Gagliardi: None declared, Maria Chiara Gerardi Speakers bureau: Eli-Lilly, Marina Muscarà: None declared, Elisa Verduci: None declared, oscar massimiliano epis: None declared

Abstract Background Autoimmune blistering skin diseases (AIBD) are a group of rare chronic autoimmune diseases which are associated with ocular surface diseases especially dry eye disease. This study is designed to investigate the relationship between ocular surface disorders and quality of life among patients with autoimmune blistering skin diseases. Methods Twenty-four AIBD patients (18 pemphigus and 7 pemphigoid) and twenty-five non-AIBD controls were included. Ocular surface disease index (OSDI), ocular surface evaluation, including slit-lamp examination, Schirmer I test, tear break-up time, corneal fluorescein staining, lid-parallel conjunctival folds, meibomian gland evaluation, presence of symblepharon and corneal opacity were assessed. Life quality was evaluated by multiple questionnaires, including Medical Outcomes Study 36-Item Short Form Questionnaire (SF-36), Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI) and Health Assessment Questionnaire-Disability Index (HAQ-DI). Ocular surface tests and quality of life were compared between AIBD patients and non-AIBD controls. In the AIBD patients, the associations between ocular surface parameters and quality of life were also evaluated. Results 92% of AIBD patients and 87.5% of age- and sex-matched non-AIBD controls were diagnosed with dry eye in this study. Compared with non-AIBD controls, AIBD patients reported lower SF-36 scores (P < 0.05) and severer OSDI, Schirmer I test, tear break-up time, corneal fluorescein staining, presence of symblepharon and corneal opacity measures (P < 0.05). OSDI, Schirmer I test were correlated with SF-36 composite scores or scores on the SF-36 subscales. Conclusions AIBD patients experience reduced quality of life and more severe ocular surface disorders including dry eye, symblepharon and corneal opacity. Early treatments of dry eye and collaborations among multidisciplinary physicians are necessary in patients with AIBD.

Il glaucoma è una patologia neurodegenerativa sostenuta dalla morte per apoptosi delle CGR. Rappresenta la principale causa di cecità irreversibile al mondo. Non sono ancora stati compresi a fondo tutti i meccanismi che causano la degenerazione neuronale nel glaucoma (tanto che sussistono delle forme di glaucoma a PIO normale). Un ruolo importante nel meccanismo patogenetico glaucomatoso viene riconosciuto oggi ad una condizione di infiammazione cronica a livello retinico determinata da alterazioni dei livelli di PIO. Lo scopo del presente progetto di dottorato è stato un approccio multidisciplinare al glaucoma, di tipo clinico e biochimico-molecolare. In primo luogo, è stato implementato un prototipo di perimetro (Compass, Centervue, Padova, Italia), attuando dapprima un database normativo di soggetti sani al fine di integrare le caratteristiche demografiche per il test perimetrico 30-2. Successivamente, è stata valutata l’affidabilità test-retest dell’apparecchio, eseguendo il campo visivo “New Grid” per sei volte consecutive in un gruppo di pazienti clusterizzati secondo l’MD, ottenendo una bassa variabilità intra-test. È stato altresì calcolato l’agreement tra tre diversi revisori, i quali hanno esaminato indipendentemente le perimetrie e le foto fundus Compass, stabilendo un peggioramento o meno della patologia glaucomatosa, nonché la concordanza tra l’analisi da remoto dei campi visivi e immagini Compass, e la visita clinica standard dei pazienti affetti da glaucoma. I risultati hanno messo in evidenza un’ottima concordanza tra i Reviewers e tra gli esami da remoto e la visita clinica. Ai fini di stabilire la precisione punto per punto del perimetro, è stata eseguita un’analisi del Compass 10-2 in pazienti affetti da atrofia geografica, trovando una corrispondenza punto per punto della perimetria con l’immagine retinica sottostante. In ultimo, è stata effettuata un’analisi dell’osmolarità lacrimale e di tutti i parametri clinici del film lacrimale in pazienti affetti da glaucoma asimmetrico. Per quanto riguarda l’indagine biochimico-molecolare, è stata effettuata una analisi preliminare nell’umore acqueo della proteina di gap-junction Connessina 43 in un piccolo gruppo di soggetti sani e glaucomatosi, che ha posto in evidenza un aumento quasi doppio della dell’espressione della molecola nei soggetti glaucomatosi, anche se la ridotta numerosità del campione non ha prodotto un risultato statisticamente significativo. È stato inoltre utilizzato in questo progetto di dottorato un metodo innovativo di analisi: la metabolomica, ramo scientifico che si occupa di analizzare i metaboliti <1,5 kDa che derivano da specifici processi chimici cellulari in campioni biologici umani. Utilizzando la Spettroscopia di Risonanza Magnetica Nucleare 1H, sono stati analizzati campioni di vitreo di pazienti sottoposti a vitrectomia, identificando un aumento di acetone e metanolo negli occhi glaucomatosi.
Glaucoma is a neurodegenerative disease caused by ganglion cells death by apoptosis. It represents the leading cause of irreversible blindness in the world. Although the mechanisms triggering the neuronal degeneration in glaucoma have not yet been fully understood, a chronic inflammatory condition at the retinal level, sustained by abnormal IOP, is considered today a main factor in glaucoma pathogenesis. The aim of this PhD project was a multidisciplinary approach to glaucoma investigation, both clinical and bio-molecular. Firstly, a prototype of visual field analyzer (Compass, Centervue, Padua, Italy) was implemented, primarily by developing a demographic database of healthy subjects for 30-2 perimetric test. Subsequently, the test-retest reliability of the device was assessed by performing the "New Grid" visual field six straight times in a group of patients clustered according to the MD, resulting in a good inter-test reliability. The agreement between three different reviewers was also calculated: they independently examined Compass visual fields and the fundus photos, establishing whether or not the glaucomatous pathology worsened, as well as the agreement between the remote analysis and the standard clinical visit of glaucoma patients. The results highlighted an excellent agreement among the Reviewers and between remote analysis and the clinical examination. In order to establish the Compass’ point-by-point accuracy, a 10-2 visual field was performed in patients affected by geographic atrophy, finding an accurate correspondence of the perimetric scores with the underlying retinal image. Ultimately, the osmometry and all the clinical parameters of the tear film were analyzed in patients suffering from asymmetric glaucoma. Afterwards, for the biochemical and molecular approach, the analysis of gap-junction protein connexin 43 in the aqueous humor of affected and unaffected glaucoma patients was performed: a nearly double expression of the protein was found in glaucomatous subjects, even if there were no statistically significant differences, probably due to the small number of samples. An innovative method of biochemical analysis was introduced in this doctorate thesis: the metabolomics, a scientific branch that deals with the analysis of <1.5 kDa metabolites deriving from specific cellular processes in human samples. Vitreous samples of patients operated by vitrectomy were analyzed by 1H-NMR Nuclear Magnetic Resonance Spectroscopy, and an increase in acetone and methanol was observed in glaucomatous eyes.