Diagnostic Test Schirmer and Tear Break Up Time (TBUT) in Uncontrolled Diabetes Mellitus Patient
Author(s): Anang Tribowo, Theodorus, Junaini Laila
Abstract
Dry eye syndrome is a condition with multiple characterizations characterized by the presence of symptoms of eye discomfort associated with decreased tear production and abnormalities of rapid tear evaporation. Examination of dry eye syndrome can be performed to assess the function of tears in quality and quantity such as Schirmer I and Tear break-up time (TBUT) tests. Schirmer I, examination to assess the quantity of tear production generated by the lacrimal gland while break-up time to assess the stability of the tear layer. This study aims to determine the accuracy of Schirmer I and TBUT tests in patients with diabetes mellitus in the eye outpatient and interne outpatient in General hospital Mohammad Hoesin Palembang. This diagnostic test was undertaken in the eye outpatient and interne outpatient in General hospital Mohammad Hoesin Palembang from July until September 2016. There were 30 diabetes mellitus (DM) type 2 patients who met the inclusion and exclusion criteria. Frequency and distribution of data are described in table form and sensitivity and specificity values will be cut off point using ROC curve. Accuracy value is measured by Kappa value. Data analysis was performed using SPSS version 20.0. 30 patients with diabetes mellitus have an average age of approximately 47 years, with the proportion of female sex : male is 22: 8. The majority of subjects (60%) addressed within the city of Palembang with the average length of DM suffered for approximately 8 years. The highest level of education in this study is the college (36.7%) while the most types of work is housewives (50%). With statistical analysis obtained accuracy value of Schirmer I and TBUT examination in diabetic mellitus eye patients is 0.633 which means the degree of suitability of measurement (realiability) is good. Accuracy of examination Schirmer I and TBUT examination in patients with uncontrolled diabetes mellitus had a sensitivity of 50%, 90% specificity, 90.9% positive predictive value (PPV), 47.37% negative predictive value (NPV), positive likelihood ratio 5 and a negative Likelihood ratio of 0.56. The effect of HbA1c on TBUT score was 40,7% while HbA1c effect on Schirmer I score was 10.7%. It can be concluded that the accuracy of Schirmer I and TBUT examination in Diabetes Mellitus eye patient is good with HbA1c effect on TBUT score of 40.7% while HbA1c effect on Schirmer I score of 10.7%.
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