Pengaruh Pemberian Suplemen Vitamin D terhadap Nilai Sensitivitas Kontras pada Penderita Tuberkulosis Paru yang Mendapat Terapi Etambutol

Abstract

Background: Pulmonary tuberculosis is still a public health problem throughout the world. One of the anti-tuberculosis drugs that are always given is ethambutol which is a bacteriostatic antimicrobial group. Ocular toxicity in the form of optic neuropathy is often reported as a side effect of the use of ethambutol. Although the toxicity of ethambutol is said to be reversible, various studies have found progressive and permanent defects that can cause a decrease in the value of visual contrast sensitivity. The contrast sensitivity test used is the Pelli-Robson Contrast Sensitivity Chart, which is the gold standard of visual contrast sensitivity examination. Vitamin D supplementation in patients with pulmonary tuberculosis who received ethambutol therapy in this study was shown to significantly increase the value of contrast sensitivity in both eyes and reduce the risk of optic nerve toxicity in patients with pulmonary tuberculosis, so vitamin D supplementation is highly recommended. Objective: This study aims to determine the difference between changes in contrast sensitivity values in the group of pulmonary tuberculosis patients who received ethambutol therapy with vitamin D supplementation (intervention group) and groups of pulmonary tuberculosis patients who received ethambutol therapy without vitamin D supplementation (control group). Methods: The design of this study is an experimental prospective study. The examinations performed were visual examination, anterior segment, intraocular pressure, posterior segment and visual contrast sensitivity. Statistical analysis used is Chi Square, Mann Whitney, Kruskal Wallis and Wilcoxon. Results: The sample of this study was 60 pulmonary tuberculosis patients who received ethambutol therapy for more than 2 months who came to the Special Lung Hospital of the North Sumatra Provincial Government and met the inclusion criteria. Subjects were divided into two groups with 30 people in each group. The first group was the intervention group who received vitamin D for 8 weeks (2 months) and the second group was the control group who did not receive vitamin D. In the intervention group, both the right eye (OD) and left eye (OS) showed an increase in contrast sensitivity values. significant (p<0.001) between before and after administration of vitamin D for 8 weeks (2 months), after being analyzed using the Wilcoxon test. However, in the control group there was no significant difference (p>0.05) in contrast sensitivity values in the right eye (OD) and left eye (OS). Conclusion: There was a significant difference in the value of contrast sensitivity changes (p<0.001) between the group given vitamin D supplements and the control group in the right eye (OD) and left eye (OS).