Tesis

Peran tes dynamic visual acuity dan tes kalori dalam menilai gangguan keseimbangan pada pasien tuberkulosis yang mendapat terapi streptomisin = The Role of Dynamic Visual Acuity Test and Caloric Test for Asessing Balance Disorders in Tuberculous Patients After Streptomycin Therapy.

Penelitian ini bertujuan untuk mengetahui peran tes dynamic visual acuity (DVA)
dan tes kalori dalam menilai gangguan keseimbangan pada pasien tuberkulosis
(TB) yang mendapat terapi streptomisin. Metode penelitian ini merupakan
penelitian pra-eksperimental untuk mengetahui perubahan hasil pemeriksaan
fungsi keseimbangan vestibuler pada satu kelompok pasien TB sebelum dan
setelah 56 kali pemberian streptomisin atau bila timbul keluhan gangguan
keseimbangan dengan tes DVA dan tes kalori. Digunakan rancangan uji
diagnostik untuk membandingkan kedua carapengukuran setelah pengobatan.
Setelah pemberian terapi didapatkan 31 (77,5%) dari 40 subyek mengeluhkan
gangguan keseimbangan. Kelemahan fungsi vestibuler perifer bilateral sebanyak 6
(15%) subyek dengan pemeriksaan kalori dan 30 (75%) dengan pemeriksaan
DVA. Rerata nilai kalori sebelum terapi sebesar 93,5 ± 32,07 °/detik dan setelah
terapi sebesar 82.30 ± 38,43 °/detik, terjadi perubahan sebesar -11,25 ± 50,55
°/detik.Median nilai kenaikan DVA sebelum terapi adalah 0 (minimal 0 –
maksimal 2) baris dan setelah terapi adalah 3 (minimal 0 - maksimal 6) baris,
terjadi perubahan sebesar 3 (minimal 0-maksimal5) baris. Sensitivitas
pemeriksaan DVA 83%, spesifisitas 27%, nilai duga positif 17%, nilai duga
negatif 90%, rasio kemungkinan positif 1,13 dan rasio kemungkinan negatif 0,63
dengan pemeriksaan kalori sebagai baku emas.Pemeriksaan DVA dapat
digunakan sebagai skrining pemeriksaan kelemahan vestibuler perifer bilateral
pada pasien tuberkulosis yang mendapat terapi streptomisin.
Kata kunci:dynamic visual acuity, tes kalori, elektronistagmografi, kelemahan
vestibuler perifer bilateral.



This study aimed to determine the role of dynamic visual acuity (DVA) and
caloric test for assessing balance disorders in patients with tuberculosis (TB)
which received streptomycin therapy. An pre-experimental study was used to
determine changes in the vestibular function test results in a group of patients
withTB before and after 56 times administration of streptomycin or when subjects
complaint of balance disorders with DVA test and caloric test. We used diagnostic
test designed to compare the two methods of measurement after treatment. After
therapy there was 31 (77.5%) of 40 subjects who complained of balance disorder.
The weakness of bilateral peripheral vestibular function was found in 6 (15%)
subjects with caloric examination and in 30 (75%) with DVA examination. The
mean value of caloric examination before therapy was 93.5 ± 32.07 °/sec and after
therapy was 82.30 ± 38.43 °/sec, the change was -11.25 ± 50.55 °/sec. The
median value of increased DVA line before therapy was 0 (minimum 0 -
maximum 2) line and after therapy was 3 (minimum 0 - maximum 6) line, there is
a change of 3 (minimum 0 - maximum 5) line. DVA examination has sensitivity
83%, specificity 27%, positive predictive value 17%, negative predictive
value90%, positive likelihood ratio1.13 and a negative likelihood ratio0.63 with
caloric examination as the gold standard. DVA testing can be used as a screening
tool in bilateral peripheral vestibular weakness in tuberculosis patients which
received streptomycin therapy.
Keywords: dynamic of visual acuity, caloric test, electronystagmography,
bilateral peripheral vestibular weakness.