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Efek vitamin C terhadap stabilitas lapisan air mata dan epitel permukaan mata pada penderita diabetes mellitus tipe 2

Tujuan: Untuk mengetahui efek suplementasi vitamin C oral terhadap kadar vitamin C di air mata, stabilitas Lapisan Air Mata dan metaplasia epitel permukaan mata pada penderita DM ripe 2. Subyek dan Metode: Penelitian ini adalah suatu uji klinis acak tersamar ganda. Penderita DM tipe 2 dengan penurunan sensitivitas kornea dibagi menjadi kelompok subyek dan kontrol. Kelompok subyek mendapatkan vitamin C oral 500 mg/hari dan kelompok kontrol mendapatkan plasebo selama 2 minggu. Kadar gula darah sewaktu diperiksa untuk menentukan efek suplementasi vitamin C terhadap kadar gula darah. Kadar vitamin C air mata diperiksa. Stabilitas Lapisan Air Mata diperiksa dengan Non Invasive Break-Up Time (NIBUT) dan integritas epitel permukaan mata diperiksa dengan pewarnaan Rose bengal. Evaluasi dilakukan sebelum dan 2 minggu setelah terapi. Pada orang normal yang memenuhi kriteria inklusi diperiksa kadar vitamin C air mata. Hasil: Kadar vitamin C air mata pada kelompok subyek meningkat sebesar 68,8 % (p = 0.152). Setelah suplementasi vitamin C, kadar vitamin C air mata pada individu dengan nilai pra terapi sama atau lebih besar dari 4 mg/dL mengalami peningkatan yang tidak bermakna. Nilai NIBUT dan skor pewarnaan Rose bengal menunjukkan perbaikan setelah suplementasi vitamin C (p < 0,05). Kesimpulan: Suplementasi vitamin C 500 mg/hari selama 2 minggu memperbaiki stabilitas Lapisan Air Mata dan integritas epitel permukaan mata pada penderita DM tipe 2 dengan penurunan sensitivitas kornea.


Objective: To determine the effect of vitamin C supplementation on the level of vitamin C in tear, tear film stability, and metaplasia of the ocular surface epithelial in type-2 diabetic patients. Methods: This study was randomized and double-blinded. Type-2 diabetic patients with decreased corneal sensitivity were grouped into subjects and control. Vitamin C 500 mg/day was orally administered for the subject group and placebo for the control group for 2 weeks. The current blood level of glucose was tested to determine the effect of vitamin C supplementation on blood glucose level. The vitamin C level in tear was assayed. Tear film stability was analyzed with Non Invasive Break-Up Time (NIBUT) and the integrity of ocular surface epithelial was assessed with Rose bengal staining. The parameters were evaluated prior and 2 weeks after suplementation. Vitamin C level in tear was examined from normal subjects. Results: Vitamin C level in tear increased in 68,8% of the subject group (p = 0,152). The vitamin C level in tear of subjects with pre therapy value of equal to or more than 4 mg/dL demonstrated insignificant increase after vitamin C supplementation. The NIBUT value and the Rose bengal staining score showed improvement (p < 0,05) after vitamin C supplementation. Conclusion: Supplementation of vitamin C 500 mg/day for 2 weeks improved the stability of tear film and the integrity of the ocular surface epithelial in type-2 diabetic patients.