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Epiforalı Hastaların Tanısında Kullanılan Testlerin Tanısal Değeri

Diagnostic Value of Lacrimal Testing in Patients with Epiphora

Journal Name:

  • Selçuk Tıp Dergisi

Publication Year:

  • 2011

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Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
Many patients admitting to ophthalmology outpatient clinics are suffering from watering eye. Watering eye may be due to hypersecretion but it may also be due to epiphora resulting from lacrimal drainage system obstruction or in adequate drainage. In patients with epiphora many tests has been developed to reach the diagnosis. When compared with the others, each tests has preferable and unpreferable aspects. We evaluated 100 eyes of 50 patients complaining from watering eye. In these patients we studied the sensitivity and specificity of the initial diagnostic tests in determining the site of blockage in the lacrimal drainage system. All patients underwent taste test, flourescein dye disappearance test, primary and secondary Jones test, lacrimal irrigation, canalicular probing, conventional dacryocystography and nuclear dacryoscintigraphy. Among the 100 eyes, 40 of them (%40) has abnormal lacrimal drainage system and 60 of them (%60) has abnormal lacrimal drainage system. Taste test, flourescein dye disappearance test and nuclear dacryscintigraphy were found to have high sensitivity and specificity value. However, the kappa agreement of taste test was lower than the flourescein dye disappearance test and nuclear dacryoscintigraphy (kappa<0.70). Canalicular probing was the most sensitive test in the diagnosis of upper lacrimal drainage system (%100.0), while nuclear dacryoscintigraphy was the most sensitive test in the diagnosis of lower and functional nasolacrimal duct obstruction (%97.0 and %100.0, respectively).Results of the present study suggest that flourescein dye disappearance test, lacrimal irrigation and canalicular probing should be chosen as initial diagnostic tests for the diagnosis of epiphora in patients suffering from watering eyes. However, there is no gold standad that can be used alone to diagnose epiphora. Therefore we have to use more than one of the diagnostic methods for determining the site of the blockage in the lacrimal drainage system.
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Abstract (Original Language): 
Göz polikliniğine başvuran hastaların önemli bir kısmında göz yaşarması şikayeti vardır. Göz yaşarması hipersekresyona bağlı olabileceği gibi lakrimal drenaj sistemindeki (LDS) bir tıkanıklık ya da yetersizlik sonucu gelişen epiforadan da kaynaklanabilir. Epiforalı hastaların tanısında kullanılabilecek birçok test geliştirilmiştir. Bu testlerin birbirlerine göre üstün olan ve olmayan yönleri vardır. Çalışmamızda göz yaşarması şikayeti olan 50 olgunun 100 gözü değerlendirildi. Bu olgularda ilk uygulanabilecek tanı yöntemleri ve bu tanı yöntemlerinin LDS'ndeki tıkanıklığın yerini belirlemedeki sensitivite ve spesifisiteleri araştırıldı. Tat testi (TT), Flörosein kaybolma testi (FKT), primer Jones testi (PJT), sekonder Jones testi (SJT), lakrimal irrigasyon, kanaliküler probing, konvansiyonel dakriyosistografi (KDSG) ve nükleer dakriyosintigrafi (NDSG) testleri yapıldı. 100 gözün 40'ında LDS normal (%40.0) ve 60'ında anormal (%60.0) bulundu. TT, FKT ve NDSG'nin sensitivite ve spesifisite değerleri yüksek bulundu (p>0.05). Ancak TT'nin klinik tanı karşısındaki uyumu FKT ve NDSG'den düşüktü (kapa<0.70). Üst LDS tıkanıklığı tanısı koymada en sensitif test kanaliküler probing (%100.0), alt ve fonksiyonel nazolakrimal kanal tıkanıklığı tanısı koymada en sensitif test NDSG (sırasıyla %97.0 ve %100.0) idi. Çalışmamızın sonuçları göz yaşarması olan olgularda epifora tanısı koyabilmek için ilk uygulanabilecek tanı yöntemlerinin FKT, lakrimal irrigasyon ve kanaliküler probing olduğunu düşündürmektedir. Ancak epiforalı hastaların tanısında kullanılabilecek altın standartta tek bir test yoktur. LDS'ndeki tıkanıklığın yerini belirlemek için birden fazla tanı yöntemlerini kullanmak gerekebilir.
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  • 4
197-200
  • Turkish

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