Asteroid Hiyaloz: Çirkin Hastalığın Güzel Belirteci

Amaç: Asteroid Hiyaloz ismini, gözlerdeki camsı fibrillerde kalsiyum sabunlarının depolanması durumundan almaktadır. Bu durum; göz USG"sinde (B Scan) yıldıza benzeyen göz alıcı parlaklıkta gözlenmektedir. Onun semptomik olmayan doğası, tek taraflı oluşumu ve diabetle açıklanamayan ilişkisi dikkat edilecek hususlardır. İleriye dönük çift kör çalışmamız, umulmadık bireylerin aksine diabetin belirtisinde AH"ın faydalarını anlamak üzerine olacaktır. Materyal ve Metod: 2011 ve 2013 yılları arasında, 400 diyabetik olmayan ve 200 diyabetik hasta AH tanısının değerlendirilmesi için B mode ultrasonografi ile tarandı. Bulgular: AH"ın ortalama insidansı diyabet olmayan populasyonda %12.75 iken diyabetik populasyonda bu oran %59.5"ti. AH"ın USG gösteriminin özgül değeri %40.81, diyabeti tanımlama hassasiyetini %88.51 olduğunu bulduk. Pozitif beklenen değeri %69.31, negatif beklenen değeri %70.17"tir. Sonuç: Diyabet tanısı konulmuş bireyler yüksek AH insidansına sahiptir. AH"ın oluşumu diyabete meyilli olan bireylerde daha yaygın görükmektedir. Yani göz USG"si rutin olarak yıllık sağlık görünteleme programlarına dahil edilmesi gerekmektedir. Neden-sonuç ilişkisini değerlendirebilmek için çok merkezli çalışmalar evrensel bir doktrin haline gelen bu görüşten çok daha garantilidir.

Anahtar Kelimeler:

Göz, Asteroid Hiyaloz, Diyabet, Göz USG, B mod USG

Asteroid Hyalosis - A beautiful marker of an ugly disease

Purpose: Asteroid Hyalosis (AH) is the name given to the condition in which calcium soaps gets deposited on vitreous fibrils in eyes. It gives a beautiful shiny star-like appearance in the black vitreous on ocular ultrasound (B Scan). Its asymptomatic nature, unilateral occurrence and unexplained association with diabetes, are points to ponder. Our previous prospective double blind study was continue further to understand the utility of AH as a harbinger of diabetes in otherwise unsuspected individuals. Material and Methods: In the study period from 2011 to 2013; 400 non diabetic patients and 200 known diabetic patients, between 40-55 years of age were assessed by B mode ultrasonography for the presence of AH. Results: The overall incidence of AH in our study was 12.75 % in non-diabetic population and 59.5% in diabetic population. We found that the ultrasound demonstration of AH is 88.51% sensitive and 40.81 % specific to identify presence of diabetes and it has a positive predictive value of 69.31 % and a negative predictive value of 70.17 %. Conclusion: Individuals with diagnosed diabetes have high incidence of AH. Occurrence of AH is more common in individuals who are prone to develop diabetes. So ocular ultrasound should be included in the routine annual health screening programs. Multicentric studies to evaluate the cause-effect relationship are warranted before this dictum becomes a universal doctrine.

Keywords:

Eye; Asteroid Hyalosis; Diabetes; Ocular Ultrasound; B mode ultrasound,

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Yazışma Adresi / Address for Correspondence: Dr. Sushil Kachewar Rural Medical College, PIMS(DU), Loni, Ta-Rahata, Ahmednagar Maharashtra, INDIA Email: sushilkachewar@hotmail.com geliş tarihi/received :13.01.2014 kabul tarihi/accepted:03.02.2014