[Optic nerve neuropathy by ethambutol toxicity].

Area of Science:

• Ophthalmology
• Neurology
• Pharmacology

Context:

• Ethambutol is a key medication for tuberculosis treatment.
• Ocular toxicity, specifically optic nerve damage, is a known side effect of ethambutol.
• Understanding the clinical spectrum and management of this toxicity is crucial for patient safety.

Purpose:

• To investigate the clinical features, treatment strategies, and preventive measures for ethambutol-induced optic nerve damage.
• To analyze the relationship between ethambutol dosage, duration, and the severity of optic nerve toxicity.
• To provide recommendations for the safe use of ethambutol in tuberculosis management.

Summary:

• A retrospective analysis of 17 tuberculosis patients revealed various ocular symptoms due to ethambutol toxicity, including changes in visual acuity, visual fields, and color sensation.
• Diagnoses ranged from axial neuritis to periaxial neuritis, with visual impairment correlating significantly with daily dosage and duration of ethambutol use.
• Cessation of ethambutol and administration of vasodilators or neurotrophic drugs led to the recovery of optic nerve function.

Impact:

• Highlights the importance of regular visual function monitoring in patients receiving ethambutol.
• Emphasizes the need for physicians to be aware of ethambutol's ocular toxicity for timely diagnosis and intervention.
• Recommends using appropriate low doses of ethambutol to minimize the risk of optic nerve damage.