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Ethambutol and optic neuropathy.

W Chuenkongkaew1, P Samsen, N Thanasombatsakul

  • 1Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|September 2, 2003
PubMed
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Ethambutol can cause optic neuropathy, a vision impairment, in tuberculosis patients. Early recognition and stopping the drug, especially in those with diabetes or glaucoma, improves visual recovery.

Area of Science:

  • Ophthalmology
  • Pharmacology
  • Infectious Diseases

Background:

  • Ethambutol is a key drug in tuberculosis treatment.
  • Optic neuropathy is a potential adverse effect of ethambutol.
  • Understanding the risk factors and outcomes is crucial for patient management.

Purpose of the Study:

  • To investigate the association between ethambutol use and the development of optic neuropathy.
  • To analyze the clinical characteristics and visual outcomes of patients experiencing ethambutol-induced optic neuropathy.

Main Methods:

  • Retrospective review of 13 patients treated with ethambutol for tuberculosis between 1997 and 2001.
  • Analysis of clinical data, ethambutol dosage, duration of therapy, and visual acuity outcomes.

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Main Results:

  • Optic neuropathy occurred 1-6 months after initiating ethambutol (mean 2.9 months) at doses of 13-20 mg/kg/day (mean 17 mg/kg/day).
  • Visual recovery was observed in 54% (7/13) of patients after drug discontinuation.
  • Irreversible visual impairment was more common in patients with pre-existing diabetes mellitus, glaucoma, or heavy smoking history.

Conclusions:

  • Early detection of optic neuropathy is essential in patients receiving ethambutol.
  • Prompt discontinuation of ethambutol is recommended to mitigate vision loss.
  • Individuals with diabetes, glaucoma, or heavy smoking are at higher risk and require careful monitoring.