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Ethambutol-associated optic neuropathy.

Su-Ann Lim1

  • 1Department of Ophthalmology, Tan Tock Seng Hospital, Singapore. su_ann_lim@ttsh.com.sg

Annals of the Academy of Medicine, Singapore
|May 20, 2006
PubMed
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Ethambutol, used for tuberculosis, can cause permanent vision loss. This study highlights three cases of ethambutol-associated toxic optic neuropathy with bitemporal hemianopia, emphasizing the need for caution.

Area of Science:

  • Ophthalmology
  • Neurology
  • Pharmacology

Background:

  • Tuberculosis remains a significant global health issue, particularly in Southeast Asia.
  • Ethambutol is a key medication in tuberculosis treatment regimens.
  • Ethambutol use is linked to potential ocular toxicity, including permanent visual impairment.

Observation:

  • Three patients presented with ethambutol-associated toxic optic neuropathy.
  • Clinical presentation included loss of central visual acuity, impaired color vision, and visual field deficits.
  • The visual field loss exhibited a bitemporal pattern, suggesting optic chiasm involvement.

Findings:

  • Despite ethambutol cessation, visual function continued to decline for several months in all cases.
  • Two patients experienced mild visual improvement, while one regained normal visual acuity and color vision but showed optic disc pallor.

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  • All three patients sustained some degree of permanent visual dysfunction.

    • Implications:

    • Ethambutol-induced optic neuropathy can lead to irreversible visual deficits.
    • Caution and regular ophthalmological monitoring are crucial for patients on ethambutol.
    • The findings suggest a potential progression from optic nerve to optic chiasm involvement in ethambutol-associated chiasmopathy.