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Ethambutol-related impaired visual function in childrens less than 5 years of age treated for a mycobacterial

Michael Levy1, Florence Rigaudière, Agathe de Lauzanne

  • 1From the *Assistance publique, Hôpitaux de Paris, Hôpital Robert Debré, Service de Pédiatrie Générale, F-75019 Paris, France; †Assistance publique, Hôpitaux de Paris, Hôpital Lariboisière, Service de Physiologie clinique et d'Explorations Fonctionnelles Visuelles, F-75010 Paris, France; and ‡Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, F-75010, Paris, France.

The Pediatric Infectious Disease Journal
|March 13, 2015
PubMed

Insights

Ethambutol (EMB) can cause vision problems in young children, which are often missed. Visual-evoked potentials (VEPs) are crucial for monitoring visual function in children under five receiving EMB treatment.

Area of Science:

  • Ophthalmology
  • Pediatrics
  • Neurology

Background:

  • Ethambutol (EMB) treatment for mycobacterial infections poses a risk of visual impairment in young children.
  • Detecting EMB-induced visual toxicity is challenging in children under five due to limited communication and subtle clinical signs.

Purpose of the Study:

  • To determine the frequency of visual abnormalities in children under five exposed to EMB.
  • To evaluate the utility of visual-evoked potentials (VEPs) in monitoring visual function during EMB therapy in this age group.

Main Methods:

  • A retrospective study was conducted at Robert-Debré University Hospital, Paris, France.
  • Included were children under five treated with EMB for mycobacterial infections between January 2002 and December 2012.
  • Visual function was monitored using VEPs in a subset of patients.

Main Results:

  • Three out of fourteen children (27.3%) developed EMB-related visual impairment at 4, 7, and 36 weeks.
  • Impairments included retrochiasmatic visual pathway issues and retrobulbar optic neuritis.
  • Discontinuation of EMB led to normalization of visual function in all affected children.

Conclusions:

  • Visual function alterations due to EMB are common and likely underestimated in young children.
  • Systematic and close monitoring using VEPs is essential for children under five undergoing EMB treatment.
Abstract

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