12. Ethambutol-Induced Optic Neuropathy in Patients of Tuberculosis
Zulfiqar Ali1, Nadia Nazir1, Soufia Farrukh1, Muhammad Javaid Iqbal1, Imran Nazir2 and Zunaira Alvi2
ABSTRACT
Objective: To find out characteristics of patients having ethambutol-induced optic neuropathy (EON) at a tertiary
care hospital of South Punjab, Pakistan.
Study Design: Observational Study
Place and Duration of Study: This study was conducted at the Outpatient Department of Ophthalmology, Bahawal Victoria Hospital, Bahawalpur from January 2018 to December 2019.
Materials and Methods: During the study period, a total of 35 patients were enrolled with visual impairment following initiation of ethambutol usage and diagnosed as EON. All patients had decreased visual acuity, impairment of color vision by “Ishihara color plate”, or had abnormal results of visual field and/or flash and pattern visual evoked potential examination. Basic ophthalmologic evaluations like visual acuity, color vision as well as optic disc evaluation were done. Gender, age, medical history, date of diagnosis, treatment, visual acuity, color vision and slit lamp bio microscopy were recorded for all patients.
Results: Out of a total of 35 patients, 23 (65.7%) were male and 12 (34.3%) female. Most of the patients, 24 (68.6%) belonged to rural areas of residence while 11 (32.4%) from urban areas. In terms of types of tuberculosis, 34 (97.1%) were having pulmonary tuberculosis. Majority of the patients, 28 (80.0%) were over 60 years of age while mean age was noted to be 66.34 years with standard deviation of 10.81 years. Visual acuity loss was observed at 6.42+3.94 months following initiation of ethambutol treatment. Among 19 (54.3%) patients, visual acuity decline was bilaterally symmetric.
Conclusion: Ethambutol-induced optic neuropathy is a major concern during anti-tubercular treatment. Timely detection and withdrawal of ethambutol along with prompt treatment and monitoring by ophthalmologists should be done.
Key Words: Ethambutol, optic neuropathy, tuberculosis, visual impairment
Citation of article: Ali Z, Nazir N, Farrukh S, Iqbal MJ, Nazir I, Alvi Z. Ethambutol-Induced Optic Neuropathy in Patients of Tuberculosis. Med Forum 2021;32(1):48-50.