Ethambutol Neuroretinopathy

Vistamehr, Setareh; Walsh, Thomas J.; Adelman, Ron A.

doi:10.1080/08820530701457134

Cited by 32 publications

(18 citation statements)

References 16 publications

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“…[1][2][3] In the early stage of toxic optic neuropathy (TON) associated with these drugs, anatomic changes of the optic disc and retinal nerve fi ber layer (RNFL) are too subtle to be easily recognized, 1,4 and only a small proportion of patients show optic nerve or retinal changes. 5 There have been a few studies using optical coherence tomography (OCT) to evaluate the changes of RNFL in TON associated with antituberculosis drugs. 4,6,7 Chai and Foroozan 6 described two serial OCT examinations in 8 patients.…”

Section: Introductionmentioning

confidence: 99%

Serial Retinal Nerve Fiber Layer Changes in Patients With Toxic Optic Neuropathy Associated With Antituberculosis Pharmacotherapy

Kim

Hwang

2009

Journal of Ocular Pharmacology and Therapeutics

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Section: Introductionmentioning

confidence: 99%

Serial Retinal Nerve Fiber Layer Changes in Patients With Toxic Optic Neuropathy Associated With Antituberculosis Pharmacotherapy

Kim

Hwang

2009

Journal of Ocular Pharmacology and Therapeutics

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“…3,9,18 This duration is different among different studies, with other report mentioning a mean duration 3-5 months of drug consumption and one descriptive study in Korea even reporting that EON cases occured after nine months of drug ethambutol consumption. 3 This study only evaluated patients who consumed the drug for two months, so it is also possible that it is too early to expect some effect in RNFL thickness.…”

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confidence: 66%

Correlation between peripapillary retinal nerve fiber layer thickness and visual function changes in patients receiving ethambutol

et al. 2015

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ABSTRAK (147 dan 141 μm, p = 0,001), nasal (92 dan 88 μm, p = 0,045), dan rerata seluruh kuadran (116,77 dan 112,65 μm, p = 0,001). Tidak terdapat hubungan antara perubahan ketebalan retina ini dengan perubahan fungsi penglihatan. Kesimpulan: Konsumsi etambutol selama dua bulan dalam dosis yang dianjurkan dianggap masih aman terhadap retina manusia dan terhadap fungsi penglihatan. ABSTRACTBackground: Recent animal studies revealed the decreased amount of retinal ganglion cells after treatment with ethambutol. The aim of this study was to evaluate the changes of peripapillary retinal nerve fiber layer (RNFL) thickness in patients receiving ethambutol therapy, as well as to know the correlation of RNFL thickness changes with the changes of visual function. Methods:This was a cohort study on 29 subjects at one tuberculosis treatment center, Jakarta. Subjects underwent RNFL thickness measurement using optical coherence tomography (OCT) and several visual function parameters (visual acuity, contrast sensitivity, color sensitivity and visual field) before and two-months following ethambutol therapy. Statistical comparison between pre-and postethambutol measurements were done using either paired T-test or Wilcoxon test. Correlations between anatomical and functional changes were assessed with Spearman correlation test.Results: There were significant changes of peripapillary RNFL thickness in superior (147 and 141 μm, p = 0.001), nasal (92 and 88 μm, p = 0.045) quadrants and average RNFL thickness (116.77 and 112.65 μm, p = 0.001). No significant correlation between RNFL thickness changes and the changes of visual function parameters (p > 0.05). Conclusion:Ethambutol consumption for two months in recommended dose is still considered safe to human retina and visual status.

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“…17 In a systematic review performed by Vistamehr et al, 17 the authors summarized the clinical and electrophysiological findings of 101 cases of retinal toxicity associated with ethambutol in the literature. Reports have described patients receiving ethambutol therapy can develop retinal changes such as macular oedema, retinal pigment epithelial changes, retinal 20 These reactions appeared to be mediated by zinc and were reversible after exposure to ethambutol was removed.…”

Section: Discussionmentioning

confidence: 99%

Multifocal electroretinography changes in patients on ethambutol therapy

Lai

Ngai

Lai

et al. 2008

Eye

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Purpose To evaluate the multifocal electroretinography (mfERG) changes in patients on ethambutol therapy. Methods A cross-sectional observational study of 17 visually asymptomatic patients receiving antituberculosis therapy with ethambutol. Patients underwent complete ophthalmic examination and mfERG recordings. The first-order mfERG N1 and P1 response amplitudes and implicit times of six concentric rings were analysed and compared with 17 normal age-similar controls. Correlation analyses were performed between the patients' mfERG parameters with parameters of ethambutol usage (daily dose of ethambutol per body weight, duration of ethambutol therapy, cumulative dose of ethambutol, and cumulative dose of ethambutol per body weight). Results The mean duration of ethambutol therapy was 3.6 months (range: 2-9 months) and the mean daily dose per body weight was 13.2 mg/kg/day. Analysis of response amplitude measures showed no significant difference in the mfERG N1 and P1 response amplitudes between the ethambutol and control groups at all ring eccentricities (P40.05). For implicit times, there were significant delays in the mfERG P1 implicit times of rings 4-6 in the ethambutol group compared with controls (P ¼ 0.012 to P ¼ 0.041). Correlation analyses showed no significant correlation between the mfERG and ethambutol parameters (P40.05). Conclusions The mfERG findings suggested that visually asymptomatic patients receiving ethambutol therapy might have localized mild electrophysiological changes involving the peripheral macula. These changes might be related to localized alteration of metabolism or physiological changes associated with ethambutol therapy.

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Ethambutol Neuroretinopathy

Abstract: Clinical, electrophysiological and in vitro studies support the toxic effect of ethambutol on the retina. Therefore ethambutol ocular toxicity may be a neuroretinopathy.

Cited by 32 publications

References 16 publications

Serial Retinal Nerve Fiber Layer Changes in Patients With Toxic Optic Neuropathy Associated With Antituberculosis Pharmacotherapy

Serial Retinal Nerve Fiber Layer Changes in Patients With Toxic Optic Neuropathy Associated With Antituberculosis Pharmacotherapy

Correlation between peripapillary retinal nerve fiber layer thickness and visual function changes in patients receiving ethambutol

Multifocal electroretinography changes in patients on ethambutol therapy

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