The Use of Optical Coherence Tomography in Patients With Ethambutol-induced Optic Neuropathy

Kim, Bu Ki; Ahn, Min

doi:10.3341/jkos.2010.51.8.1107

Cited by 7 publications

(17 citation statements)

References 16 publications

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“…Of the 12 studies, six were retrospective case series, three were prospective case series, one each was retrospective case–control study and prospective cohort study, while one was a surveillance study. [ 11 - 22 ] All studies included patients with pulmonary TB. Five studies reported Mycobacterium tuberculosis as well as non-mycobacterial TB infection.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies reported Mycobacterium tuberculosis as well as non-mycobacterial TB infection. [ 11 - 15 ] Comorbidities included renal failure and human immunodeficiency virus (HIV) infection. [ 13 , 15 , 17 , 19 ] Average dose of EMB was 16.06 ± 1.73 mg/kg body weight, with the range being 12.9–18.9 mg/kg body weight.…”

Section: Resultsmentioning

confidence: 99%

“…[ 12 , 14 - 22 ] HVF was done in 10 studies. [ 11 , 12 , 14 - 20 , 22 ] Optic nerve pallor was noted in nine studies. [ 11 , 14 - 20 , 22 ] OCT was used to measure retinal nerve fiber layer changes in eight studies.…”

Section: Resultsmentioning

confidence: 99%

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Ethambutol optic neuropathy in the extended anti-tubercular therapy regime: A systematic review

Sabhapandit

Gella

Shireesha

et al. 2023

Indian Journal of Ophthalmology

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The extended use of ethambutol beyond 2 months for treating tuberculosis has increased risk of optic neuropathy. We performed a systematic review of studies evaluating optic neuropathy in extended ethambutol use since 2010 and compared the outcome with a similar systematic review (1965–2010) by Ezer et al . Literature search was conducted in PubMed, Medline, EMBASE, and Cochrane databases. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Main outcome measures were visual acuity, color vision, visual field defects, optical coherence tomography (OCT), and visual evoked potential (VEP). The JBI Critical Appraisal Checklists were used for quality assessment. Twelve studies were selected (out of 639 studies) for analysis of ethambutol optic neuropathy. Visual acuity improvement after stopping ethambutol was statistically significant. Similar improvement was not noted for other outcome measures. On comparing the results of this review with those by Ezer et al. , significant improvement was noted in visual acuity, color vision, and visual field defects. Moreover, more patients reported increased optic nerve toxicity, color vision defects, and visual field defects in the present review. Hence, we conclude that the extended use of ethambutol beyond 2 months results in significant optic nerve toxicity. Further randomized controlled trials with different populations are needed to understand the magnitude of this issue.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Ethambutol optic neuropathy in the extended anti-tubercular therapy regime: A systematic review

Sabhapandit

Gella

Shireesha

et al. 2023

Indian Journal of Ophthalmology

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“…Similarly, Kim and Park’s prospective study revealed significant post-administration increases in temporal and inferior RNFL thickness at 5 months [26]. After Zoumalan et al first reported RNFL thickness change in ethambutol-induced optic neuropathy, several retrospective OCT-based studies on RNFL thickness have similarly reported decreases in temporal RNFL thickness over the course of long-term follow ups compared with the baseline or healthy controls after ethambutol-induced optic neuropathy [14–16, 19]. The results of prospective studies, however, have been various.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal evaluation of visual function and structure for detection of subclinical Ethambutol-induced optic neuropathy

et al. 2019

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Purpose To longitudinally evaluate the visual function and structure of patients taking ethambutol by various modalities and identify useful tests for detection of subclinical ethambutol-induced optic toxicity. Methods This retrospective study enrolled 84 patients with newly diagnosed tuberculosis treated with ethambutol. Best-corrected visual acuity (BCVA), color vision, contrast sensitivity, fundus and retinal nerve fiber layer (RNFL) photography, automated visual field (VF) test, and optical coherence tomography (OCT) were performed: prior to starting; every month during administration, and 1 month after stoppage. We longitudinally compared visual function and structure with the baseline and identified the occurrence of subclinical toxicity. Results BCVA, color vision, and contrast sensitivity showed no change from the baseline. Mean temporal RNFL thickness was significantly increased at 6 months (p = 0.014). Subclinical toxicity was found in 22 eyes of 14 patients (i.e., 13% of 168 eyes), in the forms of VFI decrease (VF index, 9 eyes of 6 patients), quadrant RNFL thickness increase (5 eyes of 4 patients), and VF pattern defect (12 eyes of 6 patients). 73% of the patients showed recovery to the baseline at 1 month post-stoppage. The risk factors for occurrence of subclinical toxicity were age, cumulative dose, and medication duration. Conclusion Mean temporal RNFL thickness increased after administration. The VFI, quadrant RNFL thickness, and VF pattern defect could prove useful in assessment of subclinical toxicity. Medication duration was shown to be a strong risk factor for occurrence of subclinical toxicity.

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“…Most of the studies using OCT reported that the thickness of the NRT reduces with antituberculosis therapy [ 28 , 29 , 31 , 32 ]. However, in contrast to such findings, Kyoung et al reported an increase in the thickness of the nerve fiber layer during treatment with ethambutol [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

The use of optical coherence tomography for the detection of ocular toxicity by ethambutol

et al. 2018

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ObjectivesTo evaluate, through (OCT), alterations in retinal thickness, secondary to use of ethambutol in the treatment of patients with tuberculosis. In addition to studying the use of simpler semiological tools, such as Amsler and Ishihara, in the screening of these cases.MethodsThirty patients with ethambutol were recruited from the reference service of tuberculosis treatment at the Federal University of Espírito Santo from May 2015 to July 2016. After clinical history, the following parameters were analyzed; best corrected visual acuity, biomicroscopy, tonometry, photomotor reflex testing, Ishihara test, Amsler’s grid test, color digital retinography and optical coherence tomography with CIRRUS HD-OCT (Humphrey-Zeiss) every 2 months during treatment with ethambutol. They were divided into two groups according to the treatment: (1) standard group, two months of ethambutol; (2) extended group, nine to twelve months of ethambutol.ResultsThere was a significant reduction in OCT thickness between the pre and post treatment times in ten eyes of the extended group, mean reduction of 7,8 microns and in seven eyes of the standard group, with an average of 5.57 microns. During the study, a significant reduction of retinal thickness was observed in both groups at two months of treatment, and the delta percentage was higher in those patients who presented reduction of visual acuity and / or change in the Ishihara test.ConclusionThere was a significant reduction in the thickness of the nerve fiber layer by OCT in the patients studied, being more pronounced in those submitted to the extended treatment regimen. This reduction was observed two months after the start of therapy, and was more significant in the cases that presented changes in the Ishihara test.

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The Use of Optical Coherence Tomography in Patients With Ethambutol-induced Optic Neuropathy

Cited by 7 publications

References 16 publications

Ethambutol optic neuropathy in the extended anti-tubercular therapy regime: A systematic review

Ethambutol optic neuropathy in the extended anti-tubercular therapy regime: A systematic review

Longitudinal evaluation of visual function and structure for detection of subclinical Ethambutol-induced optic neuropathy

The use of optical coherence tomography for the detection of ocular toxicity by ethambutol

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