Incidence of toxic optic neuropathy with low-dose ethambutol

Int J Tuberc Lung Dis. 2016 Feb;20(2):261-4. doi: 10.5588/ijtld.15.0275.

Abstract

Objective: To investigate the incidence of ethambutol (EMB) induced optic neuropathy prescribed at a relatively low dose of ≤ 15 mg/kg/day for the treatment of tuberculosis (TB) or Mycobacterium avium complex (MAC) lung disease.

Design: Patients diagnosed with TB or MAC lung disease received multidrug regimens including EMB at a single institution from August 2003 to July 2009. Visual monitoring was performed at baseline and at regular follow-up. The incidence of EMB-induced visual disturbances was evaluated.

Results: Of the 415 patients included in the study, three (0.7%) developed toxic optic neuropathy over the 6-year period. Of the 289 patients prescribed a dose of ≤ 15 mg/kg/day EMB, only one (0.3%) developed toxic optic neuropathy.

Conclusions: The incidence of EMB-induced optic neuropathy among Koreans is estimated to be 0.7%, and can be reduced with lower doses of EMB.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / adverse effects*
  • Dose-Response Relationship, Drug
  • Ethambutol / administration & dosage
  • Ethambutol / adverse effects*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Mycobacterium avium-intracellulare Infection / diagnosis
  • Mycobacterium avium-intracellulare Infection / drug therapy*
  • Mycobacterium avium-intracellulare Infection / microbiology
  • Optic Nerve Diseases / chemically induced*
  • Optic Nerve Diseases / diagnosis
  • Optic Nerve Diseases / epidemiology
  • Optic Nerve Diseases / physiopathology
  • Optic Nerve Diseases / prevention & control
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Tuberculosis / diagnosis
  • Tuberculosis / drug therapy*
  • Tuberculosis / microbiology
  • Vision, Ocular / drug effects*
  • Young Adult

Substances

  • Antitubercular Agents
  • Ethambutol