+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Incidence and clinical features of ethambutol-induced optic neuropathy in Korea



Incidence and clinical features of ethambutol-induced optic neuropathy in Korea



Journal of Neuro-Ophthalmology 28(4): 269-277



The incidence, clinical manifestations, and contributory factors in ethambutol-induced optic neuropathy (EON) have not been widely studied. A retrospective chart review of 857 patients who took ethambutol for treatment of tuberculosis identified 89 patients who complained of decreased vision after initiation of treatment and were therefore referred to the ophthalmology clinic of Seoul National University Hospital, Korea, between January 2003 and December 2005. Information was extracted in regard to systemic illnesses, duration and dose of ethambutol therapy, visual acuity, color vision, ophthalmoscopic examination, visual fields, and visual evoked potentials (VEPs). EON was diagnosed in 13 (1.5%) patients during a follow-up period of 12.54 +/- 9.97 months. The average dose of ethambutol was 17.85 +/- 2.21 mg/kg/day, and the duration of therapy was 9.38 +/- 10.12 months. Ophthalmic findings included decreased visual acuity (65.4%), abnormal visual fields (65.4%), abnormal color vision (61.5%), optic disc pallor (38.5%), or increased latency on VEP tests (65.4%). Slightly less than one third of patients showed improvement in visual function after discontinuing ethambutol. The latency for recovery was 5.38 +/- 1.71 months. No patient with optic disc pallor at the time of diagnosis of EON showed visual function improvement. Renal dysfunction and the daily dose of ethambutol, but not the duration of treatment, contributed to EON. Based on this study, the incidence of EON in Koreans is estimated to be <2%. However, visual function after discontinuation of ethambutol is reversible in only a minority of patients and does not occur if optic disc pallor is present. Renal dysfunction and daily dose of ethambutol, but not duration of ethambutol treatment, seem to be related to development of EON.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 053788339

Download citation: RISBibTeXText

PMID: 19145123

DOI: 10.1097/wno.0b013e31818e3c6b


Related references

Leber's hereditary optic neuropathy masquerading as ethambutol-induced optic neuropathy in a young male. Indian Journal of Ophthalmology 54(3): 218-219, 2006

The role of copper on ethambutol's antimicrobial action and implications for ethambutol-induced optic neuropathy. Diagnostic Microbiology and Infectious Disease 30(2): 83-87, 1998

Leber's hereditary optic neuropathy mutations in ethambutol-induced optic neuropathy. Journal of Neurology 250(1): 87-89, 2003

The incidence of optic neuropathy in 84 patients treated with ethambutol. Metabolic Pediatric and Systemic Ophthalmology 12(1-3): 80-82, 1989

Incidence of toxic optic neuropathy with low-dose ethambutol. International Journal of Tuberculosis and Lung Disease 20(2): 261-264, 2016

Relation between the dosage of ethambutol and incidence of optic neuropathy. Rinsho Ganka 57(5): 687-690, 2003

Hydroxycobalamin for ethambutol-induced optic neuropathy. Lancet 2(8256): 1176-1176, 1981

Incidence and prognostic factor of ethambutol-related optic neuropathy: 10-year experience in southern Taiwan. Kaohsiung Journal of Medical Sciences 31(7): 358-362, 2015

Present status of ethambutol-induced optic neuropathy. Chinese Journal of Ophthalmology 48(2): 184-188, 2012

Ethambutol induced toxic optic neuropathy in HIV positive patients. International Journal of Ophthalmology 6(4): 542-545, 2013

Ethambutol-induced optic neuropathy and the 15257 mitochondrial DNA mutation. Investigative Ophthalmology & Visual Science 36(4): S1060, 1995

Retinal function and morphology in monkeys with ethambutol-induced optic neuropathy. Investigative Ophthalmology and Visual Science 53(11): 7052-7062, 2012

Bitemporal visual field defects in ethambutol-induced optic neuropathy. Journal of Neuro-Ophthalmology 31(2): 121-126, 2011

Use of pseudoisochromatic plates in the diagnosis of ethambutol induced toxic optic neuropathy. Rinsho Ganka 38(12): 1229-1233, 1984

Bitemporal hemianopsia in a case of ethambutol-induced toxic optic neuropathy. Rinsho Ganka 52(5): 757-760, 1998