Incidence of toxic optic neuropathy with low-dose ethambutol

• Published in: The international journal of tuberculosis and lung disease 2016-02, Vol.20 (2), p.261-264
• Main Authors: Yang, H. K., Park, M. J., Lee, J-H., Lee, C-T., Park, J. S., Hwang, J-M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antitubercular Agents - administration & dosage; Antitubercular Agents - adverse effects; Dose-Response Relationship, Drug; Emb; Ethambutol - administration & dosage; Ethambutol - adverse effects; Female; Humans; Incidence; Low Dose; Male; Middle Aged; Mycobacterium avium; 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; Toxic Optic Neuropathy; Tuberculosis - diagnosis; Tuberculosis - drug therapy; Tuberculosis - microbiology; Vision, Ocular - drug effects; Young Adult
• ISSN: 1027-3719; 1815-7920
• DOI: 10.5588/ijtld.15.0275

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.