Chuenkongkaew W, Samsen P, Thanasombatsakul N
Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
J Med Assoc Thai. 2003 Jul;86(7):622-5.
To demonstrate the association between ethambutol and optic neuropathy.
Thirteen patients who developed optic neuropathy after being treated with ethambutol for tuberculosis of the lung or lymph node at Siriraj Hospital between 1997 and 2001 were retrospectively reviewed. The clinical characteristics and initial and final visual acuity were analyzed to determine visual outcome.
All patients had optic neuropathy between 1 to 6 months (mean = 2.9 months) after starting ethambutol therapy at a dosage ranging from 13 to 20 mg/kg/day (mean = 17 mg/kg/day). Seven (54%) of the 13 patients experienced visual recovery after stopping the drug. Of 6 patients with irreversible visual impairment, 4 patients had diabetes mellitus, glaucoma and a history of heavy smoking.
Early recognition of optic neuropathy should be considered in patients with ethambutol therapy. A low dose and prompt discontinuation of the drug is recommended particularly in individuals with diabetes mellitus, glaucoma or who are heavy smokers.
证明乙胺丁醇与视神经病变之间的关联。
回顾性分析了1997年至2001年间在诗里拉吉医院因肺结核或淋巴结结核接受乙胺丁醇治疗后发生视神经病变的13例患者。分析临床特征以及初始和最终视力，以确定视觉预后。
所有患者在开始乙胺丁醇治疗后1至6个月（平均2.9个月）出现视神经病变，剂量范围为13至20毫克/千克/天（平均17毫克/千克/天）。13例患者中有7例（54%）在停药后视力恢复。在6例有不可逆视力损害的患者中，4例患有糖尿病、青光眼并有重度吸烟史。
接受乙胺丁醇治疗的患者应考虑对视神经病变进行早期识别。建议低剂量用药并及时停药，尤其是对于患有糖尿病、青光眼或重度吸烟者。
