Talbert Estlin Katherine Anne, Sadun Alfredo A
Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
Int Ophthalmol. 2010 Feb;30(1):63-72. doi: 10.1007/s10792-009-9293-z. Epub 2009 Feb 11.
Optic neuropathy is a well-known complication of ethambutol therapy and usually manifests as a decrease in visual acuity, cecocentral scotomas, and deficits in color vision.
To support or disprove the hypothesis that a significant majority of patients who develop ocular toxicity while undergoing treatment for a mycobacterium infection do so after experiencing either a prolonged course or unusually high serum levels of ethambutol.
Retrospective chart review (16 cases) and literature meta-analysis (54 cases).
Many cases lacked important data, but none countered the hypothesis. Age, duration of ethambutol, and dose of ethambutol were positively correlated with risk of toxicity.
Given an understanding of the risk factors for ethambutol optic toxicity, there exists a rationale for an optimization of ethambutol dosing protocols that can maximize the therapeutic effect while minimizing the incidence of optic toxicity.
视神经病变是乙胺丁醇治疗的一种众所周知的并发症，通常表现为视力下降、中心暗点和色觉缺陷。
支持或反驳这一假设，即在接受分枝杆菌感染治疗时发生眼部毒性的患者中，绝大多数是在经历了长时间疗程或血清乙胺丁醇水平异常高之后才出现这种情况。
回顾性病历审查（16例）和文献荟萃分析（54例）。
许多病例缺乏重要数据，但没有一例与该假设相矛盾。年龄、乙胺丁醇使用时长和乙胺丁醇剂量与毒性风险呈正相关。
鉴于对乙胺丁醇视神经毒性危险因素的了解，存在优化乙胺丁醇给药方案的理论依据，该方案可在使视神经毒性发生率最小化的同时最大化治疗效果。
