Han Jinu, Byun Min Kwang, Lee Junwon, Han So Young, Lee Jong Bok, Han Sueng-Han
Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Division of Pulmonology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Graefes Arch Clin Exp Ophthalmol. 2015 Dec;253(12):2293-9. doi: 10.1007/s00417-015-3150-8. Epub 2015 Sep 7.
The aim of the study was to evaluate longitudinal analysis of peripapillary retinal nerve fiber layer (RNFL) and perifoveal ganglion cell-inner plexiform layer (GCIPL) thickness in patients being treated with ethambutol (EMB).
This prospective longitudinal cohort study enrolled 37 patients who were treated with EMB for pulmonary tuberculosis. Best-corrected visual acuity, color vision test, automated perimetry, fundus photography, and RNFL and GCIPL thickness were measured at baseline and at 4 and 6 months after the start of EMB treatment, using Cirrus optical coherence tomography.
Among 37 patients, EMB-induced optic neuropathy occurred in one patient (2.7 %). In this patient, thickening of the RFNL and thinning of the GCIPL were noted at the onset of symptoms. After discontinuation of EMB, RNFL and GCIPL thickness progressively normalized. Changes in RNFL and GCIPL thickness were not statistically significant in the 36 patients who did not exhibit EMB-induced optic neuropathy-related symptoms during follow-up (all P values > 0.05).
Thickening of the peripapillary RNFL and thinning of the perifoveal GCIPL is an effective quantitative and early marker for diagnosis of EMB-induced optic neuropathy.
本研究旨在评估接受乙胺丁醇（EMB）治疗的患者视乳头周围视网膜神经纤维层（RNFL）和黄斑中心凹周围神经节细胞-内丛状层（GCIPL）厚度的纵向分析。
这项前瞻性纵向队列研究纳入了37例接受EMB治疗肺结核的患者。使用Cirrus光学相干断层扫描技术，在基线以及EMB治疗开始后的4个月和6个月测量最佳矫正视力、色觉测试、自动视野检查、眼底照相以及RNFL和GCIPL厚度。
37例患者中，1例（2.7%）发生了EMB引起的视神经病变。在该患者中，症状出现时发现RNFL增厚和GCIPL变薄。停用EMB后，RNFL和GCIPL厚度逐渐恢复正常。在随访期间未出现与EMB引起的视神经病变相关症状的36例患者中，RNFL和GCIPL厚度的变化无统计学意义（所有P值>0.05）。
视乳头周围RNFL增厚和黄斑中心凹周围GCIPL变薄是诊断EMB引起的视神经病变的有效定量和早期标志物。
