Park Dae Hyun, Park Tae Kwann, Ohn Young-Hoon, Park Jong Sook, Chang Jee Ho
Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, #170 Jomaru-ro, Wonmi-gu, Bucheon, 420-767, Korea.
Division of Pulmonology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
Doc Ophthalmol. 2015 Dec;131(3):237-44. doi: 10.1007/s10633-015-9518-6. Epub 2015 Nov 3.
While optic neuropathy is a well-known cause of visual disturbances in linezolid-treated patients, the possibility of linezolid-related retinopathy has not been investigated. Here, we report a case of retinopathy demonstrated by multifocal electroretinogram (mfERG) in a linezolid-treated patient.
A 61-year-old man with extensively drug-resistant pulmonary tuberculosis treated with linezolid for 5 months presented with painless loss of vision in both eyes. The patient's best corrected visual acuity was 20/50 in the right eye and 20/100 in the left eye. Fundus examination revealed mild disc edema, and color vision was defective in both eyes. Humphrey visual field tests showed a superotemporal field defect in the right eye and central and pericentral field defect in the left eye. Optical coherence tomography (OCT) revealed only mild optic disc swelling. In mfERG, central amplitudes were depressed in both eyes. Four months after the cessation of linezolid, visual acuity was restored to 20/20 right eye and 20/25 left eye. The color vision and visual field had improved. The OCT and mfEFG findings improved as well.
Although the clinical features were similar to linezolid-induced optic neuropathy, the mfERG findings suggest the possibility of a retinopathy through cone dysfunction.
虽然视神经病变是接受利奈唑胺治疗的患者出现视觉障碍的一个众所周知的原因,但利奈唑胺相关性视网膜病变的可能性尚未得到研究。在此,我们报告一例在接受利奈唑胺治疗的患者中通过多焦视网膜电图(mfERG)证实的视网膜病变病例。
一名61岁广泛耐药性肺结核男性患者接受利奈唑胺治疗5个月后出现双眼无痛性视力丧失。患者最佳矫正视力右眼为20/50,左眼为20/100。眼底检查显示轻度视盘水肿,双眼色觉均有缺陷。Humphrey视野检查显示右眼颞上象限视野缺损,左眼中央及中央周围视野缺损。光学相干断层扫描(OCT)仅显示轻度视盘肿胀。在mfERG检查中,双眼中央振幅降低。停用利奈唑胺4个月后,视力恢复到右眼20/20,左眼20/25。色觉和视野有所改善。OCT和mfEFG检查结果也有所改善。
虽然临床特征与利奈唑胺诱导的视神经病变相似,但mfERG检查结果提示存在因视锥细胞功能障碍导致视网膜病变的可能性。