DeVita E G, Miao M, Sadun A A
J Clin Neuroophthalmol. 1987 Jun;7(2):77-86.
Ethambutol is frequently used in the treatment of tuberculosis, and, although optic neuropathies have been reported with the use of ethambutol, this adverse side effect has been considered to be rare and generally reversible with discontinuation of the medication. However, we recently saw two patients with renal tuberculosis treated with ethambutol in whom visual loss from toxic optic neuropathies was severe and irreversible despite careful ophthalmological monitoring and prompt discontinuation of the agent at the first sign of impaired visual function. While ethambutol treatment is most commonly instituted for pulmonary tuberculosis, it is interesting to note that both of these patients had renal tuberculosis. Since ethambutol is actively excreted via the renal system, compromise of renal function such as due to renal tuberculosis may lead to serum concentration elevations of ethambutol sufficient to produce optic neuropathy.
乙胺丁醇常用于治疗结核病，尽管已有使用乙胺丁醇导致视神经病变的报道，但这种不良反应被认为较为罕见，且通常在停药后可逆转。然而，我们最近遇到了两名接受乙胺丁醇治疗的肾结核患者，尽管进行了仔细的眼科监测，并在视觉功能出现受损迹象时立即停药，但他们因中毒性视神经病变导致的视力丧失严重且不可逆转。虽然乙胺丁醇治疗最常用于肺结核，但值得注意的是，这两名患者均患有肾结核。由于乙胺丁醇通过肾脏系统主动排泄，肾功能损害（如肾结核所致）可能导致乙胺丁醇血清浓度升高，足以引发视神经病变。
