Peterson Elizabeth, Hawy Eman
Loma Linda University School of Medicine, Loma Linda, CA, 92354, United States.
Loma Linda University Health Eye Institute, Loma Linda, CA, 92354, United States.
Am J Ophthalmol Case Rep. 2022 Jun 11;27:101611. doi: 10.1016/j.ajoc.2022.101611. eCollection 2022 Sep.
To document an unusual example of ethambutol optic neuropathy developing three years from treatment start date in the absence of renal dysfunction.
The patient, an 82-year-old, 61-kg male undergoing treatment for , presented with visual acuity that was significantly worse than baseline three years after beginning a treatment regimen which included ethambutol at <15 mg/kg/day. He was also found to have central and paracentral scotomas in both eyes. Ethambutol treatment was immediately halted, and the patient's visual acuity and visual fields improved in the months following.
It is important to have a high index of suspicion for ethambutol toxicity in any patient on this drug who presents with vision changes consistent with optic neuropathy. The development of ethambutol optic neuropathy can be delayed, and vision loss may be reversible and can continue to improve over months after cessation of therapy.
记录一例在开始治疗三年后出现乙胺丁醇性视神经病变的罕见病例，该患者无肾功能不全。
该患者为一名82岁、体重61公斤的男性，正在接受治疗，在开始使用包括乙胺丁醇且剂量低于15毫克/公斤/天的治疗方案三年后，其视力明显低于基线水平。还发现他双眼有中心和旁中心暗点。立即停止乙胺丁醇治疗，随后几个月患者的视力和视野有所改善。
对于任何服用该药且出现与视神经病变相符的视力变化的患者，高度怀疑乙胺丁醇毒性很重要。乙胺丁醇性视神经病变的发生可能会延迟，视力丧失可能是可逆的，并且在停药后的几个月内可能会持续改善。
