Kumar A, Sandramouli S, Verma L, Tewari H K, Khosla P K
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.
J Clin Neuroophthalmol. 1993 Mar;13(1):15-7.
Delayed onset ocular ethambutol toxicity is usually considered to be reversible following prompt withdrawal of the drug. However, in a series of seven consecutive patients with severe visual deficit due to ethambutol toxicity, only 42.2% (3 of the 7 patients) achieved a visual recovery of better than 20/200 after an average follow-up of 8.3 +/- 2.1 months after stoppage of the drug. On fluorescein angiography, three cases (42.2%) progressed to optic atrophy during the follow-up with permanent visual damage. There were no predisposing or risk factors to contribute toward the poor visual gain. In this background, we recommend discontinuation of ethambutol from the antituberculous regimen. As an additional sidelight, the value of visually evoked potential in the monitoring of patients on ethambutol, especially in cases with early periaxial neuritis, has been emphasised.
迟发性眼乙胺丁醇毒性通常被认为在迅速停药后是可逆的。然而，在一系列连续7例因乙胺丁醇毒性导致严重视力缺陷的患者中，在停药后平均随访8.3±2.1个月后，只有42.2%（7例中的3例）视力恢复到优于20/200。在荧光素血管造影检查中，3例（42.2%）在随访期间进展为视神经萎缩，导致永久性视力损害。没有易患因素或危险因素导致视力改善不佳。在此背景下，我们建议在抗结核治疗方案中停用乙胺丁醇。另外，还强调了视觉诱发电位在监测使用乙胺丁醇的患者中的价值，特别是在早期轴周神经炎的病例中。
