Anti tubercular treatment (ATT) induced optic nerve changes: An observational study
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 17, Issue 2
Abstract
Tuberculosis is the most common cause of infectious disease-related mortality worldwide. Ethambutol and isoniazid (INH) are synthetic first-line agents of the anti-tubercular treatment (ATT) against Mycobacterium tuberculosis. Ethambutol optic neuropathy is a well-recognized adverse ocular event in patients who receive the drug for the treatment of mycobacterial infections. However, most cases in literature are reversible. Optic nerve involvement is a rare side-effect of INH. Visual loss due to optic neuropathy is a rare side-effect of ATT particularly ethambutol and INH. The main aim of this study was to evaluate the ocular effect of ATT with Standard regimen and visual outcome. A total of 73 Patients who were diagnosed as a case of TB and on ATT, were included in this observational study conducted in the Department of Ophthalmology and TBCD, MLBMC, Jhansi. An assessment of present complains detailed clinical history (present and past). Ophthalmological check up as external examination of the eyes, visual acuity, torch light examination, slit lamp examination, colour vision, refraction, direct ophthalmoscopy, Gonioscopy, Perimetry, Fundus photography and OCT were done. MRI was done in special cases. Standard ATT regime HRZE (H: 8-10 mg/kg body weight, R: 8-10 mg/kg body weight, Z: 30–40 mg/kg body weight, E: 25-35 mg/kg body weight) was followed in this study with minimum 6 months of duration. The the male to female ratio was 1.52:1 and incidence of optic neuropathy was 9.59%. Most of them had pulmonary tuberculosis (87.67%).. Nutritional and toxic (toxic neuropathy caused by tobacco, alcohol and other drugs) optic neuropathy was main confounding factor.
Authors and Affiliations
1Dr. Jitendra Kumar, Dr. Preeti Chaubey, Dr. Vijay Pratap Singh
Keywords
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