Incidence, risk factors and ophthalmic clinical characteristic of ethambutol-induced optic neuropathy: 7-year experience
BackgroundThe purpose of this research was to investigate the characteristics, clinical manifestations, incidence, and risk factors in ethambutol-induced optic neuropathy (EON) in the Thai population.MethodsPatients treated with ethambutol for tuberculosis (TB) were retrospectively identified in the...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-03-01
|
| Series: | Frontiers in Ophthalmology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fopht.2023.1152215/full |
| _version_ | 1811155437068746752 |
|---|---|
| author | Pareena Chaitanuwong Pareena Chaitanuwong Supaporn Srithawatpong Supaporn Srithawatpong Paisan Ruamviboonsuk Paisan Ruamviboonsuk Supanut Apinyawasisuk Supanut Apinyawasisuk Akechanok Watcharapanjamart Akechanok Watcharapanjamart Heather E. Moss Heather E. Moss |
| author_facet | Pareena Chaitanuwong Pareena Chaitanuwong Supaporn Srithawatpong Supaporn Srithawatpong Paisan Ruamviboonsuk Paisan Ruamviboonsuk Supanut Apinyawasisuk Supanut Apinyawasisuk Akechanok Watcharapanjamart Akechanok Watcharapanjamart Heather E. Moss Heather E. Moss |
| author_sort | Pareena Chaitanuwong |
| collection | DOAJ |
| description | BackgroundThe purpose of this research was to investigate the characteristics, clinical manifestations, incidence, and risk factors in ethambutol-induced optic neuropathy (EON) in the Thai population.MethodsPatients treated with ethambutol for tuberculosis (TB) were retrospectively identified in the medical record of a tertiary hospital in Thailand from January 2012 to August 2019. Development of EON was determined through review of ophthalmology records. Comparison was made between patients with EON and those without EON to identify possible risk factors. Ophthalmic outcomes were characterized.ResultsAmong 4,141 patients who received ethambutol for TB treatment, 1,062 had an ophthalmology encounter, and 20 (0.5% overall, 1.88% with ophthalmology encounters) developed EON. In unadjusted analysis, compared to patients without EON, those with EON had a similar daily dose, but longer duration of ethambutol treatment (P=0.02). They were older (mean 43.74 vs. 58.60 years, P=0.001), more likely to have hypertension (P=0.02) and smoke (p=0.01). There were no differences in gender, body mass index, diabetes, dyslipidemia, HIV infection or glomerular filtration rate. The peripapillary retinal nerve fiber layer, ganglion cell analysis, and vascular density as measured using retinal optical coherence tomography were impacted by EON. In adjusted logistic regression analysis, age greater than 60 (OR = 8.71, p = 0.01) and smoking (OR = 7.06, p = 0.01) were independent risk factors for EON.ConclusionIn patients treated with ethambutol, the incidence proportion of EON was 0.5% among those with ethambutol administered and 1.88% among those with ethambutol and an eye visit. Potential EON risk factors were age, hypertension, smoking, and duration of ethambutol medication. Smoking has not been associated with EON in prior studies. |
| first_indexed | 2024-04-10T04:33:00Z |
| format | Article |
| id | doaj.art-866bfb2724b44c74ae1bc9161bda20da |
| institution | Directory Open Access Journal |
| issn | 2674-0826 |
| language | English |
| last_indexed | 2024-04-10T04:33:00Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Ophthalmology |
| spelling | doaj.art-866bfb2724b44c74ae1bc9161bda20da2023-03-10T05:36:22ZengFrontiers Media S.A.Frontiers in Ophthalmology2674-08262023-03-01310.3389/fopht.2023.11522151152215Incidence, risk factors and ophthalmic clinical characteristic of ethambutol-induced optic neuropathy: 7-year experiencePareena Chaitanuwong0Pareena Chaitanuwong1Supaporn Srithawatpong2Supaporn Srithawatpong3Paisan Ruamviboonsuk4Paisan Ruamviboonsuk5Supanut Apinyawasisuk6Supanut Apinyawasisuk7Akechanok Watcharapanjamart8Akechanok Watcharapanjamart9Heather E. Moss10Heather E. Moss11Ophthalmology Department, Rajavithi Hospital, Ministry of Public Health, Bangkok, ThailandDepartment of ophthalmology, Faculty of Medicine, Rangsit University, Bangkok, ThailandOphthalmology Department, Rajavithi Hospital, Ministry of Public Health, Bangkok, ThailandDepartment of ophthalmology, Faculty of Medicine, Rangsit University, Bangkok, ThailandOphthalmology Department, Rajavithi Hospital, Ministry of Public Health, Bangkok, ThailandDepartment of ophthalmology, Faculty of Medicine, Rangsit University, Bangkok, ThailandOphthalmology Department, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandDepartment of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandOphthalmology Department, Rajavithi Hospital, Ministry of Public Health, Bangkok, ThailandDepartment of ophthalmology, Faculty of Medicine, Rangsit University, Bangkok, ThailandDepartment of Ophthalmology, Stanford University, Palo Alto, California, CA, United StatesDepartment of Neurology & Neurological Sciences, Stanford University, Palo Alto, California, CA, United StatesBackgroundThe purpose of this research was to investigate the characteristics, clinical manifestations, incidence, and risk factors in ethambutol-induced optic neuropathy (EON) in the Thai population.MethodsPatients treated with ethambutol for tuberculosis (TB) were retrospectively identified in the medical record of a tertiary hospital in Thailand from January 2012 to August 2019. Development of EON was determined through review of ophthalmology records. Comparison was made between patients with EON and those without EON to identify possible risk factors. Ophthalmic outcomes were characterized.ResultsAmong 4,141 patients who received ethambutol for TB treatment, 1,062 had an ophthalmology encounter, and 20 (0.5% overall, 1.88% with ophthalmology encounters) developed EON. In unadjusted analysis, compared to patients without EON, those with EON had a similar daily dose, but longer duration of ethambutol treatment (P=0.02). They were older (mean 43.74 vs. 58.60 years, P=0.001), more likely to have hypertension (P=0.02) and smoke (p=0.01). There were no differences in gender, body mass index, diabetes, dyslipidemia, HIV infection or glomerular filtration rate. The peripapillary retinal nerve fiber layer, ganglion cell analysis, and vascular density as measured using retinal optical coherence tomography were impacted by EON. In adjusted logistic regression analysis, age greater than 60 (OR = 8.71, p = 0.01) and smoking (OR = 7.06, p = 0.01) were independent risk factors for EON.ConclusionIn patients treated with ethambutol, the incidence proportion of EON was 0.5% among those with ethambutol administered and 1.88% among those with ethambutol and an eye visit. Potential EON risk factors were age, hypertension, smoking, and duration of ethambutol medication. Smoking has not been associated with EON in prior studies.https://www.frontiersin.org/articles/10.3389/fopht.2023.1152215/fullethambutoloptic neuropathydrug toxicityvisual impairmenttuberculosis |
| spellingShingle | Pareena Chaitanuwong Pareena Chaitanuwong Supaporn Srithawatpong Supaporn Srithawatpong Paisan Ruamviboonsuk Paisan Ruamviboonsuk Supanut Apinyawasisuk Supanut Apinyawasisuk Akechanok Watcharapanjamart Akechanok Watcharapanjamart Heather E. Moss Heather E. Moss Incidence, risk factors and ophthalmic clinical characteristic of ethambutol-induced optic neuropathy: 7-year experience Frontiers in Ophthalmology ethambutol optic neuropathy drug toxicity visual impairment tuberculosis |
| title | Incidence, risk factors and ophthalmic clinical characteristic of ethambutol-induced optic neuropathy: 7-year experience |
| title_full | Incidence, risk factors and ophthalmic clinical characteristic of ethambutol-induced optic neuropathy: 7-year experience |
| title_fullStr | Incidence, risk factors and ophthalmic clinical characteristic of ethambutol-induced optic neuropathy: 7-year experience |
| title_full_unstemmed | Incidence, risk factors and ophthalmic clinical characteristic of ethambutol-induced optic neuropathy: 7-year experience |
| title_short | Incidence, risk factors and ophthalmic clinical characteristic of ethambutol-induced optic neuropathy: 7-year experience |
| title_sort | incidence risk factors and ophthalmic clinical characteristic of ethambutol induced optic neuropathy 7 year experience |
| topic | ethambutol optic neuropathy drug toxicity visual impairment tuberculosis |
| url | https://www.frontiersin.org/articles/10.3389/fopht.2023.1152215/full |
| work_keys_str_mv | AT pareenachaitanuwong incidenceriskfactorsandophthalmicclinicalcharacteristicofethambutolinducedopticneuropathy7yearexperience AT pareenachaitanuwong incidenceriskfactorsandophthalmicclinicalcharacteristicofethambutolinducedopticneuropathy7yearexperience AT supapornsrithawatpong incidenceriskfactorsandophthalmicclinicalcharacteristicofethambutolinducedopticneuropathy7yearexperience AT supapornsrithawatpong incidenceriskfactorsandophthalmicclinicalcharacteristicofethambutolinducedopticneuropathy7yearexperience AT paisanruamviboonsuk incidenceriskfactorsandophthalmicclinicalcharacteristicofethambutolinducedopticneuropathy7yearexperience AT paisanruamviboonsuk incidenceriskfactorsandophthalmicclinicalcharacteristicofethambutolinducedopticneuropathy7yearexperience AT supanutapinyawasisuk incidenceriskfactorsandophthalmicclinicalcharacteristicofethambutolinducedopticneuropathy7yearexperience AT supanutapinyawasisuk incidenceriskfactorsandophthalmicclinicalcharacteristicofethambutolinducedopticneuropathy7yearexperience AT akechanokwatcharapanjamart incidenceriskfactorsandophthalmicclinicalcharacteristicofethambutolinducedopticneuropathy7yearexperience AT akechanokwatcharapanjamart incidenceriskfactorsandophthalmicclinicalcharacteristicofethambutolinducedopticneuropathy7yearexperience AT heatheremoss incidenceriskfactorsandophthalmicclinicalcharacteristicofethambutolinducedopticneuropathy7yearexperience AT heatheremoss incidenceriskfactorsandophthalmicclinicalcharacteristicofethambutolinducedopticneuropathy7yearexperience |