Ethambutol Optic Neuropathy: Vigilance and Screening, the Keys to Prevent Blindness with the Revised Anti-tuberculous Therapy Regimen

Rohit Saxena; Swati Phuljhele; Anupam Prakash; Rakesh Lodha; Digvijay Singh; Satya Karna; Anant Mohan; Rashmin Gandhi; Vimla Menon; Rajiv Garg; The Inosrg

Ethambutol Optic Neuropathy: Vigilance and Screening, the Keys to Prevent Blindness with the Revised Anti-tuberculous Therapy Regimen

J Assoc Physicians India. 2021 Feb;69(2):54-57.

Authors

Rohit Saxena¹, Swati Phuljhele², Anupam Prakash³, Rakesh Lodha⁴, Digvijay Singh⁵, Satya Karna⁶, Anant Mohan⁷, Rashmin Gandhi⁸, Vimla Menon⁹, Rajiv Garg¹⁰, The Inosrg¹¹

Affiliations

¹ Professor, Strabismus and Neuro-Ophthalmology Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi.
² Associate Professor, Strabismus and Neuro-Ophthalmology Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi.
³ Professor, Department of Medicine, Lady Hardinge Medical College and associated hospitals, New Delhi.
⁴ Professor, Department of Paediatrics, All India Institute of Medical Sciences, New Delhi.
⁵ Director, Noble Eye Care, Gurgaon, Haryana.
⁶ Associate Director, Department of Ophthalmology, Jaypee Hospital, Noida.
⁷ Professor and Head of Department of Pulmonary, Critical Care & Sleep Medicine, All India Institute of Medical Sciences, New Delhi.
⁸ Consultant Neuro-Ophthalmology Services, Centre for Sight, Hyderabad, Director Foresight Worldwide, Visiting Professor, University of Hyderabad.
⁹ President INOS and ExProfessor & Head of Unit, Neuro-Ophthalmology and Strabismus Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi.
¹⁰ Professor of Excellence and Director General, Directorate General of Health Services, Government of India, New Delhi.
¹¹ Indian Neuro-Ophthalmology Society Research Group (INOSRG): Ambika Selvakumar, Ankur Sinha, Digvijay Singh, Hemalini Sawant, Jaspreet Sukhija, Jawahar Lal Goyal, Jenil Seth, Jitendra Jethani, Jyoti Matalia, Kumudini Sharma, Mahesh Kumar, Meenakshi Dhar, Murlidhar R, Naveen Jaikumar, Nishant Kumar, Padmavathy Maharajan, Pradeep Agarwal, Rashmin Gandhi, Ravinder Battu, Rohit Saxena, Satya Karna, Shikha Bassi, Soveetha Rath, Sujata Guha, Sumit Monga, Swati Phuljhele, V Krishna, Varshini Shankar, Vimal Fudnawala, Vimla Menon, Virender Sachdeva.

PMID: 33527812

Abstract

There has been change in the guidelines for the management of tuberculosis in India. The new guidelines advocate the daily use of Ethambutol for both intensive and continuation phase of the treatment. This may be a matter of concern as increased cumulative dose may lead to increase in incidence of toxic optic neuropathy due to ethambutol. Indian Neuro-Ophthalmology Society has taken cognizance of the issue and has come-up with guidelines for prevention and early detection of the toxic optic neuropathy.

MeSH terms

Antitubercular Agents / adverse effects
Blindness
Ethambutol / adverse effects
Humans
India / epidemiology
Optic Nerve Diseases* / chemically induced
Optic Nerve Diseases* / diagnosis
Optic Nerve Diseases* / prevention & control
Tuberculosis* / drug therapy

Substances

Antitubercular Agents
Ethambutol