Correlation between peripapillary retinal nerve fiber layer thickness and visual function changes in patients receiving ethambutol

  • Dialika Dialika Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Jakarta
  • Muhammad Sidik Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
  • Syntia Nusanti Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
  • Aria Kekalih
DOI: https://doi.org/10.13181/mji.v24i1.1065
Keywords: ethambutol, optical coherence tomography, optic neuropathy, retinal nerve
Abstract viewed: 1672 times
PDF downloaded: 786 times

Abstract

Background: Recent animal studies revealed the decreased amount of retinal ganglion cells after treatment with ethambutol. The aim of this study was to evaluate the changes of peripapillary retinal nerve fiber layer (RNFL) thickness in patients receiving ethambutol therapy, as well as to know the correlation of RNFL thickness changes with the changes of visual function.

Methods: This was a cohort study on 29 subjects at one tuberculosis treatment center, Jakarta. Subjects underwent RNFL thickness measurement using optical coherence tomography (OCT) and several visual function parameters (visual acuity, contrast sensitivity, color sensitivity and visual field) before and two-months following ethambutol therapy. Statistical comparison between pre- and post- ethambutol measurements were done using either paired T-test or Wilcoxon test. Correlations between anatomical and functional changes were assessed with Spearman correlation test.

Results: There were significant changes of peripapillary RNFL thickness in superior (147 and 141 μm, p = 0.001), nasal (92 and 88 μm, p = 0.045) quadrants and average RNFL thickness (116.77 and 112.65 μm, p = 0.001). No significant correlation between RNFL thickness changes and the changes of visual function parameters (p > 0.05).

Conclusion: Ethambutol consumption for two months in recommended dose is still considered safe to human retina and visual status.

Downloads

Download data is not yet available.

References

  1. Perhimpunan Dokter Paru Indonesia. Tuberkulosis: pedoman diagnosis dan penatalaksanaan di Indonesia. Jakarta: Perhimpunan Dokter Paru Indonesia; 2011. p. 20-30. Indonesian.

  2. World Health Organization [Internet]. Global tuberculosis control: WHO report 2011 [cited 2012 Sept 13] Available from: http://apps.who.int/iris/bitstream/

  3. Lee EJ, Kim SJ, Choung HK, Kim JH, Yu YS. Incidence and clinical features of ethambutol-induced optic neuropathy in Korea. J Neuroophthalmol. 2008;28(4):269-77. http://dx.doi.org/10.1097/WNO.0b013e31818e3c6b

  4. Goyal JL, De Sarmi, Singh NP, Bhatia A. Evaluation of visual functions in patients on ethambutol therapy for tuberculosis: a prospective study. J Commun Dis. 2003;35(4):230-43.

  5. Liebold JE. The ocular toxicity of ethambutol and its relation to dose. Ann NY Acad Sci. 1966;135:904-9. http://dx.doi.org/10.1111/j.1749-6632.1966.tb45532.x

  6. Bartlett JD. Clinical ocular pharmacology. 5th ed. Bartlett JD, Jaanus SD, editors. Missouri: Butterworth Heinemann; 2008. p. 736-7.

  7. Junita TP, Sidik M, Nusanti S. Characteristic of color perception and contrast sensitivity in patients treated with ethambutol at Cipto Mangunkusumo Hospital Jakarta. Ophthalmologica Indonesiana. 2011;38(1):39-46.

  8. Salmon JF, Carmichael TR, Welsh NH. Use of contrast sensitivity measurement in the detection of subclinical ethambutol toxic optic neuropathy. Br J Ophthalmol. 1987;71(3):192-6. http://dx.doi.org/10.1136/bjo.71.3.192

  9. Fraunfelder FW, Sadun AA, Wood T. Update on ethambutol optic neuropathy. Expert Opin Drug Saf. 2006;5(5):615-8. http://dx.doi.org/10.1517/14740338.5.5.615

  10. Chai SJ, Foroozan R. Decreased retinal nerve fibre layer thickness detected by optical coherence tomography in patients with ethambutol-induced optic neuropathy. Br J Ophthalmol. 2007;91(7):895–7. http://dx.doi.org/10.1136/bjo.2006.113118

  11. Yudapratiwi N. Perbandingan densitas sel ganglion retina dengan dan tanpa suplementasi zinc pada tikus yang diberi etambutol [theses]. Bandung: Universitas Padjajaran; 2011. Indonesian.

  12. Kinoshita J, Iwata N, Maejima T, Kimotsuki T, Yasuda M. Retinal function and morphology in monkeys with ethambutol-induced optic neuropathy. Invest Ophthalmol Vis Sci. 2012;53(11):7052-62 http://dx.doi.org/10.1167/iovs.12-10308

  13. Sung KR, Kim DY, Park SB, Kook MS. Comparison of retinal nerve fiber layer thickness measured by cirrus HD and stratus optical coherence tomography. Ophthalmology. 2009;116(7):1264-70. http://dx.doi.org/10.1016/j.ophtha.2008.12.045

  14. Zoumalan CI, Agarwal M, Sadun AA. Optical coherence tomography can measure axonal loss in patients with ethambutol-induced optic neuropathy. Graefes Arch Clin Exp Ophthalmol. 2005;243(5):410-6. http://dx.doi.org/10.1007/s00417-004-1053-1

  15. Kim YK, Hwang JM. Serial retinal nerve fiber layer changes in patients with toxic optic neuropathy associated with antituberculosis pharmacotherapy. J Ocul Pharmacol Ther. 2009;25(6):531-5. http://dx.doi.org/10.1089/jop.2009.0064

  16. Wang MY, Sadun AA. Drug-related mitochondrial optic neuropathies. J Neuroophthalmol. 2013;33(2):172-8. http://dx.doi.org/10.1097/WNO.0b013e3182901969

  17. Sadun AA, La Morgia C, Carelli V. Mitochondrial optic neuropathies: our travels from bench to bedside and back again. Clin Experiment Ophthalmol. 2013;41(7):702-12. http://dx.doi.org/10.1111/ceo.12086

  18. Vistamehr S, Walsh TJ, Adelman RA. Ethambutol neuroretinopathy. Semin Ophthalmol. 2007;22(3):141-6. http://dx.doi.org/10.1080/08820530701457134

  19. Neyrolles O, Quintana-Murci L. Sexual inequality in tuberculosis. PLoS Med. 2009;6(12): e1000199. http://dx.doi.org/10.1371/journal.pmed.1000199

  20. Chung JK, Park YB, Park SP. Visual function test for early detection of ethambutol-induced ocular toxicity. J Korean Ophthalmol Soc. 2012;53(5):694-9. http://dx.doi.org/10.3341/jkos.2012.53.5.694

  21. Tang WW, Lai JS, Tham CC, Chan KK, Chan KS. Scanning laser polarimetry in pulmonary tuberculosis patients on chemotherapy. Ann Acad Med Singapore. 2006;35(6):395-9.

  22. Menon V, Jain D, Saxena R, Sood R. Prospective evaluation of visual function for early detection of ethambutol toxicity. Br J Ophthalmol. 2009;93(9):1251-4. http://dx.doi.org/10.1136/bjo.2008.148502

Published
2015-03-29
How to Cite
1.
Dialika D, Sidik M, Nusanti S, Kekalih A. Correlation between peripapillary retinal nerve fiber layer thickness and visual function changes in patients receiving ethambutol. Med J Indones [Internet]. 2015Mar.29 [cited 2024Oct.4];24(1):19-3. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/1065
Issue
Vol. 24 No. 1 (2015): March
Section
Clinical Research

Copyright (c) 2015 Dialika Dialika, Muhammad Sidik, Syntia Nusanti, Aria Kekalih

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Authors who publish with Medical Journal of Indonesia agree to the following terms:

  1. Authors retain copyright and grant Medical Journal of Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.
  2. Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.
Crossref
Scopus
Google Scholar
Europe PMC