乙胺丁醇相关视神经病变
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摘要
乙胺丁醇(ethambutol,EMB)是一种在临床广泛应用的一线抗结核药物,其具有的眼毒性是EMB最重要且严重的并发症。早期的乙胺丁醇相关视神经病变(ethambutol optic neuropathy,EON)是可逆的,延迟的诊断会导致永久性视力丧失。早期检测在EON的治疗中有重要作用。本文就EON的危险因素、早期检测、治疗和预防做一综述。
Ethambutol( EMB) has been used as first-line antibiotics to treat tuberculosis. Side effects of ethambutol have been well documented since its original use,with the most serious one being optic neuropathy. EMB-induced optic neuropathy( EON) may be reversible in the early stages,but delayed diagnosis has been shown to result in permanent visual loss. Thus the reversibility of EON is dependent on early detection. In this review,we discuss risk factors,detection methods,treatment and prevention of EON.
Ethambutol( EMB) has been used as first-line antibiotics to treat tuberculosis. Side effects of ethambutol have been well documented since its original use,with the most serious one being optic neuropathy. EMB-induced optic neuropathy( EON) may be reversible in the early stages,but delayed diagnosis has been shown to result in permanent visual loss. Thus the reversibility of EON is dependent on early detection. In this review,we discuss risk factors,detection methods,treatment and prevention of EON.
引文
1 Lo Vecchio A,Bocchino M,Lancella L,et al. Indications to Hospital Admission and Isolation of Children With Possible or Defined Tuberculosis:Systematic Review and Proposed Recommendations for Pediatric Patients Living in Developed Countries. Medicine(Baltimore)2015;94(50):e2045
2 Garg P,Garg R,Prasad R, et al. A prospective study of ocular toxicity in patients receiving ethambutol as a part of directly observed treatment strategy therapy. Lung India 2015; 32(1):16-19
3 Koul PA. Ocular toxicity with ethambutol therapy:Timely recaution.Lung India 2015; 32(1):1-3
4 Han J,Byun MK,Lee J,et al. Longitudinal analysis of retinal nerve fiber layer and ganglion cell-inner plexiform layer thickness in ethambutol-induced optic neuropathy. Graefes Arch Clin Exp Ophthalmol2015;253(12):2293-2299
5 Lee EJ, Kim SJ,Choung HK, et al. Incidence and clinical features of ethambutol-induced optic neuropathy in Korea. J Neuroophthalmol 2008;28(4):269-277
6 Ezer N, Benedetti A, Darvish-Zargar M, et al. Incidence of ethambutol-related visual impairment during treatment of active tuberculosis. Int J Tuberc Lung Dis 2013; 17(4):447-455
7 Yang HK,Park MJ, Lee JH, et al. Incidence of toxic optic neuropathy with low-dose ethambutol. Int. J Tuberc Lung Dis 2016; 20(2):261-264
8 Choi SY,Hwang JM. Optic neuropathy associated with ethambutol in Koreans. Korean J Ophthalmol 1997; 11(2):106-110
9 Chan RY, Kwok AK. Ocular toxicity of ethambutol. Hong Kong Med J2006;12(1):56-60
10 Chen HY,Lai SW,Muo CH,et al. Ethambutol-induced optic neuropathy:a nationwide population-based study from Taiwan. Br J Ophthalmol 2012;96(11):1368-1371
11 Talbert Estlin KA,Sadun A A. Risk factors for ethambutol optic toxicity. Int Ophthalmol 2010;30(1):63-72
12 Song W,Si S. The rare ethambutol-induced optic neuropathy:A case-report and literature review. Medicine(Baltimore)2017; 96(2):e5889
13 Kim KL,Park SP. Visual function test for early detection of ethambutol induced ocular toxicity at the subclinical level. Cutan Ocul Toxicol 2016;35(3):228-232
14 Papchenko T,Grainger BT,Savino PJ, et al. Macular thickness predictive of visual field sensitivity in ischaemic optic neuropathy. Acta Ophthalmol 2012; 90(6):e463-469
15 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):410-416
16 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):531-535
17 Kho RC, Al-Obailan M, Arnold AC. Bitemporal visual field defectsin ethambutol-induced optic neuropathy. J Neuroophthalmol 2011; 31(2):121-126
18 Osaguona VB, Sharpe JA, Awaji SA, et al. Optic chiasm involvement on MRI with ethambutol-induced bitemporal hemianopia. J Neuroophthalmol 2014;34(2):155-158
19 Behbehani RS, Affel EL, Sergott RC, et al. Multifocal ERG in ethambutol associated visual loss. Br J Ophthalmol 2005; 89(8):976-982
20 Kandel H, Adhikari P, Shrestha GS, et al. V isual function in patients on ethambutol therapy for tuberculosis. J Ocul Pharmaco Ther 2012; 28(2):174-178
21 Lai TY, Ngai JW, Lai RY, et al. Multifocal electroretinography changes in patients on ethambutol therapy. Eye(Lond)2009; 23(8):1707-1713
22 Polak BC, Leys M,Van Lith GH. Blue-yellow colour vision changes as early symptoms of ethambutol oculotoxicity. Ophthalmologica 1985; 191(4):223-226
23 Yiannikas C,Walsh JC,Mcleod JG. Visual evoked potentials in the detection of subclinical optic toxic effects secondary to ethambuto. Arch Neurol 1983;40(10):645-648
24 Goyal JL, De S, Singh NP, et al. Evaluation of visual functions in patients on ethambutol therapy for tuberculosis:a prospective study. J Commun Dis 2003; 35(4):230-243
25 Ayanniyi AA,Ayanniyi RO. A 37-year-old woman presenting with impaired visual function during antituberculosis drug therapy:a case report. J Med Case Rep 2011;5:317
26 Chuenkongkaew W,Samsen P, Thanasombatsakul N. Ethambutol and optic neuropathy. J Med Assoc Thai 2003; 86(7):622-625
27 Sivakumaran P, Harrison Ac, Marschner J, et al. Ocular toxicity from ethambutol:a review of four cases and recommended precautions. N Z Med J 1998;111(1077):428-430
28 Sahin A,Kursat Cingu A, Kaya S, et al. The protective effects of caffeic acid phenethyl ester in isoniazid and ethambutol-induced ocular toxicity of rats. Cutan Ocul Toxicol 2013;32(3):228-233
29 Plit ML, Theron AJ, Fickl H, et al. Influence of antimicrobial chemotherapy and smoking status on the plasma concentrations of vitamin C,vitamin E, beta-carotene, acute phase reactants, iron and lipid peroxides in patients with pulmonary tuberculosis. Int J Tuberc Lung Dis1998;2(7):590-596
30 Mehra S, Dutta NK, Mollenkopf HJ, et al. Mycobacterium tuberculosis MT2816 encodes a key stress-response regulator. J Infect Dis2010;202(6):943-953
31 Polat B, Suleyman H, Sener E, et al. Examination of the effects of thiamine and thiamine pyrophosphate on Doxorubicin-induced experimental cardiotoxicity. J Cardiovasc Pharmacol Ther 2015; 20(2):221-229
32 Cinici E, Cetin N, Ahiskali I, et al. The effect of thiamine pyrophosphate on ethambutol-induced ocular toxicity. Cutan Ocul Toxicol2016;35(3):222-227
33 Chamberlain PD, Sadaka A, Berry S, et al. Ethambutol optic neuropathy. Curr Opin Ophthalmol 2017;28(6):545-551
2 Garg P,Garg R,Prasad R, et al. A prospective study of ocular toxicity in patients receiving ethambutol as a part of directly observed treatment strategy therapy. Lung India 2015; 32(1):16-19
3 Koul PA. Ocular toxicity with ethambutol therapy:Timely recaution.Lung India 2015; 32(1):1-3
4 Han J,Byun MK,Lee J,et al. Longitudinal analysis of retinal nerve fiber layer and ganglion cell-inner plexiform layer thickness in ethambutol-induced optic neuropathy. Graefes Arch Clin Exp Ophthalmol2015;253(12):2293-2299
5 Lee EJ, Kim SJ,Choung HK, et al. Incidence and clinical features of ethambutol-induced optic neuropathy in Korea. J Neuroophthalmol 2008;28(4):269-277
6 Ezer N, Benedetti A, Darvish-Zargar M, et al. Incidence of ethambutol-related visual impairment during treatment of active tuberculosis. Int J Tuberc Lung Dis 2013; 17(4):447-455
7 Yang HK,Park MJ, Lee JH, et al. Incidence of toxic optic neuropathy with low-dose ethambutol. Int. J Tuberc Lung Dis 2016; 20(2):261-264
8 Choi SY,Hwang JM. Optic neuropathy associated with ethambutol in Koreans. Korean J Ophthalmol 1997; 11(2):106-110
9 Chan RY, Kwok AK. Ocular toxicity of ethambutol. Hong Kong Med J2006;12(1):56-60
10 Chen HY,Lai SW,Muo CH,et al. Ethambutol-induced optic neuropathy:a nationwide population-based study from Taiwan. Br J Ophthalmol 2012;96(11):1368-1371
11 Talbert Estlin KA,Sadun A A. Risk factors for ethambutol optic toxicity. Int Ophthalmol 2010;30(1):63-72
12 Song W,Si S. The rare ethambutol-induced optic neuropathy:A case-report and literature review. Medicine(Baltimore)2017; 96(2):e5889
13 Kim KL,Park SP. Visual function test for early detection of ethambutol induced ocular toxicity at the subclinical level. Cutan Ocul Toxicol 2016;35(3):228-232
14 Papchenko T,Grainger BT,Savino PJ, et al. Macular thickness predictive of visual field sensitivity in ischaemic optic neuropathy. Acta Ophthalmol 2012; 90(6):e463-469
15 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):410-416
16 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):531-535
17 Kho RC, Al-Obailan M, Arnold AC. Bitemporal visual field defectsin ethambutol-induced optic neuropathy. J Neuroophthalmol 2011; 31(2):121-126
18 Osaguona VB, Sharpe JA, Awaji SA, et al. Optic chiasm involvement on MRI with ethambutol-induced bitemporal hemianopia. J Neuroophthalmol 2014;34(2):155-158
19 Behbehani RS, Affel EL, Sergott RC, et al. Multifocal ERG in ethambutol associated visual loss. Br J Ophthalmol 2005; 89(8):976-982
20 Kandel H, Adhikari P, Shrestha GS, et al. V isual function in patients on ethambutol therapy for tuberculosis. J Ocul Pharmaco Ther 2012; 28(2):174-178
21 Lai TY, Ngai JW, Lai RY, et al. Multifocal electroretinography changes in patients on ethambutol therapy. Eye(Lond)2009; 23(8):1707-1713
22 Polak BC, Leys M,Van Lith GH. Blue-yellow colour vision changes as early symptoms of ethambutol oculotoxicity. Ophthalmologica 1985; 191(4):223-226
23 Yiannikas C,Walsh JC,Mcleod JG. Visual evoked potentials in the detection of subclinical optic toxic effects secondary to ethambuto. Arch Neurol 1983;40(10):645-648
24 Goyal JL, De S, Singh NP, et al. Evaluation of visual functions in patients on ethambutol therapy for tuberculosis:a prospective study. J Commun Dis 2003; 35(4):230-243
25 Ayanniyi AA,Ayanniyi RO. A 37-year-old woman presenting with impaired visual function during antituberculosis drug therapy:a case report. J Med Case Rep 2011;5:317
26 Chuenkongkaew W,Samsen P, Thanasombatsakul N. Ethambutol and optic neuropathy. J Med Assoc Thai 2003; 86(7):622-625
27 Sivakumaran P, Harrison Ac, Marschner J, et al. Ocular toxicity from ethambutol:a review of four cases and recommended precautions. N Z Med J 1998;111(1077):428-430
28 Sahin A,Kursat Cingu A, Kaya S, et al. The protective effects of caffeic acid phenethyl ester in isoniazid and ethambutol-induced ocular toxicity of rats. Cutan Ocul Toxicol 2013;32(3):228-233
29 Plit ML, Theron AJ, Fickl H, et al. Influence of antimicrobial chemotherapy and smoking status on the plasma concentrations of vitamin C,vitamin E, beta-carotene, acute phase reactants, iron and lipid peroxides in patients with pulmonary tuberculosis. Int J Tuberc Lung Dis1998;2(7):590-596
30 Mehra S, Dutta NK, Mollenkopf HJ, et al. Mycobacterium tuberculosis MT2816 encodes a key stress-response regulator. J Infect Dis2010;202(6):943-953
31 Polat B, Suleyman H, Sener E, et al. Examination of the effects of thiamine and thiamine pyrophosphate on Doxorubicin-induced experimental cardiotoxicity. J Cardiovasc Pharmacol Ther 2015; 20(2):221-229
32 Cinici E, Cetin N, Ahiskali I, et al. The effect of thiamine pyrophosphate on ethambutol-induced ocular toxicity. Cutan Ocul Toxicol2016;35(3):222-227
33 Chamberlain PD, Sadaka A, Berry S, et al. Ethambutol optic neuropathy. Curr Opin Ophthalmol 2017;28(6):545-551