Ophthalmic evaluation of drug-resistant tuberculosis patients taking linezolid as oral longer anti-tuberculosis regime

Abstract

Aim: To document ocular toxicity if any in drug-resistant tuberculosis patients taking linezolid as an oral longer regime. Study and Design: Hospital-based Observational study. Methods and Material: The study was carried out in tertiary health care from January 2021- October 2022. A total of 94 participants above 18 years of age who were diagnosed with drug-resistant tuberculosis taking Linezolid and had pre-treatment best-corrected visual acuity (BCVA) of 6/6 and N6 with normal color vision were included in the study. Patients were called on follow-up on the 2nd, 4th, and 6th months of post-Linezolid therapy, and BCVA, color vision, anterior segment examination, and dilated fundus examination were done and documented. Results: Out of 94 participants 45 were males and 49 females. The mean age of participants was 27.41±9.22. We observed one patient developed a diminution of vision with fundus changes of optic disc edema in the second month of follow-up and the other patient also came with a diminution of vision with optic neuropathy on the sixth month of follow-up. The third patient developed nonsignificant RPE changes without diminution of vision. Conclusion: Ocular toxicity in three cases in form of Optic Neuropathy, optic disc edema, and nonsignificant RPE changes amongst 94 participants. In our study after the withdrawal of Linezolid therapy, the visual acuity and fundus changes reverted to normal. The study highlights the importance of regular ophthalmic follow-up in patients who were on long-term linezolid therapy.