Update on ocular toxicity of ethambutol

Priscilla Makunyane,Solani Mathebula

doi:10.4102/aveh.v75i1.353

Priscilla Makunyane, Solani Mathebula

Open Access

https://doi.org/10.4102/aveh.v75i1.353

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Abstract

The purpose of this review is to update clinicians on available literature on the ocular toxicity of ethambutol and the type of eye care to be provided to patients treated with these medications. Ethambutol is a commonly used first-line anti-tuberculosis drug. Since its first use in the 1960s, ocular toxicity is described as related to dose and duration, and it is reversible on therapy discontinuation. However, the reversibility of the toxic optic neuropathy remains controversial. The mechanism of ocular toxicity owing to ethambutol is still under investigation. Other than discontinuing the drug, no specific treatment is available for the optic neuropathy caused by ethambutol. Doctors prescribing ethambutol should be aware of the ocular toxicity, and the drug should be used with proper patient education and ophthalmic monitoring.

Highlights

Tuberculosis (TB) has been present since 460 BC, as the most widespread disease of the time, and it was fatal
TB is still the most common infectious disease, and a major public health problem, infecting millions of people worldwide, including South Africa. It is estimated by the World Health Organization (WHO) that a third of the world’s population is infected by M. tuberculosis
Mild-to-severe toxic neuropathy and amblyopia owing to ethambutol have been reported.[2,3,4,5,6,7,8,9]

Summary

Introduction

Tuberculosis (TB) has been present since 460 BC, as the most widespread disease of the time, and it was fatal. The causative organism of TB is Mycobacterium tuberculosis which is a slow-growing bacterium that divides every 16–20 hours.[1] Today, TB is still the most common infectious disease, and a major public health problem, infecting millions of people worldwide, including South Africa. It is estimated by the World Health Organization (WHO) that a third of the world’s population is infected by M. tuberculosis. Ethambutol is a bacteriostatic drug,[1] developed in the early 1960s Even today, it is considered a first-line therapy against M. tuberculosis. Mild-to-severe toxic neuropathy and amblyopia owing to ethambutol have been reported.[2,3,4,5,6,7,8,9]

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