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ORIGINAL ARTICLE
Year : 2016  |  Volume : 4  |  Issue : 2  |  Page : 89-92

A Prospective evaluation of visual function for early detection of ethambutol toxicity


1 Professor & HOD, Department of Ophthalmology, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, India
2 Professor & HOD, Department of Pulmonary Medicine, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, India
3 Postgraduate, Department of Ophthalmology, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, India
4 Postgraduate, Department of Pulmonary Medicine, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, India

Correspondence Address:
V Raghu
Professor & HOD, Department of Ophthalmology, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2321-7006.302256

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Background and objectives: India is among the largest countries to implement the RNTCP. This program provides intermittent regimens to the patients, where doses of isoniazide and ethambutol are more as compare to the daily regimen. The present study was undertaken to explore the early detection of ethambutol toxicity in the patients registered under this program. Methods: This was a prospective study of 180 eyes of 90 patients being with ethambutol in the Directly observed Treatment Strategy Centre (Chalmeda Anand Rao Institute Of Medical Sciences, Karimnagar, Telangana, India).In this study visual acuity, colour vision, fundus changes and visual fields were assessed. Examinations were done before the start of therapy, after 1 month and 2 months of treatment and 1 month after stopping ethambutol. Results: No visual functional defect was noted at baseline. On follow up, following changes were observed, decrease visual acuity seen in 10% (18/180) of the eyes (p=0.02). Color vision 12.2% (22/180)of the eyes(p=0.049),among them 6 eyes developed defect in Red-Green color perception and 16 eyes developed defect in Blue-yellow colour perception. Fundus changes were seen in 6.1% (11/180) of the eyes (p=0.032). Visual field defects developed in 5.5% (10/180) of the eyes (p=0.047). Patients with ocular symptoms were advised to stop ethambutol and they showed improvement in visual acuity and colour vision after follow up of one to two months. Conclusion: Visual acuity, color vision, fundus changes and visual field examinations are sensitive tests to detect early toxicity. The early recognition of ocular symptoms is important to prevent delay in diagnosis and probable irreversible visual loss.


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