Ethambutol-induced optic neuropathy with rare bilateral asymmetry onset:A case report  

作　　者：Wen-Yan Sheng Shuang-Qing Wu Ling-Ya Su Li-Wei Zhu 

机构地区：[1]Department of Ophthalmology,Affiliated Hangzhou Chest Hospital,Zhejiang University School of Medicine,Hangzhou 310003,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2022年第2期663-670,共8页世界临床病例杂志

基　　金：Supported by the Hangzhou Science and Technology Development Project,No.20170533B70.

摘　　要：BACKGROUND Ethambutol-induced optic neuropathy(EON)most commonly manifests as bilateral symmetrical loss of vision and often cause serious and irreversible visual impairment because of the lack of early detection and effective treatment.We followed a case of EON with rare binocular asymmetric clinical manifestations and observed the changes of visual function and retinal structure after drug withdrawal,so as to further understand the clinical characteristics of this disease.CASE SUMMARY A 54-year-old man complained of gradual visual decline in the left eye.The patient presented with best-corrected visual acuity of 20/20 in the right eye and 20/50 in the left eye.Color vision examination revealed difficulty in reading green color plates in the left eye.The visual field manifested as concentric contraction in the left eye.After nearly a month of drug withdrawal,the right eye had a similar decline in visual function.At the last visit,19 mo after drug withdrawal,the visual function significantly recovered in both eyes.During follow-up optical coherence tomography(OCT)examination,both eyes manifested the thickness of the retinal nerve fiber layer from mild thickening to thinning and finally temporal atrophy,and the ganglion cell-inner plexiform layer showed significant thinning.The difference was that a reversible structural disorder in the outer retina of the nasal macula was detected in the left eye by macular high-definition OCT.CONCLUSION Nephropathy and high blood pressure,which damage the retinal microcirculation,may cause damage to the outer layer of the retina.Ethambutol may influence photoreceptor as well as retinal ganglion cells.

关 键 词：Ethambutol-induced optic neuropathy Retinal nerve fiber layer Ganglion cell-inner plexiform layer Optical coherence tomography Asymmetry Case report 

分 类 号：R774.6[医药卫生—眼科]