Published online Jan 14, 2022. doi: 10.12998/wjcc.v10.i2.663
Peer-review started: June 7, 2021
First decision: June 25, 2021
Revised: July 12, 2021
Accepted: December 8, 2021
Article in press: December 8, 2021
Published online: January 14, 2022
Processing time: 219 Days and 2 Hours
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.
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.
Nephropathy and high blood pressure, which damage the retinal microcirculation, may cause damage to the outer layer of the retina. Ethambutol may infl
Core Tip: Ethambutol-induced optic neuropathy is most commonly characterized by bilateral symmetrical loss of vision, but it may also occur successively in both eyes. Ethambutol may influence retinal photoreceptor cells and retinal ganglion cells.