International journal of ophthalmology · 2025
Identifying predictors of visual improvement in ethambutol optic neuropathy: insights from a 5-year retrospective analysis in a tertiary clinic in Indonesia.
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Valenchia, Mansyur Yunita, Arianti Alia, Viona
Аннотация
AIM: To characterize the demographic and clinical features of ethambutol optic neuropathy (EON) in an Indonesian patient population and explore prognostic factors for visual recovery.
METHODS: Retrospective study of 58 EON patients at an Indonesian eye center (2017-2022). Demographics, ethambutol treatment, ophthalmologic findings were collected. Visual outcomes after ethambutol cessation assessed at 3-12mo. Patients categorized as having visual improvement (≥2 Snellen lines and/or >5° visual field gain) or no improvement.
RESULTS: Mean age was 55.5±12.9y, with 56.9% females. Median duration of ethambutol use was 9mo (range: 2-20) at a mean daily dose of 19.7±5.3 mg/kg. At presentation, mean visual acuity was 1.3 logMAR (range: 0-2.5), with normal fundus appearance in 72.4% of eyes. The most common visual field defect was generalized depression (52.4%). After ethambutol cessation, 56.9% of patients had visual improvement. Younger age (50.24±13.8y vs 62.14±8.9y, P<0.01), lower ethambutol dose (17.3±5 vs 23.3±2.9 mg/kg·d, P<0.01), shorter treatment duration (6.79±2.6mo vs 10.27±1.2mo, P<0.01), and absence of hypertension (16% vs 83%, P=0.012) or kidney disease (0 vs 83%, P<0.01) were associated with higher likelihood of visual improvement. Diabetes did not differ between groups (P=0.889).
CONCLUSION: Over half experience visual recovery after ethambutol cessation. Younger age, lower cumulative dose, absence of hypertension or kidney disease predict better visual outcomes.
METHODS: Retrospective study of 58 EON patients at an Indonesian eye center (2017-2022). Demographics, ethambutol treatment, ophthalmologic findings were collected. Visual outcomes after ethambutol cessation assessed at 3-12mo. Patients categorized as having visual improvement (≥2 Snellen lines and/or >5° visual field gain) or no improvement.
RESULTS: Mean age was 55.5±12.9y, with 56.9% females. Median duration of ethambutol use was 9mo (range: 2-20) at a mean daily dose of 19.7±5.3 mg/kg. At presentation, mean visual acuity was 1.3 logMAR (range: 0-2.5), with normal fundus appearance in 72.4% of eyes. The most common visual field defect was generalized depression (52.4%). After ethambutol cessation, 56.9% of patients had visual improvement. Younger age (50.24±13.8y vs 62.14±8.9y, P<0.01), lower ethambutol dose (17.3±5 vs 23.3±2.9 mg/kg·d, P<0.01), shorter treatment duration (6.79±2.6mo vs 10.27±1.2mo, P<0.01), and absence of hypertension (16% vs 83%, P=0.012) or kidney disease (0 vs 83%, P<0.01) were associated with higher likelihood of visual improvement. Diabetes did not differ between groups (P=0.889).
CONCLUSION: Over half experience visual recovery after ethambutol cessation. Younger age, lower cumulative dose, absence of hypertension or kidney disease predict better visual outcomes.