Posters

The miracle of intravenous methylprednisolone in a case blinded due to ethambutol toxic optic neuropathy

Poster Details

First Author: K. Bhutia INDIA

Co Author(s):    N. Lomi   K. Pradhan   P. Singh              

Abstract Details

Purpose:

Case report on possible role of Intravenous Methylprednisolone for treatment of Ethambutol Toxic Optic Neuropathy

Setting:

Sikkim manipal institute of medical sciences, Gangtok, India

Methods:

A 30 year old male with sputum positive pulmonary tuberculosis presented with PL positive and PR negative on all quadrants in both eyes after 10days of receiving 1200 mg of ethambutol per day as a part of Category I Anti Tubercular Treatment. Pupils were fixed and non‐reactive to light, rest of anterior and posterior segment and MRI (brain and orbit) were normal. Ethambutol was discontinued and slow IV methylprednisolone 1gm per day in 250ml of 5% dextrose was started over 1hour for three days followed by oral prednisolone at 1mg/kg/day for 1 month in a tapering dose every week.

Results:

Visual acuity and color vision improved dramatically over one month. On last follow up in 3 months there was drastic vision gain to 6/9 on both eyes and color vision were normal on both eyes.

Conclusions:

Besides discontinuing ethambutol, giving IV methylprednisolone may have a beneficial role in a desperate situation with bilateral sudden diminution of vision due to ethambutol associated toxic optic neuropathy.

Financial Disclosure:

NONE