Posters

Bilateral optic neuropathy induced by antituberculous therapy: report of 2 cases

Poster Details

First Author: K.Rifai MOROCCO

Co Author(s): S. Moutamani   A. Amazouzi   L. Cherkaoui              

Abstract Details

Purpose:

The purpose of this study is to show that Despite their high efficacy, the antibacillary chemotherapy may be responsible for potentially serious side effects that require careful control during treatment.Through this observation, we insist on the risk of optic neuropathy induced by antibacillary chemotherapy, particularly ethambutol and isoniazid.

Setting:

Optic neuropathy toxic to Ethambutol remains relevant with the resurgence of tuberculosis cases.We will report the cases of the two patients, poorly supervised, falling within this framework.This is a retrospective study of 02 cases (02 women) treated in ophthalmology department of the moroccan hospital of specialties in rabat during 2018.

Methods:

The two patients were initially seen in consultation for a sharp and severe visual acuity drop after  few months of treatment with Ethambutol in combination with the other three anti-tuberculosis drugs, but without any other neurotoxic treatment. Both patients were followed for 9 and 12 months, monthly with measurement of visual acuity, ocular pressure, the optic fundus examination , the visual field, the color vision test , and the visual evoked potentials.

Results:

The patients were admitted to the emergency department for bilateral visual decrease  with a central scotoma. The interrogation founds the concept of antibacillary chemotherapy started 4 months  ago for the treatment of pulmonary tuberculosis;  a notion of hearing impairment and tingling of the upper limbs. Ophthalmologic examination revealed visual acuity reduced to 1/10 in both eyes, with bilateral papillary oedema in the fundus. Para-clinical investigations allowed the diagnosis of bilateral optic neuropathy related to the toxicity of antibacillary chemotherapy. Ethambutol was stopped and the patients start vitaminotherapy. The evolution was marked by a slight improvement of the visual acuity.

Conclusions:

The main complication of ethambutol is Bilateral toxic retrobulbar optic neuritis . The diagnosis is evoked by a decrease in visual acuity and a bilateral central scotoma in the visual field. Eye control during treatment for tuberculosis is necessary to avoid this blindings complications.

Financial Disclosure:

None