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

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 cl...

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Autores principales: Sheng, Wen-Yan, Wu, Shuang-Qing, Su, Ling-Ya, Zhu, Li-Wei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8771374/
https://www.ncbi.nlm.nih.gov/pubmed/35097092
http://dx.doi.org/10.12998/wjcc.v10.i2.663
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author Sheng, Wen-Yan
Wu, Shuang-Qing
Su, Ling-Ya
Zhu, Li-Wei
author_facet Sheng, Wen-Yan
Wu, Shuang-Qing
Su, Ling-Ya
Zhu, Li-Wei
author_sort Sheng, Wen-Yan
collection PubMed
description 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.
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spelling pubmed-87713742022-01-28 Ethambutol-induced optic neuropathy with rare bilateral asymmetry onset: A case report Sheng, Wen-Yan Wu, Shuang-Qing Su, Ling-Ya Zhu, Li-Wei World J Clin Cases Case Report 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. Baishideng Publishing Group Inc 2022-01-14 2022-01-14 /pmc/articles/PMC8771374/ /pubmed/35097092 http://dx.doi.org/10.12998/wjcc.v10.i2.663 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Case Report
Sheng, Wen-Yan
Wu, Shuang-Qing
Su, Ling-Ya
Zhu, Li-Wei
Ethambutol-induced optic neuropathy with rare bilateral asymmetry onset: A case report
title Ethambutol-induced optic neuropathy with rare bilateral asymmetry onset: A case report
title_full Ethambutol-induced optic neuropathy with rare bilateral asymmetry onset: A case report
title_fullStr Ethambutol-induced optic neuropathy with rare bilateral asymmetry onset: A case report
title_full_unstemmed Ethambutol-induced optic neuropathy with rare bilateral asymmetry onset: A case report
title_short Ethambutol-induced optic neuropathy with rare bilateral asymmetry onset: A case report
title_sort ethambutol-induced optic neuropathy with rare bilateral asymmetry onset: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8771374/
https://www.ncbi.nlm.nih.gov/pubmed/35097092
http://dx.doi.org/10.12998/wjcc.v10.i2.663
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