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Case Report
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| Bilateral retrobulbar neuritis following cessation of ethambutol | ||||||
| Vivekanand Undrakonda1, Yashodhara B.M.2, Sarita Gonsalves3, Shashikiran U.4, Smita Kapoor5 | ||||||
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1MS, DNB, Professor, Department of Ophthalmology, Alluri Sitarama Raju Academy of Medical Sciences, Eluru, Andhra Pradesh, India.
2MD MRCP (UK), MRCPS (Glasgow), Professor, Department of Medicine, MMMC, Melaka, Malaysia. 3MS, DNB, Senior Resident, Department of Ophthalmology, Kasturba Medical College, Madhav Nagar, Manipal, Karnataka, India. 4MD, Professor and HOD, Department of General Medicine, Mellaka Manipal Medical College, Madhav Nagar, Manipal, Karnataka, India. 5MBBS, Junior Resident, Department of Ophthalmology, Kasturba Medical College, Madhav Nagar, Manipal, Karnataka, India. | ||||||
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| How to cite this article |
| Undrakonda V, Yashodhara BM, Gonsalves S, Shashikiran U, Kapoor S. Bilateral retrobulbar neuritis following cessation of ethambutol. Int J Case Rep Images 2015;6(2):76–80. |
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Abstract
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Introduction:
Ethambutol related ocular toxicity, is a well-documented fact. In spite of this a regular visual acuity examination is missed during treatment and follow-ups.
Case Report: A 35-year-old male diagnosed with tuberculosis of spine, who was on antitubercular drugs for more than one year presented with complains of acute diminution of vision in both eyes two months following cessation of ethambutol. Visual electrode potential (VEP) showed prolongation of latency of P100 bilaterally based on which a diagnosis of ethambutol induced bilateral retrobulbar neuritis was made. Patient was started on intravenous methylprednisolone 1 g/day for three days which was followed by 11 days of oral steroids (1 mg/kg) which was tapered off over next 15 days. On follow-up patient showed signs of improvement in visual acuity and visual fields over the next six months. Conclusion: Visual symptoms may revert if prompt action is taken that include discontinuation of ethambutol and supplementation of pyridoxine along with steroids like in our case. Pharmacovigilance on patients receiving antitubercular drugs for exact dosage, drug combinations and duration is necessary to avoid untoward complications. | |
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Keywords:
Antitubercular drugs, Ethambutol toxicity, Retrobulbar neuritis, Scotoma, Visual acuity
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Author Contributions
Vivekanand Undrakonda – Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Yashodhara B. M. – Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Sarita Gonsalves – Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Shashikiran U. – Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Smita Kapoor – Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2015 Vivekanand Undrakonda et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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