Ethambutol neuroretinopathy

Abstract

Objective: To describe the clinical features of ethambutol neuroretinopathy.

Design: Case report and meta-analysis of the literature.

Participants: A patient with clinical and electrophysiological findings suggestive of ethambutol neuroretinopathy.

Testing: Electroretinogram, electro-oculogram and visual fields.

Main outcome measure: Clinical and electrophysiological findings.

Results: 101 cases were reviewed, retinal findings include retinal pigment epithelial changes, macular edema, flame-shaped hemorrhages. Electroretinogram findings include decreased amplitude and abnormal wave pattern in full field ERG, multifocal or pattern ERG and electro-oculogram findings include abnormal Arden ratio.

Conclusions: Clinical, electrophysiological and in vitro studies support the toxic effect of ethambutol on the retina. Therefore ethambutol ocular toxicity may be a neuroretinopathy.