A PROSPECTIVE STUDY OF OCULAR TOXICITY IN PATIENTS RECEIVING ETHAMBUTOL IN A TERTIARY HEALTH CARE HOSPITAL IN KOLKATA, EASTERN INDIA.

Abstract

BACKGROUND:India accounts highest burden of tuberculosis cases about 2.64millions with incidence of 193 in year 2019(WHO). India is among the largest countries to implement National Tuberculosis Elimination Program(previously known as RNTCP). This program provides now daily regimen to the patients,where patients have to take daily dosage of ethambutol according to the body weight category of patients along with others ATDs ,which is a cause of concern,particular with regard to the ocular toxicity of ethambutol.The present study was undertaken to explore the ocular toxicity in the newly diagnosed cases of tuberculosis patients registered under the program in terms of visual acuity,color vision,optic disc ndings,visual eld and IOP changes. :EarlyAIMS AND OBJECTIVES detection of ocular changes due to ethambutol toxicity and early stoppage of ethambutol from the further ocular damages. STUDY DESIGNS:Hospital based prospective observational study for approximately one year(April 2020 to March 2021) in a tertiary health care centre in Kolkata. Both eyes of 53 newly diagnosed tuberculosis patients were examined prior to start ATDs(including ethambutol),fourMETHODS: and eight weeks after initiation phases and anytime within eight weeks in case of sudden onset of ocular complaints.Visual acuity,color vision,optic disc ndings,eld of vision,IOP were noted,tabulated and analyzed. Out of 106 eyes in 53 patients, decrease in visualRESULTS: acuity was seen in 10eyes(9.43%) ,impairment in red-green color in 12eyes(11.32%),optic disc abnormalities in 6eyes(5.66%) and visual eld changes were seen in 8eyes(7.55%).The defects were bilateral in all cases.There were no signicant changes in IOP within 8weeks commencement of ethambutol therapy.The patients with ocular changes were advised to stop ethambutol and showed signicant improvement in vision on follow up later. In our study populations of 53 patients, 6patients (11.32%)were found with ocular changes due toCONCLUSION: ethambutol toxicity. So early detection of ocular changes due to ethambutol toxicity has great importance for its prevention.So baseline ophthalmological examination prior to start ethambutol and periodic follow up can prevent untoward irreversible vision loss due to ethambutol toxicity.