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Global issues
Ethambutol-induced optic neuropathy: a nationwide population-based study from Taiwan
  1. Hsin-Yi Chen1,2,
  2. Shi-Wei Lai3,4,
  3. Chih-Hsin Muo5,
  4. Pei-Chun Chen5,6,
  5. I-Jong Wang1,7
  1. 1Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
  2. 2Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan
  3. 3School of Medicine, China Medical University, Taichung, Taiwan
  4. 4Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
  5. 5Management Office for Health Data, China Medical University and Hospital, Taichung, Taiwan
  6. 6Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei, Taiwan
  7. 7Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
  1. Correspondence to Dr Pei-Chun Chen, Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei 100, Taiwan; peichunchen{at}ntu.edu.tw, Dr I-Jong Wang, Department of Ophthalmology, National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei 100, Taiwan; ijong{at}ms8.hinet.net

Abstract

Aim To investigate the risk factors and comorbidities associated with ethambutol-induced optic neuropathy (EON).

Method Using the Taiwan Longitudinal Health Insurance Database, we conducted a study within a nationwide representative cohort of patients treated with EMB. We identified 231 patients newly diagnosed with EON between 2000 and 2008, and 924 control subjects. Adjusted OR by estimating the risk of EON in relation to comorbidities and EMB prescription protocol was determined.

Results Compared with the control group, EON patients were at risk with older age, hypertension (adjusted OR=1.62, 95% CI 1.16 to 2.26) and renal diseases (without end-stage renal diseases (ESRD), adjusted OR=2.11, 95% CI 1.02 to 4.35; with ESRD, adjusted OR=3.73, 95% CI 1.79 to 7.74). Patients with an EMB prescription duration longer than 3 months were not at elevated risk compared with those whose prescription less than 3 months (OR=1.35, 95% CI 0.99 to 1.83, adjusted for age, sex, hypertension and renal diseases). Patients whose average daily dose was greater than 1200 mg, compared with the other two groups (800∼1199 mg, less than 800 mg) were not at increased risk for EON.

Conclusions Age, hypertension and renal diseases are risk factors for EON in the Taiwanese population.

  • Epidemiology
  • Eye (Globe)
  • Optic Nerve

https://doi.org/10.1136/bjophthalmol-2012-301870

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      Harminder Singh Dua Arun D Singh
      British Journal of Ophthalmology 2012; 96 i-i Published Online First: 17 Oct 2012. doi: 10.1136/bjophthalmol-2012-302676