Background: Ethambutol hydrochloride and linezolid are commonly used anti-tuberculous agents. Both agents can cause potentially blinding toxic optic neuropathy. Currently there is no low-cost, sensitive screening tool to detect early toxicity before permanent vision loss has occurred. Purpose: To evaluate the ability of the Adams D-15 colour vision test to detect early ethambutol- and linezolid-induced optic neuropathy. Methods: This was a retrospective case series of 15 patients who were screened for ethambutol- and linezolid-induced toxic optic neuropathy. At screening and follow-up visits, a detailed clinical history was taken, a standard of care examination performed and a battery of side-room investigations conducted, including: Farnsworth Munsell D15 (FM D15) and Adams D15 colour vision tests, retinal nerve fiber layer optical coherence tomography (RNFL-OCT) and a Humphrey visual field 24-2 (HVF 24-2). According to the results of these tests, the patients were classified into 3 groups: “No toxicity”, “Uncertain toxicity” or “Confirmed toxicity”. Results: Six patients were classified as “No toxicity”, 3 were “Uncertain toxicity” and 6 were classified as “Confirmed toxicity”. The Adams D15 showed a sensitivity of 100% for detecting a toxic optic neuropathy. Conclusion: The Adams D15 is a sensitive screening tool for the detection of early ethambutol- and linezolid-induced optic neuropathy.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uct/oai:localhost:11427/36200 |
| Date | 22 March 2022 |
| Creators | Van der Merwe, Pieter Jacobus Stephanus |
| Contributors | Tinley, Christopher |
| Publisher | Faculty of Health Sciences, Division of General Surgery |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Master Thesis, Masters, MMed |
| Format | application/pdf |
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