Ethambutol 在 HIV 积极病人导致了有毒的眼的神经病

• 作者: Colin Cook Graeme Rogers Hamzah Mustak
• 来源期刊: 国际眼科杂志：英文版
• 学科: 医学
• 关键词: ETHAMBUTOL HIV TOXIC opticneuropathy
• 年，卷（期）: 2013,（4）
• 页码范围: 542-545
• 页数: 4页
• 分类号: R774.6

摘要

AIM:To determine whether HIV and the use of antiretroviral therapy is a risk factor for the development of ethambutol toxic optic neuropathy.To describe the clinical course of ethambutol toxic optic neuropathy in patients with HIV and to identify prognostic factors.·METHODS:The case notes of 14 consecutive patients referred to the neuro-ophthalmology clinic were reviewed.Data regarding HIV status,antiretroviral therapy,visual function,ethambutol therapy dosage,and ethambutol therapy duration were collected and analysed.·RESULTS:Eleven of the 14 patients were HIV positive.Ten of the HIV positive patients were receiving antiretroviral therapy.The mean dose of ethambutol was17.25mg/kg/day.No statistically significant difference in mean dose,duration of therapy,age or CD4 count was found between those who showed visual improvement and those who did not.Delay in presentation of more than one month post symptom onset was correlated with poor visual outcome(P =0.001).·CONCLUSION:HIV and,perhaps more importantly,the potential mitochondrial toxic effects of Nucleoside analogue reverse transcriptase inhibitors(NRTIs) may be a risk factor for the development of toxic optic neuropathy from ethambutol therapy via a multiple hit effect.Delay in presentation results in poor visual outcome.Regular monitoring is recommended for HIV positive patients receiving antiretrovirals and requiring ethambutol therapy in order to avoid permanent visual loss.