"乙胺丁醇诱导视神经病变的神经影像学：及时的 MRI 可挽救视力"。

"Neuroimaging in ethambutol induced optic neuropathy: MRI in time can save the vision".

机构信息

Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560029, India.

出版信息

Indian J Tuberc. 2021 Jul;68(3):408-411. doi: 10.1016/j.ijtb.2020.09.014. Epub 2020 Sep 18.

DOI:10.1016/j.ijtb.2020.09.014

PMID:34099211

Abstract

Ethambutol is an integral part of Antitubercular therapy (ATT) and is often associated with optic neuropathy, However, neuroimaging of ethambutol induced optic neuropathy has been sparsely reported in the literature. We describe the case of a 45-year male patient, diagnosed as Tuberculous spondylodiscitis and was on ATT. Four months after ATT initiation, he presented with visual blurring in both the eyes with bitemporal hemianopia and central scotomas. Visual evoked potential (VEP) revealed prolonged latencies in N75 and P100 waveforms bilaterally. Magnetic Resonance Imaging (MRI) showed optic chiasma and bilateral optic tract hyperintensities on 3D Fluid Attenuated Inversion Recovery (FLAIR) and 3D Double Inversion Recovery (DIR) sequences. Ethambutol was discontinued immediately. On follow-up after 8 weeks, visual acuity reversed back to normal in both eyes.

摘要

乙胺丁醇是抗结核治疗（ATT）的重要组成部分，常与视神经病变相关。然而，乙胺丁醇引起的视神经病变的神经影像学在文献中报道较少。我们描述了一例 45 岁男性患者，诊断为结核性脊椎炎，正在接受 ATT。在 ATT 开始后 4 个月，他出现双眼视力模糊，伴有双颞侧偏盲和中央暗点。视觉诱发电位（VEP）显示双侧 N75 和 P100 波潜伏期延长。磁共振成像（MRI）显示 3D 液体衰减反转恢复（FLAIR）和 3D 双反转恢复（DIR）序列上视交叉和双侧视神经束高信号。立即停用乙胺丁醇。随访 8 周后，双眼视力均恢复正常。