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KMID : 0360220150560121997
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Journal of the Korean Ophthalmological Society
2015 Volume.56 No. 12 p.1997 ~ p.2003
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Bitemporal Hemianopsia in Ethambutol-Induced Optic Neuropathy
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이혜진:Lee Hye-Jin
유수리나:Rhiu Soolienah/이선호:Lee Sun-Ho/정진호:Jeong Jin-Ho
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Abstract
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Purpose: To report three cases with bitemporal hemianopsia after using ethambutol to treat tuberculosis.
Case summary: A 50-year-old male with chronic renal failure and tuberculous pleurisy, a 57-year-old male with diabetic retinopathy and pulmonary tuberculosis, and a 59-year-old male with diabetes and pulmonary tuberculosis were referred for evaluation due to decreased visual acuity for several months after taking ethambutol to treat tuberculosis. All 3 patients had abnormal color vision and visual evoked potential in both eyes. Visual field showed bitemporal hemianopsia with or without central scotoma. Brain imaging tests were normal. Although ethambutol was discontinued in all three patients, one patient with renal disease showed further decrease in visual acuity and visual field worsened to total field defect.
Conclusions: Ethambutol-induced optic neuropathy is a wide spectrum disorder and based on our cases, can present as bitemporal hemianopsia mimicking compressive chiasmal lesions. A thorough history should be taken and immediate discontinuation of ethambutol is recommended in cases when bitemporal hemianopia occurs.
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KEYWORD
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Bitemporal hemianopsia, Ethambutol, Optic chiasm, Optic neuropathy, Tuberculosis
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