J Korean Ophthalmol Soc > Volume 56(12); 2015 > Article
Journal of the Korean Ophthalmological Society 2015;56(12):1997-2003.
DOI: https://doi.org/10.3341/jkos.2015.56.12.1997    Published online December 15, 2015.
Bitemporal Hemianopsia in Ethambutol-Induced Optic Neuropathy.
Hye Jin Lee, Soolienah Rhiu, Sun Ho Lee, Jin Ho Jeong
1Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea. amario@naver.com
2Department of Ophthalmology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
양이측반맹을 보인 에탐부톨 시신경병증
이혜진1⋅유수리나2⋅이선호1⋅정진호1
제주대학교 의학전문대학원 안과학교실1, 한림대학교 의과대학 동탄성심병원 안과학교실2
Received: 12 June 2015   • Revised: 14 October 2015   • Accepted: 24 November 2015
Abstract
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.
Key Words: Bitemporal hemianopsia;Ethambutol;Optic chiasm;Optic neuropathy;Tuberculosis


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