■这项研究的目的是调查其特征,临床表现,发病率,泰国人群乙胺丁醇诱导的视神经病变(EON)的危险因素。
■2012年1月至2019年8月,在泰国一家三级医院的病历中回顾性发现了接受乙胺丁醇治疗的结核病(TB)患者。通过回顾眼科记录确定EON的发展。对EON患者和无EON患者进行比较,以确定可能的危险因素。对眼科结果进行了表征。
■在接受乙胺丁醇治疗的4141名患者中,1,062人遇到了眼科疾病,和20(总体0.5%,1.88%的眼科遭遇)发展为EON。在未经调整的分析中,与没有EON的患者相比,EON患者的日剂量相似,但乙胺丁醇治疗持续时间较长(P=0.02)。他们年龄较大(平均43.74vs.58.60年,P=0.001),更可能有高血压(P=0.02)和吸烟(P=0.01)。没有性别差异,身体质量指数,糖尿病,血脂异常,HIV感染或肾小球滤过率。乳头周围视网膜神经纤维层,神经节细胞分析,使用视网膜光学相干断层扫描测量的血管密度受到EON的影响。在调整逻辑回归分析中,年龄大于60岁(OR=8.71,p=0.01)和吸烟(OR=7.06,p=0.01)是EON的独立危险因素。
■在用乙胺丁醇治疗的患者中,在服用乙胺丁醇的患者中,EON的发生率为0.5%,在服用乙胺丁醇和眼科就诊的患者中为1.88%。潜在的EON危险因素是年龄,高血压,吸烟,和乙胺丁醇药物的持续时间。在先前的研究中,吸烟与EON无关。
UNASSIGNED: The purpose of this research was to investigate the characteristics, clinical manifestations, incidence, and risk factors in ethambutol-induced optic neuropathy (EON) in the Thai population.
UNASSIGNED: Patients treated with
ethambutol for tuberculosis (TB) were retrospectively identified in the medical record of a tertiary hospital in Thailand from January 2012 to August 2019. Development of EON was determined through review of ophthalmology records. Comparison was made between patients with EON and those without EON to identify possible risk factors. Ophthalmic outcomes were characterized.
UNASSIGNED: Among 4,141 patients who received ethambutol for TB treatment, 1,062 had an ophthalmology encounter, and 20 (0.5% overall, 1.88% with ophthalmology encounters) developed EON. In unadjusted analysis, compared to patients without EON, those with EON had a similar daily dose, but longer duration of
ethambutol treatment (P=0.02). They were older (mean 43.74 vs. 58.60 years, P=0.001), more likely to have hypertension (P=0.02) and smoke (p=0.01). There were no differences in gender, body mass index, diabetes, dyslipidemia, HIV infection or glomerular filtration rate. The peripapillary retinal nerve fiber layer, ganglion cell analysis, and vascular density as measured using retinal optical coherence tomography were impacted by EON. In adjusted logistic regression analysis, age greater than 60 (OR = 8.71, p = 0.01) and smoking (OR = 7.06, p = 0.01) were independent risk factors for EON.
UNASSIGNED: In patients treated with
ethambutol, the incidence proportion of EON was 0.5% among those with
ethambutol administered and 1.88% among those with
ethambutol and an eye visit. Potential EON risk factors were age, hypertension, smoking, and duration of
ethambutol medication. Smoking has not been associated with EON in prior studies.