Bilateral optic neuropathy due to combined ethambutol and isoniazid treatment. 1979

G Karmon, and H Savir, and D Zevin, and J Levi

The case of a 40-year-old patient who underwent an unsuccessful cadaver kidney transplantation and was treated with ethambutol and isoniazid is reported. A bilateral retrobulbar neuropathy with an unusual central bitemporal hemianopic scotoma was found. Ethambutol was stopped and only small improvement of the visual acuity followed. Isoniazid was discontinued later, followed by a dramatic improvement in the visual acuity. The hazards of optic nerve toxicity due to ethambutol are known. We emphasize the potential danger in the use of ethambutol and isoniazid.

UI MeSH Term Description Entries
D007538 Isoniazid Antibacterial agent used primarily as a tuberculostatic. It remains the treatment of choice for tuberculosis. Isonicotinic Acid Hydrazide,Ftivazide,Isonex,Isonicotinic Acid Vanillylidenehydrazide,Phthivazid,Phthivazide,Tubazide,Acid Vanillylidenehydrazide, Isonicotinic,Hydrazide, Isonicotinic Acid,Vanillylidenehydrazide, Isonicotinic Acid
D008297 Male Males
D009901 Optic Nerve Diseases Conditions which produce injury or dysfunction of the second cranial or optic nerve, which is generally considered a component of the central nervous system. Damage to optic nerve fibers may occur at or near their origin in the retina, at the optic disk, or in the nerve, optic chiasm, optic tract, or lateral geniculate nuclei. Clinical manifestations may include decreased visual acuity and contrast sensitivity, impaired color vision, and an afferent pupillary defect. Cranial Nerve II Diseases,Foster-Kennedy Syndrome,Optic Disc Disorders,Optic Disk Disorders,Optic Neuropathy,Second Cranial Nerve Diseases,Cranial Nerve II Disorder,Neural-Optical Lesion,Disc Disorder, Optic,Disk Disorder, Optic,Disorder, Optic Disc,Foster Kennedy Syndrome,Lesion, Neural-Optical,Neural Optical Lesion,Neural-Optical Lesions,Neuropathy, Optic,Optic Disc Disorder,Optic Disk Disorder,Optic Nerve Disease,Optic Neuropathies,Syndrome, Foster-Kennedy
D004977 Ethambutol An antitubercular agent that inhibits the transfer of mycolic acids into the cell wall of the tubercle bacillus. It may also inhibit the synthesis of spermidine in mycobacteria. The action is usually bactericidal, and the drug can penetrate human cell membranes to exert its lethal effect. (From Smith and Reynard, Textbook of Pharmacology, 1992, p863) Dexambutol,EMB-Fatol,EMB-Hefa,Etambutol Llorente,Ethambutol Hydrochloride,Etibi,Miambutol,Myambutol,EMB Fatol,EMB Hefa,Hydrochloride, Ethambutol,Llorente, Etambutol
D006423 Hemianopsia Partial or complete loss of vision in one half of the visual field(s) of one or both eyes. Subtypes include altitudinal hemianopsia, characterized by a visual defect above or below the horizontal meridian of the visual field. Homonymous hemianopsia refers to a visual defect that affects both eyes equally, and occurs either to the left or right of the midline of the visual field. Binasal hemianopsia consists of loss of vision in the nasal hemifields of both eyes. Bitemporal hemianopsia is the bilateral loss of vision in the temporal fields. Quadrantanopsia refers to loss of vision in one quarter of the visual field in one or both eyes. Hemianopsia, Binasal,Hemianopsia, Bitemporal,Hemianopsia, Homonymous,Quadrantanopsia,Altidudinal Hemianopia,Altitudinal Hemianopsia,Binasal Hemianopia,Bitemporal Hemianopia,Hemianopia,Homonymous Hemianopia,Quadrantanopia,Altidudinal Hemianopias,Altitudinal Hemianopsias,Binasal Hemianopias,Binasal Hemianopsia,Binasal Hemianopsias,Bitemporal Hemianopias,Bitemporal Hemianopsia,Bitemporal Hemianopsias,Hemianopia, Altidudinal,Hemianopia, Binasal,Hemianopia, Bitemporal,Hemianopia, Homonymous,Hemianopias,Hemianopias, Altidudinal,Hemianopias, Binasal,Hemianopias, Bitemporal,Hemianopias, Homonymous,Hemianopsia, Altitudinal,Hemianopsias,Hemianopsias, Altitudinal,Hemianopsias, Binasal,Hemianopsias, Bitemporal,Hemianopsias, Homonymous,Homonymous Hemianopias,Homonymous Hemianopsia,Homonymous Hemianopsias,Quadrantanopias,Quadrantanopsias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012607 Scotoma A localized defect in the visual field bordered by an area of normal vision. This occurs with a variety of EYE DISEASES (e.g., RETINAL DISEASES and GLAUCOMA); OPTIC NERVE DISEASES, and other conditions. Scotoma, Arcuate,Scotoma, Bjerrum,Scotoma, Central,Scotoma, Centrocecal,Scotoma, Altitudinal,Scotoma, Paracecal,Scotoma, Paracentral,Scotoma, Peripheral,Scotoma, Ring,Scotoma, Scintillating,Scotoma, Sector,Altitudinal Scotoma,Altitudinal Scotomas,Arcuate Scotoma,Arcuate Scotomas,Bjerrum Scotoma,Bjerrum Scotomas,Central Scotoma,Central Scotomas,Centrocecal Scotoma,Centrocecal Scotomas,Paracecal Scotoma,Paracecal Scotomas,Paracentral Scotoma,Paracentral Scotomas,Peripheral Scotoma,Peripheral Scotomas,Ring Scotoma,Ring Scotomas,Scintillating Scotoma,Scintillating Scotomas,Scotomas,Scotomas, Altitudinal,Scotomas, Arcuate,Scotomas, Bjerrum,Scotomas, Central,Scotomas, Centrocecal,Scotomas, Paracecal,Scotomas, Paracentral,Scotomas, Peripheral,Scotomas, Ring,Scotomas, Scintillating,Scotomas, Sector,Sector Scotoma,Sector Scotomas
D014794 Visual Fields The total area or space visible in a person's peripheral vision with the eye looking straightforward. Field, Visual,Fields, Visual,Visual Field
D016030 Kidney Transplantation The transference of a kidney from one human or animal to another. Grafting, Kidney,Renal Transplantation,Transplantation, Kidney,Transplantation, Renal,Kidney Grafting,Kidney Transplantations,Renal Transplantations,Transplantations, Kidney,Transplantations, Renal

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