ĐẶC ĐIỂM LÂM SÀNG VÀ CẬN LÂM SÀNG BỆNH LÝ THỊ THẦN KINH DO ETHAMBUTOL TẠI BỆNH VIỆN PHỔI TRUNG ƯƠNG

Abstract

Objective: To describe the epidemiological characteristics, clinical manifestations and optic nerve involvement related to ethambutol at the National Lung Hospital. Methods: A cross-sectional case series was conducted, including patients undergoing ethambutol treatment who presented with optic neuropathy between August 2024 and August 2025, excluding those with pre-existing optic nerve disease. Results: A total of 48 patients were enrolled, with males accouting for 54.2% and females 45,8%. The mean age was 54.6 ± 14.8 years. The mean duration of ethambutol was 5.83 ± 2.66 months (range 1.5-15 months). The most common daily dose was 1000-1250 mg (54.2%), followed by 750-1000 mg (29.1%) and ≥ 1250 mg (16.7%). The mean weight-adjusted dose was 19.43 ± 2.97 mg/kg. The average time to onset of blurred vision was 5.0 ± 2.59 months (earliest 1 month, latest 14.5 months). Blurred vision was the predominant initial symtom, observed in 93.8% of patients, whereas color vision disturbances were reported in only 6.2%. Conclusion: Ethambutol-induced optic neuropathy was observed predominantly in middle-aged patients after an average treatment duration of approximately six months at a mean dose of ~20mg/kg. Blurred vision was the most common initial symtoms, whereas color vision disturbances were less frequent. Regular ophthalmic monitoring and early recognition of visual symptoms are essential to minimize the risk of irreversible vision loss.