{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:32:59Z","timestamp":1787776379992,"version":"build-2784847793"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 3","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To characterize the severity of vision loss, dose-related adverse effects, and visual outcomes in ethambutol-induced toxic optic neuropathy (ETON) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective observational study was conducted in a tertiary eye center in South India between July 2019 and December 2021. Consecutive adults (age &gt;18 years) taking revised antitubercular regimens and diagnosed with ETON were included. Data collected regarding patient demographics, presentation, dose-related severity of vision loss, and visual outcomes after drug discontinuation were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We analyzed 214 eyes from 107 patients (mean age: 51.1 \u00b1 13 years; male: female ratio = 2:1). The median follow-up time was 11 months (interquartile range: 4\u201314 months). Mean visual acuity improved from 1.2 \u00b1 0.6 log of minimum angle of resolution (logMAR) at presentation to 0.8 \u00b1 0.6 logMAR at the final follow-up. Patients above 60 years old had the worst visual acuity at presentation and had the least improvement at the last follow-up compared to those in younger age groups (1.3\u20131.2 logMAR,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.2). The mean exposure time to ethambutol was 6.8 \u00b1 3.3 months, and the mean dose was 1042 \u00b1 247 mg\/day, that is, 16.7 \u00b1 4 mg\/kg\/day. Mean presenting best corrected visual acuity (BCVA; 1.3 \u00b1 0.6 logMAR) was worse in patients taking a higher dose of ethambutol (\u226516 mg\/kg) compared to those taking &lt;16 mg\/kg (mean BCVA: 1 \u00b1 0.5 logMAR).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Higher age and higher doses of ethambutol were associated with an increased risk of vision loss and worse vision at presentation. Prolonged exposure to high-dose ethambutol, as in fixed drug dose combinations, leads to severe visual impairment which might be partially reversible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_1807_24","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T05:00:15Z","timestamp":1748581215000},"page":"S484-S491","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Clinical profile and visual outcomes in ethambutol-induced toxic optic neuropathy"],"prefix":"10.4103","volume":"73","author":[{"given":"Jenil","family":"Sheth","sequence":"first","affiliation":[{"name":"Department of Pediatric, Strabismus and Neuro-ophthalmology, Shantilal Shanghvi Eye Institute, Wadala, Mumbai, Maharashtra, India"},{"name":"Child Sight Institute, Jasti V Ramanamma Children\u2019s Eye Care Centre, L.V. Prasad Eye Institute, Kallam Anji Reddy Campus, L.V. Prasad Marg, Banjara Hills, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virender","family":"Sachdeva","sequence":"additional","affiliation":[{"name":"Child Sight Institute, Nimmagadda Prasad Children\u2019s Eye Care Centre, L.V. Prasad Eye Institute, GMRV Campus, Hanumanthawaka Junction, Visakhapatnam, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashima","family":"Goyal","sequence":"additional","affiliation":[{"name":"Department of Pediatric, Strabismus and Neuro-ophthalmology, P C Sharma Eye Hospital, Ambala City, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditi","family":"Parikh","sequence":"additional","affiliation":[{"name":"Academy for Eye Care Education, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Nalawade","sequence":"additional","affiliation":[{"name":"Child Sight Institute, Jasti V Ramanamma Children\u2019s Eye Care Centre, L.V. Prasad Eye Institute, Kallam Anji Reddy Campus, L.V. Prasad Marg, Banjara Hills, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hardik","family":"Nanavati","sequence":"additional","affiliation":[{"name":"Department of Pediatric, Strabismus and Neuro-ophthalmology, Shantilal Shanghvi Eye Institute, Wadala, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh","family":"Kekunnaya","sequence":"additional","affiliation":[{"name":"Child Sight Institute, Jasti V Ramanamma Children\u2019s Eye Care Centre, L.V. Prasad Eye Institute, Kallam Anji Reddy Campus, L.V. Prasad Marg, Banjara Hills, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"R1-20260422","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1097\/ICU.0000000000000416","article-title":"Ethambutol optic neuropathy","volume":"28","author":"Chamberlain","year":"2017","journal-title":"Curr Opin Ophthalmol"},{"key":"R2-20260422","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1001\/archopht.1962.00960020566009","article-title":"Ocular manifestations of ethambutol: Toxic amblyopia after administration of an experimental antituberculous drug","volume":"67","author":"Carr","year":"1962","journal-title":"Arch Ophthalmol"},{"key":"R3-20260422","article-title":"India TB Report 2022: Central TB Division"},{"key":"R4-20260422","doi-asserted-by":"crossref","first-page":"3734","DOI":"10.4103\/ijo.IJO_3746_20","article-title":"Ethambutol toxicity: Expert panel 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Ophthalmol"},{"key":"R11-20260422","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1136\/bjophthalmol-2012-301870","article-title":"Ethambutol-induced optic neuropathy: A nationwide population-based study from Taiwan","volume":"96","author":"Chen","year":"2012","journal-title":"Br J Ophthalmol"},{"key":"R12-20260422","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1136\/bjophthalmol-2018-312063","article-title":"Diagnostic value of ganglion cell-inner plexiform layer for early detection of ethambutol-induced optic neuropathy","volume":"103","author":"Lee","year":"2019","journal-title":"Br J Ophthalmol"},{"key":"R13-20260422","first-page":"118","article-title":"Evaluation of the long-term effect of ethambutol usage on the retinal nerve fiber layer using spectral-domain optical coherence tomography","volume":"5","author":"Varan","year":"2020","journal-title":"Beyoglu Eye 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