Effects of Antituberculosis Treatment on Visual Acuity and on Retina, as Assessed by Optical Coherence Tomography Findings
Monika Shahare, Charuta Mandke, Amrita Ajani, Veeram RajputBackground:
The impact of Anti-Tuberculosis treatment on Visual acuity and on retina using optical coherence tomography.
Methods:
All patients aged 15 to 45 years, referred to Ophthalmology OPD with tuberculosis prior to the start of antitubercular treatment (AKT), were included between 2022 and 2024. Data like visual acuity and retinal nerve fiber layer thickness were collected at baseline, prior to the start of AKT, and at 1 and 3 months after initiating AKT.
Results:
Ethambutol had the largest percentage of patients with abnormal vision, while individuals treated with linezolid, levofloxacin, cyclosporine, bedaquiline, pyrazinamide, and clofazimine had a high prevalence of normal eyesight. All patients had normal fundus findings at the initial visit and the 1-month follow-up. However, aberrant fundus abnormalities, including bilateral disc edema and flame-shaped hemorrhages, appeared by the 3-month follow-up in patients on linezolid (1.9%), levofloxacin (3.4%), cyclosporine (2.5%), bedaquiline (2.9%), pyrazinamide (2.0%), and clofazimine (2.0%). All patients on all medications showed normal color vision (CV) at the initial appointment. However, individuals started exhibiting aberrant CV results at the 1-month follow-up when taking bedaquiline, levofloxacin, and linezolid. At the 3-month mark, delanamide also showed a higher percentage of CV anomalies (14.3%).
Conclusions:
In our study, majority of patients on AKT maintained normal vision throughout the treatment, experienced mild visual impairments, with ethambutol showing the highest incidence of abnormal vision outcomes, though not statistically significant. Overall, AKT demonstrated a minimal impact on both visual acuity and on the retina in most patients.