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March 24 th 

 

 

 

 

 

 

 

 

 

 

Ethambutol And Optic Neuropathy

 

 

 

  

Modern genetic studies of the TB bacterium show that:

• Mycobacterium tuberculosis is very old 
•  (Approximately 9000 Years Old)
• It evolved along with humans 

Evidence of TB has been found in:

• Egyptian mummies (~3000 BCE)
• Ancient Indian and Chinese texts
• Skeletal remains showing spinal TB (Pott disease) 

Hippocrates (460–370 BCE) described a fatal wasting disease affecting young adults, likely pulmonary TB. 

 Medicines Used To Treat TB 

 

 

 

 

Ethambutol

  

Ethambutol was discovered by researchers working for the American pharmaceutical company:

• Lederle Laboratories  (part of American Cyanamid) 
   
   

   

  Key scientists involved included:

  • William A. Dyer
  • Paul D. Wilkinson  

             They were studying ethylenediamine derivatives  

   

                                                   Ethylenediamine To Ethambutol

   

   

   

   

   

   

  Ethambutol

   

   

   

  Soon after ethambutol was introduced in the early 1960s, doctors noticed that some patients developed:

  • Blurred vision
  • Loss of color vision
  • Decreased visual acuity

  By the mid-1960s, clinical reports confirmed that ethambutol could cause dose-dependent optic neuropathy.

       Journal Of American Medical Association: Ophthalmology

   

   

  First classic report (1962)

  One of the earliest descriptions of ocular toxicity from ethambutol was:

  • Carr RE, Henkind P.
    Ocular manifestations of ethambutol. Archives of Ophthalmology, 1962

  This paper described patients taking Ethambutol  who developed:

  • bilateral visual loss
  • decreased visual acuity
  • color vision defects

   Then And Now 

   

  

   

   

   

   

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