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Pharmacoepidemiology and Risk Management 2024; 16(2): 124-134

Published online September 30, 2024 https://doi.org/10.56142/perm.24.0015

Copyright © Korean Society for Pharmacoepidemiology and Risk Management.

Monitoring Ethambutol-Induced Optic Neuropathy in Tuberculosis Treatment: A Systematic Review of Guidelines and Recommendations

결핵 치료제 에탐부톨 유발 시신경병증 모니터링: 진료지침에 관한 체계적 문헌고찰

Seounghyun An1, Jongyoon Kim2

안성현1, 김종윤2

1Department of Ophthalmology, Dong-A University College of Medicine, Busan, Korea
2College of Pharmacy, Dongduk Women’s University, Seoul, Korea

안성현1, 김종윤2

Correspondence to:Jongyoon Kim
College of Pharmacy, Dongduk Women’s University, 60 Hwarangro 13-gil, Seongbuk-gu, Seoul 02748, Korea
Tel: +82-2-940-4517
Fax: +82-2-940-4159
E-mail: jyoonkim@dongduk.ac.kr

Received: August 13, 2024; Revised: September 6, 2024; Accepted: September 10, 2024

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Tuberculosis remains a significant public health issue globally despite being preventable and treatable. This study reviews domestic and international tuberculosis treatment guidelines, focusing on recommendations for preventing ethambutol-induced optic neuropathy, a serious side effect of a key anti-tuberculosis drug. This study reviews tuberculosis treatment guidelines published between January 2015 and June 2024, focusing on recommendations for managing ethambutol-induced optic neuropathy. A systematic search was conducted using major databases and health organization websites. Guidelines were selected based on specific criteria and evaluated using the AGREE II instrument, with strengths and limitations analyzed to identify potential improvements in monitoring strategies. This study analyzed six international and one domestic tuberculosis treatment guideline using the AGREE II instrument. Guidelines varied in development rigor and transparency, with WHO and ATS/CDC/IDSA guidelines demonstrating the most comprehensive methodologies. Four guidelines, including the domestic one, addressed ethambutol-induced visual impairment, recommending baseline and periodic vision assessments. Recommendations for monitoring and managing ocular side effects varied across guidelines, emphasizing the importance of patient education and prompt reporting of visual changes. Out of seven guidelines examined, only four, including the domestic guideline, provided specific recommendations. The study emphasizes the importance of early detection and prevention of permanent visual impairment, suggesting the need for more detailed criteria, monitoring frequencies, and advanced diagnostic methods, particularly for high-risk patients. Selective use of optical coherence tomography and angiography is recommended for early diagnosis and prevention of irreversible disability.

KeywordsEthambutol, Toxic optic neuropathy, Tuberculosis, Guidelines, Tomography, Optical coherence

Korean Society for Pharmacoepidemiology and Risk Management

Vol.16 No.2
September, 2024

eISSN 2982-5954

Frequency: Bimonthly

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