PT  - JOURNAL ARTICLE
AU  - Andrew Malem
AU  - Helen Barker
AU  - Nadia Shafi
AU  - Dennis Wat
AU  - Charles Haworth
AU  - R. Andres Floto
TI  - Rates of ophthalmic complications due to ethambutol in patients with non-tuberculous mycobacteria
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P4375
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P4375.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P4375.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - Infection with Non-Tuberculous Mycobacteria (NTM) is a growing clinical problem particularly in patients with inflammatory lung disease. For many NTM infections, treatment involves at least 12 months of combination antibiotic therapy including Ethambutol. While ophthalmic complications are extremely rare in patients taking ethambutol as part of standard quadruple therapy for Mycobacterium tuberculosis (MTB) infection, they may be higher during treatment for extended periods. We therefore carried out a retrospective analysis of patients treated with ethambutol for NTM infection at the Cambridge Centre for Lung Infection between 2006 and 2011. We identified 46 patients with confirmed NTM infection who received ethambutol. 4 individuals were excluded from further analysis because of incomplete/missing notes.We identified 5 out of 43 patients (11.9%) with documented changes in visual acuity and colour vision diagnosed by an ophthalmologist as probable ethambutol toxicity. There was no significant difference between those with ophthalmic complications and those without in the following parameters: age; dose of ethambutol per kilogram, serum creatinine levels and treatment duration. Where measured, low serum zinc levels were found in individuals who developed ophthalmic complications but these were not significantly lower than those of unaffected patients.Our data suggests that ethambutol toxicity is a relative common problem in patients with NTM infection requiring extended treatment with ethambutol despite appropriate dosing and regular ophthalmology review. Further studies will be needed to define how best to minimize this potentially devastating complication.