Temporal evolution and factors influencing visual function and RNFL thickness in ethambutol-associated optic neuropathy
Abstract Purpose This study aimed to investigate the temporal evolution and influencing factors of visual function and optic nerve structure in ethambutol-associated optic neuropathy (EON). Methods In this single-center retrospective observational study, we analyzed data from 48 EON patients (26 mal...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-04-01
|
| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40001-025-02573-9 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849713058747777024 |
|---|---|
| author | Taimin Guo Yue Fu Xiaoyu Xu Xiaoning Liu Yurong Zhang Hui Yang |
| author_facet | Taimin Guo Yue Fu Xiaoyu Xu Xiaoning Liu Yurong Zhang Hui Yang |
| author_sort | Taimin Guo |
| collection | DOAJ |
| description | Abstract Purpose This study aimed to investigate the temporal evolution and influencing factors of visual function and optic nerve structure in ethambutol-associated optic neuropathy (EON). Methods In this single-center retrospective observational study, we analyzed data from 48 EON patients (26 males and 22 females) with a 12-month follow-up. Comprehensive ophthalmologic assessments, including best corrected visual acuity (BCVA), visual field (VF), optical coherence tomography (OCT), and magnetic resonance imaging (MRI), were conducted to evaluate visual function and optic nerve structure. Statistical analyses including multiple linear regression and comparative analyses (independent t-tests/Mann–Whitney U tests) were performed to identify factors influencing recovery, with effect sizes calculated using Cohen’s d. Results Significant improvements in best corrected visual acuity and visual field were observed between 3 and 6 months. The mean improvement in BCVA was 0.25 logMAR (from 1.28 ± 0.64 at 3 months to 0.82 ± 0.60 at 6 months, p < 0.0001, Cohen’s d = 0.74, 95% CI [0.33, 1.15]), and the mean improvement in VF mean deviation was 2.5 dB (from − 13.85 ± 9.23 dB at 3 months to − 10.33 ± 7.58 dB at 6 months, p = 0.037, Cohen’s d = 0.42, 95% CI [0.11, 6.93]), indicating a critical recovery window. Peripapillary retinal nerve fiber layer (pRNFL) thinning was most pronounced between 3 and 9 months, with the temporal quadrant showing the earliest thinning (40.21% reduction by 3 months). Macular ganglion cell-inner plexiform layer (mGCIPL) thickness showed a decreasing trend (73.20 ± 4.76 μm to 55.33 ± 4.16 μm) from 1 month post-onset. Multivariate analysis revealed that disease course was the primary factor influencing VF recovery (β = − 0.31, p = 0.001), while peripapillary retinal nerve fiber layer thinning was associated with gender, ethambutol dosage, and disease duration. Female patients exhibited slower peripapillary retinal nerve fiber layer thinning compared to males. Conclusions This study identifies a critical recovery window for visual function in EON between 3 and 6 months, with peripapillary retinal nerve fiber layer thinning progressing significantly between 3 and 9 months. The temporal quadrant of the peripapillary retinal nerve fiber layer may serve as an early marker for disease progression. These findings provide valuable insights for optimizing monitoring and intervention strategies in EON patients, highlighting that early therapeutic interventions—particularly for patients showing temporal RNFL thinning or high-risk features—may maximize visual recovery potential. |
| format | Article |
| id | doaj-art-d5fc3ab1e7724f25b31425cb83218cb8 |
| institution | DOAJ |
| issn | 2047-783X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj-art-d5fc3ab1e7724f25b31425cb83218cb82025-08-20T03:14:05ZengBMCEuropean Journal of Medical Research2047-783X2025-04-0130111210.1186/s40001-025-02573-9Temporal evolution and factors influencing visual function and RNFL thickness in ethambutol-associated optic neuropathyTaimin Guo0Yue Fu1Xiaoyu Xu2Xiaoning Liu3Yurong Zhang4Hui Yang5State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular DiseasesState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular DiseasesState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular DiseasesState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular DiseasesState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular DiseasesState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular DiseasesAbstract Purpose This study aimed to investigate the temporal evolution and influencing factors of visual function and optic nerve structure in ethambutol-associated optic neuropathy (EON). Methods In this single-center retrospective observational study, we analyzed data from 48 EON patients (26 males and 22 females) with a 12-month follow-up. Comprehensive ophthalmologic assessments, including best corrected visual acuity (BCVA), visual field (VF), optical coherence tomography (OCT), and magnetic resonance imaging (MRI), were conducted to evaluate visual function and optic nerve structure. Statistical analyses including multiple linear regression and comparative analyses (independent t-tests/Mann–Whitney U tests) were performed to identify factors influencing recovery, with effect sizes calculated using Cohen’s d. Results Significant improvements in best corrected visual acuity and visual field were observed between 3 and 6 months. The mean improvement in BCVA was 0.25 logMAR (from 1.28 ± 0.64 at 3 months to 0.82 ± 0.60 at 6 months, p < 0.0001, Cohen’s d = 0.74, 95% CI [0.33, 1.15]), and the mean improvement in VF mean deviation was 2.5 dB (from − 13.85 ± 9.23 dB at 3 months to − 10.33 ± 7.58 dB at 6 months, p = 0.037, Cohen’s d = 0.42, 95% CI [0.11, 6.93]), indicating a critical recovery window. Peripapillary retinal nerve fiber layer (pRNFL) thinning was most pronounced between 3 and 9 months, with the temporal quadrant showing the earliest thinning (40.21% reduction by 3 months). Macular ganglion cell-inner plexiform layer (mGCIPL) thickness showed a decreasing trend (73.20 ± 4.76 μm to 55.33 ± 4.16 μm) from 1 month post-onset. Multivariate analysis revealed that disease course was the primary factor influencing VF recovery (β = − 0.31, p = 0.001), while peripapillary retinal nerve fiber layer thinning was associated with gender, ethambutol dosage, and disease duration. Female patients exhibited slower peripapillary retinal nerve fiber layer thinning compared to males. Conclusions This study identifies a critical recovery window for visual function in EON between 3 and 6 months, with peripapillary retinal nerve fiber layer thinning progressing significantly between 3 and 9 months. The temporal quadrant of the peripapillary retinal nerve fiber layer may serve as an early marker for disease progression. These findings provide valuable insights for optimizing monitoring and intervention strategies in EON patients, highlighting that early therapeutic interventions—particularly for patients showing temporal RNFL thinning or high-risk features—may maximize visual recovery potential.https://doi.org/10.1186/s40001-025-02573-9Ethambutol-induced neuropathyVisual functionPrognosisRisk factorsOptic neuropathy recovery |
| spellingShingle | Taimin Guo Yue Fu Xiaoyu Xu Xiaoning Liu Yurong Zhang Hui Yang Temporal evolution and factors influencing visual function and RNFL thickness in ethambutol-associated optic neuropathy European Journal of Medical Research Ethambutol-induced neuropathy Visual function Prognosis Risk factors Optic neuropathy recovery |
| title | Temporal evolution and factors influencing visual function and RNFL thickness in ethambutol-associated optic neuropathy |
| title_full | Temporal evolution and factors influencing visual function and RNFL thickness in ethambutol-associated optic neuropathy |
| title_fullStr | Temporal evolution and factors influencing visual function and RNFL thickness in ethambutol-associated optic neuropathy |
| title_full_unstemmed | Temporal evolution and factors influencing visual function and RNFL thickness in ethambutol-associated optic neuropathy |
| title_short | Temporal evolution and factors influencing visual function and RNFL thickness in ethambutol-associated optic neuropathy |
| title_sort | temporal evolution and factors influencing visual function and rnfl thickness in ethambutol associated optic neuropathy |
| topic | Ethambutol-induced neuropathy Visual function Prognosis Risk factors Optic neuropathy recovery |
| url | https://doi.org/10.1186/s40001-025-02573-9 |
| work_keys_str_mv | AT taiminguo temporalevolutionandfactorsinfluencingvisualfunctionandrnflthicknessinethambutolassociatedopticneuropathy AT yuefu temporalevolutionandfactorsinfluencingvisualfunctionandrnflthicknessinethambutolassociatedopticneuropathy AT xiaoyuxu temporalevolutionandfactorsinfluencingvisualfunctionandrnflthicknessinethambutolassociatedopticneuropathy AT xiaoningliu temporalevolutionandfactorsinfluencingvisualfunctionandrnflthicknessinethambutolassociatedopticneuropathy AT yurongzhang temporalevolutionandfactorsinfluencingvisualfunctionandrnflthicknessinethambutolassociatedopticneuropathy AT huiyang temporalevolutionandfactorsinfluencingvisualfunctionandrnflthicknessinethambutolassociatedopticneuropathy |