ABSTRACT
@#AIM: To evaluate effects of Qing Mang Yi Hao in the treatment of toxic optic atrophy.<p>METHODS: A retrospective analysis of 7 patients(13 eyes)suffered from toxic optic atrophy in Department of Ophthalmology, Dongfang Hospital Beijing University of Chinese Medicine, who were diagnosed as liver stagnation and blood deficiency and treated with Qing Mang Yi Hao formula. The formula treatments patients received were varying from 1 to 12 courses, and the clinical follow-up unequally lasted from 6-24mo. Then the formula clinical efficacy was comprehensively evaluated by comparing their visual acuity, visual field, visual evoked potential(VEP)and retinal nerve fiber layer(RNFL)thickness before and after treatment.<p>RESULTS: Seven cases(13 eyes)consisted of 5 ethambutol-induced optic neuropathy cases(10 eyes), 1 alcohol toxic neuropathy case(1 eye)and 1 rabies vaccine toxic neuropathy case(2 eyes). OCT showed the RNFL thicknesses on nasal and temporal quadrants were significantly thin at their first visits and the tendency of decreasing was noticed on each quadrant of RNFL thickness at the last follow-up. However, the visual acuity of 7 cases(13 eyes)had varying improvements: ≥0.1 4 eyes(31%), 0.06-<0.1 2 eyes(15%), 0.04-<0.06 1 eyes(8%), 0.01-<0.04 4 eyes(31%), no improvements 2 eyes(15%). The total efficacy rate of Qing Mang Yi Hao formula was 64%(27% significant).<p>CONCLUSION: Qing Mang Yi Hao could improve visual function, delay the progressive optic atrophy of TON, thus plays a significant role in optic neuroprotection.
ABSTRACT
PURPOSE: To evaluate the efficacy of optical coherence tomography (OCT) on diagnosis and follow-up in patients with ethambutol-induced optic neuropathy and to evaluate the prognosis of ethambutol-induced optic neuropathy. METHODS: Seven patients (14 eyes) with a history of ethambutol-induced optic neuropathy underwent best corrected visual acuity measurement (BCVA), visual field exam, fundus exam, and OCT at their first visit and again six months later. RESULTS: There was an overall statistically significant improvement in vision (p=0.001); however, two patients (four eyes) showed no improvement. A decrease in RNFL thickness was observed in all eyes. Additionally, there was a statistically significant decrease of 6.4 +/- 5.37 micrometer (6.8%) in the mean RNFL thickness (p=0.003), with the greatest decrease in the temporal quadrant, which showed a mean decrease of 6.1 +/- 5.31 micrometer (9.2%) (p<0.001). CONCLUSIONS: Optical coherence tomography may be not only a valuable tool in the quantitative and structural analysis of RNFL thickness in patients with ethambutol-induced optic neuropathy, but may also provide objective information on diagnosis and follow-up. Toxicity from ethambutol is reversible with discontinuation of the drug, and vision recovers gradually. However, impaired vision can remain even with cessation of ethambutol due to retinal nerve fiber damage.