Follow Up Of Retinal Nerve Fiber Layer Thickness With Optic Coherence Tomography In Patients Receiving Anti-Tubercular Treatment May Reveal Early Optic Neuropathy

Purpose: To evaluate the effect of anti-tubercular treatment on retinal nerve fiber layer (RNFL) thickness and the efficiency of optic coherence tomography (OCT) on early diagnosis of optic neuropathy.Methods: Twenty patients diagnosed with either pulmonary or extra-pulmonary tuberculosis which were treated with anti-tubercular treatment (isoniazid (INH), rifampicin, ethambutol (ETM), and pyrazinamide) were enrolled in the study. RNFL thicknesses of the patients were measured via OCT, at baseline (before starting anti-tubercular treatment) and after the two-month treatment period. Standard ophthalmologic examinations were also performed.Results: Compared to baseline values, after the two-month treatment period, thinning was detected in the right eye's average and superior quadrant RNFLs (p = 0.024 and p = 0.006 respectively) and in the left eye's average, superior quadrant, and inferior quadrant RNFLs (p = 0.001, p = 0.008, p<0.001, respectively).Conclusion: We displayed that patients receiving INH and ETM, which were the basic medicines of anti-tubercular treatment, experienced thinning in RNFL after the two-month treatment period. Patients receiving these drugs can be followed via OCT in terms of reduction in RNFL thicknesses for early diagnose of INH and ETM toxicity.