Metta Hospital points out that patients with tuberculosis are using drugs continuously. Can affect the optic nerve |

The situation of patients with tuberculosis in Thailand in 2023 found 111,000 new patients, 13,700 deaths per year revealed that patients need to take medicine continuously. Many drugs are used for treatment. It can affect the optic nerve. Especially optic nerve degeneration caused by ethambutol. It is recommended that people taking anti-TB medicines be monitored regularly.

On October 22nd Dr. Pairoj Surattanawanit, Deputy Director General of the Department of Medical Services He revealed that tuberculosis is considered an important public health problem in the world. It is one of the top 3 diseases that cause death to the world’s population. If AIDS is included and malaria on March 24 every year the World Health Organization has declared it “World Tuberculosis Day (World TUBERCULOSIS Day)” to encourage cooperation to prevent and control the spread . In 2023, the situation of tuberculosis patients in Thailand estimates that the number of new tuberculosis patients is 111,000, but only 72,274 people are reported to be registered for treatment and dying from spending every year

Dr Arkhom Chaiweerawatana, Director of Metta Pracharak Hospital (Wat Rai Khing) He said that tuberculosis is an infectious respiratory disease. Caused by bacteria Transmission from person to person through the air When a patient coughs or sneezes and does not cover his mouth, he creates droplets. Nearby people inhale aerosols containing TB germs into the body, causing disease and illness. The main symptom of pulmonary tuberculosis is a dry cough that lasts more than 2 weeks. There may also be other symptoms, such as weight loss, chest pain, low-grade fever How do you diagnose the disease? Taking an x-ray of the lungs and examining sputum for tuberculosis. Tuberculosis can be treated with very effective medicines such as ethambutol, because long-term use of the medicine can have side effects on the optic nerve. Regular eye exams are necessary.

Dr. Piyawadi Chaiongkoltrakul, MD Head of the Neuro-Ophthalmology Unit Contributing to that optic nerve degeneration caused by ethambutol It usually occurs in both eyes, with blurred vision in the center of the image and slowly diminishes without pain. It usually occurs after taking ethambutol for about 2-8 months Found to have abnormal color vision (lack of color vision) or reduced ability to distinguish between dark and light (relative sensitivity ) In the later stages, the patient will have a lower level of vision and visual field abnormalities

In the early stages of the disease, optic nerve abnormalities may not be detected. The appearance of nerve ending atrophy can be detected at a later stage. and they may find an abnormal visual field such as hemianopia blindness. At this time, it is not yet possible to clearly explain the way in which ethambutol worsens. It is believed to be caused by the drug ethambutol competing for binding with copper. Decreased function of the optic nerve and causes optic atrophy (optic atrophy) as a result, because the occurrence of side effects from ethambutol is related to the level of ethambutol found in the patient in patients receiving ethambutol. Less than or equal to 15 mg/kg per day Optic nerve degeneration was found in 1% and was as high as about 30%. People who have side effects on the optic nerve from ethambutol should stop taking ethambutol according to their family doctor.

However, side effects on the optic nerve from ethambutol can become more severe 1-2 months after stopping ethambutol People who need to use ethambutol should be screened periodically for side effects or when they have unusual vision symptoms, such as blurred vision, they should see an ophthalmologist.