O emprego da tomografia de coerência óptica na detecção da toxicidade ocular por etambutol

• Ano de defesa: 2018
• Autor(a) principal: Taffner, Brunella Maria Pavan
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Espírito Santo; BR; Mestrado em Medicina; Centro de Ciências da Saúde; UFES; Programa de Pós-Graduação em Medicina
• Palavras-chave em Português: Ethambutol; Toxicity; Optic neuropathy; Optical coherence tomography; Etambutol; Toxicidade; Neuropatia óptica; Tomografia de coerência óptica; Doenças do nervo óptico; Medicina; 61
• Link de acesso: http://repositorio.ufes.br/handle/10/8339

Purpose. To evaluate changes in retinal nerve fiber layer (RNFL) thickness by optical coherence tomography (OCT) secondary to use of ethambutol in the treatment of patients with tuberculosis or mycobacterium other than tuberculosis. In addition to studying the use of simpler tests, such as Amsler and Ishihara, in the screening of these cases. Methods. Thirty patients in use of etambutol were recruited from the reference service of tuberculosis at the Federal University of Espírito Santo from May 2015 to July 2016. After clinical history, the following parameters were analyzed; best corrected visual acuity, biomicroscopy, intraocular pressure, photomotor reflex testing, Ishihara test, Amsler's grid test, color digital retinography and optical coherence tomography with CIRRUS HD-OCT (Humphrey-Zeiss) every 2 months during treatment with ethambutol. They were divided into two groups according to the treatment: (1) standard group, two months of ethambutol; (2) extended group, nine to twelve months of ethambutol. Results. There was a reduction in optic disc OCT thickness between pre and post treatment in ten eyes of the extended group, mean reduction of 7,8 µm (variation between 3 and 19) and in seven eyes of the standard group, with an average of 5.57 µm (variation between 3 and 10). During the study, a significant reduction of RNFL thickness was observed in both groups at two months of treatment, and the delta percentage was higher in those patients who presented changes in the Ishihara test. Conclusion. There was a significant reduction in the thickness of the retinal nerve fiber layer by OCT in the patients studied, being more pronounced in those submitted to the extended treatment. This reduction was observed two months after the start of therapy, and was more significant in the cases that presented changes in the Ishihara test. The Amsler test did not present significant alteration in the evaluated groups. Most of the cases with reduction of CFNR by OCT does not showed reduction in visual acuity or change in the Ishihara test.