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Research Paper | Ophthalmology | Volume 15 Issue 2, February 2026 | Pages: 1339 - 1346 | India
Analysis of Clinical and Functional Optic Nerve Changes in Patients Receiving Anti-Tuberculosis Therapy
Abstract: Background: Anti-tuberculosis therapy (ATT), particularly ethambutol, is known to cause optic neuropathy. Early detection of structural and functional optic nerve changes is essential to prevent irreversible visual impairment. Aim: To evaluate clinical and functional optic nerve changes in patients receiving anti-tuberculosis therapy over a six-month follow-up period. Materials and Methods: This prospective longitudinal study included 50 patients undergoing ATT. Participants were evaluated at baseline, 3 months, and 6 months. Clinical examination included fundus evaluation, color vision testing, optical coherence tomography (OCT) for retinal nerve fiber layer (RNFL) thickness, and automated perimetry. Repeated-measures analyses were performed using Cochran's Q test, McNemar test, Friedman test, Wilcoxon signed-rank test, and paired t-test. Structural?functional correlations were assessed using Pearson and Spearman correlation coefficients. Results: Ocular involvement was observed in 44% of patients. RNFL thinning increased significantly from 0% at baseline to 20% at 3 months and 36% at 6 months (Cochran's Q = 27.11, p = 0.000001). Mean RNFL thickness decreased significantly over time (Baseline: 104.11 ± 7.31 ?m; 6 months: 95.32 ± 12.77 ?m; Friedman X2 = 17.76, p = 0.000139). Visual field defects increased from 0% at baseline to 16% at 6 months (Cochran's Q = 14.25, p = 0.000805). A significant reduction in visual field mean deviation was observed at 6 months (p = 0.000595). Strong positive correlations were noted between RNFL thickness and visual field mean deviation (r = 0.674, p < 0.001) and color vision score (r = 0.772, p < 0.001). Conclusion: Anti-tuberculosis therapy is associated with progressive structural and functional optic nerve changes. OCT-measured RNFL thinning correlates strongly with functional visual impairment, emphasizing the importance of periodic ophthalmic monitoring in patients receiving ATT.
Keywords: Anti-tuberculosis therapy, Optic neuropathy, RNFL thinning, Optical coherence tomography, Visual field defects, Ethambutol toxicity
How to Cite?: Dr. Aasnath Nancy Jerriton, Dr. K. Kanmani, Dr. Mamata Subhakar, Dr. Raj Kawsik, Dr. Ravuri Meghana, "Analysis of Clinical and Functional Optic Nerve Changes in Patients Receiving Anti-Tuberculosis Therapy", Volume 15 Issue 2, February 2026, International Journal of Science and Research (IJSR), Pages: 1339-1346, https://www.ijsr.net/getabstract.php?paperid=SR26105005347, DOI: https://dx.dx.doi.org/10.21275/SR26105005347