The effects of pyridoxine on retinal nerve fiber layer in tuberculous treatment

Abstract

Aim: Ethambutol and isoniazid, two of the main drugs used in the treatment of tuberculosis, can lead to optic neuropathy. Optical coherence tomography (OCT) is a non-invasive, repeatable, high resolution imaging technique used in the diagnosis and follow-up of optic nerve diseases. The purpose of this study was to investigate the effect of pyridoxine added to antituberculous therapy on retinal nerve fiber layer (RNFL) thickness and the effectiveness of OCT in the early diagnosis and monitoring of optic neuropathy. Material and Methods: Twenty four patients diagnosed with pulmonary or non-pulmonary tuberculosis were included in the study. Patients divided into two groups. One group received antituberculous therapy alone, and the other group received 50 mg pyridoxine in addition to antituberculous therapy. RNFL thickness in both eyes was measured using OCT before treatment and 2-month after treatment. Results: The change in the second month of treatment according to baseline in terms of average RNFL thicknesses in the right eyes, showed a statistically significant difference between the groups using and not using pyridoxine (p=0,038). However, there was no significant difference in the left eyes in terms of RNFL thickness in any of the quadrants between the groups. Conclusion: Despite a decrease in RNFL thickness in patients receiving antituberculous therapy alone, no change in RNFL thickness occurred in patients receiving pyridoxine in addition to antituberculous therapy. We think that early ototoxicity can be detected with RNFL thickness measurement using OCT in asymptomatic patients and that the addition of pyridoxine to antituberculous therapy prevents ototoxicity.