抗結核化学療法剤Ethambutolによる視力障害についての調査報告
スポンサーリンク
概要
- 論文の詳細を見る
Ethambutol (EB), an anti-tuberculous drug, was released into the market in February, 1967 in Japan by Lederle (Japan), Ltd. and by Kaken Chemical Co., Ltd. under the trade name of ESANBUTOL and EBUTOL respectively.<BR>In order to find out the status of visual disturbances caused by EB and to prevent them as far as possible, we, Lederle (Japan), Ltd. and Kaken Chemical Co., Ltd., have made follow up studies on the visual disturbances in the patients who were treated with EB.<BR>During the period from February, 1967 to January, 1968, 171 cases of possibly EB-related side effects and adverse reactions were reported to us by doctors. Out of 171 cases, 131 complained visual disorder and the others complained paralysis of lower extremities, exanthema, gastrointestinal upsets, mental disturbances, etc. We visited the doctors who treated these cases to check the daily dose, total amount of EB administered till the adverse reaction occurred, the grade of visual disturbances and its prognosis, etc. Ninty-three cases with visual disturbances which coincided with one of the two categories were selected out of 131 cases. They are; 1) the case with visual acuity reduced by more than three lines of the internationally used Snellen chart when the visual disorder was only decrease in visual acuity, and 2) the case with visual acuity reduced by less than 3 lines of the Snellen chart when the visual disorder was complicated by any of central and peripheral scotomas and abnormal color vision. The follow-up studies were made on the course of recovery from the disturbances up to Feb., 1970. The results of studies are summarized in the following.<BR>1) Visual disturbances due to EB were highly significant in the patients who were over fifty years old (X2 test, = 0.01). The average age was 51.3 years old.<BR>2) The significant relation was observed between the visual disturbances and the body weight of the patients. The disturbances were observed more frequently in the patients whose body weights were below 50 kg (X2 test, =0.05). The average body weight was 46.5 kg.<BR>3) The total dosage of EB administered before the emergence of visual disturbances was 148.3 g in average. No corelation was observed between the total dosage and emergence of disturbances.<BR>4) Seventy-five out of 93 cases have recovered their visual acuity after 5.8 months in average.<BR>5) In 13 out of 93 cases, visual disturbances were not recovered by the end of June, 1968. Visual acuities of these 13 patients were not recovered to the levels or close to the levels which they had before the treatment with EB. Of 13 cases, 5 recovered the visual acuity by February, 1970, but 4 did not. Out of the rest 4 cases, 2 died and 2 could not be followed up by doctors. Four cases who did not recover by Feb. 1970, had been with visual distur bances for more than 2 years. Two out of 4 cases are still suffering from the disturbance in the central and peripheral visual field but they are gradually getting better. The other 2 cases are not showing any improvement, requiring further follow-up survey.<BR>6) Of 75 cases who recovered from the visual disturbances, EB was readministered to 14 cases. No adverse reaction were reported in these cases when the survey was conducted.<BR>7) For the treatment of the visual disturbances, hydroxocobalamine and activated thiamine derivatives were mainly used.
- 一般社団法人 日本結核病学会の論文