Ethambutol ocular toxicity in treatment regimens for Mycobacterium avium complex lung disease

Am J Respir Crit Care Med. 2005 Jul 15;172(2):250-3. doi: 10.1164/rccm.200407-863OC. Epub 2005 Apr 28.


Ethambutol (EMB) is an important component of multidrug treatment regimens for Mycobacterium avium complex lung disease. Ocular toxicity is the most important potential EMB toxicity, especially in the elderly population with M. avium complex lung disease. Two hundred twenty-nine patients with M. avium complex lung disease, 55% women and 53% with nodular/bronchiectatic disease, received a mean of 16.1 +/- 10.8 months of multidrug therapy that included EMB. Fifty patients (22%) were known to have preexisting ocular disease. While on EMB, 97 (42%) patients consulted an opthalmologist and 24 (10%) stopped EMB at least temporarily. Eight of 139 patients (6%) on daily therapy were diagnosed with EMB ocular toxicity, whereas 0 of 90 patients on intermittent therapy had EMB ocular toxicity (p = 0.05). All patients with EMB ocular toxicity developed symptoms between outpatient clinic appointments; none were diagnosed with routine visual acuity and color vision testing. All patients with EMB ocular disease returned to baseline ocular status after discontinuation of EMB. Intermittent EBM administration was associated with less ocular toxicity than daily EMB administration in this patient population.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / adverse effects*
  • Antitubercular Agents / therapeutic use
  • Drug Administration Schedule
  • Ethambutol / administration & dosage
  • Ethambutol / adverse effects*
  • Ethambutol / therapeutic use
  • Eye Diseases / chemically induced*
  • Female
  • Humans
  • Lung Diseases / drug therapy*
  • Male
  • Middle Aged
  • Mycobacterium avium Complex*
  • Mycobacterium avium-intracellulare Infection / drug therapy*


  • Antitubercular Agents
  • Ethambutol