A case of isoniazid-induced optic neuropathy

Abstract

A case of optic neuropathy induced by combined isoniazid and rifampin treatment is reported. The patient was a 61-year-old woman with a tuberculous abscess of the lung. She was treated with isoniazid (8.5–20 mg/kg/day, total dosage about 120 g) and rifampin (15 mg/kg/day, total dosage about 81 g) for approximately six months. At the end of this time, raised levels of glutamate oxalacetate transaminase and glutamate pyruvate transaminase were seen with peripheral sensory neuropathy. Rifampin was discontinued. Two months later, optic neuropathy also developed. Bilateral reduction of visual acuity, a central scotoma and abnormality of color vision were observed. Isoniazid was withdrawn and treatment by pyridoxine (vitamin B,) was initiated. Complete recovery of the optic neuropathy as well as the peripheral neuropathy was seen ten months after the withdrawal of isoniazid.