Abstract
Purpose :
To detect any change in macular pigment optical density (MPOD) and central macular thickness (CMT) after standard treatment for pulmonary tuberculosis (PTB)
Methods :
In this prospective observational case- control study, we recruited 26 newly diagnosed PTB patients at the University of Malaya medical center (UMMC), Kuala Lumpur, Malaysia from September 2014 to June 2015. We measured visual acuity (VA), MPOD (macular pigment screener- MPS II 9000, Topcon, Newbury, UK), and CMT (optical coherence tomography, OCT- Cirrus SD-OCT, Carl-Zeiss Meditec, Dublin, CA) in all patients before and after standard anti-TB treatment (2 months of combination therapy with isoniazid, rifampicin, ethambutol and pyrazinamide followed by 4 months of combination therapy with isoniazid and rifampicin). We also recruited 22 healthy subjects and followed the same protocol and timeline. The patients were categorized based on age, gender and ethnicity. To analyze significance of CMT and MPOD changes after treatment, two-sample t-test was applied to find significant differences in means and Fisher exact test to detect any association between control and treatment groups.
Results :
There was no statistically significant change in the mean MPOD or VA after standard PTB treatment, but the mean CMT showed a significant increase (4.4μm, p = 0.02). The standard deviation was larger for CMT and MPOD in the treatment group compared to the control group (p = 0.001 and 0.01 respectively). There was no correlation between MPOD change and CMT change in the treatment group (p = 0.94).
Conclusions :
Standard PTB treatment did not adversely affect VA and MPOD. The changes in CMT showed no effect on VA. A prospective longitudinal study with a larger sample size is needed to fully explore the long-term effect of anti-tuberculosis drugs on the macula.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.