Neuro-ophthalmic complications of tuberculosis and its treatment: a systematic review and meta-analysis.
Ethambutol optic neuropathy occurred in about 1.5% of tuberculosis patients treated with ethambutol.
Neuro-ophthalmic complications of tuberculosis and its treatment: a systematic review and meta-analysis.
Tuberculosis (tuberculosis) and its treatment have been associated with significant neuro-ophthalmic morbidity; however, the magnitude and determinants of these complications remain incompletely characterized.
This systematic review and meta-analysis aimed to evaluate the incidence and risk factors of ethambutol optic neuropathy (ethambutol optic neuropathy), neuro-ophthalmic manifestations of tuberculous meningitis (tuberculous meningitis), and prognostic biomarkers for visual outcomes.
Following PRISMA 2020 guidelines, we searched PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar up to the 30th of September 2025.
Pooled rate of ethambutol-related optic nerve damage causing vision problems across studies.
Renal impairment (OR 3.73, 95% CI: 1.78-7.83) and hypertension (OR 2.37, 95% CI: 1.46-3.84) were significant risk factors.
Tuberculous meningitis neuro-ophthalmic manifestations included cranial nerve III palsy (17.4%), papilledema (12.5%), and optic atrophy (16.7%), with pediatric patients demonstrated significantly higher hydrocephalus rates (72.5% vs 13.0%, RR 5.56).
Visual recovery occurred in 52.4% of clinical ethambutol optic neuropathy cases.
Tuberculosis-related neuro-ophthalmic complications represent significant morbidity with identifiable risk factors. Visual evoked potentials offer superior subclinical detection and early intervention improves visual outcomes.
Screening protocols targeting high-risk populations are recommended.