Linezolid-associated optic neuropathy in drug-resistant tuberculosis patients in Sulianti Saroso Infectious Disease Hospital

<ns3:p>Background Patients with drug resistance tuberculosis (DR-TB) treated with linezolid are at a higher risk of optic neuropathy, but there is limited data on this issue in regions affected by DR-TB. This research aims to evaluate the incidence and contributing factors of optic neuropathy associated with linezolid and to document the treatment and care experiences of patients with drug-resistant tuberculosis (DR-TB) undergoing these treatment regimens. Methods This retrospective cohort study analyzed routine clinical and laboratory data from the Medical Record Hospital and the SITB (Sistem Informasi Tuberkulosis) database of the Ministry of Health. All patients diagnosed with DR-TB who received linezolid between January 2022 and December 2024, patients were monitored after completing treatment. Ophthalmological evaluations, conducted by a consultant ophthalmologist, comprised visual acuity screening, slit-lamp examination, and fundus assessment. Results Between January 2022 and December 2024, 103 patients started linezolid-containing DR-TB treatment, primarily men (60.2%) and in the productive age group (≤60 years). Among them, 31 developed optic neuropathy (ON). Significant risk factors include treatment duration longer than 6 months, which increases the risk of ON threefold (p=0.039; adjHR: 3.06; 95%CI: 1.06-8.85), and active smoking, which raises the risk by 2.9 times compared to non-smokers. Conclusion This report highlights optic neuropathy in patients with drug-resistant tuberculosis (DR-TB) treated with linezolid. Among 31 patients, optic neuropathy was reported, underscoring the necessity for regular monitoring and access to specialized diagnostics. As the use of linezolid grows, healthcare programs must prioritize resources for early diagnosis, prevention, and management of this side effect.</ns3:p>