instruction: hello doctor patient is a 61 year old female six months ago she was diagnosed with bone to and undergoing medication ethambutol rifampicin and isoniazid after six months of usage her eye vision is suddenly diminishing then her doctor told to discontinue ethambutol immediately and started using some b12 1500 my injections on alternate days after one week they started steroids just to rule out if there might be any optic nerve inflammation we have done mri and the findings are below tiny flair hyperintense foi in the frontal and parietal and white matter small vessel ischemic changes widened perioptic csi space to hyperintense signal is seen in the chiasm and optic tract kindly suggest what to do
output: hello I passed carefully through your question and reviewed your uploaded mri magnetic resonance imaging report I would explain that these mri findings to hyperintensity in the optic nerve and the optic chiasm are indicative of optic nerve inflammation neuritis which could be related to ethambutol adverse effects the troubles with vision are a clinical sign of optic neuritis too so considering that there is a correlation between radiological and clinical findings I would conclude about optic neuritis and would recommend to stop ethambutol as soon as possible in order to avoid possible blindness I hope this helps