Erythropoietin in Treatment of Methanol Optic Neuropathy.

Abstract

BACKGROUND:

Methanol poisoning can cause an optic neuropathy that is usually severe and irreversible and often occurs after ingestion of illicit or homemade alcoholic beverages. In this study, we evaluated the potential neuroprotective effect of erythropoietin (EPO) on visual acuity (VA) in patients with methanol optic neuropathy.

METHODS:

In a prospective, noncomparative interventional case series, consecutive patients with methanol optic neuropathy after alcoholic beverage ingestion were included. All patients initially received systemic therapy including metabolic stabilization and detoxification. Treatment with intravenous recombinant human EPO consisted of 20,000 units/day for 3 successive days. Depending on clinical response, some patients received a second course of EPO. VA, funduscopy, and spectral domain optical coherence tomography were assessed during the study. Main outcome measure was VA.

RESULTS:

Thirty-two eyes of 16 patients with methanol optic neuropathy were included. Mean age was 34.2 years (±13.3 years). The mean time interval between methanol ingestion and treatment with intravenous EPO was 9.1 days (±5.56 days). Mean follow-up after treatment was 7.5 months (±5.88 months). Median VA in the better eye of each patient before treatment was light perception (range: 3.90-0.60 logMAR). Median last acuity after treatment in the best eye was 1.00 logMAR (range: 3.90-0.00 logMAR). VA significantly increased in the last follow-up examination (P < 0.0001). Age and time to EPO treatment after methanol ingestion were not significantly related to final VA. No ocular or systemic complications occurred in our patient cohort.

CONCLUSIONS:

Intravenous EPO appears to improve VA in patients with methanol optic neuropathy and may represent a promising treatment for this disorder.

• Authors: Farzad Pakdel, Mostafa S Sanjari, Asieh Naderi, Niloofar Pirmarzdashti, Anousheh Haghighi, Mohsen B Kashkouli
• Journal: Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society (J Neuroophthalmol) Vol. 38 Issue 2 Pg. 167-171 (Jun 2018) ISSN: 1536-5166 [Electronic] United States
• PMID: 29300238 (Publication Type: Case Reports, Journal Article)

Chemical References

• Recombinant Proteins
• Solvents
• Erythropoietin
• Methanol

Topics

• Adolescent
• Adult
• Erythropoietin (therapeutic use)
• Female
• Humans
• Infusions, Intravenous
• Male
• Methanol (toxicity)
• Middle Aged
• Ophthalmoscopy
• Optic Nerve Diseases (chemically induced, diagnosis, drug therapy)
• Prospective Studies
• Recombinant Proteins (therapeutic use)
• Solvents (toxicity)
• Tomography, Optical Coherence
• Visual Acuity (drug effects)
• Young Adult