Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2023; 11(15): 3502-3510
Published online May 26, 2023. doi: 10.12998/wjcc.v11.i15.3502
Outbreak of methanol-induced optic neuropathy in early COVID-19 era; effectiveness of erythropoietin and methylprednisolone therapy
Seyed Ali Tabatabaei, Mohammad Amini, Ali A Haydar, Mohammad Soleimani, Kasra Cheraqpour, Mansoor Shahriari, Hossein Hassanian-Moghaddam, Nasim Zamani, Mohammad Reza Akbari
Seyed Ali Tabatabaei, Mohammad Amini, Ali A Haydar, Mohammad Soleimani, Kasra Cheraqpour, Mohammad Reza Akbari, Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
Mansoor Shahriari, Department of Ophthalmology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran 1617763141, Iran
Hossein Hassanian-Moghaddam, Department of Clinical Toxicology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran 1964512642, Iran
Nasim Zamani, Department of Internal Medicine, Street, Agnes Medical Center, Fresno, CA 93720, United States
Author contributions: Amini M and Haydar AA contributed equally to this work; Tabatabaei SA, Amini M, Haydar AA, Soleimani M and Cheraqpour K designed the research study; Hassanian-Moghaddam H, Zamani N and Akbari MR performed the research; Shahriari M contributed new reagents and analytic tools; Haydar AA, Soleimani M, Cheraqpour K and Shahriari M analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Institutional review board statement: This study follows the tenets of the Declaration of Helsinki. Ethical approval was obtained from Institutional Review Board of Tehran University of Medical Sciences.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: There is no additional data available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammad Soleimani, MD, Academic Editor, Academic Research, Postdoctoral Fellow, Senior Researcher, Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin square, Tehran 1336616351, Iran. soleimani_md@yahoo.com
Received: January 7, 2023
Peer-review started: January 7, 2023
First decision: January 30, 2023
Revised: February 1, 2023
Accepted: April 14, 2023
Article in press: April 14, 2023
Published online: May 26, 2023

Methanol is a highly toxic, non-potable alcohol. Outbreaks of methanol toxicity occur due to its fraudulent addition to alcoholic beverages as a cheaper substitute for ethanol. Recently, alongside the coronavirus disease 2019 (COVID-19) pandemic, rumors circulated on social media that consuming alcohol can prevent or cure the virus, leading to a COVID-19 and methanol-induced optic neuropathy (MON) syndemic.


To investigate the impact of erythropoietin (EPO) on the outcomes of patients diagnosed with MON.


In this prospective study, 105 patients presenting with acute bilateral visual loss secondary to methanol intoxication were enrolled from March to May 2020 at Farabi Eye Hospital. A comprehensive ocular examination was conducted for all participants. Recombinant human EPO and methylprednisolone were administered intravenously to all patients for three consecutive days.


The mean age of the participants was 39.9 years (± 12.6). Ninety-four patients were male and eleven were female. The mean pre-treatment best corrected visual acuity (BCVA) improved from 2.0 ± 0.86 to 1.39 ± 0.69 logarithm of the minimum angle of resolution post-treatment (P < 0.001), with significant improvement observed in all age categories and genders (P < 0.001). Visual acuity improvement was also significant regardless of whether the patient presented before or after 72 h (P < 0.001), and the post-treatment BCVA remained significant at all monthly follow-up visits (P < 0.001).


EPO and methylprednisolone therapy have been shown to be effective in improving visual outcomes in patients with MON when administrated within the first month of exposure. Public awareness efforts are necessary to prevent further outbreaks of methanol toxicity in the current COVID-19 era.

Keywords: Alcohol, Ethanol, Methanol, Optic neuropathy, Erythropoietin, COVID-19

Core Tip: This is a prospective cohort study that assessed the impact of erythropoietin (EPO) and methylprednisolone treatment on 105 patients diagnosed with acute bilateral visual loss due to methanol-induced optic neuropathy. The results suggest that administering EPO within the first month of methanol exposure can significantly improve visual outcomes.