Published online May 26, 2023. doi: 10.12998/wjcc.v11.i15.3502
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, which is a type of non-drinking alcohol, has a highly toxic profile to humans. Methanol toxicity can damage to different sites of the human body such as the optic nerve. Epidemics of methanol toxicity occur when it is fraudulently added to alcoholic beverages as a cheaper substitute for ethanol, especially where alcoholic drinks are prohibited by law. Most recently, in parallel with the coronavirus disease 2019 pandemic, a methanol toxicity outbreak emerged in Iran.
The prognosis of methanol-induced optic neuropathy (MON) is generally poor. Currently, two antidotes are available for methanol toxicity: ethanol and fomepizole. Erythropoietin (EPO), a hormone produced mainly in the kidneys, has been shown neuroprotective and neuroregenerative properties.
We conducted a prospective study to investigate the effects of EPO on visual outcomes in MON patients.
In this prospective study, patients with acute bilateral visual loss secondary to methanol intoxication from one month before presentation were enrolled. All patients underwent toxicology screening and received hemodialysis when deemed necessary. A comprehensive ophthalmic examination was performed. Patients were hospitalized for a three-day period. Intravenous recombinant human EPO (10000 IU/mL) was administered every 12 h for all three consecutive days. In addition, all patients received intravenous methylprednisolone (250 mg) every 6 h for three days.
The mean best corrected visual acuity (VA) improved significantly (P < 0.001). VA improvement was significant regardless of whether the patient presented before or after 72 h (P < 0.001).
EPO and methylprednisolone therapy have been shown to be effective in improving visual outcomes in patients with methanol-induced optic neuropathy when administrated within the first month of exposure.
Further research is needed to compare different treatment protocols, establish optimal dosages and timing of EOP through randomized clinical trials.