Therapeutic Effects of High Dose Intravenous Prednisolone on Methanol Induced Toxic Optic Neuropathy

Background: The effects of high dose steroids for the treatment of methanol optic neuropathy was evaluated in this study. Methods: In an interventional case series, ۹ patients with a history of sudden visual loss after an ingestion of homemade alcoholic beverages were included in the study. The patients received ۲۵۰ mg intravenous methyl prednisolone every ۶ hours for ۴ days continued with oral prednisolone at ۱ mg/Kg for ۱۰ days. Best corrected visual acuity (BCVA), optical coherent tomography (OCT), fundus photo, and a complete ophthalmologic exam of the patients were taken before the treatment and ۳ months after treatment. Six of them referred before ۴۸ hours and ۳ after ۷۲ hours. Results: All patients were men. The mean age was ۲۴.۶۸ ± ۴.۲ years.  In those who referred before ۴۸ hours, the mean BCVA before the treatment was ۰.۸۶ ± ۰.۰۸ in the right eye (RE) and ۰.۹۳ ± ۰.۱ in the left eye (LE) using the logMAR scale. Four patients showed nerve fiber layer edema as a white density in peripapillary area. After treatment, the mean BCVA in the RE was ۰.۳۳ ± ۰.۱۸ and ۰.۲۹ ± ۰.۲ in the LE using the logMAR scale. The differences between before and after treatment were significant (P = ۰.۰۰۸ and P = ۰.۰۰۳, respectively). The mean macular thickness and CDR were unchanged. In those who referred after ۷۲ hours, BCVA was not changed significantly (۰.۹۶ ± ۰.۳ and ۰.۹۴ ± ۰.۲ vs. ۰.۹۷ ± ۰.۳ and ۰.۹۴ ± ۰.۲ in RE and LE respectively). Conclusion: Intravenous high dose methyl prednisolone may have benefits in the treatment of methanol optic neuropathy, if initiated before ۴۸ hours.

Keywords:

Methanol , Optic Neuropathy , Poisoning , Prednisolone