Visual outcome of methanol toxic optic neuropathy after erythropoietin treatment in Riyadh, Saudi Arabia

Malek Alrobaian; Arwa Alkhuraiji; Rema Almohanna; Mohammed Alshehri; Bader Alyahya

doi:10.4103/sjopt.sjopt_174_22

Visual outcome of methanol toxic optic neuropathy after erythropoietin treatment in Riyadh, Saudi Arabia

Saudi J Ophthalmol. 2023 Jul 15;38(1):41-46. doi: 10.4103/sjopt.sjopt_174_22. eCollection 2024 Jan-Mar.

Authors

Malek Alrobaian^{1

2}, Arwa Alkhuraiji^{1

2}, Rema Almohanna^{2

3}, Mohammed Alshehri⁴, Bader Alyahya⁵

Affiliations

¹ Department of Ophthalmology, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia.
² King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
³ Department of Surgery, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia.
⁴ Department of Emergency Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia.
⁵ Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Abstract

Purpose: The purpose of this study is to evaluate the visual response of methanol-induced optic neuropathy to management with erythropoietin (EPO) along with conventional therapy.

Methods: This retrospective case series examines the ophthalmological data of patients diagnosed with methanol-induced optic neuropathy between 2020 and 2021 at two centers, Riyadh, Saudi Arabia. Patients' characteristics and the results of initial and final ophthalmological examinations were documented and compared between patients who received EPO in addition to conventional management and those who received only conventional management.

Results: A total of nine cases were reviewed, of which eight (88.9%) were males and one was female (11.1%). The mean age was 37.7 years. At presentation, funduscopic examination revealed optic disc edema in four eyes (two patients), and 14 eyes had normal appearance (seven patients). Among the nine patients who received conventional management, 5 (55.6%) additionally received intravenous EPO during the treatment course. There was no clinically or statistically significant difference in terms of visual outcome between the two groups. The mean visual acuity at the final presentation was 1.32 ± 0.79 logarithm of the minimum angle of resolution (LogMAR) in the EPO group and 1.36 ± 0.85 LogMAR in the non-EPO group. Optical coherence tomography indicated that the EPO group had an average retinal nerve fiber layer thickness of 48.13μm (±6.2), at the final assessment.

Conclusion: Managing the visual impairments in individuals with methanol-induced optic neuropathy using intravenous EPO resulted in similar final visual outcomes compared to conventional management.

Keywords: Erythropoietin; methanol; optic neuropathy; toxicity.