Methanol Toxic Optic Neuropathy: Clinical Characteristics and Visual Acuity Outcome after High-Dose Methylprednisolone

• Published in: Neuro-Ophthalmology Japan Vol. 33; no. 4; pp. 421 - 427
• Main Authors: A, Kartika, B, Setiohadji
• Format: Journal Article
• Language: English; Japanese
• Published: The Japanese Neuro-Ophthalmology Society 2016
• Subjects: methanol toxic optic neuropathy; methylprednisolone; visual acuity
• ISSN: 0289-7024; 2188-2002
• DOI: 10.11476/shinkeiganka.33.421

Purpose: To describe the clinical characteristics and visual acuity outcome in methanol toxic optic neuropathy patients after treatment with high-dose intravenous methylprednisolone. Method: This is a descriptive retrospective study. Data were gathered from the medical records of 244 patients (488 eyes) diagnosed with methanol toxic optic neuropathy over a 5 year period (January 2010 until December 2014). They were treated with high-dose intravenous methylprednisolone 1 g/day followed by oral methylprednisolone 1 mg/kg which was tapered off. The sex, age, onset of blurred vision, time interval between alcohol ingestion and the treatment, funduscopic examination and visual acuity during the initial assessment, on the third day and at the one week, two week and one month follow-up visits were obtained and analyzed. Results: There were 244 patients included in our study. Two-hundred-twenty six (92.6%) were male. One-hundred-six (43.5%) were 26-35 years of age. One-hundred-sixty-nine (68.3%) had onset of visual loss 24 hours after alcohol exposure. One-hundred-eighty-seven (64.5%) had an interval that was 2 days – 1 week between alcohol ingestion and steroid treatment. One-hundred- sixty-five (67.6%) had optic disc swelling seen by funduscopy. Most patients had an initial visual acuity between light perception and counting fingers at 1 meter. On the third day of intravenous methylprednisolone treatment, 288 out of 488 eyes (59%) showed improvement of visual acuity, 175 eyes (35.8%) showed no improvement and 25 eyes (5.1%) had decreased visual acuity. Conclusion: The majority of patients were male and most cases were between the ages of 26-35 years of age. Loss of visual acuity mostly occurred after 24 hours of alcohol ingestion and the majority of cases received treatment 2 days–1 week of alcohol ingestion. Fundusopic examination showed optic disc swelling in most cases. Treatment with high-dose intravenous methylprednisolone may improve visual acuity of patients with methanol toxic optic neuropathy.