Therapeutic effects of high-dose intravenous prednisolone in methanol-induced toxic optic neuropathy

Abstract

Purpose: We evaluated the effects of high-dose steroids for the treatment of methanol optic neuropathy.

Methods: In an interventional case series, 6 patients with a history of sudden visual loss after an ingestion of homemade alcoholic beverages were included in the study. The patients received 250 mg intravenous methyl prednisolone every 6 h for 4 days and continued with oral prednisolone at 1 mg/kg for 10 days. Best-corrected visual acuity (BCVA), optical coherent tomography, fundus photo, and a complete ophthalmologic exam of the patients were taken before the treatment and 3 months after treatment.

Results: All the patients were male. The mean age was 26.34±2.7 years. The mean BCVA before the treatment was 0.86±0.08 in the right eye and 0.93±0.1 in the left eye using the logMAR scale. Four patients showed nerve fiber layer edema as a white density in peripapillary area. After treatment, the mean BCVA was 0.33±0.18 in the right eye and 0.29±0.2 in the left eye using the logMAR scale. The differences between before treatment and after treatment were significant (P=0.008 and P=0.003, respectively). The mean macular thickness and cup.to.disc ratio were unchanged.

Conclusion: Intravenous high-dose methyl prednisolone may have benefits in the treatment of methanol optic neuropathy.