Pakravan Mohammad, Esfandiari Hamed, Sanjari Nasrin, Ghahari Elham
a Ophthalmic Research Center and Department of Ophthalmology , Shaheed Beheshti Medical University , Tehran , Iran.
Am J Drug Alcohol Abuse. 2016 Nov;42(6):633-639. doi: 10.1080/00952990.2016.1198800. Epub 2016 Jul 27.
Methanol-induced optic neuropathy (MTON) is frequently seen in countries where alcohol consumption is banned or poorly regulated. MTON frequently results in blindness and there is no empirically validated treatment.
To evaluate the effect of erythropoietin (EPO) as an adjunctive treatment for MTON.
In this nonrandomized interventional comparative study, all participants were diagnosed with MTON and received the steroid methylprednisolone. Eleven participants received intravenous EPO (10000 IU twice a day) for three days as an adjuvant to methylprednisolone (EPO group); 11 participants in a historical control group received methylprednisolone only (control group). Main outcomes were best-corrected visual acuity (BCVA), peripapillary retinal nerve fiber layer thickness (PRNFLT), and visual field mean deviation (MD).
Mean BCVA improved significantly in both groups: from 2.93 ± 0.55 to 1.75 ± 1.16 LogMAR at month 3 (p < 0.001) in the EPO group, and from 2.65 ± 0.68 to 2.19 ± 0.75 at final visit in the control group (p = 0.001). The final BCVA was significantly better in the EPO group (p = 0.012). The mean PRNFLT decreased in both groups. However, at the final follow-up, PRNFLT was significantly thinner in the control group (53 ± 6 vs. 77 ± 26 microns, respectively; p < 0.001).
Intravenous EPO plus high-dose intravenous steroid may be an effective combination therapy for the patients with MTON.
甲醇所致视神经病变（MTON）在酒精消费被禁止或监管不力的国家屡见不鲜。MTON常导致失明，且尚无经实证验证的治疗方法。
评估促红细胞生成素（EPO）作为MTON辅助治疗的效果。
在这项非随机干预性对照研究中，所有参与者均被诊断为MTON，并接受了类固醇甲泼尼龙治疗。11名参与者接受静脉注射EPO（每天两次，每次10000国际单位），为期三天，作为甲泼尼龙的辅助治疗（EPO组）；11名历史对照组参与者仅接受甲泼尼龙治疗（对照组）。主要结局指标为最佳矫正视力（BCVA）、视乳头周围视网膜神经纤维层厚度（PRNFLT）和视野平均缺损（MD）。
两组的平均BCVA均有显著改善：EPO组在第3个月时从2.93±0.55 LogMAR提高到1.75±1.16 LogMAR（p<0.001），对照组在末次随访时从2.65±0.68提高到2.19±0.75（p = 0.001）。EPO组的最终BCVA显著更好（p = 0.012）。两组的平均PRNFLT均下降。然而，在末次随访时，对照组的PRNFLT显著更薄（分别为53±6微米和77±26微米；p<0.001）。
静脉注射EPO加高剂量静脉类固醇可能是MTON患者的一种有效联合治疗方法。
