Zamani Nasim, Hassanian-Moghaddam Hossein, Shojaei Maziar, Rahimian Sara
a Toxicological Research Center, Department of Clinical Toxicology , Loghman-Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences , Tehran , Iran.
b Ministry of Health , Excellence Centre of Clinical Toxicology , Tehran , Iran.
Cutan Ocul Toxicol. 2018 Jun;37(2):186-190. doi: 10.1080/15569527.2017.1373121. Epub 2017 Sep 14.
Following methanol intoxication, optic nerve neuropathy may occur, which is currently treated by different therapeutic regimens. Erythropoietin (EPO) has recently been introduced as a good therapeutic option in methanol-induced optic neuropathy. The aim of the current study was to evaluate the efficacy of EPO in improvement of the visual disturbances in methanol-intoxicated patients.
In a case-control study, all patients who had referred to our toxicology centre with confirmed diagnosis of methanol toxicity were considered to be included. Of them, those who had referred with visual disturbances, survived, and their visual disturbances had not improved after haemodialysis were entered. Cases received EPO and corticosteroids while controls only received corticosteroids. They were then compared regarding their visual outcome.
All five patients in the control group mentioned that after discharge, their visual acuity had improved while in the cases, three mentioned visual improvement, two mentioned their visual acuity had deteriorated after discharge, two mentioned no change in their visual acuity and three mentioned that their visual acuity had first improved but then deteriorated with a mean two-month interval period. In fundoscopic evaluations, two controls had normal fundospcopy while eight cases had abnormal fundoscopy (p = 0.055).
Protective effect of EPO on methanol-induced optic nerve may be strong at the beginning of the intervention but is probably transient.
甲醇中毒后可能发生视神经病变,目前采用不同的治疗方案进行治疗。促红细胞生成素(EPO)最近被引入作为甲醇所致视神经病变的一种良好治疗选择。本研究的目的是评估EPO对改善甲醇中毒患者视觉障碍的疗效。
在一项病例对照研究中,所有转诊至我们毒理学中心且确诊为甲醇中毒的患者均被纳入研究。其中,那些因视觉障碍前来就诊、存活且血液透析后视觉障碍未改善的患者被纳入。病例组接受EPO和皮质类固醇治疗,而对照组仅接受皮质类固醇治疗。然后比较他们的视觉结果。
对照组的所有5名患者均表示出院后视力有所改善,而病例组中,3名患者表示视力改善,2名患者表示出院后视力恶化,2名患者表示视力无变化,3名患者表示视力先改善但随后恶化,平均间隔时间为两个月。在眼底镜检查中,2名对照组患者眼底镜检查正常,而8名病例组患者眼底镜检查异常(p = 0.055)。
EPO对甲醇所致视神经的保护作用在干预开始时可能较强,但可能是短暂的。