McKellar M J, Hidajat R R, Elder M J
Department of Ophthalmology, Christchurch Hospital, New Zealand.
Aust N Z J Ophthalmol. 1997 Aug;25(3):225-30. doi: 10.1111/j.1442-9071.1997.tb01397.x.
The present report describes previously undocumented changes in the electroretinogram (ERG) and visual-evoked response (VER) following acute methanol ingestion and highlights the ocular effects of methanol poisoning.
Two cases of acute ocular damage following methanol ingestion are presented. One patient underwent extensive electrophysiological and psychophysical testing.
Both patients reported transient visual disturbances. In each patient vision was 6/6 in both eyes at presentation but subsequently improved to 6/4. Colour vision (Ishihara plates) and pupillary reactions were normal. The optic discs were hyperaemic and swollen and retinal oedema extended along the major vascular arcades. There was cystoid macular oedema and 'pseudo cherry red spots' were observed. Automated field analysis revealed a generalized depression of retinal sensitivity, an enlargement of one blind spot and paracentral scotomas. The scotopic ERG was subnormal with diminished a- and b-waveforms and the cone response to flicker was reduced. The pattern VER P2 waveform was normal in latency but decreased in amplitude.
Acute methanol ingestion can cause characteristic ocular damage, together with widespread electrophysiological dysfunction. The data presented suggest that methanol affects the photoreceptors, Muller cells and the retrolaminar portion of the optic nerve.
本报告描述了急性甲醇摄入后视网膜电图（ERG）和视觉诱发电位（VER）中此前未记录的变化，并强调了甲醇中毒的眼部影响。
报告了两例甲醇摄入后急性眼部损伤的病例。其中一名患者接受了广泛的电生理和心理物理学测试。
两名患者均报告有短暂的视觉障碍。两名患者初诊时双眼视力均为6/6，但随后提高到6/4。色觉（石原氏色盲测试图）和瞳孔反应均正常。视盘充血、肿胀，视网膜水肿沿主要血管弓延伸。存在黄斑囊样水肿，并观察到“假性樱桃红斑”。自动视野分析显示视网膜敏感性普遍降低，一个盲点扩大，旁中心暗点出现。暗视ERG异常，a波和b波波形减弱，对闪烁光的视锥细胞反应降低。图形VER的P2波形潜伏期正常，但波幅降低。
急性甲醇摄入可导致特征性眼部损伤，并伴有广泛的电生理功能障碍。所提供的数据表明，甲醇会影响光感受器、米勒细胞和视神经的视网膜后段。
