Factors predicting optic nerve axonal degeneration after methanol-induced acute optic neuropathy: a 2-year prospective study in 54 patients

Zakharov, Sergey; Nurieva, Olga; Kotikova, Katerina; Urban, Pavel; Navrátil, Tomáš; Pelclová, Daniela

doi:10.1007/s00706-015-1581-x

Cited by 21 publications

(11 citation statements)

References 40 publications

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“…Finally, in the group of patients with brain haemorrhages, the long‐term visual damage was present more often than in the group of patients without haemorrhagic lesions ( p < 0.001) and in the group of patients with non‐haemorrhagic CNS damage ( p = 0.015), as it was shown earlier . This fact confirms that brain haemorrhages generally occur in the most severely poisoned patients with combined damage of the optic nerve, retinal–blood barrier, retinal ganglion cells and brain structures.…”

Section: Discussionsupporting

confidence: 82%

Acute Methanol Poisoning: Prevalence and Predisposing Factors of Haemorrhagic and Non‐Haemorrhagic Brain Lesions

Zakharov

Kotikova

Vaněčková

et al. 2016

Basic Clin Pharma Tox

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Abstract:The purpose was to study the prevalence and predisposing factors of brain lesions in survivors of acute methanol poisoning. Clinical data on 106 patients with methanol poisoning were collected during the Czech mass poisoning outbreak. Of 83 survivors, in 46 (55%) patients, follow-up examinations including magnetic resonance imaging of brain (MR) were performed 3-8 and 24-28 months after discharge from the hospital. Of 46 patients with a median age of 49 (interquartile range, 35-57) years, 24 (52%) patients had a total of 40 abnormal brain findings with haemorrhagic lesions detected in 15 (33%) and non-haemorrhagic lesions found in 9 (19%) patients. The patients with haemorrhagic brain lesions were more acidemic (lower arterial blood pH, higher base deficit) and had higher glycaemia and lactacidaemia on admission than those without haemorrhages (all p < 0.05). Thirteen of 32 (41%) of patients with systemic anticoagulation and 2 of 14 (14%) of patients without it had haemorrhagic lesions (p = 0.080). Bleeding complications during the treatment occurred in 4 of 15 (27%) patients, and 5 of 15 (33%) patients had conditions predisposing to haemorrhage in the group with haemorrhagic lesions. In three cases with a series of computer tomography (CT)/MR performed during hospitalization, the necrotic lesions in the brain remained non-haemorrhagic during hospitalization and haemorrhagic lesions were detected on the follow-up MR examinations only. No association between brain haemorrhages and systemic anticoagulation during dialysis was found: brain haemorrhages might occur in severely poisoned patients treated without systemic anticoagulation, whereas treatment with high doses of heparin might not lead to brain haemorrhages.Methanol poisoning due to the consumption of illicit alcoholic beverages represents an important medical problem throughout the world [1][2][3][4][5]. This poisoning generally occurs either intentionally through abuse or attempted suicide or unintentionally through misuse or accident [6,7]. Despite the progress in diagnosis and treatment of methanol poisoning, morbidity and mortality are still high [8,9]. If therapeutic measures are inadequate or delayed, mortality may exceed 40% and serious longterm visual and central nervous system (CNS) sequelae may occur [10][11][12]. The strategy of active case finding and prehospital ethanol administration in the patients with suspected poisoning can improve outcome in a large-scale outbreak of methanol poisoning [13,14].Methanol in the human organism is metabolized to the highly toxic formic acid/formate ion, which inhibits mitochondrial respiration [15][16][17][18]. The accumulation of formic acid results in metabolic acidosis, visual impairment and damage to basal ganglia [19][20][21]. Rapid administration of antidotes and haemodialysis are crucial for successful treatment [22][23][24][25]. Importance.The role of haemodialysis in the treatment of methanol poisoning is well-established: it effectively eliminates both methanol and formate and helps to cor...

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Section: Discussionsupporting

confidence: 82%

Acute Methanol Poisoning: Prevalence and Predisposing Factors of Haemorrhagic and Non‐Haemorrhagic Brain Lesions

Zakharov

Kotikova

Vaněčková

et al. 2016

Basic Clin Pharma Tox

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“…49 On the other hand, progressing chronic retinal axonal degeneration leads to the strengthening of the association between RNFL thickness and the N1P1 amplitude of VEP. 50 The interesting finding was the association between the amplitude of VEP and the rate of chronic axonal loss: the lower the initial N1P1amplitude (ie, the higher the number of acutely damaged retinal ganglion cells), the higher the rate of chronic axonal degeneration during the following years. The mechanisms of neuroinflammation responsible for chronic neuronal degeneration after traumatic and nontraumatic brain injury may be involved in this process.…”

Section: Discussionmentioning

confidence: 99%

Progressive Chronic Retinal Axonal Loss Following Acute Methanol-induced Optic Neuropathy: Four-Year Prospective Cohort Study

Nurieva

Diblik

Kuthan

et al. 2018

American Journal of Ophthalmology

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“…12 Specifically, the toxicity is a combined effect of the metabolic acidosis and an intrinsic toxicity of the formate anion. 13 Methanol poisoning is a medical emergency. It will be a permanent phenomenon in human communities and requires special attention.…”

Section: Discussionmentioning

confidence: 99%

The awareness of blindness related to misuse of illicit liquor containing methanol: A community study

Mahayana

Gani

Pawiroranu

2018

J Community Empowerment for Health

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Methanol is a cheap organic solvent and additive in the production of illicit liquors. There are many recorded incidences in Indonesia regarding methanol intoxication induced visual loss. We aimed to investigate the level of awareness of liquor-containing methanol misuse in the community related to its hazard of visual loss. Participants were recruited from 3 primary health care units which represent the population of rural communities in Yogyakarta, Indonesia and then divided into two groups: drinkers (cases) and nondrinkers (control). The participants answered closed questions in a questionnaire about knowledges related to the misuse of illicit liquor. Forty participants (mean age: 39.8 ± 13.39) completed the questionnaires. There were 40% and 60% of participants who reside in the city and suburbs; their education levels were 2.5%, 12.5%, 30%, 35%, and 7.5% for uneducated, elementary, junior, senior high school, and undergraduate, respectively. There were 6 drinker and 34 nondrinker participants (sex difference p <0.001). Only 1 drinker and 7 nondrinkers answered correctly regarding the ethanol based liquor. Fifty percent of drinkers and 32.35% of nondrinkers were aware that illicit liquors were most probably mixed with methanol. The drinkers were aware that liquor-containing methanol can cause sudden death (33.33%) or sudden visual loss (33.33%), while 55.8% nondrinker answered only sudden death. Participants’ awareness levels regarding the content and the visual outcome of methanol-containing liquor remain low. From this pilot study, we confirmed the need to conduct further research with a larger sample size, followed by clear ethical considerations for prevention.KEYWORDS alcohol poisoning; methanol illicit liquor; vision loss; blindness prevention

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Factors predicting optic nerve axonal degeneration after methanol-induced acute optic neuropathy: a 2-year prospective study in 54 patients

Cited by 21 publications

References 40 publications

Acute Methanol Poisoning: Prevalence and Predisposing Factors of Haemorrhagic and Non‐Haemorrhagic Brain Lesions

Acute Methanol Poisoning: Prevalence and Predisposing Factors of Haemorrhagic and Non‐Haemorrhagic Brain Lesions

Progressive Chronic Retinal Axonal Loss Following Acute Methanol-induced Optic Neuropathy: Four-Year Prospective Cohort Study

The awareness of blindness related to misuse of illicit liquor containing methanol: A community study

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