Outbreak of methanol-induced optic neuropathy amid COVID-19 pandemic

Khalili, Mohammad Reza; Sadati, Maryam Sadat; Jahanbani-Ardakani, Hamidreza

doi:10.1007/s00417-020-04918-y

Cited by 6 publications

(9 citation statements)

References 3 publications

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“…Annually in the US, about 5.000 cases are diagnosed with an incidence of 6.4 cases per 1 million hospitalizations, and with the mean age of patients being 38 ± 18 years with a distinct predominance of the male sex (70 vs. 30%) (Kaewput et al 2021 ; Kraut 2016 ). According to statistical data, the prevalence of methanol intoxication is most common in developing countries and Southeast Asia, mainly among the lower economic and social strata (Abrishami et al 2011 ; Noor et al 2020 ), and is usually associated with accidental oral consumption due to similar physical properties to ethanol, especially in countries with alcohol prohibition, where a higher percentage of methanol poisonings is observed secondary to the oral consumption of contaminated alcohol from illegal domestic production (Khalili et al 2021 ). In the US, unintentional consumption of methanol is the cause of 90% of poisonings, while among cases involving intentional ingestion, suicide attempts slightly predominate (Chung et al 2018 ).…”

Section: Introductionmentioning

confidence: 99%

“…Massive outbreaks of toxic optic neuropathy (TON) associated with acute or chronic methanol poisoning occurred in the last century in the 1950s in the US (Bennett et al 1953 ; Benton and Calhoun 1953 ) and in the 1990s in Cuba (Lincoff et al 1993 ; Sadun et al 1994 ), as well as in recent decades in the El Salvador (Hassanian-Moghaddam et al 2015 ), Norway (Hovda et al 2005 ), Estonia (Paasma et al 2007 ), Czech Republic (Zakharov et al 2014 ), Libya (Rostrup et al 2016 ), Kenya (Rostrup et al 2016 ), Uganda (Doreen et al 2020 ), Turkey (Gulen et al 2020 ), India (Kumar et al 2019 ), and Tunisia (Brahmi et al 2007 ). Furthermore, in recent months, changes in social functioning caused by the COVID-19 pandemic have also contributed to a significant increase in the incidence of optic neuropathy related to methanol poisoning reported in various regions of the world including Iran (Khalili et al 2021 ; Sefidbakht et al 2020 ), as well as the US (Yip et al 2020 ).…”

Section: Introductionmentioning

confidence: 99%

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Methanol-induced optic neuropathy: a still-present problem

2022

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Methanol-induced optic neuropathy (Me-ION) is a serious condition that may result in long-term or irreversible visual impairment or even blindness secondary to damage and loss of function of the optic nerve and retina. Me-ION shows a tendency to occur as mass poisonings around the world with a clear predilection for poor societies in developing countries. The main mechanism underlying the molecular basis of Me-ION is the inhibition of the mitochondrial oxidative phosphorylation process through the binding of the toxic metabolite of methanol—formic acid—with the key enzyme of this process—cytochrome c oxidase. However, other mechanisms, including damage to the eye tissues by oxidative stress causing the intensification of the oxidative peroxidation process with the formation of cytotoxic compounds, as well as an increase in the synthesis of pro-inflammatory cytokines and influence on the expression of key proteins responsible for maintaining cell homeostasis, also play an important role in the pathogenesis of Me-ION. Histopathological changes in the eye tissues are mainly manifested as the degeneration of axons and glial cells of the optic nerve, often with accompanying damage of the retina that may involve all its layers. Despite the development of therapeutic approaches, persistent visual sequelae are seen in 30–40% of survivors. Thus, Me-ION continues to be an important problem for healthcare systems worldwide.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Methanol-induced optic neuropathy: a still-present problem

2022

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“…Most patients were misled by the misinformation that ingesting alcohol or hand sanitizers could protect against COVID-19, while some were caused by alcohol abuse associated with fear and anxiety. Tis resulted in 800 deaths, and many survived with blindness or visual impairment [3][4][5][6][7]. Tus, methanol poisoning continues to be an important issue in public health, emergency, and ophthalmology worldwide.…”

Section: Introductionmentioning

confidence: 99%

“…It is naturally contained in fermented beverages and widely used in industry, including cleaning products, antifreeze, pesticides, and fuel sources [8,9]. Accidental oral ingestion is the primary exposure route [1,3,[9][10][11]. Inhalation and dermal absorption associated with occupational exposure or intentional abuse have been increasingly reported [8,[12][13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

“…Persistent visual sequelae are seen in 30–40% of survivors [ 2 ]. During the COVID-19 pandemic, the methanol poisoning rate increased unexpectedly in Iran [ 3 , 4 ], Turkey [ 5 ], and the United States [ 6 , 7 ]. Most patients were misled by the misinformation that ingesting alcohol or hand sanitizers could protect against COVID-19, while some were caused by alcohol abuse associated with fear and anxiety.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics of Methanol-Induced Optic Neuropathy: Correlation between Aetiology and Clinical Findings

Sun

Zhang

et al. 2022

Journal of Ophthalmology

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Purpose. To show the clinical characteristics, identify the magnetic resonance imaging (MRI) and optical coherence tomography (OCT) features, and observe the visual outcome of methanol-induced optic neuropathy. Methods. Clinical data were retrospectively collected from in-patients diagnosed with methanol-induced optic neuropathy in the Neuro-Ophthalmology Department of the Chinese People’s Liberation Army General Hospital from January 2016 to January 2021. Results. Eight patients were included in this study. The exposure time was 6–34 h for ingestion, 3-4 months for inhalation, and more than ten years for skin absorption. All patients demonstrated bilateral acute visual impairment. Seven of eight patients had other accompanying systemic symptoms. Seven of eight patients demonstrated optic nerve lesions in MRI, and five presented with a hyperintense T2 signal in a “central” type. OCT showed the macular ganglion cell layer and inner plexiform layer (mGCL-IPL) thinning before the peripapillary retinal nerve fiber layer (pRNFL) thinning. The visual improvement was achieved transiently for seven of eight patients after treatment. One patient with a mitochondrial DNA mutation maintained a bilateral no-light perception (NLP) from the onset to the last visit. All patients had poor visual prognoses, with either light perception or NLP. Conclusions. Methanol-induced optic neuropathy is a rare bilateral optic neuropathy with a poor visual outcome. A centrally hyperintense T2 signal of the optic nerve is common in methanol-induced optic neuropathy. The thinning of the mGCL-IPL is more sensitive than that of the pRNFL for early diagnosis. A mitochondrial genetic defect may be a predisposing factor for methanol-induced optic neuropathy.

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