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Sobhi N, Abdollahi M, Arman A, Mahmoodpoor A, Jafarizadeh A. Methanol Induced Optic Neuropathy: Molecular Mysteries, Public Health Perspective, Clinical Insights and Treatment Strategies. Semin Ophthalmol 2024:1-12. [PMID: 38804878 DOI: 10.1080/08820538.2024.2358310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 05/17/2024] [Indexed: 05/29/2024]
Abstract
Methanol-induced optic neuropathy (MION) represents a critical public health issue, particularly prevalent in lower socioeconomic populations and regions with restricted alcohol access. MION, characterized by irreversible visual impairment, arises from the toxic metabolization of methanol into formaldehyde and formic acid, leading to mitochondrial oxidative phosphorylation inhibition, oxidative stress, and subsequent neurotoxicity. The pathogenesis involves axonal and glial cell degeneration within the optic nerve and potential retinal damage. Despite advancements in therapeutic interventions, a significant proportion of affected individuals endure persistent visual sequelae. The study comprehensively investigates the pathophysiology of MION, encompassing the absorption and metabolism of methanol, subsequent systemic effects, and ocular impacts. Histopathological changes, including alterations in retinal layers and proteins, Müller cell dysfunction, and visual symptoms, are meticulously examined to provide insights into the disease mechanism. Furthermore, preventive measures and public health perspectives are discussed to highlight the importance of awareness and intervention strategies. Therapeutic approaches, such as decontamination procedures, ethanol and fomepizole administration, hemodialysis, intravenous fluids, electrolyte balance management, nutritional therapy, corticosteroid therapy, and erythropoietin (EPO) treatment, are evaluated for their efficacy in managing MION. This comprehensive review underscores the need for increased awareness, improved diagnostic strategies, and more effective treatments to mitigate the impact of MION on global health.
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Affiliation(s)
- Navid Sobhi
- Nikookari Eye Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mirsaeed Abdollahi
- Nikookari Eye Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Arman
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ata Mahmoodpoor
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Anesthesiology and Intensive care, Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
| | - Ali Jafarizadeh
- Nikookari Eye Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Durmaz Engin C, Kucuk HC, Yaman A, Men S, Bajin MS. The Role of Optic Nerve Diffusion Restriction on Visual Prognosis in Methanol Poisoning. Neuroophthalmology 2024; 48:159-168. [PMID: 38756343 PMCID: PMC11095577 DOI: 10.1080/01658107.2023.2293865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/22/2023] [Indexed: 05/18/2024] Open
Abstract
The aim of this study was to investigate the role of optic nerve diffusion status on cranio-orbital magnetic resonance imaging (MRI) in predicting visual prognosis in cases of methanol intoxication. Diffusion-weighted imaging (DWI) from 16 eyes of eight patients who were admitted to our clinic due to methanol intoxication was analysed retrospectively. The relationship between clinical and laboratory findings, treatment regimen, visual prognosis, and imaging findings was investigated. Diffusion restriction (DR) of the optic nerve on DWI was observed in seven (43%) eyes. Regardless of the clinical and laboratory characteristics and treatment regimen, visual acuity (VA) improved in eyes in which restricted diffusion regressed over the follow-up period. DWI of the optic nerve during the acute phase of methanol poisoning may provide prognostically important data. Improvement of DR during follow-up may be an indicator of an increase in VA.
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Affiliation(s)
- Ceren Durmaz Engin
- Department of Ophthalmology, Buca Seyfi Demirsoy Education and Research Hospital, Izmir, Turkey
| | - Hasan Can Kucuk
- Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey
| | - Aylin Yaman
- Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey
| | - Suleyman Men
- Department of Radiology, Dokuz Eylul University, Izmir, Turkey
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Alrobaian M, Alkhuraiji A, Almohanna R, Alshehri M, Alyahya B. Visual outcome of methanol toxic optic neuropathy after erythropoietin treatment in Riyadh, Saudi Arabia. Saudi J Ophthalmol 2024; 38:41-46. [PMID: 38628402 PMCID: PMC11017006 DOI: 10.4103/sjopt.sjopt_174_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/29/2023] [Accepted: 03/07/2023] [Indexed: 04/19/2024] Open
Abstract
PURPOSE The purpose of this study is to evaluate the visual response of methanol-induced optic neuropathy to management with erythropoietin (EPO) along with conventional therapy. METHODS This retrospective case series examines the ophthalmological data of patients diagnosed with methanol-induced optic neuropathy between 2020 and 2021 at two centers, Riyadh, Saudi Arabia. Patients' characteristics and the results of initial and final ophthalmological examinations were documented and compared between patients who received EPO in addition to conventional management and those who received only conventional management. RESULTS A total of nine cases were reviewed, of which eight (88.9%) were males and one was female (11.1%). The mean age was 37.7 years. At presentation, funduscopic examination revealed optic disc edema in four eyes (two patients), and 14 eyes had normal appearance (seven patients). Among the nine patients who received conventional management, 5 (55.6%) additionally received intravenous EPO during the treatment course. There was no clinically or statistically significant difference in terms of visual outcome between the two groups. The mean visual acuity at the final presentation was 1.32 ± 0.79 logarithm of the minimum angle of resolution (LogMAR) in the EPO group and 1.36 ± 0.85 LogMAR in the non-EPO group. Optical coherence tomography indicated that the EPO group had an average retinal nerve fiber layer thickness of 48.13μm (±6.2), at the final assessment. CONCLUSION Managing the visual impairments in individuals with methanol-induced optic neuropathy using intravenous EPO resulted in similar final visual outcomes compared to conventional management.
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Affiliation(s)
- Malek Alrobaian
- Department of Ophthalmology, Ministry of the National Guard – Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Arwa Alkhuraiji
- Department of Ophthalmology, Ministry of the National Guard – Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Rema Almohanna
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Surgery, Ministry of the National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Mohammed Alshehri
- Department of Emergency Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Bader Alyahya
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Witczyńska A, Alaburda A, Grześk G, Nowaczyk J, Nowaczyk A. Unveiling the Multifaceted Problems Associated with Dysrhythmia. Int J Mol Sci 2023; 25:263. [PMID: 38203440 PMCID: PMC10778936 DOI: 10.3390/ijms25010263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Dysrhythmia is a term referring to the occurrence of spontaneous and repetitive changes in potentials with parameters deviating from those considered normal. The term refers to heart anomalies but has a broader meaning. Dysrhythmias may concern the heart, neurological system, digestive system, and sensory organs. Ion currents conducted through ion channels are a universal phenomenon. The occurrence of channel abnormalities will therefore result in disorders with clinical manifestations depending on the affected tissue, but phenomena from other tissues and organs may also manifest themselves. A similar problem concerns the implementation of pharmacotherapy, the mechanism of which is related to the impact on various ion currents. Treatment in this case may cause unfavorable effects on other tissues and organs. Drugs acting through the modulation of ion currents are characterized by relatively low tissue specificity. To assess a therapy's efficacy and safety, the risk of occurrences in other tissues with similar mechanisms of action must be considered. In the present review, the focus is shifted prominently onto a comparison of abnormal electrical activity within different tissues and organs. This review includes an overview of the types of dysrhythmias and the basic techniques of clinical examination of electrophysiological disorders. It also presents a concise overview of the available pharmacotherapy in particular diseases. In addition, the authors review the relevant ion channels and their research technique based on patch clumping.
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Affiliation(s)
- Adrianna Witczyńska
- Department of Organic Chemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toruń, Poland;
| | - Aidas Alaburda
- Department of Neurobiology and Biophysics, Institute of Bioscience, Vilnius University Saulėtekio Ave. 7, LT-10257 Vilnius, Lithuania;
| | - Grzegorz Grześk
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toruń, Poland;
| | - Jacek Nowaczyk
- Department of Physical Chemistry and Physicochemistry of Polymers, Faculty of Chemistry, Nicolaus Copernicus University, 7 Gagarina St., 87-100 Toruń, Poland;
| | - Alicja Nowaczyk
- Department of Organic Chemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toruń, Poland;
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Buonfiglio F, Böhm EW, Pfeiffer N, Gericke A. Oxidative Stress: A Suitable Therapeutic Target for Optic Nerve Diseases? Antioxidants (Basel) 2023; 12:1465. [PMID: 37508003 PMCID: PMC10376185 DOI: 10.3390/antiox12071465] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Optic nerve disorders encompass a wide spectrum of conditions characterized by the loss of retinal ganglion cells (RGCs) and subsequent degeneration of the optic nerve. The etiology of these disorders can vary significantly, but emerging research highlights the crucial role of oxidative stress, an imbalance in the redox status characterized by an excess of reactive oxygen species (ROS), in driving cell death through apoptosis, autophagy, and inflammation. This review provides an overview of ROS-related processes underlying four extensively studied optic nerve diseases: glaucoma, Leber's hereditary optic neuropathy (LHON), anterior ischemic optic neuropathy (AION), and optic neuritis (ON). Furthermore, we present preclinical findings on antioxidants, with the objective of evaluating the potential therapeutic benefits of targeting oxidative stress in the treatment of optic neuropathies.
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Affiliation(s)
- Francesco Buonfiglio
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (E.W.B.); (N.P.)
| | | | | | - Adrian Gericke
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (E.W.B.); (N.P.)
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Tabatabaei SA, Amini M, Haydar AA, Soleimani M, Cheraqpour K, Shahriari M, Hassanian-Moghaddam H, Zamani N, Akbari MR. Outbreak of methanol-induced optic neuropathy in early COVID-19 era; effectiveness of erythropoietin and methylprednisolone therapy. World J Clin Cases 2023; 11:3502-3510. [PMID: 37383889 PMCID: PMC10294205 DOI: 10.12998/wjcc.v11.i15.3502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/01/2023] [Accepted: 04/14/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Methanol is a highly toxic, non-potable alcohol. Outbreaks of methanol toxicity occur due to its fraudulent addition to alcoholic beverages as a cheaper substitute for ethanol. Recently, alongside the coronavirus disease 2019 (COVID-19) pandemic, rumors circulated on social media that consuming alcohol can prevent or cure the virus, leading to a COVID-19 and methanol-induced optic neuropathy (MON) syndemic.
AIM To investigate the impact of erythropoietin (EPO) on the outcomes of patients diagnosed with MON.
METHODS In this prospective study, 105 patients presenting with acute bilateral visual loss secondary to methanol intoxication were enrolled from March to May 2020 at Farabi Eye Hospital. A comprehensive ocular examination was conducted for all participants. Recombinant human EPO and methylprednisolone were administered intravenously to all patients for three consecutive days.
RESULTS The mean age of the participants was 39.9 years (± 12.6). Ninety-four patients were male and eleven were female. The mean pre-treatment best corrected visual acuity (BCVA) improved from 2.0 ± 0.86 to 1.39 ± 0.69 logarithm of the minimum angle of resolution post-treatment (P < 0.001), with significant improvement observed in all age categories and genders (P < 0.001). Visual acuity improvement was also significant regardless of whether the patient presented before or after 72 h (P < 0.001), and the post-treatment BCVA remained significant at all monthly follow-up visits (P < 0.001).
CONCLUSION EPO and methylprednisolone therapy have been shown to be effective in improving visual outcomes in patients with MON when administrated within the first month of exposure. Public awareness efforts are necessary to prevent further outbreaks of methanol toxicity in the current COVID-19 era.
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Affiliation(s)
- Seyed Ali Tabatabaei
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Mohammad Amini
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Ali A Haydar
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Mohammad Soleimani
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Kasra Cheraqpour
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Mansoor Shahriari
- Department of Ophthalmology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran 1617763141, Iran
| | - Hossein Hassanian-Moghaddam
- Department of Clinical Toxicology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran 1964512642, Iran
| | - Nasim Zamani
- Department of Internal Medicine, Street, Agnes Medical Center, Fresno, CA 93720, United States
| | - Mohammad Reza Akbari
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
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Rashidi Alavijeh M, Mazaheri-Tehrani S, Saffari AS, Fazel M, Fazel F. Intravenous plus intravitreal erythropoietin for management of methanol toxicity optic neuropathy: A case report and brief review. Clin Case Rep 2023; 11:e7011. [PMID: 36873065 PMCID: PMC9979964 DOI: 10.1002/ccr3.7011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/29/2023] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Methanol can inhibit cellular aerobic respiration pathway and causes cell hypoxia specially in optic neurons. Despite using many drugs, methanol-induced optic neuropathy (MION) still has a poor prognosis. Here we present a case of MION which is managed by a combination of intravenous and intravitreal erythropoietin in addition to corticosteroids.
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Affiliation(s)
- Mehran Rashidi Alavijeh
- Student Research Committee, School of Medicine Isfahan University of Medical Sciences Isfahan Iran
| | - Sadegh Mazaheri-Tehrani
- Student Research Committee, School of Medicine Isfahan University of Medical Sciences Isfahan Iran
| | - Amir Sepehr Saffari
- Student Research Committee, School of Medicine Isfahan University of Medical Sciences Isfahan Iran
| | - Mohammadreza Fazel
- Isfahan Eye Research Center, Department of Ophthalmology Isfahan University of Medical Sciences Isfahan Iran
| | - Farhad Fazel
- Isfahan Eye Research Center, Department of Ophthalmology Isfahan University of Medical Sciences Isfahan Iran
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Baj J, Forma A, Kobak J, Tyczyńska M, Dudek I, Maani A, Teresiński G, Buszewicz G, Januszewski J, Flieger J. Toxic and Nutritional Optic Neuropathies—An Updated Mini-Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053092. [PMID: 35270784 PMCID: PMC8910489 DOI: 10.3390/ijerph19053092] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/27/2022] [Accepted: 03/03/2022] [Indexed: 12/20/2022]
Abstract
Optic neuropathies constitute a group of conditions with various etiologies and might be caused by different factors; we can distinguish the genetic and acquired causes of optic neuropathies. Even though the symptoms are not highly specific, this condition is primarily characterized by unilateral or bilateral vision loss with worsening color detection. The loss may be acute or gradual depending on the causation. In this article, we included a specification of toxic optic neuropathy (TON) mainly triggered by alcohol abuse and also the usage of other substances, including drugs or methanol, as well as intoxication by metals, organic solvents, or carbon dioxide. Nutritional deficiencies, vitamin absorption disorder, and anemia, which usually appear during excessive alcohol intake, and their effect on the etiology of the optic neuropathy have been likewise discussed.
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Affiliation(s)
- Jacek Baj
- Department of Human Anatomy, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin, Poland; (J.B.); (A.M.)
| | - Alicja Forma
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b, 20-090 Lublin, Poland; (J.K.); (M.T.); (I.D.); (G.T.); (G.B.); (J.J.)
- Correspondence:
| | - Joanna Kobak
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b, 20-090 Lublin, Poland; (J.K.); (M.T.); (I.D.); (G.T.); (G.B.); (J.J.)
| | - Magdalena Tyczyńska
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b, 20-090 Lublin, Poland; (J.K.); (M.T.); (I.D.); (G.T.); (G.B.); (J.J.)
| | - Iga Dudek
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b, 20-090 Lublin, Poland; (J.K.); (M.T.); (I.D.); (G.T.); (G.B.); (J.J.)
| | - Amr Maani
- Department of Human Anatomy, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin, Poland; (J.B.); (A.M.)
| | - Grzegorz Teresiński
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b, 20-090 Lublin, Poland; (J.K.); (M.T.); (I.D.); (G.T.); (G.B.); (J.J.)
| | - Grzegorz Buszewicz
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b, 20-090 Lublin, Poland; (J.K.); (M.T.); (I.D.); (G.T.); (G.B.); (J.J.)
| | - Jacek Januszewski
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b, 20-090 Lublin, Poland; (J.K.); (M.T.); (I.D.); (G.T.); (G.B.); (J.J.)
| | - Jolanta Flieger
- Department of Analytical Chemistry, Medical University of Lublin, Chodźki 4A, 20-093 Lublin, Poland;
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Liberski S, Kaluzny BJ, Kocięcki J. Methanol-induced optic neuropathy: a still-present problem. Arch Toxicol 2022; 96:431-451. [PMID: 34988610 PMCID: PMC8731680 DOI: 10.1007/s00204-021-03202-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/09/2021] [Indexed: 11/28/2022]
Abstract
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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Affiliation(s)
- Sławomir Liberski
- Department of Ophthalmology, Poznan University of Medical Sciences, ul. Augustyna Szamarzewskiego 84, 61-848, Poznań, Poland.
| | - Bartlomiej J Kaluzny
- Division of Ophthalmology and Optometry, Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University, ul. Kornela Ujejskiego 75, 85-168, Bydgoszcz, Poland
| | - Jarosław Kocięcki
- Department of Ophthalmology, Poznan University of Medical Sciences, ul. Augustyna Szamarzewskiego 84, 61-848, Poznań, Poland
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Feizi S, Alemzadeh-Ansari M, Karimian F, Esfandiari H. Use of erythropoietin in ophthalmology: a review. Surv Ophthalmol 2021; 67:427-439. [PMID: 34157346 DOI: 10.1016/j.survophthal.2021.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 06/08/2021] [Accepted: 06/14/2021] [Indexed: 12/17/2022]
Abstract
Erythropoietin (EPO) is a glycoprotein hormone that regulates hematopoiesis in the human body. The presence of EPO and its receptors in different tissues indicates that this hormone has extramedullary effects in other tissues, including the eye. We focus on the biological roles of this hormone in the development and normal physiologic functions of the eye. Furthermore, we explore the role of EPO in the management of different ocular diseases - including diabetic retinopathy, retinopathy of prematurity, inherited retinal degeneration, branch and central retinal vein occlusion, retinal detachment, traumatic optic neuropathy, optic neuritis, methanol optic neuropathy, nonarteritic anterior ischemic optic neuropathy, glaucoma, and scleral necrosis.
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Affiliation(s)
- Sepehr Feizi
- Ophthalmic Research Center, Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | - Farid Karimian
- Ophthalmic Research Center, Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Esfandiari
- Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
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Methanol poisoning as a new world challenge: A review. Ann Med Surg (Lond) 2021; 66:102445. [PMID: 34141419 PMCID: PMC8187162 DOI: 10.1016/j.amsu.2021.102445] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 02/07/2023] Open
Abstract
Background Methanol poisoning (MP) occurs often via ingestion, inhalation, or dermal exposure to formulations containing methanol in base. Clinical manifestations of MP include gastrointestinal symptoms, central nervous system (CNS) suppression, and decompensated metabolic acidosis occurred with blurred vision and early or late blindness. Objective This study reviewed the clinical manifestations, laboratory and radiology findings, and treatment approaches in MP. Discussion Methanol is usually rapidly absorbed after ingestion and metabolized by alcohol dehydrogenase (ADH), then distributed to the body water to reach a volume distribution approximately equal to 0.77 L/kg. It is also eliminated from the body as unchanged parent compounds. Clinical manifestations of MP alone initiate within 0.5–4 h after ingestion and include gastrointestinal symptoms and CNS suppression. After a latent period of 6–24 h, depending on the absorbed dose, decompensated metabolic acidosis occurs with blurred vision and early or late blindness. Blurred vision with normal consciousness is a strong suspicious sign of an MP. The mortality and severity of intoxication are well associated with the severity of CNS depression, hyperglycemia, and metabolic acidosis, but not with serum methanol concentration. After initial resuscitation, the most important therapeutic action for patients with known or suspected MP is correction of acidosis, inhibition of ADH, and hemodialysis. Conclusion Since MP is associated with high morbidity and mortality, it should be considered seriously and instantly managed. Delay in treatment may cause complications, permanent damage, and even death. We attempt to review clinical manifestations, laboratory and radiology findings, and treatment approaches in Methanol poisoning (MP). The most important therapeutic action for patients with known MP is correction of acidosis, inhibition of alcohol dehydrogenase, and hemodialysis. The review emphasizes that MP has a high morbidity and mortality rate and it must be taken seriously and treated immediatly.
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12
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Karimi S, Arabi A, Shahraki T. Alcohol and the Eye. J Ophthalmic Vis Res 2021; 16:260-270. [PMID: 34055263 PMCID: PMC8126742 DOI: 10.18502/jovr.v16i2.9089] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 09/14/2020] [Indexed: 11/24/2022] Open
Abstract
In this article, we present a review of ocular conditions related to alcohol consumption. A search of the literature published from 1952 to March 2020 was performed. The titles and abstracts were screened and the eligible studies were selected. PubMed, ISI Web of Knowledge database, Scopus, Embase, and the Cochrane Library were searched. We categorized the relationship between alcohol intake and ocular conditions by the type of ocular exposure to alcohol. Accordingly, ocular findings following acute alcohol intoxication, optic neuropathy following methanol toxicity, congenital conditions related to maternal alcohol consumption, and ocular disease related to chronic alcoholism are discussed. The main feature of alcohol intoxication in the eye is abnormal eye movement. Acute optic neuropathy secondary to methyl alcohol consumption is a serious ocular disease with permanent vision loss or scotoma. Prenatal exposure to ethanol may end in fetal alcohol spectrum disease, where ocular findings are a constant component. The association between chronic alcohol consumption and increased risks of cataract, age-related macular degeneration, diabetic retinopathy, different types of optic neuropathy, impairment of visual quality, retinal vascular disease, and ocular surface disease has also been reported. Along with detrimental medical and social effects, the role of alcohol consumption in different ocular conditions should be considered, as alcohol-induced visual disturbances may contribute to the heavy burden of alcohol abuse on the healthcare system and overall quality of life.
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Affiliation(s)
- Saeed Karimi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Ophthalmology, Torfeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Arabi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Ophthalmology, Torfeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Toktam Shahraki
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Ophthalmology, Torfeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Gouda AS, Khattab AM, Mégarbane B. Lessons from a methanol poisoning outbreak in Egypt: Six case reports. World J Crit Care Med 2020; 9:54-62. [PMID: 32844091 PMCID: PMC7416361 DOI: 10.5492/wjccm.v9.i3.54] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/08/2020] [Accepted: 07/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Mass methanol poisonings are challenging, especially in regions with no preparedness, management guidelines and available antidotes.
CASE SUMMARY Six Ukrainian patients were referred to our emergency department in Cairo, Egypt several hours after drinking an alcoholic beverage made of 70%-ethanol disinfectant bought from a local pharmacy. All patients presented with severe metabolic acidosis and visual impairments. Two were comatose. Management was based on the clinical features and chemistry tests due to deficient resources for methanol leveling. No antidote was administered due to fomepizole unavailability and the difficulties expected to obtain ethanol and safely administer it without concentration monitoring. One patient died from multiorgan failure, another developed blindness and the four other patients rapidly improved.
CONCLUSION This methanol poisoning outbreak strongly highlights the lack of safety from hazardous pharmaceuticals sold in pharmacies and limitations due to the lack of diagnostic testing, antidote availability and staff training in countries with limited-resources such as Egypt.
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Affiliation(s)
- Ahmed S Gouda
- National Egyptian Center of Environmental and Toxicological Research, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
| | - Amr M Khattab
- Department of Forensic Medicine and clinical Toxicology, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
| | - Bruno Mégarbane
- Department of Medical and Toxicological Critical Care, Lariboisière Hospital, Paris 75010, France
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Icel E, Suleyman H, Yazici GN, Bakan N, Sunar M. Effects of adenosine triphosphate on methanol-induced experimental optic nerve damage in rats: biochemical and histopathological evaluation. Cutan Ocul Toxicol 2020; 39:244-248. [PMID: 32543996 DOI: 10.1080/15569527.2020.1778017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE Acute methanol exposure leads to systemic intoxication and toxic optic neuropathy. In this experimental study, we aimed to determine the protective effects of intravenous administration of ATP in methanol-induced optic neuropathy. MATERIALS AND METHODS A total of 18 male albino Wistar rats weighing between 267 and 282 g were used for the experiment. The animals were divided into three groups as healthy control (HC), methanol (M), and methanol + ATP (M-ATP) groups. Distilled water was given to the healthy control group (n = 6) as the solvent, while 20% methanol was administered orally to the rats in M (n = 6) and M-ATP (n = 6) groups at a dose of 3 g/kg. Four hours after the administration of 20% methanol orally to the M-ATP group, ATP was injected intraperitoneally at a dose of 4 mg/kg. Eight hours after ATP injection, the animals were sacrificed by high-dose (50 mg/kg) thiopental anaesthesia and biochemical and histopathological examinations were performed on the removed optic nerve tissues. Malondialdehyde (MDA), total glutathione (tGSH), total oxidant status (TOS) and total anti-oxidant status (TAS) were analysed with biochemical tests. RESULTS MDA, TOS and OSI were significantly higher and tGSH and TAS levels were significantly lower in methanol administered group compared with the healthy controls or M-ATP group (p: 0.001). There was not any significant difference between healthy controls and M-ATP group regarding the oxidative stress parameters. There was a significant destruction and increase in thickness and astrocyte numbers and edema-vacuolization in methanol administered group compared with the healthy controls or M-ATP group (p: 0.001). CONCLUSION Intravenous ATP administration had a significant positive effect on the oxidative stress parameters and optic nerve structure in methanol-intoxicated rats. Antioxidant therapies should be considered in future studies as a possible therapy for methanol-induced toxic optic neuropathy.
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Affiliation(s)
- Erel Icel
- Faculty of Medicine, Department of Ophthalmology, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Halis Suleyman
- Faculty of Medicine, Department of Pharmacology, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Gulce Naz Yazici
- Faculty of Medicine, Department of Histology and Embryology, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Nuri Bakan
- Faculty of Medicine, Department of Biochemistry, Ataturk University, Erzurum, Turkey
| | - Mukadder Sunar
- Faculty of Medicine, Department of Anatomy, Erzincan Binali Yıldırım University, Erzincan, Turkey
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Pressman P, Clemens R, Sahu S, Hayes AW. A review of methanol poisoning: a crisis beyond ocular toxicology. Cutan Ocul Toxicol 2020; 39:173-179. [DOI: 10.1080/15569527.2020.1768402] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Peter Pressman
- The Daedalus Institute, The Daedalus Foundation, San Clemente, CA, USA
| | - Roger Clemens
- International Center for Regulatory Science, University of Southern California, Los Angeles, CA, USA
| | - Saura Sahu
- Center for Food Safety and Applied Nutrition, US Food & Drug Administration, College Park, MD, USA
| | - A. Wallace Hayes
- College of Public Health, University of South Florida, Tampa, FL, USA
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Soltan Sanjari M, Pakdel F, Moosavi F, Pirmarzdashti N, Nojomi M, Haghighi A, Hashemi M, Bahmani Kashkouli M. Visual Outcomes of Adding Erythropoietin to Methylprednisolone for Treatment of Retrobulbar Optic Neuritis. J Ophthalmic Vis Res 2019; 14:299-305. [PMID: 31660109 PMCID: PMC6815326 DOI: 10.18502/jovr.v14i3.4786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 09/29/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose To compare the short-term visual function results and safety of erythropoietin as an add-on to the standard corticosteroid therapy in retrobulbar optic neuritis (RON). Methods In this prospective pilot study, adult patients with isolated RON with less than 10 days of onset were enrolled. Patients were consecutively assigned to standard intravenous methylprednisolone treatment either in combination with intravenous erythropoietin (20,000 units/day for three days) (group-1) or intravenous methylprednisolone alone (group-2). Primary outcome measure was best-corrected visual acuity (BCVA), which was assessed up to 120 days from the day the treatment was begun. Systemic evaluations were performed during and after treatment. Results Sixty-two patients with RON (mean age = 26.6 ± 5.77 years; range = 18–40 years) were enrolled into the study (group-1, n = 35; group-2, n = 27). BCVA three months after the treatment was 0.19 ± 0.55 logMAR and 0.11 ± 0.32 logMAR in group-1 and group-2, respectively (95% CI: -0.61 - 0.16; P = 0.62). Change in BCVA after three months was 2.84 ± 3.49 logMAR in group-1 and 2.46 ± 1.40 logMAR in group-2 (95% CI: -0.93-1.91; P = 0.57). Pace of recovery was not significantly different between the groups. No complications were detected among patients. Conclusion Intravenous erythropoietin as an add-on did not significantly improve the visual outcome in terms of visual acuity, visual field, and contrast sensitivity compared to traditional intravenous corticosteroid. This pilot study supports the safety profile of intravenous human recombinant erythropoietin, and it may help formulate future investigations with a larger sample size.
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Affiliation(s)
- Mostafa Soltan Sanjari
- Ophthalmology Department, Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Pakdel
- Ophthalmology Department, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Moosavi
- Ophthalmology Department, Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Niloofar Pirmarzdashti
- Ophthalmology Department, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Nojomi
- Department of Community Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Anoosheh Haghighi
- Internal Medicine Department, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Masih Hashemi
- Ophthalmology Department, Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Bahmani Kashkouli
- Ophthalmology Department, Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Abstract
PURPOSE OF REVIEW The diagnosis of visual loss from toxic-metabolic and hereditary optic neuropathies may be delayed in some cases because of a failure to elicit important information in the clinical history or to recognize typical examination findings. An understanding of the features specific to each type of toxic-metabolic and hereditary optic neuropathy, and of the underlying mechanism of insult to the optic nerve, could lead to earlier recognition, diagnosis, and treatment (when available). RECENT FINDINGS Understanding of the role of mitochondria in toxic-metabolic and hereditary optic neuropathies is growing, particularly regarding the mechanism of insult of certain agents (medications and toxins) and of vitamin B12 deficiency. New developments in the quest for treatment for hereditary optic neuropathy, specifically Leber hereditary optic neuropathy, are being seen. SUMMARY Toxic-metabolic and hereditary optic neuropathies present in a similar fashion, with painless, progressive, bilateral visual loss with dyschromatopsia and cecocentral visual field defects. The associated retinal ganglion cell and axonal loss is typically due to mitochondrial dysfunction caused by an exogenous agent (toxic), by insufficient or deficient substrate (metabolic or nutritional), or by abnormal proteins or mitochondrial structure determined by a genetic mutation (hereditary).
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Exogenous Toxins and CNS Injuries. Clin Neuroradiol 2019. [DOI: 10.1007/978-3-319-68536-6_66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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