• NIZMA PERMAISUARI Hadji Boejasin Pelaihari Hospital, South Kalimantan, Indonesia
  • NUR AISYAH RAHMAWATI Hadji Boejasin Pelaihari Hospital, South Kalimantan, Indonesia
  • SYNTIA NUSANTI Neuro-ophthalmology Division, Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • HUSNI THAMRIN Department of Ophthalmology, Hadji Boejasin Pelaihari Hospital, South Kalimantan, Indonesia




High-Dose Steroid, Intoxication, Methanol, Optic Neuropathy


Objective: Methanol-induced optic neuropathy is a visual impairment that results from damage to the optic nerve fibers caused by methanol. It is frequently bilateral with permanent visual deterioration. According to the American Academy of Clinical Toxicology (AACT), methanol-poisoned patients who present with ocular manifestations should be treated with fomepizole, ethanol, or hemodialysis, which do not remove the metabolites from the optic nerve. High-dose intravenous steroid treatment has been proposed in several studies to salvage vision because of its anti-inflammatory effect. This article examines the existing literature on the efficacy of high-dose intravenous steroid treatment in patients with methanol-induced optic neuropathy.

Methods: Literature searches were conducted using keywords and MeSH headings specifically chosen to identify published articles in CENTRAL, PubMed, ScienceDirect, ProQuest, EBSCO, and Google Scholar. Articles included were full-text, observational studies or randomized controlled trials published in English or Bahasa Indonesia.

Results: Four case series and one case report were found in the bibliographic databases. We identified 33 patients with bilateral optic neuropathy caused by methanol ingestion who were initially treated with 1 g intravenous methylprednisolone, administered as a single dose or as divided doses for 3–4 d, followed by oral prednisolone. There were visual improvements in 48 out of 56 patients (83%). No adverse events were reported.

Conclusion: Intravenous high-dose steroid treatment may benefit the visual status of patients with methanol-induced optic neuropathy. However, further studies are needed to determine the characteristics of patients who may benefit most from this regimen.


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1. Grzybowski A, Zulsdorff M, Wilhelm H, Tonagel F. Toxic optic neuropathies: an updated review. Acta Ophthalmol 2015;93:402-10.
2. Yunard A, Nusanti S, Sidik M. Methanol toxic optic neuropathy (characteristic and evaluation of therapy). Ophthalmol India 2016;42:38-44.
3. Triningrat AAM, Rahayu NMK, Manuaba IBP. Visual acuity of methanol intoxicated patients before and after hemodialysis, methylprednisolone and prednisone therapy. J Oftalmol Indonesia 2010;7:129-32.
4. Barceloux DG, Bond GR, Krenzelok EP, Cooper H, Vale JA. American academy of clinical toxicology practice guidelines on the treatment of methanol poisoning. Clin Toxicol 2002;40:415-46.
5. Nand L, Chander S, Kashyap R, Gupta D, Jhobta A. Methyl alcohol poisoning: a manifestation of typical toxicity and outcome. J Assoc Physicians India 2014;62:756-9.
6. Bhalsing S, Jhunjhunwala R. Clinical study of methanol alcohol blindness. Int J Health Sci Res 2017;3:166-9.
7. Grecia OR, Alejandro MAA, Anna HAW, Paolah MGM, Andrade LAM. Bilateral optic neuropathy secondary to fragrance ingestion. MOJ Clin Med Case Rep 2016;4:00116.
8. Sharma R, Marasini S, Sharma AK, Shrestha JK, Nepal BP. Methanol poisoning: ocular and neurological manifestations. Optometry Vision Sci 2012;89:178-82.
9. Koehrer P, Garcher CC, Bron AM. Methanol poisoning: two case studies of blindness in Indonesia. Int Ophthalmol 2011;31:517-24.
10. Shukla M, Shikoh I. Intravenous methylprednisolone could salvage vision in methyl alcohol poisoning. Indian J Ophthalmol 2006;54:68-9.
11. Abrishami M, Khalifeh M, Shoayb M, Abrishami M. Therapeutic effects of high-dose intravenous prednisolone in methanol-induced toxic optic neuropathy. J Ocul Pharmacol Ther 2011;27:261-3.
12. Sanaei Zadeh H, Zamani N, Shadnia S. Outcomes of visual disturbances after methanol poisoning. Clin Toxicol 2011;49:102-7.
13. Pakravan M, Sanjari N. Erythropoietin treatment for methanol optic neuropathy. J Neurol Ophthalmol 2012;32:325-8.
14. Samanta SK, Fariduddin K, Mahapatra N, Bhunia J, Mondal P. Hooch blindness: a community study report on a few indoor patients of toxic optic neuropathy following consumption of adulterated alcohol in West Bengal. Nepal J Ophthalmol 2012;4:162-4.
15. Wilsnack RW, Wilsnack SC, Obot IS. Why study gender, alcohol, and culture? In: Obot IS, Room R. editors. Alcohol, gender and drinking problems: perspectives from low and middle income countries. Geneva: World Health Organization; 2005. p. 3.
16. Urban NBL, Kegeles LS, Slifstein M, Xu X, Martinez D, Sakr E, et al. Differences in striatal dopamine release in young adults after oral alcohol challenge: a positron emission tomography imaging study with raclopride. Biol Psychiatry 2010;68:689-96.
17. Desai T, Sudhalkar A, Vyas U, Khamar B. Methanol poisoning: predictors of visual outcomes. JAMA Ophthalmol 2013;131:358-64.
18. Paasma R, Hovda KE, Jacobsen D. Methanol poisoning and long term sequelae–a six years follow-up after a large methanol outbreak. BMC Clin Pharmacol 2009;9:5.
19. Zhao XJ, Lu L, Li M, Yang H. Ophthalmic findings in two cases of methanol optic neuropathy with relapsed vision disturbance. Int J Ophthalmol 2015;8:427-9.
20. Kerrison JB. Optic neuropathies caused by toxins and adverse drug reactions. Ophthalmol Clin N Am 2004;17:481-8.
21. Shah S, Pandey V, Thakore N, Mehta I. Study of 63 cases of methyl alcohol poisoning (hooch tragedy in Ahmedabad). J Assoc Physician I 2012;60:34-6.
22. Surhio SA, Memon S, Memon M, Nizamani NB, Talpur KI. Alcohol related toxic optic neuropathy case series. Pak J Ophthalmol 2013;29:173-6.



How to Cite

PERMAISUARI, N., RAHMAWATI, N. A., NUSANTI, S., & THAMRIN, H. (2019). EFFICACY OF HIGH-DOSE INTRAVENOUS STEROID TREATMENT IN METHANOL-INDUCED OPTIC NEUROPATHY: A SYSTEMATIC REVIEW. International Journal of Applied Pharmaceutics, 11(6), 97–100. https://doi.org/10.22159/ijap.2019.v11s6.33559



Original Article(s)