Fomepizole therapy for reversal of visual impairment after methanol poisoning: a case documented by visual evoked potentials investigation.
OBJECTIVE
To illustrate the safety and efficacy of fomepizole in a case of methanol poisoning with initial visual impairment.


METHODS
Interventional case report.


METHODS
A 60-year-old man was admitted with blurred vision and changes in color perception 18 hours after ingesting 100 ml methanol. Fomepizole was chosen for antidotal therapy in combination with hemodialysis. Flash electroretinogram (fERG) and flash visual evoked potentials (fVEPs) examinations were obtained at the bedside 2 hours after admission and on days 1 and 8. The monocular pattern-reversal visual evoked potentials (pVEPs) were investigated on days 1 and 8.


RESULTS
A complete reversal of visual impairment was achieved within 20 hours. An abnormal b-wave amplitude and an increased peak III latency at VEPs were present on admission and recovered within 24 hours.


CONCLUSIONS
Fomepizole appeared safe and effective for a patient who had severe methanol poisoning presenting with visual impairment.
Essama Mbia
Jean-Jacques
JJ
Department of Intensive Care, Cliniques St-Luc, Université Catholique de Louvain, Brussels, Belgium.
Guérit
Jean-Michel
JM
Haufroid
Vincent
V
Hantson
Philippe
P
D000426:Alcohol Dehydrogenase / Q000037:antagonists & inhibitors; D000931:Antidotes / Q000627:therapeutic use*; D004596:Electroretinography; D005074:Evoked Potentials, Visual; D000077604:Fomepizole; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D000432:Methanol / Q000506:poisoning*; D008875:Middle Aged; D011041:Poisoning / Q000188:drug therapy; D011720:Pyrazoles / Q000627:therapeutic use*; D006435:Renal Dialysis; D012449:Safety; D014786:Vision Disorders / Q000139:chemically induced* / Q000188:drug therapy* / Q000503:physiopathology
D000931:Antidotes; D011720:Pyrazoles; D000077604:Fomepizole; D000426:Alcohol Dehydrogenase; D000432:Methanol