title: Erythropoietin as an adjunctive treatment for methanol-induced toxic optic neuropathy.
abstract: Methanol-induced optic neuropathy (MTON) is frequently seen in countries where alcohol consumption is banned or poorly regulated. MTON frequently results in blindness and there is no empirically validated treatment.
  
  
  
  To evaluate the effect of erythropoietin (EPO) as an adjunctive treatment for MTON.
  
  
  
  In this nonrandomized interventional comparative study, all participants were diagnosed with MTON and received the steroid methylprednisolone. Eleven participants received intravenous EPO (10000 IU twice a day) for three days as an adjuvant to methylprednisolone (EPO group); 11 participants in a historical control group received methylprednisolone only (control group). Main outcomes were best-corrected visual acuity (BCVA), peripapillary retinal nerve fiber layer thickness (PRNFLT), and visual field mean deviation (MD).
  
  
  
  Mean BCVA improved significantly in both groups: from 2.93 ± 0.55 to 1.75 ± 1.16 LogMAR at month 3 (p < 0.001) in the EPO group, and from 2.65 ± 0.68 to 2.19 ± 0.75 at final visit in the control group (p = 0.001). The final BCVA was significantly better in the EPO group (p = 0.012). The mean PRNFLT decreased in both groups. However, at the final follow-up, PRNFLT was significantly thinner in the control group (53 ± 6 vs. 77 ± 26 microns, respectively; p < 0.001).
  
  
  
  Intravenous EPO plus high-dose intravenous steroid may be an effective combination therapy for the patients with MTON.
authors.affiliation: a Ophthalmic Research Center and Department of Ophthalmology , Shaheed Beheshti Medical University , Tehran , Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Pakravan
authors.affiliation: a Ophthalmic Research Center and Department of Ophthalmology , Shaheed Beheshti Medical University , Tehran , Iran.
authors.forename: Hamed
authors.initials: H
authors.lastname: Esfandiari
authors.affiliation: a Ophthalmic Research Center and Department of Ophthalmology , Shaheed Beheshti Medical University , Tehran , Iran.
authors.forename: Nasrin
authors.initials: N
authors.lastname: Sanjari
authors.affiliation: a Ophthalmic Research Center and Department of Ophthalmology , Shaheed Beheshti Medical University , Tehran , Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Ghahari
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D004359:Drug Therapy, Combination; D004921:Erythropoietin / Q000008:administration & dosage / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D000432:Methanol / Q000008:administration & dosage / Q000009:adverse effects*; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D009412:Nerve Fibers / Q000378:metabolism; D009901:Optic Nerve Diseases / Q000139:chemically induced / Q000188:drug therapy*; D012160:Retina / Q000378:metabolism; D016896:Treatment Outcome; D014792:Visual Acuity; D014794:Visual Fields
chemical_list: D005938:Glucocorticoids; D004921:Erythropoietin; D008775:Methylprednisolone; D000432:Methanol
keywords: Erythropoietin; methanol-induced toxic optic neuropathy; optic nerve; toxic neuropathy