therapeutic effects of high dose intravenous prednisolone on methanol induced toxic optic neuropathy

background: the effects of high dose steroids for the treatment of methanol optic neuropathy was evaluated in this study. methods: in an interventional case series, 9 patients with a history of sudden visual loss after an ingestion of homemade alcoholic beverages were included in the study. the patients received 250 mg intravenous methyl prednisolone every 6 hours for 4 days continued with oral prednisolone at 1 mg/kg for 10 days. best corrected visual acuity (bcva), optical coherent tomography (oct), fundus photo, and a complete ophthalmologic exam of the patients were taken before the treatment and 3 months after treatment. six of them referred before 48 hours and 3 after 72 hours. results: all patients were men. the mean age was 24.68 ± 4.2 years.  in those who referred before 48 hours, the mean bcva before the treatment was 0.86 ± 0.08 in the right eye (re) and 0.93 ± 0.1 in the left eye (le) using the logmar scale. four patients showed nerve fiber layer edema as a white density in peripapillary area. after treatment, the mean bcva in the re was 0.33 ± 0.18 and 0.29 ± 0.2 in the le using the logmar scale. the differences between before and after treatment were significant (p = 0.008 and p = 0.003, respectively). the mean macular thickness and cdr were unchanged. in those who referred after 72 hours, bcva was not changed significantly (0.96 ± 0.3 and 0.94 ± 0.2 vs. 0.97 ± 0.3 and 0.94 ± 0.2 in re and le respectively). conclusion: intravenous high dose methyl prednisolone may have benefits in the treatment of methanol optic neuropathy, if initiated before 48 hours.