Subcutaneous Erythropoietin Reverses Optic Neuropathy Induced by Methanol Poisoning: Three case reports

Background: Methanol is a highly toxic alcohol and causes such severe side effects as CNS depression, blindness, acute renal failure and even death. Methods: Patients were three male referrals (aged 29-56 years) to the poisoning center at Taleghani Hospital, Urmia, Iran, in 2020. They had unknowingly ingested methanol. Their chief problems were bilateral blindness and metabolic acidosis. Upon taking medical history and physical examinations, they were assessed by an ophthalmologist, while testing the arterial blood gases and standard laboratory tests. They were given standard treatments and antidotes 3-4 days, which did not reverse the blindness. Subsequently, each patient was injected with five doses of subcutaneous erythropoietin every second day. The visual acuity progress was monitored daily until their discharge from the hospital. Results: Following 3-4 days of ineffective standard treatments, patients were injected with low doses of subcutaneous erythropoietin, which gradually reversed the visual acuity to normal level over the next 7 to 9 days. The patients were discharged from the hospital 10-12 days post admission, with normal visual acuity and without having any side effects. Conclusions: The subcutaneous erythropoietin effectively relieved the acute optic neuropathy and reversed the blindness to normal vision. This study is the first to investigate the therapeutic effects of subcutaneous erythropoietin in the treatment of optic neuropathy secondary to methanol intoxication.