Outbreak of methanol-induced optic neuropathy in early COVID-19 era; effectiveness of erythropoietin and methylprednisolone therapy

Table 1 Visual acuity before and after treatment with erythropoietin

Time	Gender		Age (yr)			Time interval (h)
	F	M	≤ 35	36-50	≥ 51	≤ 72	≥ 73
Pre	1.89 ± 1.21	2.04 ± 0.88	1.9 ± 0.86	2.2 ± 0.88	1.91 ± 1.04	1.81 ± 0.89	2.16 ± 0.88
Month 1	0.13 ± 0.04	1.19 ± 1.08	0.5 ± 0.85	1.9 ± 0.9	0.54 ± 0.68	1.64 ± 0.72	1.44 ± 1.18
Month 2	1.21 ± 0.91	1.08 ± 0.98	0.89 ± 0.89	1.29 ± 1.02	0.98 ± 0.93	0.83 ± 0.93	1.22 ± 1
Month 3	0.91 ± 0.89	1.28 ± 0.95	0.91 ± 0.83	1.5 ± 0.97	1.41 ± 0.97	1.11 ± 0.96	1.39 ± 0.91
Month 4	0.29 ± 0.32	1.37 ± 1.04	1.04 ± 1.01	1.64 ± 1.01	1.07 ± 1.05	0.93 ± 0.95	1.5 ± 1.04
Month 5	1.05 ± 0.85	1.18 ± 1.01	0.96 ± 0.96	1.26 ± 0.97	1.33 ± 1.03	1.07 ± 1	1.19 ± 1
Month 6	0.96 ± 0.85	1.4 ± 0.97	1.15 ± 0.95	1.53 ± 0.87	1.73 ± 1.05	1.39 ± 1.02	1.27 ± 0.96
Final evaluation	1.1 ± 0.85	1.16 ± 1.03	0.88 ± 0.93	1.37 ± 1.03	1.27 ± 1.01	0.95 ± 0.94	1.3 ± 1.02
P valuea	0.01	< 0.001	< 0.001	< 0.001	0.004	< 0.001	< 0.001

^aP value of pre vs final evaluation.

Table 2 Previous studies of methanol-induced optic neuropathy treated with erythropoietin

Ref.	Type of study	No. of patients	Age (yr)1/Sex	Time interval1	Management	No. of Courses	Pre VA	Post VA	Follow-up1
Pakravan et al[35], 2012	Case report	2	30/M	3 d	IV EPO 10000 IU BID for 3 d	1	OU: NLP	OU: 20/20	3 wk
			35/M	7 d	IV Methylprednisolone 500 mg BID for 5 d followed by 2 wk of oral prednisolone 1 mg/kg/d, Vitamin B6 100 mg/d, vitamin B12 100mg/d, and folic acid 10 mg/d for 1 mo		OU: NLP	OD: CF; OS: 20/30	2 wk
Pakravan et al[36], 2016	Nonrandomized interventional comparative	11	34.5/M	4.8 ± 2.6 d	IV EPO 10000 IU BID for 3 d, IV Methylprednisolone 500 mg BID for 5 d followed by 2 wk of oral prednisolone 1 mg/kg/d, Vitamin B6 100 mg/d, vitamin B12 100 mg/d, and folic acid 10 mg/d for 1 mo	1	2.93 ± 0.55 LogMAR	1.75 ± 1.16 LogMAR	3 mo
Zamani et al[38], 2018	Case-control	10	34/NA	2 d	SQ EPO 10000 IU BID for 3 d, Methylprednisolone 250 mg QID for 3 d	1	0.002	0.004	2 mo
Pakdel et al[38], 2018	Case-series	16	34.2/15 M	9.1 d	IV EPO 20000 IU QD for 3 d	3 in six cases, 2 in eight, 1 in two	Better eye: 3.6 LogMAR	Better eye: 1.0 LogMAR	7.5 mo

¹mean.

M: Male; BID: Twice; QID: 4 times per day; QD: Daily; VA: Visual acuity; OU: Both eyes; OD: Right eye; OS: Left eye; NLP: No light perception; CF: Counting fingers; IV: Intravenous; SQ: Subcutaneous; NA: Not available; EPO: Erythropoietin; LogMAR: Logarithm of the minimum angle of resolution.