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Jafarizadeh A, Homaie M, Abdollahi M, Niyousha M. Time course study of optical coherence tomography angiography in patients with methanol induced optic neuropathy. BMC Ophthalmol 2023; 23:178. [PMID: 37098467 PMCID: PMC10126549 DOI: 10.1186/s12886-023-02937-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/21/2023] [Indexed: 04/27/2023] Open
Abstract
INTRODUCTION In countries where alcoholic beverages are legally prohibited, methanol toxicity usually occurs due to ingesting homemade alcoholic drinks. The initial ophthalmologic symptoms of methanol toxicity typically appear 6-48 h after ingestion, and the severity of symptoms varies widely from mild and painless decreased vision to no-light perception vision. METHODS This prospective study examines 20 patients with acute methanol poisoning within 10 days of use. Patients underwent ocular examinations, BCVA (Best Corrected Visual Acuity) recording, and OCTA (Optical Coherence Tomography Angiography) of the macula and optic disc. BCVA measurement and imaging were repeated one month and three months after intoxication. RESULTS There was a statistically significant reduction in superficial parafoveal vascular density (P-value = 0.026), inner retinal thickness (P-value = 0.022), RNFL (Retinal Nerve Fiber Layer) thickness (P-value = 0.031), and an increase in cup to disc ratio (P-value < 0.001), and central visual acuity (P-value = 0.002) in this time course. However, there was no statistically significant difference in FAZ (Foveal Avascular Zone) area (P-value = 0.309), FAZ perimeter (P-value = 0.504), FD-300 (Foveal density, vascular density within a 300 μm wide region of the FAZ) (P-value = 0.541), superficial vascular density (P-value = 0.187), deep foveal vascular density (P-value = 0.889), deep parafoveal vascular density (P-value = 0.830), choroidal flow area (P-value = 0.464), total retinal thickness (P-value = 0.597), outer retinal thickness (P-value = 0.067), optic disc whole image vascular density (P-value = 0.146), vascular density inside the disc (P-value = 0.864), or peripapillary vascular density (P-value = 0.680) at different times. CONCLUSION Over time, methanol poisoning can cause changes in retinal layers thickness, vasculature, and optic nerve head. The most important changes include cupping of the optic nerve head, reduction in RNFL thickness, and inner retinal thickness.
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Affiliation(s)
- Ali Jafarizadeh
- Nikookari Eye Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mina Homaie
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mirsaeed Abdollahi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohamadreza Niyousha
- Department of Ophthalmology, Nikookari Eye Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Saikia P, Kumar Dolui S, Pran Mahanta S. CsPbBr 3 perovskites: A dual fluorescence sensor to distinguish ethanol from methanol. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2023; 291:122309. [PMID: 36621025 DOI: 10.1016/j.saa.2022.122309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/03/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
In recent years, lead halide perovskites have emerged as a promising material with defect tolerance, thermally stable, and optoelectronic properties. However, the instability is the major factor which hinder their potential applications in various fields. This work demonstrates the chemical stability of Cesium Lead Bromide (CsPbBr3) under different passivation condition with an objective to develop alcohol sensor. Cetyltrimethyl ammonium bromide (CTAB) passivated CsPbBr3 demonstrated as a turn off fluorescent probe for alcohols and more significantly turn on fluorescent probe for ethanol. Herein, it is shown that CTAB passivated CsPbBr3 can effectively discriminate ethanol from methanol owing to its different mode of interaction with ethanol and methanol. The outstanding optical properties of halide perovskites with an ultra-low detection limit of 7.3 ppb was obtained for ethanol detection. The sensing performance of the material is also validated with petrol and cough syrup samples showing excellent performance for future implementation with practical applications.
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Affiliation(s)
- Priyankamoni Saikia
- Department of Chemical Sciences, Tezpur University, Sonitpur 784028, Assam, India
| | - Swapan Kumar Dolui
- Department of Chemical Sciences, Tezpur University, Sonitpur 784028, Assam, India.
| | - Sanjeev Pran Mahanta
- Department of Chemical Sciences, Tezpur University, Sonitpur 784028, Assam, India.
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Li J, Feng ZJ, Liu L, Ma YJ. Acute methanol poisoning with bilateral diffuse cerebral hemorrhage: A case report. World J Clin Cases 2022; 10:6571-6579. [PMID: 35979299 PMCID: PMC9294890 DOI: 10.12998/wjcc.v10.i19.6571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/04/2022] [Accepted: 05/07/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Acute methanol poisoning (AMP) is a systemic disease that mainly affects the central nervous system and is characterized by ocular damage and metabolic acidosis. If appropriate treatments are inadequate or delayed, the mortality can exceed 40%. As the most serious complication, cerebral hemorrhage is rare with reported prevalence of 7%-19%.
CASE SUMMARY A 62-year-old man drank liquor mixed with 45% methanol and 35% alcohol. His vision blurred 10 h later and he fell into coma in another 9 h. Serum toxicological tests were performed immediately, and continuous renal replacement therapy (CRRT) was carried out as the lactic acid exceeded 15 mmol/L and blood pH was 6.78. In addition, the toxicological report revealed 1300.5 μg/mL of methanol in serum and 1500.2 μg/mL in urine. After 59 h of CRRT, the methanol level decreased to 126.0 μg/mL in serum and 151.0 μg/mL in urine. However, the patient was still unconscious and his pupillary light reflex was slow. Computed tomography showed hemorrhage in the left putamen. After 16 d of life support treatment, putamen hemorrhage developed into diffuse symmetric intracerebral hemorrhage. In the end, his family gave up and the patient was discharged, and died in a local hospital.
CONCLUSION Cerebral hemorrhage requires constant vigilance during the full course of treatment for severe cases of AMP.
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Affiliation(s)
- Jin Li
- Department of Critical Care Medicine, Air Force Medical Center, PLA, Beijing 100142, China
| | - Zhi-Juan Feng
- Department of Critical Care Medicine, Air Force Medical Center, PLA, Beijing 100142, China
| | - Lei Liu
- Department of Critical Care Medicine, Air Force Medical Center, PLA, Beijing 100142, China
| | - Yu-Jie Ma
- Department of Critical Care Medicine, Air Force Medical Center, PLA, Beijing 100142, China
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Biochemical mechanism underlying the pathogenesis of diabetic retinopathy and other diabetic complications in humans: the methanol-formaldehyde-formic acid hypothesis. Acta Biochim Biophys Sin (Shanghai) 2022; 54:415-451. [PMID: 35607958 PMCID: PMC9828688 DOI: 10.3724/abbs.2022012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Hyperglycemia in diabetic patients is associated with abnormally-elevated cellular glucose levels. It is hypothesized that increased cellular glucose will lead to increased formation of endogenous methanol and/or formaldehyde, both of which are then metabolically converted to formic acid. These one-carbon metabolites are known to be present naturally in humans, and their levels are increased under diabetic conditions. Mechanistically, while formaldehyde is a cross-linking agent capable of causing extensive cytotoxicity, formic acid is an inhibitor of mitochondrial cytochrome oxidase, capable of inducing histotoxic hypoxia, ATP deficiency and cytotoxicity. Chronic increase in the production and accumulation of these toxic one-carbon metabolites in diabetic patients can drive the pathogenesis of ocular as well as other diabetic complications. This hypothesis is supported by a large body of experimental and clinical observations scattered in the literature. For instance, methanol is known to have organ- and species-selective toxicities, including the characteristic ocular lesions commonly seen in humans and non-human primates, but not in rodents. Similarly, some of the diabetic complications (such as ocular lesions) also have a characteristic species-selective pattern, closely resembling methanol intoxication. Moreover, while alcohol consumption or combined use of folic acid plus vitamin B is beneficial for mitigating acute methanol toxicity in humans, their use also improves the outcomes of diabetic complications. In addition, there is also a large body of evidence from biochemical and cellular studies. Together, there is considerable experimental support for the proposed hypothesis that increased metabolic formation of toxic one-carbon metabolites in diabetic patients contributes importantly to the development of various clinical complications.
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A state-of-the-art review of the chemical composition of sugarcane spirits and current advances in quality control. J Food Compost Anal 2022. [DOI: 10.1016/j.jfca.2021.104338] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Sharif AF, AlAmeer MR, AlSubaie DS, Alarfaj NH, AlDawsari MK, AlAslai KM, BuSaleh MJ, AlSabr AI, Al-Mulhim KA. Predictors of poor outcomes among patients of acute methanol intoxication with particular reference to Sequential Organ Failure Assessment (SOFA) score. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:60511-60525. [PMID: 34156622 DOI: 10.1007/s11356-021-14998-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
Methanol intoxication is a global problem with serious morbidities and mortalities. Apart from the lifelong disabilities experienced by methanol intoxication survivors, mortality rates of up to 44% of exposed patients have been reported. The aim of the current study was to outline the early findings that could be utilized as effective in-hospital outcome predictors among cases of methanol exposure. Furthermore, the role of the Sequential Organ Failure Assessment (SOFA) score was evaluated as an early in-hospital outcome indicator among patients presented with acute methanol intoxication. A multicenter study including 37 patients diagnosed with acute methanol intoxication and referred to three major poison control centers in Saudi Arabia during the past 3 years (January 1, 2018-January 1, 2021) was conducted. Data including demographics, exposure history, presenting complaints, clinical findings, and laboratory investigation were collected. The patients were scored on Glasgow Coma Scale (GCS), Poison Severity Score (PSS), and SOFA score on admission. Out of the presented patients, 83.8% were alcoholic men. No deaths have been reported, and 51.4% were discharged with unfavorable outcomes, including 29.7% suffered optic neuropathy and blindness, 18.9% showed acute renal impairment, and 10.8% were complicated with respiratory failure. The diastolic blood pressure, anion gap, visual acuity, number of hemodialysis sessions, PSS, duration of Intensive Care Unit (ICU) stay, and SOFA score were all significant organ failure predictors (P < 0.05). However, only the SOFA score showed the best significant prediction on multivariate analysis, with an odds ratio (95% confidence interval) of 0.10 (0.04-0.17) and P = 0.003. At a cutoff of greater than 4.5, the SOFA score could significantly predict unfavorable outcomes with area under curve (AUC) = 0.955, accuracy 89.2%, specificity 94.4%, and sensitivity 84.2%. Early identification of methanol exposed patients at risk is critical and lifesaving. The SOFA score is a substantially useful and early inclusive unfavorable outcome predictor.
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Affiliation(s)
- Asmaa Fady Sharif
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, El Geish Street, Tanta, Gharbia, 31527, Egypt.
- Clinical Medical Sciences Department, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia.
| | - Mahdi Riyadh AlAmeer
- Clinical Medical Sciences Department, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
- Respiratory Care Department, Riyadh Care Hospital, Riyadh, Saudi Arabia
| | - Duhaim Saad AlSubaie
- Clinical Medical Sciences Department, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
- Emergency Medicine Department, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia
| | - Naser Husam Alarfaj
- Clinical Medical Sciences Department, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
- Administartion of Radiology Department, King Saud Medical City (KSMC), Riyadh, Saudi Arabia
| | - Mubarak Khalifah AlDawsari
- Clinical Medical Sciences Department, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
- Diagnostic Radiology Department, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia
| | - Khalid Mansour AlAslai
- Clinical Medical Sciences Department, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
- Emergency Medicine Department, Prince Mohammed Bin Abdulaziz Hospital (PMAH), Riyadh, Saudi Arabia
| | - Mahmoud Jawad BuSaleh
- Clinical Medical Sciences Department, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Abdulaziz Ibrahim AlSabr
- Clinical Medical Sciences Department, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
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Roy S, Das S, Ray A, Parui PP. Fluorometric trace methanol detection in ethanol and isopropanol in a water medium for application in alcoholic beverages and hand sanitizers. RSC Adv 2021; 11:30093-30101. [PMID: 35480280 PMCID: PMC9040838 DOI: 10.1039/d1ra05201b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/25/2021] [Indexed: 12/29/2022] Open
Abstract
Detection of methanol (MeOH) in an ethanol (EtOH)/isopropanol (iPrOH) medium containing water is crucial to recognize MeOH poisoning in alcoholic beverages and hand sanitizers. Although chemical sensing methods are very sensitive and easy to perform, the chemical similarities between the alcohols make MeOH detection very challenging particularly in the presence of water. Herein, the fluorometric detection of a trace amount of MeOH in EtOH/iPrOH in the presence of water using alcohol coordinated Al(iii)-complexes of an aldehydic phenol ligand containing a dangling pyrazole unit is described. The presence of MeOH in the EtOH/iPrOH causes a change of the complex geometry from tetrahedral (Td) to octahedral (Oh) due to the replacement of the coordinated EtOH/iPrOH by MeOH molecules. The Td-complex exhibited fluorescence but the Oh-species did not, because of the intramolecular photo-induced electron transfer (PET). By interacting the Oh species with water, its one MeOH coordination is replaced by a water molecule followed by the proton transfer from the water to pyrazole-N which generates strong fluorescence by inhibiting the PET. In contrast, the water interaction dissociates the Td-complex to exhibit fluorescence quenching. The water induced reversal of the fluorescence response from the decrease to increase between the absence and presence of MeOH is utilized to detect MeOH in an EtOH/iPrOH medium containing water with a sensitivity of ∼0.03–0.06% (v/v). The presence of water effected the MeOH detection and allows the estimation of the MeOH contamination in alcoholic beverages and hand sanitizers containing large amounts of water. Detection of MeOH in EtOH/iPrOH and commercial samples based on water induced reversal of fluorescence response from the decrease to increase between the absence and presence of MeOH.![]()
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Affiliation(s)
- Snigdha Roy
- Department of Chemistry, Jadavpur University Kolkata 700032 India +91-33-24146223 +91-9433490492
| | - Sanju Das
- Department of Chemistry, Maulana Azad College Kolkata 700013 India
| | - Ambarish Ray
- Department of Chemistry, Barasat Govt. College Kolkata 700124 India +91-9836650180
| | - Partha Pratim Parui
- Department of Chemistry, Jadavpur University Kolkata 700032 India +91-33-24146223 +91-9433490492
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Methanol poisoning as a new world challenge: A review. Ann Med Surg (Lond) 2021; 66:102445. [PMID: 34141419 PMCID: PMC8187162 DOI: 10.1016/j.amsu.2021.102445] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 02/07/2023] Open
Abstract
Background Methanol poisoning (MP) occurs often via ingestion, inhalation, or dermal exposure to formulations containing methanol in base. Clinical manifestations of MP include gastrointestinal symptoms, central nervous system (CNS) suppression, and decompensated metabolic acidosis occurred with blurred vision and early or late blindness. Objective This study reviewed the clinical manifestations, laboratory and radiology findings, and treatment approaches in MP. Discussion Methanol is usually rapidly absorbed after ingestion and metabolized by alcohol dehydrogenase (ADH), then distributed to the body water to reach a volume distribution approximately equal to 0.77 L/kg. It is also eliminated from the body as unchanged parent compounds. Clinical manifestations of MP alone initiate within 0.5–4 h after ingestion and include gastrointestinal symptoms and CNS suppression. After a latent period of 6–24 h, depending on the absorbed dose, decompensated metabolic acidosis occurs with blurred vision and early or late blindness. Blurred vision with normal consciousness is a strong suspicious sign of an MP. The mortality and severity of intoxication are well associated with the severity of CNS depression, hyperglycemia, and metabolic acidosis, but not with serum methanol concentration. After initial resuscitation, the most important therapeutic action for patients with known or suspected MP is correction of acidosis, inhibition of ADH, and hemodialysis. Conclusion Since MP is associated with high morbidity and mortality, it should be considered seriously and instantly managed. Delay in treatment may cause complications, permanent damage, and even death. We attempt to review clinical manifestations, laboratory and radiology findings, and treatment approaches in Methanol poisoning (MP). The most important therapeutic action for patients with known MP is correction of acidosis, inhibition of alcohol dehydrogenase, and hemodialysis. The review emphasizes that MP has a high morbidity and mortality rate and it must be taken seriously and treated immediatly.
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Ghanbari A, Ghareghani M, Zibara K, Delaviz H, Ebadi E, Jahantab MH. Light-Emitting Diode (LED) therapy improves occipital cortex damage by decreasing apoptosis and increasing BDNF-expressing cells in methanol-induced toxicity in rats. Biomed Pharmacother 2017; 89:1320-1330. [DOI: 10.1016/j.biopha.2017.03.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 02/24/2017] [Accepted: 03/09/2017] [Indexed: 11/24/2022] Open
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Dogan H, Yilmaz Karakus B, Serefoglu Cabuk K, Uzun O, Yenice H, Orucoglu A. Transdermal Spirit (Methanol) Poisoning: A Case Report. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017; 18:e23767. [PMID: 28191327 PMCID: PMC5292112 DOI: 10.5812/ircmj.23767] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 12/09/2014] [Accepted: 03/20/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Methanol is a highly toxic substance and methanol poisoning results in severe health situations. Methanol poisoning occurs when it is consumed by various methods such as orally, by inhalation, and transdermally. Transdermal poisoning is rarely seen and causes severe health complications. CASE PRESENTATION A 59-year-old male patient was admitted to the emergency room due to blurred vision and knee pain. He had wrapped alcohol soaked cotton around his knees because of pain, and left it for 10 hours at night. On physical examination the knees only exhibited redness. Upon funduscopic examination, signs of poisoning were not seen, but a high anion gap metabolic acidosis was shown by arterial blood gas analysis. Hemodialysis was performed for severe acidosis and the patient was admitted to the ICU. The patient was treated and discharged from the ICU without sequelae. CONCLUSIONS Methanol poisoning presents to the emergency department in our country with many different situations and with varying histories. In different parts of the world, transdermal intoxication cases may be more prevalent and they may be overlooked, therefore, we aimed to present this case.
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Affiliation(s)
- Hatice Dogan
- Department of Emergency Medicine, Bagcilar Research and Training Hospital, Istanbul, Turkey
- Corresponding Author: Hatice Dogan, Department of Emergency Medicine, Bagcilar Research and Training Hospital, Istanbul, Turkey. Tel: +90-2124404000, Fax: +90-2124404242, E-mail:
| | - Banu Yilmaz Karakus
- Department of Emergency Medicine, Bagcilar Research and Training Hospital, Istanbul, Turkey
| | - Kubra Serefoglu Cabuk
- Department of Ophthalmology, Bagcilar Research and Training Hospital, Istanbul, Turkey
| | - Ozlem Uzun
- Department of Emergency Medicine, Bagcilar Research and Training Hospital, Istanbul, Turkey
| | - Huseyin Yenice
- Department of Emergency Medicine, Bagcilar Research and Training Hospital, Istanbul, Turkey
| | - Aysun Orucoglu
- Department of Emergency Medicine, Bagcilar Research and Training Hospital, Istanbul, Turkey
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Işcan Y, Coşkun Ç, Öner V, Türkçü FM, Taş M, Alakuş MF. Bilateral total optic atrophy due to transdermal methanol intoxication. Middle East Afr J Ophthalmol 2014; 20:92-4. [PMID: 23580862 PMCID: PMC3617539 DOI: 10.4103/0974-9233.106406] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
In this case report, we document a 54-year-old woman with total bilateral optic nerve atrophy after local application of methanol containing spirit. Almost all the reported cases of methanol intoxication in the literature are caused by oral ingestion. In this rare case, we present transdermal absorption of methanol that may cause irreversible blindness in addition to intracerebral lesions.
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Affiliation(s)
- Yalçin Işcan
- Department of Ophthalmology, Batman State Hospital, Batman, Turkey
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Abstract
Accidental or intentional ingestion of substances containing methanol and ethylene glycol can result in death, and some survivors are left with blindness, renal dysfunction, and chronic brain injury. However, even in large ingestions, a favorable outcome is possible if the patient arrives at the hospital early enough and the poisoning is identified and appropriately treated in a timely manner. This review covers the common circumstances of exposure, the involved toxic mechanisms, and the clinical manifestations, laboratory findings, and treatment of methanol and ethylene glycol intoxication.
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Sahin A, Kaya S, Türkcü G, Cingü AK, Yüksel H, Türkcü FM, Yüksel H, Cınar Y, Arı S, Sahin M, Caça I, Gökalp O. The effects of caffeic acid phenethyl ester in acute methanol toxicity on rat retina and optic nerve. Cutan Ocul Toxicol 2013; 32:263-7. [PMID: 23461623 DOI: 10.3109/15569527.2013.771642] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE We aimed to test caffeic acid phenethyl ester (CAPE) as an antidote for acute methanol (MeOH) toxicity and to compare it with ethanol. METHODS This study included five groups, each containing eight rats. The groups were control, methotrexate (MTX), MeOH, ethanol and CAPE. All rats except control group were treated with intraperitoneal (i.p.) MTX (0.3 mg/kg/d) for 7 d. At the 8th day of the experiment, i.p. injection of MeOH (3 g/kg) was administered in MeOH, ethanol and CAPE groups. Four hours after MeOH treatment, 0.5 g/kg ethanol was injected i.p. in ethanol group; 10 μmol/kg CAPE i.p. in CAPE group; serum physiologic i.p. in other groups. After 8 h, rats were anaesthetized and sacrificed. Total anti-oxidant status (TAS), total oxidant status (TOS) were measured on the dissected and excised retina and optic nerve samples. Fellow eyes were used for histopathologic evaluation and the cell count of retinal ganglion cell (RGC) layer. In addition, interactions of alcohol dehydrogenase with CAPE, ethanol, MeOH and pyrazole derivatives were investigated. RESULTS Either CAPE or ethanol co-treatment decreased the TOS levels and increased the TAS levels compared to the MeOH group. MeOH treatment decreased the mean cell count in RGC layer. CAPE co-treatment significantly prevented cell loss (p = 0.040). Besides, in silico calculations showed that binding affinity of CAPE to alcohol dehydrogenase was higher than those of MeOH, ethanol, and pyrazole derivatives were. CONCLUSION This study demonstrated that CAPE treatment decreased the oxidative stress in acute MeOH intoxication in the retina and optic nerve; beside that, protected RGC layer histology. In silico, CAPE had higher affinity score than MeOH, ethanol, pyrazole and pyrazole derivatives in the case of interaction with alcohol dehydrogenase.
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Affiliation(s)
- Alparslan Sahin
- Department of Ophthalmology, Dicle University School of Medicine, Diyarbakır, Turkey.
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Sanaei-Zadeh H. What are the therapeutic effects of high-dose intravenous prednisolone in methanol-induced toxic optic neuropathy? J Ocul Pharmacol Ther 2012; 28:327-8. [PMID: 22304617 DOI: 10.1089/jop.2011.0209] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sanaei-Zadeh H, Zamani N. A case of optic nerve atrophy with severe disc cupping after methanol poisoning. KOREAN JOURNAL OF OPHTHALMOLOGY 2011; 25:463; author reply 463. [PMID: 22131788 PMCID: PMC3223718 DOI: 10.3341/kjo.2011.25.6.463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Sanaei-Zadeh H, Zamani N, Shadnia S. Outcomes of visual disturbances after methanol poisoning. Clin Toxicol (Phila) 2011; 49:102-7. [PMID: 21370946 DOI: 10.3109/15563650.2011.556642] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Methanol poisoning and toxic optic neuropathy is still seen worldwide. Little attention has been paid to the persistent visual disturbances following methanol poisoning. We aimed to evaluate the outcomes of visual disturbances in methanol-poisoned patients referred to us with visual disturbances. METHODS This retrospective observational case series evaluated the outcomes of visual disturbances in patients with methanol poisoning hospitalized in Loghman Hakim and Hazrat Rasoul Akram hospitals between March 2003 and October 2009. Medical charts were evaluated for age, gender, time between consumption and hospital presentation, gastrointestinal symptoms, abnormal neurological findings at presentation and during hospital admission, arterial blood gas results, treatment modalities, history of chronic diseases, and status of vision at presentation and discharge from the hospital. The patients or their relatives were contacted 1 year after the admission date of the last patient and questioned about the status of the patients' vision at the time of hospital discharge, after discharge, and at the time of phone contacts. RESULTS A total of 50 patients with methanol poisoning and visual disturbances at presentation survived. Thirty-seven cases were followed; 16 showed visual disturbance improvement before hospital discharge, and 21 had visual disturbance after discharge. Visual disturbances were classified into two groups: severe to total blindness and blurred/snowfield vision. Patients were also grouped into one of four categories: group I: patients whose blurred or snowfield vision completely recovered within up to a maximum of 2 weeks after discharge (n=7); group II, the patients who were blind at the time of discharge (n=5) and partially recovered within a maximum of 3-4 weeks; group III, the patients who were blind at the time of discharge and gained no improvement in their vision (n=5); group IV, who were blind at the time of discharge, partially recovered within few days to approximately 1 month and experienced reduced vision and blindness after about a maximum of 9 months (n=4). Patients whose visual disturbances improved with treatment and the patients in group I were considered as transient (n=23) and groups II, III, and IV as permanent visual disturbance cases (n=14). Significant difference was not seen in age, sex, elapsed time to presentation, gastrointestinal symptoms, abnormal neurological and CT findings, and arterial blood gas results at presentation between the transient and permanent visual disturbance groups. No association existed between the visual disturbance and abnormal neurological and CT findings. CONCLUSION Blurred or snowfield vision in methanol poisoning resolved. However, outcomes of the blindness cannot be predicted. Insome patients, blindness improves but these patients eventually experience reduced vision afterwards.
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Affiliation(s)
- Hossein Sanaei-Zadeh
- Department of Forensic Medicine and Toxicology, Tehran University of Medical Sciences, Hazrat Rasoul Akram Hospital, Tehran, Iran.
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Lin SH, Tseng GF, Liang CC, Hung YC. Methanol Intoxication With Bilateral Putaminal and Occipital Necrosis. Tzu Chi Med J 2010. [DOI: 10.1016/s1016-3190(10)60064-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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21
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Geibprasert S, Gallucci M, Krings T. Alcohol-induced changes in the brain as assessed by MRI and CT. Eur Radiol 2009; 20:1492-501. [DOI: 10.1007/s00330-009-1668-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Revised: 10/21/2009] [Accepted: 10/23/2009] [Indexed: 11/25/2022]
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22
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Affiliation(s)
- Matthew Salzman
- Drexel University College of Medicine, Emergency Medicine Control, Philadelphia, PA, USA.
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23
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Mora-Ordóñez JM, Martín D, Curiel Balsera E, Muñoz Bono J. Intoxicación mortal por metanol: donante de órganos. Med Clin (Barc) 2008; 130:39. [DOI: 10.1157/13114548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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24
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Ari Ş, Çaça İ, Kayabaşi H. Bilateral Complete Optic Atrophy and Hemorrhagic Infarction of the Putamen Caused by Methanol Intoxication. ACTA ACUST UNITED AC 2007; 39:249-52. [DOI: 10.1007/s12009-007-0038-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2007] [Revised: 11/30/1999] [Accepted: 03/27/2007] [Indexed: 10/22/2022]
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25
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Sefidbakht S, Rasekhi AR, Kamali K, Borhani Haghighi A, Salooti A, Meshksar A, Abbasi HR, Moghadami M, Nabavizadeh SA. Methanol poisoning: acute MR and CT findings in nine patients. Neuroradiology 2007; 49:427-35. [PMID: 17294234 DOI: 10.1007/s00234-007-0210-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2006] [Accepted: 01/07/2007] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Methanol poisoning is an uncommon but potent central nervous system toxin. We describe here the CT and MR findings in nine patients following an outbreak of methanol poisoning. METHODS Five patients with a typical clinical presentation and elevated anion and osmolar gaps underwent conventional brain MRI with a 1.5-T Gyroscan Interna scanner. In addition nonenhanced CT was performed in another three patients with more severe toxicity. RESULTS Bilateral hemorrhagic or nonhemorrhagic necrosis of the putamina, diffuse white matter necrosis, and subarachnoid hemorrhage were among the radiological findings. Various patterns of enhancement of basal ganglial lesions were found including no enhancement, strong enhancement and rim enhancement. CONCLUSION A good knowledge of the radiological findings in methanol poisoning seems to be necessary for radiologists. The present study is unique in that it enables us to include in a single report most of the radiological findings that have been reported previously.
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Affiliation(s)
- S Sefidbakht
- Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
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Spampinato MV, Castillo M, Rojas R, Palacios E, Frascheri L, Descartes F. Magnetic resonance imaging findings in substance abuse: alcohol and alcoholism and syndromes associated with alcohol abuse. Top Magn Reson Imaging 2006; 16:223-30. [PMID: 16340646 DOI: 10.1097/01.rmr.0000192175.26243.a7] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Alcohol abuse is common among the population and results in significant diseases that shorten life span. Ethanol may result in chronic brain changes such as atrophy but may also result in neurologic disease that may be acute or chronic and sometimes life threatening. Accompanying vitamin deficiencies may lead to Wernicke's encephalopathy and changes in serum osmosis may lead to several acute demyelinating disorders. In addition, pregnant women who consume alcohol place their babies at high risk for the fetal alcohol syndrome. In this article we review these disorders and emphasize their imaging features.
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Affiliation(s)
- M Vittoria Spampinato
- Neuroradiology Fellow Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7510, USA
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En-nouali H, Mahi M, Akjouj S, Nassar I, El Quessar A, El Hassani MR, Chakir N, Benchaaboun N, Jiddane M. [What is your diagnosis? Methanol poisoning]. JOURNAL DE RADIOLOGIE 2005; 86:957-60. [PMID: 16342883 DOI: 10.1016/s0221-0363(05)81476-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- H En-nouali
- Service de Neuroradiologie, Hôpital des spécialités ONO, CHU Ibn Sina, Rabat, Maroc
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28
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Craenen G, Brown SM, Freedman KA, Windisch TR, Corona J. Rapid, painless unilateral vision loss in a 37-year-old healthy woman. Surv Ophthalmol 2004; 49:343-8. [PMID: 15110670 DOI: 10.1016/j.survophthal.2004.02.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A 37-year-old woman experienced painless, progressive vision loss to no light perception in the left eye over the course of 3 days. The right eye was unaffected. On examination, the only other abnormal finding was a +4 left afferent pupillary defect. She was initially diagnosed with retrobulbar optic neuritis and admitted for treatment with intravenous methylprednisolone. Neuro-imaging revealed a large right anterior cerebral artery aneurysm that crossed the midline to compress the left optic nerve. The aneurysm was treated with coil embolization, which was technically successful but which did not lead to significant improvement in vision.
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Affiliation(s)
- Geert Craenen
- Department of Ophthalmology and Visual Sciences, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
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Buono LM, Foroozan R, Savino PJ, Danesh-Meyer HV, Stanescu D. Posterior ischemic optic neuropathy after hemodialysis. Ophthalmology 2003; 110:1216-8. [PMID: 12799249 DOI: 10.1016/s0161-6420(03)00257-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To report a case of visual loss from posterior ischemic optic neuropathy (PION) after hemodialysis. DESIGN Observational case report. METHODS Neuro-ophthalmic examination, neuro-imaging including computed tomography (CT) scan, magnetic resonance imaging (MRI) of the head and orbits, and magnetic resonance angiography (MRA) of the neck and cerebral vasculature, as well as electrophysiologic testing including electroretinogram (ERG) and visually evoked response (VER) were performed. RESULTS Acute onset of painless bilateral no light perception vision with absent pupillary response to light and normal funduscopic examination occurred shortly after completion of hemodialysis. Computed tomography scan and MRA results were normal. Magnetic resonance imaging scan showed small vessel ischemic white matter changes. Electroretinogram results were normal and the VER was unrecordable. CONCLUSIONS Visual loss after hemodialysis is a rare complication and is associated with anemia and hypotensive events. The visual loss is usually a result of anterior ischemic optic neuropathy. We were unable to find another instance in the literature of visual loss after hemodialysis resulting from PION.
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Affiliation(s)
- Lawrence M Buono
- Neuro-Ophthalmology Service, Wills Eye Hospital, Thomas Jefferson Medical College, Philadelphia, Pennsylvania, USA
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30
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Abstract
Visual perceptions seen with retinal and optic nerve disease may overlap with those resulting from retrochiasmal disorders. A few disorders typically present with distinctive perceptions, but the majority have less specific symptoms. Features include whether or not the visual phenomena are negative or positive, monocular or binocular, and the location and form of any deficits. Among negative phenomena, transient visual loss usually is the result of ischemic disease, but particular precipitants may suggest demyelination or photoreceptor degeneration. The pattern and location of visual field defects may help localize disorders to the level of the macula, papillomacular or other inner retina nerve fiber bundles, optic nerve, or chiasm. Altered brightness perception may point to optic nerve or photoreceptor disease. Decreased acuity is among the most common and least specific symptoms, but association with other symptoms may help to narrow the differential diagnosis. Dyschromatopsia points to either a photoreceptor or optic nerve pathologic condition (Table 7). Among positive phenomena, hallucinations resulting from anterior visual system disorders typically are unformed, although deafferentation of retrochiasmal pathways may produce formed hallucinations. The common "floaters" frequently are benign, but occasionally herald more concerning disorders. Various types of photopsias commonly occur with vitreal disorders or photoreceptor disorders. Macular disease typically leads to distortions of the central visual field, and other particular disorders lead to a host of characteristic distortions of color, form, or brightness. Careful attention to the ophthalmologic examination, visual fields, and subtle variance in symptomatology also help to distinguish among various disorders.
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Affiliation(s)
- Timothy Murtha
- Harvard Medical School, Joslin Diabetes Center, Boston, MA, USA
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31
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Barceloux DG, Bond GR, Krenzelok EP, Cooper H, Vale JA. American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning. JOURNAL OF TOXICOLOGY. CLINICAL TOXICOLOGY 2002; 40:415-46. [PMID: 12216995 DOI: 10.1081/clt-120006745] [Citation(s) in RCA: 427] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
EPIDEMIOLOGY Almost all cases of acute methanol toxicity result from ingestion, though rarely cases of poisoning have followed inhalation or dermal absorption. The absorption of methanol following oral administration is rapid and peak methanol concentrations occur within 30-60minutes. MECHANISMS OF TOXICITY Methanol has a relatively low toxicity and metabolism is responsible for the transformation of methanol to its toxic metabolites. Methanol is oxidized by alcohol dehydrogenase to formaldehyde. The oxidation of formaldehyde to formic acid is facilitated by formaldehyde dehydrogenase. Formic acid is converted by 10-formyl tetrahydrofolate synthetase to carbon dioxide and water. In cases of methanol poisoning, formic acid accumulates and there is a direct correlation between the formic acid concentration and increased morbidity and mortality. The acidosis observed in methanol poisoning appears to be caused directly or indirectly by formic acid production. Formic acid has also been shown to inhibit cytochrome oxidase and is the prime cause of ocular toxicity, though acidosis can increase toxicity further by enabling greater diffusion of formic acid into cells. FEATURES Methanol poisoning typically induces nausea, vomiting, abdominal pain, and mild central nervous system depression. There is then a latent period lasting approximately 12-24 hours, depending, in part, on the methanol dose ingested, following which an uncompensated metabolic acidosis develops and visualfunction becomes impaired, ranging from blurred vision and altered visual fields to complete blindness. MANAGEMENT For the patient presenting with ophthalmologic abnormalities or significant acidosis, the acidosis should be corrected with intravenous sodium bicarbonate, the further generation of toxic metabolite should be blocked by the administration of fomepizole or ethanol and formic acid metabolism should be enhanced by the administration of intravenous folinic acid. Hemodialysis may also be required to correct severe metabolic abnormalities and to enhance methanol and formate elimination. For the methanol poisoned patient without evidence of clinical toxicity, the first priority is to inhibit methanol metabolism with intravenous ethanol orfomepizole. Although there are no clinical outcome data confirming the superiority of either of these antidotes over the other, there are significant disadvantages associated with ethanol. These include complex dosing, difficulties with maintaining therapeutic concentrations, the need for more comprehensive clinical and laboratory monitoring, and more adverse effects. Thus fomepizole is very attractive, however, it has a relatively high acquisition cost. CONCLUSION The management of methanol poisoning includes standard supportive care, the correction of metabolic acidosis, the administration of folinic acid, the provision of an antidote to inhibit the metabolism of methanol to formate, and selective hemodialysis to correct severe metabolic abnormalities and to enhance methanol and formate elimination. Although both ethanol and fomepizole are effective, fomepizole is the preferred antidote for methanol poisoning.
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Affiliation(s)
- Donald G Barceloux
- American Academy of Clinical Toxicology, Harrisburg, Pennsylvania 17105-8820, USA
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Cursiefen C, Bergua A. Acute bilateral blindness caused by accidental methanol intoxication during fire "eating". Br J Ophthalmol 2002; 86:1064-5. [PMID: 12185141 PMCID: PMC1771266 DOI: 10.1136/bjo.86.9.1064] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- C Cursiefen
- Department of Ophthalmology, University of Erlangen-Nürnberg, Germany.
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