Skip to main content
Log in

Acute blindness and putaminal necrosis in methanol intoxication

  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose: To review the neuro-ophthalmological and radiological findings of acute methyl alcohol intoxication. Method: 8 acute methyl alcohol intoxication cases were evaluated. Results: All patients were male and their ages varied between 21 and 55. At the initial examination, 6 to 12 days after methanol intake, visual acuity ranged from no light perception to counting fingers at 2 meters with no color perception. Bilateral dense central scotomas were detected in patients whose vision was slightly preserved. Pupillary light reactions were either absent or sluggish. In 4 cases, edema of the optic disk and the peripapillary nerve fiber layer was observed. Three months later, optic atrophy had developed. Five patients underwent magnetic resonance imaging. Bilateral putaminal hyperintense lesions on T2 weighted images were observed in 3 cases. Two patients died and autopsy permission could not be obtained. Follow-up examination 12 months later revealed optic atrophy in the other six cases, with no improvement in vision. Conclusion: Methanol intoxication is detrimental to health, possibly resulting in blindness and occasionally death. In association with ocular signs and the other systemic and laboratory features, the ophthalmologist should be alert to the diagnosis of methanol intoxication in which visual loss may be the only symptom.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Prabhakaran V, Ettler H, Mills A. Methanol poisoning: two cases with similar plasma methanol concentrations but different outcomes. Can Med Assoc J 1993; 148: 981¶ 4.

    CAS  Google Scholar 

  2. Agency for Toxic Substances and Disease Registry. Methanol toxicity. Am Fam Physician 1993; 47: 163¶ 71.

    Google Scholar 

  3. Naragi S, Dethlefs RF, Slobodniuk RA, Sairere JS. An outbreak of acute methyl alcohol intoxication. Aust NZJ Med 1979; 9: 65¶ 8.

    Google Scholar 

  4. Swartz RD, Millman RP, Billi JE. Epidemic methanol poisoning: Clinical and biochemical analysis of a recent episode. Medicine 1981; 60: 373¶ 82.

    PubMed  CAS  Google Scholar 

  5. McMartin KE, Ambre JJ, Tephly TR. Methanol poisoning in human subjects. Role for formic acid acumulation in the metabolic acidosis. Am J Med 1980; 68: 414¶ 8.

    Article  PubMed  CAS  Google Scholar 

  6. Gonda A, Gault H, Churchill D, Hollomby D. Hemodialysis for methanol intoxication. Am J Med 1978; 64: 749¶ 58.

    Article  PubMed  CAS  Google Scholar 

  7. Osterloh YD, Pond SM, Grady S, Becker CE. Serum formate concentrations in methanol intoxication as a criterion for hemodialysis. Ann Inter Med 1986; 104: 200¶ 3.

    CAS  Google Scholar 

  8. Brent J, Lucas M, Kulu\(\overset{\lower0.5em\hbox{$\smash{\scriptscriptstyle\smile}$}}{g} \) K et al. Clinical and laboratory observations. Methanol poisoning in a 6-week-old infant. J Pediatrics 1991; 118 (pt 1): 644¶ 6.

    Article  CAS  Google Scholar 

  9. Vogt MJ, Heffner JE, Sahn SA. Pulmonary and clinical, and visual disturbances in a 31 year-old man. Chest 1993; 103:262–3.

    PubMed  CAS  Google Scholar 

  10. Greiner JV, Pillal S, Limaye SR. Sterno-induced methanol toxicity and visual recovery after prompt hemodialysis (letter). Arch Ophthalmol 1989; 107: 643.

    PubMed  CAS  Google Scholar 

  11. Ingemansson S. Clinical observations on ten cases of methanol poisoning with particular reference to ocular manifestations. Acta Ophthalmologica 1984; 62: 15¶ 24.

    Article  PubMed  CAS  Google Scholar 

  12. Aufderheide TP, White SM, Brady WJ, Steven HA. Inhalational and percutaneous methanol toxicity in two firefighters. Ann Emerg Med 1993; 22: 1916¶ 8.

    Article  PubMed  CAS  Google Scholar 

  13. Wu Chen NB; Donoghue ER; Schaffer MI. Methanol intoxication: Distribution in postmortem tissues and fluids including vitreous humor. J Forensic Sci 1985; 30: 213¶ 6.

    PubMed  CAS  Google Scholar 

  14. Liesivuori J, Savolainen H. Methanol and formic acid toxicity: Biochemical mechanisms. Pharmacol Toxicol 1991; 69: 157¶ 63.

    Article  PubMed  CAS  Google Scholar 

  15. Potts AM, Johnson LV. Studies on the visual toxicity of methanol. I. The effect of methanol and its degradation products on retinal metabolism. Am J Ophthalmol 1952; 35: 107¶ 13.

    PubMed  CAS  Google Scholar 

  16. Benton CD, Calhoun FP. The ocular effects of methyl alcohol poisoning: Report of a catastrophe involving three hundred and twenty persons. Trans Am Acad Ophthalmol 1952; 56: 875¶ 83.

    Google Scholar 

  17. Martin-Amat G, Tephly TR, McMartin KE, et al. Methyl alcohol poisoning. II. Development of a model for ocular toxicity in methyl alcohol poisoning using the rhesus monkey. Arch Ophthalmol 1977; 95: 1847¶ 50.

    PubMed  CAS  Google Scholar 

  18. Hayreh MS, Hayreh SS, Baumbach GL, et al. Methyl alcohol poisoning. III. Ocular toxicity. Arch Ophthalmol 1977; 95: 1851¶ 8.

    PubMed  CAS  Google Scholar 

  19. Baumbach GL, Cancilla PA, Martin Amat G, et al. Methyl alcohol poisoning. IV. Alterations of the morphological findings of the retina and optic nerve. Arch Ophthalmol 1977; 95: 1859¶ 65.

    PubMed  CAS  Google Scholar 

  20. Sharpe JA, Hostovsky M, Bilbao JM, et al. Methanol optic neuropathy: A histopathological study. Neurology 1982; 32: 1093¶ 1100.

    PubMed  CAS  Google Scholar 

  21. Ley CO, Gali FG. Parkinsonian syndrome after methanol intoxication. Eur Neurol 1983; 22: 405¶ 9.

    PubMed  CAS  Google Scholar 

  22. Mozaz MJ, Wyke MA, Indakoetxea B. Parkinsonism and defects of praxis following methanol poisoning (letter). J Neurol Neurosurg Psychiatry 1991; 54: 843¶ 4.

    PubMed  CAS  Google Scholar 

  23. del Carpio O’Donnovan R, Glay J. Subarachnoid hemorrhage resulting from methanol intoxication: demonstration by computed tomography. Can Assoc Radiol J 1992; 43: 229¶ 301.

    Google Scholar 

  24. Pelletier J, Habib MH, Khalil R, et al. Putaminal necrosis after methanol intoxication (letter). I Neurol Neurosurg Psychiatry 1992; 55: 234¶ 5.

    CAS  Google Scholar 

  25. Koopmans RA, Li DKB, Paty DW. Basal ganglia lesions in methanol poisoning: MR appearance. J Comput Assist Tomogr 1988; 12: 168¶ 9.

    PubMed  CAS  Google Scholar 

  26. Glazer M, Dross P. Necrosis of the putamen caused by methanol intoxication: MR findings. Am J Radiol 1993; 160: 1105¶ 6.

    CAS  Google Scholar 

  27. Chen JC, Schneiderman JF, Wortzman G. Methanol poisoning: Bilateral putaminal and cerebellar cortical lesions on CT and MR. J Comput Assist Tomogr 1991; 15(3): 522¶ 4.

    PubMed  CAS  Google Scholar 

  28. Gaul HP, Wallace CJ, Auer RN, et al. MR findings in methanol intoxication. Am J Neuroradiol 1995; 16: 1783¶ 6.

    PubMed  CAS  Google Scholar 

  29. Anderson CA, Rubinstein D, Filley CM, Stears JC. MR enhancing brain lesions in methanol intoxication. J Comput Assist Tomogr, 1997; 21: 834¶ 6.

    Article  PubMed  CAS  Google Scholar 

  30. Hantson P, Duprez T, Mahieu P. Neurotoxicity to the basal ganglia shown by magnetic resonance imaging (MRI) following poisoning by methanol and other substances. J Toxicol Clin Toxicol 1997; 35: 151¶ 61.

    Article  PubMed  CAS  Google Scholar 

  31. Jacobsen D, McMartin KE. Antidotes for methanol and ethylene glycol poisoning. Clin Toxicol 1997; 35: 127¶ 43.

    CAS  Google Scholar 

  32. Palmisano I, Gruver C, Adams ND. Absence of anion gap metabolic acidosis in severe methanol poisoning: A case report and review of the literature. Am J Kidney Dis 1987; 9: 441¶ 4.

    PubMed  CAS  Google Scholar 

  33. Chow MT, Di Silvestro VA, Yung CY, et al. Treatment of acute methanol intoxication with hemodialysis using an ethanol-enriched, bicarbonate-based dialysate. Am J Kidney Dis 1997; 30: 568¶ 70.

    PubMed  CAS  Google Scholar 

  34. Ingemansson SO. Studies on the effect of 4-methylpyrazole on retinal activity in the methanol poisoned monkey by recording the electroretinogram. Acta Ophthalmol Suppl [Copenh] 1983; 158: 5¶ 24.

    Google Scholar 

  35. Fraser AD. Methanol Poisoning. Can Med Assoc 1993; 149: 134¶ 6.

    CAS  Google Scholar 

  36. Rotenstreich Y, Assia EI, Kesler A. Late treatment of methanol blindness. Br J Ophthalmol 1997; 81: 416¶ 7.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Önder, F., İlker, S., Kansu, T. et al. Acute blindness and putaminal necrosis in methanol intoxication. Int Ophthalmol 22, 81–84 (1998). https://doi.org/10.1023/A:1006173526927

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1006173526927

Navigation