Progressive Chronic Retinal Axonal Loss Following Acute Methanol-induced Optic Neuropathy: Four-Year Prospective Cohort Study

0497405 - ÚFCH JH 2019 RIV US eng J - Journal Article
Nurieva, O. - Diblík, P. - Kuthan, P. - Sklenka, P. - Meliska, M. - Bydžovský, J. - Heissigerová, J. - Urban, P. - Kotíková, K. - Navrátil, Tomáš - Komarc, M. - Seidl, Z. - Vaněčková, M. - Pelclová, D. - Zakharov, S.
Progressive Chronic Retinal Axonal Loss Following Acute Methanol-induced Optic Neuropathy: Four-Year Prospective Cohort Study.
American Journal of Ophthalmology. Roč. 191, JUL 2018 (2018), s. 100-115. ISSN 0002-9394. E-ISSN 1879-1891
Institutional support: RVO:61388955
Keywords : mass poisoning outbreak * clinical-features * outcomes * neuroinflammation * neurodegeneration
OECD category: Physical chemistry
Impact factor: 4.483, year: 2018
Method of publishing: Open access

PURPOSE: To study the dynamics and clinical determinants of chronic retinal nerve fiber layer thickness (RNFL) loss after methanol-induced optic neuropathy.
DESIGN: Prospective cohort study.
METHODS: All patients underwent complete ophthalmic evaluation including spectral-domain optical coherence tomography 3 times during 4 years of observation: 4.9 (+/- 0.6), 25.0 (+/- 0.6), and 49.9 (+/- 0.5) months after discharge. PARTICIPANTS: Eighty-four eyes of 42 survivors of methanol poisoning, mean age (standard deviation) of 45.7 (+/- 4.4) years, and 82 eyes of 41 controls, mean age 44.0 (+/- 4.2) years. MAIN OUTCOME MEASURES: Global and temporal RNFL loss.
RESULTS: Abnormal RNFL thickness was registered in 13 of 42 (31%) survivors of methanol poisoning and chronic axonal loss in 10 of 42 (24%) patients. Significant decrease of global/temporal RNFL thickness during the observation period was found in the study population compared to the controls (P < .001). The risk estimate of chronic global RNFL loss for arterial blood pH < 7.3 at admission was 11.65 (95% confidence interval 1.91-71.12) after adjusting for age and sex. The patients with chronic axonal degeneration demonstrated progressive visual loss in 7 of 10 cases. The patients with abnormal RNFL thickness had magnetic resonance signs of brain damage in 10 of 13 vs 8 of 29 cases with normal RNFL thickness (P = .003). Signs of brain hemorrhages were present in 7 of 13 patients with abnormal RNFL thickness vs 5 of 29 cases with normal RNFL thickness (P = .015).
CONCLUSIONS: Methanol-induced optic neuropathy may lead to chronic retinal axonal loss during the following years. Arterial blood pH on admission is the strongest predictor of chronic RNFL thickness decrease. Chronic retinal neurodegeneration is associated with the progressive loss of visual functions and necrotic brain lesions. (C) 2018 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license.
Permanent Link: http://hdl.handle.net/11104/0289974