Methanol Induced Optic Neuropathy: Molecular Mysteries, Public Health Perspective, Clinical Insights and Treatment Strategies

ABSTRACT

Methanol-induced optic neuropathy (MION) represents a critical public health issue, particularly prevalent in lower socioeconomic populations and regions with restricted alcohol access. MION, characterized by irreversible visual impairment, arises from the toxic metabolization of methanol into formaldehyde and formic acid, leading to mitochondrial oxidative phosphorylation inhibition, oxidative stress, and subsequent neurotoxicity. The pathogenesis involves axonal and glial cell degeneration within the optic nerve and potential retinal damage. Despite advancements in therapeutic interventions, a significant proportion of affected individuals endure persistent visual sequelae. The study comprehensively investigates the pathophysiology of MION, encompassing the absorption and metabolism of methanol, subsequent systemic effects, and ocular impacts. Histopathological changes, including alterations in retinal layers and proteins, Müller cell dysfunction, and visual symptoms, are meticulously examined to provide insights into the disease mechanism. Furthermore, preventive measures and public health perspectives are discussed to highlight the importance of awareness and intervention strategies. Therapeutic approaches, such as decontamination procedures, ethanol and fomepizole administration, hemodialysis, intravenous fluids, electrolyte balance management, nutritional therapy, corticosteroid therapy, and erythropoietin (EPO) treatment, are evaluated for their efficacy in managing MION. This comprehensive review underscores the need for increased awareness, improved diagnostic strategies, and more effective treatments to mitigate the impact of MION on global health.

KEYWORDS:

• Methanol toxicity
• neuroinflammation
• optic neuropathy
• visual impairment

ACKNOWLEDGEMENTS

Figure 1 was produced in biorender.com. According to the policy of this site, publishing with a source is not prohibited. Additionally, the authors used ref-n-write and Grammarly in order to facilitate paraphrasing and grammar checking, during the preparation of this work. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

AUTHORS’ CONTRIBUTIONS

NS and AJ conceptualized this review. NS, MA carried out the literature review. NS, AJ, MA, AM, and AA wrote the first draft. AJ and AM revised the draft. NS and AJ designed figures. The final manuscript was read and approved by all authors. It should be noted that AJ and AM are co-corresponding authors of this manuscript.

Additional information

Funding

This study was not funded by any particular organization, company, etc.