Outbreak of methanol-induced optic neuropathy amid COVID-19 pandemic
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LETTER TO THE EDITOR
Outbreak of methanol-induced optic neuropathy amid COVID-19 pandemic Mohammad Reza Khalili 1 & Maryam Sadat Sadati 2 & Hamidreza Jahanbani-Ardakani 1 Received: 17 August 2020 / Revised: 24 August 2020 / Accepted: 27 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Dear Editor, A pandemic related to a new coronavirus infection identified as COVID-19, as starting in Wuhan, China, was announced by the World Health Organization on March 11, 2020 [1]. As one of the hotspots, Iran experienced an unprecedented tremendous outbreak with over 340,000 cases of COVID-19 to date [2]. We recently witnessed a significant increase in the number of patients referring to our eye emergency department in Khalili Hospital affiliated to Shiraz University of Medical Sciences, Shiraz, Fars province, Iran, with methanol-induced optic neuropathy. The diagnosis was confirmed with a careful and detailed history taking and a comprehensive physical examination. All of the patients had history of alcohol drinking accompanied with painless, bilateral vision loss. Progressive loss of visual acuity usually had started with a blur at the fixation point. By taking a meticulous past drug history, we excluded other causes of toxic optic neuropathy including linezolid, ethambutol, amiodarone, and sildenafil. Other probable causes of optic neuropathy such as inflammatory and ischemic optic neuropathies were also excluded. In physical examination, optic nerve and macula were evaluated using slit lamp biomicroscope and a Volk 90 D condensing lens. Optic nerve hyperemia and swelling were assessed and recorded. Dyschromatopsia was assessed using Ishihara color vision plates. From about 300 patients with methanol poisoning that were referred or consulted to us, 108 cases of methanolinduced optic neuropathy were diagnosed in our eye emergency department (unpublished data) in only 2 weeks’ time. This * Mohammad Reza Khalili [email protected] 1
Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
2
Department of Dermatology, Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
incidence is far higher than the total number of patients that have been referred to our center and were diagnosed as methanol-induced optic neuropathy within the last 15 years. The most common presenting symptom was blurred vision and most common sign was optic disc abnormality including hyperemia and swelling in optic nerve head. Based on the information obtained from the patients, there were several factors that have led to the methanol poisoning and methanol-induced optic neuropathy outbreak. Firstly, there is a misconception among the public that consuming alcohol-based drinks may be protective against COVID-19. Since Iran is an Islamic country, use of alcoholic drinks is prohibited and is against the country’s law. Obtaining alcoholic drinks in Iran is quite difficult and those who wish to use alcoholic beverages have to buy
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