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Factors predicting optic nerve axonal degeneration after methanol-induced acute optic neuropathy: a 2-year prospective study in 54 patients

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Abstract

Prospective cross-sectional study was conducted in 54 patients (mean age 46.7 ± 3.7 years) to determine the character of optic nerve axonal degeneration after acute methanol poisoning. Methanol was measured by a gas chromatographic method with flame ionization detection. Formate was measured enzymatically. Measurement of full-field visual evoked potential with monocular checkerboard pattern-reversal stimulation was performed 3–8 and 24–28 months after discharge. The amplitudes of N1P1 and P1N2 components of evoked response were used for analysis of axonal loss. Altogether, 13 of 50 patients (26 %) had abnormal amplitudes at the first examination (including the patients with nonrecordable amplitudes), and 37 patients had normal amplitudes. Mean N1P1/P1N2 amplitudes for right eyes (REs) were 6.30 ± 1.10/8.70 ± 1.50 µV and for left eyes (LEs) were 6.56 ± 1.00/8.30 ± 1.40 µV. The group with abnormal amplitudes had lower arterial pH (p = 0.009), bicarbonate (p = 0.036), higher base deficit (p = 0.005), glucose (p = 0.015), and lactate (p = 0.018). At the second examination, insignificant amplitude changes were registered (REs 6.50 ± 1.10/9.80 ± 1.60 µV, LEs 6.40 ± 1.10/9.30 ± 1.60 µV; both p > 0.05). In 2 of 44 REs (5 %) and in 4 of 45 LEs (9 %) with 2 consecutive examinations the initially normal amplitudes deteriorated to abnormal values. In 3 of 45 patients (7 %) the abnormal amplitudes deteriorated in both eyes indicating the ongoing process of chronic neuronal degeneration. The dynamics of amplitude deterioration correlated with serum lactate (r = 0.533; p < 0.001), glucose (r = 0.462; p = 0.005), and formic acid (r = 0.380; p = 0.046) on admission to hospital. The correlation was present between the magnetic resonance signs of hemorrhagic brain lesions and the amplitude changes (r = −0.535; p < 0.001).

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Acknowledgments

This work was supported with the Project of the Ministry of Health of the Czech Republic 9/15/NAP, the Projects of the Charles University in Prague PRVOUK—P25/1LF/2, P26/1LF/2, and P28/1LF/6, and EU Project “Material—technical Research Base for the Diagnostics and Treatment of Environmentally caused and Oncological Disorders and their Risks, in the General University Hospital in Prague” (reg. No. CZ.2.16/3.1.00/24.12).

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Authors and Affiliations

  1. Department of Occupational Medicine, First Faculty of Medicine, Toxicological Information Centre, Charles University in Prague, Prague 2, Czech Republic

    Sergey Zakharov, Katerina Kotikova & Daniela Pelclova

  2. General University Hospital, Na Bojisti 1, 120 00, Prague 2, Czech Republic

    Sergey Zakharov, Katerina Kotikova & Daniela Pelclova

  3. Department of Occupational Medicine, First Faculty of Medicine, Charles University in Prague, Na Bojisti 1, 120 00, Prague 2, Czech Republic

    Olga Nurieva & Pavel Urban

  4. J. Heyrovský Institute of Physical Chemistry of the AS CR, v.v.i., Dolejškova 3, 182 23, Prague 8, Czech Republic

    Tomas Navratil

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  1. Sergey Zakharov
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  2. Olga Nurieva
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  3. Katerina Kotikova
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  4. Pavel Urban
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Correspondence to Sergey Zakharov.

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Ethics

The study was approved by the General University Hospital Ethics Committee in Prague, Czech Republic. Informed consent was obtained from the participants of the study. The study adhered to the tenets of the Declaration of Helsinki.

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Zakharov, S., Nurieva, O., Kotikova, K. et al. Factors predicting optic nerve axonal degeneration after methanol-induced acute optic neuropathy: a 2-year prospective study in 54 patients. Monatsh Chem 147, 251–261 (2016). https://doi.org/10.1007/s00706-015-1581-x

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  • DOI: https://doi.org/10.1007/s00706-015-1581-x

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