Corticosteroid treatment for methanol poisoning

Liberski 2022Permasuari 2019

Methanol poisoning can cause optic neuropathy, leading to severe visual impairment, or even blindness, which can be irreversible.

Prevention of optic neuropathy is focused on:

• inhibiting the metabolism of methanol to its toxic acid metabolites with antidotal therapy
• facilitating the elimination of both methanol and its toxic acid metabolites with haemodialysis.

Case reports and case series suggest corticosteroids may be beneficial as an adjunctive treatment to prevent long-term visual impairment. Given the risk of irreversible blindness, it is reasonable to consider corticosteroid treatment for patients with coma, visual impairment or severe metabolic acidosis (pH less than 7.20).

If corticosteroids are indicated to prevent visual impairment in methanol poisoning, use:

Assessment by an ophthalmologist should occur as soon as reasonably possible, for a comprehensive eye examination and determination of the need for further treatment and follow-up reviews.