Document Detail


Methanol poisoning: predictors of visual outcomes.
MedLine Citation:
PMID:  23303293     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether laboratory markers of methanol ingestion and subsequent toxicity can serve as predictors of visual outcomes in patients.
METHODS: Retrospective medical record review of 122 patients in a cluster outbreak of methanol poisoning. Data collected included history, complete ocular and systemic examination details, time to presentation, amount of alcohol ingested, and results of laboratory investigations, such as hemogram, glucose levels, hematocrit level, arterial pH, methanol levels, potassium and bicarbonate levels, and anion and osmolar gap determination, as well as hepatic and renal function tests. Therapy administered consisted of ethyl alcohol, sodium bicarbonate, and nutritional supplements, with hemodialysis in severe cases. Visual acuity (VA), pupillary reaction, and optic disc findings were assessed at presentation and 3 months after discharge. Patients were classified according to their visual disturbance: transient (group 1) or permanent (group 2). Appropriate statistical analysis was performed. Outcome measures included determining the association between biochemical markers of methanol poisoning and final VA.
RESULTS: A total of 122 patients (1 female and 121 male) were admitted for treatment; of these, 10 died. Only 1 patient showed a 2-line drop in VA. pH was the strongest predictor of final VA and improvement in VA among all markers. The odds that a patient with an initial pH greater than 7.2 would have only transient visual disturbances were high (odds ratio, 31; 95% CI, 6-149).
CONCLUSIONS: The degree of acidosis at presentation appears to determine final VA; early presentation and treatment did not seem to significantly alter the visual outcome, especially in severe poisoning.
Authors:
Tejas Desai; Aditya Sudhalkar; Usha Vyas; Bakulesh Khamar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  JAMA ophthalmology     Volume:  131     ISSN:  2168-6173     ISO Abbreviation:  JAMA Ophthalmol     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-20     Completed Date:  2013-05-09     Revised Date:  2013-07-15    
Medline Journal Info:
Nlm Unique ID:  101589539     Medline TA:  JAMA Ophthalmol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  358-64     Citation Subset:  AIM; IM    
Affiliation:
Department of Ophthalmology, Nagri Eye Hospital, India.
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MeSH Terms
Descriptor/Qualifier:
Acidosis
Adult
Bicarbonates / blood
Blood Gas Analysis
Blood Glucose / metabolism
Blood Proteins / metabolism
Female
Hematocrit
Humans
Hydrogen-Ion Concentration
Kidney Function Tests
Liver Function Tests
Male
Methanol / blood,  poisoning*
Middle Aged
Poisoning / diagnosis*,  physiopathology
Prognosis
Retrospective Studies
Solvents / poisoning*
Vision Disorders / diagnosis*,  physiopathology
Visual Acuity / physiology
Water-Electrolyte Balance
Young Adult
Chemical
Reg. No./Substance:
0/Bicarbonates; 0/Blood Glucose; 0/Blood Proteins; 0/Solvents; 67-56-1/Methanol
Comments/Corrections
Erratum In:
JAMA Ophthalmol. 2013 May;131(5):698

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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