Case Presentation:
A 45-year-old man referred to toxicology department of Loghman Hakim Hospital complaining of bilateral blurred vision, vomiting, nausea. He was oriented and he had drunk about 500 cc alcohol two days ago and was suffering from blurred vision since yesterday.
Laboratory blood tests was as following (Table 1):
Patient’s history, clinical sings and laboratory test results confirmed methanol toxicity so 4 hours of emergency hemodialysis performed for him, alcohol 96̊ 140cc and 560cc D/W 5% administered during hemodialysis, we also prescribed erythropoietin (Eprex 10000U) SC for 3 days, Methylprednisolone 250mg IV for 6 hours for 3 days, Amp folinic acid 60mg for 3 hours,3 vial Na/HCO3 IV stat. VBG results after hemodialysis showed: PH: 7.54, PCO2:48.4, HCO3:23.7 So metabolic acidosis and right eye’s vision was corrected but not the left eyes. Considering patient’s condition hemodialysis was done for the second time, but he still suffered from central field loss in the left eye then he was referred to ophthalmologist that reported: right eye’s acuity 7/10, left eye’s acuity 3m, RADP positive, left eye’s abducent movement and its color was disturbed and retinal examination was consistent with methanol intoxication. Erythropoietin (Eprex 10000U) for 3 days and Brimogan (Brimonidine and Timolol) TDS has been prescribed for left eye.