Acute blindness and putaminal necrosis in methanol intoxication

Purpose: To review the neuro-ophthalmological and radiological findings of acute methyl alcohol intoxication. Method: 8 acute methyl alcohol intoxicat ion cases were evaluated. Results: All patients were male and their ages va ried between 21 and 55. At the initial examination, 6 to 12 days after meth anol intake, visual acuity ranged from no light perception to counting fing ers at 2 meters with no color perception. Bilateral dense central scotomas were detected in patients whose vision was slightly preserved. Pupillary li ght reactions were either absent or sluggish. In 4 cases, edema of the opti c disk and the peripapillary nerve fiber layer was observed. Three months l ater, optic atrophy had developed. Five patients underwent magnetic resonan ce imaging. Bilateral putaminal hyperintense lesions on T2 weighted images were observed in 3 cases. Two patients died and autopsy permission could no t be obtained. Follow-up examination 12 months later revealed optic atrophy in the other six cases, with no improvement in vision. Conclusion: Methano l intoxication is detrimental to health, possibly resulting in blindness an d occasionally death. In association with ocular signs and the other system ic and laboratory features, the ophthalmologist should be alert to the diag nosis of methanol intoxication in which visual loss may be the only symptom .