Predicting the outcome in methanol-induced optic neuropathy cases: A guessing game?

Methanol-induced optic neuropathy remains a challenging problem for health-care systems worldwide. The outcomes for patients with methanol-induced optic neuropathy are often unpredictable, with many cases resulting in severe and irreversible visual impairment. This case series aims to illustrate the diverse range of outcomes associated with methanol-induced optic neuropathy. This report describes three cases of methanol-induced optic neuropathy with varying outcomes despite similar conditions at presentation. One case involved methanol exposure through inhalation, while the other two cases resulted from methanol ingestion. Initially, all three cases presented with poor visual acuity, and no clear systemic manifestations were observed. The patients received high-dose corticosteroid treatment and neuroprotectors. Remarkably, the patient with the youngest age demonstrated the most significant improvement during follow-up, whereas the oldest patient, who was a smoker and alcoholic, exhibited the least improvement. This case series highlights the substantial differences in outcomes among these cases despite the identical treatment approach for all. The treatment outcomes for methanol-induced optic neuropathy may vary, even when patients present with similar severity and receive identical therapy. Age and lifestyle are considered prognostic factors affecting the outcome of therapy. However, prompt diagnosis and treatment are needed to improve the prognosis.