Erythropoietin: A Step Forward in Optic Nerve Regeneration and Treatment of Optic Neuropathies

Background and Aim: Methanol poisoning is able to result in an opticneuropathy which is often severe and irreversible and might occursafter the ingestion of illegal/homemade alcoholic beverages. Wealready published the significant effect of this cytokine in patients withtraumatic optic neuropathy. In this study, we evaluated the potentialneuroprotective effect of erythropoietin (EPO) on visual acuity (VA) inpatients with methanol optic neuropathy. We will briefly review the roleof EPO in optic nerve regeneration.Methods: In a forthcoming, noncomparative interventional case series,patients with methanol optic neuropathy after the ingestion of alcoholic beverage were consecutively examined. All these patients were initiallyadministered systemic therapy, including metabolic stabilization anddetoxification. Treatment with intravenous recombinant human EPOconsisted of 20 000 units/day for 3 successive days. Depending on theclinical responses and outcome, some patients were given a secondcourse of EPO. VA, fundoscopy, and spectral domain optical coherencetomography were assessed during the study. The main outcome measurewas the VA. Results: Thirty-two eyes of 16 patients with methanol optic neuropathywere included. In this study, the mean age was 34.2 years (±13.3 years),and the mean time interval between the methanol ingestion and thetreatment with intravenous EPO was 9.1 days (±5.56 days). The meanfollow-up after the treatment was 7.5 months (±5.88 months). Themedian VA in the better eye of each patient before the treatment wasa light perception (range: 3.90-0.60 logMAR). The last acuity medianafter the treatment in the best eye was about 1.00 logMAR (range: 3.90-0.00 logMAR). The VA was markedly increased in the last follow-upexamination (P < 0.0001). Age and time to EPO treatment after methanolingestion were not significantly related to final VA. In this patient cohort,no ocular or systemic complications occurred.Conclusion: Intravenous EPO appears to improve the VA in patients withmethanol optic neuropathy and may represent a promising treatment forthis disorder. Considering our studies in EPO in optic nerve rehabilitation/regeneration it can be considered in optic nerve regeneration strategies.

کلیدواژه ها:

Erythropoietin ، Optic nerve regeneration ، Optic Neuropathies