Methanol poisoning: two case studies of blindness in Indonesia

We report two recent cases of methanol intoxication in French patients living in Bali. These intoxications were secondary to the consumption of adulterated liquor. Both patients presented acute bilateral loss of vision a few days after methanol ingestion with no sign of recovery. The fundus showed bilateral optic atrophy that was well correlated with retinal nerve fibre layer thickness measured with spectral-domain optical coherence tomography and compatible with toxic optic neuropathy. In one of the patients, macular swelling in one eye was observed. Electroretinograms were normal contrasting with abolished visual evoked potentials. Methanol was isolated from a sample of the beverage with gas chromatography. Methanol intoxication may occur in Asia and therefore adequate information for tourists and the local population is required.