What is a potential cause of elevated anion gap metabolic acidosis known for causing visual changes?

Methanol toxicity is well-known for causing elevated anion gap metabolic acidosis and is associated with distinctive visual changes. When methanol is metabolized in the body, it is converted to formaldehyde and formic acid, both of which can lead to significant metabolic derangements. The formic acid is particularly notorious for causing damage to the optic nerve, leading to visual disturbances or even blindness in severe cases.

Additionally, the high anion gap in metabolic acidosis occurs due to the accumulation of unmeasured anions, which is characteristic of methanol metabolism. Identifying methanol toxicity is critical in an emergency setting, especially given the visual symptoms that can differentiate it from other causes of metabolic acidosis. This connection between methanol, metabolic acidosis, and its ocular effects is vital to understand in clinical scenarios, allowing for timely diagnosis and management.

In contrast, the other options listed can cause elevated anion gap metabolic acidosis but do not typically present with visual changes. For instance, while ethylene glycol can also result in visual problems, it is more commonly associated with renal toxicity and not specifically noted for visual changes compared to methanol.