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Bernardo A. Schlaen, Mario J. Saravia, Cristobal A. Couto, Erika Hurtado, Pablo Koll, Noelia Paira; Use Of Intravitreal Methotrexate In Uveitic Macular Edema And Intraocular Inflammation. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2722.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the outcomes of methotrexate intravitreal injection (IVMTX) in patients with uveitic macular edema and/or active uveitis
This is a retrospective case series study. Clinical records of patients with active uveitis and/or uveitic macular edema (ME), with intolerance or resistance to systemic and/or local corticosteroids who received IVMTX injection, were collected from two centers (Hospital Universitario Austral & University of Buenos Aires). Every patient must have received a dose of 400 µg/0.1ml of intravitreal methotrexate. Age, sex, and post injection follow up time were registered. Pre and post injection best corrected visual acuity (BCVA) of all studied eyes studied were recorded. In cases with ME, optical coherence tomography (OCT) pre and postinjection values in the central subfield of the macular thickness map were collected. Systemic and local antiinflammatory and immunosuppressive medication used by each patient was registered.
As is shown in table 1, 5 patients (4 male, 1 female) were included in this study. The average age was of 41 ± 20 years (range:16 to 70 years). 3 patients (4 eyes) underwent an IVMTX injection due to the presence of uveitic ME. The average preinjection central retinal thickness was of 487± 44.14 microns. The average postinjection central retinal thickness was of 308 ± 91.04 microns. The difference was statistically significant (t test, p=0.012). Preinjection BCVA was worse than 20/40 in 3 of 4 eyes with ME. Postinjection BCVA was better than 20/30 in 3 of 4 eyes with ME. The other two, with a diagnosis of Vogt Koyanagi Harada syndrome, underwent an IVMTX injection due to the presence of active panuveitis. Signs of inflammatory activity were reduced in both patients. One of them had an improvement of the BCVA from 20/100 to 20/30. The other had no change of BCVA.
Intravitreal methotrexate may be useful for the treatment of uveitic macular edema and/or active uveitis.
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