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Related Experiment Videos

Visual field defects during low-dose methotrexate therapy.

B A Johansson1

  • 1Department of Ophthalmology, University Hospital of Linköping, Sweden.

Documenta Ophthalmologica. Advances in Ophthalmology
|January 1, 1992
PubMed
Summary
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Low-dose methotrexate treatment for psoriasis can cause vision problems, including optic nerve swelling and visual field defects. These visual changes appear linked to methotrexate dosage adjustments.

Area of Science:

  • Ophthalmology
  • Dermatology
  • Toxicology

Background:

  • Psoriasis is a chronic autoimmune skin condition often requiring systemic therapy.
  • Methotrexate is a common immunosuppressive drug used for severe psoriasis unresponsive to conventional treatments.

Observation:

  • A patient undergoing low-dose methotrexate therapy for recalcitrant psoriasis developed visual disturbances.
  • Ophthalmic examination revealed optic disc swelling, progressing to optic disc atrophy.
  • Paracentral visual field defects were observed, exhibiting fluctuations correlating with methotrexate dosage.

Findings:

  • The observed visual symptoms and optic nerve changes suggest a potential toxic effect of methotrexate on the optic nerve.
  • Fluctuations in visual field defects paralleled changes in methotrexate dosage, indicating a dose-dependent relationship.

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Implications:

  • Methotrexate may pose a risk of optic nerve toxicity, necessitating careful ophthalmic monitoring in patients receiving this medication.
  • This case highlights the importance of considering medication side effects, such as methotrexate optic neuropathy, in patients presenting with visual symptoms.