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The use of low dose methotrexate in children with chronic anterior and intermediate uveitis

A R Malik1, C Pavesio

  • 1East Surrey Hospital, Redhill, UK.

The British Journal of Ophthalmology
|June 21, 2005
PubMed

Insights

Low-dose methotrexate (MTX) effectively treats chronic uveitis in children, improving vision and reducing steroid dependence. This safe treatment helps prevent sight-threatening complications associated with chronic eye inflammation.

Area of Science:

  • Pediatric Ophthalmology
  • Rheumatology
  • Immunology

Background:

  • Chronic uveitis in children can lead to severe vision loss.
  • Long-term corticosteroid use for uveitis carries significant side effects.

Purpose of the Study:

  • To evaluate the effectiveness of low-dose methotrexate (MTX) in managing chronic anterior and intermediate uveitis in pediatric patients.
  • To assess the impact of MTX on visual acuity, ocular inflammation, and corticosteroid requirements.

Main Methods:

  • Retrospective case review of 10 children with chronic uveitis treated with MTX.
  • Data collected included patient demographics, uveitis characteristics, MTX dosage and duration, and clinical outcomes.
  • Clinical parameters assessed: visual acuity, anterior chamber inflammation, and topical/oral corticosteroid use.

Main Results:

  • Improved visual acuity to 6/6 or better in 100% of right eyes and 80% of left eyes post-MTX.
  • 60% of children showed decreased anterior chamber inflammation.
  • Significant reduction in topical steroid use (5.6 to 1.5 times/day) and oral steroid dosage (18 mg to 2.85 mg/day).
  • Nausea was the most common side effect (20%), with no discontinuations due to adverse events.

Conclusions:

  • Low-dose methotrexate is an effective and safe therapeutic option for pediatric chronic anterior and intermediate uveitis.
  • Increased awareness among pediatricians and ophthalmologists is crucial to prevent sight-threatening complications.
  • MTX offers a viable alternative to long-term steroid therapy, mitigating associated risks.
Abstract

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