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Intravitreal methotrexate infusion for proliferative vitreoretinopathy
Ama Sadaka1, Robert A Sisk2, James M Osher3
1Department of Ophthalmology, University of Cincinnati College of Medicine.
Clinical Ophthalmology (Auckland, N.Z.)
|October 5, 2016
Summary
Intravitreal methotrexate infusion (IMI) during pars plana vitrectomy (PPV) effectively reduced proliferative vitreoretinopathy (PVR) in high-risk patients. This treatment showed good visual acuity and retinal attachment with no significant safety concerns.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Pharmacology
Background:
- Proliferative vitreoretinopathy (PVR) is a major cause of retinal detachment (RD) failure.
- Patients with a history of PVR or severe intraocular inflammation are at high risk for developing PVR.
Purpose of the Study:
- To evaluate the efficacy and safety of intravitreal methotrexate infusion (IMI) during pars plana vitrectomy (PPV).
- To assess IMI's role in preventing PVR in high-risk patients undergoing RD repair.
Main Methods:
- Retrospective review of 29 eyes treated with IMI during PPV for tractional RD and recurrent PVR or high PVR risk due to inflammation.
- Outcomes including visual acuity, retinal attachment, and PVR incidence were analyzed.
Main Results:
- 66% of eyes achieved best-corrected visual acuity ≥20/200 at 6 months.
- 90% of retinas remained attached post-IMI, with only 10% developing limited recurrent PVR.
- No complications were attributed to IMI during a mean follow-up of 27 months.
Conclusions:
- IMI during PPV is associated with a low incidence of PVR in high-risk eyes.
- The procedure demonstrated a favorable safety profile for RD repair in this patient cohort.
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