Low-Dose Intravitreal Methotrexate for Proliferative Vitreoretinopathy

Area of Science:

• Ophthalmology
• Retinal Diseases
• Pharmacology

Background:

• Proliferative vitreoretinopathy (PVR) is a significant cause of vision loss.
• Intravitreal methotrexate (MTX) has previously shown efficacy at higher doses (400 μg/0.1 mL) for PVR.
• The effectiveness of lower-dose MTX for PVR requires further investigation.

Purpose of the Study:

• To evaluate the efficacy and safety of a lower dose of intravitreal methotrexate (MTX), specifically 200 μg/0.05 mL, for treating proliferative vitreoretinopathy (PVR).

Main Methods:

• Retrospective review of patients with grade ≥C1 PVR treated with 200 μg/0.05 mL MTX injections during and after PVR surgery.
• Analysis of surgical outcomes, visual acuity, and adverse events in 24 eyes.

Main Results:

• Retinal reattachment was achieved in 79% of eyes after a single surgery and 21% after an additional surgery.
• Visual acuity improved significantly from logMAR 1.63 to 0.97 at 12 months (P < .001).
• One case of transient corneal abrasion was the only reported adverse event.

Conclusions:

• Low-dose intravitreal MTX (200 μg/0.05 mL) is effective in achieving retinal reattachment in PVR.
• This dosage also leads to significant visual acuity recovery in PVR patients.
• Low-dose MTX presents a safe and effective treatment option for PVR.