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INTRAVITREAL METHOTREXATE INJECTION FOR THE TREATMENT AND PREVENTION OF PROLIFERATIVE VITREORETINOPATHY
Patrick J Hughes1, Neelakshi Bhagat, Orlando G Gonzalez-Martinez
1Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey.
Retina (Philadelphia, Pa.)
|September 17, 2024
Summary
Serial intravitreal methotrexate injections achieved a 90% success rate for retinal reattachment in eyes with proliferative vitreoretinopathy or high-risk retinal detachment. This treatment offers a promising option for complex retinal conditions.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Pharmacology
Background:
- Proliferative vitreoretinopathy (PVP) and open globe injuries pose significant challenges in retinal reattachment surgery.
- Effective management strategies are crucial to improve surgical outcomes and prevent vision loss.
Purpose of the Study:
- To evaluate the efficacy and safety of serial intravitreal methotrexate (MTX) injections.
- To assess the impact of MTX on retinal reattachment rates in complex cases.
Main Methods:
- Retrospective chart review of 21 eyes undergoing pars plana vitrectomy and intravitreal MTX.
- Serial intravitreal MTX injections (400 microg/0.1 mL) administered postoperatively.
- Surgical procedures included membrane peeling, laser, and silicone oil infusion.
Main Results:
- A 90% single-operation retinal reattachment rate was achieved in 19 out of 21 eyes.
- Mean visual acuity improved from LogMAR 3.2 (hand motions) to 2.5 (CF/hand motions).
- Corneal epithelial defects occurred in 33% of patients.
Conclusions:
- Serial intravitreal MTX injections are associated with a high rate of single-operation retinal reattachment.
- MTX demonstrates potential as a therapeutic agent for managing PVP and high-risk retinal detachments.
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