Low-Dose Intravitreal Methotrexate for Proliferative Vitreoretinopathy

BACKGROUND AND OBJECTIVE: Proliferative vitreo-retinopathy (PVR) has been mitigated by intravit-real methotrexate (MTX) 400 jig/0.1 mL in several studies. Here, we evaluate the results from a lower dose of MTX, 200 jig/0.05 mL.MATERIALS AND METHODS: We identified and re-viewed records of patients with grade >= C1 PVR who were treated with 200 jig/0.05 mL MTX injections: during PVR surgery and every 2 weeks thereafter.RESULTS: Twenty-four eyes met inclusion criteria with a mean of 5.6 injections and follow-up rang-ing 6 to 56 months. The retina was reattached in 19 of 24 eyes (79%) after a single surgery and in 5 of 24 eyes (21%) after one additional PVR surgery. Visual acuity improved from baseline logMAR 1.63 to 0.97 at 12 months (P < .001), with 5 of 20 achieving 20/60 or better and 16 of 20 achieving 20/200 or better. One eye developed a transient corneal abrasion that resolved within 1 week.CONCLUSION: Low-dose MTX (200 jig/0.05 mL) dur-ing and after PVR surgery resulted in good rates of retinal reattachment and visual acuity recovery.