Low-dose methotrexate therapy for ocular inflammatory disease.
BACKGROUND
Methotrexate is a second-line anti-inflammatory agent used in the treatment of rheumatic diseases. At low doses (12.5 mg/week), it is associated with few serious side effects.


METHODS
Twenty-two patients (5 men, 17 women) with chronic noninfectious ocular inflammatory disease, who had not responded to or who had become intolerant of corticosteroid or alternate cytotoxic agents, were treated weekly with oral low-dose, pulse methotrexate. Treated diseases included chronic uveitis-vitreitis (9), scleritis (4), inflammatory pseudotumor (3), orbital myositis (3), and retinal vasculitis (3).


RESULTS
Follow-up ranged from 2 to 39 months (mean, 11 months). Response time ranged from 3 to 9 weeks (mean, 5 weeks) after implementation of methotrexate therapy. Sixteen of 22 patients had reduction of inflammatory activity. Fourteen of these 16 patients were able to taper or discontinue corticosteroid therapy. Five patients had complete remission of their disease; six patients did not respond to methotrexate.


CONCLUSIONS
Treatment with low-dose methotrexate appears to be effective therapy for steroid-resistant ocular inflammatory disease.
Shah
S S
SS
Department of Ophthalmology, Cleveland Clinic Foundation, OH 44195-5024.
Lowder
C Y
CY
Schmitt
M A
MA
Wilke
W S
WS
Kosmorsky
G S
GS
Meisler
D M
DM
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004304:Dosage Forms; D005128:Eye Diseases / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000188:drug therapy; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
D004304:Dosage Forms; D008727:Methotrexate