Methotrexate therapy for chronic noninfectious uveitis: analysis of a case series of 160 patients.
OBJECTIVE
To evaluate the outcomes of patients with chronic noninfectious uveitis unresponsive to conventional antiinflammatory therapy who were treated with methotrexate.


METHODS
Retrospective noncomparative interventional case series.


METHODS
All patients with chronic noninfectious uveitis treated with methotrexate at a single institution from 1985 to 1999.


METHODS
Charts of patients seen on the Ocular Immunology & Uveitis Service at the Massachusetts Eye & Ear Infirmary were reviewed. Patients with chronic uveitis of noninfectious origin treated with methotrexate were included in the study.


METHODS
Control of inflammation, steroid-sparing effect, visual acuity, adverse reactions.


RESULTS
A total of 160 patients met the inclusion criteria. Control of inflammation was achieved in 76.2% of patients. Steroid-sparing effect was achieved in 56% of patients. Visual acuity was maintained or improved in 90% of patients. Side effects requiring discontinuation of medication occurred in 18% of patients. Potentially serious adverse reactions occurred in only 8.1% of patients. There was neither long-term morbidity nor mortality caused by methotrexate.


CONCLUSIONS
Methotrexate is effective in the treatment of chronic noninfectious uveitis that fails to respond to conventional steroid treatment. It is an effective steroid-sparing immunomodulator, is a safe medication, and is well tolerated.
Samson
C M
CM
Ocular Immunology & Uveitis Service, Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts 02116, USA.
Waheed
N
N
Baltatzis
S
S
Foster
C S
CS
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D012449:Safety; D014605:Uveitis / Q000188:drug therapy*; D014792:Visual Acuity
D007166:Immunosuppressive Agents; D008727:Methotrexate