The safety of intraocular methotrexate in silicone-filled eyes.
BACKGROUND
Intraocular methotrexate has been safely used in eyes with primary CNS lymphoma (PCNSL), and in eyes with uveitis and proliferative diabetic retinopathy. Dosing in silicone-filled eyes was reduced from a standard 400 microg intravitreal injection due to concerns of toxicity. The present study reports the visual results of non-PCNSL, silicone-filled eyes treated with intravitreal methotrexate using cumulative dosages ranging from 200 microg to 1,200 microg.


METHODS
In this retrospective case series, all patients with silicone-filled eyes who received intraocular methotrexate were included. Patients were observed with serial ophthalmic examinations. Best-corrected visual acuity was measured by Snellen acuity. Pretreatment acuities were compared to those obtained at last follow-up.


RESULTS
The cohort included 12 patients (13 eyes) with disease other than PCNSL. The cumulative dose of intraocular methotrexate in any one patient ranged from 200 microg to 1,200 microg. Mean follow-up was 9 months (median, 10 months; range, 2 weeks to 16 months). Best-corrected vision at last follow-up was either stable or improved from pretreatment acuity in 12 of 13 eyes.


CONCLUSIONS
Preservation of acuity in 12 of 13 study eyes suggests that intravitreal methotrexate in a cumulative dose of up to 1,200 microg is safe in silicone-filled eyes.
Hardwig
Paul W
PW
Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 55905, USA. hardwig.paul@mayo.edu
Pulido
Jose S
JS
Bakri
Sophie J
SJ
D015331:Cohort Studies; D003930:Diabetic Retinopathy / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D005123:Eye / Q000187:drug effects; D005128:Eye Diseases / Q000188:drug therapy*; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008727:Methotrexate / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D015814:Ocular Hypotension / Q000139:chemically induced; D012163:Retinal Detachment / Q000188:drug therapy; D012189:Retrospective Studies; D012828:Silicones / Q000008:administration & dosage* / Q000627:therapeutic use; D014605:Uveitis / Q000188:drug therapy; D014792:Visual Acuity / Q000187:drug effects*; D018630:Vitreoretinopathy, Proliferative / Q000188:drug therapy; D014822:Vitreous Body
D012828:Silicones; D008727:Methotrexate