title: Interferon versus methotrexate in intermediate uveitis with macular edema: results of a randomized controlled clinical trial.
abstract: OBJECTIVE
  To compare interferon (IFN) beta with methotrexate (MTX) in the treatment of intermediate uveitis with macular edema.
  
  
  METHODS
  Monocentric, prospective, randomized, controlled clinical trial.
  
  
  METHODS
  
  
  
  METHODS
  Specialized uveitis center at the University of Heidelberg. PATIENT OR STUDY POPULATION: Patients with either primary intermediate uveitis or uveitis associated with multiple sclerosis. MAIN INCLUSION CRITERIA: Visual acuity of 20/30 or worse (0.2 logarithm of the minimal angle of resolution) and macular edema of more than 250 μm (central 1-mm in optical coherence tomography; Stratus). Randomization into either IFN beta 44 μg subcutaneously 3 times weekly or 20 mg MTX subcutaneously once weekly.
  
  
  METHODS
  At 3 months, the primary outcome parameter of mean change in visual acuity was evaluated and efficacy was determined. Secondary parameters were macular edema by optical coherence tomography, inflammatory activity, and retinal sensitivity by microperimetry (MP-1; Nidek). In case of treatment failure, switching to the other treatment arm was possible.
  
  
  RESULTS
  Nineteen patients were included. Ten were randomized to MTX, and 9 were randomized to IFN beta. At 3 months, visual acuity improved a mean 0.31 logarithm of the minimal angle of resolution (range, -0.02 to -0.96, 15.6 letters on the Early Treatment Diabetic Retinopathy Study chart) in the IFN beta group versus a mean 0.09 logarithm of the minimal angle of resolution (range, 0.12 to -0.38, 4.7 letters) in the MTX arm (P = .0435, Mann-Whitney U test). Macular thickness decreased by a mean of 206 μm (range, -41 to -416 μm) in the IFN arm, but increased by 47 μm (range, 108 to -28 μm) in the MTX group (P < .0001).
  
  
  CONCLUSIONS
  Although the sample size is small, results of the trial support superiority of IFN beta over MTX in the treatment of macular edema in the setting of intermediate uveitis.
authors.affiliation: Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany; Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg, Germany. Electronic address: mackensen@uveitiszentrum.de.
authors.forename: Friederike
authors.initials: F
authors.lastname: Mackensen
authors.affiliation: Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany; Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Jakob
authors.affiliation: Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Springer
authors.affiliation: Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany; Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg, Germany.
authors.forename: Bianca C
authors.initials: BC
authors.lastname: Dobner
authors.affiliation: Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Ute
authors.initials: U
authors.lastname: Wiehler
authors.affiliation: Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Weimer
authors.affiliation: Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Rohrschneider
authors.affiliation: Department of Internal Medicine, University of Heidelberg, Heidelberg, Germany; Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Fiehn
authors.affiliation: Department of Internal Medicine, University of Heidelberg, Heidelberg, Germany; Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg, Germany.
authors.forename: Regina
authors.initials: R
authors.lastname: Max
authors.affiliation: Department of Neurology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Storch-Hagenlocher
authors.affiliation: Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany; Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg, Germany.
authors.forename: Matthias D
authors.initials: MD
authors.lastname: Becker
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007279:Injections, Subcutaneous; D016899:Interferon-beta / Q000009:adverse effects / Q000627:therapeutic use*; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D015867:Uveitis, Intermediate / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests
chemical_list: D007166:Immunosuppressive Agents; D016899:Interferon-beta; D008727:Methotrexate