title: The role of methotrexate in resolving ocular inflammation after specific therapy for presumed latent syphilitic uveitis and presumed tuberculosis-related uveitis.
abstract: OBJECTIVE
  This study was designed to investigate whether the antiinflammatory and antiproliferative activity of oral and intravitreal methotrexate (MTX) suppresses intraocular inflammation in patients with presumed latent syphilitic uveitis and presumed tuberculosis-related uveitis.
  
  
  METHODS
  Interventional prospective study including three cases with presumed latent syphilitic uveitis treated with intravenous penicillin and oral MTX, and two cases with presumed tuberculosis-related uveitis treated with standard antituberculosis therapy and intravitreal MTX injections. Treatment efficacy of all cases was assessed by best-corrected visual acuity, fundus fluorescein angiography, and optical coherence tomography.
  
  
  RESULTS
  Four eyes of 3 patients with presumed latent syphilitic uveitis had improved best-corrected visual acuity, suppression of intraocular inflammation, and resolution of cystoid macular edema in 6 months with oral MTX therapy. No recurrence of intraocular inflammation was observed in 6 months to 18 months of follow-up period after cessation of MTX. Two eyes of two patients with presumed tuberculosis-related uveitis showed improved best-corrected visual acuity, suppression of intraocular inflammation, and resolution of cystoid macular edema after intravitreal injections of MTX. No recurrence of intraocular inflammation was observed in 6 months to 8 months of follow-up period after cessation of antituberculous therapy.
  
  
  CONCLUSIONS
  For the first time in the treatment of presumed latent syphilitic uveitis and presumed tuberculosis-related uveitis, we believe that MTX might have an adjunctive role to suppress intraocular inflammation, reduce uveitic macular edema, and prevent the recurrences of the diseases.
authors: *Department of Ophthalmology/Uveitis, Dunya Eye Hospital Ltd, Ankara, Turkey; and †Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts. A. Ziaei is now at Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts.
authors: Ozlem
authors: O
authors: Sahin
authors: Alireza
authors: A
authors: Ziaei
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D059425:Interferon-gamma Release Tests; D058449:Intravitreal Injections; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D011446:Prospective Studies; D013588:Syphilis Serodiagnosis; D013592:Syphilis, Latent / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D041623:Tomography, Optical Coherence; D014392:Tuberculosis, Ocular / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D014605:Uveitis / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D010406:Penicillins; D008727:Methotrexate