title: Intravitreal methotrexate infusion for proliferative vitreoretinopathy.
abstract: OBJECTIVE
  The purpose of this study was to evaluate intravitreal methotrexate infusion (IMI) during pars plana vitrectomy (PPV) for retinal detachment in patients with high risk for the development of proliferative vitreoretinopathy (PVR).
  
  
  METHODS
  Patients presenting with severe recurrent PVR with tractional retinal detachment and/or a history of severe ocular inflammation were treated with IMI. Clinical outcomes were determined from a retrospective medical chart review.
  
  
  RESULTS
  Twenty-nine eyes presenting with either tractional retinal detachment and recurrent PVR (n=22) or a history of severe inflammation associated with high PVR risk (n=7) received IMI during PPV. Best-corrected visual acuity at 6 months was ≥20/200 in 19 of 29 eyes (66%) and remained stable or improved compared with initial presentation in 24 of 29 eyes (83%). At the last follow-up examination, the retinas of 26 of 29 eyes (90%) remained attached after IMI while three eyes required another reattachment procedure. Three additional eyes (10%) developed recurrent limited PVR without recurrent RD and were observed. No complications attributable to IMI occurred during a mean follow-up of 27 months.
  
  
  CONCLUSIONS
  Eyes at high risk for PVR development due to a history of prior PVR or intraocular inflammation had a low incidence of PVR following IMI at the time of PPV for RD repair. No significant safety issues from IMI were observed in this series.
authors.affiliation: Department of Ophthalmology, University of Cincinnati College of Medicine.
authors.forename: Ama
authors.initials: A
authors.lastname: Sadaka
authors.affiliation: Department of Ophthalmology, University of Cincinnati College of Medicine; Department of Opthalmology, Cincinnati Children's Hospital Medical Center; Cincinnati Eye Institute, Cincinnati, OH, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Sisk
authors.affiliation: Department of Ophthalmology, University of Cincinnati College of Medicine; Cincinnati Eye Institute, Cincinnati, OH, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Osher
authors.affiliation: Department of Ophthalmology, Bahcesehir University Medical Faculty, Istanbul, Turkey.
authors.forename: Okan
authors.initials: O
authors.lastname: Toygar
authors.affiliation: Department of Biological Sciences, University of Delaware, Newark, DE, USA.
authors.forename: Melinda K
authors.initials: MK
authors.lastname: Duncan
authors.affiliation: Department of Ophthalmology, University of Cincinnati College of Medicine; Cincinnati Eye Institute, Cincinnati, OH, USA.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Riemann
keywords: pars plana vitrectomy; recurrent retinal detachment; tractional retinal detachment