Repeated Injection of Methotrexate into Silicone Oil-Filled Eyes for Grade C Proliferative Vitreoretinopathy: A Pilot Study.

Abstract

PURPOSE:

To evaluate the effects of repeated intra-silicone oil (SO) injections of methotrexate (MTX) on the outcomes of surgery for rhegmatogenous retinal detachment (RRD) with grade C proliferative vitreoretinopathy (PVR-C).

METHODS:

In this prospective pilot case series, eyes with RRD and PVR-C underwent pars plana vitrectomy and intraocular injection of SO. At the conclusion of the procedure, 250 µg of MTX was injected into the SO-filled vitreous cavity. Intra-SO injection was repeated at weeks 3 and 6; the minimum follow-up period was 6 months. The main outcome measure was retinal reattachment rate.

RESULTS:

Eleven eyes of 11 patients (mean age, 52.73 ± 18.01 years) were included. The mean follow-up period was 9 ± 3 months (range, 6-15 months). Total retinal detachment with anterior and/or posterior PVR-C was present in all eyes before surgery. Mean preoperative best-corrected visual acuity (BCVA) was 2.62 ± 0.04 logMAR. All operated eyes exhibited retinal reattachment posterior to the equator during the follow-up period. Mean postoperative BCVA was significantly improved to 1.02 ± 0.51 logMAR (p = 0.003). No ocular or systemic side effects were observed.

CONCLUSION:

Repeated intra-SO injection of MTX as an adjunctive therapy for RRD complicated by PVR showed promising results and was not associated with adverse effects. Further studies are needed to confirm its possible beneficial effects on the final anatomic and functional outcomes in these cases.

• Authors: Ramin Nourinia, Farinaz Borna, Anoushiravan Rahimi, Mohammad Hossein Jabbarpoor Bonyadi, Yashar Amizadeh, Arash Daneshtalab, Bahareh Kheiri, Hamid Ahmadieh
• Journal: Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde (Ophthalmologica) Vol. 242 Issue 2 Pg. 113-117 ( 2019) ISSN: 1423-0267 [Electronic] Switzerland
• PMID: 31163427 (Publication Type: Journal Article)
• Copyright: © 2019 S. Karger AG, Basel.

Chemical References

• Immunosuppressive Agents
• Silicone Oils
• Methotrexate

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Endotamponade
• Female
• Humans
• Immunosuppressive Agents (administration & dosage)
• Injections, Intraocular
• Laser Coagulation
• Male
• Methotrexate (administration & dosage)
• Middle Aged
• Pilot Projects
• Prospective Studies
• Retina (pathology)
• Retinal Detachment (diagnosis, etiology, therapy)
• Silicone Oils
• Tomography, Optical Coherence
• Treatment Outcome
• Visual Acuity
• Vitrectomy (methods)
• Vitreoretinopathy, Proliferative (complications, diagnosis, therapy)
• Young Adult