Combination of Intravenous Methotrexate and Methylprednisolone Therapy in the Treatment of Severe Ocular Inflammatory Diseases

ABSTRACT

Purpose: To evaluate the efficacy of intravenous methotrexate and methylprednisolone in severe, sight-threatening ocular inflammatory conditions.

Methods: This was a retrospective observational case series. Patients who had received intravenous methotrexate for ocular inflammation with at least 24 months of follow-up were included in the study.

Results: Ten patients (20 eyes) were included in this study. Mean age of the patients was 47.2 ± 17.7 (range:19–74). At 1-month follow-up visit, nine patients showed improvement and one patient failed treatment. At 12-month follow-up visit, all patients were in remission. Two patients were only on intravenous methotrexate infusions. At twenty-four-month follow-up visit, only one patient, in remission, was on intravenous methotrexate therapy. Leukopenia was the only adverse effect observed.

Conclusion: Intravenous methotrexate and methylprednisolone infusions can be an effective method of treatment in patients with severe, sight-threatening ocular inflammatory conditions.

KEYWORDS:

• Intravenous methotrexate
• methylprednisolone
• ocular inflammation
• retinal vasculitis
• scleritis
• uveitis

Disclosure statement

Dr. C Stephen Foster declares the following:

Consultancies with Aldeyra Therapeutics (Lexington, MA), Allakos (Redwood City, CA), Bausch & Lomb Surgical, Inc (Rancho Cucamonga, CA), Eyegate Pharma (Waltham, MA), Genentech (South San Francisco, CA), Novartis (Cambridge, MA), pSivida (Watertown, MA)

Grants or grants pending with Aciont (Salt Lake City, UT), Alcon (Aliso Viejo, CA), Aldeyra Therapeutics (Lexington, MA), Bausch & Lomb (Rochester, NY), Clearside Biomedical (Alpharetta, GA), Dompé pharmaceutical (Milan, Italy), Eyegate Pharma (Waltham, MA), Mallinckrodt pharmaceuticals (Staines-upon-Thames, UK), Novartis Pharmaceuticals (Cambridge, MA), pSivida (Watertown, MA), Santen (Osaka, Japan).

Payment for lectures including service on speaking bureaus: Alcon (Aliso Viejo, CA), Allergan (Dublin, Ireland), Mallinckrodt pharmaceuticals (Staines-upon-Thames, UK).

Stock or Stock Options: Eyegate Pharma (Waltham, MA)

Dr. Stephen D. Anesi declares the following:

Consultancies with Santen (Osaka, Japan), Mallinckrodt (Staines-upon-Thames, UK), Allakos (Redwood City, CA), Eyepoint (Watertown, MA), and Takeda (Tokyo, Japan).

Speakerships with AbbVie (Chicago, IL), Mallinckrodt (Staines-upon-Thames, UK), and Eyepoint (Watertown, MA).

Dr. Peter Chang declares the following:

Consultancies with Eyepoint (Watertown, MA) and Alimera (Alpharetta, GA).

Speakerships with AbbVie (Chicago, IL), Mallinckrodt (Staines-upon-Thames, UK), and Eyepoint (Watertown, MA).

All other authors have no proprietary or commercial interest in any materials discussed in this article or additional financial disclosures to declare.

Data availability statement

The data that support the findings of this study are available from the corresponding author, [CSF], upon reasonable request.