Methotrexate therapy for chronic noninfectious uveitis: analysis of a case series of 160 patients

Ophthalmology. 2001 Jun;108(6):1134-9. doi: 10.1016/s0161-6420(01)00576-0.

Abstract

Purpose: To evaluate the outcomes of patients with chronic noninfectious uveitis unresponsive to conventional antiinflammatory therapy who were treated with methotrexate.

Design: Retrospective noncomparative interventional case series.

Participants: All patients with chronic noninfectious uveitis treated with methotrexate at a single institution from 1985 to 1999.

Methods: Charts of patients seen on the Ocular Immunology & Uveitis Service at the Massachusetts Eye & Ear Infirmary were reviewed. Patients with chronic uveitis of noninfectious origin treated with methotrexate were included in the study.

Main outcome measures: Control of inflammation, steroid-sparing effect, visual acuity, adverse reactions.

Results: A total of 160 patients met the inclusion criteria. Control of inflammation was achieved in 76.2% of patients. Steroid-sparing effect was achieved in 56% of patients. Visual acuity was maintained or improved in 90% of patients. Side effects requiring discontinuation of medication occurred in 18% of patients. Potentially serious adverse reactions occurred in only 8.1% of patients. There was neither long-term morbidity nor mortality caused by methotrexate.

Conclusions: Methotrexate is effective in the treatment of chronic noninfectious uveitis that fails to respond to conventional steroid treatment. It is an effective steroid-sparing immunomodulator, is a safe medication, and is well tolerated.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Chronic Disease
  • Drug Evaluation
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Methotrexate / therapeutic use*
  • Middle Aged
  • Retrospective Studies
  • Safety
  • Uveitis / drug therapy*
  • Visual Acuity

Substances

  • Immunosuppressive Agents
  • Methotrexate