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Subconjunctival methotrexate in the treatment of non infectious ocular inflammatory diseases

Metotrexate subconjuntival no tratamento de doenças inflamatórias oculares não infecciosas

SUMMARY

We studied the effect of subconjunctival injections of methotrexate (MTX) in 18 patients with non-infectious ocular inflammatory processes (unilateral anterior uveitis 11 patients, corneal graft rejection 3 patients, nodular sclerouveitis with no systemic disease 2 patients, Vogt-Koyanagi-Harada's disease 1 patient, and Behcet's disease 1 patient). Weekly subconjunctival injections of 7.5mg of MTX were given. Daily slit lamp examination was performed to evaluate the degree of inflammatory activity in the anterior chamber or sclera and conjunctiva during the treatment. Patients were clinically followed for an average of 7.8 months (3 to 12 months) and no patient had evidence of local or systemic side effects. The conjunctiva remained yellowish and edematous for approximately 24hs after the injections and returned to the previous aspect after that. Our results showed that subconjunctival weekly injections oflow dose MTX have a favorable response in the treatment in nine of 11 cases of anterior uveitis, three cases of corneal graft rejection, and one patient of Vogt-Koyanagi-Harada disease. One patient with Behcet disease, and two with scleritis did not respond to the treatment.

Key-Words:
Methotrexate; Eye; Uveitis; Inflammation; Immunosuppression; Drug

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