Abstract
Intravitreal methotrexate (MTX) has been proven to be an effective treatment for various intraocular diseases. In this article, a comprehensive review was performed on intravitreal applications of methotrexate. Different aspects of the administration of intravitreal MTX for various clinical conditions such as intraocular tumors, proliferative vitreoretinopathy, diabetic retinopathy, age-related macular degeneration, and uveitis were reviewed and the adverse effects of intravitreal injection of MTX were discussed. The most common indications are intraocular lymphoma and uveitis. Other applications remain challenging and more studies are needed to establish the role of intravitreal MTX in the management of ocular diseases.
Highlights
Methotrexate (MTX), a Food and Drug Administration (FDA)-approved folic acid antagonist, inhibits DNA synthesis, repair, and subsequently cellular proliferation
We reviewed the current evidence on the application of intravitreal MTX
Intravitreal MTX was injected for intraocular tumors, uveitis, complex retinal detachment, diabetic retinopathy, age-related macular degeneration (AMD), and other indications
Summary
Methotrexate (MTX), a Food and Drug Administration (FDA)-approved folic acid antagonist, inhibits DNA synthesis, repair, and subsequently cellular proliferation. MTX increases the release of adenine nucleotides into the extracellular space which are converted to adenosine by cell-surface enzymes and exerts its inhibitory effects on most inflammatory cells.[5] Inhibiting the reduction of dihydrobiopterin to tetrahydrobiopterin by MTX results in the We reviewed the current evidence on the application of intravitreal MTX
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