Serial Intravitreal Methotrexate Injections to Combat Recurrent Proliferative Vitreoretinopathy in a Pediatric Patient

Abstract

Purpose: To describe the use of serial intravitreal methotrexate to combat proliferative vitreoretinopathy (PVR) in a pediatric patient with recurrent retinal detachment (RD). Methods: A retrospective case analysis was performed. Results: A 6-year-old patient with bilateral panuveitis presented with recurrent RD in the right eye. After treatment with 2 RD surgeries performed elsewhere, the patient developed PVR that necessitated 5 additional surgeries for recurrent detachment. The patient subsequently received a total of 8 injections of methotrexate 400 µg/0.1 mL (0.1 mL) in the operating room at 1- to 2-week intervals over a 3-month period. Through 13 months of follow-up after the first methotrexate injection, there was no evidence of recurrent RD, PVR, or epiretinal membrane formation. Conclusions: Frequent serial intravitreal methotrexate injections apparently played a role in preventing recurrent PVR formation in this pediatric patient with a history of intraocular inflammation and recurrent RD.