Methotrexate for Sympathetic Ophthalmia: A Report of 3 Cases
Corrina P. Azarcon, MD1, Franz Marie Cruz, MD1,2,3, Teresita R. Castillo, MD1, Cheryl A. Arcinue, MD1,4
1University of the Philippines- Philippine General Hospital, Manila
2Peregrine Eye and Laser Institute, Makati City
3St. Luke’s Medical Center, Quezon City
4Asian Eye Institute, Makati City
Correspondence: Corrina P. Azarcon, MD
Department of Ophthalmology and Visual Sciences
Philippine General Hospital
Taft Avenue, Ermita, Manila, Philippines 1000
Disclosure: The authors report no financial disclosures.
Objective: To describe the visual and clinical outcomes of 3 patients with sympathetic ophthalmia treated with a combination of systemic steroids and methotrexate.
Methods: This was a small, descriptive case series.
Results: We reported 3 cases of post-traumatic sympathetic ophthalmia treated with steroids and methotrexate. Two patients had inciting eyes with no light perception on presentation, while one had a best-corrected visual acuity (BCVA) of counting fingers. The initial BCVA of the sympathizing eyes ranged from 20/20 to 20/50. Control of ocular inflammation was achieved using methotrexate (12.5 to 15 mg weekly) in addition to oral steroids and topical therapy. The final BCVA of the sympathizing eyes ranged from 20/20 to 20/30, indicating that good visual outcomes were attainable with steroids and methotrexate as part of the maintenance regimen. None of the patients developed adverse side-effects from methotrexate.
Conclusion: This small case series demonstrated the effectiveness and safety of methotrexate for control of intraocular inflammation in sympathetic ophthalmia.
Keywords: sympathetic ophthalmia, steroids, methotrexate, clinical outcomes, panuveitis