Methotrexate therapy for chronic noninfectious uveitis: Analysis of a case series of 160 patients
Section snippets
Material and methods
The patients in this series were drawn from the total uveitis population seen on the Ocular Immunology & Uveitis Service at the Massachusetts Eye & Ear Infirmary between January 1985 and October 1999. The patients treated with MTX form the basis of this report. The Ocular Immunology & Uveitis Service is a tertiary referral service; most patients reported herein were referred by their primary ophthalmologists. Previous history and subsequent follow-up data were obtained through communications
Results
One hundred sixty patients in the chart review met the inclusion criteria. Seventy-four percent of the patients were female. The average age at onset of uveitis was 33 years. The average duration of uveitis before starting MTX was 5 years 3 months (median, 5 years), with a range from 4 months to 30 years. Mean duration of therapy was 14 months, with a range from 1 month to 96 months. Patients with follow-up times of 5 months or less consisted solely of those who experienced intolerance to the
Discussion
MTX was among the first nonsteroidal immunosuppressive medications used in the treatment of uveitis.4, 14, 15, 16, 17 Although it has been cited as an immunosuppressor agent for the treatment of uveitis and other ocular inflammatory disease since 1965, studies supporting its efficacy in ocular inflammatory disease are few.18, 19 This is in striking contrast to studies that strongly support the efficacy of MTX in the treatment of RA, including several randomized placebo-controlled trials.9, 10,
Acknowledgements
The authors acknowledge the assistance of Mr. Paul Chang and Ms. Fehma Tufail in obtaining follow-up data.
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