The role of Intravitreal Methotrexate as an Adjunct to Local or Systemic Corticosteroids in Vitrectomy for Rhegmatogenous Retinal Detachment and Choroidal Detachment: A Pilot Study

Abstract

Purpose: To evaluate the role of repeated intravitreal Methotrexate (IMTX) as an adjunct to pars plana vitrectomy (PPV) in the management of rhegmatogenous retinal detachment with choroidal detachment (RRDCD). Method: We compared anatomical and visual outcomes of RRDCD eyes that underwent PPV with (group B) or without repeated IMTX (group A). Results: The study included 25 eyes of 25 patients, 16 eyes in group A and nine in Group B. Both groups had similar baseline characteristics. In Group A, successful retinal attachment was achieved in 50% as compared to 89% in Group B, however the difference was not statistically significant (p=0.08). Also, Group B had a significantly greater change in visual acuity from baseline to the last follow-up visit (1.6+1.5 logMAR units) compared to Group A (1.18+1logMAR units) (p=0.05). There were no significant safety concerns with the use of IMTX. Conclusion: Repeated IMTX after vitrectomy for RRDCD improves outcomes without posing major safety concerns. Nonetheless, further investigation is necessary to establish the optimal IMTX dosage and duration to prevent recurrence effectively.