Intraocular Methotrexate for the Treatment and Prevention of Proliferative Vitreoretinopathy: A Review

To review the current literature on the use of intravitreal methotrexate (IVT MTX) for the treatment and prevention of proliferative vitreoretinopathy (PVR). All reports of IVT MTX to treat and prevent PVR published in PubMed, Google Scholar, and EBSCOhost were reviewed. The relevant current studies are included in this report. The literature search yielded 32 articles describing the use of MTX in PVR. These included preclinical studies, 1 case report, and several case series. Early studies found that IVT MTX is a promising medication for the treatment and prevention of PVR. MTX works as a potent anti-inflammatory agent through a new mechanism of action different from that of other medications for use in PVR. Few side effects have been reported and were mostly limited to mild reversible corneal keratopathy. There are 2 current ongoing randomized controlled clinical trials to further evaluate the efficacy of MTX for PVR. MTX is a safe and potentially efficacious medication for the treatment and prevention of PVR. Additional clinical trials are needed to further establish this effect.