Methotrexate treatment for sarcoid-associated panuveitis
Section snippets
Methods
Two hundred seventy-four consecutive charts of patients with the diagnosis of either sarcoidosis or unspecified uveitis (which included choroiditis, chorioretinitis, retinal pigment epithelial inflammation, iridocyclitis, pars planitis, posterior uveitis, vasculitis, and panuveitis) examined by one of us (GJJ) in the Duke Uveitis clinic from 1989 to 1997 were reviewed. Those with sarcoid-associated panuveitis or idiopathic panuveitis with a clinical suspicion of sarcoidosis who were treated
Results
After chart review, 11 patients meeting the aforementioned inclusion criteria were identified and analyzed. All 11 patients studied suffered from bilateral panuveitis. Two eyes had no light perception vision initially and were not included in any of the analyses. A third eye had no light perception vision develop during the study and was enucleated. This eye was included in visual acuity result comparisons (20 eyes total from 11 patients) but excluded in comparisons for topical corticosteroid
Discussion
In our series, we report the successful use of low-dose MTX in 11 patients (20 eyes) with chronic sarcoid-associated panuveitis. All of the patients in our study suffered from bilateral disease. To our knowledge, there are only two series of low-dose MTX in the management of ocular inflammatory disease.20, 21 In 1992, Holz et al20 reported MTX treatment in a cohort of 14 total patients with a mixture of diagnoses, including vasculitis, panuveitis, and intermediate uveitis. Outcomes for specific
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- 1
Dr. Dev is a recipient of the Heed Ophthalmic Foundation Fellowship and is currently affiliated with the Medical College of Wisconsin Eye Institute, Vitreoretinal Section, Milwaukee, Wisconsin.
- 2
Dr. Jaffe is a Lew R. Wasserman Merit Award recipient from Research to Prevent Blindness.