Methotrexate for proliferative vitreoretinopathy
The use of methotrexate, e.g., repeated dosing or sustained-release formulations of methotrexate, for treating or reducing risk of proliferative vitreoretinopathy (PVR) or epiretinal membranes (ERM), e.g., after surgical vitrectomy to treat retinal detachment.
1. A method of treating proliferative vitreoretinopathy (PVR) or epiretinal membranes (ERM), or reducing the risk of PVR or ERM, in a subject, the method comprising intravitreally administering a sustained release formulation of methotrexate over at least a three-month period, or implanting into the eye of the subject a device that provides sustained release of methotrexate over at least a three-month period.
2. The method of claim 1 , wherein the sustained release formulation is or comprises a lipid-encapsulated formulation; multivesicular liposome (MVL) formulations of methotrexate (MTX); nano- or microparticles; polyion complex (PIC) micelles; or bioadhesive polymers.
3. The method of claim 1 , wherein the bioadhesive polymers comprise one or more of hydroxypropyl methylcellulose (HPMC), carboxymethylcellulose (CMC), polyacrylic acid (PAA), or hyaluronic acid (HA).
4. The method of claim 1 , wherein the device is non-biodegradable.
5. The method of claim 1 , wherein the sustained release formulation of methotrexate delivers the methotrexate intravitreally over at least a three-month period.
6. The method of claim 5 , wherein the sustained release formulation is or comprises a lipid-encapsulated formulation; multivesicular liposome (MVL) formulations of methotrexate (MTX); nano- or microparticles; polyion complex (PIC) micelles; or bioadhesive polymers.
7. The method of claim 5 , wherein the bioadhesive polymers comprise one or more of hydroxypropyl methylcellulose (HPMC), carboxymethylcellulose (CMC), polyacrylic acid (PAA), or hyaluronic acid (HA).
8. The method of claim 1 , wherein the subject is undergoing an ocular surgical procedure that increases the subject's risk of developing ERM or PVR.
9. The method of claim 8 , wherein the ocular surgical procedure is a pars plana vitrectomy (PPV), Retinal Detachment (RD) surgery; ERM surgery; scleral buckle surgery; or a procedure in the other eye.
10. The method of claim 9 , wherein the subject requires a PPV to treat a rhegmatagenous retinal detachment secondary to trauma; preexisting proliferative vitreoretinopathy; or for other indications associated with high risk condition for PVR development.
11. The method of claim 10 , wherein the indication associated with high risk condition for PVR development is a giant retinal tear, a retinal break larger than 3 disc areas, a long-standing retinal detachment, or a detachment associated with hemorrhage.