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 or reducing the risk of proliferative vitreoretinopathy (PVR) or epiretinal membranes (ERM) in a subject, the method comprising administering a plurality of intravitreal injections of methotrexate over a period of at least one, two, three, or more months, given no more frequently than weekly.
2. The method of claim 1 , comprising administering ten or more intravitreal injections of methotrexate.
3. The method of claim 1 , wherein each injection provides a dose of 400 mcg in 0.1 ml methotrexate.
4. The method of claim 1 , wherein the methotrexate is administered posterior to the limbus.
5. 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.
6. The method of claim 5 , 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.
7. The method of claim 6 , 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.
8. The method of claim 7 , 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.
9. The method of claim 5 , wherein:
a first injection is given at conclusion of the surgical procedure;
eight weekly injections are given until postoperative month two; and
a final tenth injection is given at postoperative month three.
10. The method of claim 1 , comprising administering nine consecutive weekly injections, and a tenth injection three months after the first injection.
11. The method of claim 1 , comprising administering additional injections after the tenth injection.
12. The method of claim 11 , comprising administering one, two, three, four, five, six, seven, eight, or nine additional injections after the tenth injection.
13. The method of claim 12 , wherein the additional injections are administered monthly.
14. A method of treating proliferative vitreoretinopathy (PVR) in a subject, the method comprising:
identifying a subject who has PVR and is undergoing an ocular surgical procedure to treat the PVR;
administering to the subject a first injection of methotrexate at conclusion of the ocular surgical procedure;
administering to the subject eight weekly injections until postoperative month two; and
administering to the subject two, three, or four additional injections thereafter.
15. The method of claim 14 , wherein the additional injections are administered biweekly.
16. The method of claim 14 , comprising administering to the subject three additional injections.
17. The method of claim 14 , comprising administering to the subject four additional injections.
18. The method of claim 17 , wherein the four additional injections are administered biweekly for two months thereafter.
19. The method of claim 14 , wherein the injections are intravitreal.
20. The method of claim 14 , wherein each injection provides a dose of 400 mcg in 0.1 ml of methotrexate.
21. The method of claim 14 , wherein the methotrexate is administered posterior to the limbus.
22. The method of claim 14 , wherein the ocular surgical procedure is a pars plana vitrectomy (PPV) or Retinal Detachment (RD) surgery.