Methotrexate for sympathetic ophthalmia: A report of 3 cases

@#OBJECTIVE: To describe the visual and clinical outcomes of 3 patients with sympathetic ophthalmia treated with a combination of systemic steroids and methotrexate. METHODS: This was a small, descriptive case series. RESULTS: We reported 3 cases of post-traumatic sympathetic ophthalmia treated with steroids and methotrexate. Two patients had inciting eyes with no light perception on presentation, while one had a best-corrected visual acuity (BCVA) of counting fingers. The initial BCVA of the sympathizing eyes ranged from 20/20 to 20/50. Control of ocular inflammation was achieved using methotrexate (12.5 to 15 mg weekly) in addition to oral steroids and topical therapy. The final BCVA of the sympathizing eyes ranged from 20/20 to 20/30, indicating that good visual outcomes were attainable with steroids and methotrexate as part of the maintenance regimen. None of the patients developed adverse side-effects from methotrexate. CONCLUSION: This small case series demonstrated the effectiveness and safety of methotrexate for control of intraocular inflammation in sympathetic ophthalmia.

A review article on neuroretinitis

@#Neuroretinitis is an inflammatory optic neuropathy with a classic fundoscopic appearance of optic disc swelling and hard exudates on the macula in a star formation. It can be a manifestation of systemic, infectious or autoimmune disease. In nearly half of cases, the etiology is idiopathic. This review aims to summarize the clinical presentation, fundoscopic mimics, etiologies, investigation, and treatment of neuroretinitis. Cat-scratch disease, the most common cause of infectious neuroretinitis, and recurrent idiopathic neuroretinitis, which can cause ocular morbidity, are discussed in detail.