Methotrexate Helpful Against Uveitis in Children

August 8, 2005

Br J Ophthalmol 2005;89:806-808.

Low-dose methotrexate appears to be a safe and effective treatment for

chronic anterior and intermediate uveitis in children, UK researchers report

in the July issue of the British Journal of Ophthalmology.

The investigators note that uveitis is a relatively rare disease in children

that can lead to blindness. The most common cause of uveitis in this

population is juvenile idiopathic arthritis, followed by idiopathic uveitis

and par planitis. Corticosteroids are the primary agents used to treat the

disease, but side effects are common with long-term use.

Previous reports have described the use of methotrexate in children with

JIA-associated uveitis. In the present study, Dr. A. R. Malik, from East

Surrey Hospital, Redhills and Dr. C. Pavesio, from Moorfields Eye Hospital

in London, expand on this by also including children with

sarcoidosis-related and idiopathic uveitis.

The authors report the outcomes of 10 methotrexate-treated children with

uveitis.

Visual acuity of at least 6/6 on the Snellen scale was achieved in all of

the right eyes and in eight of the left eyes, the investigators note.

Methotrexate therapy was also associated with a drop in anterior chamber

inflammation in six children.

Prior to methotrexate therapy, topical steroids were applied 5.6 times per

day, on average. After methotrexate therapy, this figure fell to 1.5 times

per day. Moreover, the oral steroid dose also dropped significantly.

The most common side effect, noted in two patients, was nausea. However,

none of the patients stopped methotrexate therapy due to adverse effects.

The results suggest methotrexate is a useful agent for uveitis in children.

" An increased awareness of its efficacy is required among pediatricians and

ophthalmologists, " the authors conclude, " to prevent sight threatening

complications of chronic uveitis and its treatment with long-term use of

steroids. "

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