Purpose: To investigate whether intravitreal methotrexate could be safely administered and improve vision in patients with ocular disease other than primary central nervous system lymphoma (PCNSL). Design: A retrospective, small-case series. Methods: Patients with various clinical conditions were treated with intravitreal methotrexate (cumulative dose ≤400 μg). Visual acuity and clinical examination were recorded to assess the safety and efficacy of the injection. Results: Of 16 study eyes, final visual acuity was improved in seven, remained stable in five, and decreased in four. There was no observed toxicity attributable to methotrexate in any case. Conclusion: Preservation of visual acuity in 12 of 16 study eyes suggests that a 400-μg intravitreal injection is safe in ocular disease other than PCNSL. The loss of acuity in four eyes with advanced preexisting pathology may be just as likely attributable to the natural history of the disease as to intraocular methotrexate.
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