Dr.SRILATHA.H.S, S19824
We report an unusual case of posterior uveitis where intravitreal Methotrexate (I/V Mtx) was used as an adjunct with good response. A 57 yr old male with past history of penetrating injury in right eye (RE) presented with acute painful diminution of vision in left eye (LE). Examination of LE showed subretinal deposits in the parapapillary and mid peripheral region with subretinal fluid at macula. OCT showed normal choroidal thickness. Differential diagnoses included sympathetic ophthalmia(SO), primary intraocular lymphoma(PIOL) and fungal endophthalmitis(FE). Vitreous biopsy turned out to be negative for PIOL and FE. He was started on oral prednisolone and methotrexate, but there was no response. I/V Mtx was given as adjunct, following which lesions reduced only to recur. After 15 injections, patient consented for enucleation of RE. Histopathology diagnosis turned out to be SO.
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