Clinical Science
Dual Application of Methotrexate Improves Functional and Anatomical Outcomes in Diabetic Tractional Retinal Detachment
Ophthalmic Surgery, Lasers and Imaging Retina, 2025;0(0):1–8
Abstract
Background and Objective
This study evaluated the use of a dual-delivery methotrexate (MTX) strategy for diabetic tractional retinal detachment (TRD). Diabetic retinopathy (DR) is a leading cause of blindness. Inflammation plays a key role in TRD, and MTX has anti-inflammatory properties.
Patients and Methods
This is a pilot study that included 60 patients with TRD. They were block randomized to either MTX with pars plana vitrectomy (PPV) (n = 30) or PPV alone (control, n = 30). MTX was added to the irrigation fluid during surgery and an intra-silicone injection at the end. One month after silicone oil removal, visual acuity (VA), multifocal electroretinography (mfERG), and spectral-domain optical coherence tomography (SD-OCT) were assessed.
Results
One month after silicone oil removal, VA and mfERG were significantly better with a lower prevalence of epiretinal membranes, disorganization of retinal inner layers, and cystic macular changes by SD-OCT in the MTX group.
Conclusion
This study found that dual-delivery MTX during PPV is a promising strategy to improve functional and anatomical results in diabetic TRD.
[Ophthalmic Surg Lasers Imaging Retina 2025;56:XX–XX.]
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