PDF(Pubmed)
Abstract：
Intravitreal methotrexate injection (400 µg/0.1 mL) is the current mainstay for managing vitreoretinal lymphoma. Various complications associated with intravitreal methotrexate are cataract, keratopathy, maculopathy, sterile endophthalmitis, optic atrophy, vitreous haemorrhage, etc. The most common adverse effect of intravitreal methotrexate is keratopathy occurring in more than half of cases. The severity may range from diffuse punctate keratopathy to severe epitheliopathy leading to photophobia, pain, visual blurring, epiphora, etc. This may become a reason for reduced compliance with treatment. The management of these complications includes oral folic acid, topical folinic acid supplementations and reduced frequency or cessation of methotrexate intravitreal injections. Here, we report a simple method of eyewash in a large amount of balanced salt solution after the intravitreal injection procedure to reduce the severity of keratopathy, which helped the patient tolerate the treatment.
摘要：
玻璃体内注射甲氨蝶呤（400µg/0.1mL）是目前治疗玻璃体视网膜淋巴瘤的主要方法。与玻璃体内甲氨蝶呤相关的各种并发症是白内障，角膜病变,黄斑病变,无菌眼内炎，视神经萎缩,玻璃体出血,等。玻璃体内甲氨蝶呤最常见的不良反应是在超过一半的病例中发生的角膜病变。严重程度可从弥漫性点状角膜病变到导致畏光的严重上皮病变。疼痛,视觉模糊，顿唇,等。这可能成为治疗依从性降低的原因。这些并发症的处理包括口服叶酸，局部补充亚叶酸，减少氨甲蝶呤玻璃体内注射的频率或停止。这里,我们报道了一种简单的方法，在玻璃体内注射过程后，在大量的平衡盐溶液中洗眼，以减少角膜病变的严重程度，这有助于患者耐受治疗。
