When should methotrexate injections be initiated for proliferative vitreoretinopathy?

This is an excellent question with a nuanced answer. Currently, we lack substantial level 1 evidence to guide precise treatment strategies for off-label use of methotrexate (MTX) in the treatment or proliferative vitreoretinopathy (PVR). Based on animal and human clinical retrospective studies, the ...

Anterior segment toxicity from intravitreal MTX can be somewhat mitigated by using the smallest diameter (32-34 gauge) needle available, minimizing the injection schedule, and immediately irrigating the eye with copious artificial tears.