Utility of Intravitreal Methotrexate in Diabetic Macular Edema Resistant to Conventional Therapies

Exclusion Criteria

• •History of allergy to MTX.
• •An ocular condition is present such that, in the opinion of the investigator, visual acuity loss would not improve from resolution of macular edema (e.g., foveal atrophy, pigment abnormalities, dense subfoveal hard exudates, nonretinal condition.
• •An ocular condition is present (other than diabetes) that, in the opinion of the investigator, might affect macular edema or alter visual acuity during the course of the study (e.g., vein occlusion, uveitis or other ocular inflammatory disease, neovascular glaucoma, epiretinal membrane, etc.).
• •An eye treated for Glaucoma
• •Eyes that underwent vitrectomy
• •History of intraocular malignancies.
• •Intraocular surgery with the prior 3 months.
• •Recent significant change in diabetic medications.
• •Insulin usage less than a year.
• •Life threatening co morbidities such as cancer under therapy.
• •Use of oral, intravenous, periocular or intraocular corticosteroids (steroids) in prior 3 months.
• •Liver function that exceeds three times the upper limit of normal at baseline, or within 6 weeks of that appointment.
• •Pregnant females.
• •Vitreous hemorrhage (active) in study eye
• •Anticipation of the need for laser pan retinal photocoagulation in the next 6 months.
• •Media opacities
• •Herpetic disease of cornea
• •Corneal dystrophy with significant corneal edema.
• •Any major surgery within the last 30 days