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June 27, 2019

Intravitreal Methotrexate for Recurrent Epithelial Downgrowth

Author Affiliations
  • 1Casey Eye Institute, Oregon Health & Science University, Portland
JAMA Ophthalmol. 2019;137(9):1082-1083. doi:10.1001/jamaophthalmol.2019.2151

Epithelial downgrowth is a rare but feared complication of intraocular surgery or penetrating globe trauma, characterized by the intraocular migration of epithelial cells. Despite treatment, epithelial downgrowth can lead to endothelial decompensation, angle-closure glaucoma, intractable pain, and tractional retinal detachment.1 Reported treatments include membrane peel, argon laser, excision of affected intraocular structures, and fluorouracil injection.2 Despite this, more than 50% of patients with epithelial downgrowth undergo enucleation.1