Combination of Methotrexate and Mycophenolate mofetil for Refractory Uveitis & Scleritis: A Case Series

Purpose: This study analyses the efficacy and safety of combination of methotrexate and mycophenolate mofetil with treatment-resistant uveitis and scleritis. Method: Retrospective Chart Review Result: The study included five patients with uveitis and one with scleritis who received combination of antimetabolites. The median age of these patients was 19.5 years, and all of them had bilateral involvement. Two patients had Juvenile Idiopathic Arthritis while one patient each had Behçet’s disease, Eales disease, undifferentiated anterior scleritis and pars planitis. The median duration of immunosuppressive and/or corticosteroid treatment before switching to combined therapy was 217 (192-1325) days. Remission of uveitis was achieved in all patients. The median duration of follow-up in these patients was 338.5 (209-901) days. At the end of the follow-up, topical steroids were withdrawn in three eyes, and oral corticosteroids were tapered off completely. All except one patient tolerated the combined treatment. Conclusion: The combination of oral methotrexate and mycophenolate mofetil can be a useful alternative in patients resistant to conventional immunosuppression.