To evaluate the effects of oral methotrexate (MTX) in patients with central serous chorioretinopathy (CSC).

This interventional, prospective, uncontrolled clinical trial included 23 eyes of 23 consecutive patients presenting with chronic symptomatic CSC and persistent subretinal fluid (SRF) for longer than 3 months. All patients were treated with 7.5 mg/w of oral MTX for 12 weeks. The best corrected visual acuity (BCVA), central macular thickness (CMT), SRF, and total macular volume recorded by monthly optical coherence tomography were analyzed. Complete blood count and serum liver enzymes level were monitored.

Mean duration of CSC was 13 months (3-36 months). Mean BCVA improved from 20/40 at baseline to 20/30 at 3 months, and 20/28 at 6 months (P=0.002 and 0.003 respectively). CMT improved from 375 μm at baseline to 278 μm and 265 μm at 3 and 6 months respectively (P=0.002 and 0.007 respectively). Total macular volume improved from 9.33 mm3 at baseline to 8.48 mm3 and 8.31 mm3 at 3 and 6 months respectively (P=0.001 and 0.001 respectively) .Thirteen (62%) eyes achieved complete resolution of SRF. No MTX-associated toxicity was detected.

Low-dose oral MTX may be an alternative therapeutic option for the treatment of chronic CSC.