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Uveitis Clinical Updates: New CMV Screening and Managing Care During COVID-19

CMV Screening Protocol

Studies have highlighted a need for a standardized approach to screening for cytomegalovirus (CMV) retinitis in transplant patients, as there are no national ophthalmic screening guidelines for this vulnerable population.

In collaboration with multidisciplinary care teams at  and 麻豆学生精品版, the Moran Uveitis Division developed a screening protocol for CMV retinitis in bone marrow and solid organ transplant patients.

The timely, systematic ophthalmic examinations were implemented in Fall 2019 to maximize early disease detection and potential interventions to prevent irreversible vision loss in a disease that is largely asymptomatic in early stages.

鈥擪atherine Hu, MD

CMV Screening Protocol

COVID-19 and Uveitis Care

There have been no published reports of COVID-19-associated uveitis; however, retinal

microvascular changes have been described. Consensus has been evolving as to the optimal management of uveitis patients during the pandemic, especially for those in immunomodulatory therapy (IMT).

While there is concern these patients would be at higher risk of severe SARS-CoV-2 infection, literature from multiple subspecialties with large numbers of patients on IMT has not shown this to be the case. 

Recommendations include continuation of IMT in the absence of known infection, use of local rather than systemic steroids when possible for those at very high risk for severe COVID-19, and a multidisciplinary approach to carefully monitor patients who develop active infection necessitating the discontinuation of IMT.

鈥擬arissa B. Larochelle, MD

Ongoing Uveitis Clinical Trials

Vitreous Biopsy Analysis
PI: Akbar Shakoor, MD

Macular Edema Ranibizumab v. Intravitreal Anti-inflammatory Therapy (MERIT) Trial
PI: Albert T. Vitale, MD

Adalimumab vs. Conventional Immunosuppression for Uveitis (ADVISE) Trial
PI: Albert T. Vitale, MD

Adalimumab in Juvenile Idiopathic Arthritis-Associated Uveitis Stopping Trial (ADJUST)
PI: Albert T. Vitale, MD

Other

Machine Learning Algorithm for Electroretinography Sorting
PI: Akbar Shakoor, MD

Selected Uveitis Division Publications 2020


Larochelle RD, Larochelle MB, Aung YY, Linn T, Heiden D, Vitale AT.
Journal of VitreoRetinal Diseases (In Press). July 2020.
 

Xuesen Cheng, Qingnan Liang, Leah A. Owen, Akbar Shakoor, Albert T. Vitale, Ivana K Kim, Denise J. Morgan, Yumei Li, Margaret M. DeAngelis, Rui Chen.
Investigative Ophthalmology & Visual Science. June 2020, Vol.61, 1956.
 

Bradley H. Jacobsen, Avni A. Shah, Sahil Aggarwal, Christopher Mwanansao, Molly McFadden, Moussa A. Zouache, Akbar Shakoor.
Ophthalmic Surgery, Lasers and Imaging Retina. 2020.
 

Pauline T. Merrill, Albert T. Vitale, Manfred Zierhut, Hiroshi Goto, Martina Kron, Alexandra P. Song, Sophia Pathai, Eric Fortin.
Ocular Immunology and Inflammation. 2020 May 29;1-7. Online ahead of print.
 
Surgery in Uveitis
Christopher D. Conrady, Lynn Hassman, Akbar Shakoor.
. 2020 - Springer; pp 181-198.
 

Christopher D. Conrady, Richard M. Feist Jr., Albert T. Vitale, Akbar Shakoor.
BMC Ophthalmology. 2020; 20:181.
 

Rachel C. Patel, Albert T. Vitale, Donnell J. Creel, Kathleen B. Digre.
Journal of Neuro-Ophthalmology. 23 March 2020.
 

Isil Kutluturk, Aniruddha Agarwal, Shiri Shulman, Albert T. Vitale, Maurizio B. Parodi, Christoph D. Conrady, et al.
Ocular Immunology and Inflammation. Published online: 20 Feb. 2020.