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

Mar 01, 2021 9:00 AM


New CMV screening protocol
New CMV Screening Protocol: Click image for a downloadable PDF.

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 Primary Children’s Hospital and University of Utah Health, 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.

—Katherine Hu, MD

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.

—Marissa 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

Bilateral Placoid Choroiditis in an HIV patient with Cryptococcus Neoformans Meningitis and Disseminated Cryptococcal Disease
Larochelle RD, Larochelle MB, Aung YY, Linn T, Heiden D, Vitale AT.
Journal of VitreoRetinal Diseases (In Press). July 2020.
 
Single-Nuclei RNA-Seq Provides Comprehensive Transcriptomic Classification of Human Retinal Cell Types
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.
 
Prevalence of Retinal Diseases and Associated Risk Factors in an African Population from Mwanza, Tanzania
Bradley H. Jacobsen, Avni A. Shah, Sahil Aggarwal, Christopher Mwanansao, Molly McFadden, Moussa A. Zouache, Akbar Shakoor.
Ophthalmic Surgery, Lasers and Imaging Retina. 2020.
 
Efficacy of Adalimumab in Non-Infectious Uveitis Across Different Etiologies: A Post Hoc Analysis of the VISUAL I and VISUAL II Trials
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.
Uveitis. 2020 - Springer; pp 181-198.
 
Long-term Visual Outcomes of Endophthalmitis and the Role of Systemic Steroids in Addition to Intravitreal Dexamethasone
Christopher D. Conrady, Richard M. Feist Jr., Albert T. Vitale, Akbar Shakoor.
BMC Ophthalmology. 2020; 20:181.
 
Not All That Flickers Is Snow
Rachel C. Patel, Albert T. Vitale, Donnell J. Creel, Kathleen B. Digre.
Journal of Neuro-Ophthalmology. 23 March 2020.
 
The Clinical Characteristics of Unilateral Placoid Pigment Epitheliopathies
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.

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