Dr. Copyright 2023 University of Illinois College of Medicine |, James Scholar Program for Independent Study, Procedural Competencies for Graduating Medical Students, Student Financial Aid and Debt Management, Graduate Education in Biomedical Sciences, Medical Scientist Training Program (MSTP), Office of Graduate Diversity Programs (OGDP), Center for Clinical and Translational Science, Support to Help Medical Students Become Great Physicians, Honoring a Legacy and Advancing the Future of Medical Education, Assistant Professor of Ophthalmology Co-Director, Uveitis Service, Associate Residency Program Director, Director, Medical Student Education, University of Illinois College of Medicine. In most cases, if someone has autoimmune, bilateral severe disease, Ill direct them toward systemic therapy. Reviewed On 12/1/2022 Search now: Director, Surgical Ocular Immunology and Uveitis, UH Cleveland Medical Center, Director, Vitreoretinal Diseases, UH Cleveland Medical Center, Ophthalmology - American Board of Ophthalmology. Eye care professionals across the Chicagoland area can read articles, watch helpful videos, and learn about upcoming educational opportunities. I typically start with 1 mg per kg, which for most patients ends up being 60 mg. Then I do a taper of about 10 mg per week. 11100 Euclid Ave Most of all, patients need to understand that treating uveitis is a long process, she concludes. But if not, I hope he is around for a very long time. Many initial studies are looking at tocilizumab for treating non-infectious uveitis and the data looks promising, agrees Dr. Janardhana. Pachydaki SI, Jakobiec FA, Bhat P, Sobrin L, Michaud NA, Seshan SV, DAmico DJ. Always greeted with a smile and never wait! Can last from a few weeks to many years. She received her undergraduate degree from Georgia Institute of Technology and her medical degree from the Medical College of Georgia. In and finished in a timely manner. He is a compassionate, kind person. 2014 Jan;2(3):301-310. Eye drops, however, cannot treat uveitis in the back of the eye. The idea is to achieve quick control with steroids while starting something that will be better tolerated over the long term., In terms of contraindications for oral steroids, Dr. Merrill says you want to carefully consider the systemic side effects. He is a vitreoretinal surgeon, uveitis specialist, and is a trained immunologist. In addition, we disclose payments to employed practitioners of $5,000 or more from companies with which the practitioners interact as part of their professional activities. But I almost never recommend them, because they require careful monitoring of factors such as blood pressure, and there are issues concerning tolerability. If the patient has isolated anterior uveitis, we can typically quiet that down with topical drops and dilation drops. Uveitis, if not controlled or put into remission can lead to damage of structures within the eye. Reviewed On 5/1/2023 In the not-too-distant future, we hope to have more easily accessible PCR tests that can do pan-bacterial and pan-fungal testing, in addition to pan-viral testing., Once infection has been ruled out, Dr. Janardhana also starts the patient on steroids. Reviewed On 2/1/2023 2021 May 21, Rahul N. Khurana, Pauline T. Merrill, Steven Yeh, Eric B. Suhler, Mark R Barakat, Eduardo Uchiyama, Christopher R. Henry, Milan Shah, Robert C Wang, Barry Kapik, Thoma> ;The British Journal of Ophthalmology. Jul 24, 2023. Use of intravitreal rituximab for treatment of vitreoretinal lymphoma. Fellows are supported to attend and present at national conferences, including AAO, AUS and ARVO. Excellent care. Long-Term Safety and Efficacy of Adalimumab in Patients with Noninfectious Intermediate Uveitis, Posterior Uveitis, or Panuveitis. Dmitry Pyatetsky, MD. Office and procedures are very efficient. Extension study of the safety and efficacy of CLS-TA for treatment of macular oedema associated with non-infectious uveitis (MAGNOLIA). Thank you. Humira is FDA-approved for uveitis, so thats been a huge advance., Dr. Henry says he starts the majority of patients needing immune suppression on an antimetabolite or a biologic. Cleveland, OH 44106 ***, Reviewed On 7/1/2023 Causes can include allergy, infection, chemical exposure, trauma or the cause may be unknown. Giving. Uveitis - Feinberg School of Medicine Uveitis/Ocular Immunology | Ophthalmology | Loyola Medicine The progress of uveitis is also somewhat unpredictable, she continues. Dr. Merrill says that what she does after steroid drops depends on the situation. Should Dr. Karrup ever consider leaving UHUH should do everything possible to keep him. Yutiq may not be as potent as Ozurdex, but it can evoke a longer response without the need for so many injections. I was very impressed with the care. Dr. Kurup is a Wonderful doctor, and the entire staff there is always friendly, helpful and nice. It was excellent. We have weekly grand rounds and biweekly retina/uveitis imaging conference, both excellent educational opportunities. Dr Kurup is an outstanding medical provider for my macula degeneration. > ;Ocular Immunology and Inflammation. 2016 Nov 1, Quan Dong Nguyen, Pauline T. Merrill, Glenn J. Jaffe, Andrew D. Dick, Shree Kurup, John D. Sheppard, Ariel Schlaen, Carlos Pavesio, Luca Cimino, Joachim Van Calster, A> ;Lancet. Dr. Bhat joined the faculty in 2014. Dr. Kurup and his team of Abraham and Laura provide outstanding and compassionate care to their patients. We do believe that factors like stress, illness and even traveling can act as triggers to reactivate the disease and cause a flare-up, but theres no way to predict exactly whats going to happen, or when. Reviewed On 11/1/2022 2016 Sep 17, Carmen A. Puliafito, Scott W. Cousins, Jason Bacharach, Victor H. Gonzalez, Nancy M. Holekamp, Pauline T. Merrill, Matthew P Ohr, Richard K. Parrish, Christopher D. Ri> ;Ophthalmic Surgery, Lasers & Imaging Retina. Shree Kurup MD Doctor Profile & Reviews | University Hospitals Shree K Kurup MD, FACP, joined the University Hospitals Eye Institute in 2018 and serves as the director of the Division of Vitreoretinal Diseases, Surgery and Ocular Immunology and Uveitis. We have very busy clinical practices with all types of uveitis. The justification for this has been to prevent antibodies against the adalimumab from forming. This does a couple of things. Efficacy of Adalimumab in Non-Infectious Uveitis Across Different Etiologies: A Post Hoc Analysis of the VISUAL I and VISUAL II Trials. Swelling of the uvea toward the back of the eye. The Uveitis Service treats patients with inflammation of the uveal tract: the middle vascular layers of the eye critical to its normal function. They will learn to manage immunomodulatory therapy, including methotrexate, mycophenolate, adalimumab, infliximab and other biologic agents. I know he will do professional work. UICs seven health sciences colleges and health care delivery enterprise. 2010 Feb; 128(2):174-83. We are involved in multiple national clinical trials. Social Media Center. First Case of Subretinal Ocular Angiostrongyliasis Associated with Retinal Detachment in the United States. Suite: 306 Northwestern Medicine | Northwestern . degree in biology. Chronic Herpes Simplex Scleritis: Characterization of 9 Cases of an Underrecognized Clinical Entity. Hudson, OH 44236 Treatment of lisch corneal dystrophy with photorefractive keratectomy and mitomycin C. Cornea. Reviewed On 9/2/2022 These diseases can cause minor or severe vision loss. 2009 Sep;148(3):350-60. Our uveitis service is very active academically, and all of our physicians publish in prominent journals. It typically works well for my patients, so if the patient is failing antimetabolites, starting a medication like Humira would be my next step., Antimetabolites such as methotrexate and mycophenolate mofetil (CellCept) are still very much in use, notes Dr. Merrill. The initial treatment would be oral steroids, usually 60 mg per day until the eye is quiet, but for no more than a month. Then, I order a number of panels to look for autoimmune inflammatory markers. 2016 Jan 1, Kelly L. Larkin, Ujwala S. Saboo, Grant M. Comer, Farzin Forooghian, F. Mackensen, Pauline T. Merrill, H. Nida Sen, Arun D. Singh, Rohan W Essex, Stewart Lake, Lyndell> ;The British Journal of Ophthalmology. Dr. Kurup is golden! I am very satisfied with my care. He and his nurse, *** are very kind, caring & patient with me as my anxiety for eye injections is very high. He has been patient and understanding in spite of my high anxiety nature. Please consider using one of these supported browsers. The world needs more Dr. Karrups'. The choice of therapy often depends on chronicity, bilaterality, duration, contraindications to medications, and whether theres an associated systemic disease. Image courtesy ofChristopher R. Henry, MD. 645 N. Michigan Ave.Suite 440Chicago, IL 60611, Northwestern University Feinberg School of Medicine, Corneal External Disease and Refractive Surgery. 2009 May-Jun;17(3):185-90. Surgeons agree that the first step in addressing uveitis is determining the cause of the problem. Manage Specialty Care with FollowMyHealth, For appointments/referrals: 2021 Aug 18, Elizabeth A Atchison, Aimee J Szewka, Pauline T Merrill> ;Journal of Vitreoretinal Diseases. Good experience, Reviewed On 6/1/2023 U veitis is one of the most confounding diseases that ophthalmologists are tasked with managing. Varun Pawar - Ophthalmology (Eye) | Mount Sinai - New York Dr. Kurup is an excellent physician who is very careful, knowledgeable and thorough. 2023 Apr 1, Michael A Singer, Pauline T. Merrill, Steven Yeh, Colette Hall, Barry Kapik, Thomas A. Ciulla> ;Clinical & Experimental Ophthalmology. They coordinated my care and were ready for me. Rated 4.9. star star star star star. Thanks k you! Mayfield Heights, OH 44124 The University of Illinois Hospital and Clinics is a patient-centered organization. SOE Congress 2023 in Prague Unites Young Ophthalmologists. Were still awaiting studies to see how efficacious these medications are against noninfectious uveitis, she says, but if patients are already on these medications for systemic disease and have a history of uveitis, I dont immediately change medications, unless the patient has a recurrent uveitis flare or persistent chronic uveitis.. She received her medical degree from Washington University School of Medicine in St. Louis and has been in practice 23 years. Best Uveitis Specialist - Chicago, IL - Book Online - Zocdoc 2010 May;94(5):579-83. Catherine T. Thuruthumaly, MD | Froedtert & the Medical College of If the patient just has mild anterior uveitis, drops might be all the patient needs, she explains. Durezol is a really good medication for anterior and intermediate uveitis. Starting in 2005 we had the Retisert fluocinolone surgical implant, she says. iPhone and iPad are trademarks of Apple Inc., registered in the U.S. and other countries. As a rule of thumb, you should assume it could be syphilis or TB until proven otherwise., Dr. Merrill notes that, in some cases, you may be able to identify viral uveitis via a thorough exam. Jakobiec FA, Nguyen J, Bhat P, Fay A. MDM2-Positive Atypical Lipomatous Neoplasm/Well Differentiated Liposarcoma versus Spindle Cell Lipoma of the Orbit. Common side effects of methotrexate are nausea, vomiting and fatigue; more severe side effects include liver toxicity, cytopenia and even kidney dysfunction in high doses. Clinical signs can be fairly characteristic for some viral presentations such as acute retinal necrosis, but I still often confirm that with PCR testingin addition to testing for syphilis, of course.. The Yutiq implant releases fluocinolone at a significantly lower rate, which translates to less risk for the patient; the risk of needing glaucoma surgery at three years is around 5 percent with Yutiq. Dr. Kurup cares for both adult and childhood vitreoretinal diseases and ocular inflammation. I am confident he is taking very good care of my vision. Dr. Kurup is great. We want something that will treat both eyes, she explains. Fellows are funded and get to live in the amazing city of Chicago. Dr really listened to my concerns and gave me directions to follow up with. My vision is so much improved I am now able to read & drive my car again!! Corticosteroid therapy for uveitis, on the other hand, may lead to elevations in intraocular pressure (IOP) that induce glaucoma. 2021 Jun 1, Pauline T. Merrill, Albert T. Vitale, Manfred Zierhut, Hiroshi Goto, Martina Kron, Alexandra P. Song, Sophia Pathai, Eric Fortin> ;Ocular Immunology and Inflammation. Our surgical services include cataract surgery, complex uveitic cataract surgery and ocular injections. 2009 May;247(5):687-92. Dr. Nehali Saraiya is an ophthalmologist who specializes in eye exams & routine eye care, cataracts, and uveitis in the Charlotte area at our SouthPark, Matthews, and Pineville offices. Dr. Merrill has been listed inBest Doctors in America. One reason that managing uveitis is challenging is that up to half of the cases are idiopathic, notes Priya Janardhana, MD, director of the uveitis service and an assistant professor of ophthalmology at the University of Massachusetts Medical School in Worcester. To make an appointment with him, call 704-295-3000. Yutiq can last up to two and a half years; I typically reserve it for patients whove responded well to several Ozurdex injections. Reviewed On 4/1/2023 Anterior uveitis is the most common and least serious type. Of course, the flip side is that its not as strong, so patients may continue to need other treatments as well, but hopefully with fewer severe flare-ups of the inflammation.. I have faith in this doctor, Reviewed On 9/2/2022 J Ophthalmic Inflamm Infect. Treating Uveitis, 2021: The State of the Art - Review of Ophthalmology We currently sometimes use intravitreal methotrexate off-label; thats being looked at in the MERIT study of the MUST trial group, which is comparing Ozurdex, methotrexate and Lucentis for uveitic macular edema in otherwise quiet eyes., Some patients with severe noninfectious uveitis wont respond sufficiently to antimetabolites, Dr. Janardhana points out. Doctor P, Sultan A, Syed S, Christen W, Bhat P, Foster CS. Fellowship in Uveitis and Ocular Inflammatory DiseasesNorthwestern University, Feinberg School of Medicine, Chicago, IL The service offers a variety of treatments for ocular inflammatory diseases, including steroid-sparing immunosuppressive therapies, and works closely with other subspecialties including rheumatology, infectious disease, and pulmonology. However, even after treating with the appropriate medication youll often still have inflammation that needs to be addressed. The studies of that approach found rapid control of macular edema with possibly fewer IOP concerns than we have with intravitreal injections, she notes. Crystal Lake, IL 5.00 ( 31 reviews) " One of the best dr experiences I've had. If its severe disease, Ill prescribe oral prednisone, as high as 60 mg/day, for two weeks. Retisert is still useful in some cases, but the patient has about a 30-percent chance of needing glaucoma surgery after a Retisert implant. That might mean a series of short-term peri-ocular or intravitreal steroid injections, or a longer-lasting injection such as Ozurdex or Yutiq, or systemic immunosuppressive therapy. HE WAS VERY BUSY! [See below.] I may offer the option of a short- or long-acting periocular or intravitreal steroid injection to a patient with unilateral noninfectious uveitis who hasnt been on oral steroids, she says. Reviewed On 4/1/2023 216-844-3601, 5850 Landerbrook Dr Image courtesy ofPauline T. Merrill, MD. He is ideal! Bhat P, Jakobiec FA, Folberg R. Comparison of tumor-associated vasculatures in uveal and cutaneous melanomas. Second is severity. Eye doctors can check for uveitis as part of a dilated eye exam. Many of those patients will need topical drops, too., Every patient with uveitis is unique, he adds. 216-844-3601, 18599 Lake Shore Blvd 2023 by Northwestern Medicine and Northwestern Memorial HealthCare. Vitreo-Retinal Surgery and Disease - Vitreoretinal Foundation Pllc (2006 - 2007), Fellowship | Vitreo-Retinal Surgery and Disease Methotrexate might be OK for patients who only drink alcohol once in a while, but if they drink alcohol more than a few times a month I give them mycophenolate mofetil. The basic science data suggests that the steroid concentrates in the suprachoroidal space and the adjacent retina and choroid, with very little getting into the anterior chamber or angle, explains Christopher R. Henry, MD, a fellowship-trained vitreoretinal surgeon and uveitis specialist who practices at Retina Consultants of Texas. The service offers a variety of treatments for ocular inflammatory diseases, including steroid-sparing immunosuppressive therapies, and works closely with other subspecialties including rheumatology, infectious disease, and pulmonology. Uveitis Specialist in Chicago | Illinois Retina Associates 2021 Sep 27, Pauline T. Merrill, Christopher R. Henry, Quan Dong Nguyen, Ashvini K. Reddy, Barry Kapik, Thomas A. Ciulla> ;Ocular Immunology and Inflammation. This starts suddenly and can last up to 8 weeks. I am very grateful to him & his excellent staff. Dr.Kurup is a wonderful doctor, he truly cares about his patients. Reviewed On 6/1/2023 Meet the Teams Downtown Chicago Northern Suburbs Western Suburbs Locations toggle view Expert opinion on Orphan Drugs. Ocul Immunol Inflamm. Uveitis can lead to other problems such as glaucoma, cataract, scar tissue in the eye, and new blood vessel growth. Then you tailor your treatment to the organism., If the uveitis is infectious, whether viral, bacterial or fungal, we treat with the appropriate antiviral, antibacterial or antifungal medication, says Priya Janardhana, MD, director of the uveitis service and an assistant professor of ophthalmology at the University of Massachusetts Medical School in Worcester. Dr. Merrill adds that another masquerader you need to consider is intraocular lymphoma, particularly in older patients. Fellowship, Surgical Retina and Vitreous, 1995 - 1997, Internship, Internal Medicine, 1991 - 1992, Washington University in St. Louis School of Medicine, BA, Biology, Summa Cum Laude, 1982 - 1986, Pauline T Merrill, Nancy Holekamp, Daniel Roth, Jonathan Kasper, Ruben Grigorian> ;American Journal of Ophthalmology. This doctor was about the 5th one I had seen. In fact, my patients who are on this medication usually also have systemic disease, and its worked well to control both. Uveitis is an inflammation of the inside of the eye. Her areas of main interest are posterior uveitidies that include Vogt-Koyanagi-Harada (VKH) disease, Behcets, and sarcoidosis, infectious retinopathies, as well as white dot syndromes such as birdshot chorioretinopathy. And, we talk with the patient about all of the systemic side effects that can occur, from short-term mood changes, sleeplessness and weight gain, to longer-term effects ranging from changes in blood pressure to osteoporosis. In cases where someone has had an ongoing uveitis and the process appears to be a long-term threat to their vision, Ill typically start with a course of oral steroids first. At the same time, UH understands that these relationships may create a conflict of interest. The injection helps get them through that initial period., Dr. Henry says he also tends to use Ozurdex more often than the other options. Reviewed On 1/1/2023 Chronic central serous chorioretinopathy responsive to rifampin. So we use prednisone to control that aspect of the process while the antibiotic or antiviral is controlling the infection., Some of the more interesting things on the horizon for infectious uveitis are in the area of diagnostics, notes Dr. Henry. Plan extra time for travel. The POINT trial found that Ozurdex may have some advantages over periocular or sub-Tenons injections in terms of treating uveitic macular edema, Dr. Henry notes. 2016 Jan 1, Ofelya Gevorgyan, Mariam Riad, Rebecca D Sarran, Pauline T. Merrill, Joel A. Eye care professionals across the Chicagoland area can read articles, watch helpful videos, and learn about upcoming educational opportunities. Chicago, IL 60612 ***. The practical result is that addressing uveitis requires a lot of trial and error, ruling out possible causes to avoid inappropriate treatment, and then working your way through a series of options to find the right treatmentor combination of treatmentsthat will bring your patient relief and preserve vision. Dr. Janardhana explains that she considers moving to other options when a patient is being weaned off of oral steroid therapy and the disease begins to reactivate. Retisert, the surgical implant, can last up to five years. Right: After tapering a course of oral prednisone as a bridge to treatment with monthly Remicade infusions and weekly methotrexate. Suprachoroidal CLS-TA with and without Systemic Corticosteroid and/or Steroid-Sparing Therapy: A Post-Hoc Analysis of the Phase 3 PEACHTREE Clinical Trial. Out of all of my health care providers, Dr Kurup is definitely my favorite. Chronic birdshot chorioretinitis. Good experience, Reviewed On 9/2/2022 Very satisfied with care and treatment I received. We have to try different medications in a stepwise approach, and it can take several months just to find the right medication to get their disease to quiet down. YO Need to Know: 5 Pearls for Uveitis Diagnosis, How to Avoid Big 216-UH4-KIDS (216-844-5437), For general information: These are typically given in a rheumatologists office. In addition, uveitisespecially noninfectious uveitisis often a chronic disease, and every patient is different. I explain that uveitis is kind of a blanket term, she says. CellCept (dose range 750 to 1,500 mg by mouth twice a day), Dr. Janardhana continues.
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