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When I got there, the doctor had all of my information up and ready BEFORE I came into the room. 2014 Oct;22(5):414-423, Bhat P, Goldstein DA. 2009 Nov; 148(5):779-789. The doctor was very attuned to my condition and explained to the fellow hat I should be following one doctor. Chronic central serous chorioretinopathy responsive to rifampin. Ophthalmologist & Uveitis Specialist 1310 48th Street Unit 207 Brooklyn, NY 11219 Tel: 718-436-8988. Right: After tapering a course of oral prednisone as a bridge to treatment with monthly Remicade infusions and weekly methotrexate. Northwesterns uveitis fellowship is one year of in-depth exposure to all aspects of uveitis care, led by Debra Goldstein, MD, a world-renowned uveitis expert. Fellows are funded and get to live in the amazing city of Chicago. Some medications work for one patient but not the next, and we dont know why. I highly recommend him! 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. Reviewed On 11/1/2022 Always feel I am in good hands. Reviewed On 7/1/2023 After that, I taper down slowly over the following months to 7.5 mg per day or less. All rights reserved. 2023 Aug 1, Pauline T Merrill, Nancy Holekamp, Daniel Roth, Jonathan Kasper, Ruben Grigorian> ;American Journal of Ophthalmology. Ophthal Plast Reconstr Surg. You verify the infection with either systemic lab serology orsometimesdirect ocular cultures. Reviewed On 4/1/2023 If that happens, my next step is to switch within this class of drugs to infliximab (Remicade), which is an infusion., Dr. Henry agrees that patients with the most aggressive and vision-threatening processes may need biologic infusions. In particular, its important to rule out tuberculosis prior to starting TNF inhibitors., Of course, some patients may fail even on those options. My vision is so much improved I am now able to read & drive my car again!! Because of the expertise of ophthalmologists like Drs. 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. Dr. Kurup does all he can to treat my mother's vision issues and preserve her eyesight to the extent possible. Epub 2010 Jun 25. Reviewed On 12/1/2022 Ocular Immunology and Uveitis - National Eye Institute (2003 - 2005), Fellowship | Medical Retina What is a uveitis specialist? However, a lot of patients dont improve significantly with topical steroids in a short period of time, or they have more posterior involvement. But if someone has a serious intermediate uveitis, posterior uveitis or panuveitis, that patient will probably need systemic therapycorticosteroids, with or without a bridge to longer-term immune suppressionalthough a few of them can be managed with local steroid injections. Anything that affects the uvea can affect your vision. Vitreo-Retinal Surgery and Disease - Vitreoretinal Foundation Pllc (2006 - 2007), Fellowship | Vitreo-Retinal Surgery and Disease We review these reports and implement management plans, as appropriate, to address conflicts of interest that may arise in connection with medical research, clinical care and purchasing decisions. Retisert is still useful in some cases, but the patient has about a 30-percent chance of needing glaucoma surgery after a Retisert implant. 988 Uveitis Specialists Near Me - Book Appointments Online - Zocdoc He is a member of the American Society of Cataract and Refractive Surgery, the North Carolina Medical Society, and the American Uveitis Society. Our faculty members are experts in uveitis; learn more about their work within the field. 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. Please consider using one of these supported browsers. Goldstein has authored hundreds of articles and multiple chapters and lectures around the world. Bhat P, Jakobiec FA, Kurbanyan K, Zhao T, Foster CS. So I typically go to a biologic before considering a T-cell inhibitor., Dr. Janardhana agrees. Most are members of the American Uveitis Society, and some are actively engaged in uveitis research. 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. Uveitis Intermediate Swelling of the uvea in the middle of the eye. Suprachoroidal CLS-TA versus Rescue Therapies for the Treatment of Uveitic Macular Edema: A Post Hoc Analysis of PEACHTREE. Plan extra time for travel. Then theres the ongoing LUMINA study of intravitreal sirolimus from Santen. However, I use the cytotoxics much less now that we have options like the biologics, especially Humira. The issues with Retisert are, first, that it can be difficult to get insurance to approve it because its so expensive; and second, the patient is virtually guaranteed to end up with a cataractassuming they havent already had cataract surgeryand very likely to develop glaucoma. Hudson, OH 44236 Since uveitis is often connected with other diseases or conditions, some laboratory testing may also be needed. Anterior uveitis in patients with spondyloarthropathies in a single US academic center: a retrospective study. 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. Manage Specialty Care with FollowMyHealth, For appointments/referrals: Dr. Merrill retired on September 1, 2021. For that reason, I either have the patient on topical steroid drops, give a steroid injection or prescribe oral prednisone to serve as a bridge until the antimetabolite takes full therapeutic effect., Dr. Merrill points out that one of the holy grails for treating uveitis would be a nonsteroidal injectable medication. Reviewed On 2/1/2023 He is a vitreoretinal surgeon, uveitis specialist, and is a trained immunologist. Reproduction in whole or in part without permission is prohibited. Reviewed On 4/1/2023 Dr. Kurup completed his ophthalmology residency at New York Eye & Ear program, where he also served as chief resident. Theyve done well. This can develop gradually and last for many years. Uveitis is inflammation inside the eye and can be due to multiple immune, infectious and malignant causes. List of Specialists - Uveitis.org | OIUF And, in the not-too-distant future, we may have even more sustainable treatment options. Suite: 300 Dr. Kurup is an accomplished writer, having articles in more than 50 peers reviewed high quality journals. Sumit K. Gupta MD | FLACS | Uveitis - Charlotte Eye Ear Nose & Throat Mayfield Heights, OH 44124 CellCept can cause similar side effects, but its less likely to cause liver toxicity, so its OK to use in patients who drink alcohol. Rheumatologist: a specialist who treats autoimmune conditions (commonly referred to as rheumatic diseases), which affect the body's immune system, like the inflammation that contributes to uveitis. Reviewed On 11/1/2022 Dr. Bhat has conducted research on systemic immunosuppression for various ocular inflammatory conditions as well as herpetic diseases of the eye especially herpetic scleritis. Westlake, OH 44145 2012 Jan 1, Assessing the Precision of ICD-10 Codes for Uveitis in 2 Electronic Health Record Systems, Sophia M Saleem, Alan G Palestine, Pauline T Merrill, Douglas A Jabs, Jennifer E Thorne, JAMA, Efficacy and Safety of Intravitreal Sirolimus for Non-Infectious Uveitis of the Posterior Segment: Results from the SAKURA Program, Clearside Biomedical Announces Multiple Oral Presentations to Be Given at the American Society of Retinal Specialists (ASRS) Annual Meeting, Presentation of Clearside Biomedicals Extension Study of PEACHTREE for XIPERE Exhibits Durability Following Second Dose, Combination Lucentis and Ocular Photodynamic Therapy With Visudyne, With Evaluation-based Retreatment, Connect with other colleagues in the same hospital or clinic, Search all U.S. specialist profiles and refer a patient, Read the latest clinical news and earn CME/CEU credits, Vitreoretinal disease, Uveitis, Retina surgery, Optical coherence tomography. Causes can include allergy, infection, chemical exposure, trauma or the cause may be unknown. This starts suddenly and can last up to 8 weeks. I am very grateful to him & his excellent staff. Ophthalmology - Our Lady Of Mercy Medical Center (2000 - 2003), Residency | Internal Medicine 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. I specialize in ophthalmology. 2021 Sep 27, Pauline T. Merrill, Christopher R. Henry, Quan Dong Nguyen, Ashvini K. Reddy, Barry Kapik, Thomas A. Ciulla> ;Ocular Immunology and Inflammation. UH practitioners seek advance approval for certain new industry relationships. He is currently holding a new patent for drug testing in sharks as well as periocular and skin disease. Am J Ophthalmol. Good experience, Reviewed On 9/2/2022 This office was excellent -very nice punctual and professional! The technique is quite intuitive, and the patients I had in the open-label AZALEA trial did extremely well.. Graefes Archives of Clinical and Experimental Ophthalmology. 216-844-3601, 950 Clague Rd Thankful that I was referred to Dr. Kurup with my autoimmune and vision problems. Social Media Center. 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. He is a compassionate, kind person. Dr. Merrill has written chapters for three books,The Principles and Practice of Ophthalmology,Curbside Consultation in Retina and Cystoid Macular Edema-Medical and Surgical Management. He has served on advisory committees to the FDA and NIH patent offices and is an editor of numerous journals. Dr. Merrill completed an internship in internal medicine at Good Samaritan Hospital in Portland, Oregon, and an ophthalmology residency at Duke University Eye Center in Durham, N.C. She went on to complete a fellowship in vitreoretinal surgery at the Cullen Eye Institute at Baylor College of Medicine in Houston, Texas, after which she joined Illinois Retina in 1997. Unilateral Retinal Vasculitis as the Presenting Manifestation of Parry-Romberg Syndrome (Progressive Hemifacial Atrophy). Swelling of the uvea toward the back of the eye. The 0.19-mg Fluocinolone Acetonide Intravitreal Implant Reduces Treatment Burden in Diabetic Macular Edema. Can last from a few weeks to many years. Providing safe, high-quality and cost-effective care for our patients is our foremost responsibility. Reviewed On 2/1/2023 Can last from a few weeks to many years. Director, Medical Student Education, Mailing Address: Surgeons note that this has some potential advantages over the other options. Patients are referred to this service for the diagnosis and management of infectious and non-infectious ocular inflammatory conditions such as scleritis and anterior, intermediate, posterior, and panuveitis. Reviewed On 7/1/2023 The University of Illinois Hospital and Clinics is a patient-centered organization. Additional testing such as OCT and fluorescein angiography may also be necessary. Dr. Kupur is a Great Doctor, with a Fantastic Personality!! Primary Specialty Ocular Inflammation and Uveitis Secondary Specialty Ophthalmology CALL 312.695.8150 Nearest Location Northwestern Medicine Department of Ophthalmology 259 E Erie St Ste 1520 Lavin Family Pavilion Chicago IL 60611 Phone: 312.695.8150 Fax: 312.695.3652 0.06 mi Directions Insurance For specific plans, see the full plan list. The Hudson office is efficient and well-organized. Dr. Kurup and his team *** are amazing. 2010 Nov-Dec; 26(6):413-5. 2021 Aug 18, Elizabeth A Atchison, Aimee J Szewka, Pauline T Merrill> ;Journal of Vitreoretinal Diseases. Br J Ophthalmol. Fellowship in Uveitis and Ocular Inflammatory DiseasesNorthwestern University, Feinberg School of Medicine, Chicago, IL Bedford, OH 44146 Sometimes chronic uveitis will be quiet for years, and suddenly it becomes active, for reasons we cant determine. Dr. Kurup exhibits a high level of expertise, yet patiently explains my conditions and treatments with a friendly manner. Schedule a Consultation Today! American Journal of Ophthalmology. Studies are being conducted for the treatment of noninfectious uveitis using other biologics such as golimumab and secukinumab (Cosentyx, an IL-17 inhibitor), she says, as well as T-cell inhibitors such as abatacept (Orencia). Jan 2019 - May 20201 year 5 months Greater Chicago Area -Private practice ophthalmology providing comprehensive care, including diabetic eye care, cataract surgeries, and treatment for glaucoma. 2010 May;94(5):579-83. This starts suddenly and can last up to 8 weeks. Our surgical services include cataract surgery, complex uveitic cataract surgery and ocular injections. Use of intravitreal rituximab for treatment of vitreoretinal lymphoma. Second is severity. Also, she adds, if a patient is taking oral steroids, depending on the type of inflammation and uveitis the patient has, I watch to see if the inflammation comes back as Im tapering. 2018 Oct 1, Quan Dong Nguyen, Pauline T. Merrill, Yasir J. Sepah, Mohamed Ibrahim, Alay S. Banker, Andrea Leonardi, Michelle Chernock, Sri Mudumba, Diana V. Do> ;Ophthalmology. Reviewed On 12/1/2022 I have a few patients with birdshot chorioretinopathy who are on cyclosporine, and some patients whove had organ transplants who are taking tacrolimus, he says. 2014 Jan;2(3):301-310. Uveitis - Feinberg School of Medicine Those patients will benefit from either local injections or systemic treatment.. For a less-aggressive, chronic, but still vision-threatening uveitis Ill sometimes lean towards methotrexate or mycophenolate first. Here, surgeons with extensive experience managing these patients offer their advice. 2012 Mar 12, Zac B. Ravage, Kirk H. Packo, Catherine M Creticos, Pauline T. Merrill> ;Retinal Cases & Brief Reports. Reviewed On 6/1/2023 Assessing the Precision of ICD-10 Codes for Uveitis in 2 Electronic Health Record Systems. Most of all, patients need to understand that treating uveitis is a long process, she concludes. The world needs more Dr. Karrups'. ***, Reviewed On 7/1/2023 Reviewed On 6/1/2023 2014 Jan 1, H. Nida Sen, Lea T. Drye, Debra A. Goldstein, Theresa A. Larson, Pauline T. Merrill, Peter R. Pavan, John D. Sheppard, Alyce E. Burke, Sunil K. Srivastava, Douglas A. It can be caused by autoimmune diseases or an infection, and we cant identify the cause in half of the uveitis cases we see. 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. 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. The doctor and his staff provided excellent care. If topical drops are insufficient, most surgeons move on to either systemic steroid treatment or steroid injections into the eye. Reviewed On 12/1/2022 Reviewed On 12/1/2022 The exam is simple and painless your doctor will give you some eye drops to dilate (widen) your pupil and then . As always, Dr. Kurup and his team provided excellent care and courtesy. 28 patients in 2.5 hours!! If youre interested in learning more about uveitis treatmentplease contact us for a consultation by calling one of our locations near you. 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. It has numerous possible etiologies that require different treatment approaches, and every patient is unique; theres currently no way to be sure how the patient seated in front of you will react to a given treatment. This may require laser or surgical treatment. It has very good penetration to the posterior part of the eye. Financial Assistance Many of those patients will need topical drops, too., Every patient with uveitis is unique, he adds. I feel very confident he providing the best medical care for my eyes. He is not only one of its Best Doctors from 2008 to 2016, but is also a consultant for Best Doctors. Reviewed On 5/1/2023 2021 Mar 12, Eric B. Suhler, Glenn J. Jaffe, Eric Fortin, Lyndell L Lim, Pauline T. Merrill, Andrew D. Dick, Antoine P. Brzin, Quan Dong Nguyen, Jennifer E. Thorne, Joachim Van Ca> ;Ophthalmology. The initial treatment would be oral steroids, usually 60 mg per day until the eye is quiet, but for no more than a month. 2010 Aug; 150(2):230-242.e2. Dr. Bhats primary focus is inflammatory diseases of the eye and she specializes in the diagnosis and management of infectious and non-infectious ocular inflammatory conditions such as scleritis, and anterior, intermediate and posterior uveitis. Seminars in Ophthalmology 2009 May-Jun;24(3):166-71. Dr. Merrill has published numerous papers on topics ranging from uveitis and ocular complications of AIDS, to vitreous hemorrhage and diabetic macular edema. Very thorough provider and his team. Tocilizumab (Actemra) is relatively new, says Dr. Henry. Of course, no matter how effective your treatment may be, patient expectations are a huge factor in how the patient will perceive your efforts over the long run. These are typically given in a rheumatologists office. Reviewed On 7/1/2023 216-844-3601, 5850 Landerbrook Dr Types of Uveitis Anterior Uveitis Swelling of the uvea near the front of the eye. Uveitis. Jakobiec FA, Bhat P, Colby K. Immunohistochemical Studies of Conjunctival Nevi and Melanomas. Multiple Evanescent White-Dot Syndrome in a 9-Year-Old Girl. Its important for patients to remain compliant with appointments and for us to monitor labs and symptoms frequently while on these medications. 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. But I almost never recommend them, because they require careful monitoring of factors such as blood pressure, and there are issues concerning tolerability. Dr. Kurup has a stellar record of academic and public service. Chronic birdshot chorioretinitis. 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. I think the lack of extensive data is the reason tocilizumab is still not a go to medication, she adds. Dr. Kurup was born in Calicut, India, and lived in the midwestern Chicago . So if you go with Retisert, youre going with what I call the bionic eye approach [treatment options that may cause changes inside the eye].. We want something that will treat both eyes, she explains. But no matter what it takes, I make sure they know that Im there to work with them and help them get better., September 14, 2023 | Addressing a Major Gap in the Treatment of Dry Eye Disease, September 19, 2023 | Addressing a Major Gap in the Treatment of Dry Eye Disease, October 3, 2023 | Addressing a Major Gap in the Treatment of Dry Eye Disease. Often, an eye drop that reduces inflammation (corticosteroids) is used for the front of the eye. Ophthalmology. Its currently possible to get bacterial and fungal PCR sequencing through labs such as the University of Washington, but it can be a difficult test to order, and there can be a several-week timeframe to obtain results. If its syphilis, the patient gets IV penicillin; if its herpes or shingles, they get valacyclovir; and so on. The only issue is that every conversation began with how much things cost. He works hard to find the cause of a problem when other doctors overlooked the issue, I'm comfort with the care Dr. Krupp provides because his treatment process is the best. ike many ophthalmic problems, uveitis can be a challenge for clinicians. Theyre very toxic, he points out. Medical Retina - National Eye Institute (2003 - 2005), Residency | Ophthalmology The new technique for performing suprachoroidal injections is fun, he notes. As of December 31, 2016, Shree Kurup did not disclose any Outside Relationships with Industry. Suprachoroidal CLS-TA with and without Systemic Corticosteroid and/or Steroid-Sparing Therapy: A Post-Hoc Analysis of the Phase 3 PEACHTREE Clinical Trial. I complimented the the doctor on a well run office and how well I was treated as a patient during my appt, Reviewed On 9/2/2022 2016 Apr 1, John H. Kempen, Mark L. Van Natta, Michael M. Altaweel, James P. Dunn, Douglas A. Jabs, Susan Lightman, Jennifer E. Thorne, Janet T. Holbrook, Glenn J. Jaffe, Brenda B> ;American Journal of Ophthalmology. Bhat P, Castaeda-Cervantes RA, Doctor PP, Foster CS. I explain that uveitis is kind of a blanket term, she says. Dr. Bhat spent time with Dr. C. Stephen Foster doing research in ocular immunology and inflammation and then with Dr. Frederick A Jakobiec understanding ophthalmic pathology. 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. I typically start the patient on an antimetabolite, either methotrexate (dose ranges from 7.5 to 25 mg, oral, intramuscular or subcutaneously, weekly) or mycophenolate mofetil, a.k.a. Helpful resources include insurance information, downloadable patient forms, new patient information, and what to expect at your office visit. I trust him and admire him as a dr and a caring person. Hence, methotrexate isnt a good choice for patients who drink alcohol, because liver toxicity can occur. I know he will do professional work. Reviewed On 12/1/2022 Right: Fluorescein angiogram showing CME and vasculitis. Theres no way anyone can be certain whether or not the uveitis is infectious just by looking. This is a balancing act; we dont want to encourage the infection by suppressing the immune system, but the bodys immune system is creating all of this inflammation with its immune cells trying to fight the infection, and thats whats actually causing the damage. However, its important to monitor intraocular pressure carefully and warn patients of the risk of cataract formation with long-term use.. Some patients dont respond sufficiently to it, while others are stable on it for years and then it stops working, she notes. Jul 24, 2023. Doctor knowledgeable and sensitive to concerns. But if not, I hope he is around for a very long time. Always do a complete eye exam before you start thinking about treatment, and be sure to consider viral uveitis, she says. Reviewed On 12/1/2022 Infliximab for the treatment of refractory scleritis. 14 Lawton Street #2FL Intravenous daclizumab for recalcitrant ocular inflammatory disease. Uveitis - Diagnosis & treatment - Mayo Clinic The studies of that approach found rapid control of macular edema with possibly fewer IOP concerns than we have with intravitreal injections, she notes. Reviewed On 11/1/2022 Dr. Kurup has been very kind and supportive as well as his staff. Uveitis Specialists in the United States - Uveitis.org | OIUF Specialty Care Building (SCB) 2021 Nov 6, Kayne McCarthy, Keke Liu, Gregg T. Kokame, Pauline T. Merrill, Marina Gilca, Jack A. Cohen> ;Hawai'i Journal of Health & Social Welfare. 2018 Dec 1, Marina Gilca, Pauline T. Merrill> ;Retinal Cases & Brief Reports. 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..

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