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Article ; Online: Uveitis and Posterior Ophthalmic Manifestations Following the SARS-CoV-2 (COVID-19) Vaccine.

Patel, Kishan G / Hilton, Taylor / Choi, Rene Y / Abbey, Ashkan M

2022 Volume 30, Issue 5, Page(s) 1142–1148

Abstract: Purpose: To present four cases of posterior ophthalmic manifestations associated with a temporal relationship to SARS-CoV-2 vaccination.: Methods: Retrospective case series with a review of clinical findings.: Results: Four patients presented with ...

Abstract	Purpose: To present four cases of posterior ophthalmic manifestations associated with a temporal relationship to SARS-CoV-2 vaccination. Methods: Retrospective case series with a review of clinical findings. Results: Four patients presented with various posterior ophthalmic findings including uveitis, maculopathy, and optic neuropathy. Each of their clinical courses varied in terms of ophthalmic imaging and exam findings. Conclusion: The coronavirus disease 2019 (COVID-19) pandemic has ushered in a new wave of challenges to healthcare, epidemiological endeavors, and widespread vaccination efforts. Novel vaccines have been developed for the SARS-CoV-2 virus, including both mRNA and viral vector-based platforms. The ocular manifestations and side effects related to the SARS-CoV-2 vaccine is not well established or understood. There may be an association between vaccination and posterior ophthalmic manifestations.
MeSH term(s)	Humans ; COVID-19 ; COVID-19 Vaccines/adverse effects ; Retrospective Studies ; RNA, Messenger ; SARS-CoV-2 ; Uveitis/chemically induced ; Uveitis/diagnosis ; Vaccination ; Viral Vaccines
Chemical Substances	COVID-19 Vaccines ; RNA, Messenger ; Viral Vaccines
Language	English
Publishing date	2022-06-28
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1193873-0
ISSN	1744-5078 ; 0927-3948
ISSN (online)	1744-5078
ISSN	0927-3948
DOI	10.1080/09273948.2022.2079533
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Article ; Online: Filtering-Associated Endophthalmitis after Trabeculectomy or Tube-Shunt Implant.

Simonett, Joseph M / Choi, Rene Y / Flaxel, Christina J

Ophthalmology. Retina

2020 Volume 5, Issue 3, Page(s) 279–284

Abstract: Purpose: To determine the rate, clinical features, and outcomes of filtering-associated endophthalmitis in eyes that underwent trabeculectomy or tube-shunt implantation.: Design: Retrospective database study with selective chart review.: ... ...

Abstract	Purpose: To determine the rate, clinical features, and outcomes of filtering-associated endophthalmitis in eyes that underwent trabeculectomy or tube-shunt implantation. Design: Retrospective database study with selective chart review. Participants: Eyes that underwent incisional glaucoma surgery at our institution between January 1, 2012, and December 31, 2019. Methods: An electronic medical record database was used to identify all eyes that underwent trabeculectomy or tube-shunt implantation during the study period. Date of surgery, date of last ophthalmology clinic visit, and filtering-associated endophthalmitis diagnoses were obtained and used to perform a Kaplan-Meier analysis. The log-rank test was used to compare rates of filtering-associated endophthalmitis after trabeculectomy and tube-shunt implantation. Microbiology, management, and clinical outcomes data from patients with filtering-associated endophthalmitis were also collected and analyzed. Main outcome measures: Cumulative risk of filtering-associated endophthalmitis as determined by Kaplan-Meier analysis. Visual acuity improvement to within 2 lines of baseline at 3 months of follow-up and globe salvage at last available follow-up in eyes with filtering-associated endophthalmitis. Results: Kaplan-Meier analysis of 1582 eyes that underwent incisional glaucoma surgery yielded a 5-year cumulative incidence for filtering-associated endophthalmitis of 1.32%. No statistically significant differences were found between rate of endophthalmitis after trabeculectomy or tube-shunt implantation (P = 0.761, log-rank test). Seven of 16 cases (43.8%) of filtering-associated endophthalmitis showed positive culture results from either a vitreous sample or explanted tube shunt. Recovery of vision to within 2 lines of pre-endophthalmitis baseline was achieved in 53% of patients at 3 months of follow-up. Rate of globe salvage was 100% at last available follow-up. Conclusions: Risk of filtering-associated endophthalmitis is persistent and relatively constant for at least 5 years after incisional glaucoma surgery. The overall prognosis of filtering-associated endophthalmitis remains poor; however, good visual and anatomic outcomes can be achieved in some patients with prompt intervention.
MeSH term(s)	Aged ; Bacteria/isolation & purification ; Endophthalmitis/diagnosis ; Endophthalmitis/etiology ; Endophthalmitis/microbiology ; Eye Infections, Bacterial/diagnosis ; Eye Infections, Bacterial/etiology ; Eye Infections, Bacterial/microbiology ; Female ; Glaucoma/physiopathology ; Glaucoma/surgery ; Humans ; Intraocular Pressure/physiology ; Male ; Prostheses and Implants/adverse effects ; Prostheses and Implants/microbiology ; Prosthesis-Related Infections/diagnosis ; Prosthesis-Related Infections/etiology ; Prosthesis-Related Infections/microbiology ; Retrospective Studies ; Surgical Wound Infection/diagnosis ; Surgical Wound Infection/etiology ; Surgical Wound Infection/microbiology ; Trabeculectomy/adverse effects ; Visual Acuity
Language	English
Publishing date	2020-07-17
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ISSN	2468-6530
ISSN (online)	2468-6530
DOI	10.1016/j.oret.2020.07.013
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Article ; Online: Multiple Evanescent White Dot Syndrome Presenting in a Patient With Punctate Inner Choroidopathy.

Walters, Alexander R / Choi, Rene Y / Flaxel, Christina J

Journal of vitreoretinal diseases

2020 Volume 5, Issue 3, Page(s) 270–274

Abstract: Purpose: This work reports a case of long-standing punctate inner choroidopathy (PIC) presenting with acute-onset multiple evanescent white dot syndrome.: Methods: A 44 year-old man presented with new onset of flashes and a peripheral spot of blurry ... ...

Abstract	Purpose: This work reports a case of long-standing punctate inner choroidopathy (PIC) presenting with acute-onset multiple evanescent white dot syndrome. Methods: A 44 year-old man presented with new onset of flashes and a peripheral spot of blurry vision in the right eye. His ocular history included PIC in both eyes. Results: Corrected visual acuities and intraocular pressures were normal. Posterior segment examination of the right eye demonstrated old PIC lesions and new, deep-yellow lesions in the posterior pole and midperiphery. Four months later, these lesions had resolved. Conclusions: Coexistence of PIC and multiple evanescent white dot syndrome has been rarely reported, and more research is warranted to investigate a possible shared etiology.
Language	English
Publishing date	2020-11-03
Publishing country	United States
Document type	Case Reports
ISSN	2474-1272
ISSN (online)	2474-1272
DOI	10.1177/2474126420965031
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Article ; Online: Molecular diagnosis and ocular imaging of varicella zoster virus associated neuroretinitis.

Choi, Rene Y / Lauer, Andreas / Rosenbaum, James T

American journal of ophthalmology case reports

2018 Volume 11, Page(s) 146–148

Abstract: Purpose: To report a case of varicella zoster virus associated neuroretinitis confirmed via polymerase chain reaction analysis of ocular fluid.: Observations: A 30-year-old man presented with a 1-week history of decreased vision in his left eye and ... ...

Abstract	Purpose: To report a case of varicella zoster virus associated neuroretinitis confirmed via polymerase chain reaction analysis of ocular fluid. Observations: A 30-year-old man presented with a 1-week history of decreased vision in his left eye and ulcerative skin lesions above his left eyebrow. On exam, he had clinical findings consistent with neuroretinitis characterized by optic disc edema and formation of a macular star. Polymerase chain reaction analysis of aqueous fluid was positive for varicella zoster virus. He was treated with oral valacyclovir with excellent resolution of his symptoms and clinical findings. Conclusions and importance: Varicella zoster virus is a rare cause of neuroretinitis. We report for the first time a case of varicella zoster virus associated neuroretinitis confirmed by polymerase chain reaction analysis of ocular fluid. Molecular testing of ocular tissue may lead to a definitive diagnosis.
Language	English
Publishing date	2018-07-18
Publishing country	United States
Document type	Case Reports
ISSN	2451-9936
ISSN (online)	2451-9936
DOI	10.1016/j.ajoc.2018.07.002
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Article ; Online: Fecal transplants in spondyloarthritis and uveitis: ready for a clinical trial?

Choi, Rene Y / Asquith, Mark / Rosenbaum, James T

Current opinion in rheumatology

2018 Volume 30, Issue 4, Page(s) 303–309

Abstract: Purpose of review: The intestinal microbiome is thought to play a role in the pathogenesis of inflammatory bowel disease (IBD). There are many shared clinical manifestations between IBD and spondyloarthritis (SpA), of which the most common are ... ...

Abstract	Purpose of review: The intestinal microbiome is thought to play a role in the pathogenesis of inflammatory bowel disease (IBD). There are many shared clinical manifestations between IBD and spondyloarthritis (SpA), of which the most common are peripheral arthritis and uveitis. Clinical overlap along with similar genetics between these diseases suggests a possible shared pathogenetic mechanism, which might center on the intestinal microbiota. In this review, we discuss the available evidence that SpA is a microbiome-driven disease and indicate how SpA-associated uveitis could be tied to gut dysbiosis. We conclude by discussing different treatment paradigms targeting the intestinal microbiome for SpA. Recent findings: Recent studies support the growing evidence of the intestinal microbiome as a crucial player in SpA disease pathogenesis. There is emerging evidence that the gut microbiome may play a causative role in uveitis. Summary: The field is beginning to discover a new level of understanding how the intestinal microbiome is involved in SpA. Treatment methods to alter intestinal microbiota to treat SpA-related diseases are still in its infancy.
MeSH term(s)	Animals ; Fecal Microbiota Transplantation ; Gastrointestinal Microbiome ; Humans ; Inflammatory Bowel Diseases/therapy ; Spondylarthritis/microbiology ; Spondylarthritis/therapy ; Uveitis/microbiology ; Uveitis/therapy
Language	English
Publishing date	2018-03-13
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1045317-9
ISSN	1531-6963 ; 1040-8711
ISSN (online)	1531-6963
ISSN	1040-8711
DOI	10.1097/BOR.0000000000000506
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Article ; Online: Reclassifying Idiopathic Uveitis: Lessons From a Tertiary Uveitis Center.

Choi, Rene Y / Rivera-Grana, Erick / Rosenbaum, James T

American journal of ophthalmology

2018 Volume 198, Page(s) 193–199

Abstract: Purpose: Idiopathic uveitis is frequently the most common diagnosis in series from uveitis clinics. This study sought to determine the percentage of patients initially diagnosed as idiopathic, noninfectious uveitis referred to a tertiary uveitis center ... ...

Abstract	Purpose: Idiopathic uveitis is frequently the most common diagnosis in series from uveitis clinics. This study sought to determine the percentage of patients initially diagnosed as idiopathic, noninfectious uveitis referred to a tertiary uveitis center who were subsequently found to have an identifiable cause of uveitis. Design: Retrospective case series. Methods: We performed a computerized database analysis of 179 consecutive patients who were referred to our practice with the diagnosis of idiopathic, noninfectious uveitis between 2008 and 2016. Patients were evaluated by a thorough history and ophthalmic examination with selected laboratory testing targeted by clues from the history and examination. Standardization of Uveitis Nomenclature (SUN) criteria were used to better assess different types of uveitis. Results: Fifty-two out of 179 (29.0%) patients initially diagnosed with idiopathic uveitis were subsequently diagnosed with an underlying condition. Among patients referred with a diagnosis of idiopathic disease, female patients were most commonly affected (121/179; 67.6%). Among subsequent diagnoses, sarcoidosis was the most common (19/52 or 36.5%), followed by HLA-B27-associated uveitis (11/52, 21.1%), infectious uveitis (6/52, 11.5%), tubulointerstitial nephritis with uveitis (6/52, 11.5%), and juvenile idiopathic uveitis (4/52, 7.7%). Other diagnosable conditions included Behçet disease, multifocal choroiditis, panuveitis, Crohn disease, multiple sclerosis, and relapsing polychondritis. An underlying condition was not found in 127 of 179 (70.9%) patients. Conclusions: We report that 29% of patients referred to our tertiary uveitis center diagnosed as "idiopathic" had an associated identifiable cause. Identifying an underlying condition associated with uveitis could be potentially lifesaving for some illnesses (eg, sarcoidosis with cardiac involvement) and is critical to management (eg, infection). Although we were able to use limited testing to classify many patients who had been previously incorrectly labeled with idiopathic uveitis, idiopathic uveitis remains the most common diagnosis in our uveitis clinic.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Databases, Factual ; Female ; HLA-B27 Antigen/immunology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tertiary Care Centers ; Uveitis/classification ; Uveitis/diagnosis ; Uveitis/immunology ; Young Adult
Chemical Substances	HLA-B27 Antigen
Language	English
Publishing date	2018-10-22
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	80030-2
ISSN	1879-1891 ; 0002-9394
ISSN (online)	1879-1891
ISSN	0002-9394
DOI	10.1016/j.ajo.2018.10.018
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Article: Introduction to Machine Learning, Neural Networks, and Deep Learning.

Choi, Rene Y / Coyner, Aaron S / Kalpathy-Cramer, Jayashree / Chiang, Michael F / Campbell, J Peter

Translational vision science & technology

2020 Volume 9, Issue 2, Page(s) 14

Abstract: Purpose: To present an overview of current machine learning methods and their use in medical research, focusing on select machine learning techniques, best practices, and deep learning.: Methods: A systematic literature search in PubMed was performed ...

Abstract	Purpose: To present an overview of current machine learning methods and their use in medical research, focusing on select machine learning techniques, best practices, and deep learning. Methods: A systematic literature search in PubMed was performed for articles pertinent to the topic of artificial intelligence methods used in medicine with an emphasis on ophthalmology. Results: A review of machine learning and deep learning methodology for the audience without an extensive technical computer programming background. Conclusions: Artificial intelligence has a promising future in medicine; however, many challenges remain. Translational relevance: The aim of this review article is to provide the nontechnical readers a layman's explanation of the machine learning methods being used in medicine today. The goal is to provide the reader a better understanding of the potential and challenges of artificial intelligence within the field of medicine.
MeSH term(s)	Artificial Intelligence ; Deep Learning ; Machine Learning ; Neural Networks, Computer ; Ophthalmology
Language	English
Publishing date	2020-02-27
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S. ; Systematic Review
ZDB-ID	2674602-5
ISSN	2164-2591
ISSN	2164-2591
DOI	10.1167/tvst.9.2.14
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Article ; Online: MULTIMODALITY OCULAR IMAGING IN A CASE REPORT OF HYPERVISCOSITY SYNDROME ASSOCIATED WITH LYMPHOPLASMACYTIC LEUKEMIA: THE IMAGES TELL THE STORY.

Choi, Rene Y / Jacoby, Rachel / Shakoor, Akbar

Retinal cases & brief reports

2017 Volume 13, Issue 3, Page(s) 238–240

Abstract: Purpose: To report the clinical course of a patient with ocular manifestations of hyperviscosity syndrome associated with Waldenström macroglobulinemia, and for the first time, video imaging of mobile emboli in the conjunctival and retinal vasculature.!# ...

Abstract	Purpose: To report the clinical course of a patient with ocular manifestations of hyperviscosity syndrome associated with Waldenström macroglobulinemia, and for the first time, video imaging of mobile emboli in the conjunctival and retinal vasculature. Methods and patient: A 60-year-old woman with newly diagnosed Waldenström macroglobulinemia, with no visual complaints was evaluated by the Ophthalmology service for a baseline ocular examination. Results: At presentation, ocular examination revealed a visual acuity of 20/25 in each eye. Slit lamp examination showed mobile white emboli throughout the conjunctival vasculature of both eyes, which was captured on video. Dilated fundus examination revealed peripheral vascular occlusion along with extensive collateral formation in both eyes and as dilation of vessels at the posterior pole of the left eye. Mobile arterial and venous emboli were also observed in the retinal vasculature, which were captured with slit-lamp color and infrared reflectance video imaging. Conclusion: Hyperviscosity syndrome is a rare circulation sequelae that occurs when blood is thickened secondary to an increase in immunoglobulins or a hyperproliferation of blood components as in bone marrow dyscrasias. The increase in viscosity is plainly observable in the retinal circulation, and this syndrome is often diagnosed based on visual symptoms and fundus examination. We report a patient with Waldenström macroglobulinemia who presented with multiple ocular manifestations of hyperviscosity syndrome despite the absence of visual complaints. Ophthalmologists should be aware that regardless of the lack of any subjective visual changes, ocular findings of hyperviscosity syndrome should prompt quick referral to a Hematology Oncologist for evaluation of other end-organ damage. We also for the first time, provide video documentation of mobile emboli in the conjunctival and retinal vasculature.
MeSH term(s)	Blood Viscosity/physiology ; Conjunctiva/blood supply ; Conjunctival Diseases/etiology ; Female ; Humans ; Middle Aged ; Multimodal Imaging ; Retinal Diseases/etiology ; Retinal Vessels/pathology ; Waldenstrom Macroglobulinemia/complications
Language	English
Publishing date	2017-04-04
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	1937-1578
ISSN (online)	1937-1578
DOI	10.1097/ICB.0000000000000565
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Article ; Online: INTERMEDIATE UVEITIS ASSOCIATED WITH PERIODIC FEVER, APHTHOUS STOMATITIS, PHARYNGITIS, AND CERVICAL ADENITIS SYNDROME.

Choi, Rene Y / Shakoor, Akbar / Bohnsack, John / Vitale, Albert T

Retinal cases & brief reports

2017 Volume 13, Issue 4, Page(s) 367–370

Abstract: Background/purpose: To report two novel cases of intermediate uveitis associated with Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis syndrome.: Methods: Observational case reports and review of the literature.: Results: ... ...

Abstract	Background/purpose: To report two novel cases of intermediate uveitis associated with Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis syndrome. Methods: Observational case reports and review of the literature. Results: Both patients in this report had an established diagnosis of Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis syndrome before the onset of ocular inflammation. Infectious and noninfectious systemic conditions known to be associated with intermediate uveitis were excluded. Intermediate uveitis was confirmed clinically in both patients by the presence of vitritis, snowballs, and peripheral snowbanks in the region of the pars plana. Both cases had a course characterized by recurrent inflammation; in which systemic steroid treatment, and in one case, immunomodulatory therapy was necessary. Conclusion: Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis syndrome is an auto-inflammatory fever disorder in childhood. Although other auto-inflammatory disorders such as, Blau syndrome, Muckle-Wells syndrome, and Behcets disease have been associated with various forms of uveitis, Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis has never been reported to be associated with any type of ocular inflammation. We describe for the first time, two cases of Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis syndrome presenting with intermediate uveitis.
MeSH term(s)	Child ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/immunology ; Fever/complications ; Fever/immunology ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Lymphadenitis/complications ; Lymphadenitis/immunology ; Male ; Neck ; Pharyngitis/complications ; Pharyngitis/immunology ; Stomatitis, Aphthous/complications ; Stomatitis, Aphthous/immunology ; Syndrome ; Tomography, Optical Coherence/methods ; Uveitis, Intermediate/diagnosis ; Uveitis, Intermediate/etiology ; Visual Acuity
Language	English
Publishing date	2017-05-12
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ISSN	1937-1578
ISSN (online)	1937-1578
DOI	10.1097/ICB.0000000000000600
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Article ; Online: Retinal Manifestations of Juvenile Dermatomyositis: Case Report of Bilateral Diffuse Chorioretinopathy with Paracentral Acute Middle Maculopathy and Review of the Literature.

Choi, Rene Y / Swan, Russell J / Hersh, Aimee / Vitale, Albert T

Ocular immunology and inflammation

2017 Volume 26, Issue 6, Page(s) 929–933

Abstract: Purpose: To review a case of bilateral diffuse chorioretinopathy as a presenting sign of juvenile dermatomyositis (JDM) and review the literature regarding retinal manifestations associated with this disease.: Methods: Review of case record and ... ...

Abstract	Purpose: To review a case of bilateral diffuse chorioretinopathy as a presenting sign of juvenile dermatomyositis (JDM) and review the literature regarding retinal manifestations associated with this disease. Methods: Review of case record and literature regarding retinal manifestations related to juvenile dermatomyositis. Results: A 13-year-old girl presented with bilateral diffuse chorioretinopathy as the presenting sign of juvenile dermatomyositis. A review of the literature suggests that retinopathy associated with JDM is a rare finding that is symptomatic to patients and often responds to systemic treatment of juvenile dermatomyositis. This is also the first documented case of paracentral acute middle maculopathy in the setting of juvenile dermatomyositis. Conclusion: Chorioretinopathy is a rare finding in juvenile dermatomyositis. While all patients with JDM likely do not warrant screening ophthalmologic examinations, any patient who has visual symptoms should have a careful dilated examination to evaluate for retinopathy or steroid-induced cataracts.
MeSH term(s)	Acute Disease ; Adolescent ; Choroid/pathology ; Choroid Diseases/diagnosis ; Choroid Diseases/etiology ; Dermatomyositis/complications ; Dermatomyositis/diagnosis ; Electromyography ; Female ; Humans ; Macula Lutea/pathology ; Retinal Diseases/diagnosis ; Retinal Diseases/etiology ; Tomography, Optical Coherence ; Visual Acuity
Language	English
Publishing date	2017-04-27
Publishing country	England
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	1193873-0
ISSN	1744-5078 ; 0927-3948
ISSN (online)	1744-5078
ISSN	0927-3948
DOI	10.1080/09273948.2017.1305421
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